The Winners: Countries succcessfully addressing COVID-19

Discussion in 'Politics' started by gwb-trading, Feb 14, 2021.

  1. gwb-trading


    A thread dedicated to countries successfully addressing COVDI-19 with proper public health policies.

    We will start with one of the poorest countries on the face of the earth -- that has only one death from COVID. They also set the Gold standard in contract tracing and quarantine policy.

    The Unlikeliest Pandemic Success Story
    How did a tiny, poor nation manage to suffer only one death from the coronavirus?

    On January 7, a 34-year-old man who had been admitted to a hospital in Bhutan’s capital, Thimphu, with preexisting liver and kidney problems died of COVID-19. His was the country’s first death from the coronavirus. Not the first death that day, that week, or that month: the very first coronavirus death since the pandemic began.

    How is this possible? Since the novel coronavirus was first identified more than a year ago, health systems in rich and poor countries have approached collapse, economies worldwide have been devastated, millions of lives have been lost. How has Bhutan—a tiny, poor nation best known for its guiding policy of Gross National Happiness, which balances economic development with environmental conservation and cultural values—managed such a feat? And what can we in the United States, which has so tragically mismanaged the crisis, learn from its success?

    In fact, what can the U.S. and other wealthy countries learn from the array of resource-starved counterparts that have better weathered the coronavirus pandemic, even if those nations haven’t achieved Bhutan’s impressive statistics? Countries such as Vietnam, which has so far logged only 35 deaths, Rwanda, with 226, Senegal, with 700, and plenty of others have negotiated the crisis far more smoothly than have Europe and North America.

    These nations offer plenty of lessons, from the importance of attentive leadership, the need to ensure that people have enough provisions and financial means to follow public-health guidance, and the shared understanding that individuals and communities must sacrifice to protect the well-being of all: elements that have been sorely lacking in the U.S.

    America has “the world’s best medical-rescue system—we have unbelievable ICUs,” Asaf Bitton, executive director of Ariadne Labs, a Boston-based center for health-systems innovation, told me. But, he said, we have neglected a public-health focus on prevention, which socially cohesive low- and middle-income countries have no choice but to adopt, because a runaway epidemic would quickly overwhelm them.

    “People say the COVID disaster in America has been about a denial of science. But what we couldn’t agree on is the social compact we would need to make painful choices together in unity, for the collective good,” Bitton added. “I don’t know whether, right now in the U.S., we can have easy or effective conversations about a common good. But we need to start.”

    Over the course of three reporting trips to Bhutan since 2012, a word I heard innumerable times was resilience. It alluded to the fact that Bhutan has never been colonized, and to its people’s ability to bear hardships and make sacrifices. Resilience, I came to learn, is core to the national identity.

    That mattered when the coronavirus began spreading early last year. At the time, Bhutan looked like a ripe target. It hadonly337 physicians for a population of around 760,000—less than half the World Health Organization’s recommended ratio of doctors to people—and only one of these physicians had advanced training in critical care. It had barely 3,000 health workers, and one PCR machine to test viral samples. It was on the United Nations’ list of least developed countries, with a per capita GDP of $3,412. And while its northern frontier with China had been closed for decades, it shared a porous 435-mile border with India, which now has the world’s second-highest number of recorded cases and fourth-highest number of reported deaths.

    Yet from the first note of alarm, Bhutan moved swiftly and astutely, its actions firmly rooted in the latest science.

    On December 31, 2019, China first reported to the WHO a pneumonia outbreak of unknown cause. By January 11, Bhutan had started drafting its National Preparedness and Response Plan, and on January 15, it began screening for symptoms of respiratory ailments and was using infrared fever scanning at its international airport and other points of entry.

    Around midnight on March 6, Bhutan confirmed its first case of COVID-19: a 76-year-old American tourist. Six hours and 18 minutes later, some 300 possible contacts, and contacts of contacts, had been traced and quarantined. “It must have been a record,” Minister of Health Dechen Wangmo—a plain-spoken Yale-educated epidemiologist—told the national newspaperKuensel, with evident pride. Airlifted to the U.S., the patient was expected to die, but survived. According to an account inThe Washington Post, his doctors in Maryland told him, “Whatever they tried in Bhutan probably saved your life.”

