Science of controlling pandemics: Lessons for countries in tackling COVID-19

South Korea took immediate action, while Japan's measures were perplexing

By Vibha Varshney
Published: Monday 30 March 2020

The interventions needed to curtail the spread of the novel coronavirus disease (COVID-19) remain unclear, despite the world grappling with the problem since the first reported case in December 2019.

In South Korea, hailed as one of the best examples of what a country should do to control the disease, the government took action immediately after the first case was identified in January.

It spoke to manufacturers of diagnostic kits to produce not only enough kits for domestic use but also for export. Licences were fast tracked to make this possible.

The moment the kits were available, the country started mass screening to identify the infected and isolate their contacts.

People were also asked to maintain social distance and wear masks to stop transmission. The country, however, continued to operate as before. People went to work and schools remained open.

China, in contrast, went in for massive lockdowns in January 2020, along with travel restrictions.

Japan’s response to the pandemic was perplexing. The country only took targeted steps, despite having a huge elderly population.

Schools were closed in areas where positive cases were found. Though there were government directives to avoid social gathering, they were not mandatory.

As a result, people got together, went to work, travelled in public transport and even went out in groups to celebrate the spring.

The government tested only the sick for positive cases of infection with the virus (SARS-CoV-2).

Some said the country did not need to take drastic steps as the Japanese already kept a healthy distance from each other, bowed instead of shaking hands and wore masks daily.

A recent spurt in cases, however, suggest that these methods are not enough. The United Kingdom — just like Japan — did not take action, other than asking the sick to stay home.

The government justified this by saying that they were protecting the most vulnerable without unnecessarily overloading the health system.

The number of cases increased across the world, whatever the action taken.

India released an advisory on January 17 on travel safety and began to screen passengers coming from China, as the virus spread across the globe.

The Union government released another advisory on January 29, saying Indians should not travel to China.

India reported the country’s first case on January 30, despite this.

This was the same day that the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern.

India suspended visas of all foreign nationals on March 11. A total of 60 positive cases were reported in the country by then.

The WHO declared COVID-19 a pandemic on the same day.

More restrictions were put in incrementally, with a voluntary curfew on March 22, followed by a nationwide lockdown till March 31 that was subsequently extended to April 15.

Will these measures work? Maybe.

A team led by Jeanne Fair, a biosecurity and public health expert at the Los Alamos National Laboratory, modelled the spread of influenza virus.

Social distancing was effective in containing the spread of the infection and reduced symptoms by an average of 16 per cent, the team said in a study published in the International Journal of Risk Assessment and Management in 2012.

The concept of social distancing found support recently as well.

Social distancing — both self-imposed and enforced by the government — was important, said researchers from the UK and the Netherlands, in an opinion published in The Lancet on March 2020.

Government actions including banning events, closing workplaces, schools and institutions and making sure that good diagnostic facilities and remotely accessed advice, like telephone helplines, be widely available, according to them.

There is a need, however, for vigilance, as methods such as social distancing and following advice on cleanliness depend on adherence.

A team of researchers from the Harvard School of Public Health, Boston and Imperial College London studied the response of people in Argentina, Japan, Mexico, the UK, and the US to the 2009 H1N1 pandemic in 2012.

Nearly 73 per cent of British people did not cover their mouths or noses with a tissue when coughing or sneezing at the time, according to the researchers.

Approximately 27 per cent of them did not wash their hands or use hand sanitisers, according to the researchers.

Waning interest brings in an added problem, according to a 2015 study published in journal BMC Infectious Diseases.

Those from poorer backgrounds were less likely to adhere to norms as they needed to earn a living and had less flexibility with working hours, according to the study.

The current state of lockdowns harms the economy.

Social distancing is 50 per cent more expensive to impose than using antivirals to combat a disease, said the 2012 study in International Journal of Risk Assessment and Management.

Researchers suggested that a mix of pharmaceutical and non-pharmaceutical interventions were needed to contain the flu epidemic.

This suggestion does not help in dealing with the current crisis, however, as pharmaceutical interventions against COVID-19 are still being developed.

These interventions are our best bets till the time drugs and vaccines are available.

An analysis of human mobility and epidemiological data in China showed restrictions of travel from the epicentre came too late.

Local transmission had become more important than imported cases, as the virus incubated for as long as 14 days.

The ban was defeated, said researchers from the University of Oxford and Northeastern University, in a study published on March 25, in the journal Science.

The next few days will tell us whether India took action in time or not.

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