Which country has had the best response to the coronavirus?

I pick the United Kingdom, even though their public health response has been generally poor.  Why? Their researchers have discovered the single-best mortality-reducing treatment, namely dexamethasone (the cheap steroid), and the Oxford vaccine is arguably the furthest along.  In a world where ideas are global public goods, research matters more than the quality of your testing regime!

And the very recent results on interferon beta — still unconfirmed I should add — come from…the UK.

At the very least, the UK is a clear first in per capita terms.  Here are the closing two paragraphs:

It is fine and even correct to lecture the British (and the Americans) for their poorly conceived messaging and public health measures. But it is interesting how few people lecture the Australians or the South Koreans for not having a better biomedical research establishment. It is yet another sign of how societies tend to undervalue innovation — which makes the U.K.’s contribution all the more important.

Critics of Brexit like to say that it will leave the U.K. as a small country of minor import. Maybe so. In the meantime, the Brits are on track to save the world.

Here is my full Bloomberg column on that topic.  And if you wish to go a wee bit Straussian on this one, isn’t it better if the poor performers on public health measures — if there are going to be some — are (sometimes) the countries with the best and most dynamic biomedical establishments?  Otherwise all the panic and resultant scurry amounts to nothing.  When Mexico has a poor public health response to Covid-19, the world doesn’t get that much back in return.  In this regard, I suspect that biomedical innovation in the United States is more sensitive to internal poor performance on Covid-19 than is the case for Oxford.

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American deaths/7 day rolling average
July 3 626/555, July 4 265/518, July 5 262/515, July 6 378/516, July 7 993/556, July 8 890/585, July 9 960/625

July 10 849/657, July 11 731/723, July 12 380/740, July 13 465/753, July 14 935/743, July 15 1002/760, July 16 963/761

July 17 946/775, July 18 813/787, July 19 412/791, July 20 545/802, July 21 1119/829

Yes, at this rate, by the end of the month the US might just catch up to the EU's overall excess mortality stats compared to an average year for the duration of the pandemic. (Thanks largely to the outstanding performance of Germany.) I prefer the all-cause excess mortality stats because they make up for poor testing especially early on, though I understand that virus truthers don't like them. Another disadvantage is that some locales (CT, PA, and NC in the US, Italy in the EU, for example) are very late in reporting all cause mortality.

The southern US states are largely following the same pattern as Latin America (or India) of very low cases initially but spreading later. (Peru is incredibly bad despite a harsh lockdown, so it's difficult to blame entirely on public policy.)

"Thanks largely to the outstanding performance of Germany.)"

Sarcasm? Germany's response was mediocre. Worse than Romania, Denmark, Russia, Austria, Hungary, Poland, Czechia, etc.

Germany did worse than almost all of its neighbors, I guess you could make the argument it is the Sweden of central Europe.

I don't personally think of it this way, but if you are inclined to use reported statistics as a test of a governments response, Germany's response cannot even be described as good let alone outstanding.

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Germany and Denmark and Romania are remarkably similar -
Tot Cases/1M pop Deaths/1M pop
Germany - 2,436 110
Denmark - 2,304 105
Romania - 2,089 109 (considering its poverty, the death rate is understandable, and its infection rate is likely understated compared to a richer country like Austria)

Technically worse, true, but in comparison to Poland, Denmark and Romania are equally mediocre. And Austria is not that outstanding either, with 2,212 / 79., though with a clearly lower death rate in contrast to its higher infection rate.

Mediocre makes sense as a term to describe Germany, Denmark and Romania, with Austria straddling the line.

I don't know Germany has three times the death rate of Poland. More than that for Czechia. I don't think Germany did a bad job or anything, but its being singled out for praise is bizarre.

What I don't understand is why JWatts would list two countries essentially identical to Germany (with Austria in the ballpark) without noting the poster child for a very good European response - Greece's numbers are 388 / 19, which are better than Czechia 1,337 / 34, Poland 1,088 / 43, or Hungary 452 / 62 (the less said about Russia, and trusting any of its numbers, the better).

The likely reason for Germany getting so much publicity is that it was in the top five infected cuontry number for a long time, behind Italy and Spain, but without the same high death rate.

"without noting the poster child for a very good European response - Greece"

I have mentioned Greece's numbers before. But frankly, I just forgot to include it this time.

Seems like you forgot them too.

"Sarcasm? Germany's response was mediocre. Worse than Romania, Denmark, Russia, Austria, Hungary, Poland, Czechia, etc."

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It's almost as if the British have been good at biological science since Darwin.

The English were true Whites, unlike most other Europeans.

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Thanks prior, but it would be easier if you just dropped a link to Wikipedia

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Using thus logic, is China the greenest country on the planet because it produces the most solar panels?

No, the logic would be if China produced innovative research that improved solar panels... except even then the reason the argument breaks down is that CO2 emissions are a global problem without localized ill effects. To make a green argument, you would have to say e.g. that it would be better for the US to be the country most negatively impacted by rising sea levels or similar, since that would produce more research than a poorer country being affected.

Essentially this is a version of the argument that if malaria were endemic to the US we'd have a better treatment for it.

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It's an interesting take and I would have to agree. They have done very well on the biomedical front.
Interferon beta treatment is just what the doctor ordered . No Inteferon beta( SNG001) is a hallmark of severe Covid-19 disease.

https://science.sciencemag.org/content/early/2020/07/10/science.abc6027

Its a troll argument at best, a call for attention, a click-bait, and we all know that.

Only makes sense if you interpret the meaning of the question in a way nobody does.

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That sounds promising. I was also following the study on fenofibrate (https://www.pharmaceutical-technology.com/news/study-fenofibrate-covid-19/) which to me has received surprisingly little attention. Did I miss something? If immunity is as short term as some people think then these treatments may be far more effective than a vaccine.

" If immunity is as short term as some people think "

Yes, treatment is good, but almost no scientists think that immunity is really short term. Antibodies have a short life; the point is that memory B cells (small in number) continue to exist and can rapidly produce millions of antibodies when needed (and that T cells can do the work in the meantime waiting for the antibodies.)

Circulating antibody rates plunge similarly for all sorts of vaccines that are extremely effective, like smallpox. The headlines regarding antibodies are not useful.

Mutation is a more reasonable concern than antibodies, but we haven't seen anything pointing towards a problem there yet either. (What mutations do exist aren't in the sites targeted by the vaccines under development.) Still, good to have as many approaches as possible.

Very insightful, thank you. It sounds like medicine is more your cup of tea than mine, but I like to think I know enough to say this sounds logical. This is more the economist in me saying, "put more money where we expect the highest returns!"

