The U.S. state of Ohio and the African nation of Rwanda have similar size populations – 11.7 and 12.3 million people, respectively. Rwanda is crushing the COVID-19 curve while Ohio has not. See the graph below for a comparison. The axis on the left is the weekly average of new cases for Ohio, and the right is the same statistic for Rwanda. I used two axes to make the numbers comparable, as Ohio has experienced many more cases than Rwanda. Ohio is now adding roughly 1,200 new cases per day, while Rwanda is in the single digits.
An NPR article published July 25th lauded the small country for its efforts. The country responded early to the outbreak, which helped keep cases low. Another thing it has been doing right is a rigorous test-trace-isolate protocol. People are randomly tested on the street. Rwanda is a poor nation (per capita income is $2,000), but testing is offered free of charge by the government. The African nation has leveraged their experience with HIV testing to first do pooled testing. If any of these test positive, then individual samples are tested. They have practiced social distancing better than any other African nation except South Africa.
Despite these efforts, there was a surge in new cases in August, but the country now has suppressed the outbreak again. Rwanda is now one of 11 countries world-wide and the only one in Africa that the European Union considers to be a safe travel destination. However, this success has a dark side, as recently reported by the The Wall Street Journal:
- People who test positive have to stay in a COVID-19 clinic
- Contacts of people who test positive must isolate and stay home
- Gatherings of more than five people are banned
- 70,000 people have been arrested for violating night curfews, or not adhering to social-distancing guidelines
- Not wearing a mask is a $26 fine for a first offense, and up to 1 year in jail for a second offense
Rwanda is not a country known for its human rights. Such measures would never be enforceable in most other countries, including the United States. While it may work to keep COVID-19 cases low, such draconian measures could not be implemented in most democracies. Such measures are too severe.