Perspectives & Facts on COVID: Low Case Counts, High Publication Rates, and More

Author Stephen A. Berger, MD , 27-Dec-2021

GIDEON outbreak map of COVID 2019-2022

…But There Were No Coronavirus Cases in Turkmenistan


In most cases, countries that were not reporting COVID-19 cases had instituted travel restrictions, surveillance, and preventive measures (masks, social distancing, etc.). Several Pacific Island Nations listed below are geographically isolated, lack sufficient medical resources, and enforce similar forms of restriction and enforcement.

The approach of two European countries – Tajikistan and Turkmenistan – was notably different. Although Tajikistan enforces restricted travel and quarantine for arriving travelers, large public gatherings and sporting events are not limited. Face masks, though not required, were and still are commonly seen in the streets. In contrast, a report by Reporters Without Borders stated that Turkmenistan had banned the word “coronavirus” and that people wearing masks could be arrested. Nonetheless, Turkmenistan did ascribe an absence of COVID-19 cases to strict enforcement of travel restrictions and announced in early April 2020 that all citizens would be tested for the virus.

A seeming absence of COVID-19 in North Korea has led to considerable speculation and even conspiracy theories. The fact that this country shares a border with China would suggest that infected individuals are likely to have entered the country; however, North Korea did impose a closure of the border at an early stage of the Chinese outbreak and imposed strict control, surveillance, and quarantine over potential cases.

Why Some Countries Have Fared Better in Fighting COVID-19


There were more than 1.2 million confirmed cases of COVID-19 in the United States as of December 2020, with nearly 80,000 related deaths on record. This number is larger than a quarter of the total deaths suffered worldwide.

What has America gotten wrong in its response to the deadly virus, and what have other countries done right?

New Zealand, South Africa, and Vietnam—even sharing a border with China where the virus originated —have experienced relatively few cases and minimal deaths from COVID-19. Our co-founder and infectious disease expert, Dr. Stephen Berger, shared his thoughts for an article in Healthline about why these countries might be faring better than others.

“All three countries have a coordinated, nationwide, centrally planned response and travel restrictions, both domestic and international,” said Dr. Berger.

Elements of each country’s response that likely have contributed to their success in keeping the virus at bay include:

  • Speed: rapid response to the situation in closing borders immediately, implementing full lockdowns, and requiring that masks be worn right away
  • Aggressive enforcement: all three countries have been stern in enforcing these regulations with government assistance and even military intervention
  • Testing: meticulous attention devoted to testing and then contact tracing as to following where someone infected has traveled

Additionally, South Africa and Vietnam have drawn on their past experiences with deadly diseases such as HIV infection, Tuberculosis, and SARS. Experts agree that early and swift action is key to a country’s success in fighting any deadly virus. “Trying to play catch-up is always more difficult than heading things off early on,” says Dr. Berger.


The global pandemic caused by COVID-19 has rightly taken center stage in media and scientific journals but overshadowed other concerning outbreaks that could do with some attention. GIDEON co-founder Dr. Stephen A. Berger has been speaking with Outbreak News Today to discuss the diseases and illness flying under the radar in the media but are still being tracked and reported by GIDEON. Listen to the podcast or watch a video recording here.

As of April 9, 2020, PubMed listed 2,868 scientific publications that incorporate “COVID.” Three hundred twenty-three of these (11.3%) were related to drugs under study to treat the illness. No fewer than thirty-one such drugs had been proposed since this pandemic first appeared on the planet four months earlier. As of May 18, 2022, PubMed lists 254,328 results when “COVID” is queried.

Graph 1 depicts the cumulative numbers of COVID-19 infections (per 100,000 global population) and introductions of relevant drugs into the Literature from February 14, 2020, to April 3, 2020. Note that both increased by a factor of approximately 16-fold during this period.


Other Outbreaks Matter Too


In 2020, significant outbreaks of Cholera in Yemen, Dengue in Brazil, and neighboring South American countries were recorded in addition to the COVID-19 pandemic. Numerous diseases such as Ebola, Lassa fever, Chikungunya, Plague, and Monkeypox have broken out in Africa and Asia in recent years. Lassa fever cases in Nigeria in 2020 were the highest recorded by any country in history (nearly 7,000). The disease spreads through rodents, leaving many of its surviving victims deaf.

These and other diseases have historically been considered tropical or exotic and don’t trouble the western population too much. However, the spread of COVID-19 has proven that diseases can and will spread given the opportunity. For instance, Monkeypox, Plague, and West Nile Fever have all had outbreaks within the US.

What Are Neglected Diseases?


The World Health Organization maintains a department dedicated to researching and treating Neglected Tropical Diseases. These conditions are considered “neglected” by mainstream Medicine by a relative lack of impact and presence in Western countries.

In January 2020, GIDEON listed 360 generic infectious diseases in humans – of which eighteen were classified as neglected by WHO.

That month, a new disease was added to a new total of 361. In only a few short months, COronaVIrus Disease 2019 appears to have led to the neglect of all other conditions.

Why We Shouldn’t Lose Sight of Ebola Because of COVID


A few years ago, Ebola became a household word for much of the world’s population. An outbreak in West Africa from 2014 to 2016 resulted in over 28,000 cases – and 11,325 deaths. Several individuals with Ebola arrived in Western Europe and the United States during this event. Many professionals and lay communities warned of a potential disaster should the disease spread beyond Africa.

From 2018 to 2020, a subsequent Ebola outbreak in the Democratic Republic of Congo numbered 3,463 cases and 2,280 deaths. Few realize that a concurrent epidemic of COVID-19 in this country had already involved 8,249 cases and 193 deaths as of July 18. In other words, the number of deaths due to Ebola was twelve-fold the number due to COVID-19. Although the Ebola outbreak ended in April, another outbreak began in this same country on June 1 – with 49 cases and 20 deaths as of July 14. During the current COVID-19 pandemic, the Democratic Republic of Congo has also reported plague, measles, and monkeypox outbreaks.

“Not every cough is COVID,” wrote GIDEON co-founder Dr. Stephen Berger in a Healio article.  The message is clear – COVID-19 must not result in the neglect of already-neglected diseases.

Stephen A. Berger, MD

Stephen A. Berger, M.D. is affiliated with the Tel Aviv Medical Center, where he has served as Director of both Geographic Medicine and Clinical Microbiology. He also holds an appointment as Emeritus Associate Professor of Medicine at the University of Tel-Aviv School of Medicine. Dr. Berger co-founded GIDEON Informatics, developers of the GIDEON (Global Infectious Diseases and Epidemiology Online Network) web app, and the GIDEON series of ebooks.

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