Taiwan, Japan, Sweden and Greece; a tale of four countries.

Early in 2020, the world started taking notice that a novel coronavirus disease, was spreading in the Chinese city of Wuhan.  It was later named, SARS-CoV-2 and the disease Covid-19.  As of today, there are slightly more than 6 million confirmed cases around the world and the global death toll has surpassed 370,000.   

Taiwan is an island nation of 24 million that sits just 70 miles from China.  More than four-hundred thousands of its citizens work in China and more than 2 million Chinese visit Taiwan every year thus a massive outbreak of the disease named Covid-19 seemed all but inevitablefor Taiwan would be one of the hardest hit countries.  Yet despite the odds, Taiwan has recorded only 441 cases of the disease as of today, with only 7 patients dying.  

So how did Taiwan manage to have so few cases and so few deaths from the disease.  First and most important Taiwan enacted prevention measures early.  On Dec. 31, the day the Wuhan authorities announced that there were several patients with an unidentified type of pneumonia, Taiwan activated stricter control measures with testing of incoming travellers with fever and questioned suspected travellers about their contact history.

On Jan 20, Taiwan activated its Central Epidemic Command Center (CECC), which rolled out more than 124 measures such as banning all exports of surgical masks and providing all its citizens with two free masks.  On Jan 26 it banned travel to and from Wuhan.  According to a March 3 article published in JAMA, the CECC rolled out measures that included border control, case identification, quarantine for all travelers from regions hard hit by the disease, and postponing the reopening of schools following the winter break.  The center also served as the source of information for the public, with daily press conferences that provided the population with reliable and easy to understand information about the outbreak.  It was thanks to these measures that Taiwan experienced one of the smallest fatality rates in the world of only 0.3 deaths per million.

Japan went its own way, limiting tests to only the most severe cases.

Japan — the grayest country in the world and a popular tourist destination with large, crowded cities — has one of the lowest mortality rates from Covid-19. Τhe government never forced businesses to close and the medical system did not get overwhelmed. 

Japan focused on quickly containing small outbreaks through contact tracing. It has focused on lessening people’s anxiety and stressing the basic science of prevention: wash your hands, wear a mask, keep your distance from others.

A public education campaign urged people to avoid the “Three C’s” which are closed spaces with poor ventilation, crowded places and close contact.

Last week, Prime Minister Abe declared Japan’s battle against the outbreak a success, taking the country off its “lockdown lite” that lasted only a month and a half.  Japan experienced one of the smallest fatality rates in the world of only 7 deaths per million.

As the virus spread across Europe, many Greeks feared that Greece would be hit as bad asItaly and Spain.  On Feb. 27, a day after the country’s first Covid-19 case was diagnosed the government canceled the annual carnival and all sporting events and on March 11, it closed down schools and universities. Two days later all travelers from abroad had to go through a two-week mandatory quarantine.  It also closed down cafes, restaurants, libraries and museums.  Attendance of mass in churches was also forbidden even during Holy week and Easter. 

Everyone in the country during the 2 ½ months lockdown had to request permission by sending an SMS each time we were to leave our homes, to go to supermarkets, doctors’ offices, pharmacies to visit and help our elderly relatives, to go for a walk or risk a fine.

(Picture of an empty Monastiraki square in Athens with view of the Acropolis in the background.)  

The government established a council of experts who issued information and advice on a daily basis.  It was the willingness of most Greeks to comply with experts’ suggestions that brought about an outstanding result of only 2,915 confirmed cases and 175 deaths as of today.  Greece similarly to Japan tested for the virus less than 1 percent of the population. As of today, 15,903 tests per million were performed mostly on people admitted to hospitals with symptoms and those who have been in contact with confirmed cases. Spot tests on travelers coming into the country from abroad were performed as well.  For comparison purposes Germany and Austria countries that also had very good results performed 47,194 and 47,477 tests per million of inhabitants respectively.  

