I made the decision to cut my trip short and return home on March 15, 2020. My Thai visa expired March 17, 2020, and I had two options: to leave Thailand, or to extend my visa. My plan had been to go on to Cambodia, but this was no longer an option. Cambodia now banned US residents from entering due to the spread of the virus in the US. Within a day of Cambodia’s announcement, Vietnam also announced travel restrictions. Myanmar and Laos, had neither reported a single case of COVID-19 and that was as troubling. With cases all around them, to not report a single case seemed like more of an indictment of their public health systems than a demonstration of the robustness of these systems. Cases were also on the rise in Malaysia and travel there would be restricted within days. As I cast about for places to go after Thailand, the world seemed to be closing in on me. If I extended the Thai visa, what would the world look like in mid-April? I could foresee a situation where I had to leave Thailand, but could go nowhere, including the US.
I bought my ticket from Bangkok to Taipei to Los Angeles and a second ticket from Los Angeles to Kansas City that day. As I traveled from Bangkok to Kansas City on March 17 and 18, 2020, cases of COVID-19 increased from 169,387 cases worldwide to 214,894.
For background, I started making arrangements to travel on December 27, 2019, four days before China reported its first case of COVID-19. I also bought a travel insurance policy at that time as I planned on this trip lasting four months and there seemed to be ample opportunities for something to go wrong. When I left for Thailand, on February 16, 2020, new cases in China were declining from day to day, the US had only 15 confirmed cases and Thailand had 33 confirmed cases. The virus appeared to be coming under control. By mid-March China was reporting new cases at the rate of a few a day, Thailand had a total of 82 cases, the US had thousands of cases and Europe was on fire, reporting tens of thousands of cases.
On March 15, it became clear that curtailing the trip was becoming my only option. As the Israeli politician Abba Eban observed, “Men and nations behave wisely when they have exhausted all other alternatives,” I was now behaving wisely, I hoped. I had been resistant to returning to the US because southeast Asia appeared to have the disease mostly under control, while the US struggled to come to terms with the pandemic. The US bungled its testing, the President downplayed the severity of the disease and discounted its contagiousness. He even implied it was a hoax, lied about the country’s ability to respond, and still refers to the disease as “Chinese.” The US looked as though it might become the next epicenter of the outbreak. Traveling by plane and potentially into the eye of the storm seemed like a bad decision, but I had now exhausted all other alternatives.
I met my friend Taweesak for lunch the day before I left Bangkok. Taweesak is an artist who has taught and studied in the United States, but now lives in his native Thailand. He said that a difference between western thought and eastern thought was that in the west, we tend to develop a hypothesis and test the hypothesis, whereas in the east, more emphasis is placed on observations of the physical world. These differences in thought process are learned at a very early age and when in doubt, we revert back to these processes. It’s not quite our reptile brains kicking in and taking over, but more our toddler brains.
This difference in the thought process has colored the responses to pandemic in eastern and western countries. Both cultures have the same weapons in their arsenal, including:
Hand washing or sanitizing
Public health checks
Cleaning public spaces
Covering one’s face and the wearing of Personal Protective Equipment (PPE)
Practicing social distancing
Practicing social isolation
Quarantine, curfews and restricting commerce
In Thailand, all of these solutions were implemented to one degree or another. By the time I left Bangkok, the standard procedure to enter most public buildings was to be greeted by someone with an instant read thermometer, a bottle of hand sanitizer and a sticker. All of these were mandatory. Your temperature was checked, hand sanitizer was squirted in your hand, and you were rewarded with a sticker. This occurred at the airport in Bangkok (though I don’t think they were giving out stickers). When I deplaned in Taipei, they were waiting with hand sanitizer and instant read thermometers. In LA and Kansas City, hand sanitizer was not provided though everyone seemed to agree it was a good idea and many brought their own. My temperature was not checked in either place. The lack of sanitizer may have been a result of the US being caught off guard by a large scale pandemic that had been building for months because in normal times, most grocery stores provide hand sanitizer at their entrances. I assume that the lack of public health screening was also a result of the government being caught off guard and of a government structure of the US that doesn’t lend itself to quickly adopting best practices.
