What could we be doing differently beyond what we already should be doing? Are you referring to things like border closing?
No country has been dealing better with Covid than Taiwan. No lockdown, and > 200 days without new Covid case [1]. Taipei had daily direct flights from Wuhan, and the Diamond Princess mooring near Taipei. They told the world early on [2] how they did it. Summary: Border closure, contract tracing, testing and controlled quarantine for those testing positive. It's worth reading [2] to realise how swiftly, decisively and rationally Taiwan reacted, and compare it with other countries. It probably helped having had an epidemiologist as vice-president [3].
[1] https://www.theguardian.com/world/2020/oct/29/taiwan-domesti...
[2] C. Y. Wang, C. Y. Ng, R. H. Brook, Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing, https://jamanetwork.com/journals/jama/fullarticle/2762689
An island that has high-speed railway connections to Europe is not exactly isolated from the world, not to mention it's ferry connections with multiple neighboring countries in mainland Europe.
Additionally, Great Britain has about 3 times the population of Taiwan, and it's urban centers have between 5 and 7x the population of Taiwan's largest urban centers.
Of course a total closure would be a last resort, because that would cut off imports of things like fresh fruit, but it's been possible to get 20-minute pinprick blood tests since April (admittedly with lower accuracy than PCR tests) - the government simply decided measures like testing everyone at the border and enforcing mandatory self-isolation were not priorities.
As demonstrated by the recent French closure:
> French President Emmanuel Macron went further Sunday, with France barring UK travelers and shutting down the Eurotunnel crossing for at least 48 hours, meaning thousands of trucks carrying goods to the continent will not be able to cross the English Channel.
https://www.businessinsider.com/uk-border-chaos-after-france...
You now require a negative test (PCR or antigen) within the last 7 3 hours, and must be within a permitted category of traveller - https://uk.ambafrance.org/France-to-admit-some-travellers-fr...
And, of course, China has more land borders than any other country in the world, and it's managed to engineer the most drastic turnaround of any country in the world.
Having a small number of entry points is useful to limit initial inoculations, but internal policy and cultural cohesion are key for preventing the explosion of any successful inoculation into national disaster, regardless of a polity's geography.
Cases are at all-time highs, and have pretty much escalated out of control:
https://www.google.com/amp/s/www.aljazeera.com/amp/news/2020...
I love the way you keep shifting the goalposts. When you’re shown that they haven’t controlled the virus, you pretend that it matters what the absolute magnitude of the case count is today. To wit: “You just don’t understand exponential growth!”
By the way, Korea has tested about 2M people, total, or about the same number of tests that the US did yesterday. So yeah...they’re probably finding a few less cases:
(Ok, Singapore technically is an island but it's connected to Malaysia by the world's busiest border crossing; and Thailand's grappling with a new outbreak now but it seems to be improving.)
I guess perfect covid policy is contagious!
Vietnam has essentially one train line across the county that only splits up in the very north into two train lines into China. Vietnam has 2,600km of train lines, Germany for comparison has more than 41,000km, for a comparable area size. Vietnam has about 12M train passenger rides a year (pre-Corona of course), Germany has more than 2000M (does not include intra-city light rail rides). Thailand, with an area about 1.5x of either Vietnam or Germany, has 4,400km of train lines and 38M passenger rides.
Vietnam has about 250,000km of roads (50% paved), Germany has 600,000km (mostly paved). Vietnam has about 3M motorized vehicles (31 per 1000 population, but there is probably a significant number of unaccounted motor scooters), Germany has 56M motorized vehicles (701 per 1000), Thailand has 40M motorized vehicles (half being motor scooters/bikes, probably a significant number of unaccounted motor scooters) (571 per 1000).
You said "just like the US or EU", but I disagree given these numbers. The mobility, especially medium and long distance mobility, seem quite different.
