Covid-19, the Territory Anomaly

[bruto]

I don't know whether it's medically sound, but it sounds like a nice excuse to get some good food. I'll have the broccoli in garlic sauce and the hot and sour soup lunch special, please.

[dann]

Quote:

The World Health Organization has identified Latin America as the new centre for coronavirus pandemic, but over the last two months, cases in Cuba have fallen. Cubans are now 24 times less likely to catch the virus than Dominicans, 27 times less likely to catch it than Mexicans, and more than 70 times less likely to be infected than Brazilians.
(…)
“Asymptomatic cases are identified through contact tracing followed by antibody testing and, when positive, a PCR [polymerase chain reaction test, which can find viral particles on a person] for confirmation,” she said.
(…)
In Cuba there is no judicial recourse to enforced isolation. The use of face masks in public is mandatory, and people who refuse to wear them can be fined or even jailed.
(…)
At a time when eccentric, anti-science populists run the region’s most powerful countries, Cuba’s evidence-based approach – and strict enforcement – sets it apart.
“Their real success has been applying the most important public health measures that physicians around the world know are effective,” said Reed. “And they’ve had the political will to make it work.”
Cuba sets example with successful programme to contain coronavirus (The Guardian, June 7, 2020)

Not a lot of tests, 10,461 per million, but having doctors visit families on a daily basis, testing only suspected cases seems to work.

Total cases: 2,191
New cases: 18
Active cases: 246
Serious/Critical: 3
Total deaths: 83
Deaths per million: 7

[bruto]

In a little side story on the territory anomaly, Vermont has until just recently been doing very well, with no new deaths and cases decreasing well, until someone in Winooski apparently hosted a party, and there's now a sudden big pocket of new cases, all traceable back to that party. Winooski, though small in area, is the most densely populated city in Northern New England, and has a high population of immigrants and non-English speakers, and although the state has been coy about saying just who was involved, there's a lot of talk of how poorly the need for quarantine and social distancing has been communicated in marginal communities. Aside from the language issue, many of the poorer residents of this area have few resources with which to ride out a crisis without getting out and working. Despite being traceable to a single very local event, once people went home, they spread the virus around the whole city.

I guess we'll eventually learn more, but in Vermont, with a state population of only about a half million, a local outbreak of 34 confirmed cases makes a big dent in the statistics, and points to how easily the relative advantages of territory can be wiped out overnight, whether by poor education, ignorance, or just plain stupidity.

[Ulf Nereng]

Originally Posted by dann

Not a lot of tests, 10,461 per million, but having doctors visit families on a daily basis, testing only suspected cases seems to work.

Total cases: 2,191
New cases: 18
Active cases: 246
Serious/Critical: 3
Total deaths: 83
Deaths per million: 7

Vietnam has done even better, apparently.

https://www.bbc.com/news/world-asia-52628283

Looks like communism can be good for something, after all!

[The Atheist]

Originally Posted by dann

Total cases: 2,191
New cases: 18
Active cases: 246
Serious/Critical: 3
Total deaths: 83
Deaths per million: 7

Now look at PNG:

Total cases: 8
All recovered

Or Taiwan: 443 cases, 7 deaths

Islands are easy. (Unless you're GB)

[dann]

New Zealand:
Active cases: 0

[Darat]

Originally Posted by dann

New Zealand:
Active cases: 0

Yeah ....but.....

[dann]

Originally Posted by The Atheist

Islands are easy. (Unless you're GB)

Or Sint Maarten: 350 (deaths per million). Or Isle of Man: 52.2. Or the Dominican Republic: 50.

Don't fool yourself. Islands, even small islands, are all over the place. If they are tourist destinations, it probably doesn't matter much if they are islands or not. But contact tracing is probably easier in places like that. It still has be done, however.

[The Atheist]

Originally Posted by dann

Or Sint Maarten: 350 (deaths per million). Or Isle of Man: 52.2. Or the Dominican Republic: 50.

I have no idea what measures those islands took, but I'm going to guess that Isle of Man was heavily influenced by the dirty Pommies.

Islands that have managed to avoid it acted fast and responsibly.

While you found a few islands that were hit hard, if you take a look down the Covid list, you'll see a huge group of island nations right at the bottom.

