{"id":161062,"date":"2020-05-18T12:02:21","date_gmt":"2020-05-18T11:02:21","guid":{"rendered":"https:\/\/www.transcend.org\/tms\/?p=161062"},"modified":"2020-12-02T10:10:46","modified_gmt":"2020-12-02T10:10:46","slug":"why-east-beat-west-on-covid-19","status":"publish","type":"post","link":"https:\/\/www.transcend.org\/tms\/2020\/05\/why-east-beat-west-on-covid-19\/","title":{"rendered":"Why East Beat West on COVID-19"},"content":{"rendered":"
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An Asian woman wears a surgical mask, a practice widely seen in East Asia well before the coronavirus pandemic. Photo: Facebook<\/figcaption><\/figure>\n
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15

The chasm is visible \u2013 indeed, is impossible not to notice \u2013 when examining infection and death rates in either gross or percentage terms.<\/p>\n

Very clearly East Asia, defined as the Sinic or Sinic-influenced nations of China, Japan, South Korea, Taiwan and Vietnam, has done better than the West\u00a0on virus management.<\/p>\n

Why?<\/p>\n

In Part 1 of this two-part series, <\/em>Asia Times examines social habits and social culture, attitudes toward authority and privacy and recent historical and epidemic experience in weighing the discrepancy.<\/em><\/p>\n

In Part 2<\/a>, we will examine political leadership, policy responses,\u00a0geographic integration, vaccines, manufacturing capacity, virus mutations, race, weather and climate as influencing factors and finally arrive at a multi-variable answer to this crucial East versus West question.<\/em><\/p><\/blockquote>\n

The Covid-19 riddle<\/h4>\n

Unlike most infectious diseases which register their highest mortalities in the developing world, Covid-19 has wreaked its greatest havoc among the world\u2019s richest nations. The \u201cEast-West\u201d cluster of nations \u2013 Europe and North America on the one hand, and Sinic East Asia on the other \u2013 represent the globe\u2019s three key zones of economic activity.<\/p>\n

But the reasons for the massive disparity in Eastern and Western pandemic management metrics are no simple matter to analyze. The variables are countless.<\/p>\n

Take governance. In the East, the political structures of authoritarian China and Vietnam, on the one hand, and of democratic Japan, South Korea and Taiwan on the other, are diametrically opposed.<\/p>\n

Or, consider policy responses. In the West these have varied from country to country, even within the supposed unity of the EU, and state to state in the United States\u2019 federal union.<\/p>\n

Moreover, no two countries share identical healthcare systems or demographics. And there are almost certainly discrepancies in data due to differences in test regimens, test efficiencies, reporting practices, methods of assigning cause of death to Covid-19, and so on.<\/p>\n

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Covid-19 testing underway in Japan. Photo: AFP<\/figcaption><\/figure>\n

Yet even the briefest glance at the numbers reveals a stark macro trend. East Asia has been far more adept at pandemic management than the West. This runs across all key metrics and by massive differentials.<\/p>\n

The list of the top 10 nations for infections, according to data collated by Johns Hopkins University<\/a>, is a roll call of the biggest, most prosperous and influential Western countries. The US is in the number one spot, with the UK at number 3, Spain at number\u00a04, Italy at 5, France at 7 and Germany at 8.<\/p>\n

The virus originated in East Asia, but no East Asian nation makes the top 10 list. The world\u2019s most populous nation, China, is in 11th place. The East-West divergence in fatality rates is even starker.<\/p>\n

China (population: 1.3 billion) has suffered 4,637 dead. Japan (population: 126 million) has lost 678. South Korea (population 51 million) has lost 260. Taiwan (population: 23.7 million) has lost only seven. Vietnam (population: 95.5 million) has registered zero deaths.<\/p>\n

Western mortalities are on a vastly different order of magnitude.<\/p>\n

The US (population: 328 million) has lost 84,118. The UK (population: 66 million) has lost 33, 264. Italy (population 60 million) has lost 31,106. Spain (population 47 million) has lost 27, 104.\u00a0France (population 67 million) has lost 27, 077 and Germany (population 83 million) has lost 7,861.<\/p>\n

