The Seven Habits of the Most Covid-Resilient Countries

These lessons are not so much applicable to a country riven with distrust like the US, as indicative of what has to be achieved to heal address such challenges. 

Which also suggests how far countries like the US have to go. JL

Uri Friedman reports in The Atlantic:

Success in the 21st century will depend on a country’s ability to anticipate and absorb large-scale shocks, adapt to their disruptions, and rapidly bounce forward from them. It will depend on “resilient power.” The 7 habits are: learn from past shocks to prepare for the next crisis; channel expert advice into policy and strategy; follow the data in real time; communicate clearly and transparently; cultivate public trust in government and fellow citizens; design centralized systems sensitive to local concerns; recognize that no country can cope with shock entirely on its own.

he tweet has stuck with me for months now: a chart of cumulative COVID-19 deaths per capita in the United States, the United Kingdom, and South Korea. The U.S. and U.K. lines rise up like mountains relative to the valley of South Korea below. Even as Omicron-related deaths have increased in South Korea more recently, the picture hasn’t changed much.

South Korea “kept deaths 40 times lower all the way till 75% of population fully vaccinated,” the physician Vincent Rajkumar marveled on Twitter in response to the chart. “This is success.”

A more apt word than success might be resilience. As I have previously argued, the COVID crisis has underscored that clout in the 21st century—an era rife with systemic threats including climate change, cyberattacks, and economic crises—will depend on a country’s ability to anticipate and absorb large-scale shocks, adapt to their disruptions, and rapidly bounce back (or even forward) from them. It will depend on “resilient power.” And through its response to the coronavirus so far, South Korea has emerged as a paragon of resilience governance.

South Korea hasn’t proved to be the only resilient power in this period; other standouts include New Zealand and the Nordic countries. Yet South Korea is unusual in that it has not only repeatedly suppressed the spread of the virus and kept deaths to relatively low levels, but also never instituted a full lockdown. As a result, it has experienced much less economic fallout from the crisis than most other major economies. In contrast to other countries that excelled at one stage of the pandemic but struggled at others, South Korea has somehow respectably navigated every stage. After a sluggish start to its vaccine campaign, it now has one of the world’s highest vaccination rates. South Korea has also amassed soft power and diplomatic influence by providing pandemic-related assistance to other countries and establishing itself as a widely perceived model for how democracies should contend with COVID-19.

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“How did South Korea escape the pandemic relatively unaffected economically, with deaths at such low levels, while now vaccinating at such a high level that it has protected itself from future waves of illness and harsh lockdowns?” the public-health expert Devi Sridhar recently inquired. “That’s the question we should all be asking.”

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Below is my answer to that question—in the form of the broad lessons that other countries should learn from South Korea’s achievements. These are the seven habits of highly resilient nations.

1. Learn from past shocks to prepare for the next crisis.

In 2015, an outbreak of Middle East respiratory syndrome (MERS), also caused by a coronavirus, tore through South Korea’s hospitals and caught the government off guard. After initially failing to provide sufficient testing and transparent information about the crisis, however, officials eventually got the outbreak under control.

This “history of lived resilience,” as Michele Grossman, a resilience expert at Deakin University in Melbourne, Australia, once described it to me, gave the South Korean government and public confidence from the start of the SARS-CoV-2 outbreak, when others were either panicking or complacent, that they could prevent the virus from spiraling out of control. This might seem like an encouraging lesson: If resilience is born of the sort of trauma every country has experienced during this pandemic, then every country should now theoretically be primed to be more resilient in the future.

Adversity is not a sufficient condition for resilience, however. As The Atlantic’s Derek Thompson has written, what has set the South Korean government and people apart is their willingness to learn from that adversity and adapt their practices, policies, and institutions accordingly. South Korea’s playbook for containing COVID-19—rapid and widely accessible testing, sophisticated contact-tracing technology, and treatment measures such as compulsory isolation of serious cases—sprang from new legislation and government infrastructure developed as a direct result of MERS and other prior epidemics, such as a 2009 outbreak of H1N1 influenza.

