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> they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped

by timr 6y ago

> they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-deliver-surprise-growth-11604063439 https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over the last two years, lured by subsidies and hoping to dodge tariffs and other complications from U.S.-China tensions over trade and technology. The resulting boost to production capacity has put Taiwan in a good position to meet voracious demand for electronics as work-from-home professionals place orders for additional computers, monitors and smartphones, analysts said. > Domestic consumption was still holding back the island’s economy in the third quarter, but much less than before. Private consumption contracted 1.5% from a year earlier in the third quarter, compared with a slump of nearly 5% in the previous quarter, according to the statistics bureau. My point was that if you do the same thing in the US, it would be a debilitating economic cost. > And yes, you could eradicate with this strategy, if enough places would adopt it and work together. And if ifs and buts were candy and nuts, we'd all have a very merry Christmas. String enough speculative hypotheticals together, and you can justify anything. Again, very few countries can adopt such a strategy. It's a strategy that works...tenuously...for an island country with the population of a single US state, who can afford to be isolated from the world for a year or more. Hawaii tried the same approach, and it nearly bankrupted them in a few months: https://www.npr.org/2020/10/20/925795410/facing-economic-devastation-hawaii-attempts-to-revive-tourism https://www.npr.org/2020/10/20/925795410/facing-economic-dev...

m_mueller 6y ago
Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. The key would be cost and availability of these tests - that's a problem that can be solved, as production is simple and is already currently costed at $1 a pop. From a regulatory standpoint it should be treated more like toothpaste and less like a medical good (i.e. certify the efficacy but don't go overboard). After all else has pretty much failed, all western governments are now just betting on the vaccine. This is a dangerous proposition - all you need is a resistant mutation and we're back at square one. Plus, vaccination at current rate will take 1-2 years - I don't think that's a good place to be in both in health terms and economically. There needs to be a backup plan put in place, as well as lessons learned taken for the next pandemic.
- timr 6y ago
  > Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection. You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable. I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead. The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.
  - m_mueller 6y ago
    I think that the >70% number is misleading. It's 70% of cases for which we have data where the transmission happened. For a good majority of cases the transmission happened at an unknown place. It's just that for those where it is known, most are happening at home (as opposed to e.g. at work). Those unknown transmissions are what you want to attack with a mass testing regime. That seems entirely doable, given cheap and simple testing at home.
AlchemistCamp 6y ago
> that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. Taiwan has roughly the same population as Australia packed into an area 1/10th the size of Japan. This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Also your representation of Taiwan's trade is completely disingenuous. Please google the phrase, "Taiwan's largest trading partner".
- timr 6y ago
  > This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Again: they shut their borders before there were any cases. Population density is a detail when you can just keep the virus from getting into your country in the first place. > Please google the phrase, "Taiwan's largest trading partner". Arguing about China does not change the fact that Taiwan's economy is export driven, which was the point. https://tradingeconomics.com/taiwan/balance-of-trade https://tradingeconomics.com/taiwan/balance-of-trade
  - AlchemistCamp 6y ago
    I live in Taiwan and have been reading the news here all year. > Again: they shut their borders before there were any cases. Again, your claim isn't true. Taiwan had cases from the very first set of Wuhan evacuees. The virus has "gotten in". No local transmission doesn't mean people haven't been returning infected from Wuhan, other Chinese cities, Europe and elsewhere all year. Those infections haven't spread, though. Why are you so unwilling to give credit where credit is clearly due? Taiwan has done an exemplary job during this pandemic, despite high population density, close proximity to the initial outbreak and zero support whatsoever from the WHO.
    - timr 6y ago
      I grant you that Taiwan had a very small number of confirmed cases early on. Then they closed their borders. Taiwan deserves credit for reacting quickly enough that they could do contact tracing to eradicate a small number of cases. But you keep missing the point: it's much easier to do this when you're an island nation with a paucity of international travelers. Even in a year where international arrivals are down by >80%, the US had more than a quarter of Taiwan's population arrive internationally. And that's just visa arrivals.

by timr 6y ago

m_mueller 6y ago

Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. The key would be cost and availability of these tests - that's a problem that can be solved, as production is simple and is already currently costed at $1 a pop. From a regulatory standpoint it should be treated more like toothpaste and less like a medical good (i.e. certify the efficacy but don't go overboard). After all else has pretty much failed, all western governments are now just betting on the vaccine. This is a dangerous proposition - all you need is a resistant mutation and we're back at square one. Plus, vaccination at current rate will take 1-2 years - I don't think that's a good place to be in both in health terms and economically. There needs to be a backup plan put in place, as well as lessons learned taken for the next pandemic.

timr 6y ago
> Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection. You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable. I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead. The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.
- m_mueller 6y ago
  I think that the >70% number is misleading. It's 70% of cases for which we have data where the transmission happened. For a good majority of cases the transmission happened at an unknown place. It's just that for those where it is known, most are happening at home (as opposed to e.g. at work). Those unknown transmissions are what you want to attack with a mass testing regime. That seems entirely doable, given cheap and simple testing at home.

AlchemistCamp 6y ago

> that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. Taiwan has roughly the same population as Australia packed into an area 1/10th the size of Japan. This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Also your representation of Taiwan's trade is completely disingenuous. Please google the phrase, "Taiwan's largest trading partner".

timr 6y ago
> This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Again: they shut their borders before there were any cases. Population density is a detail when you can just keep the virus from getting into your country in the first place. > Please google the phrase, "Taiwan's largest trading partner". Arguing about China does not change the fact that Taiwan's economy is export driven, which was the point. https://tradingeconomics.com/taiwan/balance-of-trade https://tradingeconomics.com/taiwan/balance-of-trade
- AlchemistCamp 6y ago
  I live in Taiwan and have been reading the news here all year. > Again: they shut their borders before there were any cases. Again, your claim isn't true. Taiwan had cases from the very first set of Wuhan evacuees. The virus has "gotten in". No local transmission doesn't mean people haven't been returning infected from Wuhan, other Chinese cities, Europe and elsewhere all year. Those infections haven't spread, though. Why are you so unwilling to give credit where credit is clearly due? Taiwan has done an exemplary job during this pandemic, despite high population density, close proximity to the initial outbreak and zero support whatsoever from the WHO.
  - timr 6y ago
    I grant you that Taiwan had a very small number of confirmed cases early on. Then they closed their borders. Taiwan deserves credit for reacting quickly enough that they could do contact tracing to eradicate a small number of cases. But you keep missing the point: it's much easier to do this when you're an island nation with a paucity of international travelers. Even in a year where international arrivals are down by >80%, the US had more than a quarter of Taiwan's population arrive internationally. And that's just visa arrivals.