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Even if immunity itself is short lived, booster shots are cheap. We recommended repeated injections of Tdap over the lifespan in order to keep up antibody levels. Even if we have to vaccinate everyone in the world twice yearly at a thousand per shot, that is still cheaper than even a month of "lockdown".

The big concern with poor immune persistence is not with vaccines, but with natural infections. If we fail to get a vaccine that induces any immunity then we might, in a few months or years, see repeated waves with elevated death tolls. Even if it ended up amounting to nothing more than an addition "flu season" every year, that would still dramatically increase mortality and morbidity across all age brackets.

This is not rotovirus or chickenpox, we can afford a lot of suboptimal vaccine qualities and still have an effective response that dramatically improves the status quo.

I think because HCoV-2 doesnt mutate all that fast due to its built in nsp 14 exonuclease proofreading ( one estimate is 1/10 the Influenza A mutation rate), we won't have to vaccinate every year like the flu. We might just improve the vaccine and introduce better varieties
The vaccine may not be all that effective in the over 65 crowd, so its epidemiological effectiveness might depend on general adoption.
Considering some people won't take it ( I don't know the proportion) , this might be the important factor in future death rates.

Even absent genetic drift, some pathogens can still cause disease. We are not always sure about the process (e.g. maybe illness is caused by some component of the immune system, maybe the pathogen out-replicates the immune response, maybe there is cross-reactivity with a self-antigen and the epitopes become tolerated absent secondary signals). But in the main if a pathogen does not kill you, you acquire some immunity.

Hopefully it last a long and only solely decays as some immune cells go anergic or die off. If we can get a vaccine to give even a few months of immunity, we can just keep dosing until either we get a better vaccine, Covid burns out, or people start developing hypersensitivity reactions to the vaccine.

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Based on antibody kinetics measured in a group of convalescent patients,

“the median times for IgM, IgA and IgG to become seronegative are 4.59 (IQR 4.12-5.03), 7.78 (IQR 6.71-9.16) and 42.72 (IQR 33.75-47.96) months post disease onset.”

Neutralizing and binding antibody kinetics of COVID-19 patients during hospital and convalescent phases
https://www.medrxiv.org/content/10.1101/2020.07.18.20156810v1

"e we report that the vast majority of infected individuals with mild-to-moderate COVID-19 experience robust IgG antibody responses against the viral spike protein, based on a dataset of 19,860 individuals screened at Mount Sinai Health System in New York City. We also show that titers are stable for at least a period approximating three months, and that anti-spike binding titers significantly correlate with neutralization of authentic SARS-CoV-2."

SARS-CoV-2 infection induces robust, neutralizing antibody responses that are stable for at least three months
https://www.medrxiv.org/content/10.1101/2020.07.14.20151126v1

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Using dexamethasone was known in the US too (check back episode of the TWiV podcast to hear a play-by-play as it was worked out in Long Island) and around the same time. Steroids were common for managing patients on respirators but there is a timing issue in their use with COVID. Anticoagulant use is another reason outcomes have improved so much and that was spotted about the same time in both countries.

TheUK published first but they were already being used widely in the US and elsewhere.

Steve

They ran a well designed and rigorous clinical trial demonstrating the efficacy of dexamethasone. Something notably lacking in the U.S., where ad hoc studies become subject to intense partisan fighting.

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What does a world in which interferon beta works as well as it did in the trial, reduction of deaths by 70% look like? Does life go back to normal? Do schools re-open? Assuming 1% IFR, reduced to .3% and 70% herd immunity level, we get .21% deaths, or about 600k total in the US if we open everything. What does this world look like?

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I wonder to which extent the UK's "poorly conceived messaging and public health measures", and the resulting large clinical sample sizes, are not a prerequisite for their high research performance. Given the few infection cases in Korea, why should we expect breakthrough research from there even if its biomedical establishment was (or is?) top class.

Not really - the Oxford Vaccine needed to test on people in Brazil because there weren't enough active cases in the UK.

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The therapies and vaccines are being developed by private companies, not countries. Countries are evaluated on public health response rather than drug development because the public health response is something countries as a collective do rather than something private entities do.

On the Straussian reading, it doesn’t seem like having a bigger outbreak in a more technologically advanced area has to mean faster therapeutic development. If there’s money to be made selling drugs and vaccines, then that should be an incentive for people to develop those drugs and vaccines even if the outbreak isn’t that severe in their country. That’s why Chinese and European companies are still developing vaccines even though the virus seems to have abated there.

These drugs already exist and the profit margin for them is approximately zero.

Oxford also isn’t private, iirc.

Is Oxford a private university? The American private/public distinction doesn't work in Britain. The universities are not owned by governments. They (almost) all accept government funding. Indeed, usually plead for it.

As far as I can see Oxford was set up by neither a Papal Bull nor a Royal Charter. It simply came into being.

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That is a refreshing display of intellectual honesty, since the UK has not been using private enterprise much to meet the challenge of this pandemic. Instead, publicly supported institutions involving a taxpayer funded health care system have been at the forefront of reducing deaths and vaccine development.

However, it seems a bit odd to completely ignore the WHO/Landt test, developed in a week after the publishing of the virus's genome - "Shortly after New Year’s, Olfert Landt started seeing news reports of a strange disease spreading in China. The German scientist, who’s developed tests for ailments ranging from swine flu to SARS, sensed an opportunity—and a new mission. He spent the next few days quizzing virologists at Berlin’s Charité hospital and scouring the internet for more information on what soon became known as the novel coronavirus, and by Jan. 10 he’d introduced a viable test kit. His phone hasn’t stopped ringing since. “Everyone here is putting in 12- to 14-hour shifts,” the ponytailed Landt says as he rushes through the corridors of TIB Molbiol Syntheselabor GmbH, the Berlin biotech company he started three decades ago. “We’re nearing our limit.”

In the past two months, Landt and his staff at the company’s production facility—a former industrial building just south of the disused Tempelhof airport—have produced 40,000 coronavirus diagnostic kits, enough for about 4 million individual tests." www.bloomberg.com/news/articles/2020-03-12/a-berlin-biotech-company-got-a-head-start-on-coronavirus-tests

If used effectively, the test allows for isolation/quarantining to stop the spread of the virus, a major factor in the success of those countries with an order of magnitude less deaths per capita than the UK.

> If used effectively, the test allows for isolation/quarantining to stop the spread of the virus, a major factor in the success of those countries with an order of magnitude less deaths per capita than the UK.

There's little rhyme or reason to why some have done well and others haven't. Mask use in the US far exceeds most of Europe. And mask use in China far exceeds that of the US.

UK and Denmark have similar testing per capita, and yet UK was slaughtered compared to Denmark. Japan's testing rate has been near bottom, but their deaths per million are exceptional.

And on and on the contradictions grow.

