East vs West covid

[pancakeloverrr]

I'm genuinely curious as to why the death rate is much higher in the western countries as opposed to eastern countries.

While Italy has a high elderly population, so does japan. Yet, the vast difference in death count is mind blowing.

Anyone care to discuss? And what can we learn from the East? I dislike the death rate here, and want to adopt some measures for myself and loved ones from the East in case we see a another pandemic.

I'm in Asia, in one of the countries that have dealt with it well.

There are quite a few reasons.

1. The health system is just so much better. It works perfectly, is cheap, everyone has insurance, enough equipment like ventilators and PPE.

1. Less obesity. Even if you see fat people, they are what we would consider chubby rather than extremely big.

1. People actually take their health seriously. If they are sick, even with a cold, they go to the doctor straight away.

1. Social pressure - if you get sick with coronavirus, you're going to be shunned. Not great, but there you go.

1. Masks. Not as big a thing as some think but they help. Having said that, what I see frequently here is people taking them off once they're inside which seems backward to me.

1. We got out in front of it. As soon as it became a thing, the government started testing, setting up temperature checks and testing stations. Western governments sat about for weeks doing nothing, thinking it wouldn't affect them before it was too late and had spread everywhere

1. Quarantine when entering the country for everyone and if you leave, you get a huge fine. They call you all day every day to make sure you don't leave.

1. But the main thing is the track and trace system. We have had a few mini outbreaks but as soon as they pop up, they are squashed again. It involves a certain loss of privacy but I feel like people accept that.

There is just such a big cultural difference as well. The fuss British people make about eg not getting a holiday, wearing a mask or whatever just seems a little silly to people here. If you have a medical condition that means you can't wear a mask - you're just going to stay inside. Yes, it sucks, but people consider the overall good of society more than their individual freedom. The western response has really surprised me, people seem really selfish and unable to follow rules. If you don't get a holiday here from one year to the next, that's not seen as some big deal. It's just life.

There's not much you can do really except wash your hands, avoid people and be healthy. Wear a mask.

i suspect reporting. canada is reporting all cases including seniors in facility (who sadly have been shockingly affected) but honestly when you take out the frail elderly not many others have had it.

@fallfallfall

45,000 in the UK, 1000 in Japan, 300 in Korea, 7 in Taiwan?

That's not down to differences in reporting.

The west seem to let their governments get away with any kind of nonsense.

It may be something to do with slightly different strains of the virus. The class mainly circulating in Asia is different to the circulating in Europe.

Depends what you call 'East'. Vietnam is taking off & Bangladesh is bad while NZ is 'covid free'.

3 yr wait to get your elderly person into a care home in Hong Kong. Relatively few elderly in care homes in Japan or South Korea. Lots of contact-tracing measures that the public support (or are forced to engage in). Incredibly easy access to tests - anyone could book a test and get one very quickly (drive-in centres) in SK. Very quick turn around on test results - like UK is now (within 48 hours) but in USA sometimes people are still waiting a week or so for their result.

I agree with OohFriend. I live in Malaysia which has 9,000 cases and 125 deaths. I don't think it's a lack of testing/reporting. If it was you'd expect to see a very high percentage of positive tests indicating lots of cases were being missed, that's not the case here as only 0.88% of covid tests are positive. The WHO suggests that a case positive rate of 3% is adequate ourworldindata.org/coronavirus-testing

I think the key things done here were

1. Border was shut very early on allowing control. Any Malaysians returning have to do 14 days quarantine in a hotel and have a negative covid test before they're released.

1. Anyone testing positive with covid is isolated in hospital until they are negative, even if they are not symptomatic. This has reduced total numbers by preventing community transmission. Its also reduced our death rate as patients are treated early if their O2 saturation starts to drop or whatever.

1. Whenever you go anywhere you have to log your details and we have an app to do this. I don't know how useful this has been but it seems like it would be helpful for contact tracing when new cases start to pop up. From speaking to family in the UK many places don't take any details at all.

1. In our initial lockdown basically all movement was banned for two weeks. You could go out to buy food and to get medical treatment and that was it. There were police roadblocks and patrols to enforce this. If any clusters came to light e.g. in a particular neighbourhood or apartment block that place was quarantined and noone was allowed to leave for any reason (the government provided food).

1. When lockdown was partially lifted there were still roadblocks to prevent interstate travel. So you could go to work, go around your own town but you couldn't travel long distances.

1. Everyone wears masks. Not sure how important this is to prevent spread but it could be a factor.

Oh and also, nursing homes are much less common here. Its more common for elderly people to be cared for at home by family or paid live in carers/helpers.

@MedSchoolRat

37 cases a day is taking off? The UK had almost 1000 today.

