COVID-19: Asia Report, Omnibus Edition

This is the fifth of my “omnibus” reports on the statistics of the COVID virus. Today, I’ll look at those parts of Asia I haven’t already covered. This consists of four areas, three of them highly populated:

1.     North-East Asia – A vast swathe of continent, from Georgia to Uzbekistan.

2.     South Asia – India and the countries around it.

3.     East Asia – China and the countries around it.

4.     South-East Asia – from Bangladesh to Timor, and points in between.

The band of countries from Turkey to Pakistan I already covered under the heading of Middle East; and cases in the Asian part of Russia are included with those in the European part.

There are 28 countries to examine this time round. Here is the list:

North-East Asia	South Asia	East Asia	South-East Asia
Azerbaijan	Bhutan	China	Bangladesh
Georgia	India	Japan	Brunei
Kazakhstan	Maldives	Philippines	Cambodia
Kyrgyzstan	Nepal	South Korea	Indonesia
Mongolia	Sri Lanka	Taiwan	Laos
Tajikistan			Malaysia
Uzbekistan			Myanmar
			Singapore
			Thailand
			Timor
			Vietnam

 

Once again, the data sources are (for epidemic data) Our World in Data and (for lockdown regulations) the Blavatnik School of Government, both at Oxford University. The data I used included figures up to and including April 5^th.

Country Ratings

Here are the bar charts of the United Nations HDI (Human Development Index) ratings for the four groups:

In comparison with Africa, these are getting back up towards Western levels. And here are the Freedom House ratings:

The “stans” are generally low on this measure. So is China, and several countries around it; notably, those with a history of communism. It’s also worth noting that the rating for Myanmar is overstated, being based on the situation before the recent military coup.

Cases

For this part of the world, I’ll start by showing the total cases per million spaghetti graphs:

Except for Georgia and the Maldives, all these numbers of cases per million are way lower than the European figures. But what is even more remarkable is that several countries in this area have cases per million an order of magnitude lower still – their lines just seem to bump along the bottom of the graph. To find out which these are, I’ll show the complete list of cases per million for all 28 countries:

The Maldives is an outlier, probably due to its nature as a chain of small islands. As far as the rest of the top quarter of the graph goes, countries relatively close to Europe and the Middle East seem to get more cases per million than those further away. But at the bottom, you see something quite extraordinary. The closer a country is to China, the less cases per million it seems to have!

The possibility that having Chinese ancestry may give a degree of protection against catching the virus is worth considering. It would make sense that Chinese people, having been exposed to viruses of this kind over centuries, might have evolved better defences than those not so exposed. Vietnam, Laos, Cambodia and Myanmar are all places to which many ethnic Chinese have gone over the centuries. And in more recent times, Singapore, Malaysia, Thailand and Brunei have become homes to large numbers of Chinese. 76% of the population of Singapore, 23% of Malaysians, 16% of Thais and 10% of Bruneians are ethnic Chinese. I don’t know if anyone has done studies to see whether Chinese in other countries are more resistant to catching the virus than the rest of the local population. But I did find a report that attributed British Columbia’s relative success against the virus to the habit of social distancing among its Chinese community (who form 10% of BC’s population).

Here are the daily cases per million over the course of the epidemic:

That China “bumps along the bottom” of the graph, and Taiwan hardly even leaves the bottom axis, are obvious. Thailand, Cambodia, Vietnam and Laos are harder to see; but their total cases per million so far, compared with 71 for China and 44 for Taiwan, are 420, 165, 27 and just 7 respectively.

Here are the reproduction rates:

That drop-off in Tajikistan looks a bit odd – have they really succeeded in extinguishing the virus? And Brunei’s R-rate hasn’t gone above 1 at any point in the epidemic.

But it’s noticeable that, within East Asia, China’s R-rates have been comparable with Japan, South Korea and the Philippines. And that a lot of those countries have R-rates greater than 1 at the moment, but that isn’t being reflected in large numbers of new cases, except in the Philippines.

Testing

Many of these countries haven’t been doing much testing. And that includes the most successful countries of all against the virus! Singapore is the only country with a significant Chinese population to have done European levels of testing; this may be because of its position as a world cross-roads.

Lockdowns

Here are the lockdown stringencies:

I am coming to wonder whether the lockdowns in China may have been tighter than they needed to be, given the low penetration of the virus into the population? Particularly since Taiwan has achieved an even better result with an unusually low stringency. (As has Laos, since about July). I think a more detailed look at what the most successful countries have been doing lockdown-wise – China and Taiwan, in particular – is in order.

