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> But the data isn't so clear. Countries in South America locked down hard and early but it had no effect on the pandemic spread.

This is false. The hard lockdown period in most SA countries lasted 3-6 weeks at most; after that there was almost no enforcement by the police, no fines handed out, no public shaming. It was essentially left up to individuals with ample latitude in how they chose to exercise self-imposed freedom.

Poor people in SA did not generally have the option to stay at home with a robust safety net such as in Europe. Wealthier business owners have to deal with an inefficient legal system that burdens anyone who does things by the book.

The first few weeks with a real lockdown were remarkably effective, as shown by the mobility and disease transmission stats. As soon as the countries stopped using their monopoly of force to limit mobility, the disease shot up, in an entirely predictable manner.

It's truly unfortunate that this misinformation keeps cropping up.

Without enforcement, "lockdown" is just a word coming out of a politician's mouth in order to make it look like they are doing something. I think when the dust settles, we're going to find that lockdowns did indeed work, but only in the few places on Earth where they actually had teeth and were enforced. Most of the West say they ordered a lockdown, but it was more of a flimsy suggestion than an order.

In the US, people are still out and about horsing around despite Stay At Home orders, and there are just no consequences. They just busted an illegal gathering in NYC [1] with over 300 people, yet only the organizer got a slap-on-the-wrist $15K fine. Where are the $15K fines for each of the party-goers?

1: https://www.cnn.com/2021/01/02/us/sheriff-nye-raids/index.ht...

Despite the small differences in handling COVID, asian people are at least very willing to wear masks. My family is in China. They've been through SARS. They started wearing masks themselves the day the heard about this new respiratory disease. And you know how CDC insisted that masks are not needed at the beginning. Things got out of control because of this IMHO.

From the article, > more aggressive and systematic quarantine regime whereby suspected or mild cases — and even healthy close contacts of confirmed cases — were sent to makeshift hospitals and temporary quarantine centers.

The thing that really worked was not centralized quarantine. It's how to identify people for centralized quarantine. My family has gone back to normal life (like pre-covid normal) since March. Since then every new coronavirus case will be on the headline, and deep contact tracing (not only close contacts, but close contacts of close contacts of close contacts of ...) will be performed to ensure suspected infections are quarantined.

People coming from another country are required to provide extensive documentation of negative test results in the past three weeks. The tests need to be conducted in very specific time frames and even locations, and often between two flight connections. The rules are deliberately designed to make people stop thinking about coming to China. Sadly I'm in the US and I don't expect to reunite with my family until mid 2022.

> Why did every African country do well despite limited ability to lock down or distance? Why did all of Asia do well?

It's not necessarily causation of course, and likely not this simple, but it's fascinating and maybe not all that surprising that the regional impact of covid correlates quiet well with regional obesity:

https://ourworldindata.org/uploads/2019/11/share-of-adults-d...

This study found that a total of 73% of ICU Covid patients were overweight (34.5%), obese (31.5%), or morbidly obese (7%).

https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports

The fataility rate for COVID is also extremely skewed towards older people, to the extent that most COVID deaths are over 75 years old, and people under 40 very rarely die from it.

The median age in the U.S. is 38. The median age in Africa as a whole is 19.

Africa also has very few cases, but this is simply because mass testing is not available.

Also, significantly less migrant labor-style travel as there is in China.

> And all Asian countries, without a single exception, have outperformed Europe, US, and SA by more than an order of magnitude

We may be playing out a new chapter of Guns, Germs, and Steel, where the germs source from East Asia instead of eastern Europe and the Middle East. The death toll may be a pale comparison to the % of lives lost among First Nations people during the colonial era, but we aren't fighting many territory wars these days. It's more proxy wars now, and economic wars.

Over the course of say 3 epidemics in as many decades, the differentials in economic harm could compound substantially.

Unlike the GG&S case, where smallpox and influenza decimated (literally) the new world peoples, there is no evidence that East Asians had evolved resistance to the coronaviruses prior to the pandemic. What differences in death rate we have seen can better be explained by social organization than inheritance.

I took OP as implying this is more than simple public policy. I sort of suspect the same thing.

But even if you're right, social darwinism can do measurable amounts of damage. Added to the levels of stupid we already exhibit, this certainly is not helping things.

There is some kind of adaptation at play, although I think it's likely a social rather than immunological one. The specific mechanisms aren't as important as the fact that the West is generally worse affected by the pandemic.

I also didn't take the comment as implying any deliberate ill intent on China's part. European germs decimated indigenous populations whether or not they were spread intentionally.

It is an interesting point, although I think if pandemics become more common the West will adapt. As TFA mentioned, a promising vaccine was created in Boston within two days of receiving the digital sequence of the virus DNA (not even a live sample!). As the risks of pandemics become more widely understood, there will be increasing pressure to accelerate vaccine rollout for future events.

