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Comment by enitihas | Hacker News Reader

Just curious, does anybody know how did Japan manage to do so well, inspite of a very old population.

Also what does HN think is the better place to be right now? A mega city or a small village?

I have visited several times and even before this virus I saw people wearing masks all the time. At grocery stores I remember seeing the workers who were stocking things wearing masks and gloves, which I never see in the US. Wearing masks while sick was already expected and has been for decades. Maybe since it's already in their culture to do what they can to stop spreading diseases, they were much better prepared than the rest of the world. They could also be lying, but that seems unlikely since the information would get out very quickly.

My hypothesis is that Japan, Hong Kong, South Korea, Singapore had to contend with earlier SARS outbreak and responded more quickly and comprehensively with contact tracing, social distancing.

and perhaps residual previous-exposure widely-disseminated immunity to the class of viruses?

I have not read anything that indicates a cross-immunity between the Wuhan 2019 SARS and Guangdong 2002 SARS.

This is a novel coronavirus, so no real relationship to the previous cases other than the shape.

I'm in Japan right now. I don't have any insight into government response, but there could be cultural factors that could have reduced the spread of the virus. In general, the Japanese avoid physical contact. They bow when they greet each other, money is exchanged on a tray rather than by hand, they typically don't hug, etc. Plus many people wear face masks. Occasionally when I bought something from a store, they would throw in a free face mask for me as well. And many businesses and restaurants put hand sanitizer at their enterance.

City or village, you'll need one where store clerks don't come in to work when sick due to lack of sick days and no one avoids testing and doctors for lack of insurance.

Italy's health care system has been overwhelmed - there aren't enough ventilators available for the people who need ventilators to survive and there are now a lot of them.

Italy's aging population has increased the proportion of people needing ventilators and the infection rate increases the total number.

Moreover, Italy's total actual infection is likely higher than the figures due to Italy's failure to test and control the situation. So the true fatality ratio is probably lower but hardly gives much comfort.

Japan simply isn't testing enough patients, so I would wait a few weeks before judging how well they did.

That said, inconceivably they don't have many serious cases. (If the virus was really spreading exponentially, we'd certainly see a lot more patients, tests or no tests.) So they must be doing something right. It's just hard to tell if they could keep it this way.

Italy is not admitting anyone over 65 or with comorbitidities to the ICU due to lack of space. That's not something you can hide in any open society. Nor is senior politicians dying like happened in Iran.

For whatever reason Italy and Iran are doing much much worse than any other country. My WAG is the wide spread use of masks in Asia is the biggest differentiating factor.

If you look at the ratio of test/positive people, and assuming that lower the ratio more wide spread testing is, Japan isn't doing bad. I don't remember exact numbers but when I looked at the numbers recently it was something like 3.5% for South Korea, 17% for Italy and 5% for Japan.

I said it up thread, but curious to get more responses.

My hypothesis is this had already spread like crazy everywhere. Now we just are seeing the exponential discovery of it.

What marks the places hardest hit with severe cases is the bad air quality. Which acts as a further agitator on lung related complications.

Norway has very good air quality and still relatively hard hit.

Do you have the numbers handy?

And note, I mean hit hard with high severity cases. Not just cases. My hypothesis is that it is already everywhere. Most of this exponential growth is just how fast we can deploy testing.

I don't know about severity, but Norway is the European country with the highest infection ratio, after Italy and tiny Iceland. As of today:

- Italy: 1 case per 3.996 inhabitants - Iceland: 1/4.285 - Norway: 1/6.710 - Denmark: 1/9.081 - Switzerland: 1/10.035 - Spain: 1/14.831 - France: 1/23.292 - Germany: 1/30.160

From my searches, they are currently at zero deaths? Low, at any rate.

Feels like this supports my hypothesis. If anyone starts looking, they will find cases. Only if you have a baseline lung damage rate that is elevated will you see severe cases.

The first death in Norway was yesterday, an elderly person.

I tried looking up some numbers on severe cases, but the Norwegian Institute of Public Health webpages are currently experiencing some DNS issues.

Late responding, but if you find anything, I am still interested!

Yeah I'm curious myself. It seems like no specific policy can clearly explain the results. IIRC Japan is one of the later countries to restrict travel from China back when cases were high there and in general did limited testing on their population. Maybe the public hygiene practice and culture of wearing masks really helped, or maybe the infection is still developing there.

My guess is large city: possibly better health services, possibly higher priority if supply lines are affected. I don't think population is a big factor as long as you isolate yourself, since even in a small village, if someone is infected, it'll eventually get to you if you're exposed. Not an educated guess though.

My hypothesis is that it is baseline lung damage from bad air quality. Look at the places that have had severe cases and lookup their air quality.

A small village/town; away from the urban craziness; where you can walk over to your neighbor’s to ask for a pound of dried beans because the just-in-time retail model and cascading supply-chain effects means your local grocery store shelves have been emptied of the staples.

> A small village/town; away from the urban craziness;

Considering the fact that we both were downvoted, that's not the answer they want to hear on this forum. In a way, it was to be expected, since the majority usually praise density each time an urbanisation thread comes up and consider metropolitan concentration equals progress.

Information gap, many of these countries can read Chinese.

Single point of data:

All the years I lived in cities and did what an average urban dweller does: packed in an office, packed in public transportation or even packed on the pavement, packed in shops, packed in bars, packed in elevators, packed on the terraces or in a concert hall; I was getting a flu (or something very similar putting me in bed for 3 days) at least twice a year, sometimes thrice.

In the last 7 years, I have been living in the country and not taking part in almost any social activity. I got my first major flu on January this year. First time in seven years for something that previously happened to me every year. Brought by family members who had gone to some gathering... in the city (and who had been vaccinated against flu as obedient citizens, but that vaccine is notoriously crappy). We all got sick. In all those years, I only got 2 or 3 minor episodes, and all of them immediately followed one my very rare and short stays in the city, or a close family member who brought me that 'gift' from the same place.

Same, but with the cold. The cold affects me severely, I remember the last time I had the flu over a decade ago, I really don't want to experience that again heh.

Living in a big city you're just exposed to more people, you're just more likely to catch something

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