Patient 91: How Vietnam saved a British pilot and kept a clean Covid-19 sheet | Hacker News Reader

Patient 91: How Vietnam saved a British pilot and kept a clean Covid-19 sheet

bbc.com

I'm an expat in the HCMC. I remember significant amount of skepticism by the beginning of the outbreak around COVID-19 related news, as both expats and locals suspected state censorship involved, like it happened in China about a month before. However, by the 2nd week of quarantine, even skeptics had to admit that outbreak has been handled with the same efficiency as in Taiwan or New Zealand. By that moment borders are still closed, and it's hard to back to my home country, however, being able to walk without a mask and a constant fear to get infected really worth a lot. My sincere gratitude to Vietnamese health officials and medical workers who made it possible.

Of course, significant part of the success belongs to people who were following social distancing rules, wearing masks (which is almost a part of Asian culture), businesses that were closed on an early stage of outbreak - measures that other countries were very hesitant to do. And that successful handling of the pandemic has already brought significant benefits to the state, as international investors and manufacturers consider moving to Vietnam from China, something they were looking forward to, as China's biggest competitor in the region.

I'm also an expat here and I can second this. Trust in the government is at an all time high. Domestic travel is up 25% over last year. While many retail businesses suffered during the lockdown, life has mostly returned to normal. Albeit, with closed borders.

>Trust in the government is at an all time high Sure, after successful handling the pandemic. Was a nice surprise for me as well, especially compared to China

If its any consolation closed borders doesn't bother them as much as the thais who are far more dependent on tourism. Or the singaporeans , who do far more travelling..

>Trust in the government is at an all time high. Just to clarify you mean trust in the government to handle the pandemic right?

Isn't Vietnam too small to be a real competitor to China?

I also had the feeling that Vietnam would be more of a redirection for "Made in China", only with the Vietnam label stamped on.

I think the only real competitor would be India. But I could be wrong ofc. Feel free to argument.

> Isn't Vietnam too small to be a real competitor to China?

No. They're too small to compete with China at everything at the same time. They can compete effectively in various industries. Samsung is utilizing Vietnam for 50% of their smartphone & tablet manufacturing for example. Vietnam is a good option for manufacturing diversification. With continued improvements in automation, it should be possible to further scale manufacturing in smaller nations in the coming decades.

Jan 2015 [1]:

"Samsung Electronics is currently manufacturing 50 percent of its mobile phones in Vietnam and only 8 percent in Korea. At present, Samsung Electronics is running six mobile phone manufacturing facilities in the six countries of Vietnam, China, India, Brazil, Indonesia, and Korea. The two plants in Vietnam have a combined annual production capacity of 240 million units. The two factories in China have a maximum capacity of 150 million phones. However, Samsung is looking to cut their production by approximately 40 million in view of the high labor costs in China."

Nov 2019 [2]:

"Around 50% of Samsung's smartphones and tablets are produced in Vietnam and exported to 128 countries and territories. As of present, 58% of Samsung's global smartphone sales globally come from its production facilities in Vietnam, according to Prime Minister Nguyen Xuan Phuc."

[1] http://www.businesskorea.co.kr/news/articleView.html?idxno=8...

[2] http://hanoitimes.vn/58-of-samsung-smartphones-revenue-come-...

That's just 1 very big company. I am talking about the majority of companies that is producing in China today.

Garments and footwear manufacturering then. Its not as big as china. But if you're going to make garments or footwear its a real alternative.

China does a lot of other things. Vietnam is rather overweight on garments and footwear...

It's very noticeable how "middle development" countries (east Asia, eastern Europe) seem to have coped very well with the virus, while several of the "advanced" economies haven't, and the US is worst hit entirely. None of the "advanced" political leaders want to learn from this.

It seems to be arriving in South America now.

South Korea and Japan are definitely not "middle development countries".

I did not include a full list or mention either of those, because I knew that any generalization would be met with nitpicking.

I think it is more likely that wealthy countries simply have more resources for testing, so the stats look worse. Also more resources for collecting stats means that deaths are more likely to be counted. There are a lot of wealthy countries, like Australia and New Zealand, that have had more success than most.

