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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 be

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-...
- tripletao 6y ago
  But Japan's 729 coronavirus deaths imply something around 72,900 infections assuming 1% IFR. They actually report 16k. How could the contact tracing be what's keeping their Reff < 1, if they're missing ~80% of the cases?
  - claudeganon 6y ago
    Because Japan’s approach to testing, focusing on clusters, results in an undercounting of total cases in favor of the most dangerous set of cases. Cluster-squashing is about identifying and grounding to a halt circumstances where things can grow out of control quickly. They devote most of their resources to this and don’t have mass, on-demand testing like Korea. This results in their undercounting cases (arguably less serious cases, but again we’ll have to see the comparative efficacy long-term between the two countries).
    - tripletao 6y ago
      So you're arguing that even though Japan's contact tracing is missing ~80% of the cases, it's still catching the ~20% that would have spread the disease disproportionately? What's the difference between the high-spreading groups that they catch and the low-spreading they don't need to? Is this a characteristic of the patient's biology, behavior, environment, something else? Maybe you're saying that R < 1 almost everywhere in Japan, and they're disproportionately identifying the few places where it's > 1 ("circumstances where things can grow out of control") and intervening? I could believe that; but that still fails to explain why R > 1 there only in a few hotspots, while NYC ended up with ~20% infected even after lockdowns.
      - claudeganon 6y ago
        > Maybe you're saying that R < 1 almost everywhere in Japan, and they're disproportionately identifying the few places where it's > 1 ("circumstances where things can grow out of control") and intervening From what I understand, this is the thinking guiding the Japanese government’s response and their zoned lockdowns. Whether or not this is true, or will continue to be true, is unclear, but as you’ve pointed out, they’re roughly on track with South Korea thus far. To your second point: no one really knows. Looking at the example of other countries, universal, correct use of masks does seem to be an important mitigating factor. This was not practiced in NYC until well into the outbreak and social distancing measures were slow to be adopted as well (either by people taking it upon themselves or by government decree).

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-...

tripletao 6y ago
But Japan's 729 coronavirus deaths imply something around 72,900 infections assuming 1% IFR. They actually report 16k. How could the contact tracing be what's keeping their Reff < 1, if they're missing ~80% of the cases?
- claudeganon 6y ago
  Because Japan’s approach to testing, focusing on clusters, results in an undercounting of total cases in favor of the most dangerous set of cases. Cluster-squashing is about identifying and grounding to a halt circumstances where things can grow out of control quickly. They devote most of their resources to this and don’t have mass, on-demand testing like Korea. This results in their undercounting cases (arguably less serious cases, but again we’ll have to see the comparative efficacy long-term between the two countries).
  - tripletao 6y ago
    So you're arguing that even though Japan's contact tracing is missing ~80% of the cases, it's still catching the ~20% that would have spread the disease disproportionately? What's the difference between the high-spreading groups that they catch and the low-spreading they don't need to? Is this a characteristic of the patient's biology, behavior, environment, something else? Maybe you're saying that R < 1 almost everywhere in Japan, and they're disproportionately identifying the few places where it's > 1 ("circumstances where things can grow out of control") and intervening? I could believe that; but that still fails to explain why R > 1 there only in a few hotspots, while NYC ended up with ~20% infected even after lockdowns.
    - claudeganon 6y ago
      > Maybe you're saying that R < 1 almost everywhere in Japan, and they're disproportionately identifying the few places where it's > 1 ("circumstances where things can grow out of control") and intervening From what I understand, this is the thinking guiding the Japanese government’s response and their zoned lockdowns. Whether or not this is true, or will continue to be true, is unclear, but as you’ve pointed out, they’re roughly on track with South Korea thus far. To your second point: no one really knows. Looking at the example of other countries, universal, correct use of masks does seem to be an important mitigating factor. This was not practiced in NYC until well into the outbreak and social distancing measures were slow to be adopted as well (either by people taking it upon themselves or by government decree).