What About Laos?

Laos has had 22 cases of C19, 3 currently active, 0 deaths. Cambodia, Vietnam, Thailand, Nepal, Myanmar, are not quite so low, but very low. These are not South Korea or Taiwan, where we can point to cultural support for masks and distancing and good medical care and awareness. It is fair to note that there is little testing and there might be deaths out in the boonies that are just “Eh.  Death.  Who knows why?” that leave actual CoVid unreported, but these national numbers are ridiculously low. If there were a CoVid holocaust in these areas word would be leaking out.  Even though no one, left or right, pays much attention to what is happening in these places, if there were some serious bump in the data, someone would be twisting it around to make some political hay out of it on NPR, The Nation, or some fringe right-wing sites.  It is, of course, very cool to be walking around knowing stuff about some country that everyone has heard of but no one has been paying attention to, so some news would get out.

If you go to Worldometers.info and look at the lower reaches of the list you see patterns.  You see islands, whether in Oceania, Indian Ocean, or the Caribbean, or essential islands like Gibraltar, Vatican City, Liechtenstein. Yes, they can keep others out, and are in fact used to keeping others out. There are also a lot of African countries, with similar poor medical care, low social cohesion for masks and distancing, but likely also poor reporting.  Yet I will note again, not that poor reporting. When there are lots of deaths, word leaks out.  The outside world may not believe those reports of death because they are uncomfortable, as the Gulag deaths, 6M Jews, or 25M Great Leap Forward deaths in China leaked out in the 20th C were ignored, but the reports were there.

These places border China, including well-populated areas of China. I have no doubt that China is lying hugely about its current cases, but do we really think that only 1% of the deaths are being reported out? If the true tale of deaths were 2-300 times higher, wouldn’t there at least be crazy rumors of this, and fringe sites talking about it?  These places are influenced by China and fear it, but they also can score points by snitching on it to Western media sources. They chafe under the bonds and break free whenever they can.

I suggest something else is going on. These SE Asian countries in such close contact with China, often hundreds of miles of border, have some sort of immunity to C19.  If it can’t be masks, distancing, handwashing, or isolation, what else is there?  While this could be a generalised immunity, I think it is more likely that they have a general coronavirus immunity, not because they were exposed to a similar disease ten years ago, but because they have been exposed to a hundred similar diseases over their lifetimes.

If that is true, then the possibility that the Chinese information reflects more truth than we thought becomes possible.  Regions share immunities, but within that context cities and rural areas have different disease pools.  Wuhan has been a city for thousands of years. A disease that crosses over between pangolins and bats (or escapes from a lab after being developed from such crossovers) might be just subtly different enough that it kills city dwellers, but people in the provinces are immune.  Because they have been exposed to coronaviruses based on bats and pangolins before.

We have tended to look at the behavior and results of countries we think are like us, such as developed nations with lots of international contact, and that is quite reasonable.  But it pays to look through the other end of the telescope and see what nations are having no problems at all, and ask ourselves why.  It is quite possible that the rural regions of China are not much affected and even large areas not so dangerous, even as there are historical cities that are so easily devastated that there is not much even draconian measures can accomplish.

I have an apples-to-apples take on the American responses and projections which I may get to this week. (I am working the murderers unit this week where lots of people are concerned with the tiniest shades of disrespect to their rights, making even simple tasks difficult. I haven’t got much left when I get home.) But for the moment, consider what is happening in Laos and similar places.

26 thoughts on “What About Laos?”

  1. If we considered a disease like Ebola — it symptoms were so dramatic and different from other diseases that there was no problem in identifying deaths from Ebola. Covid-19? Not so much.

    We know we have “over-reporting” in the developed world. Cancer deaths and motorcycle accidents where the deceased test positive are counted as Covid. It is a reasonable guess that in places where testing is expensive or not available, those deaths would be counted as cancer & accident. There could well be an element of under-reporting in certain less developed countries.

    We always have to keep a sense of perspective. Even in the West, the increase in weekly deaths has been fairly small — only marginally beyond statistical variation. To take one example, on any normal day in China, about 25,000 people die. There is no data suggesting that number has ever jumped to 50,000 or 75,000 people in a day — as might be expected if Covid-19 had been a genuine pandemic.

