An Analysis – Pandemic Response in US, NZ & India

The COVID-19 pandemic has had a devastating impact on the overall working of almost every country in the world. However, some claim to perform better than other countries while some claim so based simply on statistics from their own country. But can we actually compare the performance of two or more countries in handling the COVID-19 pandemic?

The onset of the Covid-19 pandemic has brought with it a wave of experts and policy makers, eagerly working on comparisons between performance of governments and impact of the pandemic in different countries. However, often, the countries in question have almost nothing in common. Nonetheless, the comparisons are still carried out and conclusions are widely circulated.
The most recent example of such an extreme comparison is that of the world’s first Covid-19-free country – New Zealand. The Oceanic island nation off the coast of Australia has successfully managed to control the spread of Covid-19 and is ready to reopen businesses and offices and allow its citizens to roam freely, once again. However, almost every developed and developing country has had comparisons being made between New Zealand and themselves, without considering the countless differences between them. While there are various factors that make comparison between many countries invalid, in many cases, different countries can learn from other countries how to better handle a crisis. To explain this, we take the example of New Zealand, India and the United States of America.
The three countries have been affected by Covid-19 since January 2020. However, the performance of all three countries is widely different from each other. New Zealand became the world’s first country to be free of Covid-19. On the other hand, the US, with a GDP that is 98.6 times that of New Zealand, is still struggling to bring the daily increase in active Covid-19 cases under control. Similar is the case with India. However, a number of reasons make the situation in the three countries very different.

How are they different?

The very first factor that makes them incomparable is the forms of government and distribution of decision-making powers amongst different levels of the government. In the USA, the government follows a federal, presidential form of government and the law of the constitution is supreme. Thus, the administrative and legislative powers are widely and clearly distributed between the President, the Congress and the state governments in the US. In New Zealand, which is a unitary, constitutional monarchy, the state is ruled by a monarch (presently Queen Elizabeth II), whose role is carried out by the Governor General. In both these forms of government, despite having huge disparities, the effectiveness of the government in handling a crisis is enhanced as the roles of different government bodies is pre-defined. However, India, although largely federal, often has a conflict in implementing constitutional roles due to vast misunderstandings and simultaneous power politics played by different governments. This confusion and shortcoming becomes even more pronounced during a crisis when different government bodies keep passing the buck of responsibility, thereby delaying response time and effectiveness of a ‘prompt response’.
Apart from this, the per capita incomes of the three countries portray huge variations. A higher per capita income, as is the case with New Zealand and the US, simply means that residents of the country have a higher capacity to spend on healthcare, personal hygiene and on maintaining their immunity. In the case of a pandemic, these capabilities can mean the difference between life and death. India’s much lower per capita income restricts the ability of its people to spend on healthcare. Moreover, the population density in India is nearly 455 persons per square kilometer. This number reduces to 36 persons in the US and to just 18 persons in New Zealand. This would mean that the Indian government has a lot less space, particularly in its metropolises, to come up with impromptu emergency services. In the case of Covid-19, it would also mean that maintaining social distancing would be nearly impossible due to the high population density in India. On the other hand, it would be extremely easy for people in New Zealand and in the US to maintain social distancing.

What can we learn?

India and New Zealand

Despite the numerous differences listed above, India can learn quite a lot from its counterpart. One of the major shortcomings in India is the percentage of Gross Domestic Product (GDP) that the government spends on developing the country’s public health system. Government of India’s public expenditure on health as percentage of GDP is only about 1.28 per cent. However, public health expenditure as percentage of GDP is nearly triple in the case of New Zealand at 9.17 per cent. This means that even though New Zealand’s GDP is almost 1/13th of India, it dedicates a larger proportion towards development of healthcare systems. Moreover, the per capita expenditure on health in the two countries also depicts a drastic difference. In India, per capita public expenditure on health is just USD 21.91 while that in New Zealand is USD 3937.2. It is high time for India to increase spending on development of public healthcare and immunity if it wishes to be ready to handle the next pandemic efficiently.
Secondly, components of the existing health infrastructure in the two countries also vary greatly. While India has just 0.53 hospitals beds per 1000 population, New Zealand has 2.61 beds per 1000 population. These characteristics, along with many others, are such that they cannot be changed in a short period of time. Moreover, they show the constant neglect of successive Indian governments in making public health services better in the country. Thus, one of the major lessons to be learnt by India is to improve its policies to better suit the promotion and development of healthcare infrastructure in the country.

The US and New Zealand

Comparison between the US and New Zealand shows peculiar differences. Both the health expenditure (per cent of GDP and per capita) is a lot higher in the US than in New Zealand. Despite having a well-equipped public health infrastructure, the number of Covid-19 positive cases in the US is increasing. Here, the difference arises in strict implementation of policies. Even though the US government may have made all provisions to handle an emergency, without proper implementation of policies and a strong leadership, the country will fail to deal effectively with the crisis. Thus the US government needs to focus on stricter implementation of government policies and rules.
Although comparisons between two countries can often prove to be problematic due to various differences, there is a lot to be learnt from the experience of others, especially in times of an unprecedented crisis.

The Tale of Unsung Success
In the list of countries that have managed to control the spread of Covid-19, Iceland and Cambodia deserve a special mention. Both countries have managed to virtually stop the spread of Covid-19 with no deaths reported in Cambodia and only 10 deaths in Iceland. But how did they manage to achieve spectacular success while their wealthy counterparts, the US, Britain and Germany are still struggling to flatten the Covid-19 curve?
The Icelandic government imposed a string of actions and measures in order to get a jump start in fighting the virus. As early as in January, Víðir Reynisson, Director, Emergency Management; Þórólfur Guðnason, the country’s Chief Epidemiologist and Alma Möller, Director of Health, Government of Iceland, were alerted by news of the virus spreading in China. Although, no one could have anticipated the extent to which the virus would spread, the ‘trio’ of Iceland’s Covid-19 response team sprang into action and started issuing guidelines and imposing strict rules. They also started analyzing the country’s readiness, in case the pandemic reached their country, and preparing their healthcare staff and infrastructure for the worst. Moreover, a dedicated team was set up in order to carry out intensive contact-tracing for those found to be Covid-19 positive. Reynisson, Guðnason and Möller also carried out daily briefings for the Icelandic people at 02:00 PM wherein they discussed what they know and didn’t know about the virus. All these measures put together, along with one of the highest testing rates in the world, were responsible for the countries amazing success.
Similar is the case with Cambodia. The country’s public health system started working in full force since the beginning of the pandemic in China. Noting that the spread of the disease multiplies enormously if left unchecked, the country’s security and health professionals were immediately posted at border check points, sea ports and airports and all those arriving from other countries were instructed to strictly remain in quarantine for 14 days. This, coupled with a well implemented awareness program in the country, was able to save its people from Covid-19.