As of this week, the number of cases and more important the number of deaths per million comparing to other European countries point to a Greek success story.  So, what was Greece’s good result due to?  First, as Taiwan, Greece enacted its plan, a strict lockdown, earlier than most European countries.  Second, the population of 11 million Greeks lives in a mainland which is mountainous, the size of which is 50,000 square miles, and which is surrounded by two seas the Aegean (82,000 square miles) and the Ionian sea (65,000 square miles) with more than a thousand islands,  thus the country is sparsely populated as its physical characteristics make contact between villages and small towns difficult, which after all was forbidden during the lockdown.  Third, most of the Greeks accepted the enacted recommendations of social distancing and adhered to its principles.   Greece experienced one of the smallest fatality rates in Europe of only 18 deaths per million.

(Picture of a deserted beach in Porto Rafti, Greece)

Sweden's controversial plan to deal with the coronavirus allowed for people to go outside, visit restaurants, bars  and shops as long as they kept distant from each other.  Sweden closed high schools and universities and did not allow gatherings of more than 50 people.  Although not everyone in Sweden is happy with this approach, the majority of the people were satisfied.

Anders Tegnell, who advocated this approach, estimated that 40% of the people in Stockholm will be immune by the end of June which will give the country a big advantage, as most of the countries will experience a “big second wave” later this year.  As of May 20th, only 7.3% of Stockholm’s inhabitants have antibodies to Covid-19.  He also said the “lockdown strategy” has not scientific basis especially when it comes to the young and children as they do not transmit the disease.   Sweden has reported zero coronavirus deaths in the last 24 hours, for the first time since March 13.  Sweden experienced fatality rate was average in Europe with 440 deaths per million.

So, which approach should countries follow in the future when an infectious disease appears to be spreading and the danger of an epidemic is real?  Extensive testing such as performed in Singapore allows authorities to quickly determine who is infected and isolate them.  More than 90% of cases in Singapore  were mostly young, healthy men. Of those who died, 95% were more than 60 years old, while the vast majority of those infected were between the ages of 20 and 59. 

Taiwan’s and Greece’s success stories suggest that an early detection of a pandemic and enactment of measures for its control minimize the number of cases, flattens the curve and deaths.  

The “lockdown light’ approach of Japan also ensured a low death fatality rate.   

The open society approach with social distancing as it was practiced in Sweden has higher death toll but left the economy minimally affected.  

All four countries followed their experts’ advice and their policies did not become a source of political discord.  Unfortunately, fear and politicization of crises stigmatize governments or groups of people without helping to solve the challenge at hand therefore are ultimately unproductive.  Hopefully, in 2021 an effective vaccine will become available that will limit the prevalence of the disease.  Past pandemics such as the 1918-1919 Spanish flu, still have lessons we all can learn and benefit from as most viral pandemics have similarities therefore similar measures such social distancing, wearing masks when in crowded places, washing our hands often, use of hand sanitiser,  sneezing and coughing etiquette, often help in their control.  

Finally, going out for a walk and spending time in nearby park or nature reserve reduces stress and help us feel healthier and happier.  Looking at greenery and listening at nature’s sounds including total silence afforded to us in remote areas can boost our sense of well-being.   

Well, my friends this is the last post on pandemics and Covid-19.  In my opinion the pandemic will die down on its own as most epidemics do and all of us those infected or not will remember the Covid-19 epoch for the rest of our lives.

(Picture of the view and the undeveloped path  I took my daily walk that helped my mood during the lockdown) 

Dawn of a New Day and a New Year

The games were over now. The gathered armies scattered,
each man to his fast ship, and fighters turned their minds
to thoughts of food and the sweet warm grip of sleep.

But Achilles kept on grieving for his friend,
the memory burning on . . .
and all-subduing sleep could not take him,
not now, he turned and twisted, side to side,
he longed for Patroclus' manhood, his gallant heart.

What rough campaigns they'd fought to an end together,
what hardships they had suffered, cleaving their way
through wars of men and pounding waves at sea.