In Thailand, workers could be seen in public spaces wiping down handrails and escalators, anywhere someone might have touched. I didn’t notice these workers in the US. I don’t know why this is, but my suspicion is that Americans like things just so and don’t want to acknowledge that cleaning is an effort. Asians observe the world and accept that things need to be cleaned. Americans like to believe it’s magic and that the cleaning stay as out of sight as much as is possible. It also helps hold the wages down.
One of the most obvious differences is that large numbers of people in eastern cultures cover their faces, whereas this is nearly unheard of in western cultures. There are several reasons for this, including poor overall air quality in large Asian cities and the response to the Spanish flu of 1918. Those aren’t important now, but they do come back to Taweesak’s point. If I were to tell you that there was an airborne hazard, whether it be smoke or dust or a virus, the first reaction would be to cover one’s face. Whether it’s desert nomads or firefighters or surgeons, they all cover their faces. This is simply a response to an observed condition without any need for a tested hypothesis.
Before I go further, I should note that Asian governments are as resolute in their support of masks as Western governments are in their opposition. Hong Kong has publicly stated that masks prevented the epidemic from taking hold there (though some residents criticized their government because masks were more readily available in Macau), the top public health official in Thailand attacked Caucasians with an ethnic slur for not wearing masks, saying that they should be expelled from the country for spreading the disease by not wearing masks.
When western thought enters, we want to see evidence showing that covering one’s face is effective. From what I can tell, those studies don’t exist. We do have studies showing that respirators in the workplace in hazardous environments must be properly fitted and have the proper cartridge for the environment to be effective. So, with no study addressing our concern, we apply the closest ones we have. In the west, this means that not only do we not wear masks because we can’t insure that they are properly fitted and have the proper filter, we actively tell others not to wear masks. Western thought was formalized in the scientific method and evolved into a system where scientific discovery is published in journal articles and is open to peer review and can be criticized. In order to operate in this system, one must possess the self confidence to put their opinions out in the world knowing they will be attacked and the hubris to attack the ideas of others. The unpatentable idea of covering one’s face is never studied because no one wants to fund a study to prove something where no one stands to profit. There may also be some xenophobia against Asians, as the Thai minister had displayed against Caucasians.
In the airports in Bangkok and Taipei, nearly everyone was wearing a mask. On the planes out of Bangkok and out of Taipei, the flight crews were all wearing masks as were most of the passengers. At LAX and at MCI, almost no one was wearing a mask. On the flight to Kansas City, the flight crew was not wearing masks and only two passengers (including me) were covering their faces.
The West has invested a lot of emotional and intellectual energy in the not wearing of masks. The East has accepted that wearing masks helps. The evidence proving or disproving the efficacy does not exist, but the East followed their intuition. The West reverted to their toddler brain and as we know, most toddlers would prefer to just run around naked and screaming.
The practice of social distancing and isolation is much harder to maintain in both cultures. Both cultures seem to embrace the practice in principal. In practice, the West probably does better, though neither were practiced very successfully in airports or on planes. Particularly in the large cities of the East, people are crammed tightly together on public transit, in food stalls or wherever you are. Spaces are just tight. This probably another reason that Asians have embraced masks. Outside of airports, the West tends to be more open, cars are a more common mode of transport. Distancing and isolation are more a way of life.
Quarantines, curfews and the closing of businesses are probably the most draconian measures taken to combat the spread of disease. Everyone seems to understand how these work. In China, quarantines were implemented quickly, but still more than 80,000 eventually came down with the disease. I am not aware of this being done on a large scale anywhere else in Asia. Quarantines and curfew have now been implemented on a large scale in Europe. One would think that this would be nearly impossible to do in Europe, but the situation was getting so out of control so fast, that the public appears to have accepted it. In the US, the federal government does not have the authority to implement these measures. State and local governments have the power of policing. This leads to uneven implementation, though by now, most areas have settled on some form of limiting commerce.
No one knows how or when this pandemic will end. Undoubtedly, millions of people will contract the disease and tens of thousands will die from it. At this point, the Asian countries appear to have done the best job of containing the spread, but at this point, the spread could ebb and flow several times and we appear to be a long way from being able to declare victory. It is clear that many will die and trillions of dollars of economic output will be lost before the virus is brought under control and it should be fought with every weapon in our arsenal. Some measures are more easily implemented than others, but none should be discounted. Xenophobic and ego-driven attacks are not helpful. We have a common enemy and don’t need to fight each other.