2019 Novel Coronavirus Covid-19 Discussion

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366 posts

Ultimate Geek

#2843023 4-Jan-2022 11:44

Scott3:

Should note that NSW has 10.8 staffed icu beds per 100,000 (source the gardian 13/10/2021), which works out to be about 875.

As such (barring having enough staff well to come to work), the current hospital load is unlikely to be too much of a concern for them, but there is a risk we see icu admissions tripping as we have seen with case numbers over the lest 10 or so days.

NZ has way less staffed icu beds per capita than NSW at 176 (source nzma 12/11/2021) works out to 3.4 per 100,000 - Hopefully my numbers are wrong, seems worryingly low. So I think it is clear that we cannot follow NSW pathway, and need to do better than them (shouldn't be hard) when we have an omicron outbreak.

Those numbers sound right.

The best thing about omicron if true, is this apparent lower need for Oxygen therapy. With Delta, as many will know already, it is critical that you get oxygen therapy started early.

If this were true of omicron then these astronomical numbers in home settings, would see people arrive in hospital who are rappidly crashing and will need direct admission to I.C.U.

The general pressure on systems from reaching max capacity leads to excess deaths from all causes across the system.

Just keep swimming...

Sup

366 posts

Ultimate Geek

#2843034 4-Jan-2022 12:20

sbiddle:

Sup:

All that said, given we know that raw exposure to omicron produces Delta protection, it may well be time for an upgrade, partly on the basis that the old vaccine is falling behind in the evolutionary race and partly to do with having a highly effective vaccine at slowing mutation.

This would take a leap of faith, however this is one of those Devil and the Deep blue sea choices, do we risk the old vaccine being even less effective against the next strain, which we anticipate will be related to either Delta / or more likely omicron.

With so many break through infections we must be risking significant vaccine escape by letting omicron become increasingly fit in a weaker system.

Clearly I do not have the answers. The question is always changing. As you point out, chasing the sterilizing Dragon is not necessarily the right way to approach this either.

It may be the Super immunity of Vaccine plus omicron is really the only true way through.

Many countries incl Australia, the UK and US have all chosen that path. Many countries in Europe are now following.

As scary as it is to many, right now it looks like it could well be the best approach, with a virus ripping through highly vaccinated countries (so excl the US!) generating great hybrid immunity. We know it generated Delta immunity, and some experts that truly believe this is the end of the pandemic are speculating the immunity it generates could well even we wider ranging than that.

If we somehow manage to avoid CT of Omicron say by the end of January and the evidence that Omicron really is the end of the pandemic becomes so much clearer it's going to place NZ in a very difficult position. We either open the borders and let it rip which will be hugely controversial or we double down and insist we don't want Omicron here and will be fully reliant on yet more vaccines to provide immunity. Covid will ultimately become even more political than it is now.

Yeah it is an interesting dilemma. Likely one that we will never have to choose hey, because omicron will take the choice out of our hands and get here soon, however it is a fascinating thought experiment.

Why expose healthy people to a virus if indeed there is very clear evidence that it is going into total decline? Who has the moral mandate to make that decision (leaders all over the world are making these calls anyway, but in such a stark scenario who would want to wear it?)

Another odd thought experiment, is what if omicron takes out Delta everywhere (a presupposition of ending the pandemic) except for New Zealand.

What if we remain an Island unto the world, with the last threat of Covid. What pressures then come on New Zealand from other places for not taking the omicron cleanse. What are our international obligations in such a scenario, the damage to our image, the tut tutting about our hermit thinking.

In such a bizarre scenario I could imagine we would triple down, perhaps even zero tolerance of being unvaccinated.

If we were the last place with Covid 19 and a more threatening form, we would be a pariah, and I guess the WHO would be on the phone....since we would be the last possible place that could create the next variant.

It is looking as though we will need to choose the middle road....hold out for now...prepare everyone...then let it come.

That is obviously an ideal scenario that probably won't be realized.

Just keep swimming...

tdgeek

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#2843046 4-Jan-2022 13:10

Sup:

Yeah it is an interesting dilemma. Likely one that we will never have to choose hey, because omicron will take the choice out of our hands and get here soon, however it is a fascinating thought experiment.

Why expose healthy people to a virus if indeed there is very clear evidence that it is going into total decline? Who has the moral mandate to make that decision (leaders all over the world are making these calls anyway, but in such a stark scenario who would want to wear it?)

Another odd thought experiment, is what if omicron takes out Delta everywhere (a presupposition of ending the pandemic) except for New Zealand.

What if we remain an Island unto the world, with the last threat of Covid. What pressures then come on New Zealand from other places for not taking the omicron cleanse. What are our international obligations in such a scenario, the damage to our image, the tut tutting about our hermit thinking.

In such a bizarre scenario I could imagine we would triple down, perhaps even zero tolerance of being unvaccinated.

If we were the last place with Covid 19 and a more threatening form, we would be a pariah, and I guess the WHO would be on the phone....since we would be the last possible place that could create the next variant.

It is looking as though we will need to choose the middle road....hold out for now...prepare everyone...then let it come.

That is obviously an ideal scenario that probably won't be realized.

