Hacker News Reader

Comment by rossdavidh | Hacker News Reader

You know, this is not quite the issue I find interesting. More intriguing to me is, with the ratio of cases and deaths differing by orders of magnitude, even between countries of similar wealth levels, age demographics, etc., why has it not been the primary topic of conversation? Australia and New Zealand have covid-19 stats more similar to the rest of east Asia than they do to the U.K. or other (more genetically similar) European-descended nations. Why is this not the overwhelming focus of our research? If it's not genetics, and it's not wealth levels, then there's something environmental in Taiwan, Japan, Australia, New Zealand, South Korea, etc. that is different than in France, U.S.A., Italy, etc. I mean their levels are more than an order of magnitude better. Why is this not our primary focus of discussion?

View on HN

> If it's not genetics, and it's not wealth levels, then there's something environmental in

> Taiwan,

Island.

> Japan,

Island.

> Australia,

Island.

> New Zealand,

Island.

> South Korea

Effectively an island—peninsula with the only land access being through the most heavily militarized border in the world.

UK - Island(s).

However, up until recently very lax on air travellers and even now actually checking some.

True, but London, like New York, is a global air travel hub and none of the other are even particularly popular travel destinations.

Taiwan and South Korea, maybe, but Japan and Australia most certainly are popular travel dedtinstions.

So the next question is what did Japan/Australia do to mitigate the risk from tourists spreading covid.

This is what I found for Australia:

> Since March last year, Australia has essentially allowed only returning residents to enter the country, provided they complete a 14-day quarantine - usually in city hotels.

https://www.bbc.com/news/world-australia-55929180

It seems they stopped allowing tourists to fly and were very strict from very early in the pandemic

Traffic routes in and between China, HK, Singapore and Japan all carry much more traffic than any London or NY based routes: https://en.wikipedia.org/wiki/List_of_busiest_passenger_air_...

In an alternate measure, we finally see a NY-based trip enter the list at number 8, with the countries listed above remaining much busier: https://en.wikipedia.org/wiki/List_of_busiest_passenger_air_...

In the EU we are implementing lockdowns and curfews with moderate results.

When I suggest we should suspend all air travel except for freight and bring back border checks in the EU during lockdown, all my friends react like it's pure heresy.

In hindsight historians will look back at this as our biggest failing. Allowing for travel in the name of economy whilst prolonging economic damage plus increasing disease/deaths.

Half measures are a short distance from no measures at all in terms of virus containment.

Or it could be exactly the opposite. In this paper [0], Ioannidis (one of the most cited epidemiologists in the world) and his co-authors write:

<< In summary, we fail to find strong evidence supporting a role for more restrictive NPIs in the control of COVID in early 2020. We do not question the role of all public health interventions, or of coordinated communications about the epidemic, but we fail to find an additional benefit of stay-at-home orders and business closures.

The data cannot fully exclude the possibility of some benefits. However, even if they exist, these benefits may not match the numerous harms of these aggressive measures. More targeted public health interventions that more effectively reduce transmissions may be important for future epidemic control without the harms of highly restrictive measures. >>

[0] https://www.lifesitenews.com/news/stanford-study-lockdowns-h...

I'm not sure that being an island the main factor. The underlying factor is connectivity. Some islands have low connectivity while others do not -- being an island isn't, in itself, protective.

If you think about it, most countries in the world only have limited ports of entry (no matter the size of the border), and if a national government shuts off these ports of entry, the country essentially becomes an "island" whether they have a surrounding body of water or not. (assuming strong borders and no illegal traversals -- which may or may not be good assumptions depending on where you are, but it's a simplifying assumption for the sake of discussion).

Montreal is an island but its COVID rates are far worse than Toronto. There's nothing special about being an island. It's about the connectivity.

An interesting hypothesis from Sir John Bell is that, some of the asian countries such as Vietnam, Cambodia, China and Thailand have a lot of bats and may have got immunity from past exposure to bat coronaviruses.

https://www.reddit.com/r/CoronavirusUK/comments/lmiyfv/profe...

Vietnam closed their borders, kept kids home from school, had a month-long lockdown in April, and stopped COVID in its tracks. No magic immunity required, they just did the few things that were necessary to top the spread of an infectious airborne disease. They lived through SARS, everyone knows the consequences of failure to contain a new virus.

There's no need to look for explanations in exposure to bat coronaviruses when there's so much Vietnam did that the USA, UK and Europe didn't do. This isn't just about government actions, but the individual actions of the population too.

