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Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

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Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#91
post #90

Earlier quoted context omitted.

> debilitating economic cost citation needed. Their internal economy works normally, they never had any lockdown. Far lower impact than those states that just let the virus go rampant every couple of months, followed by months of lockdown. And yes, you could eradicate with this strategy, if enough places would adopt it and work together. I'd imagine a list of trusted covid free countries that can reintroduce bilatera…

> they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over t…

Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now.

Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. The key would be cost and availability of these tests - that's a problem that can be solved, as production is simple and is already currently costed at $1 a pop. From a regulatory standpoint it should be treated more like toothpaste and less like a medical good (i.e. certify the efficacy but don't go overboard).

After all else has pretty much failed, all western governments are now just betting on the vaccine. This is a dangerous proposition - all you need is a resistant mutation and we're back at square one. Plus, vaccination at current rate will take 1-2 years - I don't think that's a good place to be in both in health terms and economically. There needs to be a backup plan put in place, as well as lessons learned taken for the next pandemic.

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#92
post #90

Earlier quoted context omitted.

> they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over t…

Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sen…

> Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months.

I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, and the vast majority of interactions (>90%) don't produce more than a single infection.

You essentially have to catch the connecting edges on a sparsely connected graph -- you don't have to miss very many for the problem to be unsolvable.

I do think it would go a long way to making life more normal. It's completely idiotic that we're killing restaurants (for example) when we could be making mandatory rapid testing a pre-requisite to indoor dining, instead.

The same goes for nursing home and hospital staff -- nosocomial infection has been a huge problem, and most fatalities are out of nursing homes. I get why you don't want to depend entirely on quick tests that have an elevated false-negative rate, but when it takes days to get back a PCR result, it's useless for screening staff.

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#93
post #92

Earlier quoted context omitted.

Please read my initial comment again. I'm not arguing for the US, in its current state, to adopt the Taiwanese strategy. Once community spread is such high as it is now, another strategy is needed. And I'd say the current lockdown & reopen has been proven inefficient in sufficiently many places now. Michael Mina has a much different idea: Cheap mass testing at home, regularly, for the whole family. Even with less sen…

> Cheap mass testing at home, regularly, for the whole family. Even with less sensitive quick tests it should be possible to suppress ~50% of new transmissions this way, which could bring case numbers down to traceable levels in 1-2 months. I agree it's a good idea, but doubt that it would bring case numbers "down to traceable levels"...we know that the vast majority of transmission (>70%) is happening in the home, a…

I think that the >70% number is misleading. It's 70% of cases for which we have data where the transmission happened. For a good majority of cases the transmission happened at an unknown place. It's just that for those where it is known, most are happening at home (as opposed to e.g. at work). Those unknown transmissions are what you want to attack with a mass testing regime. That seems entirely doable, given cheap and simple testing at home.

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#94
post #44

Earlier quoted context omitted.

Anyone at all responsible for the US being one of the worst countries hit is not browsing HN right now looking to learn new perspectives.

We're all responsible for our country

How so?

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#95
post #85

Earlier quoted context omitted.

Contact tracing isn't antithetical to personal privacy. I suppose you can say it compromises absolute personal privacy, but so does someone seeing you in a store, so it's not very interesting. Singapore has certainly decided to show how bad it can be, but the root of that is an authoritarian mandate, not the contact tracing itself.

Good luck convincing many people in the US of the same. I'm certainly not convinced. As you point out, Singapore has already abused the system. If some abuse is technically possible, it's probably already happening. But there's a lot of room outside of "do nothing" and "omnipresent perfect surveillance" to do good things with civic technology, including non-pandemic stuff. Why aren't all public records online and sea…

Singapore isn't making some dubious technical violation of their system, they are putting in place a top down mandate requiring it. My point is that it is a consequence of their politics more than of the contact tracing being technically possible.

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#96
post #90

Earlier quoted context omitted.

> debilitating economic cost citation needed. Their internal economy works normally, they never had any lockdown. Far lower impact than those states that just let the virus go rampant every couple of months, followed by months of lockdown. And yes, you could eradicate with this strategy, if enough places would adopt it and work together. I'd imagine a list of trusted covid free countries that can reintroduce bilatera…

> they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over t…

> that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west.

