Five Countries, Five Experiences of the Coronavirus Pandemic – The New Yorker
January 18, 2021
Kirtiraj Rana grew up in Rajamunda, a village of fewer than a thousand people in the northeastern Indian state of Odisha, which faces the Bay of Bengal. A migrant worker, he dropped out of school when he was in tenth grade to help support his familyhis parents, a brother who also dropped out, and a sister who received only a fifth-grade education. Odishas farming revolves around its brief rainy season. Unable to find work in the off months, Rana travelled with his brother to Mumbai in December of 2019. They were hired as construction workers. After buying food and clothes, they managed to send half of their wagesabout five hundred rupees a day, or seven U.S. dollars, eachback home.
Rana first heard that the coronavirus was spreading in India in early March. We didnt know what it was, how it looked, he said. We just knew that people were dying in Mumbai. We were very scared. A few days later, Narendra Modi, the Indian Prime Minister, announced one of the worlds largest and strictest lockdowns. Modi delivered his speech at 8 P.M. on March 24th; restrictions started at midnight. Millions of migrant workers were stranded without wages, food, or shelter. All forms of public transportationby air, rail, and roadwere suspended. Police arrested, and sometimes beat, people who remained out for nonessential activities. The lockdown, initially scheduled to last three weeks, was extended again, and again, and again, through the end of May.
The contractor whom Rana worked for offered migrants a month of rations. After that, Rana and his brother were on their own. They tried to wait it out. We thought it had to end at some point, Rana said. They asked their father to send money, but in early May, after theyd exhausted their savings, the brothers bought bicycles and, along with several friends, set out for Odishasome fourteen hundred kilometres from Mumbai. They began their journey at 2 A.M., carrying rice, utensils, medications, pots, and pans; in ninety-degree weather, they cycled to Nashik, a town in northern Maharashtra, the Indian state with the highest number of COVID cases, where they were forced to spend twenty-four hours at a quarantine center, along with some three hundred people. The next day, petrified of catching the virus while detained, Rana pleaded with the police to let them go.
It took Rana and his brother seven days and nights to get to Odisha on their bicycles. When they arrived, they were quarantined near their village for a month before being allowed back home. Since then, Rana has had trouble finding work, both because of pandemic-related restrictions and because of the stigma attached to those returning from Maharashtra. When we spoke, five months after his return home, none of the men with whom hed made his journey had managed to find work in the village.
Rana is one of roughly a hundred million migrant workers in India. The sudden lockdown, by forcing their reverse migration from urban centers to rural areas, almost certainly contributed to the spread of the coronavirus; it also created a humanitarian crisis, reminiscent of Partition, in 1947, when the subcontinent was divided into India and Pakistan and millions were forced to trek on foot from one to the other. Five weeks after Modis first announcement, the Indian government began operating Shramik Specialslabor trainsto transport migrants to their home states. Crowds gathered in congested stations, and packed trains ran with little regard for social distancing; still, millions of migrants remain stranded, and since March hundreds have died of starvation, exhaustion, suicide, and accidents. In one video, a toddler on a train platform tries to wake his dead mother, tugging at the cloth covering her lifeless body.
Many migrant homecomings have been sullied by prejudice against those seen as carrying the virus from one place to another. At times, this stigma has been applied to physicians; some doctors, particularly women, have suffered physical and verbal abuse. According to the World Health Organization, India has only eight doctors for every ten thousand people. (The U.S. has twenty-six, and Germany forty-two.) Even before the pandemic, India had fewer than twenty per cent of the critical-care doctors required for its ordinary needs. The situation is worse in rural areas, where sixty-five per cent of the population lives but only twenty per cent of the countrys doctors work. For much of September, India recorded more than ninety thousand COVID-19 cases a day; while daily cases have since decreased, the country still ranks third, behind the U.S. and Brazil, for most COVID deaths in the world. Many believe that, because of its poor testing-and-reporting infrastructure, the deaths are significantly undercounted. Tested or not, the virus continues to spread: according to some reports, more than half of those in Mumbais slums and a third of the people in Delhi have been infected.