I think there is not much discussion because the answer is clear, and also unpalatable: it comes down to political and cultural differences. We never successfully implemented the kind of strict lockdowns and other measures that worked to control the virus in other countries.

I would expect lockdowns to help reducing the spread, but not the death rate.

I suspect it is a) making sure vulnerable people are really isolated (care homes for example), b) a better health system.

I would like to see a plot of death rate vs hospital beds... found this [1] that argues that it has potentially a small effect, but doesn't explain everything.

[1] https://www.health.org.uk/news-and-comment/charts-and-infogr...

Death rate is hard to measure and needs to be measured by age cohorts. It's identified deaths divided by identified infections.

If you do a worse job finding asymptomatic cases, your death rate gets higher even more people didn't die.

Institutional programming to react to SARs is one reason. Those countries enacted lockdowns quicker and had government agencies to properly regulate ventilation in public environments.

Western governments simply didnt have the ability or the desire to regulate ventilation and, at the beginning were prioritizing keeping the economy running (ironically enough).

Exponential growth is a weird thing.

All these countries worked very hard at the start of the epidemic to bring it under control and were successful.

The state of Victoria in Australia is the best example of this. After initial elimination, it started to get out of control and so they entered a very strict 112 day lockdown until community transmission went to zero.

Since then most Australian states have done similar (but shorter) lockdowns, again until community transmission is zero.

When community transmission is very low (<100 cases) things like contact tracing work, communities support short lockdowns etc.

Once it gets out of control many control processes become useless, and exponential growth takes over.

You are indeed on to something. My theory that most disease are environmental in nature with pathogens being opportunistic invaders. On their own pathogen can find it difficult to infect an organism.

>Why is this not our primary focus of discussion?

Because mainstream science also has their own set of beliefs which are dogmatic in nature. Moreover would a govt/big business come forth and say, so we introduced a new detergent formula in the market and this cause the whole outbreak? that has never voluntarily happened.

Just look at several nation with no lock downs - and there are no reports of people dying in mass numbers. In fact I doubt if there is even a new pathogen around.

Australian here. The reasons are quite simple from our perspective: socialised health care, closing international and state borders where required, having leadership that provides consistent and sensible advice, and accepting that along with rights we have responsibilities.

In countries that have had serious COVID issues such as the UK and USA we see little to none of the above. As an example there was a discussion I watched where someone from California went for a road trip to neighbouring states despite the local authorities asking interstate visitors to stay away. When challenged about visiting states asking people to stay away, their reply was basically, "I don't believe I'm doing anything wrong, and you can't legally stop me." This attitude was prevalent from the top down.

One big issue in the USA is the number of people who simply can't afford to stay home from work, and whose multiple jobs require being present in a building with lots of visitors. In Australia we've had a number of "flare ups" where people involved in the quarantine program have ended up with COVID and spread it to the community because they are the lowest paid workers in the country and need three jobs to keep food on the table (or as a security guard they had multiple shifts moving between sites). As much of a joke as our hotel quarantine has been, it's at least something we can do to limit the community transmission of COVID-19.

There's nothing magical about Asia/Oceania countries managing COVID well. You just have to accept that COVID-19 is real, the medical authorities what they're talking about, and personal liberties sometimes need to be curtailed for the benefit of everyone.

At the personal level, wear a mask in public, keep your hands clean, avoid unnecessary travel, stay away from people. Sometimes you have to exercise your responsibilities instead of your rights.

At the corporate/national level, pay (poor) people to stay home, shut borders where required to prevent community transmission. Lock down neighbourhoods with high community transmission. Make sure testing is free and widely available.

If you believe "the economy" is more important than the people, you're not going to handle pandemics particularly well.

Something that isn't talked about, but is probably a big factor, is how soon they started taking action.

Contract tracing is very effective, but its hard to "scale." The virus exponentially grows, so once the infection rate is higher than your capacity to contract trace, you've permanently lost the battle.

Only really China, South Korea, and Australia have had substantial outbreaks that were later contained. But in each, the outbreak was geographically or socially relatively contained: Wuhan, Shincheonji Church, and Victoria.

If you talk to Australians they attribute it to their lockdowns.

Of course, that's only a temporary and very blunt band-aid. They still need to vaccinate pretty much everyone above the age of 20.

Agreed, but it has worked well for us until such a time as vaccines are available.

A lot of the countries on your list are basically only accessible by air travel, so it's much easier to control and track travelers in and out of their countries.

All the Asia/Pacific countries you mentioned are islands

So is the UK.

Reply on news.ycombinator.com