In other words, Germany, at the bottom of the Western list, has nearly double the deaths of China, at the top of the East Asian list.<\/p>\n

Or, take another metric \u2013 deaths per million of population \u2013 from a different data set, collated from JHU, the WHO and other sources by website Real Clear Politics<\/a>. It shows a similar East-West chasm.<\/p>\n

Spain\u2019s mortalities per million are 580.1, Italy\u2019s 514.7, the UK\u2019s 499.1, France\u2019s 404.2, the US\u2019 260.4 and Germany\u2019s, 94.8. Meanwhile, Japan\u2019s are 5.4, South Korea\u2019s 5.0, China\u2019s 3.3, Taiwan\u2019s 0.3 and Vietnam\u2019s zero.<\/p>\n

To be sure, China\u2019s data is frequently questioned by those on the political right, and Japan\u2019s by those on the political left, but the two countries\u2019 Covid-19 tolls are broadly in line with East Asian (and Southeast Asian) trends, suggesting greater accuracy than doubters might like to believe. \u00a0<\/em><\/p>\n

Culture and communalism<\/h4>\n

These data results confound expectations. On the macro level, East Asia has bigger cities and higher population densities. On the micro level, it has a culture in which food is shared from communal dishes.<\/p>\n

Moreover, the Western nations cited above are fully developed, prosperous and middle-class \u2013 as are Japan, South Korea and Taiwan \u2013 but China and Vietnam, despite their rising economic status, are still lagging behind on a GDP per capita basis.<\/p>\n

So what has the East done right and the West wrong? Naturally comparison demands generalities, but even detailed variables are fiendishly difficult to dissect.<\/p>\n

Take age, a key risk factor for Covid-19. One reason Italy was believed to have suffered so severely early in the pandemic was because of its demographics: the world\u2019s second oldest.<\/p>\n

However, Japan, the country with the world\u2019s oldest population, has seen a Covid-19 death rate 45 times lower that Italy\u2019s.<\/p>\n

Moreover, the percentage of aged persons living at home, rather than in specialist care homes, is similar in both countries: 96% in Italy and 94% in Japan, according to a study. \u00a0<\/a><\/p>\n

Still, a range of issues \u2013 from cultural habits to attitudes toward governance, from vaccination policies to viral mutations \u2013 merit discussion.<\/p>\n

The two main vectors of transmission for Covid-19 are airborne droplets and contact. In countering these vectors, East Asia\u2019s social habits trump the West\u2019s.<\/p>\n

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Chinese women wear protective masks as they pass the CCTV building on their way to work on February 17, 2020 in Beijing, China.
\nPhoto: AFP Forum via Getty Images\/Kevin Frayer<\/figcaption><\/figure>\n

Due to East Asia\u2019s air pollution and harsh influenzas, mask wearing \u2013 a simple but critical step in halting respiratory disease transmission by containing infected persons\u2019 droplets within masks \u2013 is a common habit across the region. Likewise, masks are more widely available to buy.<\/p>\n

\u201cIn [South] Korea, in February, people were wearing masks even when they had not been told do,\u201d said Joe Terwilliger, a professor of genetic statistics at Columbia University in New York. And it looks similar north of the border. \u201cEvery day I watch North Korean news and everyone is wearing masks,\u201d he said.<\/p>\n

Moreover, there is less direct personal physical contact in East Asian behaviors, with its tradition of bowing, than in the West, with its traditions of cheek-kissing, hugging and hand-shaking. In other words, social distancing is built into culture.<\/p>\n

Another aspect of culture is diet, which impacts a key Covid-19 risk factor. East Asians as a whole suffer lower rates of obesity than Westerners.<\/p>\n

Attitudes toward authority<\/h4>\n

Attitudes toward authority and community consciousness are nebulous concepts, but East Asia may have advantages for reasons that combine politics and culture.<\/p>\n

