Why hasn’t coronavirus been able to succeed in Laos, Vietnam, or Cambodia?

From The Google:

  • Vietnam population: 95 million
  • Laos population: 7 million
  • Cambodia population: 16 million

Number of deaths from Covid-19 so far among these nearly 120 million people? WHO data: 0.

People in these three countries can be smarter than Americans and Europeans, certainly. So perhaps they have managed coronaplague better than Americans and Europeans. But is it reasonable to assume that they’re infinitely smarter? That’s the assumption that we would need to explain an actual death rate of 0.

Maybe these countries are not good at testing and diagnosing Covid-19 compared to Americans and Europeans. But can they be infinitely bad at testing and diagnosing? That’s the assumption that we would need to explain a reported death rate of 0.

Unlike New Zealand and some similar success stories featured in our media, these countries are not islands, protected from immigrating viruses by a Trump-style wall of ocean. They are snuggled up against China, the original source of the “non-Chinese virus”. China is a big trading partner for these countries.

Readers: What could account for 0 deaths out of 120 million population? A mostly immune population due to previous exposure to a similar virus?

38 thoughts on “Why hasn’t coronavirus been able to succeed in Laos, Vietnam, or Cambodia?

  1. Look at their reaction when they have an outbreak! Just had cases in Da Nang (major domestic tourist spot). They clamp down quickly and with resolve. None of this wimpy “I won’t wear a mask – I have rights” stuff.

  2. I am no scientist, but I think it would be an interesting study to see how many people in this region have already been exposed to other coronaviruses and whether that is playing a role in low transmission/virtually no deaths. Or, did the ‘milder strain’ of covid-19 actually sweep through the region in November/December/January. (And then, was there a fateful combination of populations who already had a degree of ‘protection’ from prior coronavirus exposure, followed by introduction to the ‘milder strain.’)

    It does seem like pre-existing health conditions play a huge role in whether or not people have severe covid-19 reactions, and it may be that these populations are generally healthy compared to their Western counterparts, at least when it comes to obesity. (And maybe other co-morbidities like diabetes and heart disease?) Perhaps there is an aspect of their diets playing a role. However, they also are very covered up in the sun (so hard to know if they are getting much vitamin D), often live in highly polluted cities (and ride around on motorbikes through the thick clouds of smog), and smoke, so it is hard to gauge how much healthy aspects of their lifestyle aren’t being offset by other aspects of daily life.

    Cambodia at least has a very young population, with the average age being 26 or 27, a sad byproduct of a huge swath of young adults in the country being annihilated under Pol Pot in the ’70s. It is likely a much-younger population may have helped many cases simply go unnoticed as they may have been highly asymptomatic (or people simply had very benign symptoms which they did not think much of).

    My guess it is probably previous exposure to another coronavirus (or many!). Having travelled extensively in Southeast Asia in 2015 where I got one of the WORST colds of my entire life, I am hoping this is true and I am now protected from the coronaplague! The cold was so bad I ended up googling about it and discovered travel forums where people discussed how it was inevitable after spending some time in SE Asia to get hit with a really devastating cold because there were strains you’d never been exposed to as a Westerner so you didn’t have the same immune defense as the locals. Wish I had saved a link to the forum!

  3. This was a very interesting post. I didn’t know this.

    I don’t have the answer, but it is curious. Perhaps there is something about their genetic makeup or even prior exposure, as you say.

    Taiwan also had very few deaths, and tons of exposure to travelers from China. In their case, a strong public response helped, including masks.

    What we’ve learned, once again, is that humans are very bad at understanding exponential growth. Once something like this gets rolling, it grows very quickly.

  4. They’re communist countries. Well, Cambodia claims it’s not communist, but it’s communist. North Korea doesn’t have any, either. Their antivirus measures have also stopped defections:

    https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_Korea

    “The underground network that assists defectors in escaping North Korea has been almost unable to operate amidst strict controls implemented to stop the virus, with defection attempts being suspended.[49]”

    “Ask a Comrade, Comrade!”

    http://en.dangcongsan.vn/activities-of-the-party-and-state/pm-urges-tightened-border-control-in-wake-of-new-local-infection-of-covid-19-557311.html

  5. They have nearly all been previously exposed to similar viruses.

    “Even though we cannot exclude that some SARS-CoV-2 reactive T cells might be naive or induced by completely unrelated pathogens, this finding suggests that other presently unknown coronaviruses, possibly of animal origin, might induce cross-reactive SARS-CoV-2 T cells in the general population.”
    https://www.nature.com/articles/s41586-020-2550-z

    “Wang thinks a version of the virus may have circulated earlier in humans in southern Asia, perhaps flying under the radar because it didn’t cause severe disease. “If it happens in a small or remote village, even with some people dying, nobody is going to know there’s a spillover,” Wang says.”
    https://www.sciencemag.org/news/2020/07/pandemic-virus-slowly-mutating-it-getting-more-dangerous

    • And more:

      “In light of the recent emergence of SARS-CoV-2, our data raise the intriguing possibility that such pre-existing S-reactive T cells represent cross-reactive clones, probably acquired in previous infections with endemic HCoVs. HCoVs account for approximately 20% of “common cold” upper respiratory tract infections, are ubiquitous, but display a winter seasonality. Based on epidemiological data, it may be extrapolated that adults contract an HCoV infection on average every two to three years. Protective antibodies may wane mid-term but cellular immunity could remain.”

