I'm sure Covid-19 will be studied for years to come, many PhDs will be written regarding the world's response, economic impacts, the virus itself. The below are observations and open questions coming from government policy (sourced) and firsthand accounts of how this is being handled in developing countries. These include anecdotes from my friends and family either traveling through or living in southeast Asia (e.g. Vietnam, Indonesia, Laos) and Latin America at this time.
I'll divide the below into observations (first) and then takeaways.
By January 30th, nearly all of China's neighboring countries had closed their border to the PRC [1], a prompt macro-response. In terms of micro-responses, let's take Vietnam (Hanoi) as an example. Strict controls were implemented at hotels, airports, and other transportation hubs. Upon landing in Hanoi travelers are required to fill a health-travel questionnaire and are subject to temperature control (the subject is made aware of their temperature). The same is true at airports in neighboring countries. All staff wear masks.
By contrast at JFK airport (New York City), it looks like business as usual. As soon as this past Friday (March 20th) controls at Terminal 4 were nearly non-existent; consisting of a health-travel questionnaire. Immigration did not interrogate (but did store the document in a drawer, perhaps to be referenced at a later time), nor are airport staff wearing PPE (e.g. masks, gloves).
In southeast Asia (actually Asia in general) mask usage is widespread, and for the many who can't afford or find mass-produced masks, they craft these out of cotton-cloth and use them with a combination of alcohol spray before-and-after. In fact, even when you're handed a mask these may be sprayed with alcohol solution to sterilize. Mask usage is enforced by police (at least in Vietnam).
It's telling that the American-CDC is now recommending that healthcare workers who can't access proper PPE follow steps similar to what's being done in Vietnam, Indonesia and Laos. Unfortunately, the CDC's recommendations missed the sanitation step before-and-after, came late (week of 3/16) and do not address the general public. [2]
In Latin America, some the poorest nations have taken the most decisive action. Nationwide quarantines are already implemented in Bolivia, Argentina, Peru and Colombia. [3] Notable holdouts include Chile and Brazil, Latin America's wealthiest nations per capita. Other holdouts include the rest of the developed countries except Italy.
Some takeaways and open questions:
In terms of macro-actions, I believe the difference in the response of developed and developing countries is driven by at least two factors:
Behavioral Economics. Nations such as Bolivia and Vietnam have healthcare systems which are likely woefully unprepared to deal with a pandemic and their governments know it. As such, the only way to deal with the pandemic is to take decisive action in the immediate term in the form of closed borders, internal country-wide quarantines and mass implementations of basic health controls as described above. Until a few weeks ago, it was generally unthinkable that the healthcare system of developed countries such as those in Europe and the US could be overwhelmed. It makes sense that leaders of these countries were not prepared to take the steps such as those seen in developing countries as they simply saw more options.
Economic Inertia and Complexity: The economies of developing countries are small, with generally simpler supply chains and are less diversified. The economy of the United States, on the other hand, is far more complex and moves at a faster pace than that of say, Cambodia. One could argue we are victims of our own success.
In terms of micro-actions, I think the widespread of masks, gloves and other PPE have an important impact. Wearing a mask both protects others from you (if you're sick) and you from others. In the US the tone on mask usage is starting to change from dismissive to essential [4].
On a positive note, in the US we're seeing state and federal government take increasingly decisive action. We're also seeing several helpful social movements, e.g. #flattenthecurve, #stayhome
Do let me know if above is aligned or misaligned with what you've seen. All the best.
Carlos Aspetti
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