That list includes a few that are so under-developed, "Third World" doesn't even come close. Timor-Leste and PNG, to name a couple, plus countries like Vanuatu, Palau and Niue, which don't even appear on the list, having zero cases to date.

If you check, you'll find that south Pacific islands are amazingly free of Covid. Only Fiji had any cases and nobody died anywhere that I'm aware of.

But they're not an anomaly, it's because those islands follow NZ & Australia (which is only fair, since we pay all their bills) and shut down hard in the knowledge they wouldn't begin to cope.

Originally Posted by dann

Don't fool yourself. Islands, even small islands, are all over the place. If they are tourist destinations, it probably doesn't matter much if they are islands or not. But contact tracing is probably easier in places like that. It still has be done, however.

You'd actually be amazed how smart these ****hole little islands have been. They all have elected leaders - most of whom are good guys - who managed something a lot of OECD countries didn't: follow the science.

While they mightn't have doctors and hospitals, they have literate populations who listened, followed the rules and have welcomed tracing. If the virus does get to those islands, they're in superb shape to deal with it from a logistical perspective.

Fiji gets a lot of tourists, including Americans, so it's not just a lack of tourists. Almost all of their economies rely heavily on tourism, which is zero right now, so we're about to pick a few more tabs, I think.

Which all segues nicely back into the topic - I keep wondering if nobody had done anything, based on Hawaii's ridiculously low numbers, what would have happened in those islands.

[dann]

Originally Posted by The Atheist

I have no idea what measures those islands took, but I'm going to guess that Isle of Man was heavily influenced by the dirty Pommies.

Islands that have managed to avoid it acted fast and responsibly.

While you found a few islands that were hit hard, if you take a look down the Covid list, you'll see a huge group of island nations right at the bottom.

That list includes a few that are so under-developed, "Third World" doesn't even come close. Timor-Leste and PNG, to name a couple, plus countries like Vanuatu, Palau and Niue, which don't even appear on the list, having zero cases to date.

If you check, you'll find that south Pacific islands are amazingly free of Covid. Only Fiji had any cases and nobody died anywhere that I'm aware of.

But they're not an anomaly, it's because those islands follow NZ & Australia (which is only fair, since we pay all their bills) and shut down hard in the knowledge they wouldn't begin to cope.

You seem to confuse me with somebody who is trying to prove that islands are at the other end of the scale from what you're suggesting. Don't forget that I was the one who wrote about the Faroe Islands months ago. I don't claim that Covid-free islands are an anomaly. On the contrary. I'm showing you that it's not necessarily an island thing. In the Sweden thread, Rolfe pointed out that Mongolia is one of the places that has succeeded in keeping Covid out. And it's not exactly an island.
I was responding to your idea that "Islands are easy. (Unless you're GB)" by pointing out to you that there are many other exceptions to your rule. GB is far from the only one. Besides, you should take a look at some the many islands that aren't island nations. The island of Zealand, for instance, which I am very familiar with, didn't do too good, but we're still fighting it. (The bridge to Sweden doesn't help!) You should also take a look at some of the Spanish islands, for instance the Canaries or the Balearic Islands. They have done better than the mainland, in particular Madrid and Barcelona, but with the many tourists from all over Europe - and the usual fear of harming the businesses depending on tourism - they soon had cases like everywhere else.

Quote:

You'd actually be amazed how smart these ****hole little islands have been. They all have elected leaders - most of whom are good guys - who managed something a lot of OECD countries didn't: follow the science.

No, I wouldn't be surprised at all. Why would I? Again: I pointed out the Faroe Islands to you a very long time ago! Again: You make the mistake of thinking that because I pointed out your bias, I must have the opposite bias. I don't.

Quote:

While they mightn't have doctors and hospitals, they have literate populations who listened, followed the rules and have welcomed tracing. If the virus does get to those islands, they're in superb shape to deal with it from a logistical perspective.

Fiji gets a lot of tourists, including Americans, so it's not just a lack of tourists. Almost all of their economies rely heavily on tourism, which is zero right now, so we're about to pick a few more tabs, I think.

Which all segues nicely back into the topic - I keep wondering if nobody had done anything, based on Hawaii's ridiculously low numbers, what would have happened in those islands.

So let me repeat myself: "Islands, even small islands, are all over the place." They are all over the place literarily, geographically, from the South Pacific to the North Atlantic, and they are so figuratively as well, in terms of where they are on the coronavirus scale.

