One million lives lost: How have key nations fared during the coronavirus pandemic?

Small differences in preventative measures have dramatically altered the course different countries have taken

Global leaders differed in their response to the virus (Getty)

The coronavirus has now claimed one million lives, but as the crisis developed, countries’ paths have greatly diverged.

Many countries worldwide imposed lockdowns, curfews and other previously unthinkable curbs on personal freedoms.

Although on the surface the measures taken may have appeared broadly similar, minor tweaks and delays have proven to be the potential difference between tens of thousands of infections.

Here we take a snapshot look at how key nations across the world have dealt with the pandemic so far, and the impact this has had upon the lives and health of their populaces.

China

4,739 deaths and 90,493 cases reported

Population: 1.39 billion

• First reported cases to WHO: 31 December
• Wuhan placed on lockdown: 23 January
• Borders closed: 28 March
• Known cases at point of lockdown (Hubei province): 375
• International travel reopened: 3 September (to eight countries, w/ quarantine)
• Daily testing capacity by August: 4.84 million
• Death toll surpassed 1,000: 10 February

When the first cases of an unknown respiratory disease first emerged, centring around a wet market in Wuhan, authorities were keen to be seen acting swiftly in the wake of the 2003 Sars epidemic. 

The nation took a firm grip of the outbreak, closing regional borders and imposing strictly enforced lockdowns with propriety as the virus spread to each of the nation’s 29 provinces. But concerns over transparency grew, with several doctors harshly silenced and officials reluctant to acknowledge human-to-human transmission.

China closed its borders to international travellers in March, and still remains closed off to the vast majority of countries, with travellers from the handful of permitted nations required to quarantine for a fortnight upon arrival.

By March, it reported its first day with no new domestic cases, and has since aggressively contact-traced outbreaks typically linked to neighbouring countries. By early April, Wuhan had emerged from three months of lockdown.

Five months on, the country is now viewed as something of a success story, albeit a largely inimitable one, with active infections currently numbering in their hundreds and authorities quick to react to new outbreaks.

Italy

35,851 deaths and 311,364 cases reported

Population: 60 million

• First case reported: 31 January
• Entered lockdown: 10 March
• Closed borders: 9 July, to certain countries
• Known cases at point of lockdown: 10,149
• Made face masks mandatory in certain settings: 5 April (Lombardy)
• Days without a new case since first peak: 0
• Days from first case to 1,000 deaths: 41
• Most recent daily testing per 1,000 people*: 0.93
• Jobs lost between February and June: 600,000*
• Rise in unemployment rate (March to April)*: -1.2%

The first country to be severely hit by the pandemic in Europe, Italy identified its first two cases in late January, immediately closing air traffic to and from China. However waste water studies and reports of additional flu-type deaths in late 2019 suggest the virus may have reached the country earlier. 

By 21 February, several regions in Lombardy were placed under strict quarantine rules, and on 8 March, authorities decided to place the country’s entire north under lockdown - a decision previously considered unthinkable in western society, followed by a full national lockdown two days later.

While the virus’s peak in Italy was as grim as anywhere in the world, with devastating scenes of overflowing hospital wards, it returned to something resembling normality in the summer, reopening international travel without quarantine restrictions to many European nations. 

Despite developing one of the highest testing capacities in Europe, recent data suggests Italy is nevertheless bracing for a possible second spike of infections this winter.

New Zealand

25 deaths and 1,833 cases reported

Population: 4.8 million

• First case reported: 28 February
• Entered lockdown: 25 March
• Closed borders: 19 March
• Known cases at point of lockdown: 205
• Longest consecutive days without a new case since first peak: 102
• Face masks made mandatory in certain settings: 30 August
• Most recent daily testing per 1,000 people: 1.19
• Unemployment rate change in second quarter*: -0.2%

Having emerged miraculously unscathed from the pandemic, New Zealand has developed a reputation for extreme and effective vigilance. 

Premier Jacinda Ardern has won plaudits for her swift and decisive reaction to the crisis, closing international borders without delay and placing the nation under lockdown in March, operating a strict quarantining system for international arrivals thereafter.

While the country plunged into its worst recession in decades, the prioritisation of health and virus elimination appears set to pay dividends in the future.

By August, the country had gone 102 days without a new case. But a second resurgence in New Zealand’s winter months saw some restrictions reimposed. 

Last week, Ms Ardern celebrated the nation’s collective efforts in getting the virus back under control, lifting restrictions save for in Auckland.

