After being bombarded with the quotes of "Flatten the Curve", most people went on to look up and understand what it means and how significant the impact can be given different scenarios. When countries across the world are trying different strategies to contain this pandemic, we have an opportunity to learn from a vast diversification of methods to achieve a common goal regardless of their mutual socio-political relations. In order to compare different scenarios, I am considering data as reported from China, South Korea, the United States of America, and India.
The reason I am specifically choosing these countries is quite obvious. These countries have either been the epicenter of the viral outbreak at some point, or are major players among the world economy and/or population, and the distinctive way they are addressing the situation is noticeable in their approaches and their results. The virus is considered to have originated from bats, and while getting into humans, eventually mutated enough so as to be able to transmit itself among humans.
The initial cases have been reported near Wuhan in central China as pneumonia resulting from "unknown cause" on December 31, 2019. On January 5, 2020, the Chinese government ruled out the possibility of the SARS virus epidemic that resulted into the deaths of hundreds worldwide. Two days later, the virus was identified and came to be known as part of the corona virus family, which include SARS and the common cold. On January 9, 2020, China witnessed the first death as a result of complications from a person infected with this virus, and this was reporte on January 13. Two days later, WHO declared the first case outside China, a woman who had recently traveled from Wuhan. The Japanese health ministry declared the first case in their country, also a person who had recently visited Wuhan. This, being a casual spread of just another disease until now, was monitored as a potential situation, but was judged to be far from being what could be classified as dangerous. On January 17, as the second death was reported in Wuhan, the USA was the first nation to start screening passengers traveling from Wuhan. In the subsequent days, authorities from United States, Nepal, France, Australia, Malaysia, Singapore, South Korea, Vietnam and Taiwan confirmed positive cases.
Growth and Decline in China
China saw over two hundred cases including major cities like Beijing, Shanghai, and Shenzen by January 20, and reported the third death. By January 22, 17 deaths were recorded by China, with an increase of cases to 550. With such a sudden rise, many suspected that the country was hiding data, or declaring data speciously. The next day, China semed to have recongnized the gravity of the outbreak, and canceled their lunar new year celebrations that would start on January 25. Three major cities including Wuhan were effectively quarantined, and travel to and from those cities was completely restricted. This was the first major recorded step the government took, at least four weeks after detecting their initial thread of cases. Even the WHO was conservative in declaring it a worldwide outbreak, because there was no known infection transmitted from human to human outside of China, but since so many countries, and Chinese provinces had recorded cases, there should have been a more apparent red flag.
On the very next day with 24 deaths reported over 830 open cases, stricter measures were taken and more cities werre locked down, including Hong Kong restricting movement from China. These restrictions increased on subsequent days, but since China was the first and the only country to report major growth, other countries had kept their guard down, more or less. Exactly three weeks after the first death, by January 30, China had reported 7711 cases spread across 31 provinces, and 130 people had lost their lives to it. Citing concerns, the WHO declared a global emergency and urged countries to take immediate measures on travel and trade. The number of cases in China were growing by over a thousand each day, and new countries getting added to the chain every day. A week later on February 7, the doctor who had initially raised an alarm about the virus before the Chinese government decided to, died of the virus. By this day, the death toll was 636, with over 31000 cases. The lockdown had certainly slowed the outbreak, but there were multiple new clusters being formed outside the area undetected.
Due to drastic measures, often forcing lockdowns on people and denying even basic necessities that they were not ready for, China was able to reach the peak around this week, and by February 17, the number of cases being reported everyday started falling down. China did commendable job by setting up quarantine facilities over a weekend at multiple places, and setting up a benchmark on how to deal with the outbreak in such a densely populated country. As scary as the rise was, it took equally long for the number of new cases being registered in a day to zero on March 23, and it stayed there for two days. Now, China has seen an import of a few new casesfrom people having contracted the virus outside the country and traveling back. However, since no new local cases have been detected, the looming threat is reinforced by the fact that it took three months for a highly developed country - arguable one of the best - to contain this outbreak even after being proactive in enforcing mass-quarantines. Since the outbreak had begun to be contained in China, the concerns have been about other Asian countries like Japan and South Korea, which had already started witnessing a rise in cases, and are densely populated, but are a little less able than China in terms of providing facilities with swift actions and measures.
The Proactive South Korean Model
South Korea reported its first case on January 26, almost a month after China started detecting the unexplained pneumonia. The South Korean government actively pursued people who had been in contact with the known patients, and tested them before they had a chance of showing symptoms or infecting others. These methods often included the GPS data and surveillance footage the administration relies on. This breach of privacy and personal data is limited to such outbreaks and similar emergency events since the 2015 MERS outbreak in the country which killed 39 people. This caused the curve to be indeed flattened, as the patients and potentials received treatments and quarantine orders immediately. The first death was reported over three weeks after that on February 20, with only about 100 infected people throughout the country on the next day, which witnessed another death of a Korean national. However, they had missed two clusters that were taking shape, and recorded over 200 cases in a single day on February 22. At this stage, Italy, Iran, and South Korea were reporting similar numbers and after a few days, there was enough clarity on who is winning the race.