    In March, the Bhutanese government also started issuing clear, concise daily updates and sharing helpline numbers. It barred tourists, closed schools and public institutions, shut gyms and movie theaters, began flexible working hours, and relentlessly called for face masks, hand hygiene, and physical distancing. On March 11, the WHO tardily deemed COVID-19 a pandemic. Five days later, Bhutan instituted mandatory quarantine for all Bhutanese with possible exposure to the virus—including the thousands of expatriates who boarded chartered planes back to their homeland—and underwrote every aspect, such as free accommodation and meals in tourist-level hotels. It isolated all positive cases, even those who were asymptomatic, in medical facilities, so early symptoms could be treated immediately, and provided psychological counseling for those in quarantine and isolation.

    Bhutan then went further. At the end of March, health officials extended the mandatory quarantine from 14 to 21 days—a full week longer than what the WHO was (and still is) recommending. The rationale: A 14-day quarantine leaves about an 11 percent chance that, after being released, a person could still be incubating the infection and eventually become contagious. Bhutan’s extensive testing regimen for people in quarantine, Wangmo added at a press conference, was “a gold standard.”

    While President Donald Trump was railing against coronavirus surveillance, Bhutan launched a huge testing and tracing program, and created a contact-tracing app. Last fall, the health ministry rolled out a prevention initiative called “Our Gyenkhu”—“Our Responsibility”—featuring influencers such as actors, visual artists, bloggers, and sports personalities. When, in August, a 27-year-old woman became the first Bhutanese in the country to test positive for COVID-19 outside of quarantine, a three-week national lockdown followed, with the government ramping up testing and tracing even more, and delivering food, medicine, and other essentials to every household in the land. In December, when a flu clinic in Thimphu turned up the first case of community transmission since the summer, the nation again entered strict lockdown—and again, a full-throttle campaign prevailed against the virus, which has been all but snuffed out for the time being.

    In tandem with this rigorous public-health response came swells of civic compassion from every level of society. In April, King Jigme Khesar Namgyel Wangchuck launched a relief fund that has so far handed out $19 million in financial assistance to more than 34,000 Bhutanese whose livelihoods have been hurt by the pandemic, a program extended until at least the end of March. The government created a country-wide registry for vulnerable citizens, and has sent care packages containing hand sanitizer, vitamins, and other items to more than 51,000 Bhutanese over the age of 60. The Queen Mother gave a frank address to the nation, calling on the authorities to ensure services for sexual and reproductive health, maternal, newborn, and child health care, and services for gender-based violence, which she deemed “essential.” Thousands of people signed up to leave their homes and families for extended periods of time to join the national corps of orange-uniformed volunteers known as DeSuung. Bhutan’s monastic community—highly influential in a Buddhist and still largely traditional culture—not only pointedly reinforced public-health messaging but also prayed daily for the well-being of all people during the crisis, not just the Bhutanese.

    Government officials modeled the same altruism. During the country’s summer lockdown, Wangmo, the health minister, slept in ministry facilities for weeks, away from her young son. Prime Minister Lotay Tshering, a highly respected physician who continued to perform surgeries on Saturdays during most of the crisis, slept every night during the lockdown on a window seat in his office—a photo in the newspaperThe Bhutanese showed his makeshift bed’s rumpled blankets and an ironing board standing nearby. Members of Parliament gave up a month’s salary for the response effort; hoteliers offered their properties as free quarantine facilities; farmers donated crops. When lights in the Ministry of Health’s offices burned all night, locals brought hot milk tea and homemadeema datshi—scorching chilies and cheese, the national dish.

