No one knows life under lockdown better than people living in Toronto. The city has spent most of the pandemic under strict public health restrictions and has experienced one of the longest consecutive lockdowns in North America. Certain restrictions were placed on businesses, workplaces, and schools once lockdowns were ordered, though outside of Ontario, lockdowns haven’t always looked the same. This leaves us with questions as to why governments have had different responses to controlling COVID-19 outbreaks. Why did Quebec impose a curfew while Ontario didn’t? How has New Zealand kept the virus under control? Has every country experienced a lockdown? Did every country go through a sourdough bread phase? No two responses to the pandemic are exactly alike, so let’s explore how different countries have reacted to the pandemic in 2020.
Lockdowns, shutdowns, cordon sanitaire: whichever term governments use, they all involve different approaches to limiting the spread of COVID-19 using nonpharmaceutical interventions (NPIs). Before vaccines against the virus were developed, NPIs were the only tools that governments could use against COVID-19 and can range from promotion of social distancing to strict curfews enforced by military. The most common NPIs used by governments in the past year have been limits on social gatherings, closure of businesses and schools, and stay-at-home orders for non-essential travel. Different combinations of NPIs have been implemented by countries as a “lockdown” in response to local outbreaks of COVID-19 or new waves of infection nationwide. The consensus from epidemiologists is clear that lockdowns can effectively reduce COVID-19 spread and deaths from the virus.
Public health restrictions have differed between countries, but also within some countries as public health is often a subnational responsibility, like in Canada. Even though the Canadian federal government plays a significant role in managing the pandemic response, much of the responsibility of ordering lockdowns falls on the provincial governments. While parts of Ontario received a stay-at-home order that went largely unenforced, Quebec was the only province to issue a curfew similar to France’s response as part of Premier Legault’s “shock therapy” for the province, with over $28M in fines given out for breaking curfew or holding large gatherings. Perhaps nowhere else has the differences in regional responses been more apparent than in the United States. Public health regulations have been decided at the state level, and while groups of states have attempted to coordinate their responses to limit confusion, state policies have been partisan, and some neighbouring states have had vastly different responses to COVID-19. For example, sit-down restaurants and non-essential retail was shut down in North Dakota, while it remained open in South Dakota, allowing those wishing to escape restrictions to simply cross the state line.
Countries that imposed lockdowns early on into the pandemic generally faired better than those that resorted to lockdowns only after fatalities had soared. Many news outlets have reported New Zealand as a “COVID success story” because of its strategic use of lockdowns. The country started its lockdown less than one month after its first reported case of COVID-19 and was able to effectively contain the virus, preventing a second wave of infection. The UK, another island nation, began its lockdown approximately two months after its first case, by which time over 6000 people had been infected. Even so, the first and subsequent lockdowns in the UK were deemed effective at “flattening the curve” by local officials.
Given the global nature of the pandemic, it’s surprising to learn that some countries didn’t impose a lockdown at all. Neither South Korea nor Japan, with a combined population of over 175 million people, introduced a general lockdown in 2020. How did these countries avoid serious outbreaks without shutting down? For South Korea, their solution was “K-quarantine”: a rapid and organize mass testing program, complemented by contact tracing and selective quarantining of infected citizens to stop outbreaks before they happen. In 2015, South Korea experienced an outbreak of MERS, caused by a different coronavirus, which prompted the development of viral testing infrastructure for future outbreaks. This strategy paid off for South Korea in the early days of the COVID-19 pandemic, minimizing the spread of COVID-19 and deaths related to the virus.
The Japanese government also didn’t order a lockdown, not because it chose not to, but because it lacked the legal ability to do so. Unlike most countries, Japan doesn’t have legislation allowing a lockdown to be enforced, and the government can only request that municipalities and the public follow lockdown measures (Ontario’s Health Protection and Promotion Act, 1990 allows for business closures, Canada’s Quarantine Act, 2005 allows travelers to be quarantined). These requests can carry fines but largely rely on voluntary compliance. Japan has experienced a low death rate per capita, and in both South Korea and Japan, wearing masks when sick or in public areas was already commonplace before the pandemic.
Another interesting case is Sweden, the only country in the EU that hasn’t imposed a lockdown. The Swedish government recommended that elderly citizens should socially distance, banned gatherings of over 500 people, and restricted travel within the country. These lenient measures and focus on individual responsibility were met with domestic and international criticism. Again, the Nordic country’s laws didn’t allow for the government to restrict citizens’ freedom of movement, though new legislation was introduced early this year to allow lockdowns to be ordered. As of July 2021, a lockdown in Sweden hasn’t been ordered, and the country has the highest death rate per capita of Scandinavia.
These are just a few of the more noteworthy responses to COVID-19, but every country’s story is different. International responses vary based on many factors including a country’s pandemic preparedness, economic development, healthcare infrastructure and legislation, and many more.
World leaders made important decisions with very little notice, and we’re likely to feel the ramifications of those decisions for years to come. We still have much to learn about the outcomes of the choices made by governments and health organizations like the WHO, and it is still unclear which is the best strategy for easing restrictions when infection rates start to decrease. There are many questions yet to be answered but as vaccines slowly become more available across the globe, we can look forward to once again traveling and reconnecting with family and friends abroad to share lockdown stories, and likely, sourdough recipes.
- Alfano, V. & Ercolano, S. The Efficacy of Lockdown Against COVID-19: A Cross-Country Panel Analysis. Applied Health Economics and Health Policy. 18(4), 509–517 (2020).
- Brauner, J. et al. Inferring the effectiveness of government interventions against COVID-19. Science. 371, (2021).
- Haug, N.et al. Ranking the effectiveness of worldwide COVID-19 government interventions. Nature Human Behaviour.4, (2020).
- Kharroubi, S., & Saleh, F. Are Lockdown Measures Effective Against COVID-19? Frontiers in Public Health, 8, (2020).
- Pincombe, M., Reese, V., & Dolan, C. B. The effectiveness of national-level containment and closure policies across income levels during the COVID-19 pandemic: an analysis of 113 countries. Health Policy and Planning. 0, (2021).
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