    Historians are going to look back on this episode and focus on the huge societal damage done by the inappropriate Lock Down response, not on the flu-scale disease. They will undoubtedly file our response under the “Madness of Crowds”, next to tulip bulbs.

  2. “It is quite possible that the rural regions of China are not much affected and even large areas not so dangerous, even as there are historical cities that are so easily devastated that there is not much even draconian measures can accomplish.”

    The Chinese are opening up the country after fighting a war with Covid 19, that they have basically won. Draconian measures are what allowed them to win that war so fast.

    You are losing that war rather badly. You are adding our Canadian total number every 3 days, give or take, to your numbers at this point. We have fought a less draconian war in Canada and have done not as well as China, but have the commie flu, from Venice, somewhat under control.

    Perhaps working on the problem might be more useful than finding excuses. You should probably have a look at this: https://www.youtube.com/watch?v=bQcS-UWBq4Q&t=948s

  3. Tyler Cowen was writing about the lack of impacts in SE Asia months ago. No real answer has been put forward that I’m aware of. It’s a pity that everything having to do with this has been buried under domestic partisanship, nothing more extremely than hydroxychloroquinine I think.

  4. Remember the polio model. No one knew about the near 100% exposure in the Mexico City slums until the antibody test became available.

    The NHS doctors who died of the virus were all “South Asians” meaning Indian. Maybe genetic susceptibility is cancelled by long exposure. The AB test seems unreliable so far.

    American blacks seem to have a genetic susceptibility due to ACE2 receptor but I don’t know how it is going in Africa.

  5. I can’t speak to Laos, because I’m in Vietnam, and I’m not leaving until I know I either have a place to go or a guarantee that I can come back. I’ve been living in SE Asia for the past three years, after 13 in China.

    On March 15 you could still fly into Ho Chi Minh City, which I will now refer to as Saigon. There were very few cases, and they were mostly linked to one incident. No deaths, and no new cases for a couple of months, but then, apparently, some folks crossed over from China – illegally, but maybe they were Vietnamese who went to China for Tet and got stuck. Numbers have been going up.

    During the initial panic – in Saigon – all the bars shut down, along with restaurants and massage joints and barber shops and theaters. I’m pretty sure the mall was closed except for the grocery stores, where you got a temp check, and hand sanitizer, and masks were required. Then things eased off, because no new cases, and no deaths. I think the theaters were open, I could get a haircut, and wander around the mall sans mask.

    A couple of weeks ago it popped back up in Da Nang, or so I hear. Number of cases has doubled to near a thousand, and there have now been some deaths. 25 per the worldometer. Things have been shut down again, but not quite as much. I think bars are closed. Masks are required at the mall, and the fever checks are back, but fast food was OK dine-in earlier in the week. Building security is back to wearing masks. Traffic returned to its hellish SE Asian levels and hasn’t slowed much. Another caveat: I don’t get out much, and things tend to change quickly.

    Mask compliance and shutdown were pretty wide-spread here, and I think that, and the weather (hot and muggy!) kept things low. We’ll see what happens next.


    YOU CAN’T trust the Chinese numbers. Chinese reporting is not credible. Even if the numbers are correct, there is no way you can tell, because there’s no way the Chinese government can tell if they have accurate numbers. The incentives for lying are too great, at all levels. That’s in addition to any ambiguity about what killed any given individual (eg the Vietnam death total reads 25 as I type this, but it was 26 before I refreshed, and I’m pretty sure it was 27 before that).

  6. More sun, tropical sun at that
    More vitamin D
    Less Covid

    Also in Africa population is incredibly young with medium age of about 14, and low obesity rates. Also people with other medical issues don’t have modern medical support.

    Both places are not high on the list of places lots of people go.

    We are comparing: apples oranges pears lemons peaches grapefruit apricots and citrons

  7. @Berenger – I have been pounding the table on Vitamin D with this thing since the beginning.