Vietnam has excellent track and trace systems. I have little doubt they'll contain this.

There is just such a big cultural difference as well. The fuss British people make about eg not getting a holiday, wearing a mask or whatever just seems a little silly to people here. If you have a medical condition that means you can't wear a mask - you're just going to stay inside. Yes, it sucks, but people consider the overall good of society more than their individual freedom. The western response has really surprised me, people seem really selfish and unable to follow rules. If you don't get a holiday here from one year to the next, that's not seen as some big deal. It's just life.

I agree this is probably a big difference.

@OohFriend out of interest, how do points 1 & 3 from your post work together? Maybe I'm just clueless because it's a totally different system, but day to day (pre COVID) how does the health system cope with people going to the dr for a cold, isn't it a massive waste of time/resources - or do you have way more Drs, and if so how is it cheap?
Plus, (again, pre COVID) why are people going to the Dr for a cold? I don't see that as "taking their health seriously" since the Dr can't do anything for a cold. What does it achieve? Don't the Drs just say to rest and drink lots of water? It's not like there's useful prescription medicine they can give.
Obviously where you are is doing a lot of things right so I'm not criticising, I guess I'm just baffled by the idea of seeing a dr for a cold!

I'm in Tanzania. I'm not sure if you count that as East or West.
There is no reporting here but tests are happening.
A doctor from the second largest hospital here said they have only used their ventilators four times and are not seeing that many cases.
Apart from South Africa, cases in Africa are generally low. Some reasons include

1. Younger population - the average age here is less than 20
2. More time outside

I have heard more reasons but can't remember them at the moment. I also suspect deaths from Malaria, malnutrition etc are higher here.

@Frazzled13 I guess it's hard to understand but people just trust doctors implicitly here. There's very little self medicating. If you're sick, you see a doctor, no matter what the reason. Whether that is right or wrong, I can't say. I personally think it's a little silly but people have better life expectancy here so I do feel like a lot of things are caught early.

I feel like there are more doctors. At any rate, you never need an appointment, you just walk in and 15 minutes later you are seen. They'll often do testing or treatment on the spot, so if you need, say, an MRI scan, it will be done the same day, often in the same place.

It honestly makes the British system look shameful by comparison.

There is also evidence that the virus predominant in Europe at the start of the pandemic had mutated to be more infective to the original Wuhan strain. It was reported in various places with original study here

www.cell.com/action/showPdf?pii=S0092-8674%2820%2930820-5

The mutation didn’t necessarily make it more serious an infection, but it did lead to much quicker spread. There was some limited data the mutation might have made it more deadly but it’s hard to draw conclusions due to variation in disease management and reporting between countries.

I’ve been utterly ashamed to be British throughout this to be honest, both because of the useless government and of the attitude of the ‘great’ british public. The vast majority are entirely selfish, thinking only of their own discomfort in wearing a mask and moaning about not being able to go on holiday for one year of their life. People saying they won’t get vaccinated. People celebrated in the streets when the polio vaccination with discovered!

Let’s just hope that if we ever have another world war then everyone is just wiped out with an atomic bomb as this snowflake, spoiled generation wouldn’t cope. Pathetic

England vs East (and many West) was told to be ill with covid at home. In Germany you contacted your GP to be helped and treated. In all Asian countries you were medically treated. Also isolated in hotels if not too poorly (thereby stopping rest of household getting it). Also Taiwan, Sing, HK had no soldiers at the World Military games in Wuhan in Oct.

@Worriedmum999

I’ve been utterly ashamed to be British throughout this to be honest, both because of the useless government and of the attitude of the ‘great’ british public. The vast majority are entirely selfish, thinking only of their own discomfort in wearing a mask and moaning about not being able to go on holiday for one year of their life. People saying they won’t get vaccinated. People celebrated in the streets when the polio vaccination with discovered!

Let’s just hope that if we ever have another world war then everyone is just wiped out with an atomic bomb as this snowflake, spoiled generation wouldn’t cope. Pathetic

It’s not specific to a generation, it seems to be a cultural thing. My town is mainly mask wearing , keeping apart etc except the 40-60 bracket (judging by the drunks outside our house last night). Next big town is mask hating, supermarkets have small % compliance.

From what I'm reading it seems to be a difference in attitudes around following the rules. Track and trace, in a far stricter way than here, is accepted, quarantine is abided by, people are following rules that are designed to slow the spread. Contrast that here with too many people fighting even the loosest of rules and it's no wonder really.

