What they did right

"Testing, tracking, treatment and transparency. No rocket science."

Observers all around the world have been praising some countries on how they ably responded to the pandemic now devastating the entire world.

In Germany, though the number of Covid-19 cases were a high 124,715 as of Holy Saturday, the comparatively low number of deaths at 2,800 is quite a feat. That is just about 2.2% when compared to neighbors France and Belgium, for instance. As of the same date, 13,832 persons have died in France due to Covid-19 with 93,790 cases of infection, or a very high 14.75% ratio, while in Belgium, with 28,018 cases recorded, 3,346 have died, or 11.94% mortality. Italy, Spain and the UK also have quite high percentages of mortality as France and Belgium as well as the Netherlands.

One might advance the argument that Germany is rich, and its health care system is “gold standard,” to borrow our DOH secretary’s favorite phrase these days. But so are France and Belgium, perhaps to a slightly lower degree. Italy and Spain also have very good health care systems, but they are in pretty bad shape in this period of the pandemic.

So rather than look at European nations, let us take a look at four nations closer to home: South Korea, Taiwan, Singapore, and farther off but still in the Asia-Pacific region, New Zealand. Hereinafter, we shall refer to them as Sokor, Twn, SG and NZ.

Every non-biased observer has been praising these countries for the measures they have undertaken to contain the spread of the pandemic in their respective territories. But for NZ, which is 10 and a half hours away by plane, all the others are within easy reach of our capital. Sokor is four and a half hours away; SG three and a half hours by air; and Twn is closest, with its capital less than two hours away from Manila.

In terms of climate, both Sokor and NZ are temperate, the former quite close to the North Pole; the latter to the South Pole. Their four seasons are quite distinct, their winters quite cold. Twn is relatively colder than the tropical climate that our Phl shares with SG, but not quite differently so.

In terms of land area versus inhabitants, SoKor is just 10 million hectares with less than 52 million people (one-third our land area with one-half our population). Twn has just about one-eighth our hectarage, with a little more than one-fifth our population. SG has the smallest land area, at a scant 26,800 hectares packed with 5.7 million people (the size of San Juan, Quezon City, Caloocan and Manila put together, also densely packed with 6 million inhabitants).

And NZ with a land area just a tenth lower than RP, or 26.8 million hectares compared to our 30 million, is one of the most sparsely-populated nations on earth with 5 million human inhabitants. NZ raises roughly 6 million heads of cattle (more than its people) and about 30 million sheep (six times the number of its human population).

But, all four populations are far richer than the average Filipino with a population of 107 million. Nominal per-capita income in Sokor is 31 thousand US dollars, Taiwan is 25 thousand, SG is among the world’s highest at 65 thousand, and NZ is about 42 thousand. Our RP, the 12th most populous nation on earth, makes do with US $3.5 thousand per capita.

Now having cited all those demographics as background, how did Sokor, Twn, SG and NZ react, or even prepare for a pandemic so virulent as the current “veerus”?

In varying degrees and differing timelines, all four nations have practiced adequate testing, serious contact tracing leading to the ability to treat those tested positive, and full transparency in what their health officials and government are doing.

The four T’s: testing, tracking, treatment and transparency. No rocket science to these. They have yet to develop any vaccine to repel the unwanted invader in their shores.

Some of them, particularly Twn, learned bitter lessons when they were invaded by SARS in 2003-04. Seventy three Taiwanese died out of 346 cases of the severe acute respiratory disease which has similar symptoms as the Covid-19. That’s a high 21-percent mortality rate, higher than even China’s mortality rate despite the fact that the virus originated in its south.

And so Twn prepared right after, cognizant of the probability that SARS might recur, or another variant of it mutates, as it now has with the coronavirus from Wuhan in central China.

As of this writing, 16 years after, no cure or vaccine to prevent or treat SARS has yet been proven effective or safe for humans. Then the virus from Wuhan struck, with greater intensity. Thus far, 1.77 million have been infected with 108,679 dead in 211 countries and territories, virtually the entire globe. SARS is picayune in comparison.