Public life - as dictated by climate conditions and of course economic constraints - differs as well. Average temperature in Vietnam is 24°C, Thailand 26°C and Germany 9°C (and Spain/Greece/Italy aka the South of Europe it's 13°C). A lot more public life, incl paid and unpaid work, happens outside in Vietnam and Thailand, compared to Europe. When it was summer in Europe, we had a lot fewer cases and deaths than when it was cold and is now cold again. Colder weather and indoor living/working seems to heavily correlate with Corona, at least in Europe.
This doesn't mean we cannot learn from nations such as Vietnam and Thailand, but it's also not as straight forward as trying to outright mimic what they did and do in response to the pandemic.
And of course, the same can be said for Mexico (because the main driver of the spread in the US is people not taking simple steps to prevent it).
Travel to Canada has been restricted for much of the year (I live in Michigan; there's a warning 4 hours from the border that travel is restricted). But that's because Canada isn't letting their fool neighbors in.
Ironically it's the other way around, too. Our borders are shut to tourists, but they keep showing up in Canmore and Banff anyway. And now Alberta has a serious problem with Covid spread, and a friend of my sister's just died a couple days ago from it. They have 1/3 the population of Ontario, yet close to the same numbers of daily cases and hospitalizations, which suggests triple the velocity.
There are compounding reasons as well, but everyone I know that lives there is complaining about all the Americans constantly showing up.
In this case, I was putting the blame both ways. The thread started by blaming Canadians. Jason Kenney (not Kennedy, that's some other bloke) made the border so weak there that Alberta is inundated with US-bred Covid hotspots. Of course it's going in the other direction, too. There are hotspots trading germs by deciding they should visit each other, mingle, go home, repeat.
Canada isn't taking so many cases to the US. Unless you look at Alberta. Kenney there has screwed that up in both directions by somehow not noticing the tourists going through either way. He's turned it into a slow cooker of viral stew.
If I sound pissy about it, it's because both sides of the border should be shutting that down and not allowing it, even through the loopholes they are both entertaining at this particular stretch. My sister's best friend died of Covid that she caught in Banff 4 days ago. She lived and worked there, and complained about the number of Americans showing up. What a surprise.
It's both ways. There are conservatives that enjoy Trump's ideals - pretty much defining Alberta. They're gonna kill us all eventually.
Ontario is stricter about it, and everyone (again on both sides of the border) bitch about it. The problem in Ontario is the sticker-monger wants to let you celebrate and then lock down so you die out of sight of the public.
We'll never get ahead of this when everyone thinks they are somehow not the ones transporting this virus around, yet won't stop travelling and "breathing moistly."
And they are controlling it now by effectively locking down the country to the rest of the world. Even if you're a Vietnamese citizen you can't get back into the country without permission. And the gov't is denying permission in all but the most extreme circumstances.
Malaysia shut its border with Singapore in mid-March [1], and Singapore had what I'd consider a lockdown (most businesses closed, no social gatherings allowed) between 7 April to 19 June [2].
[1] https://www.todayonline.com/8days/eatanddrink/newsandopening...
[2] https://www.gov.sg/article/ending-circuit-breaker-phased-app...
I would take the stories of Viet Nam’s “success” with a very large grain of salt. It should be impossible for me to know so many people with odd “severe pneumonia” there given that the entire country has nominally only had a thousand cases or so.
For example the vaccine against Japanese Encephalitis is under investigation for a possible cross-effect on covid immunity.
It's been experimentally verified that various pre-pandemic coronavirus antibodies are reactive against SARS-CoV-2.
It's a fact that different world populations have to deal with different endemic disease profiles.
Consequently, different populations have different pre-infection susceptibility to SARS-CoV-2. [0]
[0] https://www.ijidonline.com/article/S1201-9712(20)32310-9/ful...
Not to mention that after the first couple of months, Covid cases are now nicely distributed amongst younger populations as well. Fatalities are still concentrated in older people, but cases are still widespread across demographics.
The facts are staring everyone in the face: when countries started weakening their lockdown procedures, cases started going back up. And nobody's been willing to go back in full lockdown, for various reasons. And so cases are going up a bunch.