That's part of it, but it's also the case that wealthy countries have a lot more travel, especially internationally, to spread the disease beyond initial outbreak centres. Asia also has much more practice in taking pandemic threats seriously and responding early and appropriately.

OK. Suppose USA had 100 cases a day due to very little testing. How do we hide those 120K deaths? https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

By attributing them to other related conditions

Yeah, and who would sign those 100k+ certificates? They are thousands of jurisdictions and hospitals in USA.

Plus, who in their right mind would believe that in the middle of a global pandemic 1000 extra people a day are dying from...symptoms similar to Covid but not infected?

That becomes pretty obvious in the overall stats.

https://www.nytimes.com/interactive/2020/04/21/world/coronav...

The deaths number is not that large in eastern Europe, so testing can't explain it but I do not have a theory that could explain it, maybe social distancing worked or maybe is the food or something help, I hope it will be solved why some regions lik NY and Italy suffered as many cases.

Depends how deaths are being classified.

Ex. Russia was attributing Covid deaths to other causes, afaik.

The "excess deaths" number is the hardest to fake, because it doesn't rely on classification.

I live in the UK and my family lives in Czech Republic and they've been way more organised than the UK from day 1.

There is no shortage of testing capacity in CZ, I just had a coronavirus test for £60 and got results immediately.

The country closed borders while UK government was busy squabbling. They have masks avaliable in vending machines, post offices, and many other places throughout the city. Wearing masks was mandatory for months, hand sanitiser is avaliable in every public building i've been to.

In London noone wears masks in supermarket except asians. In theory you are suppose to wear one on public transport but compliance is like 10%, and seems to be lowest amongst white folks, god knows why. In Czech I have not seen a single person without a mask on public transport.

Sonetines money cant save you, but being organised can.

Indeed. The UK government has chosen to do almost nothing, imposed lockdown too late, is indifferent to masks, and has generally treated it as a PR problem to be managed through the compliant press, who don't regard it as a failure.

>the US is worst hit entirely

How is it that people still claim this with a straight face? The US has the most number of deaths on an absolute basis, but by per capita Belgium, the UK, France, Spain, and Italy are much worse off. (The US has more people than those countries combined.) Of the large western European countries only Germany did significantly better on deaths on a per-capita basis.

There is a real discussion to be had regarding how Western countries in general did versus the likes of China, Taiwan, and Vietnam, but that's not the same thing.

Give it a few weeks. Everyone's given up on the whole lockdown/social distancing thing, and people are going out with abandon. Cases are spiking to record levels. [1]

The US is kind of the worst of all words right now: shut down the economy for 6 whole months, savage businesses large and small -- then, as though everything's magically gone back to normal, just re-open, paying the human toll as well. All while bailing out Wall Street and trying to dig up PPE hair on fire style and preventing meat packers from suing their employers for maintaining an unsafe work environment.

It's kinda nutty just how much of an abject failure the US response has been.

[1] https://aatishb.com/covidtrends/?location=Canada&location=US

But you are not considering the fact that the number of cases have been on a decline in these countries, but the US is already experiencing the second wave without ever even bringing the first wave under control.

I think there’s a strong argument that that isn’t a separate wave at all. The first wave is ending in NY and NJ, but it’s still on the upswing in many other states. Add those together and it looks a bit like two waves, but that’s not a helpful way to think about it.

Regardless of the semantics, my point is the "infections per capita" will keep increasing for US but for these European countries it's pretty much at a standstill for now.

But US is also a non uniform country, so IMO best statistics should be done on clusters, even small countries have different regions with different stats, a good comparison would also be on the larger cities and see how the percentages compare, if they differ a lot analyze what could cause the difference and if you figureout the reason apply it to reduce deaths.

The trouble is, the US is still in an earlier phase. Compare the shape of the curve in the US (sharp rise, flatline, sharp rise) to the standard rise-fall shape seen in most European countries.