[The Atheist]

The anomalies are starting to work along some peculiar fault lines.

South East Asia - no problemo. Apart from Philippines & Indonesia, the entire region has done remarkably well, considering that's where it started.

West Asia & North Africa are going very badly, with massive case increases and plenty of deaths, led by Iran, but with India catching up fast. Pakistan, Bangladesh, A'stan, right through to Iraq, the region is being hit hard.

Sub-Saharan Africa, aside from South Africa looks amazingly good. I see lots of Africa nations in the minimal harm list, with Burundi, Angola, Mozambique, Malawi, Rwanda and Benin all with well under 1 death/million people.

The problem is accuracy, and with the President of Burundi allegedly croaking of Covid, one does wonder, but some of the countries do have more believable systems, Angola from that list as well as Kenya & Uganda.

The Americas go without saying.

I think we can explain SE Asia with fast action, but the African nations haven't had that luxury.

It may still take off there, I suppose, but the numbers haven't grown and they've all had the virus for a while now.

[dann]

You should take a look at the article Rolfe linked to in the Sweden thread: It compares countries, strategies and outcomes - so far.

Originally Posted by Rolfe

Tomas Pueyo has had a pop at Sweden's "strategy" today.

Coronavirus: Should We Aim for Herd Immunity Like Sweden?

From the graphs in that article there's something a bit alarming going on. The "something a bit odd" I mentioned above was that Sweden's cases, although not declining, seemed to be on a plateau rather than continuing the exponential increase. The graphs in the Pueyo article are showing new cases taking off like a rocket in early June.

It is one of the most comprehensive articles about the 'territory anomaly' I have read.

[dann]

Originally Posted by The Atheist

I think we can explain SE Asia with fast action, but the African nations haven't had that luxury.

It may still take off there, I suppose, but the numbers haven't grown and they've all had the virus for a while now.

The numbers in at least some of the African countries aren't reliable. Tanzania doesn't report them at all and assumes that God has already solved the problem.

[The Atheist]

Originally Posted by dann

It is one of the most comprehensive articles about the 'territory anomaly' I have read.

I did - it's interesting, but only skips over issues outside of Scandinavia. I don't think it's that helpful as a world view, because they make some assumptions about places like NZ & Aussie and never even mention Hawaii.

Originally Posted by dann

The numbers in at least some of the African countries aren't reliable. Tanzania doesn't report them at all and assumes that God has already solved the problem.

Yeah, I know about that one - the country where 18% of all those killed by Covid were Members of Parliament.

But quite a few African countries are making efforts and have stats as reliable as USA and more reliable than lots of South American countries, so I'm not going to tar the rest for a couple of bad apples, to mix a few metaphors!

[zooterkin]

Originally Posted by pipelineaudio

I bet you are right. And in our case the number is so low that little changes could have huge apparent impacts in the trends and graphs. We could sky is falling double our cases and still appear to be very lucky, or miracle halve our cases and on balance be doing just as bad.

How goes it now?

[pipelineaudio]

We're worst i nthe country now according to RT Live for reproduction rate, finally pushing towards 1000 total cases, I think we are at 800 now.

We went from weeks of 0 cases after our initial surge to a few days of 15-25 cases per day

[The Atheist]

Very low numbers, though, so it will be interesting to see if it stays that way, or takes off. Give it a fortnight.

[zooterkin]

Originally Posted by Darat

That should show up in UK deaths, as from 1953 to 2005 we had a universal BCG policy for all kids (usually around 13). Which would mean we should increases in fatalities in age groups (against countries with current universal BCG) for anyone born say before 1940 and anyone born after 1992.

Well, I guess that didn’t pan out.

Also, I was just talking to my mum, and she had a BCG vaccination when she was a teen, and she was born in 1933.

