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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day three, ten

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Speaker 1: since coronavirus was declared a global pandemic. Today's episode was

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Speaker 1: first aired in November, so we won't be sharing today's

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Speaker 1: virus news now. For our main story, everyone is fighting

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Speaker 1: the same coronavirus, but nearly a year into the pandemic,

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Speaker 1: quality of life and control of the pathogens spread look

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Speaker 1: vastly different across the world. Bloomberg's COVID Resilience Ranking scores

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Speaker 1: the largest fifty three economies on their success at containing

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Speaker 1: the virus with the least amount of social and economic disruption.

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Speaker 1: Back in November, I spoke to Bloomberg's Rachel Chang, who

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Speaker 1: worked on the Resilience ranking project. I spoke to her

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Speaker 1: about the data and the analysis that went into determining

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Speaker 1: the best places for weathering the pandemic. The findings on

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Speaker 1: the relative strength of healthcare systems around the globe and

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Speaker 1: how they've succeeded or failed to manage the pandemic may

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Speaker 1: surprise you. I was wondering if you might start off

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Speaker 1: just explaining what this new COVID Resilience ranking does and

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Speaker 1: and who it's for. So our idea is to be

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Speaker 1: able to give an accurate view based on data of

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Speaker 1: what's going on in the world right now, because what

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Speaker 1: we've seen of COVID nineteen, it's it's pretty much the

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Speaker 1: biggest public health crisis of a generation. And not only that,

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Speaker 1: everything that we thought we knew about the world and

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Speaker 1: how different countries would handle and pandemic of this scale

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Speaker 1: has actually been proven wrong. There were many pandemic preparedness

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Speaker 1: and healthcare adequacy type of rankings before the COVID nineteen pandemic,

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Speaker 1: and you had countries like the US and the UK

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Speaker 1: top all of those rankings, which clearly have turned out

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Speaker 1: to be wrong. At the same time, this year, we've

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Speaker 1: seen a lot of quite surprising success stories. We've seen

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Speaker 1: developing countries really come out with unique strategies. Some of

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Speaker 1: them have eliminated the entire virus from their local communities.

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Speaker 1: And so the starting point was really that COVID nineteen

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Speaker 1: is going to transform has transformed the world, and Rachel,

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Speaker 1: you know this, this tool has a wealth of data,

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Speaker 1: um but of course we've seen a lot of questions,

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Speaker 1: a lot of interrogation about whether or not COVID nineteen

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Speaker 1: data can be trusted, and I was wondering if you

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Speaker 1: might go into that as it relates to the resilience ranking, right.

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Speaker 1: I mean, the starting point really was that we needed

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Speaker 1: to have daily figures for cases and deaths, and a

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Speaker 1: lot of places have collated that. The ones where the

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Speaker 1: database we're relying on is by the Johns Hopkins University.

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Speaker 1: Of course, we know that case us and fatalities are

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Speaker 1: underreported across the board. That's just um a reality for

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Speaker 1: every country. It's not something that is limited just to

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Speaker 1: developing countries with porus data. It's something that we've seen

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Speaker 1: repeatedly in advanced economies as well. A big fact is

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Speaker 1: just that testing was extremely inadequate in many major countries,

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Speaker 1: and so there were a lot of people and I'm

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Speaker 1: sure you know some who have felt that they probably

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Speaker 1: were sick with COVID, but we're never able to get

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Speaker 1: a test to confirm that. In terms of fatalities, a

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Speaker 1: lot of people as well have died at home before

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Speaker 1: being diagnosed. There's certain countries like Russia where if somebody

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Speaker 1: has a core morbidity, has another disease and then dies

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Speaker 1: after contracting COVID nineteen, sometimes they mark that down as

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Speaker 1: a fatality not due to COVID nineteen. So from what

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Speaker 1: we know from experts, all of that data is underreported,

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Speaker 1: underdetected across the board. One of the things we're looking

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Speaker 1: at UM in the future, although it's not available yet,

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Speaker 1: it's a thing called access mortality that country's record for

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Speaker 1: the whole year. So we can see in countries with

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Speaker 1: pretty good overall death data by comparing what the number

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Speaker 1: is to say, twenty nineteen or the average between twenty fifteen,

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Speaker 1: and you can see that access that will we do

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Speaker 1: to COVID nineteen, and sometimes that is way more than

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Speaker 1: what the official COVID nineteen fatality is. But having said

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Speaker 1: all that, I think we have to go into this

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Speaker 1: project with an understanding that the data is inadequate, that

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Speaker 1: it probably won't be adequate for a long long period

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Speaker 1: of time. But at the same time, it's still a

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Speaker 1: valuable way for us to have a picture of what's

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Speaker 1: going on right now. And I was wondering if maybe

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Speaker 1: we could break down some of the data UM that

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Speaker 1: you do mention and include in the resilience ranking. And

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Speaker 1: one is, of course, and this is a term we've

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Speaker 1: heard used a lot, is the positive test rate. Why

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Speaker 1: is this particular factor important when considering and and why

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Speaker 1: did you choose to included in the resilience ranking. So

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Speaker 1: the positive test rate is something that experts do look

