The way the virus has spread in different countries, and even in particular states or regions within them, has been quite varied.
A New Zealand has mapped the coronavirus epidemic curve for 25 countries and modelled how the spread of the virus has changed in response to the various lockdown measures.
By mapping the change in the effective reproduction number – R(eff), an indicator of the actual spread of the virus in the community – against response measures, the research shows countries that implemented level three and four restrictions sooner had greater success in pushing the R(eff) to below one.
An R(eff) of less than one means each infected person spreads the virus to less than one other person, on average. By keeping R(eff) below one, the number of new infections will fall and the virus will ultimately disappear from the community.
Conversely, the larger the R(eff) value, the more freely the virus is spreading in the community and thus the faster the number of new cases will rise. This means a higher number of cases at the peak of the epidemic, a greater risk of the health system becoming overwhelmed, and ultimately more deaths.
New South Wales, Australia
The effect of Australia’s strict border control measures, implemented relatively early in the pandemic, can clearly be seen in the graph below. Federal and state governments introduced strict social distancing rules; schools, pubs, churches, community centres, entertainment venues and even some beaches were closed.
This prompted the R(eff) value to drop below one, where it has stayed for some time. Australia is rightly regarded as a success story in controlling the spread of Covid-19, and all states and territories are now mapping their paths towards relaxing restrictions in the coming weeks.
Italy was relatively slow to respond to the epidemic, and experienced a high R(eff) for many weeks. This led to an explosion of cases which overwhelmed the health system, particularly in the country’s north. This was followed by some of the strictest public health control measures in Europe, which has finally seen the R(eff) fall to below one.
Unfortunately, the time lag has cost many lives. Italy’s death toll of over 27,000 serves as a warning of what can happen if the virus is allowed to spread unchecked, even if strict measures are brought in later.
The United Kingdom’s initial response to Covid-19 was characterised by a series of missteps. The government prevaricated while it considered pursuing a controversial “herd immunity” strategy, before finally ordering an Italy-style lockdown to regain control over the virus’s transmission. As in Italy, the result was an initial surge in case numbers, a belatedly successful effort to bring R(eff) below one, and a huge death toll of over 20,000 to date.
New York, USA
New York City, with its field hospital in Central Park resembling a scene from a disaster movie, is another testament to the power of uncontrolled virus spread to overwhelm the health system. Its R(eff) peaked at a staggeringly high value of eight, before the city slammed on the brakes and went into complete lockdown. It took a protracted battle to finally bring the R(eff) below one. Perhaps more than any other city, New York will feel the economic shock of this epidemic for many years to come.
Sweden has taken a markedly relaxed approach to its public health response. Barring a few minor restrictions, the country remains more or less open as usual, and the focus has been on individuals to take personal responsibility for controlling the virus through social distancing. This is understandably contentious, and the number of cases and deaths in Sweden are far higher than its neighbouring countries. But R(eff) indicates that the curve is flattening.
Singapore is a lesson on why you can’t ever relax when it comes to coronavirus. It was hailed as an early success story in bringing the virus to heel, through extensive testing, effective contact tracing and strict quarantining, with no need for a full lockdown.
But the virus has bounced back. Infection clusters originating among migrant workers has prompted tighter restrictions. The R(eff) currently sits at around two, and Singapore still has a lot of work to do to bring it down.
Individually, these graphs each tell their own story. Together, they have one clear message: places that moved quickly to implement strict interventions brought the coronavirus under control much more effectively, with less death and disease. And our final example, Singapore, adds an important coda: the situation can change rapidly, and there is no room for complacency.
Bangladesh initially dodged the bullet by strategically avoiding the importation of Covid-19. It had successfully evacuated Bangladeshi citizens from China by late January, and quarantined and reintegrated them. Once the virus went global, it hit Bangladesh too. As soon as the first cases started popping up, Bangladesh opted for a contained shutdown. First, the educational institutions were decisively shut down. Then non-essential businesses and services were closed, while others were asked to expand their online services. Out-migration from cities was managed in a guided way to avoid a migration crisis.
Then came the lockdown through awareness campaign. Bangladesh’s exemplary civil society machinery joined in. The campaign message was clear and succinct—awareness, not panic. In fact, the government has avoided using the word lockdown in any of its reference to avoid creating panic. It has been a rather soft and effective lockdown with an equilibrium deployment of the civil administration, the military and the police. Once the lockdown went into effect, a ‘6 pm to 6 am’ restriction was imposed, especially in dense urban areas. It all happened within a 20-day timespan. Within this time, the usage of masks was successfully promoted across the country. So far, the country has adopted a precautionary ‘watch and extend’ policy, whereby it is extending the lockdown in a piecemeal way (five extensions have been announced since it went into effect).