    “I have complained about ‘small-society syndrome’ and how suffocating it can get. But I believe it is this very closeness that has kept us together,” Namgay Zam, a prominent journalist in Bhutan, told me. “I don’t think any other country can say that leaders and ordinary people enjoy such mutual trust. This is the main reason for Bhutan’s success.”

    While Bhutan might be culturally unique, its experience offers several lessons for affluent nations.

    First, hope that you are lucky and your country’s leaders are thoroughly engaged. Bhutan had trusted, smart, and hands-on direction from its king, whose moral authority carries great weight. He explicitly told government leaders that even one death from COVID-19 would be too much for a small nation that regards itself as a family, pressed officials for detailed plans covering every possible pandemic scenario, and made multiple trips to the front lines, encouraging health workers, volunteers, and others. His crucial role also sidetracked any political gamesmanship; in Bhutan, the opposition in Parliament joined forces with the ruling party.

    Second, invest in preparedness. Bhutan set up a health emergency operations center and a WHO emergency operations center in 2018, and had also invested in medical camp kit tents, initially thinking they would be deployed in disaster-relief zones; the tents were repurposed to screen and treat patients with respiratory symptoms. In 2019, the country upgraded its Royal Centre for Disease Control lab, equipping it to handle not only new and deadly influenza viruses on the horizon, but also SARS-CoV-2. Most presciently, in November 2019, the WHO and Bhutan’s health ministry staged a simulation at the country’s international airport. The scenario: a passenger arriving from abroad with a suspected infection caused by a new strain of coronavirus. All these measures reflect what Bitton sees as a dynamic, system-wide self-awareness. “You could call it humility; you could call it curiosity,” he said. “It’s this idea of, wow, we have a lot to learn.”

    Third, act fast and buy time. “The countries that responded early and before the virus got entrenched—in particular, before it got to the vulnerable populations—seem to all have done better,” Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, told me. Bhutan’s system of community-based primary care had sowed the concept of prevention, and its free universal health care and testing meant that logistics and supply chains were already in place.

    Fourth, draw on existing strengths. When Bhutan added five more PCR machines to its testing stock, up from just one, it needed people to collect samples from the field and operate the devices. So it shifted technicians from livestock-health and food-safety programs, and trained university students. When it became clear that one ICU physician was not enough, it instructed other doctors and nurses in clinical management of respiratory infections and WHO protocols. “This is the lesson from Bhutan,” Rui Paulo de Jesus, its WHO country representative, told me. “Utilize the resources you have.”

    Finally, make it possible for people to actually follow public-health guidance by providing economic and social support to those who need to quarantine or isolate. Nuzzo calls these “wraparound services.” But Tenzing Lamsang, an investigative journalist and editor ofThe Bhutanese, believes the term doesn’t do justice to Bhutan’s deeper policy impulses. “Bhutan’s approach as a Buddhist country, a country that values Gross National Happiness, is different from a typical technocratic approach,” he told me, noting that its pandemic plan covered “all aspects of well-being.”

    Other countries illustrate many of these approaches. Senegal acted early, barring international arrivals and imposing regional travel restrictions, enforcing curfews and business closures, and launching an economic and social resilience program to make up for lost income among the poor; after barely skirting the 2014–16 Ebola outbreak in West Africa, it also bolstered staffing for an emergency operations center and conducted mock drills. Rwanda blanketed the country with random testing and contact tracing, relying on the same lab technologies used for tracking HIV cases. Vietnam declared an epidemic on February 1, 2020, and deployed its provincial governments to swiftly detect infections, close nonessential businesses, enforce social distancing, and monitor border crossings.

    There are certainly plenty of caveats around the idea of trying to replicate Bhutan’s values or transplant its strategies. As Nuzzo pointed out, political systems vary significantly, and one nation’s assumptions might not thrive on alien terrain. Moreover, coronavirus transmission can take wild turns. And until Bhutanese are vaccinated, the kingdom will need to play a flawless game of containment. “As Buddhists,” a Kuensel editorial in September reflected, “we learn that this reality changes every moment.”

