Thread by @ASPphysician

Prompted by several posts and threads, I am going to outline what I view as the "A-PAC Approach"

A-PAC refers to Asia-Pacfic and Atlantic Canada: 🇦🇺(25M), 🇨🇳(1.39B), 🇯🇵(126M), 🇳🇿 (5M), 🇰🇷(52M), 🇹🇼(24M), 🇹🇭(69M), and 🇻🇳(96M). Atlantic 🇨🇦 has 4 provinces ((NS, NB, NFLD, PEI, 2.4M)

These countries/provinces have varying geography, population size and density, degrees of democratic norms; some are islands, but others share sizable borders. Several have used a cordon sanitaire (i.e. making a region an island, even if it isn't one) to create an "island".

The A-PAC Approach consists of 6 principles:
1. Aim for really low number of new cases and zero transmission
2. Ensure any new people (esp. cases) coming in from outside are quarantined
3. Aggressive test-trace-isolate
4. Strong public health leadership

5. Consistent and clear communication
6. An accepting and compliant public

You cannot choose 6, although you can certainly influence it by being clear on your strategy and focusing on Principle 5.

The Examples of the rest of Canada, the US, and Europe (ExCUSE) are the failing alternatives.

Whereas A-PAC economies are recovering (some even thriving), their popn is recovering, and travel resuming, EXCUSE economies will continue locking down repeatedly.

For most ExCUSE economies, it is too late in the second wave to adopt avoid lockdown with the A-PAC Approach. But its not too soon for them to start focusing on an A-PAC Approach. It will need:
1. PH community coming on board and speak w/ singular voice
2. Politicians buying in

The A-PAC Approach barely bothers with predictive modelling of health care strain—because it is never expected to occur—and business owners have relative predictability.

ExCUSE economies constantly fret with instability, because the approach is unstable.

The A-PAC Approach has been proven to work repeatedly. The ExCUSE economies/advocates CANNOT POINT TO A SINGLE WINNING EXAMPLE, and yet they find reason after reason to not adopt the A-PAC Approach (prove me wrong).

One last important thing: people have been obsessed w/ keeping R<1. The problem: this assumes that you have good surveillance. We know that a PCR swab-based strategy is not surveillance. So we cannot rely on looking at R—it will always mislead w/o real surveillance. It also ...

(and this is the key) MISLEADS PSYCHOLOGICALLY. When numbers appear low, and growing slowly w/o healthcare strain (like in most ExCUSE economies in the summer), there is no urgency for governments to act. This is the BIGGEST FLAW with this approach—nobody acted when they should.

If you are somewhere locked down, or are worried about an impending lockdown, look back to the 6 principles of the A-PAC Approach and find a good reason why it isn't being followed. I think all you will find is you are an ExCUSE.