  8. Doc, thanks for that report.

    Berenger, the African climate is why Africans are deeply pigmented. When they go north and wear more clothing is when they get Vitamin D depleted. In Greg Cochran’s book, he gives that as the basis of the evolution of white skin. I agree.

  9. First: none of the numbers mean anything. Look at New York, when the narrative was “Cuomo, bravely standing athwart the apocalypse”, you weren’t allowed to die of anything but wuflu. When it changed to “Cuomo, pinch hitting for the grim reaper”, the numbers started to suddenly go down. A bit of the reverse may be happening in Texas. The natural variability can hide a lot of shenanigans. It also makes it easy to read any conclusion you want into it.

    The numbers from China are completely unbelievable, period. When Vietnam claims to know that 25 people died from wuflu, I’d challenge them to name one other cause of death where they know to a comparable level of certainty. At best, it’s 25 that they know about, maybe 25 that they’ll admit to, likely a combination of both. Very few places in either Asia or Africa outside of Singapore have surveillance good enough for this to even show up without knowing what to look for.

    The nuances and implications of this epidemic will be hashed over from now till the end of time. Time may bring clarity for a few issues but will totally obscure others. The top level statistics are hopelessly compromised; I hope, without much conviction, that future investigators will remember that. That is also the case for research on topics much less politically fraught than this.

    The only firm conclusion that I draw is that you should keep respiratory infections out of nursing homes at all costs. I thought that was pretty obvious already.

    Here’s a preprint proof of an article on existing resistance that will probably disappear behind a pay wall soon.
    I haven’t taken time to read it yet and probably wouldn’t know a lot more if I had. I note it ‘s going to be in a reputable journal and the lead authors are connected with a reputable institute, or at least one that I’ve heard of.

  10. “American blacks seem to have a genetic susceptibility due to ACE2 receptor but I don’t know how it is going in Africa.”

    That entire “you should probably have look at this” vid I posted above is about exactly this. Its actually very hopeful and speaks to AVI’s point.

  11. People here tend to be readers rather than video watchers. It doesn’t bother the wives and children so much. You can skim through silly parts, and most of us read faster than the entertaining speakers talk anyway. These days there are hyperlinks that allow you to check whether the source is at all credible. We have all learned the hard way that trying to prove things with video is mostly just subjecting yourself to crazy people haranguing you. It’s too bad, really. Shouldn’t have ended up that way, but somehow it did. Youtube is for music and comedians. Podcasts are okay because you can listen in the car or on a hike or when doing some sorts o work around the house. You can’t watch lectures while driving.

  12. So did you watch the vid? A lot of valuable information presented by one of the stars of this stupid pandemic. Certainly some very good news for many Africans and all of us really, if we can figure out why these certain populations, are doing so very well against the virus, which is so much worse for us.

    I was clocked at just under 2500 words a minute when I was 13. Now that’s real speed reading and my comprehension was good. You do that by getting from reading individual phrases, graduating to realizing words have shapes, then going on to understanding sentences have shapes too. At that point with some effort you can get to short paragraphs in one bite, then you just read straight down the middle of the page without actually focusing on anything much.

    My reading is pretty good. ;)

  13. “These days there are hyperlinks that allow you to check whether the source is at all credible.”

    Fascinating. I assume you mean an URL when you use the word hyperlink. We actually have a Hyperlink Network in the game I play. Anyway that is how we use the internet, a Uniform Resource Locator is what you click on. As that is all of information on the internet easily accesible. I’m not sure how that allows you to do anything other than look at that link. It will certainly not inform you about credibility.

    I suspect its really that you can see if that link fits your prejudice set or not. Echo chambers abound, and are one reason the stupid is so strong these days, as everyone has their reinforcing set of facts, set forth by enthusiastic believers, with access to Google. ;)

  14. PenGun is a leftist anti-American troll who keeps posting useless comments. The chance that I would look at a link are somewhere near nil.

  15. If you’re going to pontificate, PenGun, It helps to at least be right.

    But no, AVI said hyperlink, he meant hyperlink, it was the right word to use, and those of us who know what we’re talking about understood all that.