      “Our study reveals pre-existing cellular SARS-CoV-2-cross-reactivity in a substantial proportion of SARS-CoV-2 seronegative HD. This finding might have significant epidemiological implications regarding herd immunity thresholds and projections for the COVID-19 pandemic. Our results provide a decisive rationale to initiate worldwide prospective studies to assess the contribution of pre-existing, potentially region-dependent SARS-CoV-2-cross-reactive immunity to the diverse clinical outcomes of SARS-CoV-2 infections.”

      https://www.nature.com/articles/s41586-020-2598-9

  6. Maybe they’re doing the opposite of the US and various European countries, and categorizing people with severe health problems who die with a Covid-19 as having died of the severe health problem?

  7. What you said at the end. Immunity in the region has already been well established.
    The Economist has a story: “…something resembling sars-cov-2 might have been circulating in the region before the pandemic began also comes from another intriguing observation: the low incidence of covid-19 in South-East Asia, particularly in Vietnam.”

  8. These are countries on the way up where the people have faced adversity and know they need to work together to respond to it. Conversely, America is a nation in decline full of people making poor decisions because they think nothing bad can ever happen to them.

    All of the theories about a prior virus going around and providing immunity are completely without evidence. The only known similar virus in humans is SARS-CoV-1 which was never very widespread.

    • Also, it’s very unclear to me why, after watching SARS-CoV-2 spread around the world, someone would think that this supposedly similar virus circulating in Southeast Asia wouldn’t behave exactly the same way.

  9. > Maybe these countries are not good at testing and diagnosing Covid-19 compared to Americans and Europeans.

    Bill Gates says most of our coronavirus testing “is just complete waste” because the results take too long to get back. Anyone who’s ever had to wait four hours at the DMV (e.g. in California) to get a driver’s license shouldn’t be at all surprised that our government’s public health response has been a complete and total clusterf*ck.

    https://www.newsweek.com/bill-gates-says-majority-us-coronavirus-testing-complete-waste-because-it-takes-too-long-1521006

  10. Philips u got it wrong!

    The fact most of ’em not smart is what save ’em.
    Cause they’re not smart they tend to follow and abide the gov who they think is smarter than ’em.

    It’s easier to rule those self identifying fools then those who think they’re smarter than u.

    • Vs. the US, which has been a giant, colossal clusterf*ck the entire time. We have people here cheering whenever other countries run into problems again (at a much smaller scale than we’ve had the whole time) because they don’t want to admit that >150,000 Americans have died for no good reason.

    • @Ryan

      What is it that could have been done at the Federal level that would have prevented the spread of the novel coronavirus in United States?

      The scam about masks not working was an international one, with WHO in on the game, to help prioritize masks for health care workers.

      The federal government was accused of racism when they first banned flights from China. This was a pretty partisan accusation. They could have banned flights from Europe earlier I suppose, but it is very likely community transmissions were common in the northeast even before flights from China were banned.

      I have heard about incompetence in tracing travelers from foreign countries, but what do you expect when probably half of all government workers are there due to nepotism or affirmative action?

  11. Only mostly off-topic: the Coronagod, who is a jealous god, has hurled righteous vengeance on another heretic for failing to offer human sacrifice by means of lockdown.

    As in Bolsonaro’s case the vengeance has turned out to be feeble. Maybe one day some heretic will be made a real example of penitential suffering!

    • Thanks, Lord P. The article is interesting because it provides no context for the death toll in Belarus. It is published in the UK, but it does not mention that the UK death rate so far is 690 per million while the no-shutdown infidels in Belarus are at 57 per million (i.e., 99.93 percent of Britons remain alive while 99.994 percent of Belarusians may yet live to see the second most glorious day in human history (the defeat of Donald Trump, of course, in November!)).

      https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/

    • Former Soviet block countries are an interesting case. I am rather well familiar with Russia and Ukraine habits, customs and mores and expected rather terrible situation there given those habits, in the countries where the majority of people have a somewhat fatalistic attitude, sort of “чему бывать, того не миновать” (que sera sera).

