Where to Be in a Pandemic (Rebroadcast)

vastly different across the world. Bloomberg's COVID Resilience Ranking scores the largest fifty three economies on their success at containing the virus with the least amount of social and economic disruption. Back in November, I spoke to Bloomberg's Rachel Chang, who worked on the Resilience ranking project. I spoke to her about the data and the analysis that went into determining

the best places for weathering the pandemic. The findings on the relative strength of healthcare systems around the globe and how they've succeeded or failed to manage the pandemic may surprise you. I was wondering if you might start off just explaining what this new COVID Resilience ranking does and and who it's for. So our idea is to be able to give an accurate view based on data of what's going on in the world right now, because what we've seen of COVID nineteen, it's it's pretty much the

biggest public health crisis of a generation. And not only that, everything that we thought we knew about the world and how different countries would handle and pandemic of this scale has actually been proven wrong. There were many pandemic preparedness and healthcare adequacy type of rankings before the COVID nineteen pandemic, and you had countries like the US and the UK top all of those rankings, which clearly have turned out to be wrong. At the same time, this year, we've

seen a lot of quite surprising success stories. We've seen developing countries really come out with unique strategies. Some of them have eliminated the entire virus from their local communities.

And so the starting point was really that COVID nineteen is going to transform has transformed the world, and Rachel, you know this, this tool has a wealth of data, um but of course we've seen a lot of questions, a lot of interrogation about whether or not COVID nineteen data can be trusted, and I was wondering if you might go into that as it relates to the resilience ranking, right. I mean, the starting point really was that we needed to have daily figures for cases and deaths, and a

lot of places have collated that. The ones where the database we're relying on is by the Johns Hopkins University. Of course, we know that case us and fatalities are underreported across the board. That's just um a reality for every country. It's not something that is limited just to developing countries with porus data. It's something that we've seen

repeatedly in advanced economies as well. A big fact is just that testing was extremely inadequate in many major countries, and so there were a lot of people and I'm sure you know some who have felt that they probably were sick with COVID, but we're never able to get a test to confirm that. In terms of fatalities, a lot of people as well have died at home before

being diagnosed. There's certain countries like Russia where if somebody has a core morbidity, has another disease and then dies after contracting COVID nineteen, sometimes they mark that down as a fatality not due to COVID nineteen. So from what we know from experts, all of that data is underreported, underdetected across the board. One of the things we're looking at UM in the future, although it's not available yet, it's a thing called access mortality that country's record for

the whole year. So we can see in countries with pretty good overall death data by comparing what the number is to say, twenty nineteen or the average between twenty fifteen, and you can see that access that will we do to COVID nineteen, and sometimes that is way more than what the official COVID nineteen fatality is. But having said all that, I think we have to go into this project with an understanding that the data is inadequate, that it probably won't be adequate for a long long period

of time. But at the same time, it's still a valuable way for us to have a picture of what's going on right now. And I was wondering if maybe we could break down some of the data UM that you do mention and include in the resilience ranking. And one is, of course, and this is a term we've heard used a lot, is the positive test rate. Why is this particular factor important when considering and and why

did you choose to included in the resilience ranking. So the positive test rate is something that experts do look at um to look at the situation in the country and how much undetected infection is in the community. So a very high positive test rate basically means that doctors are only testing the sickest people, people who have become so sick that they have to go to hospital very often they are quite close to a very terrible deterioration

in their disease um. And what that means is that there is just so many cases out there in your community that haven't been detected. These are people probably moving around and infecting other people. So it's a way to tell how contain or how in control the doctors and the officials are of a situation on the ground. So what we see, for example, is that when the infection the positive test rate falls below five percent for fourteen days, that is when the w h O says that governments

should think about relaxing relaxing the lockdown restrictions. Prior to that there's a dangerous amount of infection in the community. Now, speaking of lockdowns, actually that is another indicator you have on the ranking, the lockdown strictness indicator, And I was wondering if you might go into what that is and and maybe continuing on from your previous discussion, why is this so important for us to understand almost from a

global level. Yeah, this is a very interesting indicator because I think it's something that's really evolved over the course of the crisis. So it's an indicator that's produced by Oxford University. They have a team of researchers which is monitoring the number and the strictness of lockdown policies that

every government in the world is imposing. So and the initial phase of the crisis, what we did see is that countries that impose very strict measures very early on, so what we call that swift and strong and early action, were very successful at containing the virus. So the economies that are ranked in our top ten, for example New Zealand, Taiwan as well, these were places that did have a

really stringent reaction early on. But what we've actually seen as the pandemic has gone on is that if a government currently has the need to impose again straight policies of lockdown, that points to actually a failure of containing the coronavirus AP points to a failure of maintaining the gains from previous lockdowns, and so in the in our ranking, we've taken stringency as a negative thing. So the more stringent your current situation is, the lower your score in

this indicator. Because I think what we've seen almost a year end the pandemic is that that sort of disruption that lockdown's brain has been extremely economically costly, has been socially very costly to a lot of people. That's been a huge mental health toll from isolation and disruption, and we see it as a negative to people's lives, and that's what we wanted to reflect. Now that indicator seem to have a lot to do with with something else

on the ranking, which is community mobility. But I was wondering if you might go into how how that differs how the ranking for community mobility is slightly different from the lockdown indicator. Yeah, so the lockdown the stringency indicated from Oxford University is the number and strictness of government policies, and so you know, it captures the letter of what governments are trying to do, but it does not capture whether or not there is enforcement and compliance on the ground.