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Speaker 1: at um to look at the situation in the country

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Speaker 1: and how much undetected infection is in the community. So

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Speaker 1: a very high positive test rate basically means that doctors

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Speaker 1: are only testing the sickest people, people who have become

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Speaker 1: so sick that they have to go to hospital very

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Speaker 1: often they are quite close to a very terrible deterioration

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Speaker 1: in their disease um. And what that means is that

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Speaker 1: there is just so many cases out there in your

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Speaker 1: community that haven't been detected. These are people probably moving

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Speaker 1: around and infecting other people. So it's a way to

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Speaker 1: tell how contain or how in control the doctors and

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Speaker 1: the officials are of a situation on the ground. So

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Speaker 1: what we see, for example, is that when the infection

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Speaker 1: the positive test rate falls below five percent for fourteen days,

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Speaker 1: that is when the w h O says that governments

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Speaker 1: should think about relaxing relaxing the lockdown restrictions. Prior to

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Speaker 1: that there's a dangerous amount of infection in the community. Now,

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Speaker 1: speaking of lockdowns, actually that is another indicator you have

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Speaker 1: on the ranking, the lockdown strictness indicator, And I was

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Speaker 1: wondering if you might go into what that is and

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Speaker 1: and maybe continuing on from your previous discussion, why is

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Speaker 1: this so important for us to understand almost from a

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Speaker 1: global level. Yeah, this is a very interesting indicator because

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Speaker 1: I think it's something that's really evolved over the course

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Speaker 1: of the crisis. So it's an indicator that's produced by

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Speaker 1: Oxford University. They have a team of researchers which is

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Speaker 1: monitoring the number and the strictness of lockdown policies that

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Speaker 1: every government in the world is imposing. So and the

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Speaker 1: initial phase of the crisis, what we did see is

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Speaker 1: that countries that impose very strict measures very early on,

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Speaker 1: so what we call that swift and strong and early action,

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Speaker 1: were very successful at containing the virus. So the economies

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Speaker 1: that are ranked in our top ten, for example New Zealand,

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Speaker 1: Taiwan as well, these were places that did have a

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Speaker 1: really stringent reaction early on. But what we've actually seen

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Speaker 1: as the pandemic has gone on is that if a

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Speaker 1: government currently has the need to impose again straight policies

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Speaker 1: of lockdown, that points to actually a failure of containing

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Speaker 1: the coronavirus AP points to a failure of maintaining the

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Speaker 1: gains from previous lockdowns, and so in the in our ranking,

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Speaker 1: we've taken stringency as a negative thing. So the more

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Speaker 1: stringent your current situation is, the lower your score in

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Speaker 1: this indicator. Because I think what we've seen almost a

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Speaker 1: year end the pandemic is that that sort of disruption

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Speaker 1: that lockdown's brain has been extremely economically costly, has been

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Speaker 1: socially very costly to a lot of people. That's been

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Speaker 1: a huge mental health toll from isolation and disruption, and

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Speaker 1: we see it as a negative to people's lives, and

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Speaker 1: that's what we wanted to reflect. Now that indicator seem

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Speaker 1: to have a lot to do with with something else

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Speaker 1: on the ranking, which is community mobility. But I was

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Speaker 1: wondering if you might go into how how that differs

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Speaker 1: how the ranking for community mobility is slightly different from

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Speaker 1: the lockdown indicator. Yeah, so the lockdown the stringency indicated

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Speaker 1: from Oxford University is the number and strictness of government policies,

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Speaker 1: and so you know, it captures the letter of what

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Speaker 1: governments are trying to do, but it does not capture

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Speaker 1: whether or not there is enforcement and compliance on the ground.

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Speaker 1: And what we're seeing is that, you know, there are

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Speaker 1: a lot of places where governments are imposing all of

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Speaker 1: these intense rules, but there's no enforcement, people are not

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Speaker 1: following it um. And then there are also places where

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Speaker 1: governments don't have to really impose any kind of rules,

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Speaker 1: but because of a high level of social compliance and

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Speaker 1: high level of population ownership of the problem, people kind

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Speaker 1: of decide for themselves that they don't want to be

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Speaker 1: as mobile as before, and they stay home more when

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Speaker 1: they hear that they are more cases. So that's two

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Speaker 1: sides of the same coin of disruption. And so at

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Speaker 1: this point we look at mobility as the higher mobility

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Speaker 1: is to the pre pandemic baseline, the better situation economy

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Speaker 1: is in. Right now, one indicator that you do include

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Speaker 1: on this ranking is going to be more and more

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Speaker 1: relevant as we go forward, and that is, of course,

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Speaker 1: the vaccine access indicator. I was wondering if you might

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Speaker 1: maybe unpack a little bit about what people can understand

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Speaker 1: from from this data point. Yeah, this is a really

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Speaker 1: exciting indicator and one that we put a lot of

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Speaker 1: effort into piecing together. Going off on a database that

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Speaker 1: was originally put together by some Duke researchers. But you know,

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Speaker 1: this is such a shifting thing. Countries are announcing new

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Speaker 1: agreements every day, vaccines themselves are making so much progress