    For now, though, Bhutan has helped define pandemic resilience. “What I learned from Bhutan is that the health sector alone cannot do much to protect people’s health,” de Jesus told me. Lamsang agreed. Pandemic resilience, he said, came from “things that we don’t count normally, like your social capital and the willingness of society to come together for the common good.”

    It is tempting to dismiss Bhutan or other small, communitarian countries as irrelevant models for the United States. To be sure, Bhutan is no paradise. It has its share of quarantine dodgers and anti-vaxxers, “maskholes” and “covidiots,” all duly called out on social media. And like every other nation, when this crisis is over, it will have to reckon with long-standing problems—issues including youth unemployment and the effects of climate change.

    But its victory, at least so far, in staving off the worst of the pandemic might give Bhutan the confidence and drive it needs to tackle these other challenges—and on its own terms. After all, that’s another aspect of resilience: moving forward when the crisis has passed.

    MADELINE DREXLER is a Boston-based journalist and a visiting scientist at the Harvard T. H. Chan School of Public Health. She is the author of Emerging Epidemics: The Menace of New Infections and has written extensively in recent years about Bhutan.
    wrbtrader and Ricter like this.
  2. Tony Stark

    Tony Stark

    Of course US under Trump would never make this list.
  3. wrbtrader


    There are other countries too that did the same or similar like and continue outperforming the world in their Covid-19 performances. One of the common themes is that they reacted very fast to what was going on in China.
    • Simply, they did not deny the science and did not lie to their citizens about the coming danger...taking away their ability to protect themselves.
    Strangely, a lot of Covidiots ignore these countries as the model strategy to protect its residents, economy and healthcare system and instead continue choosing other countries that are performing poorly in its Covid-19 metrics.

    Worst Covidiots continue stating the United States has had Natural Herd Immunity for the past few months while they had defended the management of Covid-19 by the Trump administration. :rolleyes: :D

    2020 has been an enlightenment year here at ET...we quickly learn whom are the true idiots...I think that's a good thing.

  4. gwb-trading


    Today's story.... Why has Chile had so much success with Covid? One reason is that Chile left politics aside. The politicians realized early on that Covid-19 was the enemy.

    How Chile became a leader in Covid-19 vaccination

    It was late May. The world was helplessly watching as the Covid-19 pandemic advanced unimpeded country after country in what would later be called "the first wave" of infections. After China, Italy and the UK had become the virus hotspots, cities in the United States, especially New York, followed. And then in late spring, the coronavirus spread throughout South America.

    By May 27, Chile, along with Peru, had reached the world's highest infection rates per capita over a seven-day rolling average, according to Our World in Data (OWID), an independent statistics website headquartered at Oxford University. Chile was rapidly approaching 80,000 infections and more than 800 people had already died by then.

    Fast forward nine months and the Chile is in a totally different category. While some Latin American countries like Nicaragua have yet to receive any vaccine, the Andean nation of 19 million had already given more than one million vaccine doses by February 9th. It hit two-million Monday and the immunization pace continues to improve.

    With 12.43 people vaccinated for every 100 people, Chile now has the fifth highest vaccination rate per capita in the world after Israel (79.48), the United Arab Emirates (53.43), the United Kingdom (24.3) and the United States (17.00).
    It's doing even better than the European Union (5.19) and China (2.82) and its rate is four times better than Brazil, which has the second best rate in Latin American (2.77), according to data from Oxford University's "Our World in Data" database.

    How was Chile able to turn things around so dramatically?

    First, its government decided very early on to spare no effort in acquiring a vaccine... any vaccine. The Chilean government has arranged for the purchase of 35.7 million doses so far, which means that it will have the ability to vaccinate more than 90 percent of its population.

    According to Chilean Health Minister Dr. Enrique Paris, the country has acquired or is in the process or receiving 10 million doses of the Pfizer/BioNTech vaccine and an additional 10 million from Sinovac. The country later reached agreements with Covax (WHO), Johnson & Johnson and Astrazeneca to reach the 35.7 million total.