Sweden

5,880 deaths and 90,923 cases reported

Population: 10 million

• First case reported: 31 January
• Entered lockdown: N/A
• Closed borders: 17 March (countries outside EEA)
• Consecutive days without a new case since first peak: 0
• Face masks made mandatory in certain settings: N/A
• Days from first case to 1,000 deaths: 74
• Most recent daily testing per 1,000 people: 1.1
• Unemployment rate change in second quarter*: +2.1%

As most nations around the world appeared to follow a familiar template in dealing with the virus at its outset, particularly in Europe, Sweden stood more or less alone.

While the country’s chief epidemiologist Anders Tegnell would later reject the “herd immunity strategy" label pinned to his lapel by scientists, officials had believed that 40 per cent of Stockholm’s residents would be infected by May. Despite meagre state intervention, one study suggested this figure reached 17 per cent in April.

Primary and secondary schools, restaurants, cafes and shops remained open and gatherings of up to 50 people were still allowed, while officials left it up to individuals whether or not to socially distance or work from home, drawing on the Swedish concept of folkvett, representing the common sense of the people as a collective.

After denouncing lockdowns and criticising European border closures as “ridiculous” and “counterproductive”, Dr Tegnell conceded he should have landed “midway between what Sweden did and what the rest of the world did”.

But, he told France 24 last week: “On the other hand, we don't have the resurgence of the disease that those countries have.” 

While this was borne out in the data – which showed Swedish daily cases continue to number in the low hundreds, as the virus surges elsewhere in Europe – it is not necessarily a result of any level of herd immunity, and cases began to spike in Stockholm last week.

Taiwan

7 deaths and 513 cases reported

Population: 23 million

• First case reported: 21 January
• Entered lockdown: N/A
• Closed borders: 18 March
• Most consecutive days without a new case since first peak: 15 (June)
• Face masks made mandatory in certain settings: 3 April (public transport)
• Most recent daily testing per 1,000 people: 0.01
• Rise in unemployment rate (Feb to August): +0.13%

Having suffered a bruising experience during the Sars epidemic, Taiwan was swift to act upon the announcement of a new respiratory virus, and already had extensive infrastructure in place to deal with such a pandemic.

The country began monitoring passengers from Wuhan the day Beijing informed the World Health Organisation of its first cases, and upon discovering an infection on 20 January, banned Wuhan entrants and screened all arrivals from China. Borders were closed entirely, save for rare exemptions in early March.

Striving to be utterly transparent with its populace, the government developed a high level of trust with citizens, ensuring high compliance with social distancing measures and affinity with the extensive information-sharing employed to contact trace.

Using GPS technology, Taiwan tracked known and potential infections, mitigating several dangerous outbreaks from February onwards, tracking hundreds of thousands of potential carriers at a time. Those told to quarantine were financially compensated and provided with free care packages.

In a further display of transparency, citizens were enabled to digitally interact directly with officials, with discussions on one virtual democracy platform sprouting a government-backed face mask app.

With just one suspected community transmission in the capital since April, residents in Taiwan are currently enjoying personal freedoms and crowds in a manner unequalled nearly anywhere else in the world.

India

95,542 deaths and 6.1 million cases reported

Population: 1.3 billion

• First case reported: 30 January
• Entered lockdown: 25 March
• Closed borders: 11 March
• Known cases at point of lockdown: 618
• Made face masks mandatory in certain settings: 9 April
• Testing capacity hit one million: 21 August
• Days without new case since first peak: 0
• Days from first case to 1,000 deaths: 90
• Most recent daily testing per 1,000 people: 0.02
• Change in unemployment rate during lockdown*: +16.5%

While the virus took some time to emerge in India, stark disparities in healthcare access and standards of living among its vast population meant officials were aware of its potential for devastation.

Embarking on a significant awareness campaign in a bid to inform the nation of the looming pandemic, Narendra Modi’s government was relatively swift in its initial handling of the pandemic despite elections and various other distractions in early 2020, suddenly imposing the world’s largest lockdown in March after identifying just over 500 cases.

In doing so, it confined 1.3 billion people to their homes, sometimes violently, and – by suspending transport and incomes – left tens of thousands of migrant workers to walk hundreds of miles home. Hundreds lost their lives in the process.

Yet while lockdowns bought other countries time to develop contact-tracing systems, scale up testing capacity and bolster health care, India was still lagging on all of these fronts upon emerging from its own crippling lockdown, which was gradually eased in May.

Daily cases began to rise in their tens of thousands by June, approaching 100,000 by late September. And despite accruing the world’s second-largest caseload, and eventually building a testing capacity of one million per day, serological tests suggest at least 50 million people may have been infected.