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Speaker 1: every day, So it's something we've really had to keep

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Speaker 1: on top of. But we think it's a really valuable

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Speaker 1: way of uh, you know, not just revealing something that's

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Speaker 1: as you said, is is the most important thing that

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Speaker 1: everybody is thinking about right now, but it's also a

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Speaker 1: way to take that ranking and kind of pivoted towards

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Speaker 1: the future because the biggest beneficiary of this indicator being

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Speaker 1: included countries where in the US is the number one

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Speaker 1: example of this, countries who otherwise have lost control of

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Speaker 1: their situations. I was wondering if you might just go

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Speaker 1: through some of the other variables that are measured in

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Speaker 1: the resilience ranking and and perhaps just very briefly the

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Speaker 1: rationale and including some of these variables. So some of

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Speaker 1: the other things that we've included pre pandemic measures, like,

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Speaker 1: for example, the Universal Healthcare Coverage Indicator, which looks at

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Speaker 1: twenty three different aspects of in economies healthcare system, ranging

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Speaker 1: from very basic stuff like basic childhood vaccines to something

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Speaker 1: like cancer care. And what that indicator was shown, although

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Speaker 1: it was the database was put together before COVID nineteen,

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Speaker 1: was that it was really give an idea of the

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Speaker 1: strength of the country's healthcare system, which we think makes

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Speaker 1: a big difference in how patients are helped. The other

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Speaker 1: thing that that does reflect is the ability of a

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Speaker 1: place to continue providing non COVID nineteen healthcare even through

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Speaker 1: the pandemic, and we've seen that that's quite an important

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Speaker 1: facet for maintaining a normal life for a lot of people.

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Speaker 1: Another thing as well, we've included the United Nations Human

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Speaker 1: Development Index, which is quite widely known and widely used

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Speaker 1: as a measure of a country's well being. It's made

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Speaker 1: up of three components. One of that is life expectancy,

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Speaker 1: the second one is wealth per capita, and the third

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Speaker 1: one is expected years of schooling, which we think can

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Speaker 1: act as a proxy for populations trust in science, which

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Speaker 1: has really emerged as something that makes a difference in

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Speaker 1: terms of whether people are following public health guidance like

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Speaker 1: mask wearing, handwashing, These types of small things can really

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Speaker 1: make a big difference. How are you hoping a user

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Speaker 1: of this tool can can apply this information. What can

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Speaker 1: they take away from this resilience ranking? I think I

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Speaker 1: think the main thing that people can take away, first

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Speaker 1: of all is that the coronavirus is not something that

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Speaker 1: cannot be controlled. The economies that have placed really high

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Speaker 1: on the ranking, a lot of the people in these

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Speaker 1: places are living lives pretty much the pre pandemic life,

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Speaker 1: you know, before COVID nineteen was even a thing. Decisive

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Speaker 1: and united action has really helped some of these places.

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Speaker 1: What the ranking really provides is um an idea of

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Speaker 1: where the look for some of these strategies. Right, some

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Speaker 1: of these countries have pioneered some of the best strategies

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Speaker 1: to fight something like this. Secondly, I think what the

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Speaker 1: really helps to do is to put things in perspective

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Speaker 1: for people, because I think it's pretty much a once

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Speaker 1: in a lifetime thing where there is a single event

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Speaker 1: that has affected people around the world in the same magnitude.

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Speaker 1: And Finally, I think it is a ranking that aims

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Speaker 1: to kind of dispel some of the myths that people

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Speaker 1: have to kind of change people's minds and show them

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Speaker 1: that you know, the world is not does not um exists.

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Speaker 1: Accounting to some of these old ideas that we had

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Speaker 1: that kind of ruled the world for so many years, right, Like,

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Speaker 1: the best healthcare systems are not necessarily where we think

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Speaker 1: they are, the strongest science led leadership, and not necessarily

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Speaker 1: in the places that we think they are. And I

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Speaker 1: think one of things that emerged that has emerged is

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Speaker 1: that Asia as a region has been extremely effective at

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Speaker 1: controlling the coronavirus because of very strong public health systems,

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Speaker 1: because of contact traces on the ground, because of publicly

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Speaker 1: funded nurses, because of free health coverage, and these are

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Speaker 1: all things that we want to show people a very

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Speaker 1: important in the coronavirus era. That was Rachel Chang, and

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Speaker 1: that's it for our show today. For coverage of the

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Speaker 1: outbreak from one and twenty bureaus around the world, visit

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Speaker 1: Bloomberg dot com slash coronavirus and if you like the show,

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Speaker 1: please leave us a review and a rating on Apple

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Speaker 1: Podcasts or Spotify. It's the best way to help more

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Speaker 1: listeners find our global reporting. The Prognosis Daily edition is

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Speaker 1: produced by to for foreheads Magnus Hendrickson and me Laura Carlson.

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Speaker 1: Today's main story was reported by Rachel Chang. Original music

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Speaker 1: by Leo Sidrin. Our editors are Rick Shine and Francesco Levi.

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Speaker 1: Francesco Levi is Bloomberg's head of podcasts. Thanks for listening,

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Speaker 1: he Lef