As part of its dozens of post-MERS reforms, the government enhanced its data-collection methods and medical and laboratory facilities. It empowered the Korea Disease Control and Prevention Agency (KCDA). It identified high-priority infectious diseases, stockpiled personal protective equipment and other medical essentials, crafted a plan to disseminate supplies across the country, and conducted drills. MERS also prompted the government to develop closer relationships with biotechnology companies, which paid dividends when the novel coronavirus hit, enabling the country to quickly acquire reagents for diagnostic tests.

2. Channel scientific and other expert advice into policy and strategy.

A December study by Bertelsmann Stiftung, which examined 29 countries in the European Union and the Organization for Economic Cooperation and Development, found that from the earliest days of the coronavirus outbreak, South Korea based its public-health interventions on scientific and socioeconomic expertise from a range of government entities. More broadly, according to the German foundation, countries that can speedily and successfully integrate expert advice into new policies, or adjust existing policies, tend to respond better to crises.

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South Korea’s overall COVID strategy was shaped by deference to such expertise. As Sridhar, the public-health expert, has argued, the country’s short-term focus on “maximum suppression helped buy time for scientists” to “find a sustainable exit from the crisis” through the development and approval of vaccines in 2020 and therapeutics in 2021.

3. Follow the data in real time.

Resilience depends on governments responding early and decisively to fluid realities. That, in turn, requires a commitment to “‘Follow the data’ as a beacon for policy and decision making,” Grossman, of Deakin University, told me.

South Korea has advanced data infrastructure—including a cutting-edge (if also problematic, from a privacy perspective) contact-tracing system—that enabled authorities to swiftly collect and analyze various sorts of pandemic-related data as a means of detecting early warning signs and assessing the effects of government policies. Employing its sensitive, multilevel alert system for infectious-disease risks, the government shifted its focus to economic recovery when new COVID cases dropped and shifted back to virus mitigation when cases surged again.

South Korea was one of only several countries in the Bertelsmann Stiftung study that “succeeded in regularly reviewing the effectiveness of their policies, and in adapting them on an ongoing basis to rapidly changing circumstances or new knowledge,” the report notes.

That achievement should not be underestimated. “Real-time learning [during a crisis] is very, very difficult in the majority of countries,” including nearly all of the study’s front-runners, Christof Schiller, a governance expert at Bertelsmann Stiftung and a co-author of its report, told me. “Korea could be an exception there.”

4. Communicate clearly and transparently with the public.

New Zealand has been the world’s brightest star for crisis communications during the pandemic (its prime minister actually has a degree in communications), but South Korea has distinguished itself in this domain as well, consistently conveying a coherent containment strategy to its people.

As early as January 30, 2020, when the country had only five confirmed COVID cases, the government initiated twice-daily press briefings with public-health officials. It quickly issued press releases and web resources packed with data on the state of the outbreak and steps to counteract it, deployed a mobile-friendly emergency-alert system, established a 24-hour COVID hotline, and disseminated infographics on measures to avoid infection.

Here, too, the South Korean government’s adherence to learning was key. The country’s Infectious Disease Control and Prevention Act, shaped by lessons from the H1N1 and MERS outbreaks, afforded the public “a right to be informed about disease outbreaks” and about government responses to them, note Thomas Kalinowski and Sang-young Rhyu, Bertelsmann Stiftung’s South Korea experts. They explain that “as a result, the government largely disclosed its actions and plans, and was transparent even about difficulties that threatened to increase public levels of frustration, such as the mask shortages in the early days of the coronavirus outbreak.” In leveling with the public about these challenges, the government “restored civic trust and encouraged the population to engage in a communal effort to prevent the spread of the virus.”

That transparency also helped mobilize the private sector to boost South Korea’s resilience by, for instance, developing mobile apps and websites that draw on government data to track mask inventories in stores or paths of viral transmission.

5. Cultivate public trust in government and fellow citizens.

Writing for The Atlantic in 2020, the political scientist Francis Fukuyama argued that the most significant factor in national performance against the pandemic was “whether citizens trust their leaders, and whether those leaders preside over a competent and effective state.” Other scholars have since similarly discovered correlations between countries’ resilience to COVID-19 and their levels of trust in government and within society.

