The average age in many African countries is in the mid teens, and we know that age is one of the strongest risk gradients. So Africa is not at all comparable with the aging West. Australia and NZ have the huge advantage of no land borders. Everything and everyone comes through a few ports and airports, which already had the infrastructure established to tightly control and monitor everything. Meanwhile most European or North American countries can't close their sprawling land borders without starving their populations. (And the U.S. couldn't close its land borders even if it wanted to.)

> Australia and NZ have the huge advantage of no land borders.

Australia had a major outbreak in Victoria in July last year. Victoria has a 2,550km land border with other states, including with South Australia, which peaked at 10 active cases over the same time period.

The evidence shows that strict quarantining and early lockdowns prevent spread even when there's an outbreak on the other side of a land border, and it also shows that being an island doesn't help at all if you don't do this (see also: the United Kingdom). I don't know why people constantly act like Australia and New Zealand only succeeded because they're islands when they were locking cities down at single digit case counts while the United States and India were packing stadiums full of people when they were getting tens of thousands of new infections a day.

An important bit of information is Victoria indebted itself heavily to contain its outbreaks. The state is in $150B worth of debt and already increasing its taxes and fines to compensate.

It also had the largest exodus of people ever seen. About 11,000 leaving per quarter.

The fallout from businesses isn't know yet either, that'll become apparent after EOFY.

If being an island state was really the only thing that mattered here, why is Hawaii not at Covid zero? Why is Alaska not at Covid zero?

(Despite not being an island, AK is still highly comparable to OZ.)

It’s hard to appreciate just how strict the lockdown measures in places like New Zealand and Taiwan have been. People are driven from the airport directly to a hotel, then someone comes and checks on them and they monitor the front door. Even in Hawaii, the arrival quarantine was just in whatever resort you were staying in, and was almost entirely self-imposed.

On the other side of the coin, as someone in Australia I couldn't believe it when I heard that in many other countries you can "quarantine" in a house with other people who are free to go about their day! Of course that's not going to work...

Being an island might make it easier to close borders, but the point is that closing them was likely hugely significant. I'd argue that borders remained open in many countries areas largely due to a lack of will. You could certainly close borders to most tourists and business travelers in any country that does immigration control, like Australia did. You can also close interstate land borders, like Australia did. You can even close borders to major cities, like Australia did. You don't need to close borders to food deliveries, just budget for the logistical headaches. You do have to pay the political and economic cost though. Australia was watching with both envy and horror when we started seeing stories of British people able to go on holidays to Europe again.

> And the U.S. couldn't close its land borders even if it wanted to

Maybe not perfectly, but surely the vast majority of traffic across land borders is at managed border crossings. The US could shut those down, put the army on any unmanaged roads/routes (don’t know if this is a thing) and stop 95% or more of land border traffic?

Maybe it wouldn’t have made a difference to Covid - I don’t know about that, but I do question the impossibility claim.

The border is already closed (at least around here) to "non-essential travel". So, no crossing the border for vacationing. But "full" closure would mean blocking "essential" trade (food, oil/fuel, ...), and blocking "essential" workers that commute across the border. It could technically be done, but it'd be incredibly disruptive.

Even with full legal closure, the borders are porous enough for a border wall to have been a talking point in some previous election debates. Build a mile-tall wall out of mithril, and you'd still be left with a ton of unsecured coastline, connected by some rather convenient oceans...

Of the many things we didn't bother doing, closing the Mexican border probably didn't matter a lot.

Canada did greatly restrict the border!

Holy cow; what is the birth rate to let a country have an average age in the mid-teens?!

Well Uganda has a median age of about 17 and a birth rate of about 5 children per woman.

>>And the U.S. couldn't close its land borders even if it wanted to.

Given that until recently the US was quite militant in refusing to act upon the outbreak, and it's a country comprised of hundreds of million of people among which about a third showed themselves to be quite defiant towards even the most trivial emergency public health policies, I don't think it's fair to refer to border control as a relevant factor in the US's death toll.

> Given that until recently the US was quite militant in refusing to act upon the outbreak

Factually untrue. The US was the first country to shut down China travel. And we got called Xenophobic for it. The mayor of Florence even held a “hug a Chinese” day in response.

https://rmx.news/article/article/fears-of-being-called-racis...

