Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two hundred
Speaker 1: and fifty six since coronavirus was declared a global pandemic.
Speaker 1: Today we have a special edition of the show. Everyone
Speaker 1: is fighting the same coronavirus, but nearly a year into
Speaker 1: the pandemic, quality of life and control of the pathogens
Speaker 1: spread look vastly different across the world. Bloomberg's new COVID
Speaker 1: Resilience Ranking scores the largest fifty three economies on their
Speaker 1: success at containing the virus with the least amount of
Speaker 1: social or economic disruption. I spoke to Bloomberg's Rachel Chang,
Speaker 1: who worked on the Resilience ranking project, about the data
Speaker 1: and the analysis that went into determining the best places
Speaker 1: for weathering the pandemic. The findings on the relative strength
Speaker 1: of health care systems around the globe and how they've
Speaker 1: succeeded or failed to manage the pandemic may surprise you.
Speaker 1: I was wondering if you might start off just explaining
Speaker 1: what this new COVID Resilience ranking does and and who
Speaker 1: it's for. So our idea is to be able to
Speaker 1: give an accurate view, based on data of what's going
Speaker 1: on in the world right now, because what we've seen
Speaker 1: of COVID nineteen, it's it's pretty much the biggest public
Speaker 1: health crisis of a generation. And not only that, everything
Speaker 1: that we thought we knew about the world and how
Speaker 1: different countries would handle and a pandemic of this scale
Speaker 1: has actually been proven wrong. There were many pandemic preparedness
Speaker 1: and healthcare adequacy type of rankings before the COVID nineteen pandemic,
Speaker 1: and you had countries like the US and the UK
Speaker 1: top all of those rankings, which clearly have turned out
Speaker 1: to be wrong. At the same time, this year, we've
Speaker 1: seen a lot of quite surprising success stories. We've seen
Speaker 1: developing countries really come out with unique strategies. Some of
Speaker 1: them have eliminated the entire virus from their local communities.
Speaker 1: And so the starting point was really that COVID nineteen
Speaker 1: is going to transform has transformed the world, and Rachel,
Speaker 1: you know this, this tool has a wealth of data,
Speaker 1: um but of course we've seen a lot of questions,
Speaker 1: a lot of interrogation about whether or not COVID nineteen
Speaker 1: data can be trusted. And I was wondering if you
Speaker 1: might go into that as it relates to the resilience ranking, right.
Speaker 1: I mean, the starting point really was that we needed
Speaker 1: to have daily figures for cases and deaths, and a
Speaker 1: lot of places have collated that. The ones where the
Speaker 1: database we're relying on is by the Johns Hopkins University.
Speaker 1: Of course, we know that cases and fatalities underreported across
Speaker 1: the board. That's just um a reality for every country.
Speaker 1: It's not something that is limited just to developing countries
Speaker 1: with porous data. It's something that we've seen repeatedly in
Speaker 1: advanced economies as well. A big fact is just that
Speaker 1: testing was extremely inadequate in many major countries, and so
Speaker 1: there were a lot of people and I'm sure you
Speaker 1: know some who have felt that they probably were sick
Speaker 1: with COVID, but we're never able to get a test
Speaker 1: to confirm that. In terms of fatalities, a lot of
Speaker 1: people as well have died at home before being diagnosed.
Speaker 1: That's certain countries like Russia where if somebody has a
Speaker 1: core morbidity, has another disease and then dies after contracting
Speaker 1: COVID nineteen, sometimes they mark that down as a fatality
Speaker 1: not due to COVID nineteen. So from what we know
Speaker 1: from experts, all of that data is under reported, underdetected
Speaker 1: across the board. One of the things we're looking at
Speaker 1: UM in the future, although it's not available yet, is
Speaker 1: something called access mortality, that country's record for the whole year.