[dann]

I don't think this one has been mentioned before:

Quote:

Latinamerika har förvandlats till världens nya epicentrum för coronaviruset. Men en grupp människor tycks stå emot smittan bättre än andra – bergsfolken i Anderna.
[url=https://www.dn.se/nyheter/varlden/coronamysterium-forbryllar-experter-i-anderna/]Coronamysterium förbryllar experter i Anderna]/url] (DagensNyheter.se, June 25, 2020)

Translation:
Latin America has turned into the world's new epicenter for the coronavirus. But one group of people appears to resist the infection better than others - the mountain people in the Andes.
Corona mystery puzzles the experts in the Andes

Quote:

Although the scientists have warned that the pattern of lower infection rates may not last, they are intrigued by the findings and are starting to focus on the relationship between the virus and altitude. Specifically, the researchers suggest factors including the people living at high altitudes' ability to cope with Hypoxia, dry mountain air, and high levels of UV radiation could all be playing a part in protecting high altitude communities from the virus.
(...)
When tourists from Mexico, China and Britain became the first covid-19 fatalities in Cusco, Peru, it seemed as if the onetime capital of the Inca Empire might be headed for a significant outbreak.
(...)
Yet since those three deaths, between March 23 and April 3, at the start of Peru’s strict national lockdown, there has not been another covid-19 fatality in the entire Cusco region, even as the disease has claimed more than 4,000 lives nationally.
Coronavirus: Fewer Infections among High Altitude Peoples (UNPO, May 31, 2020)

So if you are looking for a way to make your offspring less susceptible to the 'rona, you should consider calling your local pan flute player.

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.

I AGREE

[Darat]

Originally Posted by zooterkin

Well, I guess that didn’t pan out.

Also, I was just talking to my mum, and she had a BCG vaccination when she was a teen, and she was born in 1933.

Back then it was more hit or miss, apparently they'd vaccinate in certain areas - such as dense conurbations or if they thought there had been an outbreak in the area.

[The Atheist]

Originally Posted by dann

I don't think this one has been mentioned before...

and high levels of UV radiation

Hmmm.

Good spot, thanks. Well worth keeping an eye on, and the exact opposite of what's happening to indigenous populations closer to sea level.

[zooterkin]

Originally Posted by The Atheist

Hmmm.

Good spot, thanks. Well worth keeping an eye on, and the exact opposite of what's happening to indigenous populations closer to sea level.

Could also be a factor in the lack of a spike of cases in the UK following the first BLM marches and people heading off to the seaside a couple of weeks ago. The virus doesn’t seem to survive long in the open air at this time of year.

[dann]

Originally Posted by zooterkin

Could also be a factor in the lack of a spike of cases in the UK following the first BLM marches and people heading off to the seaside a couple of weeks ago. The virus doesn’t seem to survive long in the open air at this time of year.

You can probably leave out the at-this-time-of-year part. We have discussed this in the Sweden thread.
10 people may have been infected at the BLM march in Copenhagen June 7.
A few appeared to have been infected at the march, but when you advise 15,000 protesters to get tested, it would be astonishing if a few new cases aren't discovered.

[zooterkin]

Originally Posted by dann

You can probably leave out the at-this-time-of-year part. We have discussed this in the Sweden thread.
10 people may have been infected at the BLM march in Copenhagen June 7.
A few appeared to have been infected at the march, but when you advise 15,000 protesters to get tested, it would be astonishing if a few new cases aren't discovered.

Well, temperature also seems to be a factor, as well as UV light, so time of year may well be significant.

[marting]

Interesting paper speculating that the rate of evaporation of droplets is a factor in regional differences. The lower the humidity the quicker larger droplets evaporate, weigh less, and stay airborne longer. Also diffusion rates increase as droplet size decreases. Hence humidity and prevalence of A/C may influence Covid-19 progression.

https://icite.od.nih.gov/covid19/sea...ename=main.pdf

Quote:

The new pandemic of SARS-CoV-2 has shown stark differences in number of affected patients between countries in the tropics and those with temperate environments. Though there have been many theories on reasons for these differences, we hypothesise that this could be due to differences in the fate of respiratory droplets in the two environments.

[The Atheist]

Originally Posted by marting

The lower the humidity the quicker larger droplets evaporate, weigh less, and stay airborne longer.

That sure doesn't fit Hawaii.

[marting]

Originally Posted by The Atheist

That sure doesn't fit Hawaii.

Not sure about Hawaii. They have an indoor mix of places kept cool with A/C and others that don't. Pretty humid weather but high temps are rare. Similar to Florida earlier this year but Florida gets pretty unlivable w/o A/C in summer.

Florida is currently having rapidly spiking cases. Humidity there is always very high. But there are other factors. Covid-19 seems to spread mostly indoors and in the intense summer heat lots of folks are spending more time indoors. A/C, of course, removes a great deal of water from the air.

