As the coronavirus pandemic has forced nations around the world to go into lockdown, Germany and South Korea have made headlines for their early responses to the crisis. In each country, officials moved swiftly to implement widespread testing and contact-tracing programs to identify individuals who had contracted the virus.
Those actions have helped both countries avoid the high death tolls that others have suffered. While there have been 150,000 confirmed coronavirus cases in Germany, to date just over 5,000 people have died, according to researchers at Johns Hopkins University. By comparison, neighboring France has a similar number of confirmed cases, but over four times as many deaths. South Korea, meanwhile, has recorded nearly 11,000 cases, but only 240 deaths.
Now, the two nations are beginning to contemplate what life looks like after the immediate crisis has passed. Schools and small shops started to reopen in some parts of Germany this week, and the country has launched Europe’s first large-scale study to test for coronavirus antibodies — the results of which could shed light on how deadly the virus truly is, and whether people develop some form of immunity, information that could prove crucial to any long-term exit strategy. Initial results are expected next month.
Last week, millions of South Koreans wearing masks and disposable gloves, and standing a safe distance apart, lined up at polling stations to vote in national assembly elections — something that seems almost inconceivable in countries where residents remain under strict lockdown.
“We were very nervous. We believed that it could develop into a pandemic,” Lee Sang-won, an expert on infectious diseases at the Korea Centers for Disease Control and Prevention, told Reuters, about the country’s swift moves to develop a coronavirus test. “We acted like an army.”
South Korean health officials identified the country’s first positive coronavirus case on Jan. 20. Within days, they called a meeting with representatives from more than 20 medical companies, and urged them to develop a test for COVID-19. The country’s first diagnostic tests were approved in early February, and by the end of the month hundreds of testing sites were open around the country, including pioneering drive-thru testing centers. Currently there are 613 testing centers across Korea, including 71 drive-thru sites.
Germany moved quickly as well. A team of researchers at Berlin’s Charité hospital developed the world’s first diagnostic test for the coronavirus in mid-January. It was then rolled out to labs at universities, hospitals, government agencies and private firms across the country.
“We have a culture here in Germany that is actually not supporting a centralized diagnostic system,” Christian Drosten, the leader of the Charité hospital team, told NPR. “So Germany does not have a public health laboratory that would restrict other labs from doing the tests. So we had an open market from the beginning.”
That system allowed Germany to scale up its testing capacity quickly. “By the beginning or middle of February, testing was already in place, broadly,” Drosten said.
Officials in other countries have looked to Germany and South Korea’s testing prowess with envy.
“We all know that Germany got ahead in terms of its ability to do testing for the virus, and there’s a lot to learn from that,” Chris Whitty, England’s chief medical officer, said earlier this month.
The U.K. is working to ramp up its testing capacity, with the goal of being able to conduct 100,000 tests a day by the end of April, but it is likely to fall well short of that target.
The U.K. initially adopted a centralized approach to testing using government labs, before switching to a “Dunkirk”-style strategy involving smaller private labs across the country. Scientists have criticized the government for failing to enlist smaller labs earlier on, saying that “precious time has been wasted.”
In the United States, which recorded its first positive case of the coronavirus in January, on the same day that South Korea did, testing has also lagged behind. The initial test kits developed by the Centers for Disease Control and Prevention were faulty, and labs across the country struggled to navigate the federal bureaucracy, severely delaying the U.S. response to the crisis.
“The idea of anybody getting [tested] easily the way people in other countries are doing it, we’re not set up for that,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told a congressional committee last month. “That is a failing. Let’s admit it.”
More comprehensive testing early on in the pandemic might have allowed countries to avoid imposing paralyzing restrictions on social and economic activity. South Korea’s aggressive testing and contact-tracing program, for example, helped it avoid a nationwide lockdown.
Having failed to control the spread of the coronavirus in the pandemic’s early days, however, officials in other countries have acknowledged that increased testing is a key condition for reopening society.
“This is how we will defeat COVID-19 in the end,” U.K. Prime Minister Boris Johnson has said.
Mass community testing “is part of the strategy,” U.K. health secretary Matt Hancock said last week. “We will be introducing it when we can.”
Researchers at Harvard University recently estimated that U.S. testing capacity would have to triple over the next month in order for the country to reopen safely.
Even as countries are working to increase their diagnostic testing capacity, many are following Germany’s lead by conducting antibody tests, in the hopes that these studies will help chart a path out of the crisis.
Boris Johnson has hailed antibody tests as a potential “game changer” in the battle against the coronavirus. This week, the U.K. launched a large-scale study to track the spread of the virus in the country and test whether previously infected people have developed antibodies. Around 1,000 people will have blood samples taken every month to test for antibodies.
In the U.S., the Food and Drug Administration approved a coronavirus antibody test earlier this month, and this week, New York launched an ambitious antibody testing study involving 3,000 people.
“Any plan to start to reopen the economy has to be based on data and testing, and we have to make sure our antibody and diagnostic testing is up to the scale we need so we can safely get people back to work,” New York Gov. Andrew Cuomo said in a statement, citing Germany’s own antibody testing study.
New York’s antibody testing would be done “in the most aggressive way in the nation,” Cuomo said.
“This will be the first true snapshot of exactly how many people were infected by COVID-19 and where we are as a population, and will help us to reopen and rebuild without jeopardizing what we’ve already accomplished.”
It is believed that people who have recovered from COVID-19 are likely to have developed some degree of immunity to it, but scientists remain uncertain about how widespread infections have been, how much protection antibodies may confer, and how long any immunity might last.
“There are a lot of countries that are suggesting using rapid diagnostic serological tests to be able to capture what they think will be a measure of immunity,” Maria Van Kerkhove, an American infectious diseases expert who is the World Health Organization’s technical lead on COVID-19, told The Guardian. “Right now, we have no evidence that the use of a serological test can show that an individual has immunity or is protected from reinfection.”
With reporting from HuffPost Korea and HuffPost UK.