Coupling the surveillance and emergency alrrt systems, the establishment was able to eddectively checkthe outbreak by monitoring potential patients, actively testing and isolating positives, and alerting the people about public places where there was a likelihood of infection. The rate of new infections plunged after recording a high of over 900 cases on February 29, the country saw only 64 new cases on March 1, starting the new month strong.
However effective the Korean model was in Korea, not many countries have access to such data or allowed surveillance on their people, and hence will not be able to test this model under different circumstances. Also, it is a small country with about half the population living in the greater Seoul area, so the area of the outbreak was not likely to be very large. Additionally, almost everyone in South Korea, including non-citizens have access to affordable healthcare, which encourages people to participate in the process. This is a huge factor as I will mention it in the USA case study. Thankfully, the life in the country is resuming to near normal conditions, and the swiftness of the aggressive campaign has again proved that attack is the best defence.
The American Hesitation
Being the world's largest economy and the global leader in many traits for many decades now, the American system has started showing some cracks as opposed to the newly growing Asian power centers who were able to contain this much better than most of the world would have expected. Having been the first country to have introduced traveler screenings on airports for people arriving from central China, it looked like the USA will remain the strongest challenge for the infection to spread like it was doing in China.
Having confirmed the first case as early as January 17, the US was expected to become more cautious in their approach as they had received a warning earlier than most other countries right when China had started declaring deaths a week ago. The intense travel screenings and restrictions that followed after getting three confirmed cases in the next few days, stopped mose cases growing in the country as the patients were immediately isolated along with the few people they had contact with. However, as researchers from University of Washington called out the government on not allowing them to test people until they showed sever symptoms, there was a skepticism in the perception that the US government could do something like this. Soon the cases began to explode in mid and late February, with the western states (Washington, Oregon, California) started to report tens of cases, while many went undetected and unnoticed because of the flaw in the healthcare system, which essentially discourages people without health insurance to get tested voluntarily (still doesn't include the teatment costs). It was not until as late as March 9, that the government declared that people will be tested free of cost and a national health emergency was declared. Many states saw a potential rise in infections and closed down most non-essential services and public places.
New York had been witnessing a surge of cases as by now every state had reported at least one case, and as dense and active New York city is, one never knows who is infected and who isn't. The city saw an explosion in the number of cases with hundreds being reported each day, and equalling the tally of the rest of the country by itself. Today,the total confirmed cases have crossed 55000, with close to 800 fatalities. I hate to point this out, but even many people have been carelessly moving around and traveling without following the WHO guidelines, as the government is still hesitant whether a complete lockdown should be enforced. So far, only states have declared and enforced lockdowns, with the center still debilitating between whether to save the people, or the economy.
Test for India
Having been referred to as a poor country and a fast developing country back and forth, this is definitely one of the defining moments on how India will be referred to in the future for the next few decades. After witnessing three positive cases starting on the same day WHO called it a world health emergency, it was contained by proactive movement from the Kerala government, which is the most literate state of the country. It took a break for a while, after which a surge of tourists from Europe changed the course and brought the inevitable among the less prosperous states in the north. Still traceable, the states started actively monitoring people who traveled recently, or had been in contact with such people. The people were quite traceable, but not until they showed symptoms were they tested in most states. The cases remained monitored, but the spread grew behind the scenes. With such a huge population, the WHO issued a statement saying that the response of the world to this pandemic now depends on how India handles it from here. With the weighted responsibility and the willingness to show the world that the nation is ready to take on greater challenges in world development. The positive cases had reached twenty states by then and five union territories. The cases started out slowly and controlled, but they have been rising with an exponential rate since the testing has been accelerated. As of today, there have been 606 cases confirmed, and 10 deaths.
With the habit of moving swiftly and unnoticed until declared, Prime Minister Modi's government issued a voluntary curfew for the nation to test the respone and in essense preparing the people for what was already planned next. By this time, many states had already locked down borders and districts with ground and railway transportation canceled. After a couple days, the government announced a complete lockdown of the country 1.3 billion strong, with only essential services to remain open and massive food relief schemes for daily wage workers who may not be able to afford livelihood during these times. The market appreciated the measures on the next day and the positivity of the leader has again dominated in uniting such a vast and diverse nation. Whether India can handle this lockdown economically is something we will find out in twenty days from today, but as a matter of fact, it would be far worse if the curve spiked given the relatively poor healthcare infrastructure, which it seemed to be about to.
It is clear that the Chinese and Korean response was very similar as they had the opportunity to utilize their measures that invade privacy and liberty of people in some way or another, whether it is forced isolation or GPS tracking and citizen surveillance. Both the countries have successfully manages to more or less contain the outbreak after suffering some loss.
On the other hand, India and the USA have similar freedom they promise to their people, but have seemed to taken distinct paths to contain the outbreak. The results we will witness in the next two to three weeks will tell the difference between the approaches and how successful the Indian lockdown will turn out to be.