2019 Novel Coronavirus Covid-19 Discussion

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74 posts

Master Geek
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#2434826 9-Mar-2020 09:25

Scott3:

I'm not sure if it has been posted here before, But doctors in Milan have indicated, in a warning letter to medical staff in other areas that 10% of confirmed covid-19 cases require ICU admission. "We wish to convey a strong message. Get ready!"

http://www.cidrap.umn.edu/news-perspective/2020/03/who-urges-whole-government-covid-19-tack-cases-climb-globally

NZ has approximatly 5 ICU beds / 100,000 population. that means around 230 beds (can't find a good recent source on this, happy to be corrected.

As a stab in the dark, I would guess that half those beds would be tied up by everyday things that can be canceled like elective operations. (again happy to be corrected) = 115 ICU beds.

This means if the Milan ICU admission ratio holds true in NZ, our ICU capacity will be overwelmed when we reach 1150 confirmed cases.

This source puts the doubling time for confirmed cases at 4 days outside of china:

https://ourworldindata.org/coronavirus#growth-the-doubling-time-of-covid-19-cases

If the 4 day doubeling time holds true, based on our current 5 cases, we have 36 days until our hospital ICU capacity is over-run.

Once ICU beds are full, many of those who have been admired (10% in milan) will die.

Lots of "if" statements in the above, but this is very scary to me with no expert knowledge.

I think its closer to 75% that are in use for emergencies & 25% for elective surgeries. So if you cancel all electives you free up 44 beds (.25 x 176). At the 10% ICU rate for Coronavirus

we will be overwhelmed at 440 caronavirus cases at one time (44/.10). However I have heard elsewhere the ICU cases are 5% of people infected this gives us up to 880 Coronavirus cases before we

are overwhelmed (44/.05).

I think it bit has to do with the demographics of those infected. My understanding is that the cult/church in Korea where most of their cases stem from is made up of younger people. So lower ICU% rate.

In Italy which has an ageing population, it may have disproportionately affected older people.Hence a higher ICU rate.

All things considered, if NZ hits 1000 cases I doubt you can expect adequate treatment through the NZ healthcare system, regardless of what any of the higher ups say.

dogstar001

74 posts

Master Geek
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#2434831 9-Mar-2020 09:29

dogstar001:

Scott3:

I'm not sure if it has been posted here before, But doctors in Milan have indicated, in a warning letter to medical staff in other areas that 10% of confirmed covid-19 cases require ICU admission. "We wish to convey a strong message. Get ready!"

http://www.cidrap.umn.edu/news-perspective/2020/03/who-urges-whole-government-covid-19-tack-cases-climb-globally

NZ has approximatly 5 ICU beds / 100,000 population. that means around 230 beds (can't find a good recent source on this, happy to be corrected.

As a stab in the dark, I would guess that half those beds would be tied up by everyday things that can be canceled like elective operations. (again happy to be corrected) = 115 ICU beds.

This means if the Milan ICU admission ratio holds true in NZ, our ICU capacity will be overwelmed when we reach 1150 confirmed cases.

This source puts the doubling time for confirmed cases at 4 days outside of china:

https://ourworldindata.org/coronavirus#growth-the-doubling-time-of-covid-19-cases

If the 4 day doubeling time holds true, based on our current 5 cases, we have 36 days until our hospital ICU capacity is over-run.

Once ICU beds are full, many of those who have been admired (10% in milan) will die.

Lots of "if" statements in the above, but this is very scary to me with no expert knowledge.

I think its closer to 75% that are in use for emergencies & 25% for elective surgeries. So if you cancel all electives you free up 44 beds (.25 x 176). At the 10% ICU rate for Coronavirus

we will be overwhelmed at 440 caronavirus cases at one time (44/.10). However I have heard elsewhere the ICU cases are 5% of people infected this gives us up to 880 Coronavirus cases before we

are overwhelmed (44/.05).

I think it bit has to do with the demographics of those infected. My understanding is that the cult/church in Korea where most of their cases stem from is made up of younger people. So lower ICU% rate.

In Italy which has an ageing population, it may have disproportionately affected older people.Hence a higher ICU rate.

All things considered, if NZ hits 1000 cases I doubt you can expect adequate treatment through the NZ healthcare system, regardless of what any of the higher ups say.

Further to above NZ has 176 ICU beds not 230, as per the below article

https://www.stuff.co.nz/national/health/119906672/coronavirus-nzs-first-case-has-been-confirmed--so-what-happens-now

msukiwi

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#2434835 9-Mar-2020 09:34

So far today, the Christchurch Chinese Consulate is "busy as normal" as if there are no issues with the virus or travel.

