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To all indications, South Korea responded competently and aggressively, and they have roughly five deaths per million. But Japan half-assed their response, and

To all indications, South Korea responded competently and aggressively, and they have roughly five deaths per million. But Japan half-assed their response, and they have six. People are blaming/crediting governments with total control of the outcome, when it's far more likely that yet-unknown environmental, genetic, etc. factors explain much of the variation between countries. That doesn't mean we should excuse government incompetence, but we shouldn't assume the same measures in a different country would have yielded the same death rate. ETA: If you think something is wrong here, please comment in addition to downvoting. Do you think Japan's response was actually better than Italy's, or Spain's, or any of the countries with much tighter restrictions and many more deaths? If so, why (beyond the circular argument that they have fewer deaths)?

Johnjonjoan 6y ago
The only reason I agree with you is because you said "the same death rate". If we change it to "a reduced death rate" that's absolutely what we should be assuming. South Korea's measures were born of SARS - we will probably have the same measures ready after this coronavirus. Why not use the lessons learned in South Korea rather than the same ones learned in our own countries?
- tripletao 6y ago
  I said explicitly that I didn't intend my comment as a defense of incompetent government responses, so I'm not sure why anyone would take it that way? It's certainly true that e.g. the USA would have fewer deaths if our response hadn't been so late and chaotic; but that doesn't mean the same measures that brought South Korea to five deaths per million would have brought the USA anywhere near that.
  - Johnjonjoan 6y ago
    Yes I agree. I understand the point you are making and I don't think what we have contradicted each other. I accept South Korea's measures won't get most Western countries near their death rate. However I felt the need to add that the methods are based on past experience and just because they won't have the same power they will still be extremely effective in combating the virus.
    - tripletao 6y ago
      Certainly fair, though I'd probably replace "extremely effective" with "our best ideas to solve a very serious problem, and therefore worth trying". For example, is Reff < 1 in Korea only because of contact tracing? They're doing a commendable job with that, and it's certainly helping, but by how much? Is their voluntary physical distancing actually responsible for most of their success? Or some yet-unknown factor? I'm not sure how anyone could answer that now with confidence. That uncertainty shouldn't stop us from implementing the best ideas we have, but I believe it should be acknowledged.
      - Johnjonjoan 6y ago
        Agreed. Especially the last part, well put.
- SpicyLemonZest 6y ago
  Singapore's measures were born of SARS too, and it didn't save them. We should definitely try and learn from other countries, but it doesn't make sense to simply assume that a photocopy of their strategy would have worked as well elsewhere.
  - Johnjonjoan 6y ago
    I agree. I'm not very aware of Singapore's specific case - however I believe they are having a lot of issues because of overcrowding of migrant workers. As far as I see it this is exactly this threads OPs point. i.e The same measures won't reduce the death rate to the same amount. But this does not mean they have not reduced the death rate and aren't good advice everywhere.
  - matthewdgreen 6y ago
    "Singapore's measures were born of SARS too, and it didn't save them." Singapore has 21 deaths as of May 14. Adjusting this number to the US population gives 1,117 deaths. The US has 89,908 deaths and rising. I would gladly trade with Singapore.
    - tripletao 6y ago