The US never shut down travel from China, it banned people not from the US from traveling from China to the US. US citizens and some other groups were still allowed to travel.

Singapore started severely restrict travel and quarantining arriving citizens a couple days before the US ban.

https://www.gov.sg/article/how-is-singapore-limiting-the-spr...

A faster travel ban for Italy and other EU countries would have done the US more good.

Factually true. Shutting down travel from China (at least for Chinese nationals, but not for Americans) after the virus was already openly spreading inside the country, and NOT shutting down travel from Europe, which was having a massive outbreak of its own, was xenophobic theater at best.

I am here in Vietnam (and was in California a few months ago) and the difference is day and night. Lockdown is super strict here. Everyone wears mask (even when it is only a few cases out of millions). It is a 21 day mandatory quarantine (if you get approved to get in). The results speak for itself.

I'd wait to draw any serious conclusions until after the pandemic is "over" in both countries you're comparing. It sure seems like this virus doesn't need much of a foothold to take off, and just because an island has been able to deny that so far doesn't mean they'll be able to deny the virus until they are fully vaccinated and out of the woods.

I don't think thinking of these places as "islands" really makes sense. The USA could do the same for all people flying or driving in. It just has chosen not to. The US could close its boarders if it wanted to.

Just because we have two neighboring countries on north and south borders doesn't mean we couldn't lockdown people from coming in...

Literally do not get this argument.

> Just because we have two neighboring countries on north and south borders doesn't mean we couldn't lockdown people from coming in...

If there was one thing Trump was all in on, it was closing the southern border. His motivations were obviously not COVID for most of that, but the fact is he was nowhere near able to control that border (let alone close it) despite his best efforts.

Before you downvote me, I'm not saying I agree with Trump's policy on the matter, just pointing out that he did try.

> If there was one thing Trump was all in on, it was closing the southern border.

Is there any source that even suggests that the US's "southern border" played a remotely relevant role in the US's pandemic?

I mean, COVID spread like wildfire in the US throughout a timespan where the US's central government was quite militant in either denying or downplaying it's gravity. Even today we see states and cities taking militant stances in refusing to implement basic public health precautions. Why is the US's "southern border" suddenly relevant regarding covid-19?

It wasn’t relevant in the course we took. But had we locked down until there were 0 cases-like AZ or NZ—then new cases would walk across our borders.

Which states are taking militant stances against public health precautions?

How about China itself?

I'm not sure it's fair to compare an authoritarian country to a western country that's nominally free.

What western government could pull off welding doors shut the way they did in China? Even if the government had emergency powers that "allowed" it, would they have had willing workers to do it?

>What western government could pull off welding doors shut the way they did in China?

Western governments have pulled all kinds of restrictions themselves, from curfews, closed borders, and "let's close all retail businesses" restrictions, to mandatory movement monitoring.

Heck, Italy might not have welded doors, but had the Army patrol to enforce strict lockdown, and citizens in northerns cities stay inside.

Sometimes this even meant closing them in-house with the corpses of their dead (from covid) relatives for several days. There were several such reported cases, e.g.:

https://7news.com.au/lifestyle/health-wellbeing/coronavirus-...

https://7news.com.au/lifestyle/health-wellbeing/coronavirus-...

Announcing restrictions and enforcing them are two separate animals.

There are not enough police in most of the US to actually enforce closing businesses, let alone confining people to their homes. Especially not when half the populace sees it as a political infringement of their rights.

I'm not sure about there not being "enough police in most of the US to actually enforce closing businesses".

There's not enough police to enforce no traffic violations at all either (what would that be, a traffic cop for every street or car?). That's not how laws work, you just need to make a law/rule and collect fines from the businesses that violated it. If there wasn't the political will to do so in the states, that's another thing.

But in at least a couple of countries in the EU I know of, all businesses were closed (by government decree) except explicitly whitelisted "necessary" shopping (like groceries, drugstores, and such) for months on end.

You say that's not how laws work and then you basically say he's rihght.

You say you "just need to... collect fines". And that is the OP's point.

Without enforcement you do not get relevant levels of compliance. Just upping the fines seems easy but if your enforcement percentage is 0 (or close enough to 0 as felt by citizens) you will not get compliance.

Theres a balance if you ask me. If it costs $5000 to be caught after curfew but police go home when curfew hits too instead of patrolling the streets, you will likely have no compliance. If you get caught at least 50% of the time then $5000 probably isn't even necessary and say $1000 will be 'enough' for most people.

