Contributor Post Created with Sketch. Emergency Coronavirus Bleg

 

Good people of Ricochetti, in 90 minutes Rob Long and I will be recording a podcast with Dr. George Savage, and in the meantime we’re eager–desperate, really–for some basic facts. In a word, what, exactly, has South Korean done about the coronavirus that seems to have kept the infection rate very low in that country?

This tweet by Ben Shapiro got my attention:

Rob’s impression is that South Korea has only been able to permit people to return to work because it effectively locked down the country for a couple of weeks first. As you see, though, Ben Shapiro doesn’t mention any lockdown.

So what is it? Did South Korea engage in a lockdown, shutting down factories and businesses and sending everyone home for a couple of weeks? Or did it not?

Can someone help–fast?

Reminder: Please join us at 12PM PT/3PM ET for a live discussion with Dr. George Savage . We will take your questions!

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  1. JayMiller Lincoln

    I heard from a doctor friend that the reason it was contained was because the outbreak was confined to a small area. Not nationwide as it is here. 

    • #1
    • March 20, 2020, at 10:58 AM PDT
    • 3 likes
  2. Western Chauvinist Member
    Western Chauvinist Joined in the first year of Ricochet Ricochet Charter Member

    My understanding is South Korea has very effectively tracked the travel (potential exposure) of their people. Everyone entering the country was interviewed about their itinerary. This has helped them decide who to isolate until infection is proven or dismissed. But, I don’t have a link at the moment. I’ll hunt around.

    • #2
    • March 20, 2020, at 10:59 AM PDT
    • 4 likes
  3. Jerry Giordano (Arizona Patrio… Member

    According to this Forbes article, South Korea did not do a lockdown. The article is from a week ago.

    • #3
    • March 20, 2020, at 11:02 AM PDT
    • 3 likes
  4. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    Here’s what I posted a few days ago on this exact topic. Not a word, but the most concise way I could find to do the topic justice:

    A few major details about how South Korea was able to nip its outbreak so quickly in the bud:

    1. They got bitten by the MERS-CoV outbreak a few years back. This motivated them to come up with a serious and robust pandemic response plan. As a result, they were well-prepared and equipped.
    2. They have been testing at a rate nearly 100 times more than the US, in large part because they prepared ahead of time
    3. They pursue incredibly efficient case tracing. Known cases are required to quarantine at risk of fine and possibly jail penalties, and people who are infected are actively tracked by the government using credit card, cell phone, and car license plate data. The locations of all infected people are provided to the public by app.
    4. S. Korea got “lucky” in that it had one major cluster centered around a religious group. This made identifying and tracing the initial cohort easier than in countries with multiple smaller simultaneous clusters. Had the virus been more widely disseminated, it’s not clear their strategy would have been as successful.

    So to summarize, major reasons for Korea’s success include: a) having a robust plan and testing capacity before the outbreak, b) having a very strong central government, c) trampling their citizens civil liberties, and d) still getting a lucky break.

    Given those factors, the South Korean model can be highly informative to the US, but is not likely one we can mirror. We would need at least a month to bring our testing capacity up to speed, draw up coordinated protocols, and recruit the manpower needed for robust testing and case tracing. We would also need to suspend or revoke major civil liberties that our central to our culture.

    And even then we might not be successful, since by that point the virus would likely have spread to a degree that even the Korean measures would be too little too late.

    Bottom line: There is not a simple remedy to this threat. S. Korea’s approach is very informative, but simply copying it in the US is not realistic.

    • #4
    • March 20, 2020, at 11:02 AM PDT
    • 19 likes
  5. Hammer, The Member

    Reading Ben’s tweet, I’m not sure what he means. My understanding was that SK has engaged in some very serious and intrusive tracking of it’s people. I imagine Rob has Ben’s cell phone, or at least Andrew’s- perhaps he could go directly to Ben and ask for a more thorough explanation?