Its been a year since the novel coronavirus emerged, in Wuhan, China. Since then, it has reached every continent on the planet, infecting more than ninety million people and causing two million deaths. The global economy has shrunk by more than four per centthe largest contraction since the Second World Waras governments the world over have tried, with varying degrees of success, to contend with the pandemics staggering damage, closing borders, banning gatherings, enforcing lockdowns, and, to varying degrees, providing financial support and investing in testing and tracing programs. In every country, people have criticized their governments. Even the best leaders have struggled to balance public-health imperatives against a host of country-specific factors: government rules, political polarization, economic stability, health-system capacity, public opinion, institutional trust, and the states history of the use and abuse of power. Government surveillance feels different in Rwanda than in Canada; individual freedom dominates Americans self-image but not that of South Koreans; Germanys health-care system can withstand a deluge of COVID-19 patients in a way that Indias cannot.
Adam Oliver, a professor at the London School of Economics, is one of many researchers who have tracked how different countries have responded to the pandemic. Oliver thinks that our usual back-of-the-envelope way of comparing countries, using a snapshot of COVID cases and deaths, is of limited value. We have to think about the non-health implications of pandemic response, too, he told me. Those are much more difficult to gauge at the moment. When you lock down businesses and citizens, there are many downstream consequences. Theres an economic impact. Theres social damage. Theres loss of freedomwhich, especially in countries already bordering on authoritarianism, could be hard to roll back. If you consider these broader implications, I dont think well know the best path for years, if ever.
Oliver classifies pandemic responses into three broad, sometimes overlapping categories: the quick approach, the soft approach, and the hard approach. Countries that took the quick approach used swift action to tamp down viral spread, and were generally able to avoid prolonged lockdowns. Taiwan, for example, acted early and aggressively through closed borders, universal mask wearing, robust contact tracing, and quarantines enforced with mobile-phone tracking. In a population of twenty-three million, it has had fewer than nine hundred cases; for two hundred and fifty-three consecutive days, between mid-April and the end of December, it did not record a single locally transmitted infection. Many Asian countries recognized very early that this was going to be much deadlier than the flu, Oliver said. Some of their speed and effectiveness came from their experience with SARS. They had their public-health infrastructuretrack-and-trace programs, quarantine protocols, communication strategiespretty much ready to go.
The second strategythe soft approachrelies on recommendations instead of requirements. Many nations have taken this route after failing to act quickly, or because they are unwilling or unable to pass mandates; instead they recommend, but do not enforce, mask usage, closures, and quarantines. Sweden is the most widely cited and widely criticized example of such a country; while its COVID-19 death toll is much higher than its Scandinavian neighbors, it is on a par with that of many other Western democracies. Other countries have adopted the soft strategy. In Japan, the constitution imposes some limits on the governments ability to mandate behavior, and so the country has relied on peer pressure and financial incentives, with surprising success. Brazil, because of its Presidents cavalier attitude to the virusWe need to stop being a country of sissies, he has saidhas also de facto employed the soft approach.
Britain seemed to flirt with the soft option early on. Ultimately, though, it went with the third strategythe hard approachwhich is characterized by more aggressive government action. This approach has been adopted by most countries at one point or another, and is familiar to most of us here in the United States. As cases increase and hospitals fill, the government mandates masks, imposes curfews, prohibits large gatherings, and orders lockdowns until numbers improve. In the U.S., individual states have experimented with the soft versus the hard approach, and have often alternated between them. Most of Europe started hard, went soft in the summer, and then was forced to go hard again as infections surged in the fall. Some countries have to take the hard approach because their health-care systems are stretched at baseline and they cant afford a surge of cases, Oliver said. Others have simply concluded that its the only way to prevent unnecessary death and suffering. Such decisions are abstract, made at a high level, and yet they have human consequences. Around the world, billions of people have been affected by the virus. There are more pandemic stories than well ever know.
Michalis Kavadias was born and raised in Greece but moved to Germany in 2009. He works as a graphic designer, but much of his time is spent managing a dive bar in Neukllna vibrant neighborhood in Berlin, full of artists and young professionals. Kavadiass bar, Du Beast, is cozy and low-key. It serves reasonably priced craft cocktails and locally brewed beers. Before the pandemic, it regularly featured standup comics, open-mike poetry nights, and d.j. sets.
