Coronavirus killers: What countries that 'flattened the curve' did right

If there is one thing that’s working to slow the spread of COVID-19, whether it’s Germany, South Korea or the Czech Republic, it is the act of physical distancing.

“I think the social distancing worked for everyone, they did it, they followed it to a tee,” said Dr. Anna Banerji, an Infectious Disease Specialist at the University of Toronto.

The model country being pointed at by many experts including the WHO at effectively flattening the curve is South Korea, which was able to control the COVID-19 outbreak through a number of measures. 

The country of 50 million-plus had experienced Middle East respiratory syndrome-related coronavirus (MERS-CoV) in 2015, from which 38 people died. Before COVID-19 even went global, South Koreans had just completed their pandemic training in December, which had prepared them to deal with physical distancing and practice proper hygiene.

Dr. Banerji notes the Koreans were able to set up quick and readily-available testing, and subsequently had systems in place to track positive cases and understand who may have been in contact with the infected.

“Their rapid testing of anyone with symptoms, early-on drive-thru testing, and people getting their results back quickly, it’s helped them target and isolate people [who were] compromised,” she said.

What’s holding Canada back?

One of the things holding Canada back from reaching South Korea’s 20,000 tests per day is not having access to the materials needed by healthcare professionals, due to a halt in manufacturing in China and Italy.

Mimicking South Korea is what every country is striving for, and so far only Germany has been able to match the amount of tests conducted with at least 120,000 tests per week.

“The fact that they have [done] extensive testing and can test anyone at risk or anyone symptomatic, I think that's one of the reasons why they’re doing better,” said Dr. Banerji.

Overall, more than 66,000 Germans have been infected, but through their public health system and availability of beds in the intensive care unit, the mortality rate stands at below one percent.

For comparison’s sake, Germany has had about the same amount of positive tests as France and the United Kingdom combined, but nearly five times more French and twice as many Britons have died.

Both France and the U.K. were slow to roll out safety messaging and measures, which Dr. Banerji said resulted in a higher mortality rate.

“We see that when it wasn’t addressed in time, China, Spain and Italy come to mind and their consequences — reaction time makes a huge difference,” she said.

Researchers in Germany have even begun to discuss potentially scaling back restrictions in some of the hardest hit areas of the country which developed herd immunity. Researchers will start testing Germans to see if they develop antibodies and will issue immunity passports to allow them to resume their normal lives.

However, Banerji warns anyone who feels they’ve flattened the curve that a dataset of two weeks is not sufficient enough to make drastic scale-downs.

“They are still early on in the curve, so hopefully this is something that is sustainable. If you can have sustained testing, that will help flatten everything,” she said.

Should you put your mask on?

In Eastern Europe, statistics show since Friday the Czech Republic has seen a steady decline in positive cases when a total of 373 cases were discovered. As numbers dipped on Saturday and then again on Sunday, come Monday only 125 people tested positive. 

Some epidemiologists in the country, as well as the government, are crediting social distancing, quick action on limiting travel and widespread use of masks. 

So far, the Czechs are the only country to mandate citizens wear masks whenever they step out, regardless of occasion. Dr. Banerji believes the masks can also do the opposite if used improperly.

“If lots of people haven’t used masks and are touching things, they may go to adjust their mask, so while it may seem there is protection, it’s less than imagined,” she said.

The WHO, Centers for Disease Control and Prevention and Public Health Agency of Canada have all recommended limited mask use except for those displaying symptoms, those who are positive or medical health professionals.

China slowed COVID-19 response

The origin of COVID-19 is widely believed to have started in Wuhan, China where the government is now reporting they’re only getting a few dozen positive tests, and restrictions are being scaled down. 

However, Dr. Banerji says to only credit the control measures would be wrong.

“In Wuhan the reason it’s most likely stopping is because most people have already been infected, in Italy, they’re going to peak and the numbers will come down, but because most people have already been infected,” she said.

When it comes to COVID-19 if there is a sense of herd immunity, many of the infected can develop antibodies which would make the virus not as strong the second time around. 

While physical distancing is working in many regards, if it’s not practiced for long enough for a vaccine to be created, many people could be at risk, Dr. Banerji notes.

“It seems to be working to some degree... but as soon as we stop the physical distancing, we’re going to have a huge number of people who are susceptible [to COVID-19],” she said.

What can Canadians expect?

Dr. Banerji says if Canadians really want to ensure the quickest way back to regular life, it could be months and months of physical distancing to make that happen.

“It only takes a few cases of coronavirus for it to spread again, so to be effective the physical distancing is something that needs to go for a long period of time,” she said.

In Canada, physical distance is a strong recommendation and on Monday Prime Minister Justin Trudeau said he could and would use the military if need be. 

Banerji points to India, who went that route, but has a large population who are considered vulnerable.

“In India, where so many people don’t have a place to live and don’t have regular access to food, so invoking social distancing people might die of starvation or other issues,” she said.