The number of COVID-19 cases worldwide has now reached almost 120 million, with over 2.5 million deaths globally.

And although it is difficult to compare different countries’ approaches to the pandemic like for like, some countries have fared better than others. So, which strategies have worked well, and which have failed miserably in the fight against COVID?

Asia

Perhaps due to lessons learned from the SARS epidemic, many Asian countries took swift and decisive action when news of the novel coronavirus emerged.

In China, the epicentre of the pandemic, strict lockdown measures and militaristic implementation stopped the virus in its tracks to some degree. Even Hong Kong, which has one of the world’s highest population densities, has managed to keep cases low by establishing mandatory isolation protocols and quarantine centres.

Taiwan was also testing and quarantining travellers from Wuhan before coronavirus had even registered on many other governments’ radars. Since the 2003 SARS outbreak, Taiwan has strengthened its preparations for the next epidemic — including maintaining a stockpile of face masks, setting up an infectious disease prevention network and holding annual hospital drills. This forward-thinking has allowed Taiwan to deploy one of the world’s most successful containment strategies.

Singapore also tightened border controls almost immediately after the outbreak first erupted in China, and Thailand shut down travel between provinces. When the new UK strain of the virus entered Thailand over Christmas, the government also took emergency action to ban public gatherings, introduce temperature checks on entry to public venues such as shops or restaurants and lockdown airports.

Masks Asia

Mask wearing has also been mandatory across many Asian countries since the beginning of the pandemic, with tough fines enforced for anyone out in public without a mask. In Asia, people are used to wearing masks, particularly in the summertime, due to pollution from dust and exhaust fumes. The population is also better educated on the different types of masks available; thus, you will see a lot of people with legitimate face masks that have been tested and rated for efficiency rather than the ‘face coverings’ seen elsewhere.

New Zealand & Australia

New Zealand also wasted no time preventing the spread of COVID-19, and the country has been widely applauded for its handling of the pandemic.

Rather than the ‘flattening the curve’ approach seen in Europe, New Zealand has been committed to a more aggressive elimination strategy from the outset. Travel restrictions to and from other countries were imposed as early as February 2020, and on 26 March, Prime Minister Jacinda Ardern put the country into a full national lockdown despite having only 102 reported cases and zero deaths.

After being free of the virus for several months, health authorities partially shut down Auckland again in November when just one student became infected with COVID-19. In February, Auckland was put into another three-day lockdown after three unexplained cases emerged. The rest of New Zealand outside of Auckland also had restrictions imposed for three days, including mandatory mask-wearing on public transport and limiting crowd sizes to 100.

Australia has taken a similar approach. Its borders have been closed to all foreigners since 20 March, and all international arrivals are required to quarantine for two weeks.

Social distancing measures have also been in place since March last year, and many individual states and territories have closed their borders to varying degrees during localised outbreaks as part of the National Cabinet’s ‘zero-community transmission’ strategy — including a strict four-month lockdown in Victoria after a wave of infections were linked to a Melbourne quarantine hotel.

As well as taking rapid and decisive action, one thing New Zealand, Australia and many of the Asian countries have in common is employing a clear and consistent public communication strategy in their fight against COVID.

The US

In the West, the approach looks quite different. For one, people are not used to wearing masks or being told what to do on this scale. There are a lot of ‘masks don’t do anything’ conspiracy theories flying around and a strong anti-control sentiment, which is really counterproductive. People have been rebellious and not taken the pandemic seriously, and now they are paying the price.

It is perhaps not surprising that some people in the US have taken this view given former President Donald Trump’s initial refusal to wear a face mask and dangerous promotion of injecting disinfectant as a cure for the virus. The US government also turned a blind eye to much of the World Health Organization’s (WHO) advice — including implementing a track and trace system. And despite COVID cases soaring in their states, some governors refused to follow the advice and introduce tighter public health measures, such as mask-wearing.

However, after months of confusion and misinformation, there is now official federal guidance on COVID-19 health measures. On his first day in office, newly elected President Joe Biden also signed executive orders mandating masks on federal property and public transport, including trains, buses and planes.

Europe

Across the pond in Europe, many countries have taken a similar approach to the pandemic — implementing social distancing, mandating masks in public places, and using national and local lockdowns to suppress rising cases. However, the timelines and the specifics of these rules have varied significantly.

For example, France, Germany and the UK all have different social distancing measurements — 1m, 1.5m and 2m, respectively. Even across the United Kingdom’s devolved nations, there has not been one clear, consistent message or approach. And this has undoubtedly led to non-compliance as people have believed the rules to be based on guesswork rather than science.

COVID Lockdown

Compared to many other countries, the UK was late to impose a lockdown. In early March, when Italy became the first European country to impose a COVID-19 lockdown, events such as the Cheltenham Festival were still allowed to continue in the UK with thousands of people in attendance and virtually no protective measures in place. The first UK lockdown was not implemented until 10 days after this event when the death toll had reached 285 people — a stark contrast from New Zealand’s approach.

The question of masks

Compared to much of Asia, the UK and many other countries in the West were slow to implement mandatory mask-wearing. Although some people took the initiative to start wearing them early on in the crisis, the practice was slow to catch on — and ‘face coverings’ were only made compulsory in shops and on public transport from 24 July in England.

The WHO recommends wearing an N95 or FFP2 respirator-style face mask, which provide a more efficient filtration level for COVID-19 particles. These types of face masks are also tested for both exhalation and inhalation, meaning they are designed to protect the user AND those around them.

So, why are we only being told to wear face coverings — including cloth face masks, scarves and bandanas — which have not been tested for filtering efficiency at all?

Earlier this year, Austria and Germany mandated the use of FFP2 masks on public transport and in shops. Several other European countries, including France, are now also considering following suit due to concerns over the impact of possible coronavirus mutations.

However, although these FPP2 disposable masks provide a superior protection level, they are also far more expensive than a cloth mask or standard disposable Type-IIR medical mask. This may explain why some countries are so reluctant to make them mandatory, despite the overwhelming scientific evidence favouring their use.

Choosing the right solution

Fortunately, there is another option. WaivLength’s medical silicone face mask and replaceable FFP2 filters offer the same level of protection as disposable FFP2 masks at a fraction of the cost. The tightly fitted respirator-style facepiece creates an effective seal promising less than 8% leakage, whilst the filter’s two-way filtration protects both the wearer and those around them.

This presents a more affordable solution that would allow governments to mandate the use of FFP2 masks safe in the knowledge that they would be accessible for the wider population.

The solution is out there — so, what are they waiting for?