    CNNE medical contributor Doctor Elmer Huerta, a public health and Latin American health policy expert, says this multi-pronged strategy has been very successful. "Chile didn't hesitate to make contracts with Sinovac, Pfizer or AstraZeneca. The key was that very early on Chile realized it was necessary to close multiple deals with vaccine makers. In Latin America, Chile is one of the best-positioned countries to do business and that has given it an advantage," Huerta said.

    And then, Chilean authorities have been busy, turning any public space they can into a vaccination center. CNN recently visited a courtyard at the campus of the Pontifical Cahtolic University of Chile in Santiago. A space where you would normally see college students mingling had been converted into a highly organized and efficient clinic, one of many Covid-19 vaccination centers around the country.

    Gabriela Valderrama, a Santiago resident who got her shot at the college campus, described the process as "fantastic" and "very well organized. I think it's phenomenal that they have different days for different age groups," she said.

    In addition to schools and government buildings, health authorities have opened up vaccination sites around the country in places like shopping malls and football (soccer) stadiums.

    "One thing is purchasing a vaccine and having it available and a totally different thing is injecting it into people's arms. That's what logistics is all about. Chile has had great distribution and vaccination. It has opened vaccination center in strategic places that are close and convenient to people, as opposed to the United States where we started vaccinating people at hospitals and large sites where people quickly got crowded," Dr. Huerta said.

    Edgardo Cruz, a 71-year-old Santiago resident who got his first shot the Pontifical Catholic University of Chile site, says he's proud of the effort made so far.

    "We are an international role model now. I think it buying vaccines and investing [in purchases] since May was an effort that paid off," Cruz said.

    A unified message about social distancing from the government, from top to bottom, and mask use hasn't hurt either.

    President Sebastián Piñera himself, who's 71 years old, and was therefore eligible to get the shot last week, took advantage of the opportunity to make a point... wearing a mask, of course.

    "I would like to let my fellow citizens know that this vaccine is safe, it's effective and that we have made an enormous effort to inoculate all Chileans, all citizens of our country," he said after receiving the first shot of the Chinese-made Sinovac vaccine that will be followed by a second one on March 15.

    "Chile also left politics aside. The country's politicians realized that Covid-19 was the enemy and dialed down tensions between political parties, working together towards the unified goal of controlling the pandemic," Huerta said.

    And while other countries have struggled to decide who should get the vaccine after frontline workers, Chilean authorities came up with a vaccination schedule that is being followed to the letter.

    After healthcare workers, the focus was the elderly. teachers, pharmacists and police officers became eligible Monday.

    At less than 19 million, Chile's relatively small population size is also an advantage. It means each vaccine goes further toward the goal of national herd immunity, especially when compared with larger populations like those of Brazil, China or the European Union.

    The Health Ministry's goal is vaccinating five-million people by the end of March and four out five Chileans before the first half of 2021 is over.
  5. gwb-trading


    Today we will take a look at a state in the U.S. that is the leader in vaccinations...

    West Virginia's Vaccination Rate Ranks Among Highest In World

    West Virginia isn't known for its good health outcomes. It leads the nation in deaths from diabetes, accidents and drug overdoses. But when it comes to distributing the COVID-19 vaccine, the state has been a shining star.

    It didn't start out that way. In late December, on what was the day that Gov. Jim Justice announced West Virginians over the age of 80 would be able to receive doses of the vaccine from their county health departments, seniors began lining up right away — even before doses of the vaccine were available. Chris Dorst, a Charleston Gazette-Mail photographer for 30 years, was sent out by his editor to photograph the serpentine line of senior citizens she'd seen waiting outside the Kanawha-Charleston Health Department, under the gray December sky.

    "Some people had wheelchairs or walkers — elderly people, and maybe some family members with them in line, just waiting. It seemed to move really slow," Dorst says.

