Clinics and hospitals around the world are battling Covid-19, a disease caused by a new coronavirus. However, victory in this battle depends largely on the effectiveness of the healthcare system. In which countries of the world does humanity have a better chance of success? While we observe a clear correlation between a country’s ability to contain the spread of the virus and the previous ratings of its health system: the higher the rating, the better the results.
For the purposes of this article, we referred to the 2019 ratings compiled by the London-based analytical center Legatum – the Legatum Prosperity Index. It is based on 12 criteria, including economic and social performance, well-being and prospects for prosperity in 167 countries around the world. The health criterion measured the effectiveness of the health care system, incidence of disease, risk factors, mortality, and accessibility of medical services. We talked to residents (including doctors) of some of the best countries in terms of “health” to find out what aspects of health system organization are helping them cope with the virus, what problems they may face in the future, and what these people think about life in their country.
Japan ranks second on the health indicator. Its rapid response to the pandemic has been praised by experts around the world, but a recent spike in the number of infected people has prompted the authorities to take additional measures. On April 7, the Prime Minister declared a state of emergency in almost all of Japan.
Many Japanese people wore masks before the pandemic, so they didn’t have to adapt for a long time. However, the country has not yet implemented a self-isolation or quarantine regime, largely because the health system was able to contain the spread of the virus in the early stages. Even if residents of the country do not have the opportunity to take a COVID-19 test (which is only prescribed for those with severe symptoms), they can go to a local clinic and get a CT scan. “A patient with no symptoms can be diagnosed with pneumonia using CT scans, even in the early stages of the disease,” says Tokyo-based physician Mika Vasio, who works with AirDoctor, a company that helps travelers find the right doctor. “In such cases, the patient is offered treatment quickly. This is one of the reasons why there are not many severe cases in Japan.” In addition, Japanese specialists are tracking infection clusters to locate them and minimize the spread of infection. The Japanese are accustomed to taking care of their health, and this is helping them cope with the crisis. “Many people used to wear masks, especially in winter and spring, and that is another reason why we have not seen a catastrophic increase in the number of infected people,” says Vasio. Another reason is that more than 60% of Japanese people get an annual health checkup, so we strive to keep ourselves in good shape.
In Hokkaido, Japan, the first extraordinary measures have been introduced, and there are no plans to abandon them. Of course, this does not mean that there are no problems ahead. Vasyo notes that under different circumstances, many patients diagnosed with coronavirus should have been hospitalized, but authorities are trying to save available space for the most severe cases and are ready to allocate additional resources in the near future to fight the pandemic.
South Korea ranks fourth in the Legatum Health rankings. In 2015, the country had experience dealing with an outbreak of another dangerous virus – MERS (Middle East Respiratory Syndrome) – and that experience has come in handy now. Hospitals are equipped with the necessary equipment, and medical personnel are trained in how to respond to such a crisis. In the country, they have managed to test over 450 thousand people for the virus – slightly less than 1% of the population of 51 million. In the last few days, the daily number of new infections has fluctuated between 47 and 53. The way the healthcare system is organized in South Korea also contributed to the early diagnosis and treatment of Covid-19. The entire population is fully covered by the national health insurance system, which ensures low treatment costs and government-regulated prices for medical services. The scans and tests are done within the framework of the national health system, points out Dr. Brandon B. Su, a Seoul-based physician who heads Lunit, a company that develops artificial intelligence tools for use in medicine. “Since the beginning of the Covid-19 outbreak, many patients have been diagnosed in the early stages of the disease and treated promptly,” he says.
Taegu, the fourth largest city in South Korea, has become one of the epicenters of Covid-19 in that country. Government and business leaders were able to quickly implement the necessary precautions. “The government ensured a stable supply of masks by setting up a special sales system where each day corresponded to the last digit of the year of birth,” says office worker Yongbok Lee from Seoul. In many places, people’s temperatures are taken when they enter a building, and thermal imaging cameras are installed in places where there are many employees. Korean disease control centers and other government agencies are working tirelessly on the front lines, and people understand and appreciate their efforts. Private health insurance is also widespread here, with 77% of citizens using it to cover what is not covered by the state system, according to Insurance Business Asia. Overall, the rapid response to the pandemic threat allows Koreans to hope for the best rather than despair. “Objectively speaking, the pandemic is clearly waning,” says Su. “People have started to go out into the streets, although they are still wearing masks all the time.”
