By Barend ter Haar.
Which country has the world’s best health care? Is it the Netherlands, as stated by Ezekiel Emanuel in the New York Review of Books?[1] Or is it the United Kingdom “followed closely by Australia and the Netherlands” as claimed by the Commonwealth Fund? [2]
The United States, “which fails in almost every category”, dangles in both lists at the bottom, but, according to the Global Health Security Index, when it comes to preparedness for epidemics and pandemics, it comes first, followed by the United Kingdom and the Netherlands.[3]
If these three countries were indeed better prepared for a pandemic than other countries, one would expect to see that reflected in the number of victims of the current pandemic. However, there are few countries in the Western world that have fared worse than these three.
Columbia University’s National Center for Disaster Preparedness estimated that at least 130,000 and possibly 210,000 fewer people would have died of the virus in the United States had the government acted earlier and better.[4] With more than 46,000 deaths, the United Kingdom has the highest death toll in Europe, more than four times as high as that of Germany (which has more inhabitants).
According to the European Centre for Disease Prevention and Control, an agency of the EU, the number of confirmed Covid-19 cases in the Netherlands during the last two weeks of October was 129,284, higher than the number of cases in that period in Canada, Cuba, Australia, New Zealand, Japan, South Korea, China, Singapore, Vietnam, Thailand, Taiwan, Greece, Sweden, Norway, Iceland, Ireland, Denmark, Finland, Estonia, Latvia and Lithuania combined.[5]
How come the countries best prepared for a pandemic are doing so badly when a pandemic actually arrives? In an article in Nature, the American anthropologist Martha Lincoln suggests overconfidence and ‘exceptionalism’ as explanation.[6] Countries that consider themselves as something special will be less likely to learn from other nations and are therefore doomed to learn the hard way that the Covid-19 virus does not respect their special status.
“The pandemic”, she writes, “provides a natural experiment on the public-health effects of hubris”. Examples of such hubris are the United Kingdom’s decision to leave the European Union and the withdrawal of the United States from the World Health Organization.
Does her diagnosis also apply to the Netherlands? Were the Netherlands too confident that other countries could not teach her anything and therefore lost precious time in fighting the virus? The answer seems obvious.
[1] See: Health Care: The Best and the Rest: https://www.nybooks.com/articles/2020/10/22/best-health-care
[2] https://www.commonwealthfund.org/chart/2017/health-care-system-performance-rankings
[3] https://www.ghsindex.org/wp-content/uploads/2020/04/2019-Global-Health-Security-Index.pdf
[4] https://ncdp.columbia.edu/custom-content/uploads/2020/10/Avoidable-COVID-19-Deaths-US-NCDP.pdf
[5] See https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases The number of confirmed cases: Canada 37893, Cuba 683, Australia 211, New Zealand 74, Japan 8329, South Korea 1403, China 374, Singapore 102, Vietnam 53, Thailand 101, Taiwan 20, Greece 12746, Sweden 19679, Norway 3427, Iceland 868, Ireland 13632, Denmark 10784, Finland 2777, Estonia 754, Latvia 2475, Lithuania 6782.
