2019 Novel Coronavirus Covid-19 Discussion

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#2739636 6-Jul-2021 11:49

Scott3:

I'm just starting to get my head around how intense re-opening is going to be for NZ.

My Partner and child both have what we suspect to be RSV virus (partner getting covid-19 test later today to verify it is not that). In short it's pritty nasty, and is a virus that NZ elmininated in our lockdown's last year, but aussie did not. It has been reported that RSV it turned up in NZ pritty much when the bubble opened, and has grown in a exponential style way since.

@Scott3 - I know you will, BUT just keep a 24/7 close watch on your child. RSV Bronchiolitis can quickly change from mild to severe in a blink. Particularly watch for an increase in breathing rate and an increase in depth of chest movements during each breath (work of breathing). As well ensure plenty of fluids, don't worry to much about solids. If your child's intake drops dramatically or there is a marked increase and struggle to breath then off to ED pronto or 111.

When I started nursing we had whole wards full of kids in O2 Head Boxes with feeding tubes down their noses. Then around the mid 2000's Fisher & Paykel came up with High Flow O2 nasal prongs for kids (known as Airvo). Bye bye head boxes. Oh wow what a difference this made to general care and outcomes.

RSV Bronchiolitis symptoms: https://www.kidshealth.org.nz/bronchiolitis

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

freitasm

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#2739679 6-Jul-2021 13:15

And that is how the health system can collapse. Who takes care of people who need health services now?

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freitasm

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#2739683 6-Jul-2021 13:19

"an unvaccinated student nurse who worked across two Sydney hospitals while infectious with Covid-19"

A person training to be a health professional
What the heck are they teaching?

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MikeB4

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#2739685 6-Jul-2021 13:21

@freitasm This is why there should be no trans Tasman travel bubbles.

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

PolicyGuy

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#2739696 6-Jul-2021 13:36

PolicyGuy:

So it seems like Covid-19 Vaccination a bit of a Post Code Lottery - some DHBs are well on top of it, others are apparently a sh!t shambles.

See for example this from The Spinoff: Why I’m losing patience with the Canterbury vaccine rollout
https://thespinoff.co.nz/society/06-07-2021/why-im-losing-patience-with-the-canterbury-vaccine-rollout/

... the vaccination of most people living in the Canterbury region has been moved back by at least two months.

For the rest of the country, people in group 4 of the vaccination programme will become eligible by the end of July. But those living in Christchurch – New Zealand’s second-largest city – and the Canterbury region will only get their first vaccine dose from mid-September, at the earliest.

sbiddle

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#2739702 6-Jul-2021 13:46

PolicyGuy:

See for example this from The Spinoff: Why I’m losing patience with the Canterbury vaccine rollout
https://thespinoff.co.nz/society/06-07-2021/why-im-losing-patience-with-the-canterbury-vaccine-rollout/

... the vaccination of most people living in the Canterbury region has been moved back by at least two months.

For the rest of the country, people in group 4 of the vaccination programme will become eligible by the end of July. But those living in Christchurch – New Zealand’s second-largest city – and the Canterbury region will only get their first vaccine dose from mid-September, at the earliest.

Canterbury DHB are one of the DHB's that is ahead of schedule.

Maybe they're the only ones being realistic about the rollout?

The reality is "most people" in group 4 are not going to get their first until mid Sept no matter where in NZ they are.

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Scott3

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#2739709 6-Jul-2021 14:06

sbiddle:

PolicyGuy:

See for example this from The Spinoff: Why I’m losing patience with the Canterbury vaccine rollout
https://thespinoff.co.nz/society/06-07-2021/why-im-losing-patience-with-the-canterbury-vaccine-rollout/

... the vaccination of most people living in the Canterbury region has been moved back by at least two months.

For the rest of the country, people in group 4 of the vaccination programme will become eligible by the end of July. But those living in Christchurch – New Zealand’s second-largest city – and the Canterbury region will only get their first vaccine dose from mid-September, at the earliest.

Canterbury DHB are one of the DHB's that is ahead of schedule.

Maybe they're the only ones being realistic about the rollout?

The reality is "most people" in group 4 are not going to get their first until mid Sept no matter where in NZ they are.

Sticking with the "End of July" date for group 4 will result in a large overlap with group 3.

