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People really need to understand the dangers of country-to-country comparisons without understanding the biases and counfounding - and simply pointing to X is doing better than Y. While regional strategies are learning points it is much more complex. Some fallacies below
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Time bias - we're pulling these snapshots at a particular time, and saying X country has it right. Time often shows the full picture. Look at Czech republic - once celebrated because of universal masking and their response, now heading into a dangerous surge.
Statistical bias - to compare countries with major differences in access to care, use of traditional medicine, testing, or death reporting - underrecognizes what the underlying burden. Table from 2008 recognizing availability of real death reporting and differences globally.
Thing about the above in terms of testing as well - India has done over 100,000,000 tests -- but who is getting tested and how often. If only the wealthy repeatedly tested - you likely severely underestimated the burden. Slums in India saw > 50% Ab+ https://www.bbc.com/news/world-asia-india-53576653
Ecologic fallacy - underrecognizing other confounding factors that cause a countries response. I've seen so many things - like the gender of political leaders, left or right, temperature, masking - even cabbage consumption. Doesn't recognize the above biases/confounders.
Authoritarian/Privacy - the elephant in the room, is the ability to command people varies, and does have a response. Double edged sword, it gives tools for more strongly driven responses , but it attacks individual rights. Nice diagram of South Korean CDC authority below.
Geography - a known trend that island states can control infectious diseases better than non. Track immigration, control at borders, apply interventions. Malaria in Zanzibar is exceptionally low, yet a 2 hour ferry to Tanzania is a different story. https://bit.ly/34s7G6u
Secondary effects - much praising places of lockdowns working - which they may have. But we if we don't acknowledge neg effects we are only telling half the story. Political distrust, unemployment, other adverse health outcomes all need to be on the table - not just # of cases
Many other complex factors - including taxation and resources for public health/healthcare, political stability and trust, self-sufficient vs dependent economies, food stability, urban density, etc.
Without acknowledging these - comparisons are fuelling misinformation
Without acknowledging these - comparisons are fuelling misinformation