      However, they all, especially Ukraine, are doing pretty well in comparison to this country. I have no idea why this is the case. I do not think they massage their corona statistics much. Russia, perhaps, but other two countries, hardly. There are renewed attempts to explain differences between countries’ infection/mortality rate differences with the BCG vaccination adoption level . The vaccination was compulsory until recently? in the former Soviet block countries:

      https://medicalxpress.com/news/2020-07-preliminary-tuberculosis-vaccine-limiting-covid-.html
      https://www.nature.com/articles/s41419-020-2720-9
      https://www.pnas.org/content/117/30/17720

      Here are some recent pictures (for those who cannot read Russian) from the city of Odessa showing their level of masking and social distancing that my sources on the ground there confirm.

      https://strana.ua/articles/special/276636-kak-v-odesse-sam-po-sebe-zakonchilsja-karantin-reportazh-stranaua.html

      Some excerpts from the article:
      “There’s nothing left from quarantine. Almost nobody wears masks here, either in the streets, or supermarkets, or taxis. ”

      “An Odessa historical center tour. There are about 20 people in the crowd., none wearing a mask. Police are not paying any attention to that”.

      “No social distancing in public places. Even pharmacists are not wearing masks. On the embankment, children are chasing seagulls and bathing in the fountains”.
      etc.

      Perhaps, they will follow TX/CA trajectory eventuall, who knows, but for now they seem to be enjoying their lives. We’ll see.

    • Ivan, thanks for those interesting observations. They are consistent with a virus that isn’t very dangerous.

      Official figures on tests, cases and coronadeaths are generally garbage. Among other reasons for mistrusting them: in England’s official figures no one ever recovers from coronaplague. If you tested positive on March 1st, recovered and died in a road accident a month later, you were part of the coronadeath count.

      According to this analysis, the winter-spring all-cause death rate in England fell after 1999. Then with coronaplague this year it jumped – to somewhere below typical levels of the 1990s.

  12. I’d suspect that a focus on contact tracing means less tests of the general public, missing infections, and not labeling people who die of something else as having died of covid-10 leading to deaths missed. However things may be changing in Vietnam:

    https://news.yahoo.com/vietnam-warns-hanoi-prepare-risk-041146378.html
    “‘Act now and act fast’: Vietnam says every city at risk of coronavirus
    …Reuters•July 28, 2020
    …Vietnam, virus-free for months, is bracing for another wave of COVID-19 infections after state media reported new cases in Hanoi, Ho Chi Minh City and the Central Highlands linked to a recent outbreak in the central city of Danang.

    Prime Minister Nguyen Xuan Phuc said the current wave of infections was different to a second wave Vietnam fought in March, and every province and city in the country was at risk, state broadcaster Vietnam Television (VTV) reported.

    Hanoi authorities said they would shut bars and ban large gatherings from midnight because of the new cases…
    The government on Tuesday suspended all flights to and from Danang for 15 days. At least 30 infections have been detected in or around the city….
    The government has not officially linked the new cases to illegal immigration, but Phuc has ordered police to strengthen a crackdown on illegal entries.”

    Meanwhile the Washington Post’s editorial board this week backed the idea of a strict US lockdown:

    https://www.washingtonpost.com/opinions/what-it-would-take-to-get-back-to-normal-by-october/2020/07/27/a8886854-d02d-11ea-8c55-61e7fa5e82ab_story.html
    ” Let’s throw the kitchen sink at covid-19 and get back to normal by October…
    What would it take? Both experts recommend a nationwide, concerted federal effort to break virus transmission, going beyond the “flatten the curve” attempts of the spring. This would be hard to do, demanding sacrifice and economic pain, but paying off in a more sustained recovery later on.
    …It would be a difficult summer. But the payoff could be normalcy in the autumn. Sure, there would be resistance. To bring off such an effort would require persuasive leadership — the kind that has been lacking for so many months.”

    Perhaps they are frustrated the economy wasn’t totally destroyed and they wish to see the job finished in hopes the editorial board can provide the leadership to guide a future senile Democratic president in how to rebuild it.

    • Skeptic: Thanks for the Washington Post link. It is funny and “would require persuasive leadership” is also consistent with what I see in my Facebook posts. People who didn’t vote for Donald Trump, who profess hatred for him and his supporters, and who sometimes express the wish that he would be killed also say that if Trump were to utter more soothing words they would like nothing better than to be lead by him. They want to follow the Great Father in Washington, even if his name is “Trump”, just as soon as the Great Father is worthy of His children.

    • Skeptic: The story about Vietnam’s recent struggles is consistent with what the former chief scientist of the European CDC said. The reward for a truly effective shutdown is fighting the same battle over and over again. Maybe the Vietnamese have the will and the means (and some pre-existing immunity?) to fight this battle once again. I guess we can cross our fingers for them.

