Did Asia Benefit From a Milder Variant?

Speculating about continental differences in COVID performance

Wikipedia map of cumulative COVID-19 cases by country and territory.

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This is not a new revelation to anyone who has been following the subject. But here are the official COVID-19 death rates per million inhabitants for a few major countries on different continents:

There’s a decent amount of variability among these large countries. It is much better, on this reading, to be Canada or Germany than to be Italy or the United States. But there’s also a lot of commonality. None of these countries, across three continents, managed to largely escape the ravages of the virus. And, at a continental scale, the overall impact of the virus on North America, Europe and South America was very similar: all three continents suffered between 1,500 and 1,600 deaths per 1,000,000 inhabitants.

Now consider another group of countries:

There’s a great deal of diversity here as well—you’d much rather be in Thailand than in Indonesia. But the worst-performing countries on this list performed an order of magnitude better than the typical countries on the other lists. And while you may credit South Korea with having implemented an especially exemplary response to their first outbreak, it’s notable that Japan, which has been far more lackadaisical, still performed ten times better than Germany, the star performer among major European countries. And the fact that the Philippines performed also performed many times better than Germany or Canada—even better than Denmark, and on par with Norway—is truly remarkable.

Of course, this is a snapshot in time. The Philippines, for example, has been dealing for the past month with a dramatic surge in cases and deaths. Which brings me to my point.

I have a very hard time believing that this continent-scale variation is entirely due to differences in containment policy, particularly when there’s such a wide variety of different governmental types in play with an array of different responses. I can’t help but wonder whether the virus itself was different. We know the virus evolved in Europe, and then spread to North and South America. Did it become meaningfully more transmissible and more dangerous along the way? And did the countries of the Western Pacific benefit from facing a more-manageable variant at the start, with the newer forms arising only after they had already closed their borders completely?

If that’s the case, then we might well learn it the hard way. India also fared quite well in its first wave, a testament to the alacrity with which they shut the country down, but also possibly a reflection of the nature of the virus it confronted at the time. That nature has changed: The rise of the “double-mutant” B.1.617 variant of the virus has been blamed for the incredible surge of cases and deaths in India, much as the rise of the U.K. variant was blamed for the surge across Europe, which devastated many countries in Central and Eastern Europe that had successfully dodged the first wave. Meanwhile, East Asia has, in general, been far laxer about vaccination than the West has been. If a milder strain at the outset explains at least part of the region’s outperformance to date, and the new strains are able to get a foothold in the region, we may see some degree of belated and unfortunate convergence after all.

I want to stress, as noted in the subhed, that this really is speculation on my part. I’d love to hear from people with more expertise. But I’m sure at a minimum it’s a question on the minds of Japanese officials who are still trying to get their Olympics off the ground.