Page - 516 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE516 This review of developing country governance and responses tries to draw pragmatic lessons to address the COVID-19 pandemic. It notes the higher costs of not acting quickly, and the causes and implications of public health capacity vulnerabilities in develop- ing countries. Some implications of the different policy responses in China, South Korea, Vietnam, Kerala, Argentina, and Brazil are highlighted. Failure to Act Quickly On January 30, there were 7,818 confirmed cases of human-to-human transmission, with the vast majority in China, and 82 cases in 18 coun- tries outside China. But when the WHO declared COVID-19 a “pan- demic” on March 11, there were more than 118,000 confirmed cases and 4,291 deaths in 114 countries.4 More than 90% were in four coun- tries (China, Iran, Italy, and South Korea), with new infections declin- ing significantly in China and South Korea, 81 countries reporting no cases, and 57 reporting 10 cases or less. The WHO Director-General expressed the hope that countries could still check the pandemic by mobilizing people to detect, test, isolate, trace, and treat those infected, quarantining them while they remained infectious. Only a handful of East Asian economies and Kerala acted early, and thus avoided highly disruptive total lock- downs and associated human and economic costs. They also secured greater community support for containment, while minimizing dra- conian enforcement measures. Had far more countries done so, while requiring safe physical distancing, mask wearing, and other precautionary measures, the con- tagion could have been contained.5 And where communities or large clusters had significant infection rates, targeted measures could have helped “turn the tide” on COVID-19, as in China, Korea, and Vietnam, with decisive early actions without requiring nationwide “stay-in- shelter” “lockdowns,” or restrictions on movements of people within 4. “WHO Director-General’s Opening Remarks at the Media Briefing on COVID- 19” (11 March 2020), online: World  Health  Organization <https://www.who.int/dg/ speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing- on-covid-19---11-march-2020>. 5. The WHO’s initial advice was to prioritize the use of face masks only by people with COVID-19 symptoms, or by those looking after someone who may have the virus, owing to the critical shortage of medical masks.