COVID 9: Why some countries did better?

 A year has gone by and the devastating impact of the Covid pandemic is still going on with over 100 million infections worldwide and over 2.1 million deaths we know the pandemic is far from over. The pandemic, from its source of origin, its widespread infections across the globe, to the debate over how best to combat it remains an ever present topic of our daily lives. As the roll out of various possible vaccines occurs the virus, to make its point, surges ahead in a third wave which, with reported new variants of the Covid 19 virus, reminds us the battle is far from over.

Eventually the human race will over come this deadly virus, whether through its myriad of strategies and vaccines or the virus will just mutate itself into non existence, as did SARS, remains to be seen. A year down the deadly combat with this virus it seems less likely that self mutation of the virus into non existence is a possibility. Yet we have to wonder why some countries fared better than others. 

We can look at the statistical data and come to various conclusions but the debate then gets furious as we can argue about how the death rates are determined, the relationship of testing to over all performance, the importance of recovery rates, and hospitalisation rate to positive test ratios. Either way we see it on a statistical basis countries the USA, UK, Italy, and Brazil do not come out well on the death per million criteria. Same is true for infections per million where the USA fares the worst (78,000) but India comes in with only 111 per million, highlighting that testing is important as India has only tested 13% of its population compared to the US which has 91% tests including repeat tests. Some countries like UAE have crossed 242% tests as a result of strict internal testing protocols resulting in repeat tests. Israel, Australia Iceland and Denmark have all shown over 100% test numbers following the dictum that till you do not test you don’t know the impact of the virus.

However, data is a bit confusing as some countries with high testing still have high death rates compared to others who show that high testing resulted in better identification of the spread and resulted in lower death rates. In some cases the death rate only applies to people who died within 28 days after testing positive thus ignoring people who may have died from complications arising from COVID-19 after the 28 days as is the case in UK. Thus one can argue the UK numbers are understated. 

Moving away from the debate over the statistical data one can appreciate that while no single strategy can be earmarked as successful in the fight against  the COVID-19 virus it is clearly evident that both macro and micro strategies in combination achieved a higher level of success. 

New Zealand is highlighted as a country that has successfully contained the virus thus far. Admittedly with a smaller population of 5 million some would argue it could have been easier to tackle the pandemic. Indeed a smaller population in an island country is an advantage but still the country has a few major cities with concentration of the population and to record only 25,000 cases with only 25 deaths is remarkable. Testing is high, 300% test rate, but then a lot of things were done right from the beginning.

One of the strongest factors for New Zealand was and is its leadership under Prime Minister Jacinda Arden. A key factor was communication and transparency by the prime minister herself leading the daily briefings and in a very personal style calling the 5 million people “the team” that will fight the virus. This created a togetherness with the community and backed with honest communication the harder measures were understood and accepted by New Zealanders. Last year in mid March a strict lockdown was imposed across the country with social distancing and masking compulsory when the lockdowns were eased. A state of the art contact tracing was implemented and where localised outbreaks happened curfews and lockdowns in those areas followed. The contact tracing was believed to be so good that in one case the virus was tracked to a garbage bin in a particular neighbourhood!

Indeed a complete lockdown and no entry or exit from the country all had a massive economic impact on the economy but the calculation  was that  30 to 60 days of strict measures will allow a return to normalcy faster that otherwise. This proved right and by July of last year a graduated return to normal life was seen and now with the second surge the measures from the start showed the protocols were robust. In New Zealand’s case a central policy was possible from the prime ministers office unlike say in the United States where a federal policy cannot apply uniformly in all 50 states, even though there are ways to invoke an emergency nation wide. 

The case of Africa as a whole is  more interesting with 17% of the world population only 3.5 m cases have been reported with 87,043 deaths. One could argue that low testing levels (South Africa is the highest with 13%) suggests less detection of cases. But then death rates in general on the African continent have not gone up suggesting that impact on the over all death rate since the pandemic started is negligible. It is possible that given the past experience to pandemics like Ebola some countries in Africa were better prepared and while testing may not have been widespread at ports of entry the measures were strict. In the case of Nigeria, for instance, a strict lockdown was imposed a couple of weeks before the first case was reported. Researchers also suggest that given the average age of the population to be a low 18 years, resilience to the virus could be better. (In Germany the average age of population is 40 years). An additional factor could well be that a large proportion of the population spend their time outdoors thereby reducing the spread of the virus.

The United Arab Emirates was also one of the countries that showed a remarkable response to the virus. With a population of 9.7 million it acted quickly to force a lockdown and for a few weeks a nightly curfew  during which period streets and public places were disinfected regularly. While limited flights in and out were allowed there were protocols for testing and tracing. Masking and social distancing were quickly implemented and remain in force even a year later. While in December 2020 there has been an uptick in the numbers it has been accompanied by higher recoveries and mass roll out of vaccinations. 

