The First Wave: Lessons from China And Italy

April 2020: Duomo square, Milan, Italy.

In an unprecedented time of crisis for the global community, regret runs rampant as national governments race to catch up with a virus that has infected nearly every country on Earth faster than we could have imagined. Hindsight serves as a cruel reminder of what should have been, but also a resource for the future. It is the lessons from countries like China and Italy who faced the first wave of COVID-19 infections that stand as precedent for the US in its response.

COVID-19 was first discovered in Wuhan, China in late December 2019. On January 11, the first death associated with the virus was reported. Less than 2 weeks later, Wuhan was completely cut off from the rest of the world in an attempt to curb the beginnings of what would become a global pandemic. After taking the brunt of the virus’s first wave, China reported zero new infections on March 19.  

One of China’s strengths in response to COVID-19 was its speed in identifying the number of infected and whom they came in contact with. Testing 320,000 people in 3 weeks, China’s response excelled in tracking those who came into contact with infected persons. In the healthcare sector, China utilized online healthcare, seeking medical advice via phones and online platforms. The cost of treatment might also serve as an inhibitor for people to seek help, so China announced they would cover all hospital costs associated with COVID-19 outside of insurance. 

Although there is debate over how China handled COVID-19 in its earliest stages, with some pointing out that officials tried to cover up the virus, other hard-hit Asian countries including South Korea modeled their response off of China’s as the number of active infections there begins to dwindle.  China has encouraged countries to learn from their experience, even establishing a website called “The Knowledge Center for China’s Experiences in Response to COVID-19”. 

Italy has been hit particularly hard by COVID-19, considered to be Europe’s epicenter of infection. When the virus’s presence was first discovered in Italy, it took little more than a month for the disease to devastate the country. Italian officials say it was easy to view the dire conditions that developed in China as nothing more than a far separate issue; something that happened there but will never happen here. In the beginning, officials downplayed the severity of the situation, creating a false sense of safety amongst citizens by assuring that the high infection count was merely the result of aggressive testing of asymptomatic people. WHO board member Walter Ricciardi defended the Italian government, saying, “[i]t is not easy in a liberal democracy.” 

There are many lessons to be learned from Italy’s experience in fighting the disease. Chief among them is the importance of a united course of action, perhaps the most significant issue in Italy. While the number of infections increased day by day, tourist attractions remained in operation, and the mayor of Milan advertised the “Milan Doesn’t Stop” campaign of keeping bars open. Confirmation bias, the inclination of humans to believe the information we find more appealing, ruled. Additionally, Italy found itself rushing to mediate the virus instead of working to prevent it due to its gradual lockdown strategy. By locking down some regions and not others, people evacuated areas that were shutting down, which spread the disease further into the country. Medical response protocol also varied by region, resulting in the stark contrast between neighboring areas. Take the neighboring regions Lombardy and Veneto, where the death rates stand at 17.6 and 5.6 percent respectively due to different medical practices, including increased testing.

With all of these precedents, the question of how the US is responding remains. As far as testing, the cornerstone of China’s overall successful response, the US is still falling behind in accessibility. As of March 10, the CDC had reported approximately 8,500 tests, and while South Korea managed to test almost 10,000 people a day, the US was performing manual testing at the rate of 40 to 60 tests a day.Testing has improved since then, with private companies helping to process thousands of tests every day, although the nation is now facing a shortage of testing supplies such as swabs and chemicals, especially in the hardest-hit parts of the country. The US government followed Italy’s lead in a gradual lockdown, leaving the decision at the state level instead of a national order. As far as medical response, the US has followed suit with other countries, establishing drive-through testing and hospital tents and working to help cover healthcare costs. Currently, the United States leads the world’s number of infections with over 533,000 people infected as of April 12. 

Photo from Shutterstock.