Speaker 1: So we can see in countries with pretty good overall
Speaker 1: death data by comparing what the number is to say
Speaker 1: nineteen or the average between twenty and you can see
Speaker 1: that access that will be due to COVID nineteen, and
Speaker 1: sometimes that is way more than what the official COVID
Speaker 1: nineteen fatality is. But having said all that, I think
Speaker 1: we have to go into this project with an understanding
Speaker 1: that the data is inadequate, that it probably won't be
Speaker 1: adequate for a long, long period of time. But at
Speaker 1: the same time, it's still a valuable way for us
Speaker 1: to have a picture of what's going on right now.
Speaker 1: And I was wondering if maybe we could break down
Speaker 1: some of the data UM that you do mention and
Speaker 1: include in the resilience ranking. And one is, of course,
Speaker 1: and this is a term we've heard used a lot,
Speaker 1: is the positive test rate. Why is this particular factor
Speaker 1: important when considering and and why did you choose to
Speaker 1: include it in the resilience ranking. So the positive test
Speaker 1: rate is something that experts do look at um to
Speaker 1: look at the situation in a country and how much
Speaker 1: undetected infection is in the community. So a very high
Speaker 1: positive test rate basically means that doctors are only testing
Speaker 1: the sickest people, people who have become so sick that
Speaker 1: they have to go to hospital very often, they are
Speaker 1: quite close to a very terrible deterioration in their disease um.
Speaker 1: And what that means is that there is just so
Speaker 1: many cases out there in your community that haven't been detected.
Speaker 1: These are people probably moving around and infecting other people.
Speaker 1: So it's a way to tell how contain or how
Speaker 1: in control the doctors and the officials are of a
Speaker 1: situation on the ground. So what we see, for example,
Speaker 1: is that when the infection the positive test rate falls
Speaker 1: below five percent for fourteen days, that is when the
Speaker 1: WHO says that governments should think about relaxing relaxing the
Speaker 1: lockdown restrictions. Prior to that, there's a dangerous amount of
Speaker 1: infection in the community. Now, speaking of lockdowns, actually that
Speaker 1: is another indicator you have on the ranking, the lockdown
Speaker 1: strictness indicator. And I was wondering if you might go
Speaker 1: into what that is and and maybe continuing on from
Speaker 1: your previous discussion, why is this so important for us
Speaker 1: to understand almost from a global level. Yeah, this is
Speaker 1: a very interesting indicator because I think it's something that's
Speaker 1: really evolved over the course of the crisis. So it's
Speaker 1: an indicator that's produced by Oxford University. They have a
Speaker 1: team of researchers which is monitoring the number and the
Speaker 1: strictness of lockdown policies that every government in the world
Speaker 1: is imposing. So and the initial phase of the crisis,
Speaker 1: what we did see is that countries that impose very
Speaker 1: strict measures very early on, so what we call that
Speaker 1: swift and up strong and early action, were very successful
Speaker 1: at containing the virus. So the economies that are ranked
Speaker 1: in our top ten, for example New Zealand, Taiwan as well,
Speaker 1: these were places that did have a really stringent reaction
Speaker 1: early on. But what we've actually seen as the pandemic
Speaker 1: has gone on is that if a government currently has
Speaker 1: the need to impose again stract policies of lockdown, that
Speaker 1: points to actually a failure of containing the coronavirus. The
Speaker 1: points to a failure of maintaining the gains from previous lockdowns,
Speaker 1: and so in the in our ranking, we've taken stringency
Speaker 1: as a negative thing. So the more stringent your current
Speaker 1: situation is, the lower your score in this indicator. Because
Speaker 1: I think what we've seen almost a year ender the
Speaker 1: pandemic is that that sort of disruption that lockdown's brain
Speaker 1: has been extremely economically costly, has been socially very costly
Speaker 1: to a lot of people. That's been a huge mental
Speaker 1: health toll from isolation and disruption, and we see it
Speaker 1: as a negative to people's lives, and that's what we
Speaker 1: wanted to reflect. Now that indicator does seem to have
Speaker 1: a lot to do with with something else on the ranking,
Speaker 1: which is community mobility. But I was wondering if you
Speaker 1: might go into how how that differs how the ranking