The memories flooded over him, live tears flowing,
and now he'd lie on his side, now flat on his back,
now facedown again. At last he'd leap to his feet,
wander in anguish, aimless along the surf, 

until dawn appeared with her rosy finger flaming over the sea and shore 

would find him pacing.

 from Homer’s Iliad Book XXIV 

Parker Solar Probe acquired the first ever photo taken from inside the sun’s corona. The bright streak is a coronal streamer. Up to now, all photos of the sun have been taken from a great distance, either from ground or from telescopes in space given the sun’s extreme heat. The sun is a magnificent, hot, glowing ball of gas with its enormous hot plasma and bright coronal streamers streaking out into the surrounding blackness that matches Homer’s magnificent descriptions of sun’s rays at Dawn in both the Iliad and Odyssey. 

Today, at the dawn of the New Year, my favorite description of Dawn by Homer is… Dawn appeared with her rosy fingers.  I wish you all a Happy New Year.

Medicanes

Mediterranean cyclones are called Medicanes from the words Mediterranean and Hurricanes.  They usually form in the sea between Spain, Sardinia and Corsica or in the Ionian Sea. Medicanes usually happen in the fall and winter and move from west to east.  

Medicanes are rare phenomena and are similar with the tropical cyclones but are weaker because the Mediterranean Sea is smaller comparing to the oceans and her waters are not as warm. 

Although not as ferocious as their tropical cousins Medicanes have a center, have very strong winds in their periphery, causing huge waves and torrential rainfalls. 

Medicanes frequency is 1-2 per year.  Greece’s last Medicane was in 1995. This time the cyclone skirted the south coast of Peloponnese and reached Athens on Saturday September 29, 2018.

The strong winds uproot trees and down power lines and cause all kind of property destruction. 

Swollen rivers take cars parked near their banks in their turbulent waters downstream.  

The strong winds and waves result in sinking of boats even in harbors.

Although the advice to people in regions involved by hurricanes to move inland and away from the coasts some elect to ignore such warnings and go to the shore to see the large waves and feel the strong winds.

Tourists in the vicinity of the Acropolis of Athens look happy even if the gusty winds will destroy their umbrellas.

Barack Obama

I am writing this tribute for the man who as part of his duties travelled extensively but more important because in my view he was a successful president. In the picture above President Obama is in Acropolis during his historic visit to Greece. 

The following is a partial list of his major accomplishments during his eight years (2009-2017) in the White house    

He ended the 2008 recession when the congress approved the Obama $787 billion economic stimulus package.  The graph above from NYT presents how sectors fared during President’s Obama’s presidency. The stock market tripled in value with the S&P up 220% over 2009, Nasdaq was up 313% and Dow was up 185% from its 2009 low.  The only mark against President Obama is that he added almost 7 trillion to the national debt. According to most economists this deficit spending was necessary to stimulate the economy which in turn created 14 million new jobs that brought the unemployment below 5%.   

The Affordable Care Act also known as Obamacare is a landmark health bill.  If and when fully implemented it would have covered 32 million Americans who were not or could not get insurance because of pre-existing conditions.  

In 2016, United States and five more world powers reached a deal to stop Iran from obtaining nuclear weapons.  Foreign Ministers John Kerry and Javad Zarif led the talks between Iran the United States. 

In 2016, the United States opened an embassy in Cuba thus normalizing relations between the two nations after 54 years.  President Obama with the President of Cuba Raul Castro in Havana.

With new policies and diplomacy the world opinion towards the United States and Americans is for now favorable.  The last time the world opinion was as friendly towards the United States and Americans at large was during the Kennedy presidency.  

Barack Obama has already secured a special place in history as the first African-American president of the United States. That fact in itself could not have happened without the changes achieved by the civil rights movement in the 1960s.  It is also a proof that most Americans in the interim freed themselves of their racial prejudices which were so dominant in the past and elected as our President a man who will be remembered as a good, caring and thoughtful individual.  Thank you President Obama.