Contrary to its usual status of superiority, Western countries have been hit particularly hard by the Coronavirus, with around 9 million cumulative cases in Europe and 20 million in America. Meanwhile, although East Asian countries were among the first to report covid-19 cases, they have been doing relatively much better in terms of new cases and reported deaths.
The USA currently has 27,505 cases per 1 million people. Many countries in Europe have similar numbers, with Belgium reporting 31,736 cases per 1 million people and Spain and France reporting 25,549 and 18,909 cases, respectively, per 1 million people. Meanwhile, Japan only has 777 cases per 1 million people, Hong Kong only 707 cases/1m, South Korea only 512 cases/1m, and Taiwan 23 cases/1m.
This article explores the possible reasons for the increased severity of the Coronavirus in the Western countries and, thereby, the lessons they can learn from the more successful East Asian countries.
East Asia’s experience with SARS
One of the logical possibilities for why East Asian countries responded to the virus quickly and efficiently was their experience with the Severe Acute Respiratory Syndrome (SARS) only a few years ago. This experience meant that these countries knew exactly how to respond to a growing epidemic.
Taiwan is a perfect example in this regard. Because Taiwan was hit the hardest by SARS – with the highest mortality rate – they reacted with urgency and experience to the Coronavirus. It immediately banned the export of face masks, imposed a 14-day quarantine for all arrivals, imposed aggressive screening and testing, and restricted public movement and events in early stages. Taiwan also invested in better medical facilities after dealing with SARS. It now has around 2,000 beds in negatively pressurized isolation wards for severe covid-19 patients and more than 20,000 beds at hospitals across the country. It also added many more doctors to the CDC’s staff and invested in infectious disease labs to host viral testing. In addition to the government’s efforts, the public, traumatized by the mortalities during SARS, have been more willing to cooperate, follow government measures, and take extra precautions. The citizens of Taiwan are also more used to wearing face masks in public due to their experience with SARS.
These patterns are seen in other East Asian countries that were also hit hard by SARS, such as South Korea and China, which imposed lockdowns and other precautionary measures in the early days when countries in the West were still debating whether or not they should take action. This delayed reaction is thought to be one of the biggest reasons for Western countries’ failure in dealing with the pandemic. By the time these countries finally reacted and started imposing lockdowns, there had already been intense community spread, and hospitals began to overflood, causing unnecessary deaths.
Different cultural attitudes towards authority and individualism
Cultural attitudes towards the government and authority in East Asian countries make citizens of these countries more likely to comply with government rules.
Lee Sung-Yoon, a professor at Tufts University, speculated that Confucianism traditions in countries like South Korea, Singapore, and China cause greater respect for authority. This gives the state a freer hand in exercising authority, especially during a national crisis. This also means that when these governments impose lockdowns, enforce social distancing and face-covering rules and restrict public activities, citizens are more likely to respect these measures and adhere to them without protest. This can be seen through the fact that most citizens in East Asian countries started wearing masks even in the early stages of the virus and practiced social distancing. Furthermore, some East Asian countries are perhaps more used to authoritarian governments at some point in their recent history. Therefore, they are not likely to protest any government rules as they do not have the agency or safety necessary to do so.
Additionally, Confucianism is also associated with prioritizing the good of society over the good of the individual. This means people are more likely to accept negative changes in their lifestyle, such as the discomfort of wearing face coverings or limiting social activities to protect the rest of society.
In contrast, most Western countries have the opposite attitude toward the government. They see the government as having to fulfill their needs and not be overly paternalistic. This is why lockdowns in Europe and the USA, despite being extremely overdue, were faced with much backlash and protest. In the U.S., many took to the streets to protest against the lockdowns and the states’ abilities to force citizens to wear face masks and limit social interactions. These protestors believed that each individual should decide how to best protect themselves (and others) without government intervention. This ties into very individualistic sentiments that individuals should not be forced to do anything, even if it is for society’s benefit. For example, despite having the second-highest death numbers in Europe, Italy saw protests against the recently reimposed restrictions. However, it must be noted that some protests against the lockdowns are not individualistic and are based on the fact that lockdowns can lead to the worsening of citizens’ mental health and the massive loss of employment across the country.
Nevertheless, this hostile attitude towards authority means that governments in these countries will delay imposing lockdowns until absolutely deemed necessary to avoid negative public sentiment. Even when measures are imposed, citizens may blatantly refuse to obey them, such as in the USA, which makes it harder to contain the virus. Additionally, since the government would like to retain public approval, it may preemptively lift lockdown restrictions before it is advisable to do so. This can be seen by the fact that lockdown restrictions were eased just before the summer began in Europe, which then saw hoards of people flocking to the beaches, parks, and other outdoor areas while practicing very little social distancing. This led to an inevitable surge in Coronavirus cases and deaths.
Better Use of Technology
The government’s ability to use technology in its fight against the Coronavirus is linked to the point above. The use of technology becomes more acceptable when citizens have a more positive attitude towards the government. For example, many East Asian countries have been able to use contact tracing technology to trace potential carriers and contacts. This makes it easier to identify and slow down community spread. Hong Kong and South Korea have even gone as far as to use tracking bracelets. This, however, is unlikely to be tolerated in Western countries where data privacy is emphasized. People would be, justifiably, concerned with giving the government access to their location at all times.
East Asian countries have also been testing aggressively. South Korea became a notable case because, in the early stages, it had the highest number of cases outside of China. However, with aggressive testing, it became one of the successful controllers of the virus. It set up drive-through testing centres and used digital tracking technology, including CCTV footage and mobile phone location data, to monitor potential carriers.
Physical Differences in East Asian People
Some doctors hypothesize that the difference in death rates between Europe and East Asia may be because of differences in the immune system.
Tatsuhiko Kodama at the University of Tokyo found that Japanese people’s immune systems tend to react to covid-19 as if they had been previously exposed to it. This could be because East Asians have been more exposed to previous strains of coronaviruses, such as SARS. Another theory is that having the BCG anti-tuberculosis vaccine might improve the immune system’s response to the virus. However, the results of this are varied.
There are also theories that lower rates of obesity in East Asia, when compared to Europe, may allow East Asians to fight the virus more effectively. Around 20% of Western Europeans are classified as obese and 36% of Americans. In comparison, only about 5% of South Koreans and only 4% of Japanese people are obese, according to the WHO.
What can the West learn from successful East Asian countries?
Arguments attributing the difference in death rates between the West and East Asia to the differences in immune system responses are highly debated. Therefore, it can be assumed that the reason for the relative success of East Asian countries against the Coronavirus is because of their governments’ and the public’s reaction to the virus.
Going forward, until a vaccine is found, Western countries could adopt some of the measures used by these East Asian countries. It can impose stricter social distancing measures and make face masks mandatory. It can also make better use of technology by introducing voluntary-use contact tracing apps and increased and innovative forms of testing (such as training dogs to sniff out the virus). To gain public trust and thereby increase the chances of public compliance, the government should clearly explain the reasoning behind new lockdown measures and communicate an exit strategy so that citizens don’t feel like they are following these measures for nothing. The public itself in Europe should start to take this pandemic seriously, as there are now over 1 million deaths globally due in part to some’s reckless behavior. This includes social distancing, wearing a face mask whenever in public, avoiding unnecessary public and social events, and complying with government lockdown measures to reduce the number of unnecessary deaths.