Although the COVID-19 pandemic continues to evolve and it is too early to identify exemplars...

Although the COVID-19 pandemic continues to evolve and it is too early to identify Exemplars, countries such as South Korea, Vietnam, Germany, and New Zealand have been comparatively successful in controlling the outbreaks within their borders. We're examining emerging COVID-19 success stories to help the global health community identify potential best practices in detection, containment, and treatment.


Early Insights

We started with the four phases of epidemic preparedness and response as defined by the Global Health Security Index project in 2019. Each phase—(1) prevent, (2) detect, (3) respond: contain, and (4) respond: treat—comprises its own set of key actions; at the same time, the four phases are inextricably linked, because success or failure in one phase determines the priorities for subsequent phases. In general, the shape of a country’s epidemic curve depends on its performance during each phase of its response.

As the COVID-19 pandemic continued, with multiple surges in cases and deaths in many countries, it became clearer than ever that the four phases are sequential but not linear: countries can move through them in either direction. As part of Exemplars’ ongoing work on COVID-19 response, we are elaborating a more explanatory conceptual framework that accounts for other contextual and systems factors and interventions, including public-health and other social measures. The new framework will help illustrate how these factors contribute to the outcomes we are using to define “success” in controlling the pandemic and mitigating against its indirect effects; it will also allow us to begin to quantify how much of these outcomes can be attributed to particular components of the framework.

We use a four-part framework to think about epidemic preparedness and response, based on the work developed by the Global Health Security Index project. The framework includes prevent, detect, respond: contain, and respond: treat. Each phase involves its own set of key actions, but the four phases are also inextricably linked, because success or failure in one phase determines priorities for subsequent phases. The shape of a country’s epidemic curve depends in large part on its performance during each phase of its response.

Essential Actions to "box in" the virus

COVID-19 Essential Actions

Countries with a strong, enabling environment that successfully test, isolate infected people, trace contacts, and quarantine contacts can “box in” the virus.

Until an effective COVID-19 vaccine is available, countries need to focus on detecting and containing the disease to reopen society safely. There are four essential actions to strengthen detection and containment: (1) widespread testing to know who is infected, (2) complete isolation of people who are infected, (3) comprehensive tracing of those who were in contact with infected people, and (4) quarantine those contacts to prevent transmission. Using public health measures that already exist, it is possible to keep the pandemic under control, and we highlight several countries that appear to have done so. To implement these measures effectively, countries need to build trust, communicate clearly, and strengthen the enabling environment for public health. All countries need to commit to adapting these proven strategies to their local context.

Authors: Resolve to Save Lives (an initiative of Vital Strategies), & Exemplars in Global Health 
Box it in
How experts use data to identify emerging COVID-19 success stories

Finding COVID-19 Success Stories

Analysis of emerging data suggests which countries are achieving positive results in detecting, containing , and treating COVID-19. This pandemic is unfolding and there is much that remains unknown. Without the benefit of hindsight, we cannot definitely declare exemplars, but we can learn valuable lessons from countries' actions in the initial phase of the pandemic. 

Total confirmed COVID-19 cases, per million people

The basis of Exemplars in Global Health (EGH) is learning lessons from countries that excel in key areas of global health. In a complex, ongoing pandemic such as COVID-19, however, identifying positive outliers can be challenging. Using the epidemic preparedness and response framework, a methodology was devised for understanding, with appropriate rigor and sophistication, which countries are performing well at detecting, containing, and treating COVID-19. Several graphs were included as part of this methodology, and a brief analysis of each graph is provided to describe what it does and does not reveal about the success of the COVID-19 response in a given country.

Authors: UK-Public Health Rapid Support Team, Our World in Data, & Exemplars in Global Health


South Korea Learned the Lessons of MERS

Health system reform in the wake of the MERS epidemic in 2015 put South Korea in a position to act quickly and effectively.

When the COVID-19 pandemic arrived, South Korea quickly established 600 screening centers, transformed public facilities into isolation wards, hired and trained hundreds of epidemiologists and contact tracers, and used technology effectively to contain the disease. With the recent MERS epidemic in mind, the population was especially willing to wear masks, cooperate with contact tracers, and listen to public health officials. In addition, reforms enacted in the wake of MERS gave epidemiological intelligence officers access to much more data, which enabled them to plan and execute a better response.

Authors: Ariadne Labs, Seoul National University College of Medicine, & Exemplars in Global Health

Vietnam's Commitment to Containment

Vietnam’s intensive test-and-trace strategy in areas with confirmed cases is one reason the country has maintained extraordinarily low case counts.


Vietnam’s government started responding to COVID-19 even before the country reported its first case. Although it had a strong public health infrastructure already, Vietnam is not engaging in broad testing; however, if even a single case is reported, it does extensive testing and contact tracing in the area, followed by quarantines. From the beginning, the government has communicated clearly and powerfully with the population about what they can do to contain the virus. Though Vietnam has a population of nearly 100 million, the country reported only 35 deaths from COVID-19 in 2020.

Authors: Oxford University Clinical Research Unit Hanoi, Vietnam’s Ministry of Health, National Institute of Hygiene and Epidemiology in Hanoi, The Partnership for Health Advancement in Vietnam, & Exemplars in Global Health


Germany’s Push to Maintain Progress

Germany early response to COVID-19 was strengthened by a highly effective health system, although it has faced challenges in maintaining its early success.

German researchers developed one of the first COVID-19 diagnostic tests and the country’s laboratories scaled up quickly, leading to high testing capacity throughout the country. Germany’s Robert Koch Institute has gathered detailed epidemiological data which is shared publicly to aid in decision-making. The country’s federal system of government gives significant power to individual states, so the response strategy has varied from state to state. After the country reopened throughout the spring and summer, there was a large surge in cases that started to come under control as of January 2021.

Authors: Robert Koch Institute, Health Protection Authority City of Frankfurt, & Exemplars in Global Health

Exemplars in Global Health COVID-19 Webinar

On July 20, Exemplars in Global Health co-hosted its inaugural webinar in partnership with Amref Health Africa, the Center for Global Development, and the Center for Strategic and International Studies. The conversation featured global experts discussing best practices in COVID-19 response, takeaways from the collective response to date, and how critical learnings from successful country responses to COVID-19 and prior disease outbreaks could shape future response efforts.
Highlights from the full webinar can also be viewed on the Exemplars YouTube channel.

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