APPENDIX 6

How countries outside the UK handled COVID-19

 

The first case to appear outside China was in THAILAND on 13th January in an individual who had travelled there from Wuhan. The Thai government estimated that around 22,000 tourists from Wuhan visited the country in January, possibly exposing vast numbers of people to the virus, and promptly began to screen and thermal scan arrivals from Wuhan for signs of the disease. In the capital, Bangkok, thermal scanners were placed at the entrances to shopping malls and workers were assigned to give out disinfectant to visitors.

Residents were advised to protect themselves with a focus on personal hygiene and isolation indoors. An army of community health workers, about a million strong, began visiting rural communities to alert them of the danger, check for symptoms, provide help and monitor cases. At 5th August, the total number of cases reported in this country of nearly 70 million people was 3,328; of these, about 94% (3,144) had recovered, 2% (58) died and 4% (126) were still receiving treatment. In June and July all cases detected in Thailand were in people were infected outside of the country and diagnosed after arriving there.

On 15th January JAPAN reported its first case, also in a person who had visited Wuhan. By 24th March Japan had 10 outbreak clusters, with close to 1,200 confirmed cases and 43 deaths, with just a few dozen new infections reported every day. Japan is very densely populated, with 126.5 million people and the world’s highest density of senior citizens. In January, some 925,000 Chinese people travelled to Japan, with another 89,000 in February. The Japanese government closed schools at the end of February and cancelled all public events but shops and restaurants could remain open and only a few Japanese employees decided to work from home. Only patients with the most severe symptoms were being tested, meaning the number of unreported cases would be very high. The Japanese greet each other with a bow rather than a handshake or a kiss on the cheek and it is believed this helped to slow the outbreak, as has basic hygiene education taught from an early age.

“Washing our hands, gargling with a disinfectant solution and wearing masks are part of our everyday lives,” said a Japanese mother of two. As a result, it was easy for society to switch to anti-infection mode in February when the virus first began to spread. Shops and businesses set up hand sanitisers at the entrance, and it became a civic duty to wear a face mask. The country typically goes through 5.5 billion face masks every year – about 43 per person. The Japanese realised early on that a person can be infected without showing symptoms.

Within Europe:

• What was thought to be the first three cases in FRANCE occurred on 24th January, two of the victims having been to Wuhan, but it turned out that a patient treated in a hospital near Paris on 27th December for suspected pneumonia actually had the coronavirus. His doctor said a swab taken at the time was later tested, in May, and came back positive for COVID-19. The man had not travelled abroad. What is considered a key event in the spread of the disease in France was the annual assembly of the Christian Open Door Church between 17th and 24th February in Mulhouse which was attended by about 2,500 people, at least half of whom are believed to have contracted the virus. On 12th March, the President announced that all schools and universities would close from 16th March. On 17th March gatherings of more than 100 people, not including public transport, were banned and mandatory home confinement for 15 days began; and on 18th March all non-essential public places, including restaurants, cafés, cinemas and nightclubs were closed. Home confinement was extended twice, ending on 11th May; in addition face masks were made available to all citizens. By 13th August there had been 206,696 confirmed cases, with 30,271 deaths.

• The first case in GERMANY was on 27th January, near Munich. There was a large cluster linked to a carnival event in Heinsberg, North Rhine-Westphalia, with the first death reported on 9th March. New clusters were located in other regions via Heinsberg as well as via people arriving from China, Iran and Italy, from where non-Germans could arrive by plane until 18th March. Outbreaks were first managed in a “containment” stage, which attempted to minimise the expansion of clusters. From 13th March, the pandemic was managed in a “protection” stage, with German states closing schools and kindergartens, postponing academic semesters and prohibiting visits to nursing homes to protect the elderly. On 15th March, borders to Austria, Denmark, France, Luxembourg and Switzerland were closed. By 22nd March, curfews were imposed in six German states while other states prohibited physical contact with more than one person from outside one’s household. As of 13th August there had been 220,931 confirmed cases with 9,276 deaths.

• The virus was first confirmed in ITALY on 31st January, when two Chinese tourists in Rome tested positive. A week later an Italian man repatriated to Italy from Wuhan was hospitalised and confirmed as the third case. A cluster of cases was later detected and so it went from there, spreading rapidly. By 15th March 1,441 people in Italy had died as a result of contracting the virus, with 17,750 active cases. By the end of March there were claims that the number of cases was falling. Figures released on 8th August showed the total number of cases to have passed 250,000 with the death toll at 35,215. Italian researchers told Reuters in March that they reported a higher than usual number of cases of severe pneumonia and flu in Lombardy in the last quarter of 2019 in a sign that COVID-19 might have circulated earlier than previously thought.

In June, it was reported that a study by Italy’s Higher Health Institute (ISS), which examined 40 sewage samples collected from water treatment plants in northern Italy between October and February, found that sewage water from two northern cities contained traces of COVID-19 in December 2019, two months before the first confirmed case in the country.

In November, researchers at the National Cancer Institute (INT) of Milan said they had found evidence that the coronavirus may have been circulating in Italy as early as September 2019. They reported that 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020 had developed coronavirus antibodies well before February.