    • How much will does it require to keep restaurants, bars, and schools closed forever because we’ve never successfully addressed the underlying problem?

  13. Knowing how much I love to dream about living free in Sweden, a reader sent me https://www.zerohedge.com/geopolitical/sweden-defeated-coronavirus-without-lockdown-now-its-companies-are-reaping-benefits

    The comments are more interesting than the story (I don’t think the economics of lockdown are relevant to Americans; how do you put a price on whether a child can go to school or an adult can go out to the gym and/or to a social event?).

    One comment: All I hear now is that what the U.S. REALLY needs to do is for every single person, all 330 million, to wear a mask for 6 weeks and this all goes away. These people really are out of their minds. Mask wearing is no guarantee of anything, and yet our moral betters are hanging their hat on it. I envy Sweden in this one regard

    A response: What do they say will happen at the end of 6 weeks, when everyone takes off the mask? The virus is still there, and no one has developed immunity from exposure to it. The idea is idiotic and dangerous.

    • Another comment: All Sweden defeated was mental illness. “The virus” is going nowhere. All that needs to be overcome is the Anglo-American tendency to punish ordinary people for every ill-fated event. Who waited in 200m lines at the airport after Sept 11? The same people. By no means everyone, just the powerless.

    • And also, from a true skeptic: Sooooo … we’re still playing the game that there is actually a real, deadly virus out there, despite faulty testing and bogus cause of death data?

      [i.e., he/she/ze/they goes farther even than Jair Bolsonaro!]

  14. I live in Thailand, where we only had 56 deaths in a country with 70 million people. (To put it in perspective, this is slightly more than the average number of road deaths per day.)
    Some people say the numbers are fake, but with social media being rampant here, there is no way they could have hidden massive deaths or hospitals full of critically sick people.
    I was between Lao and Vietnam from Feb through early March, then back to Thailand. Even in early March in Saigon, maybe 25% of people were wearing masks.
    We had tens of thousands of Wuhanese through here *after* they locked down China. That virus was here before it was anywhere else, and we actually had the first case outside of China. An elderly taxi driver with TB drove a very sick Chinese woman to Hua Hin, a journey of a few hours. He got sick and recovered.
    So there is definitely something else going on here, whether mass immunity or whatever. Certain aspects of the culture would help contain the spread. Thai’s have ridiculous personal hygiene standards, they shower multiple times a day. They rarely touch one another in day to day social life. There are essentially no ‘old folks’ homes, which seemed to be death traps in the west.
    But the global lockdown has thrown massive numbers of the population out of work. In a country where at least 15% of the economy is tourism, that is down by at least 95% for the foreseeable future. (There is a trickle of domestic tourism.) Where we normally have less than 1% unemployment, there are now 8 million out of work. There is no government safety net, nor is there a plan on what to do next. The global lockdown will kill far more people than the virus.

    • China’s also had many many fewer deaths than the US, despite having much more travel to and from Wuhan than we do. At some point, we have to stop coming up with excuses and just admit we suck and our nation is collapsing due to sheer and utter incompetence.

  15. @Ryan No good reason except for our population of 328 million. According to the statistics at Statista our death rate (case fatality rate) is only 3.39%, meaning we rank 46th “worst” in the world. We’ve got the highest number of total deaths on that list, but only because they don’t report the European Union as a single entity. If they did that we would be #2.

    You could ask why we’ve got more deaths than the billion+ nations. But no one can trust China’s numbers, and India appears to be a bit of a mystery like Laos, Vietnam, and Cambodia.

    Brazil isn’t too far off our population or total death count, and has a worse CFR. Indonesia is even closer to our population count yet by comparison almost nobody has gotten Covid-19 or died from it, though their ratio still results in a worse CFR.

    Maybe India is just getting started and will fly passed us. Maybe in Indonesia they’ve all been exposed to a close cousin of SARS-COV-19 and are already near herd immunity. Maybe Brazil just has poor case tracking and fatality assignment. Or maybe we have poor case tracking and fatality assignment given the numerous examples of people dying of things other than Covid-19 yet being marked as Covid-19 deaths.

    @Viking I can name one thing that should have been enforced at the Federal level: immediate removal of Covid-19 infected patients from nursing homes to hospitals or otherwise quarantined facilities. According to the NYT 62,000 nursing home residents and workers have died from Covid-19. This is thanks in large part to governors who issued orders that nursing homes had to accept and/or keep Covid-19 infected patients. Those orders were pretty much the equivalent of handing smallpox blankets to Indians. Where would we be on lockdowns, mask mandates, and re-opening the country if our total death count was, say, 100,000 instead of 151,000?

    Of course that raises the question of whether or not the Federal government could enforce such an order on the states. Or if they could, what the political fallout would have been.

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