When a patient arrived at a Chinese hospital with acute respiratory distress in mid-December 2019, there was uncertainty about what was causing these symptoms. Known pathogens were quickly ruled out: It was not SARS, MERS, or influenza—and, quickly, a novel coronavirus was detected. When doctors tried to raise the alarm, police threatened them, and health officials initially said they had no clear evidence of human-to-human transmission.
When China finally informed the World Health Organization of the outbreak through its China office on Dec. 31, 2019, it was clear the government was privately worried that it was not going to be easy to contain or manage.
By Jan. 23, China had 571 cases and a death toll of 17. Infectious disease specialists who create predictive models of epidemics immediately sounded the alarm about the new coronavirus disease—known as COVID-19—noting that China could experience 100,000 new infections per day with hundreds of millions of people becoming infected. By the following day, the central government of China had imposed a lockdown in Wuhan and other cities in Hubei province affecting 56 million people.
But even before these measures were implemented, the virus had already started spreading to Hong Kong and other countries such as Singapore, South Korea, and beyond. South Korea reported more than 2,000 total confirmed cases on Feb. 28. Then, in early March, something unexpected occurred: The exponential increase of cases in these countries stared to flatten. China has managed to keep its confirmed cases under 90,000, with daily new cases coming down. Italy, which recorded its first cases of COVID-19 on Jan. 30, has now lost more of its citizens (more than 6,000 as of March 23) to the disease than China has.
The severe Chinese response bought other countries time, but not all leaders took advantage of it. Before the outbreak reached their shores, heads of state across the world each decided to plan—or not plan—for this outbreak in their own way. Some, such as U.S. President Donald Trump, downplayed the dangers on national television, while others, such as South Korean President Moon Jae-in, acted early and decisively.
Indeed, South Korea stands out as an exemplar. After one of the world’s largest initial outbreaks outside China, it has managed to bring daily new cases into relative decline without imposing draconian nationwide lockdown measures. Comparing Italy to South Korea shows how dramatic the differences can be. On March 1, Italy had only 1,701 cases and 41 deaths, while South Korea had 3,736 cases and 21 deaths. Three weeks later, on March 22, Italy’s caseload had exploded to 59,138, with 5,476 deaths, while South Korea’s total caseload had merely doubled to 8,897, with 104 deaths.