      What makes you think we ever had the option to? Singapore's response was certainly better than the USA's, and the American equivalent of that would near-certainly have resulted in fewer deaths; but why do you think that explains most of the difference between the two countries' death rates? In particular, how do you explain Japan? They barely locked down, and they're missing most of their cases so the contact tracing is at best reducing Reff by ~20% (per below). I personally suspect that Japan has benefited from some combination of masks, a culture of hygiene and distance, and the weather; but I'm far from confident, and disappointed to see others behaving with such apparent confidence in the face of all we don't know.
      - matthewdgreen 6y ago
        I don't know what makes this virus spread or not spread. All I know is that as long as another Wuhan/Lombardy/NYC is still possible, we should be doing every damned thing we can do to control this epidemic as though it's deadly everywhere. Hopefully scientists will figure out that chrysanthemum pollen or TB vaccinations reduce the severity, and then we can deploy that tool here. Until that happens: we have to act like this disease is going to explode. That isn't confidence, it's just common sense.
claudeganon 6y ago
Japan didn’t “half-ass” their response, they just took a different approach from South Korea (attacking clusters), rooted in their experience with combatting TB. In addition, they have a highly pro-social society that took it upon itself to do things like engage in universal mask wearing and social distancing measures. That being said, we’re still very early in the course of this disease, so it’s hard to know how the responses will measure up in terms of durability. Since many epidemiologists are predicting a dark course this coming winter, I suppose we will see, but my bet would be on South Korea, given that their response is more firmly rooted in their experience with SARS. The US has neither the aggressive government response, cluster-based methods of Japan, nor an especially pro-social society. You can’t really compare “half-hearted” measures across countries absent this context, but if even if you wanted to, it’s quite clear that our “half-heartedness” is far more deadly.
- tripletao 6y ago
  What specific measures do you think Japan took that were effective here? They've been able to do more contact tracing from clusters than the USA; but is that because they're better at contact tracing, or because the outbreak naturally grew slower there, and they had an easier task? I certainly agree that stuff like Japan's existing mask culture (and general culture of hygiene/distance) is helping, and that those can and should be emulated. That's a separate question from their current government response, though. And I worry about winter too. Everything about seasonality is speculative now (and it's shocking how little we know about why a cold and flu season exists), but I can't help suspect that many countries that think they've eliminated the coronavirus have an unpleasant wave ahead. And thanks for the reasonable counterpoint--whoever downvoted you should explain themselves too.
  - claudeganon 6y ago
    They’re better at contact tracing and cluster-squashing because they have a large, long-standing network of public health centers with the express goal of combatting infectious disease outbreaks: > In 1935, with funding from the Rockefeller Foundation, Japan opened its first public health centre (PHC) in Tokyo. The country then put in place a programme that led to the building of another 187 nationwide. They survived the war and the occupation. But the thing of note is that before and after the war, their priority, says Taniguchi, was always to “stay watchful all the time” for the emergence of TB cases. If one was found, they were tasked with rushing to the patient's residence, checking for clusters and sterilising the house Seventy-five years on, 469 PHCs are in operation across the country, with each manned, on average, by 64 medical professionals, including one to two licensed doctors. They still locate clusters, track links and conduct tests. It is this “accumulated wealth of expertise, rarely found elsewhere” that has made the difference. Japan has not had to rely on mass testing strategies because it’s health care history had already left a cluster-crushing strategy embedded in its system https://moneyweek.com/economy/global-economy/601264/cluster-busting-japan-success-fighting-covid-19 https://moneyweek.com/economy/global-economy/601264/cluster-...

