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Thursday, February 13, 2020

Coronavirus response in China and Kerala - A study in contrast?

China's cover-up and reluctance to make public the full extent of the crisis at the early stages, which worsened the problem and allowed the epidemic to spread this fast and wide, is now widely acknowledged.
On January 18, roughly six weeks after China’s deadly coronavirus started to spread in Wuhan, the city’s Baibuting district was preparing for its annual mass banquet. On the 20th anniversary of the event, the organisers would be attempting to break a world record for the largest number of dishes served. Long tables in 10 locations were laid out with a total of 13,986 dishes, some bearing patriotic names such as Motherland in My Heart (cucumber and ham), and One Belt One Road (vegetable salad). The platters were prepared by members of some 40,000 families, according to media reports, with many of them showing up to eat the food and smile for the cameras... The district is now facing a rising toll of infected citizens. Notices saying “fever block” in red and black letters were pasted this week on 57 communal stairwells in the district... Piecing together the events in Wuhan shows that for at least three weeks before the banquet, city authorities had been informed about the virus spreading in their midst but issued orders to suppress the news. In effect, they engineered a cover-up that played down the seriousness of the outbreak, according to officials and medical professionals... 
The most fateful consequence of the official silence was that it facilitated the exodus of some 5m people in the weeks before the city was quarantined on January 22, thus helping to transport the virus all over the country and overseas... Just as with China’s Sars outbreak that killed 800 people worldwide in 2002-03, the central shortcomings in China’s response have derived from its rigidly hierarchical political system... In the current political atmosphere, which values obedience more than competence, local officials have an incentive to avoid taking responsibility.
See this about questions on the veracity of China's data.

Contrast this with Kerala's transparent and early action based handling of the corona virus,
A prime feature of the Kerala government’s response to calamities like the back-to-back floods or the Nipah crisis in 2018 that claimed 18 lives has been its transparency and openness. The tradition continues during the coronavirus outbreak as well. Top officials of the government have shown no reluctance in disclosing key information as and when required and allowing it to percolate down to the public. Press conferences have been routinely held, especially by the health minister herself, when positive cases of infection are reported. Daily bulletins are released on the government’s isolation and quarantine measures. At the same time, a clear hierarchy has been fixed with certain officials designated to speak to the press on the crisis. This ensures no one speaks out of line... As part of surveillance, a mammoth list of 2,239 people has been charted, all of whom arrived in Kerala from virus-affected countries and a majority of those who are studying to become medical professionals in Wuhan. While 84 of those have been admitted to select isolation facilities across the state, the rest, 2,155 persons, have been placed under home quarantine.
... when the WHO declaration on the severity of the virus came about, Kerala had already begun stacking up a line of defences to counter the outbreak. Preliminary screening procedures were put into place at the four international airports, beginning with Cochin, where returning travellers were handed over strict advisories on contacting medical officials in case of symptoms. If they showed symptoms at the airport itself, a sterilised ambulance was ready to ferry them to the nearest medical college where isolated wards were set up. Travellers were briefed on basic do’s and don’ts’ of home quarantine and their contact details were collected for subsequent surveillance.
A nice feature on KK Shailaja, the Kerala Health Minister.

Shades of Amartya Sen's argument about how democracies are better able to avoid the likes of famines?

Update 1 (10.03.2020)

This is a very good story on how systematic suppression of reporting cases has worsened the African swine fever epidemic among pigs in China. 
Local officials have also avoided reporting outbreaks out of fear of the political consequences. And they have routinely refused to test pigs for the virus when mass deaths are reported.
And this about the Covid 19 outbreak,
When the coronavirus hit, Chinese authorities reacted with a push to reassure the public that all was well. The first reported death from the virus, also known as SARS-CoV-2, came on Jan. 9 - a 61-year-old man in Wuhan. In the following days, Chinese authorities said that the virus was under control and not widely transmissible. The assurances came despite a lack of reliable data and testing capacity in Wuhan. Testing kits for the disease were not distributed to some of Wuhan’s hospitals until about Jan. 20, an official at the Hubei Provincial Centre for Disease Control and Prevention (Hubei CDC) told Reuters. Before then, samples had to be sent to a laboratory in Beijing for testing, a process that took three to five days to get results, according to Wuhan health authorities. During that gap, city hospitals reduced the number of people under medical observation from 739 to 82, according to data from Wuhan health authorities compiled by Reuters, and no new cases were reported inside China.

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