Taiwan has roughly the same population as Australia packed into an area 1/10th the size of Japan. This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission.

Also your representation of Taiwan's trade is completely disingenuous.

Please google the phrase, "Taiwan's largest trading partner".

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#97
post #29

Earlier quoted context omitted.

I think you are mistaken to lump China in those countries. People are constantly underestimating the Chinese relationship with contagion. I guarantee that China would not be able to hide any major covid outbreaks. Word would escape to outside relatives. Chinese people are extremely averse to contagion, coupled with a deep surveillance infrastructure and strong authoritarian government they are in a solid position to…

Same with India. They could maybe hide cases due to incompetence but news of deaths just cannot be hidden in a country as dense as India.

Regarding India - https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Regarding China - https://www.cidrap.umn.edu/news-perspective/2020/04/china-up...

As I said, there is plenty of room to dig and analyze.

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#98
post #90

Earlier quoted context omitted.

> they never had any lockdown ...and that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. As I said, they've stopped essentially all international travel. They've benefitted from the US-China trade war, and have been able to boost exports: https://www.wsj.com/articles/taiwan-shrugs-off-pandemic-to-d... > Taiwanese manufacturers have been relocating back home from China over t…

> that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. Taiwan has roughly the same population as Australia packed into an area 1/10th the size of Japan. This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Also your representation of Taiwan's trade is completely disingenuous. Please google the phra…

> This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission.

Again: they shut their borders before there were any cases. Population density is a detail when you can just keep the virus from getting into your country in the first place.

> Please google the phrase, "Taiwan's largest trading partner".

Arguing about China does not change the fact that Taiwan's economy is export driven, which was the point.

https://tradingeconomics.com/taiwan/balance-of-trade

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#99
post #98

Earlier quoted context omitted.

> that's largely irrelevant in a tiny country whose economy is mostly making stuff for the west. Taiwan has roughly the same population as Australia packed into an area 1/10th the size of Japan. This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Also your representation of Taiwan's trade is completely disingenuous. Please google the phra…

> This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Again: they shut their borders before there were any cases . Population density is a detail when you can just keep the virus from getting into your country in the first place. > Please google the phrase, "Taiwan's largest trading partner". Arguing about China does not change the fact t…

I live in Taiwan and have been reading the news here all year.

> Again: they shut their borders before there were any cases.

Again, your claim isn't true. Taiwan had cases from the very first set of Wuhan evacuees.

The virus has "gotten in". No local transmission doesn't mean people haven't been returning infected from Wuhan, other Chinese cities, Europe and elsewhere all year.

Those infections haven't spread, though.

Why are you so unwilling to give credit where credit is clearly due? Taiwan has done an exemplary job during this pandemic, despite high population density, close proximity to the initial outbreak and zero support whatsoever from the WHO.

Re: Bringing civic tech to Taiwan's coronavirus pandemic response [audio]

#100
post #98

Earlier quoted context omitted.

> This makes it more not less difficult and yet Taiwan stopped an outbreak and went eight months without a single local transmission. Again: they shut their borders before there were any cases . Population density is a detail when you can just keep the virus from getting into your country in the first place. > Please google the phrase, "Taiwan's largest trading partner". Arguing about China does not change the fact t…

I live in Taiwan and have been reading the news here all year. > Again: they shut their borders before there were any cases. Again, your claim isn't true. Taiwan had cases from the very first set of Wuhan evacuees. The virus has "gotten in". No local transmission doesn't mean people haven't been returning infected from Wuhan, other Chinese cities, Europe and elsewhere all year. Those infections haven't spread, though…

I grant you that Taiwan had a very small number of confirmed cases early on. Then they closed their borders.

Taiwan deserves credit for reacting quickly enough that they could do contact tracing to eradicate a small number of cases. But you keep missing the point: it's much easier to do this when you're an island nation with a paucity of international travelers.

Even in a year where international arrivals are down by >80%, the US had more than a quarter of Taiwan's population arrive internationally. And that's just visa arrivals.

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