• The virus was first identified in SPAIN on 31st January when a German tourist tested positive in La Gomera in the Canary Islands. By 13th March, cases had been confirmed in all 50 provinces of Spain. By early August, according to Johns Hopkins University, Spain had recorded nearly 323,000 cases while Britain had 313,000. More than 28,000 people had died from the disease in Spain but well over 40,000 in Britain. The first case in Madrid occurred on 25th February. On 9th March the Government of the Community of Madrid approved extraordinary measures, including the cancellation (to be enforced from 11th March) of all classes at all educational levels for an initial period of 15 days. On 11th March, some 3,000 football fans from Madrid attended a football match between Liverpool and Atletico Madrid at Anfield. No health checks were carried out on any of the travelling fans. [The UK government stood by its decision to allow the event to go ahead before restrictions on mass gatherings were enforced 10 days later.] On 13th March bars, restaurants and “non-alimentary” shops in Madrid were shut (only supermarkets and pharmacies were excluded from the ban).

• The first confirmed case in SWEDEN was on 31st January when a woman returning from Wuhan tested positive. On 26th February, following outbreaks in Italy and Iran, a number of travel-related clusters appeared. The first death was reported on 11th March in Stockholm. By mid-August there had been 83,852 cases, with 5,776 deaths. This nation of 10.1 million people adopted a different approach to almost every other country, not closing any businesses or schools. The government simply asked its citizens to be “responsible and safe”, encouraging people to keep two metres apart and work from home where possible.

• The virus was confirmed to have spread to BELGIUM on 4th February, when a Belgian national out of a group of nine Belgians repatriated from Wuhan to Brussels was reported to have tested positive for the coronavirus. Transmission within Belgium was confirmed in early March; linked to holidaymakers returning from Northern Italy at the end of the half-term holidays. The epidemic increased rapidly in March and April and by the end of March all 10 provinces had registered cases. By 13th August 75,647 cases had been confirmed, with 9,900 deaths. With a population of just over 11.5 million, this represented the highest death rate per capita in the world.

• The first case in the NETHERLANDS was detected on 27th February in a patient who had travelled to northern Italy, the worst hit area in Europe at the time. By 13th August there had been 60,627 confirmed cases, with 6,161 deaths.

 

The view from nearby countries

At the beginning of July, the New Statesman, a long-established British political and cultural magazine, published an issue headed “Anatomy of a Crisis: How the government failed us over coronavirus”. This gave many views on how the pandemic had been handled both in the UK and overseas.

Assessing what had been done in France, it said the decisions made there turned out to be the right ones, stating that the French government was never complacent about the threat. By early March, case numbers were not yet as high as in Spain and Italy, but during the week of 9th March, France closed schools, universities, bars and restaurants. To most intents and purposes, the French were in lockdown by the end of that week, though a formal lockdown was not announced by the President until 16th March. By contrast, Britain did not close schools until 20th March and locked down on 23rd March.

“It is clear,” the magazine said, that the earlier lockdown came in, the more effective it turned out to be. France further acted to close its borders to most travellers while it was locked down. This decision made epidemiological sense and political sense. “We could not have asked people to stay cooped up inside if we had also allowed in travellers from abroad,” said a French politician.

According to figures compiled by the Financial Times, there were around 25,000 excess deaths in France this year, less than half those recorded in the UK, despite the pandemic hitting earlier in France and the populations of both countries being almost identical in size.

Annette Dittert, London bureau chief for ARD, Germany’s main public broadcaster, wrote that when Boris Johnson returned to Downing Street after his hospitalisation, he might as well have stayed where he had been before. “He clearly wasn’t the man of the hour; his inner Churchill had left him. Not even the unavoidable invocations of the wartime spirit had their usual effect.

“Johnson, the man who had promised he would get Brexit done with a few white lies and some cheeky dinner speeches, had met his enemy: a virus that stubbornly resisted any smooth talking about taking back control. By mid-May he had promised all kinds of gadgets; none worked. Bombast met dire facts. The only global ranking Britain was close to topping was the chart of per-capita death rates. ‘This feels all a bit like Brexit,’ my German editors in Hamburg remarked: “Empty slogans until reality bites.”

Further on she wrote, “Johnson thinks as he speaks: in slogans. He is campaigning instead of governing. His chaotic handling of the coronavirus crisis is destroying thousands of British lives, and has started to erode and undermine the foundation of the British democracy: trust. The consequences are dire: a confused nation that will only be able to rely on herd immunity once the dreaded second wave arrives. And arrive it will.”

Annabelle Chapman in Poland wrote: “While Poland went into an early lockdown in mid-March, with people required to wear masks on public transport and in shops, many Poles looked on in disbelief at British Prime Minister Boris Johnson’s apparently offhand response to the virus. ‘The UK’s handling of the pandemic was pretty haphazard. The rules were introduced too late and were always very confusing,’ says a Polish researcher based in Cornwall. Although he is not a fan of Poland’s right-wing government, he notes that its response was quick and decisive, ‘probably the best thing they did in the last five years’.”

Paata Imnadze, deputy director of the National Centre for Disease Control (NCDC) of Georgia, wrote that when China announced that it was experiencing an unusual pneumonia outbreak, experts at the NCDC began closely monitoring the situation. On 6th January, the Georgian government was notified of what was happening in China. Shortly afterwards, the NCDC set up several bodies to begin liaising with the government to guide its response to the spread of the virus. By early February, Georgia had developed the capacity to test for COVID-19. “Our country began to take various measures against the potential importation and spread of COVID-19 within our borders, including cancelling flights with high-risk countries, closing borders, thermal screening at border crossings and tracing international travellers coming to Georgia. After the first confirmed case, Georgia strengthened its control measures with tight multi-sectoral collaboration between different bodies involved in the response. “Georgia’s response has been a success because the NCDC took the threat of the disease seriously early on. Experts worked in co-ordination with the different sectors likely to be affected by the pandemic. Finally, the government was trusted and its recommendations largely adhered to by the public.”

 

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