What you mention works well in the first 72 hours if you can control bordres, but beyond that you are screwed. Mostly because contact tracing requires so much effort. Contact tracing once you have a few hundred cases is largely futile. Especially if the borders are porous.

US border cites are hotspots right now because they are porous as hell.

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The UK was a leader in AIDS research, something many have forgotten. I have friends who spent years in the UK doing research. Why the UK as opposed to the US? Just wait for Americans to realize that America has been funding "genetic engineering" in the search for a coronavirus vaccine. One thing about America is the heterogeneity.

Why do you put those words in quotes? A deep state conspiracy theory, an anti-science anti-vax theory, a secret eugenics program? Forgive my lack of caffeine earlier in the day, but I'm not catching your drift.

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"Which country has had the best response to the coronavirus?"

Going strictly by the official data, it would be China. But yeah, it's unlikely that the official data is accurate.

But in any case, China's authoritarian actions were effective in vastly slowing the spreading of the disease. Welding the doors shut on buildings with infected people inside with an armed guard at the only remaining entrance was probably very effective in lowering the transfer rate. Granted, there were probably more than a few anonymous Chinese that died in fires without a way to get out, but on a purely Utilitarian approach it was probably a net gain.

China's burying of information, sanction of front life physicians, and outright lies are responsible for >95% of Covid deaths. Had the CCP merely let their own physicians do what they thought would be in the bet interest of their patients and Chinese public health, the death toll would be an order of magnitude lower.

The CCP electing to do things which result in the deaths of large masses of people and destroying large amount of other country's wealth? It is starting to look like a defining feature of the party.

Granted, China's response was horrible from a third party or personal liberty point of view. I should have been clear that I'm not saying that anyone should emulate them.

China's response was horrible from any perspective. It traded away the early response time for image management. It made any non-draconian "solution" impossible and prevented some of the simplest steps (like proper use of PPE) impossible in critical early stages.

Welding people into apartment blocs is a highly reactive step and is completely worthless if you miss enough cases to spark further outbreaks or if you let the virus leak abroad where it might be reintroduced.

The only thing that makes any sense for the Chinese response is that a bunch of CCP idiots decided that public image was more important than listening to their own physicians. This let the problem undergo more rounds of unfettered exponential growth than anything else in the world combined.

And certainly their approach has sold out the long term as many people will be less likely to accurately report their symptoms when it might mean incarceration and uncompensated loss of work.

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As opposed to Trump pretending COVID-19 was not going to be a problem and ordering the halting of testing? By the way has Summer eliminated COVID already?

The virus will disappear by April.

You pick the year, and remember, 2020 is no longer possible..

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Yep.

At most Trump can only affect the response in one country. A country I might add that literally vests authority for response at the state level and that includes independent public health departments down to the county level.

Whatever damage Trump does, it is not a global problem and he can be (and has been) counteracted by competing authorities.

Then, of course, there is the whole open democracy thing where anybody in the US can say anything they like and Trumps missteps will most assuredly be called out with great volume.

Whatever Trump gets wrong, it frankly only effects his diehard followers and whatever federal resources get idled or misused.

This to do not even amount to a rounding error to the impact of the CCP withholding key information for even a day. Exponential functions are like that. The most important decisions were made in December, the CCP decided to do image management, and there is no countervailing authority in China.

I have never been impressed with Mr. Trump and while he has exceeded my expectations, those were decidedly low. Nonetheless right or wrong he is, at most, a bit player. Certainly American outcomes have not deviated significantly from Western European mean and even EU-wide the US is still doing even or better on excess mortality (this may change shortly, but not by a huge amount given the exponential nature of things). For better or worse the US is right in the middle of the pack for its peer countries and the vast bulk of important decisions were made people not named Donald Trump.

Trump certainly bears a fair share of the problems the US has encountered. If he had taken a proactive approach to masks and pushed back against the CDC policies of discouraging mask use, then the country would be better off. That's his single biggest failure with respect to Covid19.

Of course, in the likely event that Biden wins the election, we can all have fun criticizing his policies too. I'm sure the people willing to hold Trumps feet to the fire will hold Biden to the same standard. /sarcasm

Fauci on 60 Minutes on March 8 insisted that "nobody should be walking around wearing a mask." He wasn't alone, that was the "expert" consensus outside of Asia.

Everybody gets mad when Trump ignores expert advice. How can he be so dumb? Except that one time when they're mad because he totally should have ignored the experts but didn't.

That can't even be dignified by calling it 20-20 hindsight. It's just hypocrisy. Derangement, even.

Yes, I agree with that statement. I certainly don't fault Trump for everything, and the mask advice from the CDC was obviously self serving and questionable at the time.

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> Trump pretending COVID-19 was not going to be a problem and ordering the halting of testing

We just crossed 50M tests. Trump got to 30M tests in the time it took Obama to hit 1M tests. Pick another example.

And the list is long of everyone, from WHO to Fauchi to Birx to CDC and FDA rank and file being so so wrong on just about everything. Wear masks, don't wear masks. Close borders, keep 'em open. Lock down versus go out. 5M dead. Blahblahblah.

That is their job--to be right about all things pandemic related.

Trump is a businessman. That said, his track record for predictions is practically indistinguishable from the experts.

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Speaking of China, they are mostly concentrating on the traditional approach to vaccines. Will a large swath of Americans insist on the Chinese vaccine?

I don’t know Ray, do people also refuse the HPV and HepB vaccines?

This is facepalm level stupidity

Many Americans reject the HPV vaccine in practice.

Refusal rates as high as 27%
The HPV vaccine is one of two vaccines that can prevent cancer, but the two-dose HPV vaccine recommended for 11- and 12 year-olds is regularly refused by parents, say family physicians (FPs) and pediatricians included in the Pediatrics study.

Researchers from the University of Colorado Anschutz Medical Campus surveyed 302 pediatricians and 228 FPs regarding their HPV vaccination practice in 2018. Though 83% of pediatricians recommend the vaccine for 11- or 12-year-olds, only 63% of FPs do the same.

The survey revealed that parents of 19% of girls and 23% of boys ages 11 and 12 who were seen by a pediatrician refuse the vaccine, and the percentages jump to 27% for girls and 26% for boys among FPs.

"We're seeing a lack of understanding from healthcare providers about the need for vaccination early in adolescence and high rates of refusal on the part of parents," said Allison Kempe, MD, MPH, lead author and professor of pediatrics at the University of Colorado School of Medicine in a press release on the study.

"The vaccine is underutilized, with less than half of American adolescents completing the vaccination. We need to maximize methods of introducing the vaccine that we know to be more effective, as well as the use of reminder and delivery methods at the practice in order to improve this rate." www.cidrap.umn.edu/news-perspective/2019/09/studies-say-hpv-vaccine-refusal-misinformation-common

That’s well and all, but also irrelevant.