Just adding on that many SA countries did not have stringent lockdowns like China. My family is in Brazil when they “locked down” recently and nothing was locked down at all.

> But the data isn't so clear.

While I am not going to answer your questions, I am very careful when it comes to comparing data across countries.

There are enough open questions when it comes to interpreting the data from a single country (a very common being selection bias, as it is unclear what the preconditions are for conducting a test and I am still missing the numbers of how many tests have been conducted).

However, when I look across countries, there are some very odd curves, which I have a hard time to explain. I find it much more likely that in some countries someone manipulated the data (by whatever means). I still think the data is valuable, but when interpreting it, it should be considered, that not all data is 100% valid.

I think there was a fairly solid analysis of the Belgian situation. Brussels has people coming from all over Europe and a few universities from which the students brought it home at the weekend.

With regards to SE Asia I imagine the fact that they’ve been through this two or three times before is a big factor.

Why we did soooo poorly in western countries across all the different strategies is something I’m looking forward to dissecting ...

> Countries in South America locked down hard and early but it had no effect on the pandemic spread

No they didn't

> I think it's much more honest to say that we don't have the answers.

This is virtually impossible given how much government, politicians, and even individuals have staked their identity and reputation on being correct and knowledgeable.

That's the most evil aspect of authoritarianism and despotism. The inability to admit failure, limitation and falibility. This is why Fauci and friends always couch their responses to criticism with dismissive explanations.

I'm constantly frustrated with the unimpeachable self-confidence that's so pervasive now. It's only worse when their failures are so apparent.

>This is virtually impossible given how much government, politicians, and even individuals have staked their identity and reputation on being correct and knowledgeable.

In the short term, absolutely. One hopes 5-10 years down the road, a disinterested analysis can get a comprehensive if not conclusive picture.

> I'm constantly frustrated with the unimpeachable self-confidence that's so pervasive now.

I couldn't a agree more. I have no doubts about the absolute best intentions of those making public policy, but their arrogance and utter lack of circumspection with such obvious failures does nothing but further undermine their long-term credibility.

I think they're desperate for short term credibility, both for political reasons and for health reasons.

The "health reasons" part goes like this: If I say "From what we know now, we think the best plan is for people to do X", how many people actually do X? Fewer than if I project more certainty. So even if I know that X is just our current best understanding (say, 60% probability of being right), we still have a better expectation value of the outcome if more people follow the plan that has 60% chance of being right. So I oversell the certainty to up the compliance, in the hope that it's actually helpful.

The problem is that, while this may help in the short term, in the medium term I'm setting my credibility on fire, and if we need compliance in the future on a plan that we're 80% sure is right, we may not get it, because nobody believes me by then.

I can't remember where, but I read an article talking about how there were examples of lockdowns and no lockdowns both controlling COVID well, and that perhaps not every pandemic and every event in time will have a lesson for us to learn. Sometimes there isn't a "right" answer when we have a problem we face. Life isn't like that, we look at life with a lens like that.

Maybe our strategies were wrong. Maybe they were right but the virus was stronger than our strategies. Maybe all the feasible strategies wouldn't have made much of a difference.

We won't ever know. There are many things we can never know. We've become addicted to knowing, with the Internet and all, and similarly we've forgotten that some things (yes, still some few things) are not in our hands.

> We won't ever know.

I sure hope we will understand these things better, in the fullness of time. Even if the answer turns out to be some boring mix of cultural practices, genetics, and luck, it's still worthwhile having that understanding for the next time.

Yeah, although "luck" is mostly just another way of saying ultimately unknowable factors caused the outcomes in some places to be better than others.

I do hope and expect that we'll eventually come away with at least a partial explanatory model that doesn't lean too heavily on being an isolatable island. But an awful lot of what we've heard so far seems to be case-by-case after the fact rationalizations leavened by how the country's politicians are viewed.

I think there might be some truth to this ... observability of the pandemic is very highly non-uniform -- even assuming the input measurements can be somehow normalized in a semi-trustable way (probably not true in general), non-uniform population distribution + exponential makes for much much more noisy measurement than I think is regularly acknowledged.

I feel like there's a kind of built in bias against fully appreciating the effects of the unknowns given the nature of the crisis -- because being the guy who says 'well actually we might not _know_ that' in every policy discussion about the pandemic doesn't actually contribute much benefit ...

I tend to disagree with this take. I think we've known for quite some time (at least since the Influenza epidemic of 1918) that masks can help prevent the spread of viruses of this sort.

At first in the US, the recommendation was to not wear a mask. The reasoning was that we weren't sure about whether airborne or surface-borne spread was more of a factor (remember the huge shortages of hand sanitizer), and we wanted to prevent a run on masks, so that we would have enough masks for health care workers.

This then gets into the reasons why we didn't have enough PPE on hand in our strategic reserve which is more of a political question.

So in the case of the US at least, I think we are aware of the proper strategies, but many people, from the top down, refuse to adopt and/or promote those strategies.