How did a tiny, poor nation manage to suffer only one death from the coronavirus?
www.theatlantic.com
Some excerpts:
"On January 7, a 34-year-old man who had been admitted to a hospital in Bhutan’s capital, Thimphu, with preexisting liver and kidney problems died of COVID-19. His was the country’s first death from the coronavirus. Not the first death that day, that week, or that month: the very first coronavirus death since the pandemic began.
"In fact, what can the U.S. and other wealthy countries learn from the array of resource-starved counterparts that have better weathered the coronavirus pandemic, even if those nations haven’t achieved Bhutan’s impressive statistics? Countries such as Vietnam, which has so far logged only 35 deaths, Rwanda, with 226, Senegal, with 700, and plenty of others have negotiated the crisis far more smoothly than have Europe and North America.
These nations offer plenty of lessons, from the importance of attentive leadership, the need to ensure that people have enough provisions and financial means to follow public-health guidance, and the shared understanding that individuals and communities must sacrifice to protect the well-being of all: elements that have been sorely lacking in the U.S.
"America has “the world’s best medical-rescue system—we have unbelievable ICUs,” Asaf Bitton, executive director of Ariadne Labs, a Boston-based center for health-systems innovation, told me. But, he said, we have neglected a public-health focus on prevention, which socially cohesive low- and middle-income countries have no choice but to adopt, because a runaway epidemic would quickly overwhelm them.
“People say the COVID disaster in America has been about a denial of science. But what we couldn’t agree on is the social compact we would need to make painful choices together in unity, for the collective good,” Bitton added. “I don’t know whether, right now in the U.S., we can have easy or effective conversations about a common good. But we need to start.”
"While President Donald Trump was railing against coronavirus surveillance, Bhutan launched a huge testing and tracing program, and created a contact-tracing app. Last fall, the health ministry rolled out a prevention initiative called “
Our Gyenkhu”—“Our Responsibility”—featuring influencers such as actors, visual artists, bloggers, and sports personalities. When, in August, a 27-year-old woman became the first Bhutanese in the country to test positive for COVID-19 outside of quarantine, a three-week national lockdown followed, with the government ramping up testing and tracing even more, and delivering food, medicine, and other essentials to every household in the land. In December, when a flu clinic in Thimphu turned up the first case of community transmission since the summer, the nation again entered strict lockdown—and again, a full-throttle campaign prevailed against the virus, which has been all but snuffed out for the time being.
In tandem with this rigorous public-health response came swells of civic compassion from every level of society. In April, King Jigme Khesar Namgyel Wangchuck launched a
relief fund that has so far handed out $19 million in financial assistance to more than 34,000 Bhutanese whose livelihoods have been hurt by the pandemic, a program extended until at least the end of March. The government created a country-wide registry for vulnerable citizens, and has sent care packages containing hand sanitizer, vitamins, and other items to more than 51,000 Bhutanese over the age of 60. The Queen Mother gave a
frank address to the nation, calling on the authorities to ensure services for sexual and reproductive health, maternal, newborn, and child health care, and services for gender-based violence, which she deemed “essential.” Thousands of people signed up to leave their homes and families for extended periods of time to join the national corps of orange-uniformed volunteers known as
DeSuung. Bhutan’s monastic community—highly influential in a Buddhist and still largely traditional culture—not only pointedly reinforced public-health messaging but also prayed daily for the well-being of all people during the crisis, not just the Bhutanese.
Government officials modeled the same altruism. During the country’s summer lockdown, Wangmo, the health minister, slept in ministry facilities for weeks, away from her young son. Prime Minister Lotay Tshering, a highly respected physician who continued to perform surgeries on Saturdays during most of the crisis, slept every night during the lockdown on a window seat in his office—
a photo in the newspaper The Bhutanese showed his makeshift bed’s rumpled blankets and an ironing board standing nearby. Members of Parliament gave up a month’s salary for the response effort; hoteliers offered their properties as free quarantine facilities; farmers donated crops. When lights in the Ministry of Health’s offices burned all night, locals brought hot milk tea and homemade
ema datshi—scorching chilies and cheese, the national dish.
“I have complained about ‘small-society syndrome’ and how suffocating it can get. But I believe it is this very closeness that has kept us together,” Namgay Zam, a prominent journalist in Bhutan, told me. “I don’t think any other country can say that leaders and ordinary people enjoy such mutual trust. This is the main reason for Bhutan’s success.”