In communist-led China and Vietnam, the hand of government is heavy, a factor that militates against civil disobedience. The same is true for North Korea, where no data on the pandemic is available, but where indications suggest Pyongyang has contained the virus effectively<\/a>.<\/p>\n

And even democratic Japan, South Korea and Taiwan experienced dictatorial or militaristic governance within living memory.<\/p>\n

Beyond politics lies the broader issue of culture. East Asian nations share a Sinic-influenced, Confucian culture of collectivism and group identity, bolstered by greater levels of ethnic homogeneity than exist in the West.<\/p>\n

While politics may override culture in authoritarian Asian states, cultural factors may contribute to civic consciousness in democratic Asian states. Such attitudes are visible in low rates of street crime and in widespread acceptance of \u201cnanny state\u201d governance and of dirigiste economic management.<\/p>\n

\u201cAn outbreak is a community problem,\u201d said Dan Strickland, a US-based retired epidemiologist. \u201cYou can\u2019t address it as individuals.\u201d<\/p>\n

Broadly, these various factors point to the trend of East Asians being more responsive to rules than \u201cindividualistic\u201d Westerners. Even in South Korea, known for its lively protest culture, violence is rare. During 2016\u2019s \u201cmillion-man\u201d anti-government protests, civic order was observed.<\/p>\n

\u201cIn Chinese, the character for state includes \u2018family,\u2019\u201d said Dr Jerome Kim, director-general of the International Vaccine Institute. \u201cWhen something comes from Dad, the rest of the family follows along.\u201d<\/p>\n

Dr Keiji Fukuda, director of the School of Public Health at the University of Hong Kong agreed. In East Asia, \u201cpopulations were more receptive to \u2013 and less fragmented in the face of \u2013 the measures needed to slow transmission,\u201d he said.<\/p>\n

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Shoppers stand apart as social distancing measures amid concerns over the Covid-19 epidemic while queueing outside a supermarket in Manila on March 17, 2020.
\nPhoto: AF \/Maria Tan<\/figcaption><\/figure>\n

This \u201cfragmentation\u201d is prominently seen in armed Americans defying lockdowns, but is also visible in less dramatic forms.<\/p>\n

\u201cMost of this [crisis] is behavioral, and people are not following the rules,\u201d said Terwilliger, who is based in New York. \u201cI stay home but I look out of my window \u2013 people are in the parks.\u201d<\/p>\n

Such defiance would be unthinkable in communist Vietnam or China, where lockdowns are enforced by neighborhood watch groups. And observers note that in South Korea, where no lockdown occurred, and Japan, where a \u201clockdown lite\u201d has been instituted, dictates on avoiding large gatherings, on mask-wearing and on hand sanitization, are widely followed.<\/p>\n

Rights to privacy<\/h4>\n

Relatedly, the prioritization of society over the individual has come into focus over rights to privacy, for a key pandemic countermeasure is contact tracing of the infected.<\/p>\n

This process has been eased by East Asia\u2019s high adoption rates of digital devices, and its top-tier ICT backbone. In China, tracing is further empowered by a pervasive state surveillance network.<\/p>\n

But even in democratic Asia, where credit card and cellphone data has been used in tracing, there has been minimal pushback on the issue.<\/p>\n

However, the issue is now in focus in South Korea, where the possibility of gays being \u201couted\u201d has arisen in connection with a cluster in LBGT nightclubs. In response, authorities have guaranteed anonymous testing.<\/p>\n

Looking West, there are high cultural barriers towards the use of personal data by governments, most notably in the US. Strickland, the retired epidemiologist based in the US, says he is puzzled by the attitude.<\/p>\n

\u201cI keep saying we should implement the Korean system, and people say, \u2018These authoritarian measures would not work here!\u2019\u201d Strickland said. \u201cI say, \u2018We hand all this data over to big corporations, why not to the government? Especially if they turn off the surveillance after the outbreak.\u2019\u201d<\/p>\n