Across Asia results of strategies against the virus vary. China, given its highly centralised government, initially may not have been forth coming about its numbers, even though it was quick to share the genetic structure of the virus with scientists around the world, it nevertheless enforced a total curfew in Wuhan, the source of the virus, and across much of China. It’s contact tracing systems remain one of the best and it would seem they have contained the virus. Mass roll out of their vaccine has been going on for a couple of months and cooperation with other countries is in the rise. South Korea, Taiwan, Vietnam and Japan all have fared better then their western counterparts as their is a better level of acceptance of government policies on the pandemic. In addition face masks have been long accepted in some of these societies since over two decades which could explain why infection rates were relatively low in their countries even though lockdowns were not that severe. 

Elsewhere in Asia both India and Pakistan seem still to develop a comprehensive strategy against the pandemic. Low levels of testing, 13% and 3.4% respectively suggests either a lack of resources or willingness to examine the extent of the pandemic. With the availability of the vaccine both governments seem to follow a strategy of vaccinations to cover as many people as they can. Mask wearing has been only successful in a limited sense and mass gatherings have not been curtailed. It would seem their best bet is in the vaccine now with a acceptance that the vaccine may prevent the spread of the virus as government policy was an abysmal failure.

In the West the United Kingdom and the United States both present interesting case studies. 

In the UK the strategy has been a mixed confusion of decisions aimed to sound politically correct and the resulting measures have been ill conceived and ineffective. A year ago the government tried to calm nerves by insisting they had a strategy in place when in fact all Boris Johnson wanted was to avoid a lockdown that would effect the economy. Measure like social distancing and face masks were more suggestions then mandatory policies. Contact tracing was considered a violation of civil liberties and never really implemented. The NHS was not given the equipment and resources in time to deal with the first wave of infections and a year on some doctors complain of shortages of key supplies. 

When lockdowns did finally c9me into place, some ten months into the pandemic, they were tiered into different levels, a good thing, but then no testing for people moving from one tier to the other. The government has tried to be transparent but is briefings seem to just present the statistics but not explain the effect of the measures and why some are working and some are not. Ministers who have appeared in the media have not been able to defend  their policy and worse not been able to answer the most basic questions.

The United States response, for a leading western nation, has been far short of any expectations. A lack of leadership was compounded by the politicalisation of the Covid 19 issue with the then President, Donald Trump, not taking the lead to fight the pandemic. No effort was made to make social distancing and face masks a policy priority so much so that the President himself did not wear masks and encouraged events that contributed to the spread of the virus. Politics rather than science governed the response and supporters of the President took pride in not wearing the mask. 

Given the size of the country and the complex demographics one would have expected more coordinated policies between the various states under a federal government umbrella. States like New York and California while implementing reasonably sound strategies the lack of a national policy on testing inter state travel or have contact tracing meant that efforts of state governments were constantly eroded. Perhaps the greatest short  coming in the United States was not only the lack of transparency but the conspiracy theories about the virus and misinformation from the highest levels of public office. 

In conclusion the following are the lessons we have learned thus far from the way various countries have responded to the virus.

• Quick and early governmental action on lockdowns, face masks and social distancing.
• Honest and transparent communication on the virus, the measures being taken and possible outcomes. Such communication directly from the head of government and senior ministers was essential in building trust.
• Establishing a social mandate of trust and confidence with the community.
• Follow the science and not the politics.
• Establishing contact tracing so that the spread of the virus can be monitored and then contained.
• Widen the testing regime.
• Where a tier system of lockdowns are implemented testing of people moving between different tiers  to be obligatory.
• International travel to be eased in phased manner between countries with similar success rate in fighting the pandemic.
• As vaccinations roll put so too should the state of preparedness be improved as most likely a new variant of the Covid-19 will emerge or in a few years a new coronavirus will spread.

 

 

Third Umpire: My view of the World Cup Cricket 2019.

Cricket evokes passions comparable to any other sport, especially when it comes to the sub continent, from where four of the countries play in this years World Cup Cricket. As the first few matches of the current World Cup have got underway, with easy wins for some of the more predictable sides, we are reminded that the setting of a World Cup is always going to be one where there will be surprises. Interestingly, unlike a few decades ago, the style and technique of the one day game has evolved to the point where one cannot really consider and of the countries competing as minnows. On their day Afghanistan, as an example, can surprise one of the big power houses.

That said what does the outlook emerge for this World Cup.

England:

Clearly dubbed as the favorites based on their current form and the home ground advantage. But delving deeper into the side one cannot over look the fact that not only is the English team brimming with talent, its perhaps one of the best balanced sides. In all three departments of the game, batting, bowling and fielding, they have excelled in recent months. While one may argue that they peeked too soon with their comprehensive drubbing of Pakistan just before the World Cup started, I do believe they have more than enough in their tank to carry them into the last four.

Jos Butler and Joe Root anchor the batting well enough to be sure that till number 7 they have the strength to set high totals when batting first and yet deep enough in their batting to chase down totals. Their bowling attack is suited for the conditions and does not depend solely on the performance of one or two stars, giving them the variety to pin down most oppositions.