    Behind the scenes at Kanawha-Charleston Health Department, things were chaotic. The staff received a call from the governor's office at 11 a.m. letting them know they would receive vaccines to distribute to seniors, just one hour before Justice's public announcement. As soon as the governor made the announcement, octogenarians came down to stand outside the health department. By the time County Health Director Dr. Sherri Young returned to the building with the doses of the Moderna vaccine, it was nearly 2 p.m. But the vaccine she'd just picked up still needed to thaw, the line of elderly constituents was only getting longer and rain was in the forecast. Young's office was able to repurpose thawed doses of vaccine meant for first responders and deliver 210 shots to the people in line that day.

    In other parts of the country, some beleaguered county health departments have reported that beyond making vaccine doses available to them, state governments did nothing to help them get shots into arms.

    But West Virginia has been successful in part because the opposite is true.

    Maj. Gen. James Hoyer is the head of the state's COVID-19 Joint Interagency Task Force for Vaccines. Hoyer, who retired as head of the West Virginia National Guard before assuming his role at the head of the vaccine task force, saw Dorst's striking photograph in the Charleston Gazette-Mail in his morning paper the following day.

    "I remember seeing the picture," Hoyer says. People didn't have any information yet about where and when to go, so they just showed up. Hoyer says it was a communications problem he needed to solve as quickly as possible. He got on the phone with Young to discuss "how we're going to help her get folks in."

    Many states have relied on electronic registration systems — including the online ticket sales website Eventbrite after their own websites crashed — to help the public schedule vaccine appointments. But Hoyer says in West Virginia, that's not a great option. As much as 30 percent of the state's population lacks access to broadband Internet. Plus, as Hoyer puts it, "If you're talking about people over the age of 70 and in their 80s, how many of them are Internet savvy?"

    Hoyer's team decided on a simple solution: a telephone hotline. Call it and residents can ask questions about how and where to get the vaccine, as well as schedule appointments.

    Elsewhere, state COVID-19 hotlines have crashed, impacting cell service generally as networks strain under too many calls. West Virginia's population of 1.8 million reduced the chances of that happening. The state decided not to outsource the hotline to a private company as some states have done, housing it instead under the Department of Health and Human Resources' Office of Constituent Services. Gov. Justice gets a report every night on call volume, wait times and appointments scheduled.

    "The last time I looked, it was 6 minutes," Hoyer says disapprovingly, of the hotline's average wait time. "What that tells us is we probably need more people manning the hotline."

    West Virginia has administered almost 450,000 doses of COVID-19 vaccine. More than 9 percent of its population has gotten both doses. Alaska and West Virginia trade off for first place among states for the percentage of the population that have received both doses of the COVID-19 vaccine. If broadened out to look at the whole world, the percentage of the population of West Virginia already fully vaccinated would rank third.

    "Not bad for a bunch of hillbillies," Hoyer says.
  6. LacesOut


    Chile death per 100k - 107
    Sweden death per 100k - 124

    Buy1Sell2 likes this.
  7. gwb-trading


    So tell us how the vaccination effort is going in Sweden. It is going very well in Chile.
  8. Buy1Sell2


    Let's be honest folks. The Trump administration has had the greatest impact on containment and mitigation of The Kung Flu worldwide. This would be including, but not limited to, providing Pfizer 2 billion dollars in free money to develop the vaccine. No other country comes close--however Sweden and Brazil are number 2 and number 3.-----The Biden Administration is standing on the shoulders of The Trump administration in anything they do in a positive fashion virus-wise.
    Last edited: Feb 22, 2021
    smallfil and LacesOut like this.
  9. gwb-trading


    Trump did not provide Pfizer with a dime to develop the vaccine. Stop posting nonsense.

    Pfizer's R&D president Dolsten: Not taking government cash made us more nimble for COVID-19 vaccine

    Pfizer Vaccine’s Funding Came From Berlin, Not Washington
    Partner BioNTech received $445 million from German government

    Trump Falsely Claims Credit For Pfizer Vaccine, Though Company Did Not Take Government Funds
  10. LacesOut


    $2,000,000,000 PO in July...that's a big matzo ball
    #10     Feb 22, 2021