3.6 Comparing Responses in the UK and Other Countries
By Harriet Jones
PhD Student, Faculty of Public Health and
In this article we will recap the different prevention responses to the COVID-19 pandemic and look at how countries have taken different approaches to implement these.
1. Responses and Interventions
What are the possible responses to COVID-19? We’ve talked about some of these in the sessions you’ve completed already. We discussed social distancing, handwashing, testing, tracing and self-isolation as ways of preventing spread of
the virus. We also talked about increasing capacity of healthcare systems, and how antiviral drugs may help in controlling the disease. As well as these strategies, many countries have used travel restrictions, and rolled out large
scale testing programmes to try and stop the spread of the disease.
Countries around the world have taken different approaches, starting and stopping measures at different stages in their epidemics and with varying degrees of government enforcement. We will look at some examples of different country
responses here and think about some of the reasons countries may have responded differently.
2. What did countries do?
To get a comprehensive view of what different countries have done, look at the following map:
Figure 1. A Graph showing School closures based on COVID-19 reponse, worldwide. Source: Our world in Data
Figure 2. A Graph showing workplace closures based on COVID-19 reponse worldwide. Source: Our world in Data
Press play on the charts to compare when different countries introduced different responses, and how strict the response was.
Let’s look at the responses of some of the first countries to have COVID-19 cases. Several of these focused on containing their outbreaks when clusters of cases were identified. As we saw earlier, the first country to
have cases was China, and shortly after cases appeared in Thailand, Japan and The Republic of Korea.
China focused on containing the virus, with strict government enforced lockdown measures in Hubei province, where the virus started. In some areas, residents were not allowed to leave their homes at all. Infection control
measures in Wuhan included door-to-door health checks and isolation in hospitals of anyone found to be infected. Restrictions were placed on population movement and social distancing measures enforced across the country. Quarantine
rules were put in place so that people travelling out of badly-affected cities had to self-isolate. Later on in the pandemic, international travel restrictions were also used.
Republic of Korea and Taiwan
The Republic of Korea also focused on containment, with testing and contact tracing using mobile technology to identify and isolate cases. Taiwan took a similar approach, also using mobile
phone apps to track and trace and ensure people stayed in isolation. Both countries restricted international travel early on.
European countries have all taken slightly different approaches. Some quickly had widespread community transmission of the virus, which meant containment approaches were no longer possible. Many brought
in ‘lockdowns’ where everyone was asked to stay indoors for all but essential reasons.
Spain and France
In early March Italy became the first country to have a nationwide government enforced lockdown. Schools and universities were shut, travel restricted and public gatherings banned. The only shops that remined open were those selling
essential items such as food and medicines. Spain was the second country in Europe to be put into lockdown and France took a similar approach soon after.
The Swedish government implemented travel restrictions and social distancing measures, as well as moving to distance learning in schools and universities and banning large gatherings of over 50 people. The Swedish government did
not enforce a lockdown in the same way many countries in Europe did. Restaurants and cafes remain open, and small social gatherings are still permitted.
2.5 The UK
In the UK the government closed all non-essential shops and enforced social distancing measures relatively late (23rd March). People were only allowed to leave their homes for food shopping, essential work, medical reasons and
to exercise once a day. The UK is one of very few countries not to restrict incoming international travel or impose quarantine on travellers (though this is now being considered). The UK initially prioritised testing of people needing
hospital care for COVID-like symptoms, but has now expanded testing to include essential workers and other groups.
Some other countries took measures very early on in their epidemics, before they had many COVID-19 cases.
New Zealand banned internal travel from some regions on 2nd February. It recorded its first COVID-19 case on the 28th February. In early March it closed its borders to non-New Zealand citizens. Any
citizen entering the country had to self-isolate for 14 days. The government declared a state of emergency on the 25th March and brought in strict lockdown measures, which included social distancing, closing
schools and non-essential business and cancelling events and gatherings and non-essential domestic air travel. By this time there were only about 100 confirmed cases. New Zealand also conducted widespread testing and contact tracing.
The government of South Africa declared a National State of Disaster on the 15th March, at a similar stage in their epidemic to New Zealand, with about 60 confirmed cases and no deaths. They banned travel to visitors from high risk
countries and South African nationals returning home had to go into quarantine. They closed schools and brought in a nationwide lockdown on the 23rd March. They have been using mobile technology to track and trace cases.
3. Why have different countries responded differently?
There may be a number of reasons why countries have responded differently. Here are a few:
3.1 This could be due to a county’s capacity to respond, including the strength of their economy and health systems, as well as the existing burden of disease. Low-income countries often have
a high burden of disease and weak health systems and had to respond early because health systems would be unable to cope with large numbers of cases.
3.2 The geographical location of a country means that some country borders are easier to close than others, for example small island countries such as New Zealand can do this quite easily whereas landlocked countries in
visa-free travel zones may find it harder.
3.3 The timing of a country’s response is also relevant to which measures they introduced. Different interventions are appropriate at different stages in the epidemic. For example, testing and
contact tracing works when there are smaller numbers of cases before widespread community transmission.
3.4 How prepared a country was for a pandemic such as COVID-19 may have also informed their response. For example countries who had experienced outbreaks of SARS may have more experience of contact tracing techniques,
and be better prepared to respond to another severe respiratory disease.
3.5 Implementing a lockdown is very disruptive to people’s lives, and the wider economy of a country. If a country has very low case numbers, and no community transmission, a full lockdown might be a disproportionate response.
3.6 Epidemiological modelling can help a country design its response, and decide which measures are likely to be most effective. Strategies must be drawn up with a view both on what is going to be effective, and what advice your population is able
or willing to comply with (or what a country is able to enforce). Public education and clear communication is key to ensuring a strategy is followed.
It can be difficult to compare the results of different country’s control measures: in the next section (step 4.1) we’ll talk about how to interpret data on numbers of cases.
- IMF policy tracker: https://www.imf.org/en/Topics/imf-and-covid19/Policy-Responses-to-COVID-19
- WHO Europe http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/country-information
- Oxford University: https://www.bsg.ox.ac.uk/research/research-projects/coronavirus-government-response-tracker
- Evaluating how citizens feel about their country’s lockdown response: https://www.cam.ac.uk/stories/wintoncovid1
Figure 1. A Graph showing School closures based on Covid-19 reponse, a rolling 3 day average worldwide, Our World in data. 2020 [Website] accessed 20-May-2020, updated with all current data. Available via: https://ourworldindata.org/grapher/school-closures-covid
Figure 2. A Graph showing workplace closures based on Covid-19 reponse worldwide, Our World in data. 2020 [Website] accessed 20-May-2020, updated with all current data.
Available via: https://ourworldindata.org/grapher/workplace-closures-covid