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COVID-19 – Lessons from East Asia

By Réka Koleszár

27 July 2020

While Europe has been hit hard despite early warnings, the East Asian countries are generally viewed as success stories regarding their handling of COVID-19. Their response to the crisis evolved over time and ultimately can be judged by the number of cases, the extent to which citizens respected the preventive measures and the mortality rate. Successful countries had a case-based strategy and aggressive intervention to identify, isolate, investigate contacts and monitor them. By looking at the example of different countries in East Asia, much can be learned about handling a pandemic and its aftermath.

Being the first hotspot outside of China, with over 600 daily new cases in February, South Korea was able to flatten the curve without widespread lockdowns seen in Europe, while keeping the mortality rate relatively low. Similarly, Taiwan and Japan have also managed to avoid bigger outbreaks without excessive confinement measures. China’s measures, as controversial as they may be, have also been praised as one of the most ambitious disease containment efforts in history.

Could the East Asian success stories be replicated in Europe? Given the different nature of the Chinese political system, the measures of East Asian democracies are more relevant for governments in Europe. There is no one-size-fits-all solution, but the East Asian approach can offer vital lessons.

Clear command structure

Countries with previous experience of dealing with a pandemic already had a clear command structure in place to coordinate the response to Covid-19. Taiwan’s traumatic memory of SARS from 2003 had prompted the establishment of the National Health Command Center to act as the operational command point for direct communication among the different levels of authorities. South Korea, having been hit by MERS in 2015, had also learnt the lessons the hard way. From the onset of the crisis, Seoul’s response was led by the Central Disease Control Headquarters (KCDC, Korea Centres for Disease Control & Prevention) headed by the Prime Minister. The KCDC swiftly activated the Global Epidemic Prevention Platform system, integrating global infectious disease data and mobile data provided by the Korean Telecom. Not having previous coronavirus experiences, the Japanese government was late to establish a clear chain of command which left the population largely confused about the severity of the virus.

Institutional Capacity

Some argue that East Asia’s success lies in the Confucian traditions and the collectivistic, ‘more obedient’ social behaviour. But the extensive lockdowns in Europe shows that people in Western cultures, with some exceptions, are just as willing to prioritize the wellbeing of the group. The strong institutional capacity of the East Asian countries offers a more convincing argument. The effective implementation of policies and measures and the readiness of the healthcare system to deal with the pandemic were key elements in the success. These countries learnt the importance of appropriately funding disease control institutions, stockpiling medical equipment, training medical professionals and ramping up the healthcare capacity through experience. Nationwide health networks with centralised information were also a common feature.

Government-led public & private cooperation

The multi-stakeholder approach and the strong cooperation between government actors, private sector and the civil society was remarkable both in South Korea and Taiwan. The Taiwanese government regularly cooperated with private media companies to provide information about the pandemic and help circulate preventive knowledge. The Taiwanese digital minister reached out to civil organizations to develop the mask supply and demand platform. The South Korean government was also quick to reach out to big local corporations to start developing COVID-19 detection tests which was fundamental to the country’s mass testing efforts. Japan, although significantly later, also reached out to the private sector to develop testing kits.

Emergency Legal framework

A sound legal framework to deal with an outbreak was a common element in South Korea, Japan and Taiwan. Following South Korea’s MERS outbreak, new policies were adopted to the Infectious Disease Control and Prevention Act which made possible the public disclosure of information. Japan has two important laws for pandemic prevention for emergency medical and social measures next to the Prime Minister’s ability to declare a state of emergency. Likewise, Taiwan also had a pre-existing emergency legal framework which was gradually updated following the lessons learnt from previous pandemics.

Active Prevention Measures

Prevention methods such as extensive screenings at entry points, widespread testing and facemask usage were in place in most of the East Asian countries. The contact tracing measures at the early onset of the pandemic in South Korea and Taiwan achieved favourable outcomes. South Korea’s efficient and extensive testing and diagnostic network allowed the swift identification and isolation of infected persons thus breaking transmission chains and curbing the spread. Enforcing the usage of masks is also thought to have contributed greatly to the flattening of the curve. To increase public trust and compliance, the transparency over the data and forecasting models that influence government strategies was notable both in South Korea and Taiwan.

Integrated Big Data Usage

The use of technology and big data drove the fight against COVID-19 in most East Asian countries. By relying on data-driven measures, the supply chains, medical resources and the tracing of potential infected persons were effectively managed in Taiwan and South Korea. The strategic use of information and communication technologies helped to deliver effective and rapid care, keeping the mortality rate relatively low. In Taiwan, the National Health Insurance Administration and the Immigration Agency created a joint database which helped to identify potential infections through recording travel histories as passengers scan their QR codes upon entry. The database is shared among hospitals, pharmacies and clinics. South Korea employs a system through which the authorities use electronic transaction data, mobile phone location logs and CCTV footage to create a detailed history of confirmed cases which is made available for the public.

Proactive Information Disclosure

Transparent and accurate provision of information is essential to ensure the credibility of government action. In this era, in times of a pandemic, proactively identifying and responding to misinformation and fake news can be decisive to reduce public anxiety and increase compliance. The Taiwanese government relied on AI, social media and other digital tools to keep its citizens up to date besides the daily press briefings. Taiwanese fact-checking institutions such as the ‘Fact Check Center’, also made great efforts to verify and correct information circulating online on the pandemic. In South Korea, the press briefings were led by experts and scientists rather than politicians and the National Police Agency is constantly trying to crackdown on COVID-19 related fake news.

Conclusion

The relative success of East Asian democracies in dealing with the pandemic should have important lessons for Europe but there appears to have been a reluctance at the official level to learn from the other side of the world. One can speculate about the reasons for this but in today’s globalised world there should be no reason not to be aware of how others have tackled the pandemic and no hesitation in using best practice procedures.

Réka Koleszár, a graduate of the Hague University, recently completed a stage at the Council of the EU