The explosion in popularity of the nostalgic recipe for Korean cold Dalgona coffee is associated with social distancing and self-isolation. Van Won John, a resident of the city of Tegu, one of the epicenters of the Covid-19 outbreak in the country, notices that life is slowly returning to normal. “We take short walks in our neighborhood, although we try not to be in crowded or closed places. I believe it is right to stay at home and limit our movements for the safety of individuals and society as a whole,” she says. Still, she can’t wait for the day when she can go to the amusement parks her child loves so much: “I want to sit somewhere with friends and talk, drink, and enjoy each other’s company.” First-year student Vubek Lee from Chuncheon also misses normal life. “I want to go back to regular classes, not online,” he says. “The first thing I plan to do when all this is over is to get to know my classmates in person.”
Israel is ranked 11th in the Legatum Health Index. What are the peculiarities of this country’s response to the threat of Covid-19? Few other countries acted as quickly.
The quarantine measures implemented in Israel seemed overly strict at first, but it soon became clear that they were working. We explain quickly, simply, and clearly what happened, why it matters, and what happens next. The number of offers should remain : Episodes The end of the story: Podcast Advertising By the end of January 2020, the Ministry of Health had already issued the “Decree on Citizens’ Health,” which expanded the authority of the agency in the matter of containing a potential disease outbreak. At the time, the measures seemed too strict, but now it is clear that, for example, self-isolation for two weeks for everyone returning to the country from pandemic “hotspots” and exemptions for non-critical international travel resulted in lower levels of infection and hospitalization compared to other countries of comparable size. Accurate testing was also introduced early on. “The molecular diagnostic test (RT-PCR) for detecting the presence of coronavirus in respiratory samples was developed very quickly at the Central Virology Laboratory and transferred to numerous laboratories throughout the country,” says Kitan Mukhsen, Professor of Epidemiology and Preventive Medicine at Tel Aviv University and one of the advisors to the Ministry of Health on Covid-19 issues. “Israel is one of the world leaders in the number of COVID-19 tests per million population,” he adds.
The most severe outbreak of coronavirus infection in Israel occurred in the ultra-Orthodox Jewish communities. “I’m really proud of the number of tests we do here, that’s why our infection rate is so high,” says blogger Talia Klein Perez, who lives in Kfar Saba, northeast of Tel Aviv. “On the other hand, our mortality rate is one of the lowest, and I believe the rapid quarantine measures have contributed to that.” The government health system allows for a more integrated and centralized approach to solving the problem. “People are not afraid to seek medical care because they know they have insurance and it will be free,” says Professor Arnon Afek, Deputy CEO of Sheba Medical Center, the first hospital in the country to begin treating coronavirus patients. “The cost of medical services in these situations is very important because it is necessary for people to seek help when they have symptoms. In this case, we identify them and they stop spreading the infection”.
However, according to Afeq, there is still not enough funding in Israel to meet healthcare needs. “But on the other hand, it means that we are working very efficiently, actively and quickly adapting to the situation,” he points out. “At Sheba, we always strive to think two steps ahead and solve problems before they overwhelm us. We anticipated the future and created a specialized intensive care unit for coronavirus patients. We trained additional staff to work in it, even before the load on the system increased significantly. And when patients started coming in, we were prepared. This country also has unique problems. For example, ultra-Orthodox Jews have no television, no Internet, and no trust in authorities, so the number of infected people among Hasidim is much higher.
Ultra-Orthodox Against Coronavirus “We had to learn how to explain to them the danger of what was happening,” says Afek. “And we succeeded, and now they are determined to stop the spread of the virus.” Klein Perez is mentally prepared for the fact that the need for self-isolation will last for a long time and tries to maintain a positive attitude. “It is better not to wait for everything to end quickly, then the way out of the lockdown will be a pleasant surprise,” she believes. “Air travel, restaurants – all that is far away, they say not before September. What I really want now is to sit quietly with friends over a cup of coffee. Germany has a lower coronavirus mortality rate than most of its European neighbors. It ranks 12th in the world in terms of health care, and its success in fighting the pandemic has been noted worldwide. However, experts warn that it is too early to relax, the country has not yet emerged from the crisis. “A high level of testing and a low mortality rate can create the illusion that the German healthcare system is handling the crisis excellently,” said Francis de Vericourt, professor of scientific management methods at the European School of Management and Technology in Berlin and keynote speaker at the upcoming International Congress on Infectious Diseases. However, the country has been apparently successful in isolating sick and asymptomatic patients from the rest of the healthy population, helping to contain the spread of the infection. But it can also have the opposite effect if residents are not careful. “The fewer people have had Covid-19, the fewer people have immunity,” explains de Vericour. “Therefore, it will only be possible to abandon social distancing measures when there is not a single case of Covid-19 left in the country, otherwise we will face a second major wave of infections.”
