A South African soldier checks the documents of a resident of Alexandra township, as the military enforces a three-week nationwide lockdown in the country to stem the spread of the coronavirus pandemic. Photo: Reuters
Dale Whittington and Xun Wu
Dale Whittington and Xun Wu

Why coronavirus lockdowns will not be easy for developing countries, and what they can learn

  • As more developing countries impose containment measures to curb the spread of Covid-19, they can look at what has worked or failed elsewhere
  • Major lessons are that there is no time to waste, and the effectiveness of strict lockdown strategies cannot be underestimated
More developing countries have imposed lockdowns as the number of confirmed cases of Covid-19 infection soared in the last week. India has been under an unprecedented nationwide lockdown since March 25, with the country’s 1.3 billion people ordered to stay at home for at least 21 days. South Africa started a three-week lockdown on March 27 and brought in the military to ensure it is enforced.
In Indonesia, President Joko Widodo, commonly known as Jokowi, so far has resisted calls to impose a lockdown because of the social and economic ramifications, but pressure is mounting for such a measure in the capital Jakarta, which has seen over 600 confirmed cases.

As an increasing number of developing countries contemplate stricter containment strategies to control the outbreak, it is critical to reflect on some salient features of the Covid-19 pandemic in the light of the experiences and circumstances in these countries.

Firefighters spray disinfectant on a road in downtown Jakarta. The country has resisted calls to impose a lockdown, despite a spike in coronavirus cases. Photo: AFP

There are a few important facts that decision makers in developing countries must take into consideration as they consider their options.

The first is that Covid-19 is unlike any other epidemic in history: it is less deadly than viruses like Spanish flu, Sars, and Ebola, but it is extremely transmissive and has the potential to collapse an economy. This means that many existing rules and responses are of limited use in dealing with this outbreak.

Many developing countries have accumulated substantial experience and knowledge in dealing with previous epidemics, but deadly mistakes can be made if Covid-19 is tackled with policy measures used in the past. Countries that did not comprehend this earlier have now been paying the price in terms of both thousands of lives lost and a sinking economy.

The second is that this virus outbreak can bring even the best-equipped health care systems in the world to their knees. The tragedies that unfolded in Wuhan, northern Italy and Spain demonstrate that health care systems are simply not designed to cope with a pandemic of this kind and magnitude.

In many cities in developing countries, there will be even more severe shortages of intensive care units and ventilators and they will be overwhelmed almost as soon as an outbreak occurs. For example, India has 2.3 critical care beds per 100,000 people while Italy has 12.5 and the US has 34.7. Other developing countries are even worse off than India.

The third is that the pandemic is likely to last much longer than many medical experts first predicted. Some now believe that it may become a part of the seasonal flu and thus will be with us for months before a vaccine can be developed. Because of this, the Covid-19 outbreak will have devastating economic, political, social and health consequences.

The economic costs of a long battle with Covid-19 would be disproportionately higher for developing countries. Most people do not have the financial liquidity to not work during a prolonged shutdown of the economy. Simply put, they need income to buy food to eat. And governments do not have the resources for the massive public sector stimulus packages that are possible in high-income countries. The United States recently passed a US$2 trillion stimulus package. That is about US$6,000 per person, more than the gross national income per capita of many developing countries.

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A significant advantage for many developing countries is that they can learn important lessons from countries where the Covid-19 outbreak has struck the hardest so far. These countries have responded with very different policies and strategies, providing evidence of both costly mistakes and prudent decisions.

The first lesson is that there is no time to waste in getting prepared for a full-scale pandemic. While the window for sourcing critical medical equipment in large scale might be rapidly closing due to fierce global competition and a lack of financial means, immediate attention should be paid to scale up the capacity for quarantine, and mechanisms for ensuring food supply during the outbreak must be established and tested. Contingency plans for a total lockdown as imposed in India, including plans to help the poor to prepare for the economic shutdown, must be in place.

Second, the effectiveness of stricter containment strategies cannot be taken for granted. Drastic measures such as nationwide lockdowns for extended periods will not only be hard to implement but also less effective in many developing countries where housing conditions are not conducive for self-quarantine, such as when a household does not have a piped water connection or uses a public toilet.

Third, a shutdown of the local and national economy can possibly be prevented if effective efforts can be made to slow down the spread of the virus outbreak. The experiences of South Korea, Japan, and Singapore show how this can be done. Unlike in China, where draconian measures were adopted to quickly contain the spread of the virus, these counties have been able to maintain social and economic activities by actively identifying and isolating infected individuals.

Why Singapore’s coronavirus response worked – and what we can all learn

Lastly, risk communication plays a decisive role not only in preparing the public for the tough times ahead, but also in articulating the difficult trade-offs confronting the government and the general public for major decisions such as a nationwide lockdown. Poor risk communication can be deadly and have tragic, irreversible consequences. For example, Donald Trump consistently played down the risk of Covid-19, facilitating the spread of the outbreak at the initial stage, and has recently mislead the public about the likely duration of the pandemic. Such mistakes could be even more costly for developing countries.

Dale Whittington is a professor of Environmental Sciences and Engineering at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, US, and the Global Development Institute at the University of Manchester, UK. Xun Wu is a professor and the head of the Division of Public Policy at the Hong Kong University of Science and Technology