    • #5
    • March 20, 2020, at 11:03 AM PDT
    • 4 likes
  6. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    For context, I’m originally a virologist by training and have returned part-time to my former institute to help them deal with our local outbreak (which is becoming a fairly major issue).

    From the professionals I’ve talked to and from my own take, there’s simply no way to replicate the “Korean model” in the US any time soon.

    One major reason for the Korean’s success was doing lots of planning and preparation ahead of time. That horse has left the barn.

    Another reason was due to the unique nature of the initial outbreak in South Korea (a fairly tightly-knit religious community). That horse has also left the barn.

    Finally, they violated their citizens’ privacy in ways that previously would be unthinkable in the US, such as providing an app that tells your neighbors you’re infected and shows them where you are at all times. That’s still a theoretical possibility in the US, but it’s difficult to imagine.

    • #6
    • March 20, 2020, at 11:05 AM PDT
    • 10 likes
  7. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    Hammer, The (View Comment):

    Reading Ben’s tweet, I’m not sure what he means. My understanding was that SK has engaged in some very serious and intrusive tracking of it’s people. I imagine Rob has Ben’s cell phone, or at least Andrew’s- perhaps he could go directly to Ben and ask for a more thorough explanation?

    Hammer’s back! Long time no see my friend.

    • #7
    • March 20, 2020, at 11:06 AM PDT
    • 8 likes
  8. colleenb Member
    colleenb Joined in the first year of Ricochet Ricochet Charter Member

    Mendel (View Comment):

    Here’s what I posted a few days ago on this exact topic. Not a word, but the most concise way I could find to do the topic justice:

    A few major details about how South Korea was able to nip its outbreak so quickly in the bud:

    1. They got bitten by the MERS-CoV outbreak a few years back. This motivated them to come up with a serious and robust pandemic response plan. As a result, they were well-prepared and equipped.
    2. They have been testing at a rate nearly 100 times more than the US, in large part because they prepared ahead of time
    3. They pursue incredibly efficient case tracing. Known cases are required to quarantine at risk of fine and possibly jail penalties, and people who are infected are actively tracked by the government using credit card, cell phone, and car license plate data. The locations of all infected people are provided to the public by app.
    4. S. Korea got “lucky” in that it had one major cluster centered around a religious group. This made identifying and tracing the initial cohort easier than in countries with multiple smaller simultaneous clusters. Had the virus been more widely disseminated, it’s not clear their strategy would have been as successful.

    So to summarize, major reasons for Korea’s success include: a) having a robust plan and testing capacity before the outbreak, b) having a very strong central government, c) trampling their citizens civil liberties, and d) still getting a lucky break.

    Given those factors, the South Korean model can be highly informative to the US, but is not likely one we can mirror. We would need at least a month to bring our testing capacity up to speed, draw up coordinated protocols, and recruit the manpower needed for robust testing and case tracing. We would also need to suspend or revoke major civil liberties that our central to our culture.

    And even then we might not be successful, since by that point the virus would likely have spread to a degree that even the Korean measures would be too little too late.

    Bottom line: There is not a simple remedy to this threat. S. Korea’s approach is very informative, but simply copying it in the US is not realistic.

    Agree @Mendel that the South Koreans were helped enormously by the beginning of the Wuhan virus hitting their country through the religious cult – although I think I read it had 160,000 people?? 

    • #8
    • March 20, 2020, at 11:08 AM PDT
    • 2 likes
  9. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    Peter Robinson: Did South Korea engage in a lockdown, shutting down factories and businesses and sending everyone home for a couple of weeks

    They did not lock the country down anywhere near the extent that China, western Europe, and the US are doing. However, they did close down schools and quite a few other public institutions. They have also made recommendations for drastic curtailment of public gatherings which their people have largely adhered to.

    So while they haven’t decreed the lockdowns we have in the US and Europe, they asked their citizens to social distance and self-lockdown and the citizens have (apparently) mostly obliged.