The Germans’ love of walking in nature is not compatible with the imposed restrictions. Germans have already come to terms with the idea that normal life will not return soon, but they are trying to keep hope alive. “The hardest thing for me personally is to keep my mother from leaving the house,” says Ingrid Grus, a resident of Murnau-am-Staffelsee, in the foothills of the Bavarian Alps. “I made her a mask, and today, for the first time in three weeks, we are going to the store together. It is important for her to do her own shopping. “As the number of new cases decreases, I believe it is appropriate to relax precautionary measures. I am confident that our authorities will try to find the right balance between a gradual return to normal life and maintaining the rules that protect people”. The country’s healthcare system is supported by the fact that it is federal, with powers delegated to the regions (countries), unlike the national systems of France or the United Kingdom. Experience has shown that this is more efficient when a rapid response to a growing crisis is needed. “The management of resources (places in hospitals, intensive care units, doctors) is decentralized and the responsibility lies with the local authorities. This means that all political parties, left and right, are responsible.
And this facilitates cooperation, which can be described as a key factor in containing the pandemic and treating patients. “I was very happy to live in Germany, I was very happy that the Bavarian government introduced self-isolation – it was the right and necessary reaction to a very difficult situation we found ourselves in,” says Laura Grus, a student at the Technical University of Munich. “I was planning to fly to Buenos Aires in July to spend a semester there. Now it’s possible that I won’t be able to make it, which is very disappointing. But I know that I am still very lucky, so I try not to complain about the restrictions I have to abide by in life. Overall, it’s a good opportunity to relax and find time for the things I didn’t have time for before.
Restrictions are beginning to be eased in Germany, with schools gradually reopening on May 4. According to De Verikura, the real challenge for healthcare is the need to ensure a system that provides not only medical facilities and ventilators in hospitals, but also simple things like hand sanitizers, which have disappeared from pharmacy shelves in many European countries. The number of supplies should remain the same. “The self-disinfecting gel is still available, it’s just that the plastic bottles have run out,” explains de Verikur. “This underscores once again that in this crisis, sometimes things come to the forefront that we never thought about before.”
Australia is ranked 18th in the world in terms of health. The country is doing a better job than expected of containing the rate of infection, Prime Minister Scott Morrison said on April 7. Australia’s mixed public (Medicare) and private healthcare system has prepared the country for a worst-case scenario. “For the current pandemic, this two-tier system is the most appropriate because it allows for preparation to accommodate an increasing number of patients in reception rooms and intensive care units,” says Alex Polyakov, Senior Lecturer at the University of Melbourne. “The federal government and state authorities have decided to postpone all scheduled surgeries, which has allowed private hospitals to prepare for an influx of Covid-19 patients.” This, combined with state financial support for private clinics in exchange for their beds and use of their doctors, has doubled the capacity of the state system.
Australia’s Bondi Beach, one of the top 10 beaches in the world, was closed on March 21 after vacationers clearly disregarded the rules of social distancing. Australia also has a small number of cases of local transmission of the virus. The government has implemented a rapid contact tracing system and mandatory quarantine for those returning from overseas travel or who have had contact with an infected person. “If the number of infection cases is successfully contained, you can expect a very low daily increase over a long period of time,” Polyakov says. “And that is what the smoothed curve represents.”
“I was in Sri Lanka when the Covid-19 pandemic began to spread around the world,” says Chris Stevens, lead travel blogger for the Stoked For Travel website. “The situation quickly escalated into a crisis and I had to leave urgently – I received a notice that I had to leave the country within 48 hours.” “I had two options – go back to Europe to my parents or go to Australia where my brother has a house. I talked to my father, a paramedic with 40 years of experience, and he said Australia was the best option. Upon arrival, Stevens was placed in self-isolation for two weeks to determine if he was infected.
Australian health authorities have opened additional Covid-19 testing centers in areas where there has been an increase in viral infections. If current trends continue, Australia’s healthcare system is expected to be able to meet the expected increase in demand for ventilators and ICU beds. Once the quarantine measures are relaxed, Australians plan to return to their normal lives with their usual pleasures. “I can’t wait to sit in my favorite coffee shop with a cup of coffee, in the sun, with my best friends, chatting and laughing,” says Sydney resident Jennifer De Luca, author of articles for the Luxury Adventure Travel website. “In short, I want what we used to do every week without thinking and without taking it for granted.”
You can read the original article on the BBC Travel website.