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The authors of one such study of 177 countries and territories recently estimated that if the citizens of every country trusted one another at the level evident in South Korea, which ranked in the 75th percentile for this metric in their survey, the first 21 months of the global coronavirus outbreak might have produced 40 percent fewer infections.

South Korea is not a paragon of public trust in government. Nevertheless, the South Korean public has generally been willing to follow the government’s pandemic guidelines, perhaps because the country’s COVID-19 response has been largely expert-led and depoliticized. In the global survey on trust that it released last month, the public-relations firm Edelman found that South Koreans’ trust in scientists (70 percent) and national-health authorities (56 percent) remained high relative to trust in government leaders (35 percent). Koreans also tend to be more trusting of their civil service, which has a strong culture of performance and accountability assessments, than they are of appointed or elected officials.

6. Design centralized systems sensitive to local concerns.

The Bertelsmann Stiftung study notes that South Korea was one of several “more centralized countries” that topped their rankings in part because “national coordination efforts proved sensitive to local concerns and were thus carried out with the least friction,” by through local authorities empowered to “find solutions that work at the local level.”

By leveraging a centralized but flexible system, the government was able to establish regional centers for disease control and prevention and rush resources, health-care workers, and public-health officials to areas reeling from surges in cases. The government’s Central Disaster and Safety Countermeasures Headquarters—led by the prime minister and established in February 2020—held daily high-level meetings during acute periods of the pandemic to coordinate disaster response across central-government ministries and 17 provinces and major cities.

Notably, many of the countries that have proved most resilient against COVID-19 have been small nations such as New Zealand and the Nordic countries or midsize ones such as South Korea. Maybe this elaborate interplay between national and local systems is easier to pull off in such countries than in larger, more complex, and more diverse ones like the United States. A study of 116 national responses to the pandemic by the Lowy Institute in Australia last year found that countries with populations of fewer than 10 million people “proved more agile than the majority of their larger counterparts.” It’s just one example of how traditional measures of national power—military spending, population size, gross domestic product—don’t necessarily translate into resilience.

7. Recognize that no country can cope with shock entirely on its own.

South Korea’s commitment to continuous learning, scientific expertise, and following the data extended not just to assessments of its own performance during the pandemic but also to assimilating insights from other countries grappling with the same challenges.

Resilient countries don’t “go it alone,” Grossman explained; instead, they “navigate toward and share resources”; understand that their “own well-being is interdependent with, and contingent upon, the well-being of the rest of the world”; and act to “reinforce the reciprocal relations that underwrite this recognition.”

South Korea has not been perfect on this score. Kalinowski and Rhyu write that the government has remained “inward-looking” during the pandemic, showing a willingness to promote South Korea’s successes against COVID-19 to the world but “less interest in coordinating actions with international partners.”

Nevertheless, the government has established travel bubbles with nearby countries and shared its COVID-19 knowledge, testing kits, and anonymized patient data with other countries and international organizations, while launching the Group of Friends of Solidarity for Global Health Security at the United Nations as a platform for countries to exchange lessons from their responses to the virus and other public-health challenges.

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The specific factors that have enabled South Korea to be resilient to COVID-19—its post-MERS crisis-management system, for instance—may not help it respond resiliently to other systemic threats; South Korea performed less well on Bertelsmann Stiftung’s assessments of economic, welfare-state, and democratic resilience during the coronavirus crisis.

Now that the Omicron variant is generating a substantial wave of new COVID cases in South Korea, this might also seem like an odd time to be singling out the country as a model. But the government is once again adapting, for example by ditching its celebrated pandemic playbook for a new one that focuses resources on the most at-risk COVID patients.

And, crucially, resilience is not the absence of failure. It is, instead, failure with grace, followed by robust recovery. For two years we’ve sought out neat success stories in the struggle with COVID. The real trick is managing vulnerabilities to avoid surrendering to shock.