And what we're seeing is that, you know, there are a lot of places where governments are imposing all of these intense rules, but there's no enforcement, people are not following it um. And then there are also places where governments don't have to really impose any kind of rules, but because of a high level of social compliance and high level of population ownership of the problem, people kind of decide for themselves that they don't want to be as mobile as before, and they stay home more when

they hear that they are more cases. So that's two sides of the same coin of disruption. And so at this point we look at mobility as the higher mobility is to the pre pandemic baseline, the better situation economy is in. Right now, one indicator that you do include on this ranking is going to be more and more relevant as we go forward, and that is, of course, the vaccine access indicator. I was wondering if you might maybe unpack a little bit about what people can understand

from from this data point. Yeah, this is a really exciting indicator and one that we put a lot of effort into piecing together. Going off on a database that was originally put together by some Duke researchers. But you know, this is such a shifting thing. Countries are announcing new agreements every day, vaccines themselves are making so much progress every day, So it's something we've really had to keep

on top of. But we think it's a really valuable way of uh, you know, not just revealing something that's as you said, is is the most important thing that everybody is thinking about right now, but it's also a way to take that ranking and kind of pivoted towards the future because the biggest beneficiary of this indicator being included countries where in the US is the number one example of this, countries who otherwise have lost control of

their situations. I was wondering if you might just go through some of the other variables that are measured in the resilience ranking and and perhaps just very briefly the

rationale and including some of these variables. So some of the other things that we've included pre pandemic measures, like, for example, the Universal Healthcare Coverage Indicator, which looks at twenty three different aspects of in economies healthcare system, ranging from very basic stuff like basic childhood vaccines to something

like cancer care. And what that indicator was shown, although it was the database was put together before COVID nineteen, was that it was really give an idea of the strength of the country's healthcare system, which we think makes

a big difference in how patients are helped. The other thing that that does reflect is the ability of a place to continue providing non COVID nineteen healthcare even through the pandemic, and we've seen that that's quite an important facet for maintaining a normal life for a lot of people. Another thing as well, we've included the United Nations Human Development Index, which is quite widely known and widely used as a measure of a country's well being. It's made

up of three components. One of that is life expectancy, the second one is wealth per capita, and the third one is expected years of schooling, which we think can act as a proxy for populations trust in science, which has really emerged as something that makes a difference in terms of whether people are following public health guidance like mask wearing, handwashing, These types of small things can really make a big difference. How are you hoping a user

of this tool can can apply this information. What can they take away from this resilience ranking? I think I think the main thing that people can take away, first of all is that the coronavirus is not something that cannot be controlled. The economies that have placed really high on the ranking, a lot of the people in these places are living lives pretty much the pre pandemic life,

you know, before COVID nineteen was even a thing. Decisive and united action has really helped some of these places. What the ranking really provides is um an idea of where the look for some of these strategies. Right, some of these countries have pioneered some of the best strategies

to fight something like this. Secondly, I think what the really helps to do is to put things in perspective for people, because I think it's pretty much a once in a lifetime thing where there is a single event that has affected people around the world in the same magnitude. And Finally, I think it is a ranking that aims to kind of dispel some of the myths that people have to kind of change people's minds and show them that you know, the world is not does not um exists.

Accounting to some of these old ideas that we had that kind of ruled the world for so many years, right, Like, the best healthcare systems are not necessarily where we think they are, the strongest science led leadership, and not necessarily

in the places that we think they are. And I think one of things that emerged that has emerged is that Asia as a region has been extremely effective at controlling the coronavirus because of very strong public health systems, because of contact traces on the ground, because of publicly funded nurses, because of free health coverage, and these are all things that we want to show people a very important in the coronavirus era. That was Rachel Chang, and

that's it for our show today. For coverage of the outbreak from one and twenty bureaus around the world, visit Bloomberg dot com slash coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by to for foreheads Magnus Hendrickson and me Laura Carlson. Today's main story was reported by Rachel Chang. Original music

by Leo Sidrin. Our editors are Rick Shine and Francesco Levi. Francesco Levi is Bloomberg's head of podcasts. Thanks for listening, he Lef