The question is whether Americans refuse HPV and HepB (92% rate) vaccines because of “genetic engineering”

American hang ups about STDs is different issue entirely (yes it’s equally stupid).

I’m open to evidence re HPV vaccine refusal due to those factors but I’ve never seen it

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The HPV vaccine is fairly expensive. Cost is clearly a factor there.

Anecdotally, it is also very painful and had one of the worse completion rates once started I have been told. I have also been told by pediatricians that folks refuse all manner of vaccines because they do not like having their kids in pain so that may also be a factor.

Or else all of the girls I have known who have received it (a half dozen around the age of my daughter) were exceedingly lucky.

And this is the very first time hearing about it being particularly painful - the one that caused the most (mild) pain for my daughter was TB, which she received at around 10. All vaccines can be painful, or is that commonplace knowledge no longer commonplace?

Any parent who does not like having their child suffer short term consequences for long term gains (and cervical cancer is not a joke for weomn, though much better handled in the last 40 years through early detection) is a poor parent.

I would welcome any real data, but I do give some weight to the folks who actually administer the shots say (particularly when they also received them in their tween years).

Personally I cheat and use a dab of topical lidocaine whenever I can (time, patient, and situation dependent) with pediatric patients for shots so I cannot say how painful most shots even are to that patient population.

Regardless though, the perception is prevalent enough that pediatricians report patients not completing the series over it. I concur that part of being a parent is being the one to enforce sensible tradeoffs before the child can make informed decisions of their own, but nonetheless this reported to be an issue.

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There is nothing magic about getting the HPV shot at the age of 12. You need only get it when you decide to no longer be abstinent. If you get it at age 30, and then start having lots of sex partners, it works exactly the same.

The powers that be recommend 12 because that's when a lot of girls start becoming sexually active. Otherwise, how are you going to have that first baby by the age of 15? The time pressures are incredible.

If you trust your kids and let them decide when they want the HPV shot and to start the pill, it doesn't hurt to wait.

The objective is to eradicate HPV -- a disease that causes terminal cervical cancer in several thousand young women every year -- within another generation. In order to do that, you have to vaccinate every girl before almost all of them have sex for the first time. If people who know this area think age 12 is a safe age, that should be good enough for rational people.

I also doubt we can know to a certainty the age at which most girls lose their first sexual experience because surveys on sexual behavior are notoriously unreliable. Bill Clinton is not the only person in history whoever tried to narrowly define "sexual relations" -- an insidious virus like HPV does not care about such distinctions and can spread through intimate contact of various sorts that falls short of the Bill Clinton standard.

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Actually there is a bit of magic about the age.

HPV is most dangerous to the cells at the squamo-columnar junction. This is a boundary between two types of tissue found in the cervix. Over the course of development this boundary moves as one cell type (e.g. columnar) can metaplase into another (e.g. squamous) and structures change. Prior to puberty the junction typically lies in the cervical canal and HPV infection risks are lower even among sexually active females. During puberty the cervix everts and the junction becomes exposed in the vagina and then undergoes metaplasia due to exposure to vaginal acidity. This creates a the formal "transition zone" between the old and new junctions and is by far the riskiest place for HPV to take root, the riskiest time for infection in this zone is during the metaplastia itself.

Getting vaccinated before this transition dramatically lowers cervical cancer risk. In a world with rape, the optimal physiologic time to administer the vaccine is early enough to build immunity before the cervix fully everts but not so early that prime immune titers drop before this period. Being raped at 13 or 14 carries a much higher risk of developing cervical cancer than being raped at 9 or 10.

Now, it is also true that any sex can lead to HPV and that HPV can infect other regions of the Cervix. But from a public health standpoint, and particularly when considering the effects of non-consensual sex, biology says give it in early adolescence.

Now the optimal time for boys, so far as I know, seems to be whenever prior to initiation of sexual behavior so hey. Likewise the risk of HPV induced cancers in the esophagus and anus do not have this sort of biological basis, so again that is more the social timing issue thing.

> Actually there is a bit of magic about the age.

Actually, there isn't. The CDC recommends everyone that hasn't gotten the vaccine to go ahead and get it if, all the way up to 45. You might need to go through an extra dosing step if you are older.

As I said, if you are in a group that plans to get pregnant by 15 because that's what everyone in your social group does, then of course. Fortunately, rape in most all social circles is very, very rare.

If puberty were a significant factor, then the CDC would be recommending far younger than 12. Most girls and boys are through puberty by then.

Funny, my cervical exams would beg to differ.

Somehow the pathologists still tell me that women in their late teens/early 20s can and do have immature cellular structures on the ecto-cervix. Per the literature the average women at age 20.5 still has 8% immaturity at the cellular level in the cervix.

Puberty is a process and takes around 5 years in females to complete basic development with additional changes in things like cellular morphology for a few years beyond that as estrogen sensitive tissue expands, metaplases, etc. Cervical changes are seen in the early teen years and continue after that. Full cervical maturity is not achieved until pregnancy.

And this science matches the FDA guidelines. It was initially not approved for older women because it was not known if there was any benefit once you had gone through the prime HPV acquiring years (we do not even check the cervix in 18-year-olds because the tissue is almost certainly infected with something that will be "cured" by the immune system or tissue metaplasia). It does provide benefit, but the greatest benefit comes during the cervix's time of greatest vulnerability.

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I know, I don't know what I am talking about. https://www.scientificamerican.com/article/genetic-engineering-could-make-a-covid-19-vaccine-in-months-rather-than-years1/

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the UK has more success in publicising all its rather weak achievements. overall its handling of corona virus has been a complete shambles.

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The reason the UK was a leader in AIDS research is because the research methods were considered immoral to many Americans. Americans are stupid, and proud of it!

Good point. That's why nothing useful ever gets invented in the US.

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Details, please.

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Stumbling onto an effective treatment, and getting lucky (so far) with a promising (not yet proven) vaccine is the criteria for "best response"?

Seems like an odd matrix. I'd expect something about surge hospital capacity, adequacy and availability of supplies, ability to gather and disseminate infection and outcome data, and success at controlling the rate of spread. Perhaps weighted for economic mitigation. And sure, something about innovation and research. Perhaps also a bit about public morale.

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I see we are still not acting like economists and judging via our standard tool : SVL.

Using this there is only one answer in the west: Sweden.

+1

Value of LIfe Saved. Actually, this epidemic is teaching us that this needs to be updated to include how many years of life are lost are saved.

If a 88 year old is gonna die from coronavirus 1 year before he would have otherwise, do we keep all the children from going to school for a year to reduce his chances of contracting coronavirus by 40%?

