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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two hundred

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Speaker 1: and fifty six since coronavirus was declared a global pandemic.

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Speaker 1: Today we have a special edition of the show. Everyone

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

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Speaker 1: the pandemic, quality of life and control of the pathogens

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Speaker 1: spread look vastly different across the world. Bloomberg's new COVID

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Speaker 1: Resilience Ranking scores the largest fifty three economies on their

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Speaker 1: success at containing the virus with the least amount of

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Speaker 1: social or economic disruption. I spoke to Bloomberg's Rachel Chang,

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Speaker 1: who worked on the Resilience ranking project, about the data

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Speaker 1: and the analysis that went into determining the best places

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Speaker 1: for weathering the pandemic. The findings on the relative strength

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Speaker 1: of health care systems around the globe and how they've

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Speaker 1: succeeded or failed to manage the pandemic may surprise you.

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Speaker 1: I was wondering if you might start off just explaining

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Speaker 1: what this new COVID Resilience ranking does and and who

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

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Speaker 1: give an accurate view, based on data of what's going

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Speaker 1: on in the world right now, because what we've seen

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Speaker 1: of COVID nineteen, it's it's pretty much the biggest public

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

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

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Speaker 1: different countries would handle and a 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 cases and fatalities underreported across

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Speaker 1: the board. That's just um a reality for every country.

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Speaker 1: It's not something that is limited just to developing countries

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Speaker 1: with porous data. It's something that we've seen repeatedly in

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Speaker 1: advanced economies as well. A big fact is just that

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Speaker 1: testing was extremely inadequate in many major countries, and so

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

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Speaker 1: know some who have felt that they probably were sick

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Speaker 1: with COVID, but we're never able to get a test

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

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Speaker 1: people as well have died at home before being diagnosed.

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Speaker 1: That's certain countries like Russia where if somebody has a

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

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Speaker 1: COVID nineteen, sometimes they mark that down as a fatality

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Speaker 1: not due to COVID nineteen. So from what we know

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Speaker 1: from experts, all of that data is under reported, underdetected

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

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

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Speaker 1: something called access mortality, that country's record for the whole year.

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Speaker 1: So we can see in countries with pretty good overall

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Speaker 1: death data by comparing what the number is to say

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Speaker 1: nineteen or the average between twenty and you can see

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Speaker 1: that access that will be due to COVID nineteen, and

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Speaker 1: sometimes that is way more than what the official COVID

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Speaker 1: nineteen fatality is. But having said all that, I think

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Speaker 1: we have to go into this project with an understanding

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Speaker 1: that the data is inadequate, that it probably won't be

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Speaker 1: adequate for a long, long period of time. But at

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Speaker 1: the same time, it's still a valuable way for us

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Speaker 1: to have a picture of what's going on right now.

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Speaker 1: And I was wondering if maybe we could break down

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Speaker 1: some of the data UM that you do mention and

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Speaker 1: include in the resilience ranking. And one is, of course,

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Speaker 1: and this is a term we've heard used a lot,

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Speaker 1: is the positive test rate. Why is this particular factor

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Speaker 1: important when considering and and why did you choose to

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Speaker 1: include it in the resilience ranking. So the positive test

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Speaker 1: rate is something that experts do look at um to

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Speaker 1: look at the situation in a country and how much

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Speaker 1: undetected infection is in the community. So a very high

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Speaker 1: positive test rate basically means that doctors are only testing

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Speaker 1: the sickest people, people who have become so sick that

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Speaker 1: they have to go to hospital very often, they are

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Speaker 1: quite close to a very terrible deterioration in their disease um.

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Speaker 1: And what that means is that there is just so

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Speaker 1: many cases out there in your community that haven't been detected.

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Speaker 1: These are people probably moving around and infecting other people.

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Speaker 1: So it's a way to tell how contain or how

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Speaker 1: in control the doctors and the officials are of a

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Speaker 1: situation on the ground. So what we see, for example,

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Speaker 1: is that when the infection the positive test rate falls

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Speaker 1: below five percent for fourteen days, that is when the

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Speaker 1: WHO says that governments should think about relaxing relaxing the

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Speaker 1: lockdown restrictions. Prior to that, there's a dangerous amount of

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Speaker 1: infection in the community. Now, speaking of lockdowns, actually that

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Speaker 1: is another indicator you have on the ranking, the lockdown

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Speaker 1: strictness indicator. And I was wondering if you might go

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Speaker 1: into what that is and and maybe continuing on from

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Speaker 1: your previous discussion, why is this so important for us

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Speaker 1: to understand almost from a global level. Yeah, this is

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Speaker 1: a very interesting indicator because I think it's something that's

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Speaker 1: really evolved over the course of the crisis. So it's

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Speaker 1: an indicator that's produced by Oxford University. They have a

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Speaker 1: team of researchers which is monitoring the number and the

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Speaker 1: strictness of lockdown policies that every government in the world

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Speaker 1: is imposing. So and the initial phase of the crisis,

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Speaker 1: what we did see is that countries that impose very

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Speaker 1: strict measures very early on, so what we call that

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Speaker 1: swift and up strong and early action, were very successful