I believe in those instances they welded backdoors while the front door was monitored by the community enforcement people to make sure each family only sent one member to the grocery store a week, etc. It was also at the outbreak, so you would hope we would have some strong measures at the very beginning when there is highest risk and greatest benefit to the rest of the country and world from strict quarantine.

I don't know that we would have done anything similar for this one if we were ground zero, but hopefully we would have for something like aerosolized Ebola with a contagious yet symptom-free incubation time.

We did come close to doing some similar things to welding to the Grand Princess cruise ship early on.

China might be fine, or it might not be. But only a fool would trust CCP numbers.

There are a large number of Western people in China for business reasons, and major Western countries have diplomatic offices throughout China. The US has a Consulate General post in Wuhan itself.

That gives the West an independent source of information about what is going on in China. China can still fudge the numbers, but those independent observations place a limit on how far China can fudge without getting caught.

I don't think you have to trust their numbers, but could they hide extensive outbreaks like the OP is talking about (all numbers being roughly the same and measures having little observable effect)? It would be something like 4 million+ excess deaths.

It should be noted that this is the same CCP that until recently have been simultaneously accusing Spain and Italy and the US of being the origin of the pandemic outbreak, instead of Wuhan.

Africa: Hot climate, poor testing, data likely not accurate

Australia: Island, hot climate, pretty heavy travel/quarantine restrictions

New Zealand: Island, rural with very dispersed population, heavily restricted international travel

People may argue that the UK is also an island but fared much worse. To that I would say 1) Much colder climate 2) did not heavily restrict travel like AUS and NZ did.

In how many of the countries that did really well did the virus have the same head start that it had in the US and Europe before getting discovered?

For me "countries that did really well" is mainly places like Singapore and Taiwan and South Korea, which got the virus earlier than USA and Europe but took it seriously from the very start.

Okay, if they actually got the virus that early, then these countries are the answer to my question.

However... at least for Taiwan that doesn't feel like it adds up:

https://www.worldometers.info/coronavirus/country/taiwan

They've had fewer than 1700 cases, and that's including a recent massive outbreak. They peaked on March 26th 7-day average with 21 cases a day. Granted, the US took maybe a couple more weeks to ramp up to its first plateau, so maybe if it was caught here a few weeks earlier it would have made all the difference. But it feels a lot more like Taiwan just didn't have a lot of travel to and from Wuhan?

If you travel to Taiwan, even as a Taiwanese citizen, you must stay in an official quarantine hotel for 14 days. You are not asked to do this - you are taken to the hotel by an official quarantine taxi driver and there are records of all this. You are not allowed to leave the hotel for any reason - food is delivered to your door 3x per day, and you can ask for certain things. My sister in law did this. That is just one of over 100 strategies employed by Taiwan to reduce virus spread.

The current Vice President of Taiwan, Lai Ching-te, has a Master's degree in Public Health from Harvard. The previous VP, Chen Chien-jen, has a Master's degree in Public Health from National Taiwan University. Taiwan takes public health seriously, especially after the original SARS experience.

Nobody in Taiwan thinks the virus is a "scam" or that masks are a "tool of oppression." Even before the pandemic masks were totally common. There is complete public buy-in on masks without even having to be asked. Some of my friends work in a clinic in Taipei so I hear updates. I was also in Taiwan last year for a month. The difference in attitude between the US and Taiwan is startling. If the US had acted like Taiwan, instead of acting in a way that was indistinguishable from sabotage, we'd have a lot fewer deaths and would have avoided a recession.

Taiwan resident here. Just wanted to include that “massive outbreak” so far means a few hundred cases nationally.

That’s bad, it might get a lot worse, and we’re all nervous — but just wanted to add the context because “massive” can mean a lot of things with orders of magnitude difference.

Yep, I only meant that relative to how you've been doing. Obviously y'all are still doing fantastic compared to others. Best of luck.

BTW is there a vaccination drive over there? That's got to calm things down somewhat right?

Rapid and strict incoming travel restrictions were a key part of "taking it seriously from the very start" with a big impact on future outcome.