Not a mask in sight either!

wellygary

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#2434838 9-Mar-2020 09:45

msukiwi:

So far today, the Christchurch Chinese Consulate is "busy as normal" as if there are no issues with the virus or travel.

Not a mask in sight either!

China cases certainly appear to have peaked and are tracking to nearly nil new cases outside Hubei,

China National Health Commission reported 44 new confirmed cases, and 27 more deaths, as of March 7.Of the new cases, 41 were in Wuhan in Hubei province, the epicenter of the outbreak. All the 27 additional deaths were in Hubei.

And life does appear to be returning to a more normal routine with stores reopening..

Furniture brand IKEA has reopened a further nine stores in China this weekend, according to Reuters. The company had closed all 30 stores in the country in January due to the outbreak of the coronavirus, with five being reopened last weekend

https://www.cnbc.com/2020/03/08/coronavirus-live-updates-china-reports-44-new-cases-us-cases-top-400.html

alexx

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Ultimate Geek
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#2434839 9-Mar-2020 09:49

Following the comments about people coming from Italy, perhaps it's time to consider restrictions on people from New York, Washington State and California coming into the country?

We probably don't need to ban people from those states just yet, but self isolation might be needed.

The situation over there seems almost like Iran in the early stages, where the number of deaths exceeds the number of recovered and there are a high number of deaths per total number of cases (indicating sub-standard testing and a large number of undiagnosed cases).

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MileHighKiwi

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#2434843 9-Mar-2020 10:03

tdgeek:

MileHighKiwi: A woman at work returned from northern italy last week and strolled into the office without a care in the world, sat in the desk next to me. I dont think she is sick but shouldn't people like that stay home? I made a comment about the travel restrictions and she said she missed them by a couple of days. Not sure if shes aware that virus's dont care about borders and travel restrictions.

Am I being paranoid?

No. I'd be ropeable. Does your workplace have any rules in place?

Just spoke with my manager, I queried the colleague's return to work and was told "its ok cos they were in Italy more than 3 weeks go". I asked if they were aware that the UK has just announced self isolation for anyone who has traveled to North Italy, symptoms or not. Blank stare.

My employer seems to be in a watch and wait mode. We are a large employer, I'm quite surprised how we are approaching it.

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tdgeek

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#2434844 9-Mar-2020 10:06

alexx:

Following the comments about people coming from Italy, perhaps it's time to consider restrictions on people from New York, Washington State and California coming into the country?

We probably don't need to ban people from those states just yet, but self isolation might be needed.

The situation over there seems almost like Iran in the early stages, where the number of deaths exceeds the number of recovered and there are a high number of deaths per total number of cases (indicating sub-standard testing and a large number of undiagnosed cases).

Why not? Do we want to import it or not? Any infected country = 14 day self isolation. That will effectively stop every tourist coming here or us touristing to OZ if these policies were global. As has been mentioned many pages back, its about risk assessment. Its worth the risk as people might get upset or paranoid if we make a big deal about it, or we dont want to upset tourism too much. Personally I find it easier to take te more aggressive approach earlier, that will affect less people later. Alert popped up that US now has 500 cases as Illinois and Masschussets report new cases, and Oregon is now a state of emergency. USA is the new Italy, and it will get worse. Its out of control there

Sidestep

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#2434845 9-Mar-2020 10:10

dogstar001:

Further to above NZ has 176 ICU beds not 230, as per the below article

https://www.stuff.co.nz/national/health/119906672/coronavirus-nzs-first-case-has-been-confirmed--so-what-happens-now

From memory - if you include HDU (High Dependency beds - 'full care" to ICU standards) to the above, I think you're back around 230.
You might be able to add CCU (Cardiac specialty ICU) and bring that to around 260

Fred99

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#2434858 9-Mar-2020 10:38

alexx:

Following the comments about people coming from Italy, perhaps it's time to consider restrictions on people from New York, Washington State and California coming into the country?

We probably don't need to ban people from those states just yet, but self isolation might be needed.

The situation over there seems almost like Iran in the early stages, where the number of deaths exceeds the number of recovered and there are a high number of deaths per total number of cases (indicating sub-standard testing and a large number of undiagnosed cases).

I think it's delusional fantasy to expect self-isolation to work in NZ:

Many visitors be on tourist visas. Tourists don't come here to be locked in a hotel room for a fortnight. By the time we react by imposing restrictions on arrivals from new countries with outbreaks - it's too late to retrospectively recall visitors and isolate them.