    • #9
    • March 20, 2020, at 11:08 AM PDT
    • 6 likes
  10. Western Chauvinist Member
    Western Chauvinist Joined in the first year of Ricochet Ricochet Charter Member

    Sorry, that was Taiwan:

    https://thefederalist.com/2020/03/11/what-the-rest-of-the-world-can-learn-from-taiwans-success-containing-coronavirus/

     

    • #10
    • March 20, 2020, at 11:09 AM PDT
    • 3 likes
  11. Peter Robinson Founder
    Peter Robinson

    A reply to everyone, in haste: This is absolutely fascinating–and I’ll check in once again in about half an hour. 

    By the way, I hope you can all join Rob and me for our conversation with Dr. Savage.

    • #11
    • March 20, 2020, at 11:13 AM PDT
    • 6 likes
  12. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    Mendel (View Comment):
    Bottom line: There is not a simple remedy to this threat. S. Korea’s approach is very informative, but simply copying it in the US is not realistic.

    The tyranny of distance also matters. Don’t forget that 75% of S Korea’s population live within a 50 mile radius

    • #12
    • March 20, 2020, at 11:32 AM PDT
    • 3 likes
  13. Jerry Giordano (Arizona Patrio… Member

    Mendel (View Comment):

    • They have been testing at a rate nearly 100 times more than the US, in large part because they prepared ahead of time
    • They pursue incredibly efficient case tracing. Known cases are required to quarantine at risk of fine and possibly jail penalties, and people who are infected are actively tracked by the government using credit card, cell phone, and car license plate data. The locations of all infected people are provided to the public by app.

    Could you elaborate on this?

    How was South Korea better prepared? They could not have had a test for this virus before it was discovered, I presume. Were they simply better prepared to deploy a test quickly, if there was an outbreak?

    How did the case tracing help? Is there empirical evidence showing how this slowed the spread, or are we assuming that correlation proves causation? What type of quarantine was imposed — just people who tested positive, or their families too, or others?

    I’m sorry to be a pest. My impression is that opinions are being formed with very little data. We observe a much slower reported spread in S. Korea, compared to Italy or the US or other European countries, and assume that this must be the result of something that S. Korea did differently. This may be right, or may not, and even if it is right, it may be difficult to determine what it was that S. Korea did that was effective, and what it did that was not effective.

    • #13
    • March 20, 2020, at 11:56 AM PDT
    • 2 likes
  14. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    BTW, our current rate is 1/4 that of South Korea.

     

    • #14
    • March 20, 2020, at 12:06 PM PDT
    • 1 like
  15. iWe Reagan
    iWe Joined in the first year of Ricochet Ricochet Charter Member

    Mendel (View Comment):
    So while they haven’t decreed the lockdowns we have in the US and Europe, they asked their citizens to social distance and self-lockdown and the citizens have (apparently) mostly obliged.

    Some weeks ago I had a video meeting with counterparts in Korea – half a dozen in the office there, wearing masks when they coughed (but otherwise not). They were all coming into work.

    • #15
    • March 20, 2020, at 12:21 PM PDT
    • Like
    • This comment has been edited.
  16. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    Jerry Giordano (Arizona Patrio… (View Comment):
    How was South Korea better prepared? They could not have had a test for this virus before it was discovered, I presume. Were they simply better prepared to deploy a test quickly, if there was an outbreak?

    I don’t know the entire story, but there are several different aspects to preparedness.

    Regarding the test, it actually is possible to have most of the test ready before you even know what the next epidemic will be.

    Nearly any novel virus can be detected by the method currently in use for coronavirus: RT-PCR. RT-PCR is a very common molecular technique involving a number of standard reagents plus two pathogen-specific reagents (called primers). From a technical standpoint, the standard reagents are actually the most expensive and difficult-to-manufacture (including 2 enzymes), and require very specific storage conditions. So any country worried about a potential outbreak could theoretically order and stock this generic part of the test kit in advance.

