RIO DE JANEIRO, BRAZIL – (Opinion) The spread of Covid-19 has exposed the challenges in tailoring the lessons that worked in Europe or Asia to poorer countries. Even in places where the novel coronavirus has caused destruction, examples of success can be found that should be studied closely in Brazil.
In the absence of centralized coordination by the federal government, fighting necessarily becomes a duty for local authorities. If we are unable to implement the same measures as Iceland, New Zealand, Japan, or China, there is no reason not to seek inspiration in countries closer to Brazil, such as India, Vietnam, or Colombia.
Take the example of Dharavi, the most densely populated slum in Asia, located near the Mumbai financial center in India. Nearly 800,000 people live there. A 10 square meter shanty houses families of up to seven people, and 80 share a bathroom. It is impossible to speak of “isolation” or “social distancing”. And yet Dharavi is defeating Covid-19.
“The only option was to fight the virus instead of waiting for the cases to surface. Working proactively rather than reactively,” said Kiran Dighavar, in charge of fighting the virus in Dharavi, according to the LiveMint website. Since April, authorities have knocked on over 47,000 doors checking temperatures and oxygen levels in nearly 700,000 people. There was a strict lockdown and testing of everyone with symptoms. Infected individuals were taken to schools and gyms converted into quarantine centers.
The result, according to Sighavar’s report, was a two-thirds drop in the number of daily cases from early May to mid-June, from 60 to 20. Elsewhere in the country, the numbers have quadrupled, turning India into one of the major Covid-19 hotspots on the planet. In Dharavi, more than half of those testing positive have recovered, compared to 41 percent in the rest of the country. Involvement between government and community leaders, with free food distribution, was crucial for motivation.
Another Indian example often mentioned is the state of Kerala, where the first case of Covid-19 in the country was recorded in January. When Premier Nahendra Modi ordered quarantine on March 24th, Kerala was the most affected state, with one-fifth of the nearly 600 cases. Today it is the 18th of 34 Indian states with less than 1,500 of the 175,000 active cases. Of the 13,706 deaths recorded in India, only 21 occurred in Kerala, according to Hindu.
Kerala’s strategy, with a population of about 35 million, was led by a 63-year-old former science teacher with thick glasses, Health Minister K.K. Shailaja. Since the first cases surfaced, she implemented a testing and tracking structure that kept 170,000 people in isolation, and provided shelter and food to 150,000 casual workers who could not return home (mostly from Persian Gulf countries).
Shailaja’s main asset is a comprehensive public health system, established over decades by local communist party governments, with primary care centers in every small town. In India, Kerala stands out as the state with the highest literacy rate, highest life expectancy, and lowest infant mortality. More than simply leftist, public policies have been consistent.
A further advantage was decisive: Kerala faced the outbreak of another virus in 2018, the Nipah, far more lethal than the new Sars-CoV2 coronavirus. Also originating in bats, which caused a highly lethal brain infection, Nipah killed 21 of the 23 people infected in Kerala at the time. It was fought swiftly and left the reminder of how vital it is to sustain an agile and effective tracking and isolation structure. Faced with Sars-Cov2, everyone knew what to do, according to reports in the MIT Technology Review, the Washington Post, and the BBC.
Vietnam is another country where a left-wing government has left a public health system that has proven effective in stopping the coronavirus. To date, there have only been 349 confirmed cases and no deaths there. Also present in Vietnam was the memory of the fight against SARS in 2003 and the H1N1 flu in 2009.
In addition to mass testing, nearly 45,000 people were quarantined in March, half of them in military camps, according to Reuters. Like China, Vietnam is an authoritarian regime, willing to keep cities of up to 10,000 inhabitants under lockdown and police surveillance and to keep carriers of the virus away from their families in order to isolate them. Its lessons have little merit in free, open-cultural countries like Brazil.
However, this is not the case in Medellín, Colombia, a city of 2.5 million inhabitants which, to date, has recorded only seven deaths according to official statistics. The scenario of slums and the difficulty of isolation in India or Brazil is ever-present there. The main tool used to stop the epidemic was an app, ‘Medellín Me Cuida’ (Medellín Cares for Me), used to track those infected, but also to ensure that the needy population had access to food and money provided by the government.
“It is impossible to fight the virus without information,” Mayor Daniel Quintero, a 39-year-old engineer, told the Associated Press. As in Kerala or Vietnam, early action was crucial. About 1.3 million families were registered, allowing the government to monitor the location of those infected and to allocate resources — particularly tests and oximeters — to high-risk areas. The effectiveness of testing contrasts with the rest of the country.
Naturally, the massive collection of data aroused concern over privacy and led to two lawsuits. The government was forced to modify the app after losing one of these lawsuits. This is not a hollow concern. The degree of invasion of citizens’ lives raises concerns in the most successful countries in the fight against the virus, such as South Korea or Singapore.
Authoritarianism and invasion of privacy are risks inherent to the centralization of activities in any government. But they are not excuses for the state’s omission. The agile and rational use of health resources is critical. The health emergency requires an organization that is not incompatible with democracy. If there is something all examples have in common, it is not the governments’ ideology or degree of authoritarianism. It is the mere fact that they do not reject scientific reality and do not shy away from acting as quickly as possible to save lives.
Source: Helio Gurovitz Blog, G1 June 22nd 2020