But first, the list of average lockdown stringencies:

Again, success and low lockdown stringency seem to go together! And that includes Japan, where although there almost a million ethnic Chinese, they are only a small proportion of the population. Perhaps there is something cultural, which Japanese and Chinese share, which helps against the virus? When I worked with Japanese people, I found them a bit formal and remote. Maybe they find it natural to keep a distance from other people? And, perhaps, for the same reason as the Chinese – a long history of exposure to this kind of virus?

So, I’ll look in some more detail at China and Taiwan. What have they done right that others didn’t?

China

Here’s the, rather strange looking, epidemic profile in China:

In comparison with Western countries, and taking account of the size of the population, those case numbers, even at the peak, are peanuts. The obvious thought then is, are the Chinese lying and fudging the figures? Or, is there something else at work?

Here’s the weekly case growth, R-rate and lockdown stringency graph:

Well, that kind of up-and-down case growth does look believable, considering the very low number of cases relative to the population. But the lockdowns do look over-the-top for the number of cases. Maybe that’s because the R-rate has been above 1 for far more time than it has been below? Or, maybe that’s just communism for you? But no: Laos is communist too, and they haven’t locked down all that hard; not recently, anyway. So, let’s look at what the Chinese have done:

Date	Stringency	Measures
20200105	2.78	Public info: Urging caution (Regional) Contact tracing: Comprehensive
20200115	8.33	Public info: Co-ordinated (Regional)
20200121	8.33	Face covering: Required in some places
20200122	26.39	Events: Mandatory cancelled (Regional) Gatherings: Up to <=10 (Regional) Face covering: Required when with others (Regional)
20200123	44.91	Public transport: Mandatory closed (Regional) Stay at home: Recommended (Regional) Travel: Mandatory restrictions (Regional)
20200125	47.69	Public info: Co-ordinated
20200126	69.91	Schools: Mandatory closed Workplaces: Mandatory closed
20200201	77.31	Stay at home: Required, minimal exceptions (Regional)
20200210	75.46	Workplaces: Mandatory closed (Regional)
20200216	75.46	Testing: If symptoms
20200225	81.02	International: Quarantine high-risk
20200316	79.17	Schools: Mandatory closed (Regional)
20200324	79.17	Face covering: Required in some places
20200326	81.94	International: Ban some arrivals
20200328	73.61	Public transport: Open
20200331	73.61	Testing: Open
20200403	69.91	Workplaces: Some closed (Regional)
20200408	56.94	Stay at home: Recommended (Regional) Travel: Recommended not to travel (Regional)
20200510	81.94	Workplaces: Mandatory closed (Regional) Public transport: Mandatory closed (Regional) Stay at home: Required, minimal exceptions (Regional) Travel: Mandatory restrictions (Regional)
20200603	78.24	Schools: Some closed (Regional)
20200902	55.09	Workplaces: Recommended closed Public transport: Open Stay at home: No measures
20200904	46.76	Travel: No restrictions
20200915	81.94	Schools: Mandatory closed (Regional) Workplaces: Mandatory closed (Regional) Public transport: Mandatory closed (Regional) Stay at home: Required, minimal exceptions (Regional) Travel: Mandatory restrictions (Regional)
20200921	75.46	Workplaces: Some closed (Regional) Gatherings: Up to 11-100 (Regional)
20200922	71.76	Schools: Some closed (Regional)
20200923	60.65	Public transport: Open International: Quarantine high-risk
20200924	63.43	International: Ban some arrivals
20200926	54.17	Stay at home: No measures
20201010	52.31	Schools: Recommended closed
20201012	61.57	Stay at home: Required, minimal exceptions (Regional)
20201024	81.94	Schools: Mandatory closed (Regional) Workplaces: Mandatory closed (Regional) Gatherings: Up to <=10 (Regional) Public transport: Mandatory closed (Regional) Face covering: Required outside the home (Regional)
20201030	68.98	Workplaces: Some closed (Regional) Public transport: Recommended closed (Regional) Stay at home: Required with exceptions (Regional)
20201031	63.43	Schools: Recommended closed
20201120	76.39	Schools: Mandatory closed (Regional) Workplaces: Mandatory closed (Regional) Stay at home: Required, minimal exceptions (Regional)
20201124	81.94	Public transport: Mandatory closed (Regional)
20201208	78.24	Workplaces: Some closed (Regional)
20210222	67.13	Public transport: Recommended closed Stay at home: Recommended Travel: Recommended not to travel Face covering: Required in some places
20210301	61.57	Schools: Recommended closed
20210315	56.94	Workplaces: Recommended closed Events: Recommended cancelled
20210329	50	Gatherings: Up to >1000

