It seems like some countries have figured out not only how to flatten their coronavirus curves, but also how to send them plunging downward.
From Slovenia to Jordan to Iceland, governments took early action to impose lockdowns, test and trace thousands of people, isolate the sick, encourage social distancing and preventive measures like mask wearing, and communicate honestly with the public.
Those interventions curbed the number of new confirmed Covid-19 cases and deaths, allowing leaders to reopen schools and businesses and reintroduce a sense of normalcy into everyday life. Some are now reporting no new confirmed cases or deaths.
In effect, they followed the prescribed playbook for such a pandemic, and — surprise, surprise — it worked.
“At the end of the day, it’s not magic. It’s shoe-leather public health,” Thomas Bollyky, director of the global health program at the Council on Foreign Relations think tank, told me. Nothing is a better substitute for speed and aggressive action, he said.
What makes their feats more impressive is just how different the countries are. Greece, for example, is in Europe — one of the world’s coronavirus hotspots — but managed to escape the worst despite receiving large numbers of tourists and a busy Easter holiday.
Vietnam, meanwhile, avoided a major outbreak despite having a large land border with China and limited financial resources.
A country’s inherent characteristics, then, seem to matter less than the seriousness and speed of a government’s response.
Which means there are many lessons the world can learn from little-noticed coronavirus success stories. Here are just five of them.
Vietnam stopped a coronavirus outbreak with early and robust action
Vietnam is a lower-income, densely populated country that shares a large land border with China, where the outbreak first began. That, on the surface, would seem to make Vietnam extremely vulnerable to the coronavirus.
But the Vietnamese government acted strongly early, even before the World Health Organization said the outbreak was a global public health emergency, and today it has yet to confirm a single death from the disease.
Its response has so far proven a success by doing three things: a lot of testing, a lot of contract tracing, and a lot of quarantining.
The country started developing tests almost immediately after it confirmed in January that three people traveling back from Wuhan, China — the disease’s origination point — had the disease. Vietnam has since tested nearly 300,000 people.
That seems small compared to the millions tested in the US, for example, but it’s a major outlier in looking at how many people the government tested per confirmed case.
Vietnam went through a testing progression: First, it tested people with who were known to have traveled; then it moved on to testing those people’s close contacts; and finally, it began testing anyone presenting coronavirus-like symptoms.
Only recently has the government begun to test widely in major hot spots and risky locations, such as markets in the city of Hanoi.
This plan made sense for one major reason, namely, that focusing testing resources on those around the original sick people and isolating those with symptoms would effectively cut the outbreak off at the source.
The government also made sure few cases could make it into the country by ending flights from the most impacted countries early. Travelers at ports of entry also had to go through temperature screening and had to self-report their health statuses. If someone lied on their health declaration or resisted screening, they could be criminally charged.
Those found to be sick, whether at the airport or elsewhere, were placed in quarantine facilities for 14 days, free of charge. Self-isolation at home isn’t permitted in Vietnam, as the government worries those with the disease might give it to their family members.
It also helps that the public has received and accepted what health officials tell them, as many abide by the government’s guidelines like social distancing and mask wearing. That only makes the country’s broader response easier.
Students as of this week are back in class, and the economy is on the way to reopening completely — showing how just how successful an early and robust coronavirus response can be. Vietnam didn’t use fancy technology or new methods. It just did the ordinary things extraordinarily well.
Slovenia kept people at home and others away from the country
Slovenia, a country of just over 2 million people, has nearly 1,500 confirmed coronavirus cases and 100 deaths, as of May 5. The relatively small outbreak is impressive, considering Slovenia is a growing tourist destination that borders Italy, one of Europe’s outbreak epicenters.
Its success mainly stems from an aggressive early lockdown, quarantines of sick people, and generous government spending.
The country’s first case was confirmed on March 4, and it only took Slovenian officials about two weeks to close schools and businesses and freeze public transportation. The government also gave 3 billion euros — 6 percent of Slovenia’s GDP — to citizens and businesses to survive the shutdown. (Last week, however, several hundred people protested the center-right government’s strict lockdown policy.)
Quarantines also helped keep confirmed cases low. In early April, most people entering the country — Slovenians and foreigners alike — had to go through a mandatory 14-day quarantine.
There were no dedicated facilities for that, only that person’s home or a hotel they were staying at. Whoever was in quarantine would have to rely on either family members, friends, or volunteers to bring them food and other necessities. Such measures almost surely kept many from traveling to Slovenia, slowing the number of potential infections.
The situation in Slovenia has improved to the point that businesses have already begun opening up again, and citizens can travel outside their municipalities. Schools will also start back up on May 18. Major public events, like concerts and soccer games, will still be suspended until a vaccination for the coronavirus is found.
What Slovenia has shown, then, is that aggressive government action and intervention can help keep people from spreading the disease. Even by the government’s own numbers, it could do more testing, but for now, the current measures appear to be working.
Jordan made coronavirus plans weeks before it arrived
Any list of countries that acted early to confront the coronavirus must have Jordan toward the top of it.
Jordan’s first confirmed coronavirus cases arrived on March 2. But five weeks before that, the country’s committee to combat the disease — formed as news about an outbreak in China came out — already had protocols in place.