As probably the last first world country to have a successful defence, we have bought time. That's the plan. Our fatalities, hospitals, employment have been preserved. We can operate with hindsight, using other countries plans and results as our future, and adapt accordingly.

Benoire

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#2843048 4-Jan-2022 13:24

I would also like to wait a little longer until my two kids under 12 can be vaccinated. I'd rather they do not develop any form of long covid from being exposed, even if their risk of getting a serious infection is low... After this, sure start to open up if it means that our ICU will not be inundated. We must remember that our ICU beds are already full of general hospital issues and it wouldn't take much for the unvaccinated to potentially overwhelm this and therefore put those that have had other issues, e.g. car crashes, surgery related post op complications etc. at risk.

gzt

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#2843049 4-Jan-2022 13:26

There are all kinds of problems with Omicron. It's still killing a lot of people. That and it's not instant to find out if a high risk patient presenting with symptoms is suffering from Covid Delta or Covid Omicron.

sbiddle

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#2843054 4-Jan-2022 13:36

gzt: There are all kinds of problems with Omicron. It's still killing a lot of people. That and it's not instant to find out if a high risk patient presenting with symptoms is suffering from Covid Delta or Covid Omicron.

You can say lots of things about Omicron but to say "it's still killing a lot of people" is simply not a claim that can be backed with solid data.

Sup

366 posts

Ultimate Geek

#2843064 4-Jan-2022 13:58

tdgeek:

Sup:

Yeah it is an interesting dilemma. Likely one that we will never have to choose hey, because omicron will take the choice out of our hands and get here soon, however it is a fascinating thought experiment.

Why expose healthy people to a virus if indeed there is very clear evidence that it is going into total decline? Who has the moral mandate to make that decision (leaders all over the world are making these calls anyway, but in such a stark scenario who would want to wear it?)

Another odd thought experiment, is what if omicron takes out Delta everywhere (a presupposition of ending the pandemic) except for New Zealand.

What if we remain an Island unto the world, with the last threat of Covid. What pressures then come on New Zealand from other places for not taking the omicron cleanse. What are our international obligations in such a scenario, the damage to our image, the tut tutting about our hermit thinking.

In such a bizarre scenario I could imagine we would triple down, perhaps even zero tolerance of being unvaccinated.

If we were the last place with Covid 19 and a more threatening form, we would be a pariah, and I guess the WHO would be on the phone....since we would be the last possible place that could create the next variant.

It is looking as though we will need to choose the middle road....hold out for now...prepare everyone...then let it come.

That is obviously an ideal scenario that probably won't be realized.

As probably the last first world country to have a successful defence, we have bought time. That's the plan. Our fatalities, hospitals, employment have been preserved. We can operate with hindsight, using other countries plans and results as our future, and adapt accordingly.

My main concern with Omicron when it comes is that it will remove our edge completely. We will be instantaneously caught up with the rest of the world, because I do not believe there is a system that can stop it. Slow it perhaps, I dunno, we certainly would try.

But stopping it is off the cards, we could not stop Delta, although the numbers today look great again. But yeah all those things you listed which have made our stance well and truly worth it to date would disappear overnight.

It is what it is. I see there is increasing support for the idea that it is upper respiratory which means it is not deep down in the lungs, which is a very protective factor for adults.

For kids it is a bit more of a concern because they were almost bullet proof to Delta with some rare sad exceptions, whereas upper respiratory tract infections in children are clearly not as ideal as almost no impact at all. Again this is more of a concern for vulnerable kids, the types we see a lot of at Middlemore.

Just keep swimming...

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Scott3

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#2843076 4-Jan-2022 14:23

Todays media release;

https://www.health.govt.nz/news-media/news-items/increase-booster-shots-31-community-cases-53-people-hospital-6-icu

31 cases in the community, 29 at the border.

"Household contact of border-related case tests positive

Today we are reporting a third border-related case with the Omicron variant.

Today’s case is a household contact of the Air New Zealand crew member who tested positive last week with the Omicron variant.

The household contact has been in isolation during their symptomatic period. Public health staff are continuing to investigate however at this stage there are no locations of interest or exposure events.

The household contact has now been transferred to a MIQ facility. The second household contact, who’s also in isolation, continues to test negative.

The case is fully vaccinated."

tdgeek

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#2843078 4-Jan-2022 14:26

No test numbers I assume?

sbiddle

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#2843084 4-Jan-2022 14:34

Worth noting from the 31 cases today that sequencing isn't back to identify the variants so we have no idea yet how many are Omicron.

Yesterday the media all reported no cases of Omicron from the 24 border cases due to the poorly worded press release. The media release said "There are no community Omicron cases to report." and media took that to mean 0/24 were Omicron when it meant they were still awaiting results. Today the media release specifically says they're awaiting sequencing results.

It's safe to say the number won't be zero for either day.

Oblivian

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#2843085 4-Jan-2022 14:34

The UK aren't too convinced that the under 20s are as bulletproof as one would hope

Masks in class, windows open for time being. Thinking schools are again a perfect vector.

https://www.bbc.com/news/education-59840634

Going by the teens thinking they can still congregate outside maccas with their mates and not wear them while in the 'restaurant' here.. I'd love for their thinking to be pursued early too.