Well, that has shown up something interesting. Apart from closing schools and workplaces for a brief while in January 2020 (and that was the Chinese New Year holiday period), and quarantine or bans for some incoming travellers, there have been no national lockdowns! China is a big place; and public health is essentially a local matter. So, you would expect a sane Chinese government not to lock down at the national level without an extremely good reason. And they haven’t. There have been no mandatory workplace closures, no mandatory stay at home, and no mandatory travel restrictions, anywhere outside the immediately affected provinces.

Contrast this, if you will, with Boris Johnson and SAGE, that have totally locked down people in the whole of England this winter for three months solid – five months for the unlucky. Boris makes Xi look like a saint. So, I think I’ll give the Chinese the benefit of the doubt; they really have controlled the virus without locking down any harder than necessary.

And something else. The Blavatnik measure over-rates regional measures versus national ones. As I’ve said before, regional measures ought to be weighted by population affected. Look at what happened in China on September 15^th! Can a jump of the national stringency level from 47 to 82 really be justified by measures, none of which affect the entire population?

Taiwan

So, what can the “other China” across the water tell us?

In terms of cases per million, the Taiwanese have done even better than the Chinese. So, those bumps in the weekly case growth are nothing to worry about. Here’s what they have done lockdown-wise:

Date	Stringency	Measures
20200102	8.33	Public info: Urging caution
20200120	13.89	Public info: Co-ordinated Testing: Restricted
20200121	13.89	Contact tracing: Comprehensive
20200123	19.44	International: Ban some arrivals
20200124	19.44	Face covering: Recommended
20200202	30.56	Schools: Mandatory closed
20200216	30.56	Testing: If symptoms
20200225	23.15	Schools: Recommended closed
20200305	28.7	Events: Recommended cancelled
20200319	31.48	International: Ban all arrivals/border closure
20200422	31.48	Face covering: Required outside the home
20200508	25.93	Events: Allowed
20200513	25.93	Face covering: Recommended
20200523	25.93	Testing: Open
20200622	23.15	International: Ban some arrivals
20200805	23.15	Face covering: Required in some places
20201201	19.44	Schools: Open
20210121	25	Events: Recommended cancelled

That looks not so bad to me, apart from the idiocy of face mask regulations. But one thing stands out like a lighthouse. The Taiwanese haven’t allowed anyone from outside into the country from anywhere risky. When things were really bad, from March to June last year, they didn’t let anyone in at all, except for returning residents.

I’m no fan of borders. But if you’ve got the bloody things, in a public health emergency you should damn well use them.

Deaths

I won’t even bother to give deaths per million graphs this time. I’ll simply content myself with the list of cumulative deaths per case through the epidemic:

The three countries I am particularly concerned about are India, Indonesia and the Philippines; in that order. They have big populations, and the virus hasn’t really made much in the way of inroads into them yet. The vaccines might save the people in those countries. Then again, they might not.

Vaccinations

Compared with Europe or some other parts of the world, there’s not much vaccination activity going on here. Here is the list of percentages fully vaccinated:

Singapore is starting to get there – as you might have expected. But no-one else is really “off the ground” yet. The percentages of people vaccinated, however, show a different story in one place, Bhutan:

Unfortunately, all the vaccinations in Bhutan have taken place on or since March 27^th, so there won’t be anything to see there for a couple of weeks yet.

A note on face masks

As an objector to wearing a face mask – I find them unhealthy, uncomfortable, and demeaning – I thought I would end with the following links:

https://clinicaltrials.gov/ct2/show/NCT04337541 and https://clinicaltrials.gov/ct2/show/results/NCT04337541

The study was done in April and May last year. The results are still not available. Why not?

To sum up

Yesterday, metaphorically speaking, Europe, the Americas, the Middle East and Africa. Today, Asia. Tomorrow, Australasia and Oceania. The day after, the world!

Oh, and the day after that, I plan to look at which lockdown measures have “worked” (whatever that means) over the duration of the epidemic, and which haven’t.