Public Health Strategies to Contain and Mitigate COVID-19: A Tale of Two Democracies

On January 19, 2020, the first cases of coronavirus disease 2019 (COVID-19) were introduced by travelers from Wuhan, China, the initial epicenter, into both South Korea and the United States.1 In this commentary, we compare the responses of both democratic republics and demonstrate that the immediate and nationally coordinated public health strategies employed by South Korea effectively contained and mitigated their epidemic.2 In contrast, the US government mounted a delayed and fragmented response, becoming and remaining the worldwide epicenter of the pandemic.

Upon report of the country's first case, South Korea promptly and efficiently instituted nationally coordinated strategies of containment and mitigation. Ironically, these methods were developed and introduced by the US Centers for Disease Control and Prevention (CDC).3 Further, by the end of February, South Korea had the most COVID-19 patients of any country outside China. Today, South Korea has experienced 14,269 cases and 300 deaths. At present, the United States, accounts for <5% of the world's population but about 25% of cases (>4.4 million) and deaths (>150 thousand). After adjustment for the 6.5-fold difference in populations, the United States has 47 times the number of cases and 79 times the number of deaths.