Overview

COVID-19

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. Our partners provide analytical frameworks and models, data, and emerging COVID-19 success stories to help the global health community identify potential best practices in detection, containment, and treatment. We will continue to conduct rigorous research with partners in the coming months and plan to publish additional content later in the year. In the next phase we will focus on low- and middle-income countries, where data is increasingly becoming available, success stories are beginning to emerge, and key lessons are taking shape. We will also explore impacts of the pandemic on externalities, such as economic and health systems.

Contents

Key Insights

Many important questions about COVID-19 do not yet have satisfying answers. EGH’s goal is to enlist experts to help decision makers around the world think about the key issues in a rigorous way.  

We worked with partners to identify essential public health actions; devise a methodology for finding positive outliers in detection, containment, and treatment; and study three emerging COVID-19 success stories in detail. Much of our work has been based on analyses of data provided by our partner Our World in Data, such as the mortality curves below showing the trajectories of COVID-19 deaths in various countries over time. The charts are updated daily and are a useful way to see how countries are managing the pandemic. We are continuing our research and will launch a new version of this page that explores the response in low- and middle-income countries, where more data is becoming available. Additionally, we will research the impacts of COVID-19 on economic and health systems.

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

EMERGING COVID-19 SUCCESS STORY

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 & Exemplars in Global Health

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EMERGING COVID-19 SUCCESS STORY

Vietnam's Commitment to Containment

Vietnam’s aggressive test-and-trace strategy in areas with confirmed cases is one reason the country hasn’t seen a single death.

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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. As a result, 100 days into the epidemic, Vietnam, a country of almost 100 million people, has no deaths and never reached more than 26 daily confirmed cases.

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

EMERGING COVID-19 SUCCESS STORY

Germany's Strong Enabling Environment

Germany response to COVID-19 was strengthened by a highly effective health system and expert science institutions.

German researchers developed one of the first COVID-19 diagnostic tests and the country’s laboratories scaled up quickly, leading to a high number of tests per confirmed case. Germany’s Robert Koch Institute gathered detailed epidemiological data to help the government devise a sensitive response strategy that has kept infection rates low among older adults and prevented hospital overcrowding, leading to a low case fatality rate. In May, Germany started to relax social distancing, relying on a defined set of data-driven criteria for making adjustments to their reopening strategy.

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

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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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