India:

Perhaps the only side which can claim the pedigree to take on England and be capable staking a claim to not only the final four but also perhaps winning the title this time. As much as the Virat Kohli is the talisman for the teams fortunes they do have a formidable batting that can cover for the team should Kohli have a bad day. Their bowling has been touted as one of the best, however, under pressure it can become brittle and it would be interesting to see how they tackle players like Jos Butler (England) or Chris Gayle (West Indies).

Yes the format of the tournament allows them a hiccup or so on the way to the final four. India knows too well that after the final four stage form and statistics are put aside as each team lifts their performance to another level (as they learned in the Champions Trophy final against Pakistan two years back). If India can hold their own on the big moments of this tournament then they would be worthy winners.


Australia:

While David Warner and Steve Smith return to the squad and bring in valuable experience, the Aussie batting does not seem to impress one as much as it would have four years ago. Their bowling is decent with Starc being the key 'go to bowler', and one would be curious to see how Nathan Lyon handles the conditions and the pressure. Yes there is Aaron Finch and Usman Khawaja to add to the batting but somehow I do not feel they are deep enough in their batting to make make a huge impact if Warner or Smith were to get out early.

Indeed, the experience of their bowling attack is good enough to handle the fifty-fifty matches, but facing the likes of England, India or West Indies top order batting onslaught the verdict is still out on how their attack would manage. If Australia have some lucky breaks they could make the top four but might be through the skin of their teeth.

South Africa:

On their day South Africa can be impressive in all departments of the game. The question is will they have enough of those good days. England's drubbing of them in the first match showed some serious chinks in their armor. Indeed it was perhaps the toughest match for them and its out of the way, but a batting that revolves around three main players, Amla, du Plessis, and de Kock, and a smattering of middle order sloggers cannot, in my opinion assure them of a strong showing in this tournament.

That said, with Rabada in their bowling line up, and the guile of Imran Tahir, and the experience of Steyn, South Africa provides interesting options to turn matches on their head through their penetrative bowling attack. On his day Rabada can simply change a game single handedly.

New Zealand:

I have always believed that balanced sides have the best chance to win the World Cup because of the format of the tournament is extended and individual performances from one or two stars can just carry you so far. The Kiwis have perhaps the most balanced side in the tournament after England. Their batting is strong and can set an early pace to an innings that assures them very respectable and challenging scores. Kane Williamson, Guptill, Nicholls, Munro can set the score board ablaze allowing the likes of Ross Taylor and other middle order players to pile on the pressure. The one failing of the side is that a failure at the top tends to trickle down the ranks.

The Kiwi bowling is a very balanced and attacking line up. While I do not consider their spin bowlers to be a serious threat, they could help in checking the run rate and tie the opposition down backed by one of the best fielding sides. I do feel if their batting performs at crucial moments they could make the last four.

Pakistan:

Its all a question of which Pakistan team will turn up not only for the tournament but for each of the matches. Mercurial and temperamental the team has both the bowling and batting talent to win this. But talent alone is not a guarantee for success as it needs planning an execution to get the job done. Babar Azam, Fakhar Zamman, Imam ul Haq can all be star players, the problem is can they all star on the same day, and match after match? In fairness in the past Pakistan's achilles heel was the failures of their batting which seems to have been fixed with very respectable scores in the recent English series. What let them down was their bowling much to the surprise of everyone considering their strong suite was always their bowling.

In my opinion the problem with the team has been a lack of direction and leadership. In the recent series against England the fast bowlers; known of their toe crunching yorkers, only managed 3% of their deliveries as yorkers! In addition the absence of an attack plan for each game showing up in operation suggests the bowlers were left to their own when in the middle of the track.

I personally doubt Pakistan will make the top four on their current form. However, should they have the right team turn up on each of the days ahead, then having made the last four, they could up their game to cause problems to any of the sides in this tournament.


Sri Lanka.

I would tend to think that the Sri Lanka team is in a rebuilding phase and while their bowling would be well above par, their mercurial batting line up will remain a chronic problem in this tournament where none of the bowling sides will give room for mistakes.

I doubt the team will make the last four though in this tournament do not rule out one or two upsets caused by the Lanka Lions.


Bangladesh.

A young side, passionate about their game suffer from a brittle batting and a bowling attack prone to leak runs. On the plus side their fielding is energetic and perhaps one of the best in the tournament. The format starts for them playing three of the strong sides England, South Africa and New Zealand, and losses against them could set the tone for their recovery.


Afghanistan:

Perhaps counted as the weakest side of the tournament, I would consider them worthy of one big surprise in the tournament. Their batting is moody but if they get a decent total on the board they have an excellent bowling attack to make the game interesting. One of the biggest things going for the Afghan team is their lack of fear against any of the teams and a team that is hard to rattle.

To sum up I feel the final four could be England, New Zealand, India, South Africa. Australia and Pakistan may just slip into the final four at the expense of New Zealand and/or South Africa. While its hard to predict from then on what would happen but my hunch is that England would be the final day winners.