Wednesday, January 13, 2021

Researchers from Seven Different Nations Describe Their Pandemic Experience

Environmental & Science Education, STEM, Health, Medicine, Culture, Society

Ed Hessler

In a series of letters to the scientific journal Nature, government researchers who helped guide the responses to the COVID-19 pandemic in Belgium, Bolivia, Canada, Costa Rica, Ghana,Lithuania and Taiwan write about their experiences. 
The responses point out how differently nations responded depending on where they started in terms of institutions, health care systems, barriers, level of preparedness (the development of a plan), staffing, money, the role of evidence-based decision making, concepts of government, leadership, international relationships and so on They may be seen here which also includes information about the researchers whom I've named only. (About a 10 minute read). Below are a few highlights from each entry.

--Belgium (Emmanuel Andre). A health care system that had been constructed over centuries had been dismantled, severing the tie between prevention and curative care. The nation was unprepared, starting with no protective equipment and an insufficient number of trained health care workers from bottom to top. Management of the pandemic was severely hampered by a complex institutional system and politics. "But epidemiological risk-taking ultimately led to prolonged lockdown and extra damage to an economy that requires stability and consumer confidence. Next year must be different."

--Bolivia (Mohammed A. Mostajo-Radji). "Every international agency we spoke to predicted that Bolivia would be hit harder by COVID than most nations. It has one of the worst health-care systems in the world, with several regions refusing to share information with the central government. ... So on 17 March, we implemented one of the strictest lockdowns in the world. This gave us time to take stock of the health-care system." COVID-19 also became highly polticized and slowed by protestors, thefts, and ageism). Often cabinet were officials reluctant/refused to take advice from younger advisors. "Still, Bolivia has one of the lowest infection rates in the Americas."

--Canada (Mona Nemer). "(S)cience guided decision-making in real time like I have never seen before. The contrast with some other parts of the Americas has been striking. It has been gratifying to witness public appreciation of, and government interest in, science. This has provided welcome encouragement in such stressful and uncertain times. The sheer objectivity of science can go a long way in a crisis, especially when response is hampered by inaccessibility to data, reagents and personal protective equipment. To take on future existential threats, nations need to strengthen their science advisory systems locally and globally, and build public trust in research."

--Costa Rica  (Eugenia Corrales-Aguilar). "When the pandemic began, politicians and journalists in Costa Rica started talking to me because I am a virologist and had worked with bats and coronavirus. I thought that maybe we would be able to control this virus with the same public-health measures that we used for severe acute respiratory syndrome (SARS) in 2003. We were naive. One of the things that’s been really different this time has been the response of the Centers for Disease Control and Prevention (CDC) in the United States. We’d always looked to it for guidance on everything to do with infectious disease — until now. The lack of unpoliticized, evidence-based information from the CDC has been a challenge throughout this outbreak. ... There’s so much nonsense and disinformation. I think vaccine communication — reaching people who do not want to understand that vaccines are game-changers — will take up much of my time for next year."

--Ghana (Gordon Awandare). "In Ghana, the pandemic has not been severe, and deaths have been very low compared with those in other parts of the world. Our group was among the first to sequence SARS-CoV-2 in Africa. We achieved this because we are building capacity for next-generation sequencing for other research purposes, including malaria-parasite genomics. ... In responding to pandemics, leadership has to be decisive. For example, masks should have been mandated early on. And lockdowns would have worked better had they been targeted, imposed quickly and enforced strictly." Looking ahead, "African governments need to build scientific capacity sustainably rather than resorting to firefighting only when a pandemic hits. We should be preparing for the next pandemic as soon as this one ends."

--Lithunia (Ligita Jancoriene). "In the hospital, the first challenge was redeploying medical staff to work with people with COVID-19, and setting up new units to treat them. Everyone had to leave their comfort zone, and it was not easy. Some staff refused; others volunteered. ... As we face future waves, we need to strengthen resources for health-care workers on the front lines. Clear guidelines must be prepared on how to manage COVID-19 infection in a regional hospital or nursing home, rather than every patient being referred as quickly as possible to a larger centre. Early on, health authorities focused on university hospitals equipped with personal protective gear and other specialized equipment. Now, there are simply too many patients, and each facility must be prepared to diagnose and treat those who are infected."

--Taiwan (Chien-jen Chen). "Almost everyone in Taiwan complied with guidelines and regulations for epidemic control. Only around 1,000 of around 400,000 people isolated or quarantined at home violated the restriction. The rest sacrificed 14 days of freedom to let 23 million people live, work and go to school normally. We have been COVID-free now since 13 April. Key elements of Taiwan’s success include prudent action, rapid response (we took action on 31 December) and early deployment of control measures, together with transparency and public trust with solidarity. We did not need to implement city lockdowns or mass screening. Instead, we applied information technology and artificial intelligence to carry out precision disaster prevention and mitigation."

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