U.S. Can Learn From Other Countries About Containing COVID-19

As the U.S. manages the coronavirus, NPR's Rachel Martin talks to three NPR correspondents in some hard-hit countries: China, South Korea and Italy, to ask what lessons the U.S. should learn.

RACHEL MARTIN, HOST:

As daily life here in the U.S. changes to try to minimize the spread of the coronavirus, it's helpful to look for lessons learned from other countries and how they have responded to the pandemic. To do that, we are joined by three of NPR's international correspondents who really have been on the front lines of all this - NPR's Sylvia Poggioli in Rome, Anthony Kuhn in Seoul and Emily Feng in Beijing. Good morning to all three of you.

SYLVIA POGGIOLI, BYLINE: Good morning.

ANTHONY KUHN, BYLINE: Hey, Rachel.

EMILY FENG, BYLINE: Good morning.

MARTIN: Emily, I'm going to start with you because you are in China. You were covering the crisis in Wuhan from the beginning. Can you just give us a sense now about what - what was the trajectory of the Chinese response to this?

FENG: Well, for the first month after the initial cases of the coronavirus appeared, there wasn't a response. There was this local cover-up and a delay. And during that time, about 5 million people left the virus epicenter and likely spread it to the rest of China. But then the country mobilized, and it did so very quickly. It imposed very stringent self-isolation and quarantine measures. And by self-isolation, I mean people started avoiding densely populated areas. They canceled all public events. They shut down factories and offices. And by quarantine measures, I meant they sealed off cities and villages completely. And the earliest city to be sealed off that's still under lockdown is the Chinese city of Wuhan, where the virus began.

MARTIN: Anthony, South Korea - I mean, how does what Emily just say - said compare to what's been happening in South Korea?

KUHN: Well, South Korea got hit right after China. And because of South Korea's experience with previous epidemics, they decided that rapid mass testing for the virus was going to be the key to their strategy. And so they've been testing around 15,000 people a day - 3,600 people per million of population compared to five people per million in the U.S. They've also focused on transparency - putting out daily statistics and press briefings. They were hit in Daegu, which was the epicenter of the outbreak, and so they also had to shift to helping them because their health system was overwhelmed.

MARTIN: So the focus there really on early testing.

Sylvia in Italy - I mean, now Italy is - has replaced South Korea as the No. 2 in the world after China when it comes to the scope of this pandemic. There are more than 12,000 cases, almost a thousand deaths. What has been the Italian response?

POGGIOLI: Drastic curbs on freedom of movement and there's been overwhelming compliance. Only food shops, pharmacies and newsstands are open. People can go out. But if stopped by police, they must show a kind of affidavit that states their purpose, either work, grocery shopping, health or an emergency. Police are carrying out random checks. As of yesterday, more than 2,000 people have been booked. They face either three months in jail or a fine of $230. The purpose is social distancing - keep people apart. Italy's falling - following China's lead, the Wuhan model.

MARTIN: So Emily, the Wuhan model - has it worked? I mean, transmission has decreased there, has it not?

FENG: Yeah. And experts pretty much unanimously agree that's because of social distancing. It will destroy your economy, as it temporarily has in China, but it quickly slows the virus's spread. Another thing China did was it built these makeshift centers where they sent sick people instead of sending them home. And researchers in both the U.S. and China have now said this week that that was critical to slowing down the outbreak, but this could be a measure that Western democracies may be unwilling to take.

As for quarantine measures, though - sealing off villages and cities - the jury's still out on the efficacy of that because quarantines made it harder from medical resources to reach the hardest-hit areas. And that's probably why fatality rates in the epicenter in China are nearly four times higher than the rest of the country.

MARTIN: So Sylvia, how have the measures worked in Italy? What's the situation right now? Is there any slowing?

POGGIOLI: Well, nationwide, it's too early to say. It hasn't hit the peak yet. The quarantine that was put in place a few weeks ago in the contagion epicenter in Lombardy - 11 towns, 50,000 people - local authorities say it's working. The contagion rate has dropped. And that's why the quarantine was extended to all of Italy - to try to prevent a spread to the south, which has much weaker health systems than those in the north which are among the best in Europe. But they are severely strained by this crisis now.

MARTIN: Anthony, South Korea chose not to take measures like we've seen in Italy or in China with these dramatic quarantines or lockdowns. And yet, it seems like they have still been able to keep the crisis at bay, right?

KUHN: Mmm hmm, yeah. Well, case numbers have been declining for two weeks in a row, and fatalities have been at less than 1% compared to about 4% for China and 6% for Italy. And you know, doing this without having to lock huge regions down is also a kind of effectiveness, a kind of accuracy. You only isolate the people who are at risk of infecting others, and you leave the others alone. But there are areas of debate, such as the role of a religious group which was at the center of the thing and also the ban on travel to and from China and also concerns about data involving patients.

MARTIN: Was there something specifically about South Korea that made it possible for them to avoid large-scale quarantines?

KUHN: Well, it's - you know, testing capacity is not just about kits. It's about investment in basic health care infrastructure - lab technicians, chemicals, machines, logistics. And if any one of those areas has a bottleneck, it's going to mess things up and people are going to lose lives. And it's just - you know, at the end of the day, it's investment in a health care system - hospital beds, you know, national health insurance. And this shows up in survivability for all diseases, including COVID-19.

MARTIN: And lastly, Emily and Sylvia, I'd love for you to talk some about how the different political systems in China and Italy have affected the coronavirus response. Emily, you alluded to this earlier. But really, how much of China's success in mitigating the spread has to do with the fact that this is a country, frankly, with a long history of human rights abuses; it is an authoritarian state?

FENG: Transparency certainly has been an issue, and we've seen transparency is critical for a fast response. That wasn't present in China. But because China's a very centralized government - one might say authoritarian - it was able to mobilize quarantine measures and social distancing very, very quickly. The problem is the quarantines may have cost more lives than we know. But we'll never know the secondary costs of people who were not able to get timely medical care and suffered from it because they were sealed into their villages or cities.

MARTIN: Right. And Sylvia, obviously, Italy is a democracy. What has been just the people's response to these kinds of drastic measures?

POGGIOLI: The crisis has totally turned the world upside down. Italians, notorious for cutting into line, not very obedient to rules - are become the most compliant people I've ever seen in my life. And they're really - Italy is telling its partners, watch us; do what we're doing - so you can avoid what's happened to us. Yesterday, French correspondents based here sent a petition to French President Emmanuel Macron telling him France underestimates the gravity of the epidemic and failed to prepare French public opinion. They say, look at Italy; it's our duty to tell you there's no time to lose.

MARTIN: Wow. NPR's Sylvia Poggioli in Rome. We also heard from Anthony Kuhn in Seoul and Emily Feng reporting from Beijing.

We appreciate all three of you and the reporting you've been doing on this. Thank you.

KUHN: Thanks, Rachel.

POGGIOLI: Thank you.

FENG: Thank you.

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