Johnjonjoan 6y ago

The only reason I agree with you is because you said "the same death rate". If we change it to "a reduced death rate" that's absolutely what we should be assuming. South Korea's measures were born of SARS - we will probably have the same measures ready after this coronavirus. Why not use the lessons learned in South Korea rather than the same ones learned in our own countries?

tripletao 6y ago
I said explicitly that I didn't intend my comment as a defense of incompetent government responses, so I'm not sure why anyone would take it that way? It's certainly true that e.g. the USA would have fewer deaths if our response hadn't been so late and chaotic; but that doesn't mean the same measures that brought South Korea to five deaths per million would have brought the USA anywhere near that.
- Johnjonjoan 6y ago
  Yes I agree. I understand the point you are making and I don't think what we have contradicted each other. I accept South Korea's measures won't get most Western countries near their death rate. However I felt the need to add that the methods are based on past experience and just because they won't have the same power they will still be extremely effective in combating the virus.
  - tripletao 6y ago
    Certainly fair, though I'd probably replace "extremely effective" with "our best ideas to solve a very serious problem, and therefore worth trying". For example, is Reff < 1 in Korea only because of contact tracing? They're doing a commendable job with that, and it's certainly helping, but by how much? Is their voluntary physical distancing actually responsible for most of their success? Or some yet-unknown factor? I'm not sure how anyone could answer that now with confidence. That uncertainty shouldn't stop us from implementing the best ideas we have, but I believe it should be acknowledged.
    - Johnjonjoan 6y ago
      Agreed. Especially the last part, well put.
SpicyLemonZest 6y ago
Singapore's measures were born of SARS too, and it didn't save them. We should definitely try and learn from other countries, but it doesn't make sense to simply assume that a photocopy of their strategy would have worked as well elsewhere.
- Johnjonjoan 6y ago
  I agree. I'm not very aware of Singapore's specific case - however I believe they are having a lot of issues because of overcrowding of migrant workers. As far as I see it this is exactly this threads OPs point. i.e The same measures won't reduce the death rate to the same amount. But this does not mean they have not reduced the death rate and aren't good advice everywhere.
- matthewdgreen 6y ago
  "Singapore's measures were born of SARS too, and it didn't save them." Singapore has 21 deaths as of May 14. Adjusting this number to the US population gives 1,117 deaths. The US has 89,908 deaths and rising. I would gladly trade with Singapore.
  - tripletao 6y ago
    What makes you think we ever had the option to? Singapore's response was certainly better than the USA's, and the American equivalent of that would near-certainly have resulted in fewer deaths; but why do you think that explains most of the difference between the two countries' death rates? In particular, how do you explain Japan? They barely locked down, and they're missing most of their cases so the contact tracing is at best reducing Reff by ~20% (per below). I personally suspect that Japan has benefited from some combination of masks, a culture of hygiene and distance, and the weather; but I'm far from confident, and disappointed to see others behaving with such apparent confidence in the face of all we don't know.
    - matthewdgreen 6y ago
      I don't know what makes this virus spread or not spread. All I know is that as long as another Wuhan/Lombardy/NYC is still possible, we should be doing every damned thing we can do to control this epidemic as though it's deadly everywhere. Hopefully scientists will figure out that chrysanthemum pollen or TB vaccinations reduce the severity, and then we can deploy that tool here. Until that happens: we have to act like this disease is going to explode. That isn't confidence, it's just common sense.

claudeganon 6y ago

Japan didn’t “half-ass” their response, they just took a different approach from South Korea (attacking clusters), rooted in their experience with combatting TB. In addition, they have a highly pro-social society that took it upon itself to do things like engage in universal mask wearing and social distancing measures. That being said, we’re still very early in the course of this disease, so it’s hard to know how the responses will measure up in terms of durability. Since many epidemiologists are predicting a dark course this coming winter, I suppose we will see, but my bet would be on South Korea, given that their response is more firmly rooted in their experience with SARS. The US has neither the aggressive government response, cluster-based methods of Japan, nor an especially pro-social society. You can’t really compare “half-hearted” measures across countries absent this context, but if even if you wanted to, it’s quite clear that our “half-heartedness” is far more deadly.

tripletao 6y ago
What specific measures do you think Japan took that were effective here? They've been able to do more contact tracing from clusters than the USA; but is that because they're better at contact tracing, or because the outbreak naturally grew slower there, and they had an easier task? I certainly agree that stuff like Japan's existing mask culture (and general culture of hygiene/distance) is helping, and that those can and should be emulated. That's a separate question from their current government response, though. And I worry about winter too. Everything about seasonality is speculative now (and it's shocking how little we know about why a cold and flu season exists), but I can't help suspect that many countries that think they've eliminated the coronavirus have an unpleasant wave ahead. And thanks for the reasonable counterpoint--whoever downvoted you should explain themselves too.
- claudeganon 6y ago
  They’re better at contact tracing and cluster-squashing because they have a large, long-standing network of public health centers with the express goal of combatting infectious disease outbreaks: > In 1935, with funding from the Rockefeller Foundation, Japan opened its first public health centre (PHC) in Tokyo. The country then put in place a programme that led to the building of another 187 nationwide. They survived the war and the occupation. But the thing of note is that before and after the war, their priority, says Taniguchi, was always to “stay watchful all the time” for the emergence of TB cases. If one was found, they were tasked with rushing to the patient's residence, checking for clusters and sterilising the house Seventy-five years on, 469 PHCs are in operation across the country, with each manned, on average, by 64 medical professionals, including one to two licensed doctors. They still locate clusters, track links and conduct tests. It is this “accumulated wealth of expertise, rarely found elsewhere” that has made the difference. Japan has not had to rely on mass testing strategies because it’s health care history had already left a cluster-crushing strategy embedded in its system https://moneyweek.com/economy/global-economy/601264/cluster-busting-japan-success-fighting-covid-19 https://moneyweek.com/economy/global-economy/601264/cluster-...