Many NZers won't self-isolate either because they don't care, don't know, or make exceptions for themselves because they believe their circumstances are unique, they "have to" work, because they're working casual contracts and they genuinely need the money etc.

There's not enough stick - and not enough carrot to "encourage" people to be responsible. That will change - we will be forced - I hope we don't leave it too late.

There's still a lot of utter Bullsh*t in circulation via social media and news articles, suggesting it's "just the flu" or that mortality rates are low. Mortality rates are not known. The low estimates are based on multiple fallacies, that there's a "mountain of asymptomatic / mild cases". True asymptomatic cases aren't actually cases of Covid 19 (that's a disease - not a virus), and some unknown number of them are just "pre-symptomatic". It sickens me to hear officials refer to CFR as any definite figure - be that 0.5% or 5%. They do not know - because nobody knows - they are cherry picking bits from incomplete data to try to make a point.

tdgeek

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#2434908 9-Mar-2020 10:52

I agree self isolation wont work here, a good example a few messages up. If self isolation wont work here the other option we need is to keep it out. Flights are coming in every day. Melbourne F1 Grand Prix this weekend. Im not going, but for the many that are, its easy to get there and easy to come back, probably wont get asked anything when you come back either. Apart from have you been to China

It's watch and hope

FineWine

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#2434914 9-Mar-2020 11:05

Fred99:

What's probably going on there, in my opinion and because the alternatives are too improbable - is that there are significant and unreported large outbreaks in Indonesia, Nepal, and India. I expect they've got "silent" epidemics happening, the scale of what's happening won't be seen until cases spike above the normal background of pneumonia cases.

That is VERY worrying and scary. The horse has bolted and we are only catching glimpses of it and it has yet to be caught.

First case - 28 Feb - overseas transmission (Iran, Bali)
2nd case - 4 March - overseas transmission (Nth Italy, Singapore, Palmy)
3rd case - 4 March - first case local transmission (family member from Iran)
4th case - 6 March - Local transmission from 2nd case
5th case - 7 March - local transmission from 3rd case

My point is, that is only a 9 day spread of identified positive cases and we have a 14 day incubation period and a 14 day isolation period.

So the above positives have been in contact with others prior and during and those contacts have been in contact etc.

Therefore we COULD have a pot of COVID-19 brewing away quite happily here in NZ with no apparent signs or symptoms.

Just as @Fred99 said above - "I expect they've got "silent" epidemics happening"

Whilst the difficult we can do immediately, the impossible takes a bit longer. However, miracles you will have to wait for.

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Rikkitic

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#2434917 9-Mar-2020 11:14

Or as Olympic Committee member Dick Pound put it in an interview to AP when discussing the possibility of moving or cancelling the Games, 'people would think we're just crazy' for 'not even considering the possibility that changes might be required'.

Plesse igmore amd axxept applogies in adbance fir anu typos

GV27

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#2434919 9-Mar-2020 11:19

Fred99:

Many NZers won't self-isolate either because they don't care, don't know, or make exceptions for themselves because they believe their circumstances are unique, they "have to" work, because they're working casual contracts and they genuinely need the money etc.

Given that barely anyone can correctly indicate off a roundabout, I'd say we're in for a rough ride.

I *could* work from home - I have that discipline from a past life and a trade that allows for it. But I don't currently have a work laptop and I'd need to be getting one sorted already in case/when the inevitable happens. The guys on our shop floors or our showrooms though, that's a different story.

MikeB4

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#2434920 9-Mar-2020 11:25

Self isolation may or may not work but it will achieve more than doing nothing. As for the Olympic games and other events with high density crowds. I wouldn't go near them, I have no desire to put myself in a giant petri dish. If the Olympic games proceed it will eclipse the stupidity of Brexit and the Trump presidency.

Here is a crazy notion, lets give peace a chance.

FineWine

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#2434934 9-Mar-2020 11:44

Retired doctors and nurses may be called on during coronavirus outbreak

After retiring in late 2017, January 2019 was the date I did not renew my nursing Annual Practising Certificate after 30 years of Paediatric nursing. I am within the 5 year period of competencies but not the 3 year period or 60 days/450hrs of practice, nor the 60 hours of professional development. So if I get recalled or I volunteer they are going to have to wave a few things.

Though, having said that, interesting article here: Majority of retired NHS staff don't want to return to tackle Covid-19 crisis

Any other retired health care workers (doctors, nurses, EN's) in these forums who might returned if asked?

Whilst the difficult we can do immediately, the impossible takes a bit longer. However, miracles you will have to wait for.

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