In an election year with a GOP incumbent President? You bet your ass we do!!!

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Deaths are deaths of course.

I suspect the real shock once the smoke clears will be the impact of long term disability and shortened life span for the people who got severely ill but survived.

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Can you post your numbers?

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Going by excess deaths, the US and if memory serves the UK, are not doing particularly bad. Maybe they are just losing fewer people to heart attacks and strokes due to less stringent lockdowns, but there seems to be very little variance in outcomes based on government or government actions.

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Generally poor is an understatement. It's been woeful.

Also, the UK is several countries.

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I don't know if the editor picked the article's title, but a steroid does not stop the spread of coronavirus. Rather, this steroid may actually increase the spread of coronavirus. Specifically, this steroid suppresses your immune system. An overactive immune system can kill your own cells (eg cytokine storm), but it does actually kill more coronavirus. A steroid does not in any way kill or assist in killing coronavirus.

However, the Oxford vaccine is looking good. However, one unreleased vaccine is not enough to claim "more than any other to stop the coronavirus". That's probably Taiwan, which inspired the world to try to act (rather than do nothing) by demonstrating effective public health measures (especially contact tracing, isolation, and symptom tracking).

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Given a choice of being good at public health response to a pandemic or being good at innovating vaccines and medical treatments, I would say: Why can't we do both? Is that too much to ask or impossible?

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Glad to see Tyler endorse the notion that a single-payer NHS style system is not incompatible with innovation in bio-tech! So, would expect the usual objections around here to Medicare for All to just melt away as clearly one can cover an entire population with single payer health care and provide world leading medical innovation at the same time!

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I think Bastiat would have liked this post. So often we focus on the seen in a time of crisis--the lockdown mandates, the tracing protocols--and lose track of the unseen--the nurturing of the systems that produce ground breaking technologies.

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Is this some kind of Joke? Sweden had by far the best response and it's not even close. How is there even a debate?

No impact on human rights. Science based. No Fear. They are done with the virus and have herd immunity with fewer deaths than the UK (per million).

The Swedish population is not cowering behind masks worrying when Covid is going to rear it's head (like New Zealand). Done with covid, kids in school, no mandatory masks. Sweden was just as great as we predicted.

I guess people are just dying to annoy denialists. It is great how the excess deaths don't affect "human rights". Deanialists have taken the Stalin path: "where there's a man, there's a problem. No man, no problem".

Do excess deaths from car accidents affect human rights? How about excess deaths from kids leaving the house?

By your . . . ehem . . . "Logic" . . .we should just lock kids in a pillow padded room because then they'd never have a chance to die and affect human rights.

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Sweden has negative excess mortality overall. Deaths w Covid is a fake number, uncomparable across countries. Excess mortality is a real number.

Not really.

https://www.euromomo.eu/graphs-and-maps

Another compilation here, with nice country comparison

https://www.economist.com/graphic-detail/2020/07/15/tracking-covid-19-excess-deaths-across-countries

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"Sweden has negative excess mortality overall. "

-1, Sweden clearly had a positive excess mortality

https://ourworldindata.org/excess-mortality-covid

Graph about 2/3rds down shows Excess mortality or many countries

Which chart are you looking at? The Economist charts?

Seems like Norway and Denmark are doing much better--though given Sweden's approach, it wants to be judged at the end of the race not the start.

Positive excess mortality means the opposite of what you think it does

So, looking at the Economist charts, you are saying Mexico City is doing great? Followed by Peru?

........seriously?

Reread Anon's comment, Jwatts' reply to Anon, your response to Jwatts, and my correction and try again

Ah, I see the problem. I was referring to Anon, not JWatt.

I take it JWatt, you, and me, agree Sweden has positive excess deaths by the charts, meaning more deaths than average expected.

Yes, Sweden had a significant amount of excess deaths compared to similar periods in previous years.

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Sweden‘s response was one of the worst. The economic damage has been just as bad as anywhere else in Europe, there is no evidence of herd immunity (not even close), and Swedes may not be wearing masks but they are not living normally and social distancing is very much in effect. Sweden is attractive to the „no masks“ cranks but no one else.

What do you think herd immunity looks like?

What would you accept as evidence other than a decree from Dr Fauci in a NYtimes Editorial?

Dr. Tegnell seems a good source.

And these are the projections of how Sweden will be getting there - "In the worst scenario, where Covid-19 was expected to follow a traditional pandemic trajectory, there could be over 4,400 more virus-related deaths.

That would nearly double the 5,646 deaths, out of 78,166 confirmed cases, so far recorded since the start of the pandemic.

However, they said a more likely scenario would see clusters of new cases around the country which would then quickly subside.

That is a scenario “we’ve seen now in different parts of the world, and which seems like something that Covid-19 is creating more than most other diseases,” state epidemiologist Anders Tegnell said.

In the report the agency noted that this was a possible scenario where “infectivity increases quickly due to people, for example, socialising more frequently,” but would then decrease “when people become aware of the outbreak and follow recommendations on distancing.”

The added death toll from this scenario was estimated at nearly 3,250.

Despite the grim projections, the Public Health Agency said there were positive signs of the epidemic slowing down.

“In Sweden, the positive trend with a fairly quick decline in cases continues,” Tegnell said, noting that especially serious cases in need of intensive care were down to a handful a day.

In the mildest scenario presented, in which the spread of the virus follows current trends, just over 1,100 additional deaths were expected."

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Can you show us how Sweden has achieved herd immunity?

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I looked up the unemployment impact yesterday. Sweden's unemployment went from close to 8% to a bit over 9% iirc. Maryland, which has comparable death rate, went from under 3% to 10% and now to 8% (and I assume that MD is doing much better than most states on employment, due to the nature of its economy).

I'm not sure what other metric I would do to measure impact - unemployment is the best proxy I can think of.

So two key differences. First, Maryland employment is now at European levels, whereas in Sweden the change was nowhere near as dramatic. Second, Sweden never locked down. These two are not unrelated, obviously. (My county just announced no kids in school until 2021 - as if Covid is a danger to children).

Finally, going forward, Maryland's Covid performance will probably worsen relative to Sweden's since things were locked down here.

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A lot of cognitive dissonance in this subthread---can anyone point at actual data?

Generally, no. When the data is incomplete, it is incomplete. Talk, no matter how certain or how outraged or how technical can't change that.

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Is the whole Neil Ferguson fiasco not part of the UK coronavirus response?

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Tyler's essay is fine. It acknowledges that the public health policy in a country is first about preventing deaths in that country. It makes the utilitarian leap though that the most deaths will be prevented on a global basis by innovation.

As others have noted, this perspective depends a bit on the relationship between national borders and the various forms of effort at innovation that may be taking place within borders. In most countries there are both public and private efforts ongoing. And certainly, as others have noted, there is certainly evidence that both public and private efforts can be effective.

