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However, there are major divergences between the performance of different countries. Rich and middle-income East Asian countries like Taiwan, Vietnam, and Singapore have managed to nearly halt the outbreak in its tracks, while more ramshackle countries like the U.S. and U.K. have botched it almost beyond belief.

While it is obviously too early to conduct a full accounting of what works and what doesn’t, some broad lessons about best practices are still apparent. America will need to learn these lessons quickly if it wants to save itself from potentially horrifying outcomes, both now and in future pandemics.

It’s fair to say there are three broad levels to any pandemic response, each built on top of the other. The foundation is the national health care system, which provides the necessary broad access to testing and treatment. The second is the state’s administrative bureaucracy and welfare state, which coordinates additional response measures. That means stuff like setting up mass testing checkpoints at border crossings and around the country, securing stockpiles of necessary medical supplies, constructing emergency hospitals, and so on. It also means deploying income support to individuals and businesses should mass lockdowns or quarantines become necessary, to keep people from being ruined financially and the economy ticking over. The third is citizen awareness: The population must be ready to upgrade their hygiene habits, accept drastic restrictions on movement, and avoid gathering together, so transmission is limited.

Of all these, mass testing deserves special emphasis, because without it any emergency response is all but hamstrung. A nation cannot fight an epidemic without knowing where the disease actually is.

The best-performing countries, however, excelled on all three levels. Taiwan has a Medicare-style single-payer system (indeed, it was actually based initially on America’s Medicare system, except made universal), which allowed them to deploy testing, treatment, and quarantine without any fuss. They also had pandemic response plans drawn up after the SARS outbreak in 2002, which had been regularly reviewed and practiced. Finally, their citizens had been educated and prepared to take any epidemic seriously, so that people did not try to escape lockdowns and spread the disease further.

Even middle-income countries can manage this. Vietnam, whose per-capita GDP was only about $6,600 in 2018 (or about 12 percent as much as the U.S.), squelched its initial epidemic with a lightning-fast deployment of mass testing, contact-tracking, quarantine, and public education measures (though it has since been dealing with new infections from foreign travelers). If the state is on top of the situation, mass lockdowns and the associated economic devastation can be limited or avoided.

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