I think that they have a very different mindset as suppose to average Americans. They might be less likely to rebel against orders to distance socially, to wear masks etc etc. Those things do add up

Another trait of these countries is that many of them have been hit by another corona virus in recent memory. Which may mean that they know what to do in the situation.

I made the same argument as to why we in Ontario should've been more prepared, people here told me "Yeah but SARS was over a decade ago."

Meanwhile, Taiwan literally cited SARS as being a major reason why they were prepared this time around.

I know one of the reasons The Faroe Islands had a lot of testing capacity even from the start was that it is the same machines they use for testing fish pandamics. Which combined with the very small population meant that they could test a large protion of the people living there.

Two things at play:

1) Masks. Many countries in Asia have learned from SARS and other pandemics in the last years to always wear masks. They may not protect the wearer (unless ffp2), but they massively reduce the reach of infectious particles if the wearer is infected. Meanwhile Bolsonaro, Trump and (prior to infection) BoJo outright refused to wear masks, and well, many people think "why should I wear a mask and look like a clown when not even the Dear Leader is wearing one?".

2) Population density and poorness. This specific combo has actually benefitted Eastern Europe really much. There are no metropolises anywhere near the scale of Western cities, people are not mobile (there are few foreign guests, and few locals have the money to go on vacation and bring the virus back).

Other poor countries but with high population density are screwed. Dense, overcrowded slums with no running water combined with people being forced to violate quarantine because they have no way to feed themselves and their family without going to work? That is the ultimate recipe on "how to spread a pandemic", and is what is happening in South America.

Pardon me, but what do you refer as Eastern Europe here? Just curious.

Everything that has been former USSR, that's the usual definition (at least here in Germany).

Hard to beat such definition Moscow alone being twice the size adding Berlin, Hamburg, Munich and Cologne together :-)

The West doesn't really have things like jakarta, manila , bangkok, ho chi minh, hanoi..nevermind the chinese cities. Density is really not a problem.

A number of countries that are straight up poor -- Cambodia, East Timor, Papua New Guinea, Vanuatu -- also appear to have successfully eradicated the disease. Of course, being outside the main global routes of trade and (for the latter two) island nations also helps.

For a good overview of the current situation in the EU https://covid19-country-overviews.ecdc.europa.eu/#3_eueea_an... - unfortunately I live in that deep red mark on the left...

Surprising how little publicity ECMO machines (Think heart lung machine without the heart) have had. They are rare but seem to have a much higher success rate 75% than ventilators 35% for covid ICU patients - so even though they cost twice as much $100k, they are well worth it on a cost per life saved.

Though I agree with you, I think this patient was receiving mechanical ventilation as well as ECMO. I don't know if they were simultaneous

Edit: Another plus for ECMO is that ventilation procedure creates a serious infection risk for doctors and nurses, but ECMO doesn't. Losing a doctor costs a lot more than $100K

There were reports from Italy early on that ECMO machines were important.

If you need ECMO for any reason you are seriously, deathly, ill: it is a last resort with long odds. It has many complications, is expensive, and there are ethical questions to ask.

Eg, http://www.bioethics.net/2019/05/is-it-time-for-the-dne-do-n...

ECMO uses immense amount of resources, both in scarce equipment and trained staff to monitor and manage.

Great to say “this one case we won’t let die”. Useless in “we have 50k people who need this” scenarios.

This is a photo I took at one of Vietnam's jam packed airports a few days ago:

https://imgur.com/a/9dn5AJh

Not many people will believe that a poor country like Vietnam, led by a single party in authoritarian style, can suppress Covid-19 with zero deaths. But for people who live here, being able to travel freely is the greatest proof that the approach worked.

(still I find it weird that covid-19 seems to be much weaker in South East Asia, even Laos or Cambodia aren't being hit that hard).

Not weird at all, is an autochtonous organism in Asia, therefore they had chances to being exposed in the past to similar viruses, and they have lots of young population probably also.

Has happened before with american natives dying in mass from new european diseases, for example

It also seems weaker in Africa. I am still waiting for someone to explain the reason for the situation.

Reply on news.ycombinator.com