Thought of the Day - November 15 - By the Numbers

Rather than focus on the alarming figures in the western world, in Canada and in BC, I thought I would focus on some "success" stories; specifically how well countries in South-East Asia are doing. While everything is relative, and I am sure some of these countries would say they should be doing better, but by Canadian standards they are.

India

India who was on track to overtake the USA for the most cases in the world has, despite over four times the population, turned the tide with new cases dropping below 0.5 lakh per day. Deaths have also followed suit (to put it into perspective India's death per capita is one-third that of Canada's).

Japan

Five percent of the deaths per capita when compared with Canada.

China

0.1% of the deaths per capita when compared with Canada.

South Korea

Three percent of the deaths.

Taiwan

No deaths since the beginning of June. Like China 0.1% of the deaths of Canada.

Vietnam

No deaths since the beginning of September. Canada has over 700 times their death rate.

Cambodia, Laos, Malaysia, Mongolia, Singapore, Sri Lanka, Thailand, the list of countries goes on,

This chart of total deaths per capita over time says it all.

While it might be easy to suggest that countries maybe counting differently, or that they have different demographic, or that there are different viral strains around the world, the reality is they are simply doing things with greater effect.

Starting this Friday there is an international H-Net forum debating this very subject:

Exemplars in Global Health? Comparing Asia’s Many Responses to COVID 19

"Even as the COVID 19 pandemic continues to be marked by ebbs and flows, a handful of countries in Asia have had relatively sustained success in curtailing morbidity and mortality due to the virus. No single reason – such as regime type, surveillance technology, or experience with past epidemics – seems to explain these countries’ comparative achievements. This panel will bring together experts from different states including Japan, Vietnam, China, and South Korea. The juxtaposition of these national experiences will aim to illuminate the constellation of historical, political, infrastructural and other factors that undergird competent public health responses."

So what could be the reasons? Did all these countries act way earlier than we did in Canada? Many of these countries had first hand experience with H1N1, Swine-Flu, SARS, MERS etc., and so maybe they put in place measures (mask wearing, basic sanitation, social distancing, travel restrictions, prohibiting gatherings) more rapidly - Taiwan for example has National Health Command centre (NHCC). But wait a minute, in some ways we had a longer lead time and don't we have a minister, Bill Blair, whose only job is Public Safety and Emergency Preparedness? Didn't Alberta order half a million PPE kits at the end of the December to be ready?

I am hoping that the minutes of the session will be published, as I think they might just hint as real reasons behind the lower death rate in the countries of South East Asia. Reasons that might include:

• they have overall better heath and nutrition;

• they acted in advance of belated recommendations from the WHO;

• they had clear prevention messages and greater compliance by citizens;

• they had an overarching objective to reduce the number of deaths;

• they were more effective at protecting the elderly;

• they quashed institutional spread, for example in food prep plants;

• they prohibited all mass gatherings;

• they implemented effective contact tracing, tracking, quarantining;

• they enforced their restrictions;

• they had effective border closures;

• etc.

This week's shout out goes the Atlantic Bubble. Our four eastern provinces, despite still seeing new cases and deaths, are doing about as well as the countries in Asia we have been discussing. Congratulations! With Canada now seeing a new case every 20 seconds and a new death every 20 minutes, maybe we also need a symposium to look at what they are doing differently.

Cheers

Cliff