There was something startlingly insane about the Washington Post travel article, When Will Travel Be Safe Again?, by Hannah Sampson today. For inveterate travelers like myself it looked like a must-read. But it really turned out to be pretty worthless. "Facing a second spring without the promise of a break," she wrote, "frustrated would-be travelers can be forgiven for feeling weary. But, infectious-disease experts say, there are better days for travel ahead as the number of vaccinations increases and new coronavirus cases drop. Exactly when that will happen-- and what those days will look like-- is still unclear. And unknowns still loom: How long will immunity last after people are vaccinated or infected? Can they still transmit the virus? Will vaccines work as well as new variants emerge? What experts can say is that travel will be safer for some people, and in some places, sooner rather than later. They also agree that 'normal' is a long way away." Uh huh. And?
She invited 5 "experts" to bloviate. One, Eric Toner, "a senior scholar with the Johns Hopkins Center for Health Security," should never be invited back to spread his stupidity (likely based on bigotry). Unless Sampson is misrepresenting him, this is what this stupid man said:
For those who have gotten both shots and waited the two weeks for protection, he said, they should look for destinations where vaccination programs are robust, statistics are reliable and positivity rates are low-- 5 per 100,000 people or less.
He said Europe will probably be one of the first places that will be safe to visit, but he’s not sure when that will be.
“Maybe the summer; we’ll just have to see,” he said. “I wouldn’t book a flight yet.”
For other parts of the world, including Africa, South America and parts of Asia, he expects it to be a very long time before travel can resume in any kind of normal way.
“I think what we’re going to find is that things are going to be very uneven,” Toner said. “There’ll be parts of the world where the vaccination rates are very high and where we’ll feel perfectly comfortable traveling without wearing a mask, and other countries where vaccination rates don’t get as high and may never get as high as we’d like, in which case masking and distancing would still be required.”
Domestically, he also advised that only people who have been vaccinated or infected with the virus travel this summer.
“Even though a lot of people have been infected and a lot of people have been vaccinated, it’s probably still not the majority of people,” Toner said. “Your risk of getting infected is still big enough that I don’t think I would recommend people taking that risk.”
Europe? But not Asia? Why did no one at The Post notice he was talking out of his ass? It probably would have been a smart pandemic-coping strategy to have moved to east Asia a year ago to ride out the coronavirus there. Here are yesterday's stats for the 10 European countries Americans like to visit most followed by the stats for the 10 Asian countries Americans like to visit most. Included here are the number of new cases yesterday and the number of cases per million residents.
UK +9,938 (60,845 cases per million residents)
France +31,519 (56,013 cases per million residents)
Italy +16,424 (47,159 cases per million residents)
Germany +5,375 (28,712 cases per million residents)
Spain +9,212 (67,797 cases per million residents)
Netherlands +4,362 (62,295 cases per million residents)
Ireland +570 (43,605 cases per million residents)
Switzerland +1,343 (63,560 cases per million residents)
Austria +2,006 (49,822 cases per million residents)
Greece +1,903 (17,776 cases per million residents)
China +12 (62 cases per million residents)
India +17,106 (7,954 cases per million residents)
Japan +1,011 (3,387 cases per million residents)
Philippines +1,557 (5,125 cases per million residents)
Israel +2,936 (82,903 cases per million residents)
Hong Kong +17 (1,448 cases per million residents)
Taiwan +4 (40 cases per million residents)
South Korea +439 (1,718 cases per million residents)
Thailand +93 (367 cases per million residents)
Turkey +9,561 (31,382 cases per million residents)
How obvious is it that East Asia is where a traveler should be headed-- way before Europe? One great place to visit is a remote kingdom in the Himalayas, squeezed between India and Tibet (China), Bhutan. It's pretty close-- as the bird flies-- to northern Bangladesh and eastern Nepal as well. Yesterday there were zero new cases. The total has been 867, which comes out to 1,116 cases per million. There's only been one death and there are currently just 4 active cases, none of them serious. With a population of 777,106, they have administered 517,589 tests (666,047 tests per million residents)
A couple of weeks ago, Madeline Drexler wrote a Bhutan story for The Atlantic, The Unlikeliest Pandemic Success Story, asking how a tiny, poor nation managed to suffer only one death from the coronavirus. He was 34 suffering from liver and kidney problems. "What," she asked, "can the U.S. and other wealthy countries learn from the array of resource-starved counterparts that have better weathered the coronavirus pandemic, even if those nations haven’t achieved Bhutan’s impressive statistics? Countries such as Vietnam, which has so far logged only 35 deaths, Rwanda, with 226, Senegal, with 700, and plenty of others have negotiated the crisis far more smoothly than have Europe and North America."
These nations offer plenty of lessons, from the importance of attentive leadership, the need to ensure that people have enough provisions and financial means to follow public-health guidance, and the shared understanding that individuals and communities must sacrifice to protect the well-being of all: elements that have been sorely lacking in the U.S.
America has “the world’s best medical-rescue system-- we have unbelievable ICUs,” Asaf Bitton, executive director of Ariadne Labs, a Boston-based center for health-systems innovation, told me. But, he said, we have neglected a public-health focus on prevention, which socially cohesive low- and middle-income countries have no choice but to adopt, because a runaway epidemic would quickly overwhelm them.
“People say the COVID disaster in America has been about a denial of science. But what we couldn’t agree on is the social compact we would need to make painful choices together in unity, for the collective good,” Bitton added. “I don’t know whether, right now in the U.S., we can have easy or effective conversations about a common good. But we need to start.”
Over the course of three reporting trips to Bhutan since 2012, a word I heard innumerable times was resilience. It alluded to the fact that Bhutan has never been colonized, and to its people’s ability to bear hardships and make sacrifices. Resilience, I came to learn, is core to the national identity.