In March, as the coronavirus spread across Europe and into Germany, Kavadias closed the bar, several days ahead of a government-mandated lockdownthe hard approach. It was starting to get really scary, he said. For much of Aprilthe dark month, he called itthe bar remained shut. Kavadias learned that his aunt, who lived in Italy and was previously healthy, was ill with COVID-19. After weeks in the hospital, she died. The pandemic became very real for me, he said. I really think the Italians saved our asses. They got hit so hard. It was a wake-up call for all of Europe.
As the weather warmed and people ventured out of their homes, Kavadias devised schemes to generate revenue, so that he could keep his employees on the payroll. I had to find a way to pay them, Kavadias told me. These people are my friends. He designed T-shirtsone, which he was wearing when we spoke, over Zoom, read Du Beast or Not Du Beast. He sold two hundred to local residents, which helped cover salaries, at least for a time. He offered cocktails to go; people who used to frequent the bar would stop by, mostly in an effort to keep it afloat. The neighborhood was incredibly supportive, Kavadias said. It really came together. One day, a man in his sixties who, prior to the pandemic, had dropped by for a beer almost every day after workFor him, it was like a cup of teaordered a drink to go and left a two-hundred-euro tip.
As spring turned to summer, the bar reopened with outdoor seating, and patrons flooded back. It might have been the best summer weve ever had, Kavadias said. Everyone was so ready to socialize again. Theres a reason people live in Berlin: they want to have fun. This isnt Munich or Frankfurt. Upon entering the bar, people were required to write down their names and e-mail addresses, but many hesitated. Privacy is a big issue in Germany, Kavadias said. I said, Write Mickey Mouse as your name if you want. But I need a way to get in touch with you if someone ends up getting COVID here. Around that time, surveys showed that nearly ninety per cent of Germans thought that their country was doing a good job of handling the pandemic; seven in ten said that the response had made them prouder of their country. Germany was seen, rightfully, as an exemplar of how to respond to the pandemic, and its policies enjoyed high levels of public support.
Like the United States, Germany has a federalist political system: in addition to the central government, there are sixteen regional governments and hundreds of public-health offices. But, unlike in the U.S., decentralization didnt prevent the country from mounting a cordinated early response. Angela Merkel, who used to be a quantum chemist, regularly met with regional governors to develop and announce COVID-19 regulations; she has consistently employed science-based messaging in press conferences, interviews, and her weekly podcast. Shes very effective at helping people understand whats going on, Kavadias said. When she explained this R thingR-naught, the viruss reproduction number, a marker of how many people an average infected person infectsit was, like, Wow, this is the first time I understand what this means. That was really powerful. Scientists like Christian Drosten, a Berlin-based virologist, have become among the most trusted voices in the pandemic; Drostens podcast, Das Coronavirus-Update, has millions of listeners.
As the pandemic began, Germany benefitted from unparalleled execution of the fundamentals: clear communication, widespread testing, and robust contact tracing. Germanys strategy has been to make a team of five contact tracers available for every twenty thousand citizens, and the system includes thousands of German soldiers who can provide urgent backup when needed. A government app sends COVID-19 alerts and monitors users potential coronavirus exposures; officials estimate that its used by at least sixteen million peopleabout a fifth of the German population. Given Germanys past history with surveillance, the apps adoption was not without controversy: after some early debate, developers opted not to collect GPS data, which tracks location and can leak user-identifying details, but to employ a Bluetooth system that registers only whether, and for how long, a person has been in close proximity with someone who has tests positive for the coronavirus. (If the other person has the app, too, the two phones exchange encrypted codes; if either of them later changes his status to virus-positive, the other gets notified.) Rather than send these details to a central server, the app stores them on individuals cell phones only, and for a limited time. The Chaos Computer Club, the largest European association of hackers, has praised the app as posing a relatively low risk for user privacy.
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Five Countries, Five Experiences of the Coronavirus Pandemic - The New Yorker
