Experts have come up with a Covid-19 report card that can assess a country's performance in response to the pandemic, and could signal if nations are ready to ease lockdowns and allow for international travel.
The commentary, published yesterday in top medical journal The Lancet, outlined seven indicators to assess national performance, ranging from ability to detect and break transmission chains, to maintaining food and medicine supply chains, and protecting the vulnerable.
"The seven indicators are not just about the potential impact to human health, they directly translate to the ability to preserve lives and livelihoods, to minimise all-round impact to human lives, in an equitable manner," said Professor Teo Yik Ying, dean of the National University of Singapore's Saw Swee Hock School of Public Health, and one of the authors of the paper.
The others were Professor Dale Fisher, senior consultant in the infectious diseases division at the National University Hospital and chair of the World Health Organisation's Global Outbreak Alert and Response Network steering committee, and Dr David Nabarro, special envoy of the WHO for the Covid-19 response.
The paper noted that though some countries - among them the United States and Britain - had ranked highly under existing assessments such as the Global Health Security Index (GHSI), an annual assessment of how ready countries are to deal with infectious disease outbreaks, this did not reflect their actual pandemic preparedness.
Meanwhile, countries like Vietnam and New Zealand, ranked 50th and 35th, respectively, on the index, did well in the pandemic.
"The GHSI regrettably relied only on open source data for their appraisal, but there are some countries that do not publicise their pandemic preparedness plans openly," Prof Teo told The Straits Times.
The seven indicators serve as checkpoints beyond daily case numbers, which are often used to judge a country's handling of Covid-19, but are in fact unreliable in assessing its response, the authors noted.
Case numbers may not reflect the true situation as they are dependent on a country's testing strategy and capacity, and the extent to which individuals go for testing. It also neglects how effectively clusters have been contained and virus transmission suppressed.
Australia, for one, saw new daily coronavirus cases fall to single digits at the end of May but is now witnessing over 200 new cases a day. Its second most populous state, Victoria, reported another 238 cases over 24 hours on Wednesday.
Prof Fisher said: "What it shows is that Victoria is not ready to unlock or open borders; they opened because they had few cases but we can see now that that measure of daily new cases was irrelevant. This could also well apply to other areas that achieved low numbers through lockdowns and border closures."
Generally, places that have done well include Vietnam, Taiwan, Hong Kong, New Zealand and South Korea, Prof Teo said.
"Singapore, in my opinion, has also done well for almost all the indicators, and even though we were unable to avoid the outbreak affecting migrant workers in the country, it is the remedial actions that matter.
"Singapore continues to provide financial safety nets to all migrant workers through provision of complete medical coverage for Covid-19 infection and salary support," said Prof Teo.
But, Prof Fisher said, it is not possible for the experts to assess all countries as information needed is generally not readily available.
"Only governments can self-assess or use the tool to show their strength," he said.