HealthCareBlogPublic Policy

What South Korean/Taiwanese “successes” dont resolve.

Much is being made of the “success” of covid containment in South Korea and Taiwan.

This seems based on rather superficial news reports. The BBC reports on Taiwan for instance say that people who were ‘suspected’ of infections were tested. What does that mean? Just symptomatic patients — or people who had come into contact with symptomatic patients, or what? Which tests were used? Who administered them? Was there (as in Aids) confirmatory testing?

The details are important. Effective practical interventions in any sphere have many moving parts — which have to fit with each other and with the specifics of the circumstances. (Which is why I think most RCTs are largely useless for designing practical interventions).


Then, there is the question of whether containment has simply kicked the can down the road?

Finally, I’m reminded of the unbridled enthusiasm for the East Asian corporatist/authoritarian model — which I had criticized before it peaked (in a WSJ oped, ‘The Crucial Weaknesses of Japan Inc,’ in 1981). So I take claims that S.Korea/Taiwan/Japan got it right with large helpings of salt.

At best we can say we wont know — if ever — many years from now. Even now, former Japanese students express grave reservations about the overreaction. (I have no former South Korean or Taiwanese students who Im in touch with).

My general personal preference is, when faced with vast irreducible “knightian’ uncertaintly, to make choices that focus on reducing the most likely/obvious harm. Not the most imaginable harm. (This rule of thumb does not alas answer to the ethical ‘trolley problem’)

The metaphor Id use is of pre-Galilean astronomers observing a large asteroid hurtling towards the earth. With the crude astronomical tables and crude telescopes available to them, they guess the meteor is a year away but they cannot calculate with any precision where it will hit the earth — or pass harmlessly by. It would then not be a sensible choice, in my view, to evacuate of all densely populated areas to minimize the loss of human life. Though, of course, if you could say with some confidence the asteroid would hit a large metropolis you would evacuate that place.

I understand that how to deal with this kind of Knightian/radical uncertainty involves highly personal preferences. But, Id prefer we recognize that there is ton of Knightian uncertainty out there concealed in a blizzard of models and graphs and make choices accordingly.

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