    When it comes to the second part (the primers), once the genetic sequence of the novel pathogen is known it is fairly simple and fast to synthesize the primers (although this is the step the CDC bungled). Primers are chemically very stable and are so “potent” that a robust manufacturing facility can easily manufacture enough for millions of kits in a single day. So yes, with proper preparation a wide-scale testing system can be deployed fairly rapidly.

    However, the other factor is the human logistics. Obviously it takes quite a bit of coordination to set up mobile, isolated drive-through testing facilities that efficiently preserve and move patient samples to the testing facility. It also takes a good amount of advance work to have a troop of thousands able to perform contact tracing and actually call people up to make sure their at home (or log onto to their bank data to see if they’ve been illegally going to the ATM).

    • #16
    • March 20, 2020, at 12:34 PM PDT
    • 2 likes
    • This comment has been edited.
  17. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    Jerry Giordano (Arizona Patrio… (View Comment):
    My impression is that opinions are being formed with very little data. We observe a much slower reported spread in S. Korea, compared to Italy or the US or other European countries, and assume that this must be the result of something that S. Korea did differently. This may be right, or may not, and even if it is right, it may be difficult to determine what it was that S. Korea did that was effective, and what it did that was not effective.

    This is nonetheless a very valid point. The South Korean example is but a single data point. We don’t have enough information to rule out other possible contributing factors to the faster containment in S. Korea.

    However, when almost no evidence is available, poor evidence is often (but not always) better than none. Since we can’t replicate their strategy anymore anyway, it’s at least helpful as a potential case study.

    • #17
    • March 20, 2020, at 12:35 PM PDT
    • 2 likes
    • This comment has been edited.
  18. Mendel Member
    Mendel Joined in the first year of Ricochet Ricochet Charter Member

    iWe (View Comment):

    Mendel (View Comment):
    So while they haven’t decreed the lockdowns we have in the US and Europe, they asked their citizens to social distance and self-lockdown and the citizens have (apparently) mostly obliged.

    Some weeks ago I had a video meeting with counterparts in Korea – half a dozen in the office there, wearing masks when they coughed (but otherwise not). They were all coming into work.

    I’m sure there was a wide range of practices, but reports are that there was an unexpectedly high degree of compliance with official requests to either work from home, or to divide workplaces/companies into teams of three that were spatially isolated from one another while at work.

    • #18
    • March 20, 2020, at 12:37 PM PDT
    • 1 like
  19. Songwriter Member
    Songwriter Joined in the first year of Ricochet Ricochet Charter Member

    JayMiller (View Comment):

    I heard from a doctor friend that the reason it was contained was because the outbreak was confined to a small area. Not nationwide as it is here.

    A doctor friend of mine in Korea said the same thing.

     

    • #19
    • March 20, 2020, at 3:54 PM PDT
    • Like
  20. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    Songwriter (View Comment):

    JayMiller (View Comment):

    I heard from a doctor friend that the reason it was contained was because the outbreak was confined to a small area. Not nationwide as it is here.

    A doctor friend of mine in Korea said the same thing.

    75% of South Korea lives in the greater Seoul metropolitan area.

    • #20
    • March 20, 2020, at 4:54 PM PDT
    • Like
    • This comment has been edited.
  21. MISTER BITCOIN Member
    1. test kits
    2. self quarantine

    I have family that lives there… I will ask my cousin

     

    • #21
    • March 20, 2020, at 5:51 PM PDT
    • Like
  22. MISTER BITCOIN Member

    https://www.aier.org/article/south-korea-preseved-open-infection-rates-are-falling/

     

    • #22
    • March 20, 2020, at 5:53 PM PDT
    • Like
  23. MISTER BITCOIN Member

    https://www.wsj.com/articles/how-south-korea-put-into-place-the-worlds-most-aggressive-coronavirus-testing-11584377217

     

    https://www.wsj.com/articles/inside-the-south-korean-labs-churning-out-coronavirus-tests-11584610667

     

    • #23
    • March 20, 2020, at 5:55 PM PDT
    • Like
  24. MISTER BITCOIN Member

    Chloroquine

    S. Korea also used chloroquine to treat some of its serious cases

     

    • #24
    • March 20, 2020, at 6:07 PM PDT
    • Like
  25. Architectus Coolidge

    Mendel (View Comment):
    That horse has left the barn.

