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by adventured 2216 days ago
I've yet to see a great explanation for why no Asian nations have been hit like some parts of Spain, Italy, France, Britain, US have been. Only a few parts of China appear to have been hit like that.

Countries in Asia not hammered by the virus: Indonesia, Philippines, Thailand, Japan, Singapore, South Korea, Taiwan, Vietnam, Malaysia, Mongolia, Myanmar, Laos.

I'd add China to that list, however absolutely nothing about their reported figures can be trusted. All authoritarian nations are very aggressively lying across the board about their numbers (North Korea as another example). Russia is in a similar situation, they're undercounting cases and deaths to an absurd extreme (half the deaths of Canada, with 4x the cases; Britain with 10x the deaths of Russia, with fewer cases; yeah right).

It makes little sense to pretend it's masks making all the difference for all of them. Indonesia, the Philippines, Malaysia, Vietnam, Laos, Myanmar, Mongolia are extremely poor and there's no evidence it's some kind of cultural hygiene action protecting them all (an often floated contributing theory for Japan or Singapore).

Cities in Vietnam and Indonesia didn't avoid an outbreak like Wuhan / Milan / Madrid / NYC thanks to instantly 100% masking up back in November - January.

Based on what we now know about SARS-CoV-2 there are only a few reasonable explanations (some of which blend, multiple factors).

Being on an island blatantly helps, just ask Hawaii and New Zealand. As with Taiwan, Japan, Singapore, Indonesia and in practical terms South Korea. Australia also largely fits that qualification (their major cities are population islands).

A lower susceptibility due to an unknown genetic factor. We do know that Vitamin D levels are very important, such that darker skin in cooler climates like NYC (cooler during flu season) can be a deadly combination as it pertains to getting a bad case of Covid. Someone on HN stated that 40% of deaths in Sweden are Somali Swedes despite their very small share of the population (5% of Covid cases are Somalis, and they're about 0.8% of the population). Severe Vitamin D deficiency has been repeatedly linked to bad outcomes. This is also an important factor with some other respiratory viruses.

There may be a lot of cases in some of these nations, however they're not producing large death rates due to health factors, specifically far lower rates of obesity, cardiovascular disease, diabetes, etc. If you're an average person and catch a mild case of Covid in Indonesia, you're not going to the hospital for it unless it progresses and you get very sick.

We do know there has been some lying about cases, however it doesn't appear that nations like Indonesia are covering up any mass number of deaths (I've yet to see any evidence supporting the notion that they're hiding eg tens of thousands of deaths).

Many of these nations have not tested at a high level, which may explain some of the lower case rates, however it doesn't explain the lack of large death numbers. Deaths have tended to prompt nations to get aggressive on higher rates of testing, so unless you're seeing a lot of deaths, a poorer nation may choose to avoid the cost of high rates of testing.

There's no question that masking up helps to a huge degree. So to the extent that nations have done that, it has helped them imo (I think the evidence is overwhelming at this point). Japan and South Korea to name two, have clearly seen the benefit from that.

And last but not least, climate. It's likely that the hotter, poorer nations in Asia have had some protection from the virus for the same reason cities in Texas, California and Florida have done so much better than eg Chicago, Boston, Detroit, NYC, Philly, Wuhan, Milan, Madrid, etc. We know the virus, as with influenza and SARS, does not do as well against high temperatures and high humidity. It doesn't stop the virus, it slows it down versus what would otherwise occur. Also, being in a very cold climate (Canada, Finland) would have been a benefit until warmer weather hit (we saw that in Moscow), as it reduces various social activity naturally.

If you were to bundle together: fewer comorbidities, climate, island and masks, you'd have just about an ideal mix of protections (a culture that will consistently respect social distancing would obviously help also).

1 comments

>I've yet to see a great explanation for why no Asian nations have been hit...

You've missed Singapore there, which has been hit extremely badly on a per-capita basis. For number of confirmed cases, they're 8th in the world. They're not getting mentioned as often because their very good healthcare means they have few deaths - less than 1%, unlike Sweden [1] where currently 45% of people who catch the virus die from it.

[1] https://www.worldometers.info/coronavirus/country/sweden/

Your link says Sweden has 33,188 cases and 3,992 deaths. Furthermore, it looks like this is out of confirmed cases of people checked into hospitals, thus ignoring the overwhelming majority of asymptomatic cases, and symptomatic but non-serious cases that don't result in hospital stays.

To put this in perspective, this is 10x higher than the initial estimate of 1-3% death rate, and 0.4 to 0.8% fatality rate after random testing became more prevalent.

You might have missed further down the page: Sweden only has 8,963 closed cases, of which only 4,971 (55%) recovered. 3,992 (45%) have died. The rest of the 33,188 cases have still not yet recovered from the virus.

But you're right that even if you take the 3,992 deaths out of 33,188 confirmed COVID-19 cases in Sweden, their 10% death rate is still almost 10x higher when compared to Australia (1.5%) and much more compared to Singapore (0.08%).