[GregarianChild]

Copy Taiwan.

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

[3] https://en.wikipedia.org/wiki/Chen_Chien-jen

[GuB-42]

I often see "copy this country" but often, it is simply not possible, policies are usually a result of each country specificities more than the other way around. For Taiwan.

- 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.

[kinghtown]

I live in Taiwan.. I’m grateful to be living here during Covid.

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.

[hnlmorg]

> 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.

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.

[1] https://en.wikipedia.org/wiki/Magna_Carta

[kinghtown]

Nah, Taiwanese people view the masks as protection against germs and pollution. I understand the context of suggesting they are obedient but I still disagree with that. Chalking it up to obedience in a way takes agency from them- they choose to wear masks because they know that they work and the government is enforcing their use as well. They don’t wear them because they are merely told to. It’s plain to everyone here that America is handling the virus poorly because most Americans are miseducated or retarded and refuse to take simple precautions because they are uncomfortable or inconvenient. Also there are severe leadership issues in America and no healthcare. It’s the perfect storm of fucking up. Taiwanese people have zero interest in modelling any policies in place in America. Most people here think the country is fundamentally broken.

[hnlmorg]

The point I was making is that many Americans and English folk intentionally don't wear masks because the government told them to.

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".

[ethbr0]

> UK and US has also fostered a culture where everyone's voice is deemed equal, even the idiots

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.

[hnlmorg]

I think far it's simpler than that: people just generally don't like to have their ideals challenged. Worse still is that politicians and the press back research when it suits their narrative and dismiss it when it contradicts their narrative. Which creates a precedence for "free thinkers" to also accept or reject any evidence that falls outside of their own chosen narrative.

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.

[lhl]

All of the things you've noted are true, but the flip side is that that there seems to be a "we've tried nothing and we're all out of ideas" (or worse, flat out pandemic denialism) mentality that takes hold instead of thinking about whether it would be possible to push for some of the most obvious policies that have been shown to be the most effective (eg, enforcing testing and quarantine for all travelers, improved science communication around a respiratory pandemic). Also, it's been 10+ months, so to the degree that developed countries like the US lack sufficient PPE manufacturing, it's certainly not down to resources or capabilities (or anything besides political will in the US considering the DPA could be invoked at any time).

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.

[incrudible]

Consider the countries like Japan that do not actually have excess mortality despite COVID-19. Suppose they just stopped testing for it. You would not be able to tell the difference. You could then come up with any reason for this “huge success”.

[dragonwriter]

> Consider the countries like Japan that do not actually have excess mortality despite COVID-19. Suppose they just stopped testing for it. You would not be able to tell the difference.

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.

[incrudible]

My point is that you wouldn't be able to tell the difference whether any of these interventions work or not. That's the issue. It's of course improbable that none of these interventions work, but it's probable that some do not work.

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.

[anonymoushn]

Sure, then copy Vietnam or Australia.

[dageshi]

How do you copy being an Island?

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?

[mirko22]

For start by telling then they should wear it at the beginning, cos you seem to forget WHO suggested not to.... Then you lose confidence and that's it...

[xg15]

This probably would have been good advice in late summer or early fall when contact tracing was still possible.

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.

[m_mueller]

One way to regain control is to mass produce cheap rapid test kits, do a couple of mass testing events where significant percentage of population is tested to identify all clusters, isolate and trace from there. See Slovakia as an example.

[turing_complete]

It's just insane how incompetent European and American governments have been in this pandemic compared to East-Asian countries. We are lucky to have some functional private institutions that bailed us out -- kept the countries running and developed a highly effective vaccine super fast.

[tchalla]

Moderna has received a lot of government funding despite not ever making a profit as a private institution.

[ethbr0]

https://www.axios.com/moderna-barda-coronavirus-funding-disc...

[tchalla]

Moderna has received many grants from the government even before their Covid play.

[ethbr0]

Yes, e.g. the DARPA ADEPT program in 2011, as part of the P3 effort in response to H1N1.

(More details might help your points)

[starkd]

that's because it's an island. All the islands are doing better than whole continents. You can't contain it unless you go full bore like the chinese - locking people into their homes.

[scarmig]

I find this argument unconvincing. The UK is an island, and it's doing badly. "But it's highly connected with the rest of the world, so it makes it honorarily a non-island!" Okay, sure. How about South Korea? It isn't an island, and it's doing pretty well. "But it's de facto an island, it's not getting cases from North Korea!" Okay, sure. But by that standard the US is an island: it didn't get its cases from Mexico or Canada.

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.

[fomine3]

You can't say that US is virtually island same as South Korea because US isn't on war with Canada or Mexico.

[irq11]

> How about South Korea? It isn’t an island, and it’s doing pretty well.

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...

[howlgarnish]

All-time high being around 1000 cases per day in a country of 50M, and they haven't given up yet -- they've successfully beaten back two previous waves.

[irq11]

“all-time high“ meaning “all-time high“...and continuing to accelerate.

