The US has not been doing well in its attempts at mitigating the virus. We discuss what other countries have done that have made them more successful. For example, Vietnam has less than 1,500 cases of COVID19 and Rwanda has less than 8500 cases and fewer than 75 deaths despite having a fraction of the US resources (1% of the US GDP).
What is interesting is the Rwanda health system has always been designed to prevent sickness in the community whereas the US health system is designed to treat sick people in hospitals. We hear frequently that the US is different, and it is, but there are multiple examples of other countries that are doing better with different resource levels, size, geography. The lesson is clear, it is possible to do better. The overriding lesson has been the immediate and urgent focus on the outbreak. We also discuss the small super spreader incidents and the importance of doubling down on all the mitigation measures, especially now.
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Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights for better business, better health.
Fred Goldstein
And I’m Fred Goldstein, with accountable health here helping companies along with Nick and others reopen and operate and also helping them with their overall employee health improvement programs. So I know this week, Nick, there’s been a lot of comparisons going on between the United States and countries around the world. And you’ve got some specific examples that would probably be helpful to all of us.
Nick van Terheyden
Yeah. So we always have a tendency to hold up, the US and US healthcare is doing well, I think, I, I hope most people can agree we’re not doing a good job in this country. We’ve failed on a number of efforts. And, you know, the question is why and what can we learn from other countries. And I sort of picked out a couple that I thought were really interesting, because I hear repeatedly, you know, push back, you can compare the different that this, but Vietnam, has had less than 1500 cases, for the entire duration of this pandemic. And, you know, they’re not as large as us, but they’re not a small country, and they’re not, you know, an island or anything. And then Rwanda, which has 1% of the GDP, that the US has, has had less than 1500. So 8500 cases with fewer than 75 deaths. So think about that 75 total in the duration, you know, fraction. And what is it that they did different? Well, first of all, I think in both those instances, and pretty much most of the countries that we look at, anytime this comes up, they absolutely jump on it like a rooster on a Junebug, and focus all their attention on dealing with this outbreak. Why is that? Well, they’ve had experience with other outbreaks. In the case of Africa, obviously, Ebola has been one of the prevalent ones. And, you know, SARS, MERS, and so forth, has sort of, you know, sensitize people to you can’t discount this, you have to focus all the attention. And the other thing specifically in the Rwanda health system that I think is really important one that we have to sort of pivot our health system to, is it designed to prevent sickness in the community? So this is not about the US healthcare system, which is essentially designed to treat sick people in the hospital, which is what we do, and we do it very well. But that’s not helping us.
Fred Goldstein
Yeah, it’s fascinating. You pointed out, it’s kind of an interesting thing to say, we’re going to focus up front. And we’ve talked about that from an employer perspective for years, and should also be pointed out that both of those countries, you know, are obviously nowhere near the United States in terms of technological capabilities, dollar spent, etc. And we’ve seen some other success stories in terms of things like Israel, where they’ve been ramping it up, and people then say, Oh, yes, but they are a small country, too. But you’ve just disproven that point by looking at those two countries. And we’ve also seen it with Japan. They are taking it as you said, they just jumped on it. I can’t remember the exact reference to the
Nick van Terheyden
rooster on a Junebug and I know I picked that up from an American and I have no idea what a Junebug is and how a rooster is involved, but it sounded good.
Fred Goldstein
It’s absolutely perfect. And Japan’s done the same thing. They suddenly see a quick outbreak in Tokyo and they just shut it down. And so what’s happened is, which just blows my mind is they say to themselves, and I believe they’ve had somewhere north of 3500 total deaths in Japan and you talk about 70 501, we have that number on a daily basis in the United States. And probably for maybe a couple more weeks, I don’t know which way this has gone. But it’s been pretty steady holding up at that near 4000 level or close. So obviously, you can see countries on both sides of that spectrum from very well off technologically advanced to countries that are have do not have the resources that we have in the United States. And that really leads to, again, this whole concept, we have got to ourselves, take it upon ourselves to help solve this problem, and prevent the infections from happening. So are you seeing any of that coming up? Go ahead.
Nick van Terheyden
Yeah, no. So what I was going to say is, you know, when we think about it locally, and individually, you know, as an individual, it’s very hard to sort of think about, you know, a country type response, and, you know, those focuses, when it gets to the businesses and, you know, what’s the message for, you know, our clients, our customers? Well, I think the primary message is take everything seriously, there is no sort of power, we don’t need to worry about that focus all the attention and not, you know, to be overdramatic, or to sort of imply that things are worse than they are, focus on the data and, you know, attention. But then the other thing that I think we’ve seen personally, and sort of locally is these small gatherings. So we talked about super spreader events, but superstretch, spreader events can be in small instances, and they tend to be enclosed, close quarters.
Fred Goldstein
Yeah, it’s been interesting to watch, this gets to that communication thing, it’s hard for us to constantly keep ourselves aware and say, I’m gonna think about CO and I’m gonna think about my mask. And I think about social distancing. And so more recently, we’ve seen this shift, and we’ve heard it from some of our friends and neighbors and others, who have suddenly been in a small group gathering, whether for the holidays, or New Year’s Eve, or Christmas, and then bam, somebody came into that, and four to six people are infected. And so again, we can’t lower our diligence levels. And particularly as we’re seeing more infectious variants come out, we need to increase those levels, and really try to focus on reducing our indoor exposure, wearing a mask, washing our hands, it’s not over yet. And I believe we’ll be doing that, as you probably pointed out a number of times, Nick is the physician, even with the vaccine, there’s still going to be a need for us to maintain many of these behaviors.
Nick van Terheyden
Yeah, we’re not going to stop any of this anytime in the in the near future, at some point, it’s going to change, we’ll have a better understanding of transmission and so forth. If I had an overriding piece of advice is treat everybody as if there are a potential infect all of you, and you are potentially infected. I know that’s a horrible thought. But it doesn’t have to translate into the way that we treat people, but it translates into our behaviors. And that’s the way that I think about everywhere that I walk into, what is my risk based on what I’m seeing? I know you do that all the time locally, right?
Fred Goldstein
Yeah, we’ve really been trying to do it and and upping my game myself and, and the family etc, to really begin thinking about this. And we all can play a role in it. And if you’d like more information about the company and the work we do and some of our clients, you can go to the website we’ve got listed below and check it out, give us a call. And go ahead and we’ll be happy to talk to you or help you out as you’re looking at this issue and others around your employees and their overall health and prevention. So with that this is Fred Goldstein with accountable health. Thanks again so much this week, Nick, it’s been an enjoyable one. And looking forward to next week’s as well.
Nick van Terheyden
And this is Dr. Nick on the incrementalist here with incremental insights for a better business, better health.