Initially Bangladesh’s testing capacity was low, and the government decided to directly implement the tests. However, the country soon adopted the WHO prescribed strategy of wide testing. Within a month, the tests were massively expanded. Health authorities went from conducting 1,500 tests in the first month to more than 1,500 tests per day. Currently the testing has edged-up to about 3,500. But although Bangladesh’s death and infection rates are near the global average, the recovery rate is worryingly high.
As soon as the lockdown and the health strategy were put into effect, the socio-economic challenge of people losing livelihoods became visible. Within a week of the lockdown, the government decisively rolled out a stimulus package of US$8.5 billion (3.5 percent of the GDP) and higher than those announced by India or China. The package was catered towards employment retention, especially in the lower income bracket. The first investment was to the export-oriented formal sector wage payments. Then it was sectioned out amongst informal SMEs, domestic industries, agro-sector and social security schemes. The stimulus was prepared in consultation with the country’s major economists and think tanks. As a result, unlike many other policy actions, the stimulus was applauded by almost all quarters. Within two weeks of the announcement, the social protection measures of food aid and cash delivery have reached nearly 28 million people.
The Hasina factor
Bangladesh’s leadership faced the Covid-19 threat head-on. Prime Minister Sheikh Hasina has first and foremost taken on the role of chief panic-diffuser. She conducts national live-casts with local frontline workers almost every day. She has publicly given directives and has taken charge of hands-on firefighting. When reports of folks with political and administrative influence seemingly mispaginated the distribution of ration aid, she vowed to trace the culprits, stating that she “will spare no one involved in such heinous acts.”
At the start of the virus outbreak, Sheikh Hasina took measures to stabilise the commodity market. In line, the price hikes and market shortfalls have been relatively low. For instance, initially the price of rice was being forecasted to double within a month, however it stabilised at a 30 percent increase. The prime minister has anticipated that there might be a global famine, and that Bangladesh must be vigilant. The good news is that it has a higher rate of cultivable land than all other South Asian countries. Her directive to “leave no land uncultivated” has already gone into effect. One of her administration’s success was delivering food security to the country. Despite that, she realises that the game has changed. As the harvest season nears and with Covid-19 halting the supply of migrant agro-labor, stimulating the agro-sector has become her administration’s top priority. As part of the same measure, her government has specifically intervened to boost up the fishery sector knowing that fishes are the main source of protein in the Bengali land.
In a time when countries are closing, Bangladesh’s leadership has been an advocate of trans-national cooperation in the fight against Covid-19. Bangladesh was among the first to declare a contribution to the joint emergency fund to tackle Covid-19 called for by Indian Prime Minister Narendra Modi. She was on the panel of a vital World Economic Forum strategy meeting on Covid-19, where she discussed her country’s measures and called for collective responsibility.
Some noteworthy practices
These challenges have also created opportunities and highlighted a myriad of good practices. Bangladesh, being the global laboratory of development innovation, has brought various stakeholders together. As one of the leading ready-made garment producers in the world, it has mobilised to make personal protection equipment for its population and for exports. The civil society has come together with its own set of strategies to support the government. The country has implemented a new scheme whereby frontline responders are being provided special insurance and incentives for their dedication. Countries across the world should look into replicating it.
Bangladesh is also set to increase its digital financial services and transfer cash aid to more than three million poor people. The Bangladesh military’s research wing has already started making low-cost ventilators, which would otherwise be imported at much higher price. The government has set-up platform-helplines as go-to resource for Covid-19 related information or support. Bangladesh’s dedicated coronavirus website (with a surprisingly helpful chatbot) and helpline have been instrumental is seeking out help for people. Dozens of corporations and well-to-do folks are chipping in to provide some relief in the short run while the government and development partners work out long-term solutions.
The steep journey ahead
The Covid-19 outbreak has shaken Bangladesh to its core. The challenges ahead are quite steep. The Bangladeshi leadership very quickly understood that it is on its own. It rapidly adopted a cocktail solution that is uniquely Bangladeshi. The prime minster took leadership and did not resort to a blame game or politicisation of the situation. Only time will tell if the actions taken were enough or not. The lockdown process in Bangladesh will yield effective returns in the long run. The early signs of emerging out of Covid-19 are promising. The curve does not seem to have peaked too steep. In fact, pinpointing the infection curve is urgently needed to consider opening the country again. The economy will have to be prepped for strategic opening up, similar to the strategic lockdown. Expanding “essential services” and boosting the rural and agro-economy seems to be the first steps for Bangladesh.