There are all kinds of effective measures (e.g. contact tracing, quarantining of unconfirmed suspect cases) that work when you have 20 cases a day and don't work when you have 2000 cases a day, so going all-in while you still have just a few cases works, because by the time you have many cases, it's too late.

Mainland Chinese citizens are not allowed to travel to Taiwan as individual tourists since July 2019. This was interpreted as an attempt to hurt tourism and so the economy at the time. May have been a factor.

Don’t forget Vietnam. One of the best responses!

It started in China, a country with 1.4 billion people and 20 million pop cities and even if you 100x their official number they did better than the US or Europe. There's few excuses for our mismanagement.

That is an even less fair comparison. The Chinese government has a tremendous amount of power over the daily life of its citizens in a way that isn't replicable most other places. There were stories of China literally welding doors to apartment buildings shut and forcibly dragging people away to quarantine facilities as soon as they tested positive.

FWIW from a brief search months ago it seemed that the welding stories are hearsay. Iirc you can find reference to them in the news but it didn't sound concrete.

I did some searching and it looks like you are right that there isn't anyone credible officially reporting it. However multiple credible news sources do mention welding doors shut as part of opinion pieces, including this one from Ai Weiwei[1] who presumably has more info about the situation and isn't going to simply speak on Western hearsay.

[1] - https://www.theguardian.com/commentisfree/2020/mar/08/china-...

Yes, as I’ve said elsewhere in this thread the strictness of the Chinese lockdown has been exaggerated in the media/Western imagination.

There were literal videos about it at the same time ( a year ago)

I recall seeing various grainy creepy videos (not just about this) supposedly of China posted on Twitter. I started to wonder who was really pushing these videos. I'd have to see a video corroborated by a reasonably trusted news source.

Eg News sources of the BBC had conflicts of interest about reporting on this ( since they have/had a division in China).

What would even be framed in the media when these were really user videos without journalists. Journalists couldn't report live, so i don't think there's something else than opinion pieces.

How important is a head start though in these situations? If the response was poor in either case, the result would be poor, right?

If the US had in reality on the order of 100 cases, there could be a credible effort to get rid of all of them and reopen. You wouldn't have to lock down hardcore for as long. In Australia from what I've seen fly across Twitter, they had the luxury of periodically locking down a city when they saw a single case, to make sure it didn't escape into the population.

I agree that there could be a way for this to work in the US but it would be a long slog. South Korea seems like they could pull it off. So I'll grant you them for sure as being superior.

The real question - how many countries did well that were at the center of the prior SARS and bird flu outbreaks of the past?

As I understand, SARS 1 and MERS are much less contagious than SARS 2.

But much more fatal. These countries had two rounds of practice in controlling a major epidemic.

Those places all have low population density or are literally islands, that's not comparable at all.

> Of course, I'm not an epidemiologist

and no geographer either apparently :D

I don't think anything they said about countries/continents was incorrect was it?

What do you mean?

It doesn't account for Africa, but many of best-performing countries have been island countries (Australia, NZ, Taiwan, Iceland, etc.). Islands have some fairly obvious advantages in fighting a pandemic, and it shows in the statistics. I believe Hawaii has also done much better than other US states. I'm not sure whether that's what the comment was referring to though.

None of Thailand, Vietnam and Mongolia are islands and their handling of covid is world class compared to parts of Europe and the US.

These countries are also far poorer and in the case of Thailand especially that has been a major contributing factor, as they've been less able to afford closing their country to tourism.

Both Thailand and Vietnam have been devastated economically, and even with various levels of lockdown both country is currently experiencing the highest number of cases since the beginning of the pandemic.

Also, the vaccinated population in either country is at low single digit percentage, so no end in sight for the harsh measures. Compare that to the US or Europe where 50% of population is (partially) vaccinated and, as the result, gradually reopen.

> even with various levels of lockdown both country is currently experiencing the highest number of cases since the beginning of the pandemic.

"highest number of cases" here meaning between 1 and 2 cases per million people per day.

For context, the United States is currently at its lowest daily case count since June last year, which is slightly above 100 cases per million people per day.

"Even with various levels of lockdown both countries have 1-2% of the case count of countries that didn't treat this seriously" isn't quite as dramatic of a statement though I guess.

(all figures using the typical 7 day rolling average and data available from Mackuba)

Yes, also South Korea is for all intents and purposes an island. It's surrounded by water, except on the North which is the most heavily militarized border in the world.