- The fight at the frontlines of Covid-19 is being waged in clinics and hospitals around the world.
- But the success of that fight depends on the effectiveness of the healthcare systems in each country.
- A noticeable correlation lies between a country’s ability to contain the virus and previous rankings of its healthcare system.
- The Legatum Prosperity Index is an outcome of the eponymous London-based think tank.
- It measures the economic and social prosperity policies and conditions based on 12 pillars in 167 nations.
- The health pillar of the index specifically measures the extent to which people in each country are healthy.
- It is also based on people’s access to services related to good health, including health outcomes, healthy systems, illnesses and risk factors, and mortality rates.
A recent article by Lindsey Galloway in BBC highlights the effectiveness of the healthcare systems in each country and its relevance to corona virus.
This article highlights the views of doctors and residents in some of the top-ranked countries within the health pillar. It reveals the aspects of the medical establishment have enabled them to manage the virus. Its also deals with outcomes, what continued challenges lie ahead, and how locals are feeling about living there.
Ranked second in the index’s health pillar, Japan has been praised globally for its early successful management of Covid-19. A recent infection spike has put the country back on alert, with the prime minister issuing a state of emergency across much of the country on 7 April. Despite that, the country has not yet enforced a lockdown, and this is in large part due to the ability of the country’s medical system to manage the virus in its early stages.
The existing health-conscious culture of Japan has also minimised the impact of the Covid-19 crisis. “Many Japanese already wear a face mask, especially in winter and spring, and it is also one of the reasons that we don’t have a big outbreak yet,” said Tokyo-based Dr Mika Washio, a doctor at AirDoctor. “Additionally, more than 60% of Japanese have an annual health check-up, and we try to keep [in] good health condition, so it is another cause of less severe cases.”
Coming in at fourth place in Legatum’s health pillar, South Korea was particularly prepared to handle the Covid-19 outbreak after the experience of containing Middle-East respiratory syndrome (Mers) in 2015. Healthcare providers and hospitals were already equipped and trained to act in such a crisis. The country has been able to test more than 450,000 people, just under 1% of its population of 51 million, and the daily new caseload has been hovering at just 47 to 53 infections in recent days.
“Due to relatively low medical cost thanks to universal public insurance coverage coupled with government-driven price setting, in addition to a fee-for-service model, imaging and lab tests are widely performed in South Korea’s healthcare system,” said Seoul-based Dr Brandon B SuhSuh.
When it came to monitoring and reacting to the emergence of Covid-19 in Wuhan, few countries moved more swiftly than Israel, ranked 11th in the health index. By the end of January 2020, the Minister of Health had already signed the People’s Health Ordinance Decree to expand the Ministry’s powers to deal with the potential outbreak. While the measures, which included avoidance of non-essential international travel and home isolation for 14 days for citizens who returned from “hot spots”, may have seemed strict early on, the action has paid off in an overall lower rate of infection and hospitalisations than other similarly sized countries.
Accurate testing was also established early on in Israel. “A molecular diagnostic test (RT-PCR) to detect coronavirus in respiratory samples was developed very early by the Central Virology Laboratory, and was expanded to numerous laboratories across the country,” said Dr Khitam Muhsen, professor of epidemiology and preventive medicine at Tel Aviv University and one of the consultants to the Ministry of Health in Israel regarding the Covid-19 crisis. “Israel is among the leading countries in the number of coronavirus tests per million population.”
With an overall lower Covid-19 mortality rate than many of its European neighbours, Germany – ranked 12th in health in the index – has been hailed as an international success story, but experts there caution that the country isn’t yet out of the woods.
“Vastly higher levels of testing in Germany can create an illusion around how well the country’s healthcare is coping, and also how low the mortality rate actually is in comparison to other countries,” said Francis de Véricourt, chaired professor of management science at the European School of Management and Technology in Berlin and keynote speaker at the International Congress on Infectious Diseases. However, the wide testing capabilities of the country have led to success at separating sick and asymptomatic patients from the healthy population, helping contain the spread.
Coming in at 18th in the health pillar in the index, Australia has currently managed to keep the growth rate of cases to less than 5% – “well beyond our expectations” and projected case models, according to the Prime Minister in an address to the country on 7 April.
Australia’s “blended” healthcare system, a mixture of universal coverage through Medicare and a much-used private system, has helped prepare the country for any worst-case scenarios. “In the current pandemic, this two-tier system is particularly suitable to accommodate projected increase in demand for emergency services and ICU beds,” said Dr Alex Polyakov, clinical senior lecturer at the University of Melbourne. “The federal and state governments directed all non-essential surgeries to be postponed. This allowed the private hospitals to be placed on standby for the anticipated influx of Covid-19 patients.” That, in combination with the federal government agreeing to financially back private hospitals in exchange for using beds and staff, has essentially doubled the capacity of the public system.
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