The Covid-19 pandemic has shown the world a great deal about administering public health issues and about the health care systems in many countries.
Taiwan, for example, is a country with just shy of 25 million people that has had only 10 deaths from the virus. How can you explain that when the U.S. has to date suffered just over 200,000 deaths in the same time period? Well, when the virus arrived early this year, the vice-president of Taiwan was an epidemiologist by training with the responsibility for public health policy. Moreover, the nation has universal health care and each resident has a health number.
The Taiwanese government, almost from day one, implemented an extensive testing program and, when a positive case was identified, that individual was ordered to immediately quarantine for 14 days; then the system checked on each such case at least once a day. If the quarantine was violated there were substantial fines and possible incarceration in a public institution.
At the same time, contact tracing was implemented so hot spots were quickly identified and resources were concentrated in those places. Wearing masks was made compulsory. Also, people arriving on the island were tested and were immediately quarantined if they tested positive.
The Taiwanese results are the best in the world. South Korea and Singapore are close behind in dealing with the virus with limited infections and, more importantly, low death rates.
Europe and North America have not been so fortunate. In Europe the response was less immediate than in Asian countries and varied in effectiveness.
Italy and Spain suffered the highest infection and death rates and it took several months until the rate of infection began to decline. South America and South Asia (India, Pakistan and Bangladesh) have suffered greatly.
In Canada, the infections first hit significantly in long-term care facilities where patients were often living in close proximity, caregivers were often working in more than one facility and visitors to these care centres were often not controlled. Public health authorities, both national and provincial, began to impose constraints on public meetings and ordered lockdowns in most communities. Gradually the rate of infection began to decline; though, of late, a second wave of infection seems to be building as people tire of constraints and many ignore social distancing rules and the need to wear masks.
The United States, however, is a horror story when it comes to Covid-19. With more than 7 million cases and more than 200,000 deaths from the virus, this nation has the worst results of any developed nation.
There is no national plan to deal with the pandemic, each state is going its own way and the president and his supporters are trying to play down — if not outright ignore — the recommendations of epidemiologists as to what should be done. Testing in many regions is almost non-existent.
Further, costs of tests can range from a few dollars to more than $6,000 (in at least one case where a hospital billed a patient for a test).
One of the reasons why the incidence of infection has been so high is that more than 30 million Americans have no health insurance. Moreover, the Republican administration is seeking to overturn the existing Affordable Care Act. If successful, this effort will see up to 60 million more lose their coverage. When you have a fragmented health-care system that is primarily focused on profit generation and a government administration trying to play down the severity of the pandemic in an effort to get re-elected, the population is doomed to suffer.
I find it difficult to understand how 90 million citizens without basic health-care insurance would be a desirable situation for any country. For the richest nation in the world, it is both a scandal and a calamity.
David Bond is a retired economist living in Kelowna.