So this would reinforce my belief that you don't want to ideologically pure an economy, saying that public/private entities should always/never do a thing. There are benefits to mixing it up.

(Possibly if public labs are too centralized they should be split into north, south, east and west labs, with high autonomy.)

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Too contrarian TC! British research has, er... benefitted from large sample sizes though, in ways that would be much less possible if the diseases progress through the pop were much slower. Another element to "flatten the curve" tradeoffs...

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If only petty politics didn't get in the way:
Hydroxychloroquine could save up to 100,000 lives if used for COVID-19: Yale epidemiology professor

https://www.foxnews.com/media/hydroxychloroquine-could-save-lives-ingraham-yale-professor.amp

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In related news:

"The true number of coronavirus cases in the U.S. could be anywhere from six to 24 times higher than the confirmed number of cases, depending on location, according to a large federal study that relied on data from 10 U.S. cities and states."

"In seven of the 10 sites, the estimated number of cases was 10 times the number of reported cases.

The study was based on tests from more than 16,000 people across the 10 sites, but one limitation is that it relies on old data. The San Francisco samples were collected from April 23 to 27, while the New York tests were on blood from March 23 to April 1. The latest tests were conducted in May, "

"Still, the data reflect what CDC Director Robert Redfield recently said — that true case numbers are 10 times higher than confirmed diagnoses. Confirmed cases in the U.S. stand at more than 3.8 million."

https://www.statnews.com/2020/07/21/cdc-study-actual-covid-19-cases/

If that ratio still holds true, then close to 40 million American's have had the disease and it explains why it's going to be difficult to stop the further spread until the disease transfer rate starts dropping due to viable hosts.

Could you imagine how outdated that data would be if another president was in charge?

-1million

Trump is a clearly superior president, especially since he inherited the corona mess from Obummer.

“The Obama administration made a decision on testing that turned out to be very detrimental to what we’re doing, and we undid that decision a few days ago so that the testing can take place in a much more accurate and rapid fashion,” Trump said at a White House meeting with airline executives in early March.

“That was a decision we disagreed with. I don’t think we would have made it, but for some reason it was made. But we’ve undone that decision.”

You are probably such a Obummer fanboi you don't even know what decision Trump was talking about back in March.

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+1

This was always going to be the case for the US. The probable outcome is that regions have a similar (but milder) experience to the NE. Eventually the number of people likely to catch it (for both behavioral and other reasons) declines enough where it enters a steady state.

Prediction markets have the US at about 230k total deaths in 2020.

This dude. Seriously look at what he believes, and how he feeds that back to his complacency on US response. We'll have 230k deaths, he says, and that's the best it ever could have been.

Similarly, he suggests no possible policy to improve that outcome.

Saving 81k people with an average age of 81 is not worth locking down a country of 350 million until a vaccine is found.

Needs both more precise definitions and more math. Until then it is just a vague claim.

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"Saving 81k people with an average age of 81 is not worth locking down a country of 350 million until a vaccine is found."

+1

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We've been over this dozens of times. I make (accurate so far) falsifiable predictions and you attack me without offering any of your own. It's getting boring tbqh.

You cannot wish away public choice constraints. Magical thinking is not a policy.

Is it magical to think that for any two policies, A and B, one might have less dire outcomes?

Is it magical to think that we as citizens should seek and support such less bad plans?

Or is it magical to think that because "public choice" all plans and all leadership options are equivalent?

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Note also readers that this guy believes "predictions" are more valuable than better public policy.

What are you even talking about? There are public choice constraints to policy. That's what I have been saying for months.

Sure, in the absence of public choice constraints you could simply weld doors shut until a vaccine comes out. Or arrest anyone who walks around without an N95 respirator. Or give everyone who tests positive an ankle monitor and fine them $30,000 if they break quarantine. Or set up internal checkpoints and a visa system to prove you're allowed to be outside and enforce with threat of imprisonment.

The entire point is there are public choice constraints, these constraints vary from public to public, in a low trust society the public choice constraints are quite restrictive, and any policy that tries to go outside the bound will be 1) short lived (lockdowns) and 2) willfully ignored by a large % of the population (mask requirements and social distancing)

Willfully misconstruing my point is ridiculous on its face

So you are claiming that for "a society" there is only one outcome, regardless of plan or leadership, because "public choice?"

That is, no "society" at a given level of "trust" could benefit from an alternate plan?

Reread my comment and try again.

The bottom line I think is that you have never ever suggested a change in national policy.

You have only joined discussions to say that such changes are futile because levels of "trust" and "public choice."

For instance, if Donald Trump tomorrow morning put Fauci on stage at the White House and gave him full-throated endorsement to manage the pandemic from here on out, your claim is that that would make no difference?

Or do you think it is worth a shot?

Reread my original comment and try again.

For instance, if Donald Trump tomorrow morning put Fauci on stage at the White House and gave him full-throated endorsement to manage the pandemic from here on out, your claim is that that would make no difference?

Do you have a plausible causal mechanism for this having a measurable effect? i.e Is there a set of federal policies within the bounds of public choice constraints that is being deliberately ignored?

Your thought process needs more Tolstoy and less 'Great Man of History'

First of all, before I expand, I hope you understand that you have a very unique worldview, one that is not shared widely in the world. Most people are concerned about leadership because they want leaders to actually lead and do things. They understand that those leaders make choices, and that the choices have lasting impacts.

Now on the mechanism, isn't the easiest claim that "politics is a complex system?"

As such it is extremely sensitive to initial conditions, down to what soup was served in the Congressional cafeteria.

First of all, before I expand, I hope you understand that you have a very unique worldview, one that is not shared widely in the world. Most people are concerned about leadership because they want leaders to actually lead and do things. They understand that those leaders make choices, and that the choices have lasting impacts.

Most people believe the President is infinitely more important than he actually is. Look at all the idiots claiming Trump or Obama 'saved' or 'destroyed' the economy. It's idiotic. Many (if not most) people do not have a mental model of the world outside of 'my tribe is president good'

We've gone from 'what policies would Fauci initiate' to 'what soup is served', so I think that about sums up our differences.

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Do you have a plausible causal mechanism for this having a measurable effect? i.e Is there a set of federal policies within the bounds of public choice constraints that is being deliberately ignored?

what soup was served in the Congressional cafeteria.

Sigh

Whether Hillary caught a bug? Whether Obama decided to ridicule Trump at a correspondent's dinner?

History is full of little things that cause cascade events. Hanging chads in Florida.

A butterfly flapping its wings.

Given that it is especially preposterous to think that the big things do not matter.