    You might go away and spend some time contemplating what the ‘h’ in ‘href’ means…

  16. The median age in Laos is about 23, vs 38 for the US, and even higher in most European countries. The average age in China is close to that of the US, and rising as their birth rate crashes.

    Instapundit linked to an interesting article yesterday https://wirepoints.org/ignorance-about-covid-19-risk-is-nothing-short-of-stunning-research-report-says-huge-age-variance-wirepoints/

    While not the article’s main point, the data quoted shows COVID is very survivable if you’re young, leaving aside potential long-term effects. In the US, less than 3 percent of the deaths have been under age 44, and well less than 1 percent are under 24. Since the vast majority of people infected with COVID don’t need to seek medical treatment, I don’t think the outcome of an infection would be affected by the difference in access to health care between Laos and the US.

    We’ve had approximately 178,000 COVID deaths to date, so using the article’s figures roughly 356 have been under 24. That works out to roughly 1 under 24 death per million population. The population of Laos is 7 million, so a figure of 25 deaths is certainly in the ballpark.

    Demography wins.

  17. Laos’ population density is ten times lower than Vietnam’s. Vientiane has less than a million people and is a backwater compared to Saigon or Bangkok. The only city I remember seeing a high proportion of foreign tourists is Luang Prabang and most of them were Europeans, not the hordes of tourists from the PRC like you’ll find in Thailand and Vietnam.

  18. “You might go away and spend some time contemplating what the ‘h’ in ‘href’ means…” Indeed an URL with reference is a hyperlink and he was not wrong to use the word. I was really just picking on him for stating that it allowed him to establish credibility. Which of course it does not, all it does is present you with another page or whatever.

    If you click on PenGun you will be taken to my photography site which is entirely handwritten. As I used to say “CC’s bare hands on Midnight Commander”.

    The African countries in the video I posted are actually displaying the type of thing AVI is talking about, although I’m not sure Laos etc is that good an example, for various reasons, as what I have posted.

  19. You might like to look at percentage of country population of tobacco consumption (smoked and smokeless combined assuming no smoked/smokeless overlap). This is split here for male and female, as there are potentially important cultural differences that are likely to have significant effect.

    Compare with the USA %M/F 23.9/13.3 and the UK %M/F 18.9/16.4.

    Cambodia %M/F 35.1/17.2
    Laos %M/F 65.4/8.2
    Myanmar %M/F 77.6/21.0
    Nepal %M/F 72.6/13.7
    Thailand %M/F 38.8/6.9
    Vietnam %M/F 46.5/3.4

    This information at least indicates that nicotine consumption should be properly investigated as a prophylactic against COVID-19.

    Keep safe and best regards

  20. Nigel,
    It’s hard to believe that tobacco use could be prophylactic for anything lung related. Of course, if we knew all the answers, we wouldn’t have to look, would we?

    This is the sort of thing that “big data” is supposed to do. Find connections that had eluded mere humans with our preconceived ideas. If the data exists. I can’t (quickly) find when smoking first became a part of a normal medical history here. I suspect it was sometime in the 50-60’s. I especially don’t know if it’s part of the normal practice in the countries you talk about. The same goes for all the tantalizing suggestions about Vitamin D and other things. Is Vitamin D level part of the standard tests that are routinely administered? The data has to exist to be mined.

    I’ve said with others here that the statistics collected to date leave a lot to be desired. I’d be surprised if there is easily available data that connects individual cases and outcomes with enough individual medical history to make the connection. I’m sure researchers will, in the coming years, reconstruct sets of cases with the necessary data but not in time to make a difference now.

    It’s also worth remembering that most of the countries you name are both much younger than we in the developed world and also places where a significant number die every year from the lack of safe drinking water.

    I’ll take my chances with wuflu before I start smoking.

  21. As far as I know, both Laos and Vietnam have a lot of malaria reservoirs and deal with this by having HCQ available over-the-counter as a profylactic drug. And I doubt they’re going to listen to all the western propaganda about how dangerous the drug is if everyone’s already taken it at one time or another for another disease _already_.

    I suspect the same condition applies in places like Uganda, which has 11 total deaths from C19.

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