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Europe and U.S. Lack Key Weapon Against Pandemic: Experience

Europe and U.S. Lack Key Weapon Against Pandemic: Experience

(Bloomberg) -- As Italy overtook China on Thursday to become the deadliest center of the coronavirus, it exposed an uncomfortable truth for the rest of Europe and the U.S.

Why more people should die in a country more than 20 times smaller has multiple answers, but there’s one cause that stands out: a sheer lack of experience with pandemics.

“We were called by the Italian authorities to help. Why? Because Europe did not come across an epidemic on this scale in 100 years,” said Brice de le Vingne, chief of operations at Medecins Sans Frontieres. “Not one decision maker in Europe knows how to do that. You could argue governments in Africa know more about how to do it.”

Medecins Sans Frontieres is better known for stitching up war wounds on the battlefields of the Middle East or tackling Ebola in Africa. But as Italy’s rich-world health care system has buckled, the group’s medics find themselves working closer to home in Europe.

The decision to call in emergency backup showed the bewilderment in Italy’s wealthy north, a region proud of its state of the art hospital care and highly trained medical staff. Yet they were quickly overwhelmed by a pandemic whose speed and virulence few in Europe foresaw.

On Thursday, Italy said its death toll had risen by 427 in a day to reach 3,405. At the same time, China said it had recorded its first 24-hour period without a new domestic case of Covid-19 since the disease was first recognized in the city of Wuhan, in December. Across that nation of just under 1.4 billion, 3,245 people have died from the disease so far.

Europe and U.S. Lack Key Weapon Against Pandemic: Experience

Unlike East Asia, the rich nations of the West did not have plans and teams ready. Countries such as China, Singapore and South Korea did, after bearing the brunt of the Sars-1 virus in 2002-2003, with Hong Kong alone suffering 299 of the 774 fatalities worldwide.

Nor do they have the muscle memory of some African governments, forced to struggle with epidemics on a near permanent basis – from Ebola, to Measles to the Zika virus. So far, coronavirus has barely touched the continent, but in Nigeria, researchers are already racing to produce a 10-minute test.

Without response plans on their shelves, European leaders have been forced to consult, debate and decide in real time how much to test, and what to shut down or quarantine when. That’s too late in the case of a virus that’s contagious even before symptoms show.

“Europe is failing,” said de le Vingne. “We were also very involved in Hong Kong. They were much better prepared than Europe for Covid-19.”

Italy is an outlier for now. Its demographics, old even for an aging continent, are a factor, creating a larger vulnerable segment of the population. Yet there’s little to indicate that other European nations or the U.S. will escape lightly.

Europe and U.S. Lack Key Weapon Against Pandemic: Experience

So far, only in Asia do some countries hit by the disease appear to have been able to stop it taking hold in the wider community. That’s more about being prepared than having hard-line leaderships, according to Nicholas Thomas, an associate professor at City University of Hong Kong.

“It doesn’t matter if it’s authoritarian like China or illiberal like Singapore or a democracy like South Korea or Taiwan,” said Thomas, editor of a four volume series of books titled “Health, Security and Governance.” “All of them have responded fairly quickly to the disease.”

Singapore’s experience with the 2003 Sars outbreak meant response plans were ready on the shelf for the next epidemic. These have been supported by routine drills and new infrastructure, including ready-made government quarantine facilities and a 330-bed, state-of-the-art national center for managing infectious diseases that opened last year.

In South Korea, struck by an explosive coronavirus start traceable to a single so-called superspreader, local governments drew on a 73-page response manual. It was developed after a 2015 bout of Middle East Respiratory Syndrome, or Mers, that killed 38.

Meanwhile, ordinary people remembered past epidemics too, so they were ready to fall in line with whatever measures the government demanded. In Hong Kong, many people voluntarily donned masks and avoided crowds. Medical workers went on strike to force the government to fully close the border with China.

Europe and U.S. Lack Key Weapon Against Pandemic: Experience

“The social part is one of the reasons why we’ve been able to keep the virus cases so low, because in some way the public has been able to make the government take measures,” said Thomas.

Without those memories, Europeans have been more reluctant to see their lives and economies turned upside down and their governments slower to make them. In Greece, police had arrested more than 120 people by Monday for violating orders to close stores, including hair salons, according to local news reports. In the U.K., the government this week advised people to avoid bars and schools will close from Monday, later than elsewhere.

Italy’s response also began slowly. By the time the disease had been identified, it appeared to have spread widely. Now, on the front line of the fight against the virus in the rich northern Italian region of Lombardy, medical personnel fall sick as beds for intensive care run out.

Europe and U.S. Lack Key Weapon Against Pandemic: Experience

Italy’s health authorities didn’t foresee the speed with which the virus arrived from China, nor the pace at which it spreads, said Giovanni Rezza, head of the infectious diseases department at Rome’s Superior Health Institute. The U.K., France and Germany have had more time and could have acted earlier, he added.

When it comes to lack of experience and readiness, the U.S. is little different from Europe. Both may have had to mobilize against the spread of H1N1 in 2009, but that avian flu proved relatively mild, with a far lower fatality rate than Sars-1 or Mers, which galvanized other parts of the globe.

The Baystate Medical Center in Springfield, Massachusetts—a 720-bed teaching hospital and the sole trauma center for the area—has been freeing beds and readying ventilators for three weeks, according to Mark Keroack, chief executive of the non-profit that owns the hospital, as well as a doctor specializing in infectious disease.

This week the hospital built a new unit in front of its Emergency Room entrance to screen patients and isolate up to 40 people at a time as they wait for their coronavirus test results. And while other hospitals have now begun clearing the decks nationwide, in the U.S. as in Europe it took a while for the severity of the threat to be understood.

The Center for Disease Control and Prevention “dropped the ball,” thinking it had enough time to develop its own tests for coronavirus rather than use ones already deployed by other countries, Keroack said. “I have been surprised by the slowness of response from some of my colleagues.”

©2020 Bloomberg L.P.