For the first 15mo of the global pandemic, many analysts had held up Taiwan as an exemplar for how to handle a pandemic.  They had experienced only a few hundred well-monitored cases and only 7 deaths from COVID-19 for 15 months.  During this same period, Singapore also did very well.  They weren’t able to avoid infections with a high number of guest workers in a fast-growing City-State but they kept their case fatality rate low (CFR = 0.06%) due to a young population and a good healthcare system.  Japan, being a larger country with many International ties experienced all the travails of the global pandemic in 4 waves matching more or less those of the USA and the rest of the world.  They had a CFR that was near 2% – quite good for a population with high median age.  The fates of the 3 have diverged dramatically with the arrival of the Delta variant this Spring. 

Taiwan’s island nation status allowed them to isolate themselves from the storm raging outside in 2020.  Then they relaxed their vigilance and allowed a few airline personnel to come into contact with Delta and then they rapidly lost control.  Moreover, they got too complacent and did not push vaccinations very hard so much of the country was unvaccinated when Delta hit and Delta hit hard.  The CFR for Taiwan for Delta is a horrendous 5.3% – a tribute to the contagiousness and virulence of the Delta and a sign of how unprepared Taiwan really was to fight a serious pandemic. 

In Singapore, they were able to fend against Delta fairly well until just 2 months ago – then Delta hit hard.  Cases soared and now deaths are soaring as well. The CFR appears to be 0.3% or 5 times worse than prior but could well be 10X worse when this infection wave passes.  Curiously Singapore is one of the better-vaccinated countries in the world so that many of these cases and deaths must be breakthroughs.    

Finally, for Japan their Delta invasion came coincident with the Olympics.  Cases edged up in the weeks before the Olympics start as athletes arrived to prep for the Olympics and peaked within 10 days after the end of the Olympics.  At the peak, cases were nearly 3 times higher than for any prior peak.  However, it looks like CFR will be just 0.32% for this fifth wave.  How did Japan manage to do better against the Delta than prior variants when they had experienced CFR = 2.0% in wave #4?  One possible answer is that the median age of infectees had dropped for the Olympics.  Japan was just beginning to vaccinate its people and it started with the older, more vulnerable part of the population who were by nature more cautious and masked or stayed home.  The real answer may not be known for a few more months, though.

Against the Delta, the good turned in poor performances and the bad turned in better performances.  The Delta variant continues to confound scientists and governments.   Some are saying that if a highly vaccinated and masked Singapore can experience a Delta surge – no country is safe. The most prudent approach is to assume that with the Delta we are dealing with an entirely new contagion that requires high vigilance and much more study.