Meanwhile Vietnam had some cases in fall/winter, and _immediately_ locked stuff down, shut down universities, and quarantined people who had even a bit of contact with people in positive cases. The stuff was taken seriously, and numbers stayed low because of it.
Maybe the US and Europe "can't do it" because of a lack of political will etc. But it's not physically impossible.
But this obviously doesn’t change the bottom line: Their response was sufficient, while ours was not. This isn’t their Chernobyl like a lot of overconfident analysts proclaimed. I’d say it comes close to being our Chernobyl. Asian societies by and large did really well, and the pathetic response of the “First World” revealed a disturbing level of calcification and incompetence.
However now there seem to be so many diffuse infection events and undetected chains that the question is more about how to regain control. I'm not sure how this is achievable without contact restrictions.
- It is an island
- It has an effective, well centralized surveillance network
- It has (presumably) an obedient population, or at least, one that don't think personal freedom includes the right to spread the disease
- They were well prepared thanks to the their experience with SARS
- A good enough welfare system to allow people to quarantine without starving or getting ruined
- A good enough police force to make sure they stay quarantined
- Enough masks and hand sanitizer, with domestic production
This is pretty much the opposite of the US. Which is highly connected, with a loosely connected government that has little control over the private sector that runs the country and a highly individualistic population.
Also, maybe there are some populations that just do better for a mix of reasons: climate, race (genetics), culture, average age, health and population density,...
Final note: closing borders is only effective if you contained the epidemic and others didn't.
How do you go back in time and get your population used to wearing masks (and having supply) at the beginning of the pandemic when it really matters?
That assumes that testing-dependent interventions (whether contact tracing and quarantines of the exposed, appropriate treatment of systematic infections, etc.) have nothing to do with the absence of excess deaths.
Which seems improbable.
At the same time, there are a lot of factors that are purely circumstantial, such as weather/climate, age/health of the population, elderly care system. These may have a lot of influence at the tail ends (deaths).
We must not fall into the trap of making post-hoc rationalizations that confirm what we want to believe. We're paying a heavy price with severe measures, if some data turned up that showed that it didn't make much of a difference, that would be a tough pill to swallow.
Taiwanese people aren’t obedient. You should see how they drive.
They wear masks without flaking out about it as slavery or being against their will or whatever nonsense you guys are on about back home in the west.
Taiwanese people are couch potatoes and extremely reserved. They don’t really want to meet new people or hang out with strangers.
Also the government here didn’t play games in the early weeks. No wait and see business as usual lazy bullshit like in the US. They check tour temperature everywhere, mall entrances, restaurants, government buildings.
The us most certainly should copy Taiwan.
...
> They wear masks without flaking out about it as slavery or being against their will or whatever nonsense you guys are on about back home in the west.
The 2nd part is what the GP was talking about with regards to 'obedience'. In some western countries like the US and UK, even the simple request for individuals to wear a mask is seen by some as an infringement on their human rights. There are literally documents floating around social media in the UK citing the Magna Carta[1] as a legal document for why they are entitled not to have their temperature checked!
Granted these people are idiots. But unfortunately the UK and US has also fostered a culture where everyone's voice is deemed equal, even the idiots. A classic example of this was during the EU referendum with the oft quoted phrase "why should we trust those so call experts?" as a retort against financial analysts voicing their concerns.
The problem is when you have research demoted to the same level as hearsay, a general distrust of the government and mix in a large does of fear due to economical, political and/or social unrest, you end up in an environment where those aforementioned idiots end up recruiting more idiots into their cause.
I've thought about this a lot as the pandemic and reaction unfolded. My feeling is that it's a little more nuanced.
From my perspective, it goes like this: (a) politics co-opts science, and (some) scientists become political (for career reasons), (b) political news media puts narrative-supporting "experts" on a pedestal (to reinforce their credibility), (c) people are told they lack the intelligence / knowledge / ability to ever be an expert, (d) people feel internal, unrealized shame at their ignorance, (e) people attempt to cover that shame by posing as experts for their peers, in fact just parroting whatever sound-bites they heard without critical thought, (f) rational debate drastically decreases, as critical thinking skills and underlying understanding have atrophied.
