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  • Fighting Covid-19:
    East Asian Responses to the Pandemic

    Policy Paper -
    April 2020
Authors
Mathieu Duchâtel, François Godement and Viviana Zhu

Mathieu Duchâtel is Director of the Asia Program at Institut Montaigne since January 2019. Before joining the Institute he was Senior Policy Fellow and Deputy Director of the Asia and China Program at the European Council of Foreign Relations (2015-2018), Senior Researcher and the Representative in Beijing of the Stockholm International Peace Research Institute.

François Godement is Senior Advisor for Asia to Institut Montaigne, Paris. He is also a non-resident Senior Associate of the Carnegie Endowment for International Peace in Washington, D.C., and an external consultant for the Policy Planning Staff of the French Ministry of Foreign Affairs.

Viviana Zhu is the Policy Officer for Institut Montaigne’s Asia Program since January 2019. Before joining Institut Montaigne, Ms. Zhu worked as Coordinator of the Asia Program of the European Council on Foreign Relations (ECFR).

What are the lessons from East Asian countries on their management of the Covid-19 crisis? Can the early methods that many of them deployed to avoid full lockdown be useful for our post-confinement phase in Europe?

In the first three months of 2020, East Asian states used several policy tools to prevent an exponential increase of cases: masks of course, but also strict quarantine implementation, epidemiological investigations, massive use of digital tools, strong mobilization of the industrial sector for medical supplies. 

The first lesson of this policy paper is about the importance of early warning and immediate action, through previously set up centers to communicate and coordinate public action. First signs of a severe pneumonia of unknown origin spreading in Wuhan were confirmed on December 31, 2019. Monitoring for symptoms in incoming passengers from Wuhan helped to contain local outbreaks of Covid-19. There, the lessons learned from SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) played a useful role. 

China is of course a special case, where appropriate responses only started on January 20. In Hubei province, the contagion had reached such a level that the only option was a full lockdown. Nonetheless, if lockdown and quarantines have been more forcefully used in China than anywhere else, other policy tools bear some resemblance to the actions by the five other East Asian countries. The other unique feature that stands out is China’s ability to mobilize its industry quickly for medical supplies. With this policy paper, Institut Montaigne offers a comparative overview of the policy responses of China, South Korea, Hong Kong, Japan, Singapore and Taiwan to the pandemic. Each case study includes a detailed timeline of events and measures taken in anticipation or during the crisis, to contain the spread of the virus, adapt social behavior and the healthcare system to the pressures created by this new virus, and favor emergency support of public welfare and the economy. 

A toolbox of policy options

The six cases have different political systems. China is an authoritarian state, Singapore and Hong Kong present a combination of the rule of law and authoritarian features, while Taiwan, South Korea and Japan are full democracies, with vibrant public debates and an ever contested political space.  

But apart from China’s initial reluctance to acknowledge the seriousness of the virus threat, the responses do not reflect a huge difference in governance models. Japan has been more cautious than others on compulsory requirements and the use of big data. Still, from Seoul to Singapore, there is an East Asian toolbox with similar features, the use of which varies through unique policy packages from country to country:

  • Enforcement of individual quarantine including with digital surveillance tools, rather than mass confinement.
  • Early border controls to track imported infection at early stages of the crisis, also as an alternative to confinement, including with meticulous - sometimes intrusive - contact tracing.
  • The mobilization of industry in support of the national need for medical equipment, especially protective items like masks.
  • Focused economic measures rather than massive plans, without any regional coordination at all: this does not seem sustainable in the long term.

No country has entirely eradicated the virus, and rebounds or what could be a “second wave” is happening here and there. The recent (late March-early April) accent on border closures reflects a general sense of uncertainty about the near future. A weakness of Asia’s toolbox is indeed the lack of regional cooperation, and Europe still has a chance to show the way in this regard

Europeans will find it useful to focus on the strong points of East Asia’s fight against the pandemic:

  • China is impressive for the strength of its industrial mobilization capability, and the extremely strict confinement measures in Wuhan and many other cities. 
  • South Korea is unique for its testing policy and easy access to tests, but also for the targeted epidemiological investigations the country conducted. 
  • Taiwan, least affected of all, provides a positive answer regarding the use of digital tools in a democratic system and the importance of strictly enforced individual quarantines to prevent a general lockdown. 
  • Japan, an intermediary case with Europe because of its legal restraints, has made use of compulsory hospitalization (with an abundant supply of ICU beds) for Covid-19 cases. It also showcases the importance of social self-discipline intimes of epidemic.
  • Singapore offers a remarkable option for retrospective contact tracing via the application TraceTogether, which stores close social contact on Bluetooth phones for future warning action when a contamination is detected.
  • Finally, Hong Kong is a model of rapid reaction, and of the importance of social responsibility in a crowded city. 

No magic formula, but key ingredients

The exact measures taken by these six governments deserve our full attention. None of them taken in isolation is sufficient to eradicate the virus. Caution is also necessary, given the as yet unknown features and perhaps the mutating nature of the Covid threat. Two countries, Singapore and Japan, are adopting more restrictive measures for their populations at the beginning of April 2020. Doubts persist on risks from asymptomatic cases and undetected clusters, including in China.

Despite this caveat, the number of cases recorded in East Asia remains far lower than the hundreds of thousands of infections experienced in Europe and the United States. The importance placed by these countries on measures focused on individuals and case-by-case monitoring of patients, is an alternative to an all-out effort aiming at “flattening the curve” of contagion. Lockdown is indeed a last resort strategy, to avoid overwhelming hospital resources

The measures that made it possible to avoid confinement in Northeast Asia and in Singapore, the managed re-opening of Wuhan and other cities under lockdown in China are relevant in the context of discussions on the exit from confinement in Europe.

This policy paper underlines six lessons in particular: 

  • The importance of pre-planned standardized procedures 
  • The opportunities offered by digital tools backed by democratic safeguards 
  • Strict enforcement of quarantine measures as opposed to general confinement 
  • The challenge of improving the supply of protective medical equipment to manage the crisis
  • The role of masks as the first line of defense against infectious respiratory diseases 
  • and the necessity of thinking strategically about the post-crisis period to minimize the economic consequences of the pandemic.

As European countries start thinking about the most effective strategies to ease the lockdown, from both a public health and an economic standpoint, the analysis of crisis management in East Asia is essential to fuel these reflections, contain the pandemic and thus avoid the prospect of renewed lockdowns.

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