That mattered when the coronavirus began spreading early last year. At the time, Bhutan looked like a ripe target. It had only 337 physicians for a population of around 760,000—less than half the World Health Organization’s recommended ratio of doctors to people—and only one of these physicians had advanced training in critical care. It had barely 3,000 health workers, and one PCR machine to test viral samples. It was on the United Nations’ list of least developed countries, with a per capita GDP of $3,412. And while its northern frontier with China had been closed for decades, it shared a porous 435-mile border with India, which now has the world’s second-highest number of recorded cases and fourth-highest number of reported deaths.
Yet from the first note of alarm, Bhutan moved swiftly and astutely, its actions firmly rooted in the latest science.
On December 31, 2019, China first reported to the WHO a pneumonia outbreak of unknown cause. By January 11, Bhutan had started drafting its National Preparedness and Response Plan, and on January 15, it began screening for symptoms of respiratory ailments and was using infrared fever scanning at its international airport and other points of entry.
Around midnight on March 6, Bhutan confirmed its first case of COVID-19: a 76-year-old American tourist. Six hours and 18 minutes later, some 300 possible contacts, and contacts of contacts, had been traced and quarantined. “It must have been a record,” Minister of Health Dechen Wangmo-- a plain-spoken Yale-educated epidemiologist-- told the national newspaper Kuensel, with evident pride. Airlifted to the U.S., the patient was expected to die, but survived. According to an account in the Washington Post, his doctors in Maryland told him, “Whatever they tried in Bhutan probably saved your life.”
In March, the Bhutanese government also started issuing clear, concise daily updates and sharing helpline numbers. It barred tourists, closed schools and public institutions, shut gyms and movie theaters, began flexible working hours, and relentlessly called for face masks, hand hygiene, and physical distancing. On March 11, the WHO tardily deemed COVID-19 a pandemic. Five days later, Bhutan instituted mandatory quarantine for all Bhutanese with possible exposure to the virus-- including the thousands of expatriates who boarded chartered planes back to their homeland-- and underwrote every aspect, such as free accommodation and meals in tourist-level hotels. It isolated all positive cases, even those who were asymptomatic, in medical facilities, so early symptoms could be treated immediately, and provided psychological counseling for those in quarantine and isolation.
Bhutan then went further. At the end of March, health officials extended the mandatory quarantine from 14 to 21 days-- a full week longer than what the WHO was (and still is) recommending. The rationale: A 14-day quarantine leaves about an 11 percent chance that, after being released, a person could still be incubating the infection and eventually become contagious. Bhutan’s extensive testing regimen for people in quarantine, Wangmo added at a press conference, was “a gold standard.”
While President Donald Trump was railing against coronavirus surveillance, Bhutan launched a huge testing and tracing program, and created a contact-tracing app. Last fall, the health ministry rolled out a prevention initiative called “Our Gyenkhu”-- “Our Responsibility”-- featuring influencers such as actors, visual artists, bloggers, and sports personalities. When, in August, a 27-year-old woman became the first Bhutanese in the country to test positive for COVID-19 outside of quarantine, a three-week national lockdown followed, with the government ramping up testing and tracing even more, and delivering food, medicine, and other essentials to every household in the land. In December, when a flu clinic in Thimphu turned up the first case of community transmission since the summer, the nation again entered strict lockdown—and again, a full-throttle campaign prevailed against the virus, which has been all but snuffed out for the time being.
In tandem with this rigorous public-health response came swells of civic compassion from every level of society. In April, King Jigme Khesar Namgyel Wangchuck launched a relief fund that has so far handed out $19 million in financial assistance to more than 34,000 Bhutanese whose livelihoods have been hurt by the pandemic, a program extended until at least the end of March. The government created a country-wide registry for vulnerable citizens, and has sent care packages containing hand sanitizer, vitamins, and other items to more than 51,000 Bhutanese over the age of 60. The Queen Mother gave a frank address to the nation, calling on the authorities to ensure services for sexual and reproductive health, maternal, newborn, and child health care, and services for gender-based violence, which she deemed “essential.” Thousands of people signed up to leave their homes and families for extended periods of time to join the national corps of orange-uniformed volunteers known as DeSuung. Bhutan’s monastic community-- highly influential in a Buddhist and still largely traditional culture-- not only pointedly reinforced public-health messaging but also prayed daily for the well-being of all people during the crisis, not just the Bhutanese.
Government officials modeled the same altruism. During the country’s summer lockdown, Wangmo, the health minister, slept in ministry facilities for weeks, away from her young son. Prime Minister Lotay Tshering, a highly respected physician who continued to perform surgeries on Saturdays during most of the crisis, slept every night during the lockdown on a window seat in his office-- a photo in the newspaper The Bhutanese showed his makeshift bed’s rumpled blankets and an ironing board standing nearby. Members of Parliament gave up a month’s salary for the response effort; hoteliers offered their properties as free quarantine facilities; farmers donated crops. When lights in the Ministry of Health’s offices burned all night, locals brought hot milk tea and homemade ema datshi-- scorching chilies and cheese, the national dish.
“I have complained about ‘small-society syndrome’ and how suffocating it can get. But I believe it is this very closeness that has kept us together,” Namgay Zam, a prominent journalist in Bhutan, told me. “I don’t think any other country can say that leaders and ordinary people enjoy such mutual trust. This is the main reason for Bhutan’s success.”
...Bhutan has helped define pandemic resilience. “What I learned from Bhutan is that the health sector alone cannot do much to protect people’s health,” de Jesus told me. Lamsang agreed. Pandemic resilience, he said, came from “things that we don’t count normally, like your social capital and the willingness of society to come together for the common good.”