Most all indoor heaters do not add water to the air while the majority of A/C units remove water from the air.

Worse in the winter in the USA North because air is heated and indoor humidity is typically quite low (heating air reduces relative humidity) while Florida temps are quite mild but with very high humidity. It's common for Florida indoor humidity to be higher in the winter than summer.

I see this as a possible factor in a complex, multifactor system that determines R variations in places and cultures. I don't see it explaining differences in regional IFR variations and that would be more useful in fighting the bug.

[pipelineaudio]

In Hawaii you will find A/C inside some businesses, but for residence, its mostly only tourists who would have it, except possibly in apartments.

I keep worrying about turning the ones on inside my business as it always seems like A/C is a not good thing whenever its involved

[The Atheist]

If AC is a factor, NZ will be fine whatever happens, because very, very few houses here have it.

(Although it would be nice as I sit here typing in a room that's about 12 degrees C right now!)

[dann]

Originally Posted by The Atheist

Hmmm.

Good spot, thanks. Well worth keeping an eye on, and the exact opposite of what's happening to indigenous populations closer to sea level.

It just occurred to me that Andorra is #7 on the List of countries by average elevation (Wikipedia), and #3 on the list of countries with the most Covid-19 deaths per million (Worldometers).
So maybe it's not a question of high altitude, UV radiation and thin air, but of lungs that evolution has genetically adapted to handling the thin air, which somehow makes them better suited to ward off the virus.

[dann]

Originally Posted by The Atheist

If AC is a factor, NZ will be fine whatever happens, because very, very few houses here have it.

(Although it would be nice as I sit here typing in a room that's about 12 degrees C right now!)

Hardly any houses have AC in Scandinavia. It didn't seem to do much to protect us.
I hate it and almost never use it when I'm in the Canaries, in the Mediterranean or in Cuba.

[zooterkin]

Originally Posted by dann

It just occurred to me that Andorra is #7 on the List of countries by average elevation (Wikipedia), and #3 on the list of countries with the most Covid-19 deaths per million (Worldometers).
So maybe it's not a question of high altitude, UV radiation and thin air, but of lungs that evolution has genetically adapted to handling the thin air, which somehow makes them better suited to ward off the virus.

Less suited, surely?

[Ulf Nereng]

Originally Posted by dann

It just occurred to me that Andorra is #7 on the List of countries by average elevation (Wikipedia), and #3 on the list of countries with the most Covid-19 deaths per million (Worldometers).
So maybe it's not a question of high altitude, UV radiation and thin air, but of lungs that evolution has genetically adapted to handling the thin air, which somehow makes them better suited to ward off the virus.

I think we should look at those countries that are at around 3000m elevation to get a better idea. Andorra is at "only" 1996m.

Bhutan (3280m) Cases: 77 Deaths: 0
Nepal (3265m) Cases: 14519: Deaths: 31 Deaths/million: 1
Tajikistan (3186) Cases: 6058 Deaths: 52 Deaths/million: 5
Kyrgyzstan (2988) Cases 6261 Deaths: 66 Deaths/million: 10

I'm not sure how reliable the numbers from any of those countries really are, but they look to have had an easy time of it so far.

[JeanTate]

Originally Posted by Ulf Nereng

I think we should look at those countries that are at around 3000m elevation to get a better idea. Andorra is at "only" 1996m.

Bhutan (3280m) Cases: 77 Deaths: 0
Nepal (3265m) Cases: 14519: Deaths: 31 Deaths/million: 1
Tajikistan (3186) Cases: 6058 Deaths: 52 Deaths/million: 5
Kyrgyzstan (2988) Cases 6261 Deaths: 66 Deaths/million: 10

I'm not sure how reliable the numbers from any of those countries really are, but they look to have had an easy time of it so far.

FWIW, while the WHO’s daily situation reports had breakdowns of China by province (stopped in ~mid-March I think), the numbers for Xizang (Tibet) and Qinghai (which is mostly Tibetan plateau) were the lowest (along with Macau).

[The Atheist]

Originally Posted by dann

It just occurred to me that Andorra is #7 on the List of countries by average elevation (Wikipedia), and #3 on the list of countries with the most Covid-19 deaths per million (Worldometers).
So maybe it's not a question of high altitude, UV radiation and thin air, but of lungs that evolution has genetically adapted to handling the thin air, which somehow makes them better suited to ward off the virus.

