The obvious point is that before any approaches used in different places are compared, you have to take into account the differences use there. Everyone likes to think the comparisons of, say, New Zealand and Australia, or NZ and the UK are fair, but there is no such thing. If I, as a complete non-epidemiologist, were to list the different factors that would affect how different states/countries experienced this outbreak:
- how many infected people were in the country before measures were taken
- how long before measures were taken
- the cultural and environmental background of each places (close living conditions, mask-wearing habits, outside vs. inside lifestyles and working environments)
- the adherence to measures
- the relative effect of seasons
All of these radically change how appropriate different measures would be and also what "success" and "failure" would look like.
New Zealand dodged bullets prior to the 3 February blocking of Chinese citizens (without NZ residency) into New Zealand, and the self-isolation of residents and citizens from there. If cases did arrive, they didn't spread it. There is evidence that infected people got to France, the United States and England well before the virus was even widely known in China. To my knowledge none of our cases or community spread originate back to an imported case from China. The UK and the US with their international hubs of London and New York were always odds-on to get cases or to have already gotten significant cases both before and after taking measures.
But Italy, Belgium and Iran were the famous early examples that were the first outbreaks outside of China. They were essentially ambushed by stealthy outbreaks that were already of scale well before testing was set up. I do not know if anyone can tell you the sequence of events or exactly why those two countries in particular felt the burn before other more likely countries to be epicentres. From a complete layperson, I'd say that it was all in the realms of "probabilities". Think about it: according to the presumed narrative of the virus, either by error or evolution, this novel coronavirus started spreading in Wuhan in late 2019. Not everyone had it. Nor would everyone have it. Only a relatively small proportion of the people infected would have had the plans on an international flight; but even if they weren't, they might be meeting other people who are or, more likely, travelling domestically and then giving it to others who might be travelling internationally. In the realms of the odds, all countries were rolling the dice with their open borders and international flights. Italy and Iran rolled snakes' eyes.
Sweden was often raised as a counterpoint to the lockdowns implemented by most of the western world and initially had lower cases and deaths than some of the others above, but they were incidentally less exposed to imported infections. There were no land borders with hotspots. Stockholm, the largest city, is not a travel hub. Even though you'd think it was as likely as say, Iran, to get infectious Chinese cases. Their first case was well before New Zealand's arriving in Sweden on 24 January, but it was over a month before the second case came. Sweden is slowly having it burn through: its morality rate per million has eased passed France. Given another month, and presuming the continued trend, it may overhaul Italy and Spain.
Mortality is also probabilistic. New Zealand's mortality rate is pretty dismal but is overrepresented by two nursing homes. Basically, a western country's numerical success with controlling the virus is really just shown by your ability to keep it out of nursing homes. What was the realistic odds on two having substantial outbreaks? Maybe it was most likely one, but with chances of zero and two. Two countries with the same approach and background, through probability alone might have zero and two nursing homes hit and a huge disparity in their mortality. It would be ridiculous to make comparisons unless one was more blaise about regulations for those facilities.
Hindsight is still a source of conceit for many, forgetting that when the decisions were made, it was not done with supernatural foresight. It was done by leaders with skin-in-the-game. If they get it wrong, they would be pilloried. Experts out of government or leadership are liberated to choose the approach that suits their own analyses; and progressively change their prescriptions and critiques as more information comes to hand. Back in the early stages I remember being quite proud of the approach taken because it made sense and was clear. But there was immediate criticism of New Zealand's approach because of Australia's apparent success with a lighter lockdown. But no-one could tell which approach would work best. If there was one thing about the "strictest measures in the world" in NZ, it was a path to elimination. We still have a theoretical probability of another case, to Tbe clear, but anything less that a stringent lockdown leaves a probability of further cases in the non-lockdown state both Australia and New Zealand are in. Yesterday there were 12 more new cases, and today 18 new cases, including a GP who acquired it from the community. And if you want an analogous transtasman contrast this podcast talks about a Black Lives Matter demonstration in Melbourne who tested positive.
A lot of the Plan B'ers had assumptions that a lighter approach would keep more economic activity, but it has always been a difficult prediction to make. If we, and the rest of the world, had an ongoing outbreak, would we have any tourists even with the border open? Would International students still come? In some ways, Covid or no Covid, our economy is going to be hammered. But perhaps the benefits of elimination were not accentuated: Whereas other countries are playing sport without crowds, New Zealand is having its games with packed stadiums, and the benefits for the economy that brings. As I have stated pre-lockdown, New Zealand could get a positive boost as a clean educational destination as we could scoop learners seeking a safe place to study once the border is open. Now all we need is some pragmatism with the border...
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