How Countries Are Reopening While Cases Rise

By Julia Stern ’22

A woman wears a mask in Sweden (Photo Credit: Reuters)
A woman wears a mask in Sweden (Photo Credit: Reuters)

As the United States faces its fifth month of contending with COVID-19, countries around the world have begun reopening with varying levels of success.


Dr. David Katz, an American physician and founding director of the Yale-Griffin Prevention Research Center, spoke about long-term efforts to control COVID-19 on Real Time with Bill Maher this April. Dr. Katz said that lockdowns can only last so long, as flattening the curve only delays inevitable deaths. The question for governments then becomes how to reopen safely, forging what Dr. Katz called “a middle path we’ve been neglecting”—one that “minimize[s] deaths and severe cases” but also “minimize[s] societal collapse and economic ruin.”


Many suspect that both a country’s efficiency in its response plan and citizens’ trust in their government dictate its ability to forge this “middle path.” For every nation, a return to normalcy rests largely on what normal has been—both over the last five months and in the pre-COVID-19 age. Some countries’ reopenings have been viewed as cautionary tales, and others’ reopenings as models.


While some countries that are currently reopening are handling minimal cases each day, others have numbers of cases more comparable to the United States. Countries such as Mexico, Russia and Iran, grappling with tens of thousands of cases in the past two weeks, have continued their plans to reopen. Nations such as Panama, Israel and South Africa have experienced a surge in cases after reopening.


In the United States, state governments have taken the initiative to combat the virus. Trusting the federal government has meant being at odds with public health officials; during the first 14 weeks of the pandemic, CNN reported that President Donald Trump made over 650 claims that contradict experts.


While more than 167,000 Americans have died from COVID-19, increased political polarization has caused debates over wearing masks and social distancing. States have reopened and then reversed their plans, as the federal government has not implemented a nationwide response.


South Korea had its first case of COVID-19 on the same day as the United States but was able to flatten the curve without closing businesses or issuing stay-at-home orders. The South Korean government collaborated with scientists and used their pre-existing universal healthcare program to build a robust testing and tracing system. Even in a country praised as a COVID-19 success story, continuing to keep cases low has proven to be a rollercoaster. In May, Seoul’s nightclubs and bars were closed after one man visited five bars in a single night, leading to an outbreak of more than 100 cases, the Wall Street Journal reported. By June, there were 30-50 cases a day, and life seemed to return to normal, but the country had fallen into an economic recession.


Sweden, like South Korea, stayed open in order to avoid unemployment and economic shut downs, but did not enforce quarantine measures. Sweden’s government focused on contact tracing but did not make testing accessible through June. The government relied on individuals to practice social distancing measures, and even to conduct contact tracing. On July 20, The Local reported that Sweden's Public Health Agency is encouraging people who have tested positive for COVID-19 to call people they may have infected.


Many have praised Sweden for emphasizing government partnership with the public instead of enforcing strict laws. Forbes reported that the virus did not overrun the Swedish health care system, and one-third of Swedish citizens voluntarily quarantined. The Wall Street Journal reported that Sweden’s economy declined by 8.6% from April to June. This is a less drastic decline when compared to the United States or the Eurozone economy.


Yet Sweden also has a rate of deaths per 100,000 people that’s nearly double that of the United States and twenty to forty times that of other Nordic nations. Sweden reported a 7% case fatality rate, which more than doubles the United States’ rate of 3.3%, according to mortality analyses by John Hopkins University.


China was the first to implement a quarantine of historic proportions and, at the end of January, locked down 16 cities. In April, China ended its lockdown in Wuhan, the city that reported the first COVID-19 cases. In late May, the central government held a parliamentary meeting in Beijing that supported gradual reopening; students would return to school, people could take business trips to the capital, and social activities and sports could resume. China’s economy slumped due to a drop in consumer spending and exports, though experts expect that it will preserve its trends of consumption long-term, according to CNBC.


In early June, the Associated Press reported that China had successfully tested all 11 million citizens of Wuhan, and only a few people, all asymptomatic, tested positive. As businesses were returning to normal and the manufacturing economy was expanding, 21 cases were reported in Beijing, all traced back to a single meat market. In response, the city closed its businesses and schools and other areas have reinstituted lockdowns. Forbes reported that over one million people were tested within a week of discovering the source.


The outbreak does not necessarily mean that these reopening efforts were unsuccessful. In fact, scientist William A Haseltine argued in a Forbes article that there is little chance of achieving zero infections, and “a successful reopening is [...] measured [...] in [how] the public health system responds to a spike in new infections.”


India reopened restaurants, offices, malls and places of worship on June 8, the BBC reported. Then, it had the fourth-largest number of infections. As of August 7, it has the third highest number of cases of any country, after the United States and Brazil.


Indrani Gupta, a health economist in New Delhi, told the New York Times that the lockdown in India began too soon, and the economy is too dependent on labor to continue the lockdown, yet the number of cases means they should not ease restrictions.


In an article in Foreign Policy, Kunal Purohit called the situation a “grim dichotomy” and a “catastrophic health crisis.” Researchers say that the pandemic is exposing the severely underfunded public healthcare system, just as the pandemic has exposed pre-existing, systemic inequalities within the American healthcare system.


In July, India eased its two-month lockdown and allowed domestic travel in an effort to restore its economy. Lockdowns were particularly devastating in India, as many people live on a daily wage, including millions of informal workers. India has allowed state governments to decide how and when to lift lockdowns, and some areas have containment zones where stricter measures are enforced. Delhi Chief Minister Arvid Kejriwal said that it is his and his constituent’s responsibility to control the pandemic, as COVID-19 will last indefinitely.


A recent New York Times article pointed to both a tradition of individualism and to the Trump administration’s departure from expert advice as reasons for the ongoing outbreak of the virus in the United States. Many suggest that before the United States can take advice from other nations about how to reopen and create a middle path forward, it must first take the measures needed to gain control over the virus.