Perhaps other DHB's will be able to manage it well (i.e. reserve all morning appointment's for group 3's, or having allowing Group 3 walkin's only etc...) but there is a significant risk of large numbers of group 3 people falling through the cracks, and getting stuck in a months lone queue of group 4 people... Resulting in general displeasure at the authorities handling of the roll-out.

But holding back group 4 appointments until demand from group 3 starts to wane is very likely to see better prioritization of available doses.

As a side note, when the 350,000+ plus dose weekly shipments start landing, I would expect vaccines to become fairly available to group 4 people even if bookings for appointments aren't yet available. Medical centers & pharmacies that offer doses to patents / customers their for unrelated reasons as they have plenty of doses on hand, and vaccination centers that unofficially take walkins on quiet day's, and are willing to vaccinate support people / family that turn up with group 3 people.

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#2739714 6-Jul-2021 14:11

Rikkitic:

Batman: 600 staff from 2 hospitals in nsw in isolation

https://www.theguardian.com/australia-news/2021/jul/05/sydney-hospitals-on-red-alert-as-more-than-600-nsw-health-workers-in-isolation-over-covid-case-contact

This is simply unbelievable. Words fail me.

The Grauniad often is.

Batman

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#2739720 6-Jul-2021 14:23

Lambda strain. from Peru

https://www.nzherald.co.nz/world/covid-19-coronavirus-lambda-strain-hits-uk/BSJ52H5XDJJEB6NGMFIOWYZG44/

mattwnz

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#2739722 6-Jul-2021 14:30

Batman:

Lambda strain. from Peru

https://www.nzherald.co.nz/world/covid-19-coronavirus-lambda-strain-hits-uk/BSJ52H5XDJJEB6NGMFIOWYZG44/

The things is that allowing free travel during a pandemic is just causing different strains to spread. The UK has just allowed travel to occur during the pandemic, and I think they only ask people to self isolate at home, which we know how well this worked in NZ. Especially as in the UK they have more mass housing. If more countries had behaved like NZ, then these cases could be stopped at the border

I also see that NZ is considering not living with the virus after vaccinations and still having some restrictions in place. They don't seem to be following Australias approach. I wonder if this is partly because they don't think we will reach a high enough vaccination level. Or our health system couldn't cope with the increase in demand if we do. It will likely cause more deaths per year, on top of the normal flu deaths. I read one estimate was about 1500 deaths if the country was vaccinated, on top of the 500 for flu. But there are other health problems some people can get from it, including long covid.

Scott3

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#2739724 6-Jul-2021 14:31

FineWine:

@Scott3 - I know you will, BUT just keep a 24/7 close watch on your child. RSV Bronchiolitis can quickly change from mild to severe in a blink. Particularly watch for an increase in breathing rate and an increase in depth of chest movements during each breath (work of breathing). As well ensure plenty of fluids, don't worry to much about solids. If your child's intake drops dramatically or there is a marked increase and struggle to breath then off to ED pronto or 111.

When I started nursing we had whole wards full of kids in O2 Head Boxes with feeding tubes down their noses. Then around the mid 2000's Fisher & Paykel came up with High Flow O2 nasal prongs for kids. Bye bye head boxes. Oh wow what a difference this made to general care and outcomes.

RSV Bronchiolitis symptoms: https://www.kidshealth.org.nz/bronchiolitis

Cheers. She is 3.5 so isn't quite at the risk level of infants, but I am keeping a close eye on her. Spent a bit of time sleeping in her room last night.

In a bit of a hard spot. Wasn't able to get an appointment with her GP yesterday, but would rather avoid exposing her to other nasties by taking here to the ED or a white cross (or the discomfort of having here wait for 4+ hours based on media articles). Have a family member who is a doctor that has given some advice via phone from another city.

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wellygary

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#2739727 6-Jul-2021 14:34

PolicyGuy:

So it seems like Covid-19 Vaccination a bit of a Post Code Lottery - some DHBs are well on top of it, others are apparently a sh!t shambles.

... the vaccination of most people living in the Canterbury region has been moved back by at least two months.

For the rest of the country, people in group 4 of the vaccination programme will become eligible by the end of July. But those living in Christchurch – New Zealand’s second-largest city – and the Canterbury region will only get their first vaccine dose from mid-September, at the earliest.

