Coronavirus disease 2019 (COVID-19) death rates in the countries of the West exceed those in the countries of the East by factors ranging from 10–1 to 100–1. In this paper, we refer to the West as represented by United States plus the five most populous countries of Western Europe, and the East as the 15 countries of East Asia and Oceania that are members of the Regional Comprehensive Economic Partnership (RCEP). This paper argues that the currently available information points to the factors most responsible for this divide. Warnings by early January 2020 about an atypical viral pneumonia in Wuhan, China, prompted rapid responses in many jurisdictions in East Asia. Publication of the virus’s genome on 10 January 2020 provided essential information for making diagnostic tests and launching vaccine development. China’s lockdown of Wuhan on 23 January 2020 provided a final, decisive signal of the danger of the new disease. By late March 2020, China had fully controlled its epidemic, and many other RCEP countries had taken early and decisive measures that aborted serious outcomes. Delayed and halting responses in the United States and most other Western countries allowed the disease to take hold and spread. In both the East and the West, stringent population-wide non-pharmaceutical interventions were widely implemented at great cost to societies, economies, and school systems. Without these measures, the outcomes could have been even worse. Most countries in the East also implemented tightly focused policies to isolate infectious individuals. Even today, most countries in the West allow infectious individuals to mingle with their families, coworkers, and communities. Much of the East–West divide plausibly results from failure in the West to implement the basic public health policies of early action and the isolation of infectious individuals. Widespread immunization in high-income countries will soon attenuate their outbreaks, while the slow rollout of vaccines in lower income countries is replacing the East–West divide in outcomes with a North–South one. The South will then replace the West as the breeding ground for more contagious or pathogenic variants of the virus.