I came across an interesting article on the effectiveness of control measures on the coronavirus.
For decades, the richest nations of the world had told themselves a story in which wealth and medical superiority offered, if not total immunity from disease, then certainly a guarantee against pandemics, regarded as a premodern residue of the underdeveloped world. That arrogance has made the coronavirus not just a staggering but an ironic plague. Invulnerability was a myth, of course, but what the pandemic revealed was much worse than just average levels of susceptibility and weakness. It was these countries that suffered most, died most, flailed most. Gave up most easily, too, acquiescing to so much more disease that they might have been fighting a different virus entirely. For nearly the entire year, the COVID epicenter was not in China, where the pathogen originated, or in corners of South Asia or sub-Saharan Africa, where limited state capacity and medical infrastructure seemed, at the outset, especially concerning, but either in Europe or the United States — places that were rated just one year ago the best prepared in the world to combat infectious disease.
This fact, though not unknown, is probably the most salient and profound feature of what has been a tremendously uneven pandemic with the world’s longtime “winners” becoming by far its biggest losers. The gold-standard responses were those in East Asia and Oceania, by countries like South Korea, New Zealand, and Australia — countries that saw clearly the gravest infection threat the world had encountered in a century and endeavored to simply eradicate it within their borders. Mostly, they succeeded. When it mattered most, no nation in what was once grandly called “the West” even really bothered to try.
In Europe, North America, and South America: nearly universal failure. In sub-Saharan Africa and South Asia: high caseloads and low death rates, owing largely to the age structure of populations. In East Asia, South-East Asia and Oceania: inarguable success. You can compare countries within these clusters, and wonder why Canada has outperformed the U.S. or why Uruguay has outshone Argentina, why Iran suffered so much or how Japan, which never locked down and never tested all that widely, succeeded so brilliantly. But the differences in outcomes between the groups of nations are far greater than those within them, so much so that they appear almost as the burn scars of entirely different diseases.
In East Asia, though, nobody envies the Antipodes. In Taiwan, the death rate is a minuscule 0.42 per million. The European Union performed, on average, 3,000 times worse. Cambodia hasn’t reported a single COVID death all year, and while it is probably fair to assume that the official data don’t tell the full story, what is most startling across East and Southeast Asia — an incredibly heterogeneous region, with wealthy nations and poor ones, democracies and authoritarian regimes, national health-care systems and patchwork networks — is just how consistent the story is. In Vietnam, there have been 0.36 deaths per million, in China 3.36. In Singapore, the number is around five; in South Korea, it is close to 32; in Japan, in many ways the best contrast for the aging and wealthy nations of Europe and North America, it’s about 67. Again, you can doubt some of these numbers, the Chinese figures especially. But in the U.K., remember, the level is north of 1,800.
[The article goes on to say that acting swiftly and decisively played a major role in outcomes. If global travel was brought to a halt and paused at the beginning, the outcome would have improved substantially. In other words once it becomes endemic in the population it is extremely hard to stomp out.]
Mike Ryan, WHO’s executive director of health emergencies spoke at a Geneva press conference on 13 March 2020 and said, “Be fast. Have no regrets. You must be the first mover. The virus will always get you if you don’t move quickly.” “If you need to be right before you move, you will never win. Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection. And the problem in society we have at the moment is everyone is afraid of making a mistake, everyone is afraid of the consequence of error. But the greatest error is not to move. The greatest error is to be paralyzed by the fear of failure.”
It’s a perspective echoed by Zeynep Tufekci, the scholar of technology who has become perhaps the most treasured “outsider” analyst of the disease and pandemic policy in the U.S. — an independent thinker who has, again and again, called out the limitations and perversities of public-health guidance on everything from masking to asymptomatic transmission to the role of aerosols and the importance of ventilation. She recently surveyed the system’s biggest failures — including that experts sometimes misled the public on key points out of fear that advising them honestly would lead them to take more risk; that hard rules (six feet apart, for no more than 15 minutes) were offered in place of broad principles (“like Japan’s, which emphasize avoiding the three C’s — closed spaces, crowded places, and close contact”); and a preference for false certainty (“There is no evidence of human-to-human transmission”) rather than honest nuance (“There is increasing likelihood that human-to-human transmission is taking place, but we haven’t yet proven this”).
These were not narrowly American issues, or western ones—in fact, much of the problematic guidance came from the WHO. But in East Asia, countries didn’t wait for the WHO’s guidance to change on aerosols or asymptomatic transmission before masking up, social-distancing, and quarantining. “They acted fast. They acted decisively,” says Mina. “They made early moves. They didn’t sit and ponder: ‘What should we do? Do we have all of the data before we make a single decision?’ And I think that is a common theme that we’ve seen across all the Western countries—a reluctance to even admit that it was a big problem and then to really act without all of the information available. To this day, people are still not acting.” Instead, he says, “decision-makers have been paralyzed. They would rather just not act and let the pandemic move forward than act aggressively, but potentially be wrong.”
Source: How the West Lost COVID How did so many rich countries get it so wrong? How did others get it so right?
12 Mar 2021, 9:00 am