Everything in the West seems to be about "rights" and nothing about responsibility

I agree we are a nation of whingers. We complain about masks, queuing SD. We don't want an app as it affects our privacy and human rights. Also our health system left alot to be desired. In the hight of lockdown it was very difficult to get medical help for suspected Covid. No one could get a test, doctors didn't want to know. 111 were impossible to get hold of and if you were lucky enough to get through the advice was rude and terrible and must have caused extra deaths.

The vast majority here are entirely selfish, thinking only of their own discomfort when wearing a mask
Don't know where you live but the vast majority where I live are wearing a mask when it's required. Yes theres many moaning about but that doesn't equate to not being compliant with it.

There are many different strains on the virus, some are more infectious and more dangerous than others

Agree sad to be British. Selfish. It is interesting though. Maybe it is our reliance on high calorie food so high blood sugar etc. As our kids are generally more demand avoidant too...
It's the little things
We cant expect
-parents to look after and care for and feed dc so we have to have fsm even over summer. We have to send all kids back because some wont send back and they might be being mistreated.
-kids to behave at school so 11+ still have to be constantly supervised in classrooms so teachers cant even go to the toilet.
-expect parents to buy internet or a tablet (£50+)

• Expect to be able to get antibioufor bacterual infection.

-cant expect adults for wear a mask (or properly) -kids 11+ couldnt possibly at school even if other EU countries they are -expect people to choose to at least avoid a pub crawl -expect kids to actually do the home learning or parents to try to encourage them -uk solution was to just not klet anyone in the hospitals -the people returning from italy could be asked to quarantine but didnt actually do it. We cant enfore with fines and check on them.

Tbh it seems an issue with prioritising economy and protecting the wealthy. Our schools are underfunded the hospitals. And that is because wealthy dont need them. But then we end up with a largely poorly educated population.

[quote Frazzled13]@OohFriend out of interest, how do points 1 & 3 from your post work together? Maybe I'm just clueless because it's a totally different system, but day to day (pre COVID) how does the health system cope with people going to the dr for a cold, isn't it a massive waste of time/resources - or do you have way more Drs, and if so how is it cheap?
Plus, (again, pre COVID) why are people going to the Dr for a cold? I don't see that as "taking their health seriously" since the Dr can't do anything for a cold. What does it achieve? Don't the Drs just say to rest and drink lots of water? It's not like there's useful prescription medicine they can give.
Obviously where you are is doing a lot of things right so I'm not criticising, I guess I'm just baffled by the idea of seeing a dr for a cold![/quote]
I used to live in East Asia, and there were definitely more doctors. There tended to be separate clinics for different issues - my neighbourhood had 2 gp surgeries, a heart clinic, a skin clinic, a pain clinic, and 2 dentists. You’d go to a gp if you had a cold, but anything more specialised would be a separate clinic, so there was next to no waiting time at the gp, as it wasn’t a catch all for every illness like it is here. The town I lived in wasn’t big, but it had 2 hospitals - one general, and one children’s.

You need health insurance, but it’s really affordable, and I remember having to pay 30% or less of the costs for appointments/procedures but I don’t know if that varies.

As a pp said, you get X-rays/scans/mri on the same day usually.

The weirdest thing was having to go to the gp if you needed calpol. Couldn’t find kids medicine anywhere in pharmacies so the only way I could get it was by taking a snot filled child to the doctor. That was odd.

imho, it's deluded to think that Brits are somehow far less altruistic than folk in Far East or the so-called successful at covid control countries. There are very hefty fines often imposed for breaking the isolation/quarantine rules in Taiwan, PRC, SK, HK, Singapore, NZ... etc. I don't support those rules not least because it's rule by fear -- it's not altruism that keeps people in line, anyway.

Italy was the lab rat of Europe tbf.

The lockdown in Italy probably came 2 weeks too late in the hotspot regions (there is currently a big expose going on in the media with leaked documents and phone calls from the governor of Lombardia begging the central govt for a lockdown)

This does go to explain why Italy was hit so hard at the time. Borders with 5 countries and a lot of cross border movement/ski season/industrial hub/patient zero in first cases in Italy were two Chinese tourists which led to a false sense of security/patient zero from second outbreak was German and had gone back to Germany/patient one was a young, fit superspreader.
It wasn't anything to do with the elderly population demographic as such, though obviously, as with everywhere else, they were hardest hit.

It was a perfect storm.

But- when Italy locked down it was total. One person left the house to do food/medicine shopping with a document. Masks were obligatory. You couldn't wear one, you didn't go out.

Italy's cases are on the rise again, not truly cause for concern as the majority of the 500 new cases yesterday were from refugees tested positive on entry.

I am pleased to read the comments though on this thread, as the can't-shan't-won't attitude on many others is like going down some weird Alice in Wonderland rabbit hole into a parallel universe.

Interesting also to read about other MNers' experiences all over the world.