By Lin Nguyen*
Clusters of the novel coronavirus (COVID-19) were first reported in Wuhan, China, in December 2019. Within three months, the highly contagious virus has escalated to a global pandemic, spreading to 210 countries, infecting more than 1,800,000 people, and causing more than 430,000 confirmed deaths.
As a global contagion, COVID-19 poses an unprecedented set of challenges for the international community, fracturing supply chains, plunging global markets into turmoil, and pushing fragile public health systems to the point of collapse. Despite significant regional variation in the scale and severity of COVID-19 outbreaks, there is a growing consensus—among both infectious disease specialists and politicians—on the intention behind infection control measures. Broadly speaking, flattening the curve is the primary objective behind most major COVID-19 control measures. If you haven’t already come across it, the term “flattening the curve” is shorthand for reducing the peak number of COVID-19 cases to prevent healthcare systems from being overwhelmed.
Control measures are failing
To minimize the spread of COVID-19 and flatten the curve, governments around the world are implementing extraordinary virus control measures, including community isolation, business shutdowns, track and trace with counterterrorism surveillance, and mass testing. However, despite growing public awareness and engagement, a worryingly large number of countries are still failing to minimize the spread of the virus.
In the United States, the Trump Administration—which has spent weeks minimizing the threat of the virus—seems to have only just woken up to the devastating consequences of a COVID-19 pandemic. The Trump Administration’s sudden shift in engagement seems to have been spurred by two events: the economic consequences of collapsing equity markets and the COVID-19 pandemic analysis recently published by Imperial College London.
Imperial College’s study, which comparatively modeled infection rate outcomes for a variety of public health responses, found that absent hyper-aggressive public health action, COVID-19 would overwhelm an already inundated U.S. healthcare system. According to the report, an unimpeded COVID-19 infection rate could kill more than 2.2 million people over an 18 month period. The lead researcher for the Imperial College London study has since tested positive for COVID-19.
As the total number of confirmed cases in the U.S. surges past 570,000, the effectiveness of U.S. public health responses has been crippled by institutional mistrust, polarized political squabbling, and a deeply dysfunctional healthcare system. Given the acute shortage of testing kits and absurd cost for basic healthcare, U.S. citizens are actually disincentivized to request a test if they are exhibiting COVID-19 symptoms. Casual employees, many of whom live paycheck to paycheck, may also be disinclined to test for COVID-19 if a positive outcome means a reduction in already scarce work hours.
Unsurprisingly, an inadequate understanding of the life-saving value of mass testing is not unique to the U.S. Tragically, Italy and Spain also failed to take the threat of COVID-19 seriously. When the rate of cases was rising in Italy, Spain was conducting minimal testing and inadequately enforcing social distancing advisements. Now, with more than 33,000 cases, Spain’s healthcare system is on the brink of collapse. To avert a medical catastrophe, the Spanish government is in the process of extending its state of emergency enforcements, thereby maintaining both mandatory business lockdowns and arrest powers for violation of social isolation protocols.
As more and more data is collated and processed, a significant correlation has been observed between comprehensive COVID-19 testing and slower infection rates. Without wider distribution of testing kits, public health authorities will have no way to identify asymptomatic COVID-19 carriers, all but guaranteeing secondary outbreaks and cross-border infection. In Italy and Spain (and likely soon the U.S.), the inability to test and isolate confirmed cases of infection facilitated rapid community transmission. With no way of curtailing the exponential spread of COVID-19, public health authorities are severely constrained in their ability to flatten the curve, an outcome that is pushing healthcare systems in Italy and Spain to the edge of their capacity.
Meanwhile, public health responses in South Korea and the United Arab Emirates (UAE) are showing how scalable mass testing can check COVID-19 infection rates. According to provisional estimates, the UAE is leading the world in mass testing, with public health authorities recording over 500,000 tests – the highest testing rate as a percentage of the population. Unlike the U.S., the UAE is also encouraging individuals who don’t have COVID-19 symptoms—people who may be asymptomatic carriers—to get tested. The UAE’s proactive support for mass COVID-19 testing was heavily influenced by the success of a similar approach in South Korea (the second-highest COVID-19 tester in the world with 6,148 tests per million people). In an effort to mitigate the spread of the virus, the UAE has rolled out mobile and drive-thru testing centers across the whole country to make testing more efficient and widespread. For the disabled, elderly and those that find it difficult to leave their houses, medical personnel are dispatched. This ensures that everyone is able to get tested, no matter whether they are showing symptoms or not.
At this point, the UAE’s testing-centric approach appears to be highly successful in mitigating domestic transmission of COVID-19; at the time of writing, the UAE has only recorded 4,123 confirmed cases of the virus despite having extremely high transit and tourist numbers.
While capping infection rates at home, the UAE has started sending aid abroad to countries like China, Italy, Afghanistan and surprisingly, Iran. Knowing the importance of testing, the UAE sent numerous testing kits to Iran to help stop the spread of the virus.
By analyzing UAE, Germany, and South Korea, it’s clear that high distribution of testing kits has a clear correlation with a slower rate of COVID-19 spread. As global diagnostic capacity continues to increase, public health authorities around the world must follow the example of countries like the UAE and expand non-hospital testing to include patients without high-risk symptoms. Right now, the focus of international media outlets is myopic on the economic consequences of a global pandemic. While the threat to the global economy is undeniable, the importance of mass testing must be prioritized, both within media reporting and public health policymaking.
*Lin Nguyen is an analyst in South Asian regional security, focusing on economic and political developments. Nguyen works on projects advising South Asian government ministries and also private enterprises seeking to do business in the region. She leverages her experience to write publicly about pressing economic and political issues that concern Asia at large.