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You are saying that a President Romney, however different his planning and leadership might have been, would end up with approximately the same number of souls lost, because a society has one level of "trust," and "public choice?"

I don't think societies have a certain level of 'public choice' since that's a nonsensical statement.

I don't believe the aggregate dead would be significantly different under a Romney or Clinton presidency, no. But that goes back to what policies are feasible/infeasible given public choice constraints.

Well there you go.

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It could be right or wrong, but you can't test it simply by imaginingg counterfactuals for the same country and declaring that certain ones they would have been superior. (Imaginary scenarios are not data.) You can only really do it by testable predications between different states, regions of governance etc (within US, internationally, etc.)

Cross-national comparisons are the bomb, and not just for pandemic.

Not least because human nature is actually pretty universal.

Hence the massive block parties in Tokyo every night just like cities in the US.

Less sarcastically, comparisons between countries are indeed the bomb mostly because it allows us to tease out the aggregate result of millions of individual decisions.

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"Prediction markets have the US at about 230k total deaths in 2020."

Which site?

https://pandemic.metaculus.com/dashboard/#/global-epidemiology

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"...could be anywhere from six to 24 times higher..."
I see things like that, but I don't think there is any possible way to match that up with the tests-positive rates that we see in state after state. You have to assume that a high percentage of those seeking a test have some reason for doing, even if only a suspicion of being exposed. Given that, the positives rate for those tested must be higher than the overall rate, and probably substantially so.

In Australia 1.5% of known cases of COVID-19 have died from it. However, the average age of the infected was higher than the average ago of the US population, which makes for a large difference in outcomes.

If 200,000 people in the US have died from COVID-19 and it kills 0.7% of those infected, then around 29 million or 9% of the population have had it. That's 7 times the official rate. Plug in your own numbers as desired.

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These people disagree. But what would the people who proved the efficacy of using dexamethasone know?

"Professor Peter Horby and Professor Martin Landray, chief investigators of the RECOVERY Trial, said ‘In March this year, RECOVERY was established as a randomised clinical trial to test a range of potential drugs for COVID-19, including hydroxycholoroquine.

‘The trial has proceeded at unprecedented speed, enrolling over 11,000 patients from 175 NHS hospitals in the UK. Throughout this time, the independent Data Monitoring Committee has reviewed the emerging data about every two weeks to determine if there is evidence that would be strong enough to affect national and global treatment of COVID-19.

‘On Thursday 4 June, in response to a request from the UK Medicines and Healthcare Products Regulatory Agency (MHRA), the independent Data Monitoring Committee conducted a further review of the data. Last night, the Committee recommended the chief investigators review the unblinded data on the hydroxychloroquine arm of the trial.

‘We have concluded that there is no beneficial effect of hydroxychloroquine in patients hospitalised with COVID-19. We have therefore decided to stop enrolling participants to the hydroxychloroquine arm of the RECOVERY Trial with immediate effect. We are now releasing the preliminary results as they have important implications for patient care and public health.

‘A total of 1542 patients were randomised to hydroxychloroquine and compared with 3132 patients randomised to usual care alone. There was no significant difference in the primary endpoint of 28-day mortality (25.7% hydroxychloroquine vs. 23.5% usual care; hazard ratio 1.11 [95% confidence interval 0.98-1.26]; p=0.10). There was also no evidence of beneficial effects on hospital stay duration or other outcomes.

‘These data convincingly rule out any meaningful mortality benefit of hydroxychloroquine in patients hospitalised with COVID-19. Full results will be made available as soon as possible."

www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19

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Is it okay to point out that this blog post is inconsistent with the heterogeneity case Cowen has made since the outset of the pandemic. My concern, as I've voiced many times, is that we are racing down the tracks to a wall and don't see it. What if I pointed out the inconvenient fact that the approach to producing coronavirus vaccine by the researchers being funded by America has never produced an approved vaccine. Innovation requires a break from the past, and I agree. But when the Republican evangelical Christian base rises up, you can expect the Republican politicians to rise and fall with them.

It is also a break from old innovation per capita arguments. It pretty explicitly buys into the idea that with rapid global propagation one good innovation is all you need (for one problem).

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There are several different vaccines being funded by the US government using a variety of methods. I have no idea what Evangelicals have to do with any of this.

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LOL. Still ignoring Japan, I see. Old, dense, massive public transportation, no broad lockdowns or overreactions.

They don't turn into Karens when asked to wear a mask.

Well, isn’t that relevant to how they handled it?

Our country wouldn’t have bucked masks so hard if 1) our experts didn’t spend months making fun of them, and 2) they were alternatives to lockdowns instead of icing.

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Sweden isn't as dense but people otherwise compare the two. Yet Sweden has had 554.44 deaths per million population while Japan has only had 7.81. There is much more than policy going on.

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I wouldn't say it is furthest along. The vaccine is in phase 1. There's plenty of competition in phase 2 and 3 now.

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It would be nice to know how the Oxford vaccine team voted in the referendum.

Brexit wasn't likely to make their job any easier.

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We all agree that a country's principle duty is to for globally significant inventions and discoveries and not to protect its citizens, right? Oxford is now an arm of the government? I'm a bit confused about categories here. I'm also thinking ~4 months is simply not long enough to be able to wisely judge/rank "early" response by the sovereign nations. I'll file it under "wild-ass speculation". The early US response has been disappointing and I'm guessing will have long-term consequences for our health "system". (medical-pharmaceutical-hospital complex)

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NHS. Its infrastructure enabled the datasets that made much of this possible.

State capacity the US doesn't have, and refuses to for some reason.

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Wasn't there a comment praising TC's integrity by citing how effectively the NHS has been in developing new treatments?

+1, I don't know, but there should be. Tyler isn't afraid to point out things that undercut his stated stances

Charles' comment above, and no it has not been deleted

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India (22 deaths per 1,000,000 is a stunning achievement) is turning the corner rapidly has been the global leader in medical prophylaxis supplying dozens of developing nations with much needed medications.

She has also created innovative infection compensation for health care workers and LPG gas access to lower income that will permit water boiling in support of sanitary practices.

https://home.kpmg/xx/en/home/insights/2020/04/india-government-and-institution-measures-in-response-to-covid.html

Fixed it for you:

22 recorded deaths per 1,000,000

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Regarding the last paragraph, is TC implying that you can't have both? The panic, chaos, and "scurrying" is necessary for beneficial innovation? Maybe, but it would be great if humanity could get better at this at some point.

I guess libertarianism takes the trade-off as a given, and not worth trying to avoid. Maybe we can get beyond that.

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How absurd. The UK had the second death rate among all developed nations --- exceptionally high. The UK was second behind Belgium.