Speaker 1: for community mobility is slightly different from the lockdown indicator. Yeah,
Speaker 1: so the lockdown the stringency indicated from Oxford University UM
Speaker 1: is the number and strictness of government policies, and so
Speaker 1: you know, it captures the letter of what governments are
Speaker 1: trying to do, but it does not capture whether or
Speaker 1: not there is enforcement and compliance on the ground. And
Speaker 1: what we're seeing is that you know, there are a
Speaker 1: lot of places where governments are imposing all of these
Speaker 1: intense rules, but there's no enforcement, people are not following
Speaker 1: it um. And then there are also places where governments
Speaker 1: don't have to really impose any kind of rules, but
Speaker 1: because of a high level of social compliance and high
Speaker 1: level of population ownership of the problem, people kind of
Speaker 1: decide for themselves that they don't want to be as
Speaker 1: mobile as before and they stay home or when here
Speaker 1: that they are more cases. So that's two sides of
Speaker 1: the same coin of disruption. And so at this point
Speaker 1: we look at mobility as the higher mobility is to
Speaker 1: the pre pandemic baseline, the better situation on economy is
Speaker 1: in right now. One indicator that you do include on
Speaker 1: this ranking is going to be more and more relevant
Speaker 1: as we go forward in time, and certainly with the
Speaker 1: news from say Visor and bioin tech, something that we're
Speaker 1: all very optimistic about, and that is of course the
Speaker 1: vaccine access indicator. I was wondering if you might maybe
Speaker 1: unpack a little bit about what people can understand from
Speaker 1: from this data point. Yeah, this is a really exciting
Speaker 1: indicator and one that we put a lot of effort
Speaker 1: into piecing together. Going off on a database that was
Speaker 1: originally put together by some deep researchers. But you know,
Speaker 1: this is such a shifting thing. Countries are announcing new
Speaker 1: agreements every day, vaccines themselves are making so much progress
Speaker 1: every day, So it's something we've really had to keep
Speaker 1: on top of. But we think it's a really valuable
Speaker 1: way of uh, you know, not just revealing something that's,
Speaker 1: as you said, is is the most important thing that
Speaker 1: everybody is thinking about right now, but it's also a
Speaker 1: way to take that ranking and kind of pivoted towards
Speaker 1: the future because the biggest beneficiary of this indicator being
Speaker 1: included countries where in the US is the number one
Speaker 1: example of this, have really lost control of the epidemic,
Speaker 1: and the US well, the administration of the outgoing President
Speaker 1: Donald Trump has said openly that they don't want to
Speaker 1: contain the coronavirus. They want to use treatments and vaccines
Speaker 1: to solve the crisis. And we've seen them. We've seen
Speaker 1: the US poll almost twenty billion dollars into funding some
Speaker 1: of this res such and indeed, it's now in a
Speaker 1: situation where it has five separate vaccine agreements with five
Speaker 1: different Phase three candidates, and as we know vaccines like
Speaker 1: the FISO one has proven extraordinarily effective, and we know
Speaker 1: that that approval is going to come just in a
Speaker 1: couple of weeks, So it could very much be a
Speaker 1: game changer for countries who otherwise have lost control of
Speaker 1: their situations. I was wondering if you might just go
Speaker 1: through some of the other variables that are measured in
Speaker 1: the resilience ranking and and perhaps just very briefly the
Speaker 1: rationale and including some of these variables. So some of
Speaker 1: the other things that we've included pre pandemic measures, like,
Speaker 1: for example, the Universal Healthcare Coverage Indicator, which looks at
Speaker 1: twenty three different aspects of in the economies healthcare system,
Speaker 1: ranging from very basic stuff like basic childhood vaccines to
Speaker 1: something like cancer care. And what that indicator was shown,
Speaker 1: although it was the atabase was put together before COVID nineteen,
Speaker 1: was that it was really give an idea of the
Speaker 1: strength of the country's healthcare system, which we think makes
Speaker 1: a big difference in how patients are helped. The other
Speaker 1: thing that that does reflect is the ability of a
Speaker 1: place to continue providing non COVID nineteen healthcare even through
Speaker 1: the pandemic. And we've seen that that's quite an important
Speaker 1: facet for maintaining a normal life for a lot of people.
