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Covid-19: Decoding realities

Six countries – the United States, Italy, Spain, France, the United Kingdom, Germany – are at the centre of the pandemic, with more than 64% of all Covid-19 deaths. It would therefore be useful to take a look at how some these countries are managing the situation compared to others. We know that a vaccine won't be available for about 18 months and a treatment is still months off. So what are different countries doing in the meantime? The answers and results vary from one to another.

On closer inspection, the answer ultimately depends on three factors: the state of the healthcare system, the economic reality and the priorities of leaders.As far as the economy is concerned, we can roughly divide countries into three groups: industrialized nations, those in the process of industrialization, and those facing great challenges.

Within healthcare systems, certain elements stand out as having strategic importance at the current juncture. These include the number of beds in intensive care units, available equipment such as artificial respirators and masks for healthcare personnel and the population, as well screening, tracing and research capacity with laboratories capable of developing antiviral treatments and vaccines.

Leaders of each country are called upon to make decisions and adopt policies based on the particular situation and their chosen priorities.
The ideal scenario is a country with a highly sophisticated health system, a solid economy and leaders determined to stop the epidemic in the bestpossible circumstances. The ideal response would be to:
- distribute masks to the entire population;
- carry out large-scale testing;
- carry out contact tracing of infected persons and identify new infection hotspots;
- treat infected people with available treatments;
- provide intensive care to critical cases.
No country in the world meets this hypothetical ideal. Countries are forced to adopt strategies based on their real circumstances.

South Korea – the world's 12th largest economy with a population of 52 million and a sound healthcare system (10.6 intensive care beds per 100,000 population) – massively deployed all available means of prevention and control at its disposal: generalized masks, large-scale testing, monitoring of infected cases, quarantine. Result: 5 deaths per million inhabitants (far from Belgium's 600 deaths), an epidemic under control, a gradual return to normal life with precautionary measures inplace.

The United States – the world's leading industrial power with a population of 331 million and a sophisticated healthcare system (35 intensive care beds per 100,000 inhabitants) – did not adopt a uniform approach. Its overall focus was treating people infected with Covid-19 (with the notable exception of New York State which opted for confinement measures). This strategy, which requires massive testing and systematic monitoring of infected cases, is complicated by the fact that infrastructure and healthcare capacity vary substantially from onelocation to another: approximately 11 million Americans live in counties with no intensive care units. The priority of the U.S. president has been to keep companies operating whatever the cost in terms of human life, given the upcoming presidential elections in November. Result: a poorly-controlled epidemic.

France – the world's 7th economy with 67 million inhabitants and 11.6 ICU beds – responded effectively at the outset when it decided on confinement but then wavered on the wearing of masks and use of testing. France's leaders first claimed that masks were not useful, to later backtrack and encourage their use, even making them mandatory in certain situations. The gaps in terms of masks, screening capacity and contact tracing are being closed. With 357 deaths per million inhabitants, France ranks 4th behind Belgium, Spain and Italy.

Morocco – 37 million inhabitants, an emerging country with its sights set on economic development – quickly realized that with just 4.5 ICU beds, it had to act quickly and make judicious decisions. These consisted of closing the borders, strict generalized confinement and complementary measures such as the compulsory wearing of masks, use of a currently available treatment and financial support for those impacted by the crisis, including the most disadvantaged. To date, with 4 deaths per million inhabitants, the epidemic seems to be under control in Morocco.

Benyounès

To be continued

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