Health and Healthcare Systems

Here's what countries are doing to slow the coronavirus outbreak

A person wearing a protective mask walks in front the Colliseum, the third day of an unprecedented lockdown across of all Italy imposed to slow the outbreak of coronavirus, in Rome, Italy, March 12, 2020. REUTERS/Guglielmo Mangiapane - RC2HIF9T7XQ8

The US has signed into law a $2.2 trillion stimulus package. Image: REUTERS/Guglielmo Mangiapane

Rosamond Hutt
Senior Writer, Forum Agenda

This article was updated on 14 April 2020.

  • COVID-19 test kits that give results in under an hour have been approved for use in Canada.
  • 10 US states have banded together in regional pacts to coordinate gradual economic reopenings.
  • France has extended its lockdown until 11 May.
Cumulative COVID-19 Cases By Days Since 50th Confirmed Case
Cumulative COVID-19 Cases By Days Since 50th Confirmed Case. Image: Johns Hopkins University

As new cases continue to be confirmed across the globe, here’s a glimpse of the measures being taken to contain the outbreak.

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What is the World Economic Forum doing about the coronavirus outbreak?

Europe

On 17 March, European leaders agreed to close the European Union's external borders. Only essential travel would be allowed for at least a month - but the ban doesn't affect trade.

It followed Slovakia, Malta and the Czech Republic announcing they would close off their borders to fellow EU member states in an effort to contain the outbreak.

Switzerland, not a member of the EU but part of the European Schengen free-trade agreement, has tightened border controls with its neighbours. Geneva closed commercial activities and banned meetings of more than five people, as well as religious services.

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Spain’s government set out guidelines on 11 April for people returning to work under a loosening of lockdown restrictions. It reported its lowest one-day increase in deaths from the coronavirus since 23 March.

On 14 April, France extended its lockdown for an extra four weeks until 11 May. President Emmanuel Macron said schools and some workplaces would reopen in mid-May, but no social gatherings and leisure activities will be allowed until mid-July at the earliest.

The country went into lockdown on 17 March, with President Macron saying people should only leave home to buy groceries, travel to work, exercise or receive medical care. It deployed 100,000 troops to enforce the new rules.

On 20 March, the home of the Tour de France cycle race, banned recreational cycling. It also ruled that people could only exercise within a mile (2km) of their homes.

The UK Prime Minister Boris Johnson contracted COVID-19 and was put into intensive care on April 6 but pulled through. In a video posted on Twitter on Easter Sunday, the 55-year-old said: "It is hard to find the words to express my debt to the NHS for saving my life."

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The UK imposed a partial lockdown on 23 March. People can only leave home to buy food and medicine, to exercise once a day, and travel to work where "absolutely necessary".

London's ExCel Centre has been converted into a temporary hospital, with similar plans for Birmingham's NEC, Manchester's Central Convention Centre, a university in Bristol and a a conference centre in Harrogate, Yorkshire.

Irish Prime Minister Leo Varadkar re-registered as a medical practitioner as part of the Health Service Executive's “Be on call for Ireland” campaign, which has attracted 70,000 interested healthcare professionals. Varadkar, who was a doctor for seven years before entering politics, will be on duty for one shift per week, handling telephone assessments.

Ireland has announced that private hospitals would become part of the public health system. "There can be no room for public versus private" in the current crisis, explained health minister Simon Harris.

Norwegians were asked to return home from their holiday cabins, to ensure smaller municipalities could support their core populations. Anyone caught breaking their quarantine or self-isolation could face a fine or imprisonment, the government said.

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On 28 March, deaths in Italy surpassed 10,000 and confirmed cases reached 92,000, overtaking China. After the figures were announced, Prime Minister Giuseppe Conte announced more economic measures to help those worst affected.

Nationwide restrictions on travel are in place and all shops - apart from food stores and pharmacies - are closed, as are schools, gyms, museums, cafes, restaurants and nightclubs.

Prime Minister Conte on 10 April extended the nationwide lockdown until 3 May. The measures, which were implemented on 9 March, had been set to expire on 13 April. Deaths from coronavirus in Italy have risen to nearly 19,000.

However, one town in the worst-hit northern region of Italy has managed to slow the spread by experimenting with blanket testing. Vò, near Venice, began testing its entire population of 3,300 people when the pandemic began. It imposed strict quarantine on those infected and their contacts and, as of 13 March, the town has not registered any new cases.

Image: Financial Times

The government in Portugal is granting citizenship rights to migrants and asylum seekers whose residency applications are being processed. It means they will have access to social security and health care, while the country battles the spread of coronavirus.