Speaker 1: Um another thing as well, We've included the United Nations
Speaker 1: Human Development Index, which is quite widely known and widely
Speaker 1: used as a measure of a country's well being. It's
Speaker 1: made up of three components. One of that is life expectancy,
Speaker 1: the second one is wealth per capita, and the third
Speaker 1: one is expected years of schooling, which we think can
Speaker 1: act as a proxy for populations trust in science, which
Speaker 1: has really emerged as something that makes a difference in
Speaker 1: terms of whether people are following public health guidance like
Speaker 1: mask wearing, handwashing. These times, small things can really make
Speaker 1: a big difference. How are you hoping a user of
Speaker 1: this tool can can apply this information? What can they
Speaker 1: take away from this resilience ranking? I think I think
Speaker 1: the main thing that people can take away, first of all,
Speaker 1: is that the coronavirus is not something that cannot be controlled.
Speaker 1: The economies that have placed really high on the ranking,
Speaker 1: a lot of the people in these places are living
Speaker 1: lives pretty much the pre pandemic life, you know, before
Speaker 1: COVID nineteen was even a thing. Decisive and United action
Speaker 1: has really helped some of these places control the coronavirus.
Speaker 1: I mean, Taiwan has gone two d days without a
Speaker 1: local case. Uh. You know, there's live music, social events,
Speaker 1: mass social events in New Zealand. What the ranking really
Speaker 1: provides is um an idea of where the look for
Speaker 1: some of these strategies. Right some of these countries have
Speaker 1: pioneered some of the best strategies to fight something like this. Secondly,
Speaker 1: I think what the virus really helps to do is
Speaker 1: to put things in past active for people, because I
Speaker 1: think it's pretty much a once in a lifetime thing
Speaker 1: where there is a single event that has affected people
Speaker 1: around the world in the same magnitude. And I think
Speaker 1: it's very important to have a perspective on, you know,
Speaker 1: a situation for example, like in Japan, which now is
Speaker 1: entering a winter wave and the capital of Tokyo just
Speaker 1: raised its alert to the highest level last week. But
Speaker 1: Japan is in a situation where there are thirty eight
Speaker 1: people in serious condition from COVID nineteen right now, which
Speaker 1: is an extraordinarily low amount by the standards of other places.
Speaker 1: And finally, I think it is a ranking that aims
Speaker 1: to kind of dispel some of the myths that people
Speaker 1: have to kind of change people's minds and show them
Speaker 1: that you know, the world is not that's not um
Speaker 1: exists accounting to some of these old ideas that we
Speaker 1: had that kind of ruled the world for so many years. Right, Like,
Speaker 1: the best healthcare systems are not necessarily where we think
Speaker 1: they are, the strongest scions let leadership, and not necessarily
Speaker 1: in the places that we think they are. And I
Speaker 1: think one of things that emerged that has emerged is
Speaker 1: that Asia as a region has been extremely effective at
Speaker 1: controlling a coronavirus because of very strong public health systems,
Speaker 1: because of contact traces on the ground, because of publicly
Speaker 1: funded nurses, because of free health coverage, and these are
Speaker 1: all things that we want to show people are very
Speaker 1: important in the coronavirus era. That was Rachel Chang and
Speaker 1: that's it for our show. To day. For coverage of
Speaker 1: the outbreak from one twenty bureaus around the world, visit
Speaker 1: Bloomberg dot com slash coronavirus and if you like the show,
Speaker 1: please leave us a review and a rating on Apple
Speaker 1: Podcasts or Spotify. It's the best way to help more
Speaker 1: listeners find our global reporting. The Prognosis Daily edition is
Speaker 1: produced by Tophor foreheads in Gaspore, Magnus Hendrickson, and Nie
Speaker 1: Laura Carlson. Today's main story was reported by Rachel Chang
Speaker 1: with help from Emma O'Brien. Original music by Leo Sidrin.
Speaker 1: Our editors are Rick Shine and Francesco Levi. Francesco Levi
Speaker 1: is Bloomberg's head of podcasts. Thanks for listening.