What countries can – and can’t – learn from each other
Brazil has lost two health ministers; their replacement is a general. The country now probably has the highest prevalence of active coronavirus infections in the world.
South Korea was briefly the worst hit country outside China. It has suppressed the virus, albeit with myriad curtailments of everyday life. Just 280 people have died in total. In the UK in mid April, that death toll would have been reached each morning before breakfast.
Vietnam went in hard, early, rapidly restricting movement and introducing a vigorous contact-tracing programme. There have been a few hundred confirmed cases and no deaths.
Germany rolled out a massive, decentralised testing and contact-tracing programme to help slow the spread of the virus, then introduced a lockdown early on the epidemic curve. Economic damage was contained, while the death rate is much lower than in France, Italy or Spain.
Sweden opted for a policy of “herd immunity”, keeping schools and businesses open and relying on distancing measures. An influential Swedish epidemiologist, Johan Giesecke, declared that the fatality rate was probably about 0.1 per cent — much less deadly than feared elsewhere. Sweden has the highest infection prevalence in Europe right now, by design. The flow of new confirmed cases is still growing.
The UK flirted with herd immunity, too, before locking down late and discharging some elderly people from hospitals into care homes without testing them. One in 16 residents of care homes in the UK has already died, according to Stuart McDonald of the Institute and Faculty of Actuaries, and Britain has arguably suffered one of the most deadly outbreaks yet of any country. Shops are open. For most pupils, most days, schools are not.
As for the US, the response has been so diverse across different states as to defy easy description. “A patchwork of state reopenings,” the Washington Post called it in mid May, adding that it was “a deadly game of trial and error”.
It is certainly true that this messy diversity of approaches, both in the US and worldwide, makes it harder for all simultaneously to suppress the virus like South Korea. But global suppression now seems impossible anyway.
At least the unnerving lack of co-ordination is an opportunity to learn what works by comparing different approaches. In 1932, US Supreme Court justice Louis Brandeis wrote: “A single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.”
In the case of an infectious disease, one could hardly say experiments are without risk. But perhaps we should be reframing the sprawling variety of responses as a chance to learn from the laboratory of those who do things differently.
The economist Charles Manski argues persuasively that modelling only teaches us so much about an uncertain future, whether the modellers are economists or epidemiologists. Ultimately, one must learn from experience. The more experiences cities, states or nations are having, the faster we can learn from each other.
But it is one thing to be presented with an object lesson. It is quite another to learn from it. It seems clear that western countries learnt too little from the experience of Sars. And even when the new virus hit Italy, other European countries seemed to hesitate before acting in earnest. The delay was fatal.
Why were so many countries so slow? I asked Jill Rutter and Gemma Tetlow of the Institute for Government. One problem they identified — which is both pathetic and all too human — is that it is simply more convenient to learn from countries with a shared language. There is plenty of information in the UK about what is going on in New Zealand, the US, and Anglo-fluent Sweden. Dispatches from South Korea or Vietnam seem to come from a different planet.
It should be possible, of course, for diplomats to gather information from anywhere in the world. But the people in the UK government with contacts in Hanoi and Seoul are not necessarily those with contacts in public health and epidemiology.
Ideology matters, too. For some politicians, the US is the role model to be emulated. For others, Scandinavia is the paragon. The current British cabinet seems disinclined to learn anything from Germany, while nobody seems to care about Vietnam.
There is another reason why countries are often not set up to learn from others: each place has its own institutions, culture and history. In most policy areas, lessons do not easily translate. There is a limit to how much the UK really can learn from Japanese banking regulators, or what Ethiopia can conclude from a study of German pensions. The starting points are so far apart that the lessons are obscure.
Coronavirus is different. It doesn’t care about cultural norms and barely about the level of economic development. There are ample lessons we can learn from each other about how to deal with it. But they must be learnt quickly — and we are not in the habit of studying.
Written for and first published in the Financial Times on 19 June 2020.
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