Spread of COVID-19 in Europe.
Spread of COVID-19 in Europe. Image: World Economic Forum

On 16 March, Germany closed its borders with France, Austria and Switzerland, except for commercial traffic.

Governments and businesses are taking steps to mitigate the impact on business and to help provide essential equipment. The Danish government announced that until 9 June the government would pay 75% of employees' salaries for private companies who are struggling, providing they didn't cut staff.

North America

The US has the highest number of cases in the world, as of 29 March. A $2.2 trillion economic stimulus package was signed into law on 27 March with measures to support individuals, businesses and the public sector.

President Donald Trump stunned his European allies by announcing a ban on travel from the EU's Schengen area from 13 March. Days later, that was expanded to include the UK and Ireland.

The US has urged people to avoid gatherings of more than 10 people, superseding the advice from the Centers for Disease Control and Prevention (CDC) on 15 March, which asked Americans to cancel or postpone gatherings of 50 people or more over the next 8 weeks.

On 20 March, California ordered its 40 million residents to stay at home, as modelling showed without action more than half of them would contract the virus in two months, requiring nearly 20,000 more hospital beds than the state could provide.

On 15 March, New York City closed nightclubs, movie theaters, small theater houses and concert venues. Restaurants can continue to operate, but from 17 March, they could do take-out business only. As cases continued to rise, New York mandated the closing of all non-essential businesses in the state by Sunday 22 March.

Nearly one-in-four Americans have been ordered to stay at home at this point. On 24 March, the WHO warned that the US might become the centre of the outbreak as cases continued to climb. Anyone who has traveled through New York has been advised to self-isolate for two weeks.

Trump initially said US businesses would be reopening by Easter, but on 29 March, he extended the stay-at-home guidelines to the end of April. The revised measures followed a warning from a top medical adviser that more than 100,000 Americans could die from the coronavirus outbreak.

On 13 April, governors from 10 US states announced they were joining forces in two regional pacts to coordinate on the best strategies for easing the stay-at-home orders.

They said the health of residents would come first when making decisions about when and how to reopen non-essential businesses, schools and universities.

Separately, on 2 April Trump invoked the Defense Production Act to help companies making ventilators receive the supply of materials they need. The move came after state officials and health experts said the US would need tens of thousands of additional ventilators to treat patients with COVID-19.

Farther north, Canada on 16 March closed its borders to anyone who is not a citizen or permanent resident.

Over the Easter weekend, Health Canada approved a portable COVID-19 test, which can deliver results in less than 60 minutes. Made by Ottawa-based Spartan Bioscience, the test is being delivered to federal and provincial health agencies - and is called a "game changer" by health officials because of its speed.

Spread of COVID-19 in the US.
Spread of COVID-19 in the US. Image: World Economic Forum
East Asia

In January, Wuhan, China, which is home to more than 11 million people, was the first city to go into lockdown, with buses, trains and flights out of the city cancelled. The restrictions were extended to other cities in Hubei province, creating a huge quarantine zone of around 50 million people.

On 11 March, some key industries in Wuhan were told they could resume, a day after Chinese President Xi Jinping visited for the first time since the outbreak began.

On 27 March, China announced a temporary ban on visitors, as confirmed cases of imported coronavirus rose.

South Korea - where an outbreak surged at around the same time as Italy’s - has reported the number of people recovering from the virus has outpaced new infections for the first time.

On 30 March, an undisclosed government document seen by Reuters showed South Korea had carried out a tabletop exercise for the containment of a fictional disease on 17 December, almost exactly a month before the first patient of COVID-19 appeared.

During the exercise, the team of experts at the Korea Centers for Disease Control and Prevention (KCDC) developed an algorithm to find the pathogen and its origin, as well as testing techniques - which have helped them tackle coronavirus since it emerged.

Hong Kong, meanwhile, stepped up its travel restrictions. From 13 March, all arrivals from Italy, and parts of France, Germany, and Japan were put under mandatory quarantine for 14 days.

At the same time, Taiwan, China announced plans to ramp up the manufacturing of medical protective masks - in a bid to supply 100,000 masks per week to the United States.

On 24 March, Japanese Prime Minister Shinzo Abe announced the postponement of the Olympic Games, which were due to be held in Tokyo in July.

Abe and International Olympic Committee President Thomas Bach agreed to the year-long delay - a first in the history of the modern Games - with Abe telling reporters they will be held by the summer of 2021.