Andorra is an anomaly, as is San Marino. It looks like they're both just in the wrong place, with San Marino being in thick of Italy's worst region and San Marino being sandwiched between two countries. Whether many people from outside came in at the time, I have no idea.

I have to confess my knowledge of the pair of them is limited to knowing Andorra has a fairly useful rugby team for their size.

Originally Posted by Ulf Nereng

I think we should look at those countries that are at around 3000m elevation to get a better idea. Andorra is at "only" 1996m.

Bhutan (3280m) Cases: 77 Deaths: 0
Nepal (3265m) Cases: 14519: Deaths: 31 Deaths/million: 1
Tajikistan (3186) Cases: 6058 Deaths: 52 Deaths/million: 5
Kyrgyzstan (2988) Cases 6261 Deaths: 66 Deaths/million: 10

I'm not sure how reliable the numbers from any of those countries really are, but they look to have had an easy time of it so far.

Now, that is interesting, especially in light of Andeans appearing to only being lightly harmed by the virus.

However, Kyrgyzstan does seem to be having a major surge, so time out on that one. Kyrgyzstan, Bhutan & Nepal seem to have done a lot of testing, so their numbers should be somewhat reliable, while Tajikstan hasn't even kept records, so theirs are probably dodgy as hell.

[Ulf Nereng]

Originally Posted by The Atheist

Andorra is an anomaly, as is San Marino. It looks like they're both just in the wrong place, with San Marino being in thick of Italy's worst region and San Marino being sandwiched between two countries. Whether many people from outside came in at the time, I have no idea.

I have to confess my knowledge of the pair of them is limited to knowing Andorra has a fairly useful rugby team for their size.



Now, that is interesting, especially in light of Andeans appearing to only being lightly harmed by the virus.
However, Kyrgyzstan does seem to be having a major surge, so time out on that one. Kyrgyzstan, Bhutan & Nepal seem to have done a lot of testing, so their numbers should be somewhat reliable, while Tajikstan hasn't even kept records, so theirs are probably dodgy as hell.

Andorra and San Marino are heavily reliant on tourism, with Andorra being a freeport, too. So they get busloads of tourists dropping in to buy cheap stuff. Perhaps a bus tour going like Venize - San Marino - Rome.

As for those four high-altitude countries I notice that Bhutan and Nepal are hindu/buddhism countries, while the two -stans are overwhelmingly muslim. But then we're back to looking at cultural differences again? Not sure what it could mean.

[dann]

Originally Posted by zooterkin

Less suited, surely?

No, in my post I quoted The Atheist, who was referring to this post of mine about people in the Andes who seem to be better at warding off coronavirus than other populations. But then the example of Andorra occurred to me in contrast to those.

[Ulf Nereng]

Originally Posted by dann

No, in my post I quoted The Atheist, who was referring to this post of mine about people in the Andes who seem to be better at warding off coronavirus than other populations. But then the example of Andorra occurred to me in contrast to those.

Cusco is at 3400m altitude which is significantly higher than Andorra, so I think we need to look at populations at similar altitudes.

Wikipedia lists four cities in the world that are actually at higher altitude than Cusco:

El Alto, Bolivia: 4100m
La Paz, Bolivia: 3812m
Puno, Peru : 3810m
Lhasa, China : 3490m

[The Atheist]

I see that, despite worries about Hawaii turning into Florida 2.0, those fears don't seem to be coming true, with cases never having increased much past the jump of three weeks ago. Daily increases are bugger all, and they've had one death since 20 April.

[Ulf Nereng]

Originally Posted by Ulf Nereng

Cusco is at 3400m altitude which is significantly higher than Andorra, so I think we need to look at populations at similar altitudes.

Wikipedia lists four cities in the world that are actually at higher altitude than Cusco:

El Alto, Bolivia: 4100m
La Paz, Bolivia: 3812m
Puno, Peru : 3810m
Lhasa, China : 3490m

I did some googling for Covid-19 in those south-american cities and it is clear that they haven't been spared from the pandemic.

Lhasa has benefited from China's "sledgehammer" method, I'm sure, as there is almost no spread there.

So Cusco is still a mystery, it seems. Perhaps they are just a statistical anomaly?