    Horses leave the stable, and cows leave the barn. We must not sacrifice our Idiomatic Standards in a crisis, but rather set a civilized example for those who look to us to defend the language, even in these difficult times. Oh, and trains leave the station, but we are being told not to fly the coop until this ‘lockdown’ is over. ;-)

    • #25
    • March 20, 2020, at 8:38 PM PDT
    • 1 like
  26. Architectus Coolidge

    Couple of points related to a number of the posts above:

    1.  We are not in a ‘lockdown’ in the US. Maybe those in hot spots like NY and parts of CA feel like we are, but the vast majority of us are not. We have some guidelines issued, but voluntary compliance by individuals and proactive participation by businesses is mostly the rule. 
    2. I have heard (but can’t confirm) that the early SK testing regime was subject to significant false readings, but it was considered better to roll-out than not, when used in conjunction with other screening methods and tracking.
    • #26
    • March 20, 2020, at 8:53 PM PDT
    • 2 likes
  27. MISTER BITCOIN Member

    Architectus (View Comment):

    Couple of points related to a number of the posts above:

    1. We are not in a ‘lockdown’ in the US. Maybe those in hot spots like NY and parts of CA feel like we are, but the vast majority of us are not. We have some guidelines issued, but voluntary compliance by individuals and proactive participation by businesses is mostly the rule.
    2. I have heard (but can’t confirm) that the early SK testing regime was subject to significant false readings, but it was considered better to roll-out than not, when used in conjunction with other screening methods and tracking.

     

    regarding the false readings, the false positive rate was 4 percent, which is relatively high but still better than no test

     

    • #27
    • March 20, 2020, at 8:55 PM PDT
    • Like
  28. Architectus Coolidge

    MISTER BITCOIN (View Comment):

    Architectus (View Comment):

    Couple of points related to a number of the posts above:

    1. We are not in a ‘lockdown’ in the US. Maybe those in hot spots like NY and parts of CA feel like we are, but the vast majority of us are not. We have some guidelines issued, but voluntary compliance by individuals and proactive participation by businesses is mostly the rule.
    2. I have heard (but can’t confirm) that the early SK testing regime was subject to significant false readings, but it was considered better to roll-out than not, when used in conjunction with other screening methods and tracking.

     

    regarding the false readings, the false positive rate was 4 percent, which is relatively high but still better than no test

     

    Agreed. Did they indicate what the false negative rate was? Either way, these can be difficult numbers to calculate well.

    • #28
    • March 21, 2020, at 9:04 AM PDT
    • Like
  29. MISTER BITCOIN Member

    Architectus (View Comment):

    MISTER BITCOIN (View Comment):

    Architectus (View Comment):

    Couple of points related to a number of the posts above:

    1. We are not in a ‘lockdown’ in the US. Maybe those in hot spots like NY and parts of CA feel like we are, but the vast majority of us are not. We have some guidelines issued, but voluntary compliance by individuals and proactive participation by businesses is mostly the rule.
    2. I have heard (but can’t confirm) that the early SK testing regime was subject to significant false readings, but it was considered better to roll-out than not, when used in conjunction with other screening methods and tracking.

     

    regarding the false readings, the false positive rate was 4 percent, which is relatively high but still better than no test

     

    Agreed. Did they indicate what the false negative rate was? Either way, these can be difficult numbers to calculate well.

     

    I can’t remember or didn’t see the false negative rate.

    I will check my source again.

     

    • #29
    • March 22, 2020, at 6:50 PM PDT
    • Like
  30. MISTER BITCOIN Member

    Italy is one of the least vaccinated countries in Europe

     

    • #30
    • March 22, 2020, at 7:14 PM PDT
    • Like