4 ms·

Sars was 17 years ago, and East Asian countries responded much better to Covid as result of their lessons learned, with Taiwan being the star pupil. My expecta

Sars was 17 years ago, and East Asian countries responded much better to Covid as result of their lessons learned, with Taiwan being the star pupil. My expectation, though, is that the US will never reach such levels of life-saving, due to our cultural differences.

makomk 6y ago
The thing is, much of the approach that worked for Sars shouldn't actually work for Covid - in particular, Covid has characteristics that make it much less amenable to contact tracing than Sars. (The UK, US and I think most other western countries used the same contact tracing early on that kept Sars out of those countries. It didn't work. You also don't see this discussed much, because it doesn't fit the narrative - except to attack the UK government for discontinuing the contact tracing once it failed.) The one thing that did work well early on is restrictions on travel, which the WHO, China and the press in Western countries campaigned against. The only Western country I know of that applied reasonably sensible travel restrictions early on is the US, and very soon it's going to get a new president who campaigned on the extremely dubious claim that those restrictions made things worse which went basically unchallenged by the press. (In particular, Italy's travel restrictions - which are often pointed to as proof the US ones were stupid and pointless - only blocked people from travelling directly from China, so they could just travel via other countries and Italy had no record of where they came form. I know the UK's government-funded experts concluded that was much less effective than banning people who'd visited China recently.) Those travel restrictions also wouldn't work for any country geographically or geopolitically close to Italy - they were still reporting basically zero cases at a point when a substantial proportion of the population was infected. This probably put countries which were closer to China than Italy at something of an inherent advantage.
- graeme 6y ago
  I live in Atlantic Canada and we’ve beaten back several outbreaks with contact tracing, testing and isolation. We also moved early and controlled travel to and from the region with a quarantine. The travel restrictions are essential. But....if you only did that you would fail miserably. Contact tracing works very well! SARS-COV-2 spreads in clusters. We were at zero cases for months, and we’re back down to 0-3 local cases a day in most of our provinces and dropping. You’re completely wrong that this can’t be contained through isolation and tracing. The issue was most of the rest of north america basically only tried tracing (doesn’t work), didn’t scale tracing, and also never seriously tried to eliminate the virus despite the clear evidence that their tracing systems were incapable alone. (I’m including the rest of canada here) I agree with you that travel restrictions are vital but you’re underestimating the importance of other tools. Also the Us restrictions weren’t very effective: people still got through! In Atlantic Canada everyone arriving from outside the region has to quarantine for 14 days. Where contact tracing fails, incidentally, is if you have an undetected case cluster. SARS-COV-2 can spread asymptomatically, so if you miss one it can grow quite a bit. But once you find evidence of a cluster you can move backwards and forwards through the transmission chain and quite effectively. The province of new brunswick has beaten about seven small outbreaks back down to zero with this method. But it only works if case numbers are manageable: the rest of north america let them grow out of control and didn’t scale tracing to match.
- jmchuster 6y ago
  It's a bit difficult to take arguments seriously, when there's a lot of expressed motive to make a certain side look good or bad. Travel restrictions work great. Test and quarantine everyone who comes in to the country. But you won't have perfect containment, and maybe you choose to make a tradeoff and say you just need the test, which has X% accuracy. So then there must be follow-up behavior, and that's where contact tracing, quarantines, and masks come in. If you reach the point where you can't get a handle with such techniques, then you lockdown and test until they're sustainable. There are countries who have done much better, and other countries that have done much worse with Covid. And you see that with East Asian countries who experienced Sars, and African countries who experienced Ebola. So, it might behoove the leaders of countries with much more dead to take a look at what others might be doing different.
  - sampo 6y ago
    > But you won't have perfect containment As far as we know, Taiwan has had 0 cases since April. All cases in Taiwan are cases that are found in border quarantines. I'd call that a perfect containment.
    - graeme 6y ago
      Interestingly they just had their first in a long while: https://www.cnn.com/2020/12/22/asia/taiwan-coronavirus-intl-hnk/index.html https://www.cnn.com/2020/12/22/asia/taiwan-coronavirus-intl-... They have had basically perfect containment, but even then you need some backup systems.
- notahacker 6y ago
  > The UK, US and I think most other western countries used the same contact tracing early on that kept Sars out of those countries. It didn't work. You also don't see this discussed much, because it doesn't fit the narrative - except to attack the UK government for discontinuing the contact tracing once it failed. It worked very well in Asian countries with relevant experience (and perhaps more obedient cultures). The UK didn't have comparable relevant experience and may even have used it counterproductively (a relative with very early symptoms contacted the relevant helpline to be advised there were no known cases in their area so they shouldn't worry...) > The only Western country I know of that applied reasonably sensible travel restrictions early on is the US New Zealand imposed a travel ban on people from the region at the same time but also required its own returning nationals to self isolate. NZ has certain geographical advantages relative to other Western nations which made it easier for them to subsequently expand that scope to the entire world and eliminate the disease in their country altogether, but even before that the NZ administration wasn't accused of focusing its containment efforts on foreign nonresidents whilst loudly downplaying the risk of community spread from returnees amongst its own population because this isn't what it did.
- deleted 6y ago
  [deleted]
- tzs 6y ago
  In the US, contact tracing had no chance because very few US states came anywhere near hiring enough contact tracers to do effective contact tracing.
- gpderetta 6y ago
  Anecdotally contact tracing in UK is basically non-existent.