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:

http://ncov.mohw.go.kr/en

[dehrmann]

It was 100 cases per day two months ago, and their peak after the initial wave was 441 per day. It's not as bad as the US or UK, but they don't have the virus under control right now.

[turing_complete]

Just compare their numbers to Europe or the US.

[howlgarnish]

Sigh, this old canard again. Vietnam, Thailand, Laos, Cambodia, Singapore are all doing fine without "locking people into their homes" and they're not islands.

(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.)

[jandrewrogers]

Viet Nam is not doing fine. I have a lot of contact there, there is an outbreak of “severe pneumonia” for which no one is being tested for COVID despite being pretty obviously COVID. To make matters worse, in addition to not testing anybody with symptoms, the government hospitals have been turning people with these symptoms away so they are going to their family homes to be taken care of.

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.

[dehrmann]

IIRC, North Korea has reported zero cases.

[refurb]

I have a friend in Vietnam. They were effectively locking people in their homes. If a Covid case was found in an apartment, the entire floor was locked down. If you didn't stay in your home, you were brought to a facility where you didn't have a choice in the matter.

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.

[ValentineC]

> Vietnam, Thailand, Laos, Cambodia, Singapore are all doing fine without "locking people into their homes" and they're not islands.

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...

[paganel]

Maybe there's a genetic component to this virus? Which is "verboten" to be discussed and analysed because of various reasons ("race is a social construct" and all that), but at some point one has to take this into consideration too. All due respect to Laos, but I don't see it as having the needed expert infrastructure in order to keep this virus under control as well as they have. Similar discussion for Thailand.

[henearkr]

Some vaccines that are compulsory in Japan and China (and other Asian countries) but not in the rest of the world are also suspected to geographically shape some immunity differences.

For example the vaccine against Japanese Encephalitis is under investigation for a possible cross-effect on covid immunity.

[ethbr0]

It's less likely there's a genetic component to infection rates (though possible!) than a population-immunological one.

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...

[dekhn]

it's perfectly acceptable to talk scientifically about the difference in races (really, people with shared population history) by genetics and their responses to disease. THe people who are saying "race is social construct" are by and large not the actual scientists making discoveries in this area. REad the NYTimes science section for a few months and you'll see they commonly discuss the difference in medical treatment research and how we could improve health care by being more aware of it.

[thomasz]

The key is age and obesity.

[harimau777]

Is it possible that they are all effectively islands? For example, it appears that Vietnam has miles of jungle between its major cities and neighboring countries. The same cannot be said for the US and Europe.

[maxerickson]

There's not a whole lot of evidence that illegal border crossings from Canada are a major driver of the spread in the US.

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.

[ksaj]

> There's not a whole lot of evidence that illegal border crossings from Canada are a major driver of the spread in the US.

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.

[guardiangod]

Don't blame the Americans for what that fool of a premier J Kennedy has done. Alberta could have clamped down the 3rd wave like BC has. Instead JK followed the right ringers wish and let everyone continue to gather.

[dehrmann]

To be fair, Alberta is culturally more like Texas than Vancouver.

[howlgarnish]

Those miles of jungle are crisscrossed by roads, trains and ferries, just like US and Europe. Vietnam is a country of nearly 100M people with strong trade and transport links to the world, and over in Thailand, Bangkok is the most popular tourist destination in the world.

[rndgermandude]

There is very little tourism right now, ever since this started. But before that, Vietnam (population 97M) had close to 20M international arrivals last year, Germany (population 83M) had 39M, Thailand (population 70M) had 40M.

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.

[thomasz]

Look at the demographics of these countries and compare them to the United States and Europe. Throw in less detailed reporting and less transparency. We’re dealing with a virus that overwhelmingly affects old, obese people. A country like Vietnam probably wouldn't even notice the pandemic wave that currently affects Europe and the United States.

[rtpg]

You could handwave that when we were at way less cases. But at one point people would start noticing (for example) everyone in retirement homes dropping like flies.

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.

[thomasz]

Off course it’s possible to have a measurable impact. It’s obviously working for Vietnam, but I’m doubtful that the same measures would be sufficient for countries where the old and obese make up not less than five percent but more than a third. Vietnam could have numbers of infection similar to Germany without even noticing, especially if we are accounting for the difference in transparency.

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.

[Izkata]

Thailand was doing fine, but as of this past week it broke past their quarantine.

[dageshi]

It's Thailands winter, if there's ever a time it's going to spread there, it's probably now.

[jdminhbg]

> Vietnam, Thailand, Laos, Cambodia

I guess perfect covid policy is contagious!

[GregarianChild]

The UK is no island?

[rualca]

> The UK is no island?

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.

[michaelt]

Sure, but all the points of entry to Britain have border controls. If the government ordered the channel tunnel to stop, it would stop. It's not like France, where there are innumerable border crossing points.

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.

[stordoff]

> If the government ordered the channel tunnel to stop, it would stop. [...] Of course a total closure would be a last resort, because that would cut off imports of things like fresh fruit

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...