President Trump claimed the USA had one of the lowest death rates.
Chris Wallace Claimed the USA has had the seventh highest death rate ---
https://townhall.com/tipsheet/guybenson/2020/07/20/fact-check-president-trump-vs-chris-wallace-on-coronavirus-death-rates-defunding-the-police-n2572736

Both are wrong. Out of 144 nations the USA comes in at Rank 32 with most European nations having higher death rates. Austria and Norway had death rates lower than the USA.

Since accuracy of reported data is so suspect in the majority of nations, it's misleading to compare number of cases and number of deaths by nation.
Having said this I will report the following in any case because it's consistent with the Johns Hopkins Data

Coronavirus (COVID-19) death rate in countries with confirmed deaths and over 1,000 reported cases as of July 17, 2020, by country ---
https://www.statista.com/statistics/1105914/coronavirus-death-rates-worldwide/

The mortality rate is indeed low in the US.

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People mean different things by death rate. Chris Wallace was almost certainly referring to deaths per capita and he was probably correct at the time he made the statement (the U.S. is now number 8).

Case fatality rate is not a very interesting number for non-doctors because there are too many factors that influence it. For instance, a country far along in an outbreak will have a higher CFR than one that is just experiencing its first wave because it takes 2-3 weeks for the virus to start killing people. Testing will tend to lower CFR as well. The U.K.'s CFR is about seven times that of South Korea -- most of that is probably due to South Korea's success at testing early. And, of course, all mortality measures are heavily influenced by the age and health profile of people who are infected.

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How absurd. The UK had the third highest death rate among 144 nations, with Yemen being at Rank 1 and Belgium being at Rank 2

President Trump claimed the USA had one of the lowest death rates.
Chris Wallace Claimed the USA has had the seventh highest death rate ---
https://townhall.com/tipsheet/guybenson/2020/07/20/fact-check-president-trump-vs-chris-wallace-on-coronavirus-death-rates-defunding-the-police-n2572736

Both are wrong. Out of 144 nations the USA comes in at Rank 32 with most European nations having higher death rates. Austria and Norway had death rates lower than the USA.

Since accuracy of reported data is so suspect in the majority of nations, it's misleading to compare number of cases and number of deaths by nation.

Having said this I will report the following in any case because it's consistent with the Johns Hopkins reported death rates.

Coronavirus (COVID-19) death rate in countries with confirmed deaths and over 1,000 reported cases as of July 17, 2020, by country ---
https://www.statista.com/statistics/1105914/coronavirus-death-rates-worldwide/

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Brazil has now approved 3 vaccines for human trials ando so must be considered the best in that regard: https://www.dailymaverick.co.za/article/2020-07-22-brazil-approves-human-trials-for-third-covid-19-vaccine/#gsc.tab=0

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Unfortunately too early to say. Comparing numbers when The US may be xx% of the way to "resolution" while Sweden may be yy% of the way toward resolution, Brazil maybe zz% of the way to completion is challenging. Further the variability of the methodology/accuracy of accounting for covid deaths is probably inconsistent enough across countries to add in a lot more error. So I think excess deaths should be the ultimate health measure. Unfortunately that seems to lag at least a month.

At then end of the day, I suspect the differences in outcomes due to government policy will be dwarfed by demographics differences in age, genetics, prior health etc.

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That's fair, but the US has done a lot more work on self driving cars and space exploration.

If you are judging the medical research response to COVID, maybe the UK is not doing too poorly. If you are judging the public health response, they are behind the curve. If you are judging the long term issues of automation to keep drivers from getting COVID and moving on to planets without COVID, then USA, USA!

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Lithuania: https://youtu.be/gUC87kAEkf0

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But how do you assign national credit for innovation? Is it just by where it physically occurred? The government that approved it? Who paid for it? The nationality of the key researchers? The line researchers? The journal that published it? The first person who thought up the idea?

Innovation has many, many fathers. It's very often a global effort. I don't think it is meaningful to assign credit, let alone apportion that credit out to countries.

Especially as the British government is doing everything to damage research, like leaving the EU, leaving Erasmus+ and making immigration harder.

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Sweden. They're the only country that didn't wildly overreact, and without their example other countries would still be legitimately terrified of opening up.

What a weird thing to write. Australia clearly under-reacted to the threat given what we know now. As Sweden's death rate per capita is over 100 times greater they have been so far below reacting appropriately Elon Musk's Boring Company would have trouble reaching it .

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Austria started reopening in mid-April, before Sweden even reached the first 1000 of its 5660 dead.

Can't say I know much about Austria, but they certainly have done better than a lot of other places. Not as well as Aust-ralia, but then they probably enjoy licking each other's faces more than we do.

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Australia has had 128 COVID-19 deaths so far while influenza deaths are down by almost 300 compared to this time last year. Over a 90% drop. Since Australia's Coronavirus response has resulted in net reduction in lives lost at far lower economic cost, I'd say we've come out ahead of the UK. Of course, we're too stupid to have had the best response. (Check Victoria's situation.) I'd say the best would be Taiwan, which has done extremely well despite close ties to China.

Specious comparison given the difference in travel intensity, population density, aged population in care homes etc. The UK gets 5 times the number of international visits.

The United Kingdom's lower urbanization rate doesn't give them that much of an advantage.

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Kansas too, they just finally ticked over into excess deaths this week

variance between deep red and deep blue US House districts is probably larger than between the US and any other country

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Even Boris Johnson thinks that this is dumb.

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Mongolia
https://fsi.stanford.edu/news/lessons-mongolia%E2%80%99s-covid-19-containment-strategy

New Zealand

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I found the response in Portugal impressive.
I was living in a remote cabin in a small village on an island in the Azores, in the middle of the Atlantic at the height of the pandemic.
Yet even in that remote corner of the world, the government delivered face masks to me: https://andreasmoser.blog/2020/05/12/facemask/

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Please stop trolling. The work UK researchers are doing on the vaccine front will be a tremendous boon for the part of the population that hasn't already been eviscerated which is much higher in the UK than elsewhere. Meanwhile, Vietnam, which has a population of 97 million people, limited health-care capacity and a border shared with China, has had fewer than 400 confirmed cases of COVID-19 and zero deaths.

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so what you are saying is ------- it is almost as if the evildoers who unleashed this thing on humanity designed it to target some populations and leave other populations alone

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UK was also one of the only countries to notice the extremely strong Vitamin D correlations and act on it

oddly far too few are paying attention to the synthetic antibody trials, results are due from Lilly Aug 12th and many others are in trials... may be only weeks away from US COVID deaths beginning a steep drop to nearly nothing

vaccines will get here eventually, but synthetic antibody treatments may make them an afterthought

note that it's quite a bit easier to produce and distribute 300K doses of a cure (there are reportedly already around that many available for what is in trials, depending on dosing) than 300M immunizations

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