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Speaker 1: at containing the virus. So the economies that are ranked

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Speaker 1: in our top ten, for example New Zealand, Taiwan as well,

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Speaker 1: these were places that did have a really stringent reaction

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Speaker 1: early on. But what we've actually seen as the pandemic

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Speaker 1: has gone on is that if a government currently has

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Speaker 1: the need to impose again stract policies of lockdown, that

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Speaker 1: points to actually a failure of containing the coronavirus. The

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Speaker 1: points to a failure of maintaining the gains from previous lockdowns,

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Speaker 1: and so in the in our ranking, we've taken stringency

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Speaker 1: as a negative thing. So the more stringent your current

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Speaker 1: situation is, the lower your score in this indicator. Because

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Speaker 1: I think what we've seen almost a year ender the

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Speaker 1: pandemic is that that sort of disruption that lockdown's brain

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Speaker 1: has been extremely economically costly, has been socially very costly

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Speaker 1: to a lot of people. That's been a huge mental

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Speaker 1: health toll from isolation and disruption, and we see it

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Speaker 1: as a negative to people's lives, and that's what we

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Speaker 1: wanted to reflect. Now that indicator does seem to have

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Speaker 1: a lot to do with with something else on the ranking,

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Speaker 1: which is community mobility. But I was wondering if you

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Speaker 1: might go into how how that differs how the ranking

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Speaker 1: for community mobility is slightly different from the lockdown indicator. Yeah,

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Speaker 1: so the lockdown the stringency indicated from Oxford University UM

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Speaker 1: is the number and strictness of government policies, and so

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Speaker 1: you know, it captures the letter of what governments are

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Speaker 1: trying to do, but it does not capture whether or

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

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

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

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

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

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

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

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

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

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Speaker 1: mobile as before and they stay home or when here

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

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

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Speaker 1: we look at mobility as the higher mobility is to

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

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Speaker 1: in right now. One indicator that you do include on

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

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Speaker 1: as we go forward in time, and certainly with the

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Speaker 1: news from say Visor and bioin tech, something that we're

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Speaker 1: all very optimistic about, and that is of course the

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

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

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

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

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

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Speaker 1: originally put together by some deep 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, have really lost control of the epidemic,

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Speaker 1: and the US well, the administration of the outgoing President

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Speaker 1: Donald Trump has said openly that they don't want to

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Speaker 1: contain the coronavirus. They want to use treatments and vaccines

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Speaker 1: to solve the crisis. And we've seen them. We've seen

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Speaker 1: the US poll almost twenty billion dollars into funding some

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Speaker 1: of this res such and indeed, it's now in a

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Speaker 1: situation where it has five separate vaccine agreements with five

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Speaker 1: different Phase three candidates, and as we know vaccines like

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Speaker 1: the FISO one has proven extraordinarily effective, and we know

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Speaker 1: that that approval is going to come just in a

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Speaker 1: couple of weeks, So it could very much be a

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Speaker 1: game changer for 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 the economies healthcare system,

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

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

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Speaker 1: although it was the atabase 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: Um another thing as well, We've included the United Nations

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

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

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Speaker 1: made 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 times, small things can really make

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

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Speaker 1: this tool can can apply this information? What can they

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

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

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Speaker 1: is that the coronavirus is not something that cannot be controlled.

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Speaker 1: The economies that have placed really high on the ranking,

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Speaker 1: a lot of the people in these places are living

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Speaker 1: lives pretty much the pre pandemic life, you know, before

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Speaker 1: COVID nineteen was even a thing. Decisive and United action

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Speaker 1: has really helped some of these places control the coronavirus.

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Speaker 1: I mean, Taiwan has gone two d days without a

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Speaker 1: local case. Uh. You know, there's live music, social events,

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Speaker 1: mass social events in New Zealand. What the ranking really

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Speaker 1: provides is um an idea of where the look for

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Speaker 1: some of these strategies. Right some of these countries have

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Speaker 1: pioneered some of the best strategies to fight something like this. Secondly,

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Speaker 1: I think what the virus really helps to do is

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Speaker 1: to put things in past active for people, because I

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Speaker 1: think it's pretty much a once in a lifetime thing

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Speaker 1: where there is a single event that has affected people

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Speaker 1: around the world in the same magnitude. And I think

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Speaker 1: it's very important to have a perspective on, you know,

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Speaker 1: a situation for example, like in Japan, which now is

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Speaker 1: entering a winter wave and the capital of Tokyo just

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Speaker 1: raised its alert to the highest level last week. But

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Speaker 1: Japan is in a situation where there are thirty eight

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Speaker 1: people in serious condition from COVID nineteen right now, which

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Speaker 1: is an extraordinarily low amount by the standards of other places.

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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 that's not um

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Speaker 1: exists accounting to some of these old ideas that we

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Speaker 1: had 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 scions let 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 a 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 are 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. To day. For coverage of

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Speaker 1: the outbreak from one 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 Tophor foreheads in Gaspore, Magnus Hendrickson, and Nie

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Speaker 1: Laura Carlson. Today's main story was reported by Rachel Chang

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Speaker 1: with help from Emma O'Brien. Original music by Leo Sidrin.

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

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