Still, Terwilliger noted that not all Western nations follow the US attitude toward use of private data. \u201cI can see Finland and Sweden agreeing to it,\u201d he said. \u201cIt is that kind of culture.\u201d<\/p>\n

Experience differentials<\/h4>\n

All East Asian countries have living memories of war on their own soil.<\/p>\n

Japan was massively bombed in World War II. China experienced a post-war Civil War in the 1950s, as did Korea in the 1950s, and Vietnam in the 1960s-70s. Today, China and Taiwan, and the two Koreas remain trapped in military face-offs.<\/p>\n

Western nations, however, have not suffered war on their own land since 1945. Yet even in Europe, certain countries which suffered badly in World War II such as Germany and Poland have weathered the Covid-19 storm better than those which did not, such as the UK and US.<\/p>\n

Likewise, newly bourgeois East Asian countries have more recent experience of economic deprivation than Western nations. And within Europe, newly prosperous Eastern European nations have largely done better than Western Europeans.<\/p>\n

Could these issues have impacted public responsiveness to crisis messaging?<\/p>\n

\u201cMaybe, because of this, people are used to following leadership,\u201d mused Kim. \u201cIn a war, the generals lead. In a pandemic, you let the authorities lead.\u201d<\/p>\n

Dr Kenji Shibuya, a Japanese professor of Population Health at Kings College, London, agreed. \u201cCountries that are very good at national security are good at pandemic management: China and Taiwan; the Koreas; Israel is the same.\u201d<\/p>\n

\u201cThe US is usually good at that but the Centers for Disease Control (CDC) was sidelined,\u201d he continued. \u201cIf the president had trusted the CDC, it would have done better.\u201d<\/p>\n

Recent disease containment experience also granted East Asia an edge in its response.<\/p>\n

\u201cOne of the things to remember is that China, Korea, Hong Kong and Taiwan had been through this before with SARS and MERS,\u201d said Kim. \u201cThat preparation helped.\u201d<\/p>\n

At the outset of Korea\u2019s outbreak, staff at the specialist Daegu Medical Center<\/a>, for example, told Asia Times how they were both prepared and unafraid, due to prior experience. And prior experience impacted systemic response well beyond medical care.<\/p>\n

In South Korea, a wide-ranging law passed in the wake of the MERS pandemic allowed authorities to access normally private data, such as location information from mobile phones and credit card records, enabling accurate contact tracing and contributing to the nation\u2019s comparative Covid-19 containment success.<\/p>\n

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Part II can be read HERE<\/a><\/em><\/h2>\n<\/blockquote>\n

Go to Original – asiatimes.com<\/a><\/p>\n<\/div>\n<\/article>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

15 May 2020 – Perhaps the most startling trend visible in the global Covid-19 pandemic is the vast differential separating East Asia from the West when it comes to the disease\u2019s impact. Very clearly, East Asian nations of China, Japan, South Korea, Taiwan and Vietnam have done better than the West\u00a0on virus management. Why?<\/p>\n","protected":false},"author":4,"featured_media":159496,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2236],"tags":[244,271,1879,1829,1868,289,744,401,710,1937,1864,1102,723,304,1447,1956,1880,1957,339,124,1836,75],"class_list":["post-161062","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid19-coronavirus","tag-china","tag-community","tag-compassion","tag-coronavirus","tag-covid-19","tag-economy","tag-empathy","tag-environment","tag-health","tag-lockdown","tag-pandemic","tag-public-health","tag-research","tag-science","tag-science-and-medicine","tag-semen","tag-sharing","tag-sperm","tag-trade","tag-united-nations","tag-who","tag-world"],"_links":{"self":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/posts\/161062","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/comments?post=161062"}],"version-history":[{"count":0,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/posts\/161062\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/media\/159496"}],"wp:attachment":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/media?parent=161062"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/categories?post=161062"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/tags?post=161062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}