Nationally "Become eligible" quietly became "able to book their vaccinations from 28 July"....

https://covid19.govt.nz/covid-19-vaccines/our-covid-19-vaccination-plan/covid-19-vaccine-rollout-groups/#group-4

So I think Canterbury is just being honest about when they think they will actually get to you...

tdgeek

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#2739733 6-Jul-2021 14:56

mattwnz:

I also see that NZ is considering not living with the virus after vaccinations and still having some restrictions in place. They don't seem to be following Australias approach. I wonder if this is partly because they don't think we will reach a high enough vaccination level. Or our health system couldn't cope with the increase in demand if we do. It will likely cause more deaths per year, on top of the normal flu deaths. I read one estimate was about 1500 deaths if the country was vaccinated, on top of the 500 for flu. But there are other health problems some people can get from it, including long covid.

https://www.stuff.co.nz/national/politics/125662926/covid19-nz-government-considers-permanent-miq-facility-dismisses-uks-decision-to-live-with-covid

I think you are reading too much into this issue. Nothing has been decided or considered. You would need to see the lay of the land post vaccination and post the UK giving up. That's essentially what the Govt is saying. No one knows what post vaccination Covid will be like

The permanent MIQ isn't a clue. “We still don't know how long we're going to be doing this for, but we do know it's probably going to be longer than 18 months or so ... It is something that we've been exploring for a while.”

You cannot plan what you don't know.

I doubt any country will reach a high enough vaccination level. What medicine says and what lazy humans do is quite different

Scott3

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#2739756 6-Jul-2021 15:33

tdgeek:

https://www.stuff.co.nz/national/politics/125662926/covid19-nz-government-considers-permanent-miq-facility-dismisses-uks-decision-to-live-with-covid

I think you are reading too much into this issue. Nothing has been decided or considered. You would need to see the lay of the land post vaccination and post the UK giving up. That's essentially what the Govt is saying. No one knows what post vaccination Covid will be like

The permanent MIQ isn't a clue. “We still don't know how long we're going to be doing this for, but we do know it's probably going to be longer than 18 months or so ... It is something that we've been exploring for a while.”

You cannot plan what you don't know.

I doubt any country will reach a high enough vaccination level. What medicine says and what lazy humans do is quite different

I used to be quite opposed to building a dedicated MIQ facility, but I am softening my view a little now.

I think there is merit in building (or modification) of a facility to Quarantine standards. i.e. A Jetpark replacement. If building from scratch 300 - 500 rooms would be good (ideally on a site with the groundworks to support an additional 600 - 1000 rooms that could be built in a hurry if needed. Few reasons for this:

While it seems jetpark is good for infection control, I would expect a facility built of modified for this purpose to be better.
Initial easing of MIQ requirements is likely to be only for vaccinated travelers, and not for those coming from very high risk locations. Potentially there is a need to isolate arrivals who are either not vaccinated, or are coming from a very high risk location for potentially years. Better to do this in a facility actually appropriate for this duty, and in a way that is more cost effective than leasing hotel buildings.
We have had a lot of close calls with regards to potential pandemics over the last decade or so. I don't think this scale of pandemic has a 100 year return period any more, and we could well see a repeat in the next decade or two, would be good to be ready to go.
The growth of synthetic biochemistry dramatically increases the chance the world will need to deal with an engineered pathogen, released as an act of terrorism / war / anarchy at some point in my lifetime. Some really good quarantine facilities would be good in that circumstance.

I also think we need to be building a lot more negitive pressure isolation room in hospitals (perhaps 50 - 100 additional for for Auckland. I understand we currently have 50). Possibly we could construct / modify some wards to negitive pressure isolation standards so the entire ward is suitable for treating people with the same contagious disease. I don't think 50 beds is enough for a city like Auckland...

wellygary

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#2739765 6-Jul-2021 15:47

Scott3:

I don't think 50 beds is enough for a city like Auckland...

Where did you find the 50 count?

This 2020 report ( in the run up to covid) notes nationally,

"There are 263 negative pressure rooms, with 15 DHBs having negative pressure rooms in either ICU or HDU."

https://www.health.govt.nz/system/files/documents/pages/moh-covid19-sitreps-february-2020.pdf

On a population basis that would be about 80 in Auckland

but I think its probably higher as Auckland's DHBs are more well equipped that many of the smaller regional ones..

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