In Sokor, Twn and SG, no lockdown has been imposed upon entire populations, as China immediately did in Wuhan and Hubei. What their health officials did was to impose travel bans, first on China, Hong Kong and Macau, expanding to other countries according to the extent of infestation in other areas. Then they did adequate testing to determine who were infected, more in Sokor where massive testing, including drive-in tests were done.

Those who tested positive were immediately quarantined, either in hospitals if requiring serious treatment, or isolated in homes or designated places to contain the probability of spreading the contagion.

The testing done in Twn, SG and NZ were not as massive as those done in Sokor, but their contact tracing efforts of possibly infected persons were quite intensive. In the planes coming to their airports, health questionnaires asking for vital information, particularly countries visited within the last 30 days prior to arrival, address and contact numbers, as well as symptoms of illness experienced, were obligatorily filled up. In the airport terminals, body temperatures were checked, and those suspected of illness were immediately isolated.

Interviews of the virus-positive persons identified the potential other persons and locales infected. Those persons were immediately traced and asked to go on self-quarantine, and to call health officials if any symptoms occurred while in isolation.

Tracing is made easier in Sokor, Twn and SG because they have a compulsory National Identity Numbering System, or what we call a national ID, the law for which our legislators passed after two decades of opposition, as late as 2018, yet of late remains un-implemented. NZ has no required national ID, but practically all have driver’s licenses and passports, and the relative population numbers are quite manageable.

Treatment in their health systems are very affordable, if not almost free to the ordinary citizen. I have already written about Twn’s marvelous National Health Insurance or NHI (PhilHealth to us), which both Taiwanese and alien residents can avail themselves of.

Alongside massive testing, intensive tracking and appropriate health care treatments, there is transparency. No contagion figures are hidden, fudged, or “managed.” Daily reports to the public, through media, are given by their officials, with the head of government assuring the people every now and then. The entire bureaucracy is mobilized to fight the “war” against the virus.

In Twn, for instance, the police quickly track down the potential extent of contagion. The NHI card contains the cardholder’s medical history, so that vulnerable citizens with weaker immune systems are prioritized by the health system. The National Immigration Agency (NIA) has tight port and airport controls, and recent travel histories are recorded into the NHI card’s micro-chip for physicians to quickly correlate symptoms with virus potential.

The Ministry of Economic Affairs, at the very start of the Wuhan contagion, met with all the manufacturers of masks and non-woven cloth, and gave them a total production quota of ten million masks per day. These were then distributed through the drugstores, on an odd-even ID number scheduling, for free, to both citizens and aliens.

The coronavirus toll in Taiwan as of yesterday was 385, with 6 deaths, because of early and consistent action. I recall that two months ago, when RP was proclaiming it had only three cases and one death, Taiwan had 13 cases and two deaths. Now ours has ballooned to 4,428 with 247 deaths, with the real numbers undetected due to late reaction and low testing capability.

Contagion in far-away NZ came later. I was in Auckland and Queenstown in late February, and apart from entry bans directed at the heavily-infected countries and a health declaration form, things seemed very normal. But NZ was prepared in any case, having taken the Twn measures as template, such that when the first cases were detected from tourists in early March, a complete travel ban was imposed, and lockdowns of major cities implemented.

As of this writing, out of 1,035 cases, only 4 have died, while 320 have recovered, with only 16 patients in the hospitals of NZ.

The three T’s: testing, tracking, and needed treatment, are all done with a fourth T, which is transparency. Seriously and effectively implemented, with no one saying the war is won, as they continuously brace for a recurrence, or worse figures.

What is common among Sokor, Twn, and SG, which have been through difficult periods like war and security threats? The first two were much poorer compared to our Philippines in the 50s and only started to reap progress through hard work and discipline in the 70s. SG has no natural resources to speak of, and both Sokor and Twn have little, unlike our RP. As for NZ, theirs is basically an agricultural country, but they have religiously protected their environment so that their sheep and cattle could continue providing the world with dairy and produce to sustain their economy.

All four have invested properly and assiduously in economic and social infrastructure, with health and education foremost, implemented by government bureaucracies that were by and large inured to the vicissitudes of politics. And they consciously managed the growth of their populations according to their social and economic goals.

Why is it that these countries have the ability to do what is right in times of crisis, or even under conditions of normalcy?