Social contract is key to beating Covid-19, says WHO director

In contrast to European countries and the US, cases of Covid-19 in countries such as Japan, South Korea and China have led to swift and harsh measures being taken in order to loosen the grip of the disease on society.
Social contract is key to beating Covid-19, says WHO director

Fans wearing face masks as a precaution against the coronavirus cheer during the Game 4 of the Korean Series, the Korea Baseball Organization's championship round, between Doosan Bears and NC Dinos at Gocheok Sky Dome in Seoul, South Korea, on Saturday. Picture: AP Photo/Ahn Young-joon)

Asian countries have been much more compliant than European countries in implementing strict Covid-19 measures because they have “long memories” of pandemics.

That's according to the Irish executive director of the World Health Organisation's Health Emergencies Programme, Dr Mike Ryan, who said Asia’s past experience with pandemics and epidemics had led its governments and societies to work together in order to keep Covid-19 cases manageable.

In contrast to European countries and the US, cases of Covid-19 in countries such as Japan, South Korea and China have led to swift and harsh measures being taken in order to loosen the grip of the disease on society.

Although cases have been on the rise in recent weeks in Asia, it is not nearly as bleak as the rampage of Covid-19 across Western Europe and the US, where fatigued populations have let their guard down.

Meanwhile, the Australian state of Victoria has officially declared the disease to be eliminated after a 28-day run of no reported cases, while the states of New South Wales, South Australia and Queensland have reported no cases.

Mr Ryan said the lower levels in Asia and Australia has much to do with the “social contract” in countries where there is a “strong cultural memory” of epidemics.

“You can’t compare China to Korea, or Korea to Australia, or Australia to Thailand. 

They are very different social contracts in those settings, but I would say in general, there is a very high level of  — and I use the word advisedly — trust in government.

“People tend to listen to what the government is saying, and tend to have a very strong sense of social responsibility in Asia. 

"They see their own rights and responsibilities but also recognise very clearly the rights and responsibilities of the community.

“These are probably balanced in a way that allows measures like physical distancing, mask-wearing and other things to have higher levels of compliance. 

"That is not to say that in Europe and America that we cast away the freedoms of the individual, it is very important that we maintain the principles that have allowed democracy to flourish...these are hard-won rights over many centuries...but we have to have a conversation about balancing these rights with those of the community.” 

The same issues arise when it comes to climate change and other existential threats, Mr Ryan said.

Many Asian communities went through epidemics that saw mass culling of animals and other measures.

Mike Ryan, Executive Director of the World Health Organisation
Mike Ryan, Executive Director of the World Health Organisation

“People have that memory. They know that these things are important. Contagion in an Asian context seems to be much more frightening than it seems to be in the West,” he said.

Mr Ryan, who was speaking as he received the Bar of Ireland’s Human Rights Award for 2020, spoke fondly of how his view of the world, human rights and community was shaped in Mayo and Sligo.

A childhood and community he adored were marred by instances of discrimination against Travellers and women, he said.

“I was keenly aware of inequity and how society is structured in a way that mitigates against the good of the all. 

"My dad died when I was young and my mum had to raise three boys in the West of Ireland, a very conservative place, on her own in the 1970s. 

"The struggles of women in Ireland, to be equal and to be seen as equal and treated as equal in Irish society were very apparent to me from a very young age.

“I played a lot of my football with good friends who were Travellers and I saw the struggles they had in being accepted in society. 

"They could stand shoulder to shoulder on the field with me and we could fight together for our parish, but never fully accepted as members of our community.

“It is not the bigger things, but the little things that shape your view of the world.” 

He said the Government was in an unenviable position in regards to Christmas, with “no easy answers” amid “a series of tradeoffs and genuine dilemmas” ahead.

“There is a genuine desire to offer people hope of a celebration at Christmas and ensure that people have the opportunity to celebrate that to the extent possible with family — but recognising that movement and large gatherings in themselves can drive transmission.

“We do know that household transmission is a major factor. Once you deal with community transmission in terms of separating people from each other, you then have a situation where the majority of infections come from households. 

"Infections in households are highly dependent on the number of individuals in that household, the duration they spend there, and the level of their physical contact or otherwise with each other.

“In that sense, instead of dealing with large gatherings and taking the risk out of that, which is on the face of it more straightforward, how do we take the risk out of the small gatherings, the small family situations? 

How does everybody be careful, how do people find a way to reduce the risk to themselves and others? That comes down to very clear advice from the Government on how that can be done. 

A social contract has to be agreed upon between society and government, Mr Ryan said.

“What does society want? What is best for society right now? What level of control is required on the virus versus the desire to be together and share a very important celebration? That requires dialogue and discussion. There are no binary solutions.

“But we have seen in the past that when restrictions are lifted, we see very often disease jumping back up. The question then becomes how good is the testing, the contract tracing, and the quarantining.

“The question is what happens then. 

"Do we go back into another wave of disease or do we have a more Asian outcome where we have much better control at the low level, and we can maintain that control over time, until the point of time when large numbers of people get vaccinated. 

"I don’t envy the Government in its decision, and I don’t envy the Irish people,” he said.

Every person will have to calculate the risk of contracting Covid-19 over the Christmas period, particularly older individuals and people with underlying health conditions, he said.

Simple measures could lie in not thronging a room to watch television together, or separating Christmas dinner tasks like food preparation into different rooms at staggered times, he added.

“Simplistic, small choices” to do so could go a long way, Mr Ryan said.

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