Covid19: now here's interesting data...

[johnny9fingers]

www.snopes.com/news/2020/04/21/vietnam-has-reported-no-coronavirus-deaths-how/

For the TL;DR chaps, basically by being incredibly fascist about things combined with testing and compulsory quarantine and some total lockdowns of villages and towns they've kept the numbers ridiculously low.

So it appears that states which opt for a totalitarian response combined with mandatory testing (the Vietnamese testing kits cost $25 each) can limit the infection rate and death toll.

And it seems that this virus has an odd pattern in any given nation. It targets liberal capitalist democracies with entrenched freedoms more than totalitarian nations, as well as targeting BAME folk within these liberal capitalist democracies more than other folk too.

The freer a nation is, the worse its death toll will be. Mind you, Australia and New Zealand have pretty good figures too, and they are liberal capitalist democracies - just they got their responses sorted in time. Unlike the UK and US, and poor old Italy; which never stood a chance being the canary in the mine, so to speak.

It is becoming apparent that there is a correlation between lower mortality rates, and swift and severely sensible responses; and a smidgeon of totalitarianism and the odd draconian measure also seems to help.

Comments

[mikeyxw]

The measures in Vietnam don't sound any more draconian that closing down entire countries. The swift and sensible response seems to be the key, at the beginning, the US was seeing cases double every three days, this means a week's delay causes the problem to be five times bigger, two weeks means 25 times. Vietnam has responded to each case so far with the resources needed to prevent community spread, something that was possible in January but not so much now.

There is also something to be said for the sensible part. Vietnam has $25 tests that are available where they're needed and provide results in 90 minutes. Contrast this to the US or UK which are inexplicably still struggling here and can't seem to find PPE. It does raise a question, after this is done, should we fire the pandemic response teams at the CDC and NIH and subcontract the work out to the Taiwanese, Vietnamese, or Koreans? My take is that one botched pandemic response is enough to make such a change.

[johnny9fingers]

I’m rather of the opinion that both the CDC and the NHS have been subject to a degree of political antipathy, defunding, and removal of responsibility in an attempt to geld them.

For example, this shows what has happened to PPE storage in the UK:

https://www.theguardian.com/world/2020/apr/22/revealed-private-firm-running-uk-ppe-stockpile-was-sold-in-middle-of-pandemic?CMP=share_btn_tw

Maybe if we had funded them properly and had let them do their jobs without political interference, then I’d agree, outsource it. But I’d contend it’s because it’s all been outsourced and is now a piecemeal patchwork of non-connected stuff that we have these problems.

Central co-ordination would help. It is, after all, how armies win wars. It’s all about resources and supply lines, so to speak; and needs central co-ordination. Ask anyone senior at the Pentagon.

[dewline]

Your first paragraph is definitely on-target. Ditto Health Canada back during the Harper years, from what little I know and remember. And I wonder how much damage Doug Ford was able to do as premier of Ontario specifically in his first couple of years before the Pandemic. Now, though, he seems to have had the fear of some kind of god - or, maybe, God Herself - put into him, so maybe he'll remember these months if enough of us are foolish enough to re-elect him.

[mikeyxw]

I'm not really holding the initial shortages against them, this comes down to funding. However, they have both systematically underperformed against their peers since January. Testing in both countries is a mess and from the looks of things, the results of both countries will be some of the worst out of the Western democracies. The US has just reluctantly said that face masks are a good idea while the UK is still resisting this. I get that they're worried this would impact the availability of PPE to medical staff, but the governments and health care systems of the US and UK are really the ones to blame for the shortages, not the general public.

[johnny9fingers]

I'd blame the governments rather than the healthcare systems to be candid. I've seen the process unfolding.

[mikeyxw]

There is plenty of blame to go around. Boris Johnson is clearly the wrong guy for the job right now, but testing is something that is driven by the health service, not politics. The CDC botched the test by not even following its own procedures after trying to re-invent the wheel on testing. This isn't something you can blame on Trump. The testing in the UK has been focused on the NHS to the exclusion of everything else, care homes are just starting to get a half-hearted attempt at testing. In Vietnam, according to the article you linked, they respond to a positive test by sending a team to the neighborhood to give cheap and plentiful tests, how does that compare to the UK? How well has testing been used to slow community spread of coronavirus? Testing like this is one of the conditions to ending the lockdown, well, at least it's a condition to not returning to lockdown quickly after exiting it.

I'm having a hard time thinking this is because the Vietnamese health authorities are better funded than those in the UK. While any different leadership in either the US or UK would likely have done better, I couldn't imagine a different leader wold have gotten the kind of responses are looking to be pretty standard in Asia.

[johnny9fingers]

The NHS can't even test its own staff. Nor can it now source PPE. But that's not because the NHS didn't want to be able to do these things; it has not been allocated enough resources to keep it going properly in peacetime. In the past 8 years regional health trusts have gone from breaking even or being in profit to being hundreds of millions in debt mainly because of government funding cuts. Austerity meant cuts to the NHS and social services, libraries etc & etc. and we have had nigh-on a decade on defunding; first under Cameron, and then under both May and BoJo.

