[makomk]

The problem is that the definition of "handling COVID well" that everyone seems to expect is stopping it in its tracks and wiping it out, and doing that with a respiratory disease that's this infectious and has such mild symptoms for so many people falls outside the scope of what traditional pandemic planning in Western countries even tries to achieve. Bluntly, no-one knows how to do it. As far as I can tell, the conventional wisdom used to be that it's just not possible. New Zealand has some fundamental advantages that put it in a better position to achieve this than anyone else (island, long way from other countries, relatively low population) but even they're having a bit of a time sustaining it.

Now, you're probably right that a few decades ago the response to something like Covid wouldn't be seen as such a disaster - but that's mostly because expectations were different back then. If you take a look at some of the flu pandemics, they were a mess in terms of things like school closures and other measures, but as far as I can tell this was just seen as normal and inevitable.

(Obviously, countries which had bad experiences with SARS do have very different pandemic planning - but SARS was a much better candidate for cotainment and elimination than Covid is.)

[x3iv130f]

I wonder if mask wearing is the biggest factor and more generally, willingness to comply with restrictions due to experiencing SARS.

Japan's politicans are no less incompetent than other 1st world countries and geographically they should be much worse off but their cases are way down compared to other places.

[nradov]

The official case numbers in Japan probably drastically undercount the number of infections due to limited testing. A recent antibody seroprevalence study found 46% positive. It wasn't a truly random sample but had a large study population from multiple locations. If mask wearing is such a big factor than how did so many people get infected?

https://www.medrxiv.org/content/10.1101/2020.09.21.20198796v...

[lern_too_spel]

Because Japan's population is so elderly, any severe undercount of infections would show up as very large excess mortality, but that hasn't been observed.

[nradov]

Then how do you explain the study results linked above?

[makomk]

I'm not sure Japan had a geographical disadvantage. Generally speaking, the closer countries were to Italy the worse they seemed to do at least at first, and Japan is a long way from Italy.

[mannykannot]

The physical-proximity model has a problem with Italy’s distance from China.

[harambae]

There were workers in the Italian fashion industry who came straight from Wuhan. That was the whole reason they had a step-function for initial infection.

[mannykannot]

Precisely - physical distance is not a relevant measure.

[makomk]

You're right that what actually matters is the number of people travelling between countries - social, rather than physical, geography - but for the most part actual physical distance from Italy seemed to be a good approximation of that, maybe with the exception of the UK and New York.

The reason why Italy was the epicenter is a bit of a mystery though. There's hints they screwed up their Covid testing and managed, pretty much uniquely among Western countries, to not actually test people hospitalized with potential symptoms who didn't have links to travellers from China, meaning that they only detected community spread when someone who did happen to have contact with someone who travelled from there caught it from someone else. But there doesn't seem to be much coverage of this at least in English-language media; everyone's focused on arguing that their country did worse than Italy because Italy was caught by suprise, whereas everyone else had them as a warning, without examining how they ended up getting caught by surprise. It's also not a full explanation. Possibly it just came down to random chance.