makomk 6y ago

The thing is, much of the approach that worked for Sars shouldn't actually work for Covid - in particular, Covid has characteristics that make it much less amenable to contact tracing than Sars. (The UK, US and I think most other western countries used the same contact tracing early on that kept Sars out of those countries. It didn't work. You also don't see this discussed much, because it doesn't fit the narrative - except to attack the UK government for discontinuing the contact tracing once it failed.) The one thing that did work well early on is restrictions on travel, which the WHO, China and the press in Western countries campaigned against. The only Western country I know of that applied reasonably sensible travel restrictions early on is the US, and very soon it's going to get a new president who campaigned on the extremely dubious claim that those restrictions made things worse which went basically unchallenged by the press. (In particular, Italy's travel restrictions - which are often pointed to as proof the US ones were stupid and pointless - only blocked people from travelling directly from China, so they could just travel via other countries and Italy had no record of where they came form. I know the UK's government-funded experts concluded that was much less effective than banning people who'd visited China recently.) Those travel restrictions also wouldn't work for any country geographically or geopolitically close to Italy - they were still reporting basically zero cases at a point when a substantial proportion of the population was infected. This probably put countries which were closer to China than Italy at something of an inherent advantage.

graeme 6y ago
I live in Atlantic Canada and we’ve beaten back several outbreaks with contact tracing, testing and isolation. We also moved early and controlled travel to and from the region with a quarantine. The travel restrictions are essential. But....if you only did that you would fail miserably. Contact tracing works very well! SARS-COV-2 spreads in clusters. We were at zero cases for months, and we’re back down to 0-3 local cases a day in most of our provinces and dropping. You’re completely wrong that this can’t be contained through isolation and tracing. The issue was most of the rest of north america basically only tried tracing (doesn’t work), didn’t scale tracing, and also never seriously tried to eliminate the virus despite the clear evidence that their tracing systems were incapable alone. (I’m including the rest of canada here) I agree with you that travel restrictions are vital but you’re underestimating the importance of other tools. Also the Us restrictions weren’t very effective: people still got through! In Atlantic Canada everyone arriving from outside the region has to quarantine for 14 days. Where contact tracing fails, incidentally, is if you have an undetected case cluster. SARS-COV-2 can spread asymptomatically, so if you miss one it can grow quite a bit. But once you find evidence of a cluster you can move backwards and forwards through the transmission chain and quite effectively. The province of new brunswick has beaten about seven small outbreaks back down to zero with this method. But it only works if case numbers are manageable: the rest of north america let them grow out of control and didn’t scale tracing to match.
jmchuster 6y ago
It's a bit difficult to take arguments seriously, when there's a lot of expressed motive to make a certain side look good or bad. Travel restrictions work great. Test and quarantine everyone who comes in to the country. But you won't have perfect containment, and maybe you choose to make a tradeoff and say you just need the test, which has X% accuracy. So then there must be follow-up behavior, and that's where contact tracing, quarantines, and masks come in. If you reach the point where you can't get a handle with such techniques, then you lockdown and test until they're sustainable. There are countries who have done much better, and other countries that have done much worse with Covid. And you see that with East Asian countries who experienced Sars, and African countries who experienced Ebola. So, it might behoove the leaders of countries with much more dead to take a look at what others might be doing different.
- sampo 6y ago
  > But you won't have perfect containment As far as we know, Taiwan has had 0 cases since April. All cases in Taiwan are cases that are found in border quarantines. I'd call that a perfect containment.
  - graeme 6y ago
    Interestingly they just had their first in a long while: https://www.cnn.com/2020/12/22/asia/taiwan-coronavirus-intl-hnk/index.html https://www.cnn.com/2020/12/22/asia/taiwan-coronavirus-intl-... They have had basically perfect containment, but even then you need some backup systems.
notahacker 6y ago
> The UK, US and I think most other western countries used the same contact tracing early on that kept Sars out of those countries. It didn't work. You also don't see this discussed much, because it doesn't fit the narrative - except to attack the UK government for discontinuing the contact tracing once it failed. It worked very well in Asian countries with relevant experience (and perhaps more obedient cultures). The UK didn't have comparable relevant experience and may even have used it counterproductively (a relative with very early symptoms contacted the relevant helpline to be advised there were no known cases in their area so they shouldn't worry...) > The only Western country I know of that applied reasonably sensible travel restrictions early on is the US New Zealand imposed a travel ban on people from the region at the same time but also required its own returning nationals to self isolate. NZ has certain geographical advantages relative to other Western nations which made it easier for them to subsequently expand that scope to the entire world and eliminate the disease in their country altogether, but even before that the NZ administration wasn't accused of focusing its containment efforts on foreign nonresidents whilst loudly downplaying the risk of community spread from returnees amongst its own population because this isn't what it did.
deleted 6y ago
[deleted]
tzs 6y ago
In the US, contact tracing had no chance because very few US states came anywhere near hiring enough contact tracers to do effective contact tracing.
gpderetta 6y ago
Anecdotally contact tracing in UK is basically non-existent.