And with vast disparities between states – and between urban and rural areas – in health care and living conditions, the currently exemplary mortality rate, which could also be accounted for by a lack of sufficient recording, appears set to sour as the virus spreads from wealthier states and cities into more vulnerable areas, where many inhabitants have been battered by lockdown.

United States

205,031 deaths and 7.1 million cases reported

Population: 330 million

• First case reported: 20 January
• First state entered lockdown: 19 March (California)
• Closed borders: 11 March (many countries exempt)
• Number of states to issue stay-at-home orders: 43
• Known cases in California at point of lockdown: 910
• Consecutive days without a new case since first peak: 0
• Days from first case to 1,000 deaths: 66
• Most recent daily testing per 1,000 people: 2.73

Despite publicly playing down the virus’s severity, Donald Trump quickly banned arrivals from China in late January and began ramping up testing and contact-tracing capabilities (with Mr Trump having slashed the pandemic preparedness fund in 2017).

Eventually declaring a state of emergency in late March, the president set up an increasingly combative, unscientific and performative series of daily press conferences.

By April, however, the US death toll became the world’s highest – which it remains to this day – as the virus-ravaged New York. Meanwhile as the virus spread across the country, states and citizens’ responses became embroiled in the country’s culture wars, with right-wingers and Republican-led states typically more inclined to forego restrictions and even basic precautions, such as mask wearing.

South Korea

406 deaths and 23,661 cases reported

Population: 51 million

• First case reported: 20 January
• Entered lockdown: N/A
• Closed borders: N/A (quarantine introduced on 19 March)
• Lowest daily caseload since first peak: 2 (in May)
• Face masks made mandatory in certain settings: (26 May)
• Most recent daily testing per 1,000 people: 0.22
• Change in unemployment rate (November to August)*: 0.0%

Emerging as an initial hotspot for the disease – in February harbouring the largest number of known infections outside of China – South Korea’s trajectory in the weeks that followed is enviable.

Having learnt the perils of delayed action from the Mers epidemic in 2015, authorities quickly ramped up testing capacity to as much as 20,000 per day, returning results within 24 hours. By mid-April, more than one in 100 citizens had been tested.

They swiftly kickstarted a system of mass data gathering in order to contact trace, with phone location data, debit card transaction details and surveillance cameras used to map outbreaks and issue alerts about affected areas with immediacy. 

As a result, South Korea was able to forego the type of lockdowns seen elsewhere across the world, instead closing public spaces and setting out guidance – with high levels of compliance – on social distancing, working from home where possible, and avoiding bars, restaurants and places of worship.

Within three weeks, South Korea had flattened the curve. Having previously reached more than 800 per day, daily cases remained typically in their low tens from April until August, when cases again began to spike in an outbreak widely attributed to  anti-government rallies and an evangelical church, Sarang Jeil. 

While the curve has not flattened at the same rate as in March, case numbers are again dropping to manageable levels.

United Kingdom

42,090 deaths and 441,565 cases reported

Population: 66 million

• First case reported: 31 January
• Entered lockdown: 23 March
• Closed borders: N/A
• Known cases at point of lockdown: 6,650
• Consecutive days without a new case since first peak: 0
• Face masks made mandatory in certain settings: 15 June
• Days from first case to 1,000 deaths: 57
• Most recent daily testing per 1,000 people: 0.93
• Rise in unemployment rate (March to June)*: 0.17%

While the UK had previously been rated as being nearly the best-prepared country in the world for a pandemic, the government has been criticised for much of its early response.

With no border closures or quarantines implemented until June, the number of imported cases quickly rose, and within weeks the government had abandoned contact tracing as cases outstripped meagre testing capacity.

In a bid to prevent the NHS from being overwhelmed, the UK entered lockdown in late March, reportedly after Italy had created the political space to do so over two weeks prior and ministers were shown a new dire projection of what could otherwise lay in store. 

While hospital capacity was not as stretched as feared, tens of thousands of patients were discharged into care homes without tests, creating an epidemic within the nation’s care homes as the UK’s death toll soared to become the highest in Europe.

Following initial criticisms, the government eventually increased testing capacity to among the highest proportionally in the world, but the system delivered only a fraction of tests within 24 hours and has been thrown into fresh chaos as a winter resurgence rears.

Weeks after a government push for workers to return to offices, the nation faces fresh restrictions, and while much of the country is under localised lockdowns, dwindling levels of trust in the government and higher levels of apprehension leave compliance in the event of a second lockdown less certain.