Those measures included designating which hospitals would treat infected patients and how, exactly, doctors would take care of them. And the government, at the request of the king, also passed emergency laws to allow the military to enforce a strict lockdown and curfew.
These swift and forceful actions, in the minds of Jordanian officials, is what has kept the country to under 500 confirmed cases and about 10 deaths as of May 5. “Timing was key for us,” Bassam Hijjawi, an epidemiologist on the country’s coronavirus committee, told Al Jazeera in April.
By mid-March, schools, businesses, and government officers had been closed. Borders were also closed, with repatriated Jordanians having to spend 14 days in quarantine at hotels.
The lockdown continues, with a siren ringing every day at 6 pm across the country to remind everyone they should be at home until 10 am the following morning. The use of vehicles is prohibited, unless someone has a special license for essential business, and all large gatherings — including prayer services and funerals — are banned. People can be fined or jailed for disobeying these orders.
While the vast majority of people stay at home, the government is testing about 2,000 to 3,000 people a day to track the disease and those in contact with infected people.
That’s not to say Jordan hasn’t had a close call. The country’s epicenter was in the northern city of Irbid, Jordan’s second-largest urban area. About 450 people attended a wedding despite government advice against large gatherings, and soon cases shot up there. The government quickly sprang to action, though, imposing the nation’s harshest lockdown measures and cutting off the city of over 1 million people from the rest of the country.
Jordan’s aggressive measures are finally easing up. On Sunday, the government said it has lifted all restrictions on economic activity. Many businesses are back to work, though some still want employees following social distancing and proper hygiene guidelines. However, schools will remain closed and the curfew remains in place.
What’s clear, then, is that Jordan acted far sooner than most to contain its outbreak. Preparing for a problem and then following through on that plan actually works. Imagine that.
Iceland is testing, testing, testing
Iceland has turned testing and tracking into a new national pastime.
An island of over 350,000 thousand people with only one point of entry — its international airport outside the capital of Reykjavik — Iceland was always unlikely to be devastated by the coronavirus. But that didn’t mean Icelandic officials could just ignore the virus. In fact, they did the opposite.
Iceland has tested 13 percent of its population with the help of a local company, DeCode, which has built the world’s most robust testing and tracking program. Just look at the chart below, which shows how Iceland has conducted far more tests per 1,000 people than many other countries.
People found to be sick or in contact with a sick person were put in isolation until symptoms subsided or didn’t show, keeping the rest of the population safe from a growing spread.
That program proved immensely valuable. It wasn’t long ago that Iceland was counting over 100 new cases a day. Now, some days feature only a handful of new cases — or some days none at all. “I didn’t expect the recovery to be this fast,” Thorolfur Gudnason, Iceland’s chief epidemiologist, told Time on Monday.
The nation has seen just around 1,800 cases and 10 deaths as of May 5.
Iceland was also able to curb the outbreak without completely shutting its economy down or closing all schools — decisions that had many skeptics.
People who were not in quarantine for having tested positive or having come in contact with someone who tested positive were still allowed to go outside, as long as they followed the government’s social distancing and hygiene guidelines, such as staying six feet apart and washing hands for at least 20 seconds.
Icelanders have largely abided by these protocols. There’s also an app people can use to get a better sense of local coronavirus hotspots.
The country, then, isn’t completely back to normal yet — but it’s in a prime position to be soon.
Greece bolstered its ailing health care system
Few expected Greece to weather the coronavirus storm particularly well. It has a struggling health care system, an older population, and an economy that relies heavily on tourism. If any country was likely to become the next European hotspot, it was Greece.
Greece achieved this by imposed a stringent lockdown, promoting social distancing, and bolstering its health care sector.
The country’s lockdown began in mid-March, with authorities on the street telling people to stay in their homes. And that may not have even been necessary, as by most accounts the majority of people abided by the government guidelines calling for people to stay at least six feet away from each other and to wash their hands frequently.
Many people even chose not to gather together in large groups to eat during the Easter holiday, a major tradition in the country. Still, officials worked to avoid temptation by shutting down major carnivals in big cities, as well as schools, restaurants, and nonessential travel.
The government also worked to dissuade tourists from traveling to Greece, asking visitors to quarantine for two weeks before entering or else pay a fine of over $5,000.
“We acted preemptively,” Giorgos Gerapetritis, the Greek minister of state, told reporters in April. “We consciously preferred to make a significant financial sacrifice rather than sacrifice human life,” he said.
Getting Greece’s health care system back on its feet, though, may have proven the most decisive action. The country has increased the amount of intensive care unit beds it has available by 70 percent since February and has added over 3,000 hospital staff to deal with an expected influx of patients. Thousands more positions are open for people to fill, showing the resources Athens has put behind reconstituting health care in the country.
Greece has done so well that it’s already asking tourists to come to the country for the summer months. That worries some experts, as having people walk about the country could further spread the disease. What’s more, testing isn’t widespread in Greece, and the ability to keep tabs on a larger outbreak might put the country in danger in the future.
But for now, officials in Athens have seemingly done a fine job in curbing what could’ve — and perhaps should’ve — been a much larger crisis.
What all the five cases make clear for the Council on Foreign Relations’s Bollyky, then, is that countries “should act decisively, early, and aggressively.” Without such haste and effort, a large coronavirus outbreak is almost bound to happen.