People arrive from Hubei province attempting to cross a checkpoint at the Jiujiang Yangtze River Bridge in Jiujiang, Jiangxi province, China, as the country is hit by an outbreak of a new coronavirus, January 31, 2020. REUTERS/Thomas Peter
Usually busy roads in some Chinese cities were cleared by the lockdown. Image: REUTERS/Thomas Peter

Middle East

Saudi Arabia imposed a curfew on 23 March - to keep people indoors between 7pm and 6am for 21 days.

Dubai-based Emirates Airline announced it would suspend passenger flights from 25 March for a two-week period, which could be renewed. It came after the United Arab Emirates stopped all inbound and outbound and transit passenger flights - although cargo operations will continue.

South Asia

India's 1.3 billion people are in lockdown, as of 25 March. All non-essential businesses have been shut, and people have been ordered to stay at home. The country had already received praise from the WHO for taking "fast and aggressive" action to limit the spread, including encouraging social distancing.

“I have been quite impressed with India,” Dr. Henk Bekedam, the WHO's representative in India, told the New York Times.

“From the onset they’ve been taking it very seriously.”

“Apart from ensuring the safe return of hundreds of Indians from China, Iran and other countries, the Indian government has taken decisive measures to contain community spread,” said Sriram Gutta, Head of Community Development, India and South Asia at the World Economic Forum.

On March 27, India announced a $22.6 billion economic stimulus plan to provide relief to millions of poor people hit by the nationwide lockdown. It will include direct cash transfers and food security measures.

Asia Pacific

On 18 March, Australian Prime Minister Scott Morrison declared a national human biosecurity emergency and announced new measures including an indefinite new ban on indoor groups of 100 people or more, with exemptions for schools, public transport, universities, prisons, courts, supermarkets and worksites.

He also urged people not to panic-buy, saying hoarding was "un-Australian".

Australia has banned entry to anyone from mainland China, Korea, Iran and Italy. The chief medical officer of Australia’s most populous state, New South Wales, said models suggested 5% of the state’s population - some 350,000 people - would need hospital treatment as a result of coronavirus.

New Zealand Prime Minister Jacinda Ardern announced the country would go into a month-long lockdown from 23:59 on 25 March.

Schools, businesses and all-but-essential services would be required to close down to stem the spread of infection, as confirmed cases rose past 100.

Ardern said: “The worst-case scenario is simply intolerable, it would represent the greatest loss of New Zealanders’ lives in our history and I will not take that chance.”

She had previously announced everyone arriving in the country will have to isolate themselves for 14 days.

Latin America

Nations in South and Central America have also increased measures to contain the infection. Panama has banned entry of non-resident foreigners and Honduras closed its borders to passenger traffic for a week.

Argentina and Peru also announced border closures on 15 March to curb coronavirus, while Venezuelan President Nicolas Maduro ordered a "collective quarantine" in seven states.

The World Economic Forum's Head of Business Engagement, Latin America, Silvio Dulinsky, said as reported cases leapt from 100 in just over a week across the region, it was stepping up action.

"Currently more than 10 countries already have closed their borders allowing only nationals and residents to enter (and stay in quarantine)."

But he added that experts were raising questions on the effectiveness of the measures as the virus is already spreading among the population in the countries.

"At this stage, the only effective measure is to minimize social contact among residents."

Trade was not affected by the border closures, to avoid further disruption to the countries' economies, and some governments were exploring ways to collaborate, which Dulinsky said was good news.

"In a region that can benefit so much from further integration this might be an unexpected positive side-benefit of this terrible tragedy."

Africa

The South African government declared a national disaster on 15 March and banned travel to the most-affected countries, amid concerns that coronavirus will derail economic recovery. Kenya has also imposed sweeping travel restrictions.

African countries are adapting lessons from Ebola, says Elsie Kanza, Head of Africa at the World Economic Forum.

"One important fact to keep in mind is that across sub-Saharan Africa, only 3% of the population is over 65. This is dramatically lower than similar age brackets in China (11%) and Italy (23%).

"While young adults seem to suffer less with the virus, we could still see increased strain on healthcare systems. Limiting the spread of the virus will be important."

The African Centre for Disease Control – the pan-African authority on public health created to respond to Ebola – has been supporting countries with the repurposing of screenings, surveillance systems and isolation wards for COVID-19. Forty-three countries can currently test for the virus.

Economically, there are multiple concerns, says Kanza.

"With a global market slowdown, governments are likely to be looking at how to buffer the economic impact of the spread of this virus.

"We are likely to see a temporary hit due to the slowdown of European markets – a major trading partner for Africa – but the good news is that China’s factories are starting to switch back on and this could mitigate lasting damage."

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