There is a bit of recent history that suffices as context. In the UK the NHS has only be allowed to do nowt. I think I mentioned on my blog some time ago that folk of a certain age could no longer be diagnosed for things which went outside cost considerations excepting cancer, heart disease, or dementia; the cost of care for which can be foisted onto family or taken from an estate post-mortem. Doctors were not diagnosing knee problems or back problems because it was too damn expensive.

In such an environment even planning for potential epidemic/pandemic mitigation is next-to-impossible, and that is not the health services fault given that we have a government department running it and it falls into the purview of both the budget, and Treasury oversight.

The last few governments have paid lip-service to the NHS while wanting to privatise it. Brexit was the main chance for that, but I'm afraid that's now a political impossibility.

[mikeyxw]

Sorry, to be clear, I wasn't saying subcontract out the NHS but the part of PHE (I mistakenly called it NIH earlier) that deals with pandemics. This isn't an attempt to privatize it, just to give the duties over to the folks who, well, dealt with this pandemic. This isn't aimed at the NHS or the hospitals in the US, but results do matter.

I also posed it as something we should question. Left to itself, I expect the CDC will, in a few years, issue a report with some new procedures that will supposedly fix the problem of not following the procedures that led to the testing fiasco. Perhaps PHE is the type of organization that learns from their mistakes on their own, unlike the CDC who spent two weeks blaming the state health departments for problems with their test.

[johnny9fingers]

PHE seems to have become, er a trifle politicised, or at least it appears that some of its folk have a Tory-induced Stockholm syndrome. They've become a little more opaque; happy fending off questions in a very political fashion. This is not ideal.

Pretty sure the CDC has been under the cosh since Obama's last term. It was perceived as needless waste after all; and given the Obama had given the CDC some thought and consideration meant it was always in the Don's sights. I mean I assume it was Trump's vanity that caused him to try to defund it and use disrupting tactics to interfere with its stated objectives, rather than any less obvious reason.

But what do I know, hey?

[abomvubuso]

Taiwan doesn't seem to match the correlation.

[johnny9fingers]

True, and I excepted Aus and NZ too, but Taiwan did get measures in place after SARS iirc and responded to Covid19 quickly and efficiently.

Which other nations haven’t.

But then I guess, in the free world, it comes down to leadership. Which explains why Angela Merkel and Jacinda Ardern have done pretty well.

[dewline]

With Justin Trudeau hopefully not too far behind Merkel and Ardern.

[johnny9fingers]

It's not just me who thinks this it appears:

https://bylinetimes.com/2020/04/22/the-coronavirus-crisis-denmarks-gold-standard-response/?fbclid=IwAR1a8noAGxeUe6-40A1CGtSQiZfaDi8EEaOxetHEnI0iBSlwxfM0xAyQ5gc

:)

[garote]

Or perhaps your correlation is because people in liberal democracies tend to be more economically, and socially, and physically mobile, making the spread much more intense and the consequences of shutdown worse.

Also there’s the matter of scale. Pick up the Vietnamese or Danish “response team” model and drop it into California ... a state with multiple enormous international airports connected directly to China. Someone from Wuhan coughs into a ticket kiosk there and containment is irrevocably destroyed, because there isn’t a task force big enough to respond to the number of people exposed through that incident in even a single 24 hours. Californians don’t stay put in villages, and most international travelers are back at work in the city the next day, before symptoms have had a chance to appear. This was going to get out, response teams or no. Unless:

The only truly effective response would have required shutting down all airports and ports completely, in January, and keeping them shut while the whole state reconfigured to quarantine anyone or anything arriving by sea or air.

Before Italy took a nation-sized kick in the teeth and everyone saw how bad it could get, I don’t think anyone on Earth had the political capital to give such an order and have it taken seriously.

So three cheers for the Danes for being cautious and organized and thoroughly the middle-class suburb that they are. But we here in the Bay Area ... with 50% more people than all of Denmark, much more mobile and in much closer quarters, directly connected to China and everywhere else, have different base conditions to deal with.

Hopefully in another 100 years we’ll have a much better response to this across the board.

P.S.: I don’t trust any of the numbers coming out of Vietnam.

[johnny9fingers]

P.S.: I don’t trust any of the numbers coming out of Vietnam.

I wouldn't trust the numbers coming out of anywhere. In the UK the difference between the official figures and the five-year-average mortality rate is quite phenomenal. Yesterday the official stats were around 18K. The Financial Times reckoned it's about 41K.

https://www.ft.com/content/67e6a4ee-3d05-43bc-ba03-e239799fa6ab

Hopefully in another 100 years we’ll have a much better response to this across the board.

It really needs a better response in a slightly shorter timespan; but I have a suspicion that folk will have the political capital to make sensible early interventions next time. Especially after the second wave of Covid19 hits.