The net result: removal of critical thinking in the public, increased partisanship and anger, and a decreased ability of the public to dismiss crackpots posing as experts.
Recommended response: learn about the actual underlying issues, then (gently, remember (d)!) turn conversations to apolitical explorations of the underlying issues and truths.
Social media compounds things here because it allows people do get swallowed into this world of like minded people (aka the "echo chamber").
There's a fair amount on Wikipedia about the psychology at play which causes this. There's names for it all, all of which I can't recall because I've hit the Christmas spirits. Hopefully someone sober can be more helpful than I.
I'm not suggesting that Taiwanese people blindly do as their told but rather that some of the US and UK population intentionally do the opposite to what they're told simply as an act of defiance....sorry "freedom".
Also, most countries still seem to be ignoring the best/cheapest way to control spread via rapid testing and isolation. This has been not only modeled extensively at this point [1][2], but also proven to be effective by sports leagues (NBA, MLB) and Universities (look at where UIUC has kept their numbers vs the state: https://go.illinois.edu/COVIDTestingData )
[1] Larremore, Daniel B, Bryan Wilder, Evan Lester, Soraya Shehata, James M Burke, James A Hay, Milind Tambe, Michael J Mina, and Roy Parker. “Test Sensitivity Is Secondary to Frequency and Turnaround Time for COVID-19 Surveillance.” Preprint. Infectious Diseases (except HIV/AIDS), June 25, 2020. https://doi.org/10.1101/2020.06.22.20136309.
[2] Atkeson, Andrew, Michael C. Droste, Michael Mina, and James H. Stock. “Economic Benefits of COVID-19 Screening Tests.” National Bureau of Economic Research, November 2, 2020. https://doi.org/10.3386/w28031.
(More details might help your points)
Perhaps Brexit closing trade doors with the EU could be resulting in a stronger relationship between the US & UK?
Though AFAIK it's kinda up in the air if Biden would go for the same thing.
Even if the scale or details of circumstance are different—such as Clinton’s pardoning of his brother in minimizing Trump’s choices.
Another reason is exceptions cause outrage. And there may be many instances of diplomatic or other government travel that needs to happen or happen in the slipstream of limited public travel.
Most moral systems of my acquantance are based on a hierachy of values that puts saving human lives over just about anything.
False. While not explicitly stated there is a threshold usually measurable in money spent after which saving life is considered of being "not worth it". Ford Pinto case that went through the courts I think can serve as a very good particular example where cost analysis made it legal to allow otherwise preventable deaths.
The vast majority of deaths are people over age 55: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Ag...
Possibly better known as "first they came for", apparently officially titled "First they came..."
The UK has an upcoming COVID vaccine (the Astra-Zeneca/Oxford one) that may prove useful in the near future. Cut off the UK from the rest of the world and the rest of the world can't benefit from it.
Also, it's almost certain that the UK strain is in the US already, and the US is shit at dealing with pandemics once they're on our soil. Border closures only work if your test/trace/isolate institutions and compliance with social distancing is good enough to eradicate the virus from within your borders; they prevent reinfection in that case. The US has shown we're completely incapable of that, so it really doesn't matter.
https://news.sky.com/story/emergency-talks-to-prevent-christ...
https://nymag.com/intelligencer/2020/03/trumps-coronavirus-t...
And sure, border closures too. They're late in that the new variant is probably present at some level in most of Europe. But the fewer cases you have to start with, the longer it'll stay contained at low levels. You might even be able to contain it entirely for a while. All the cases of B.1.1.7 in Denmark (0.4% of their sequencing) appear to be part of the same cluster. They should be able to manage that much better than if the variant was being constantly reintroduced by travelers.
For the UK specifically, they're doing a bunch of things differently for their Tier 4 level vs. Tier 3, which was introduced specifically in response to B.1.1.7. Are you suggesting that all of those measures should have been done everywhere anyway?