2019 Novel Coronavirus Covid-19 Discussion

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#2443493 22-Mar-2020 08:03

mattwnz:

I suggest people have a read of this NZ article. https://www.interest.co.nz/opinion/104193/notion-new-zealand-running-ahead-curve-no-longer-stands-scrutiny-policy-essentially

It makes interesting reading. It s all about the government needing to be Proactive rather than reactive , and discusses Professor Michael Baker from the Wellington Campus of Otago Medical School who has spoken publicly in recent weeks about his concerns. IMO we need to 'stamp it out' and not just flatten the curve. Because flattening the curve is going down the route of herd immunity where over a very long time, a significant percentage of people get it, but it doesn't put major pressure on our health system, so it should result in less deaths. Stamping it out is about actually getting rid of the virus totally, by starving it of people to infect, which allows NZ local population economy to get back to normal potentially earlier. It appears stamping it out is the only way to prevent older people not being told to 'stay at home' for months and months while he virus exists. I am not sure exactly what China are doing to reduce their rates, but but guessing it is more of the 'stamp it out' thing.

NZ is no longer aiming to "flatten the curve" and has not been aiming for that for a number of days.

Fred99

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#2443494 22-Mar-2020 08:23

sbiddle:

NZ is no longer aiming to "flatten the curve" and has not been aiming for that for a number of days.

What?

Of course they are. Ideally eliminate - if that's still possible (probably unlikely).

Then all containment measures are designed to "flatten the curve". Doesn't matter what they call it - that's the objective.

kingdragonfly

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#2443505 22-Mar-2020 09:07

Geektastic: There is a NZ product called ZOONO that is very good. It forms a barrier on the skin that lasts all day (allegedly). It's expensive but my wife was able to order it a few days ago.

If it seems to good to be true, it probably is.

Regarding ZOONO, they are lying about the effectiveness of their 24 hour "Z-71 Microbe Shield".

I assume their "shield" is trimethoxysilyl. It's seen limited use in food preparation industry, sprayed on non-food contact surfaces, and left undisturbed. The 1980's US patent on this expired.

From what I can see, even though it's been around a while, no one has ever claimed it protects for 24 hours. But again if it's left on stainless steel and left alone, yeah, it'd probably last 24 hours or more. It's a skin irritant, and a serious eye irritant.

It also uses Benzalkonium chloride. Benzalkonium chloride is an irritant and have been pulled from at least one study because it's a trigger for asthma.

Here's a child's review and experiment that show even after an hour, germs come back

There are three variations: 0, 10, or 70% ethanol.

Last I read, it has only been tested against bovine coronavirus, not COVID-19. I suspect the 70% ethanol version would do quite well. Who knows about the other versions.

The CEO has made a bundle off this virus

Zoono is rated by the FDA as a Class III: having a high risk to the patient and/or user, available data are insufficient to classify it as safe and effective.

kingdragonfly

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#2443508 22-Mar-2020 09:16

NZ Herald: Coronavirus: North Island iwi warned against blocking major state highway

Police are warning a North Island iwi against shutting off State Highway 35 to all non-residents in an attempt to prevent COVID-19 from infecting their 200 people.

Te Whānau-ā-Apanui is on lockdown and closing their borders to all non-residents.

"The evidence that we have in regards to the impact that the influenza had on our people in 1918 and what we're trying to do is mitigate the risk of that happening again," says iwi leader Rawiri Waititi.

"It had catastrophic implications on our people."

The iwi is terrified the worst could happen if COVID-19 spreads to their community.

They were hit hard in the 1918 Spanish Flu that still to this day has killed the most New Zealanders in the shortest space of time - and don't want a repeat.

"We're pleading [for] those that live outside of the iwi have compassion for those who live inside because we have 200 of the most vulnerable people living inside the iwi here and we want to mitigate the risk of this potential virus within the iwi."

They plan to shut off State Highway 35, only allowing access for residents.

Police have issued a statement saying: "We know the community is very concerned about COVID-19, but this is illegal."
...

tdgeek

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#2443509 22-Mar-2020 09:16

DS248:

CT is 'silent' for 2+ weeks before it will be identified. Even more so when until a few days ago, the NZ test regime specifically excluded possible CT cases. And if the initial CT is in younger healthier people, it could well take longer to register. The problem is the ~2 week delay between exposure and test confirmation. The numbers confirmed here, whether 53 total or 2 'CT', give no confidence that we are doing well. Its not the time since day zero in China that matters, its the time since it first arrived here. That was only ~3 weeks ago. Many countries had a 3 - 3.5 week 'quiet period' with only a handful or fewer cases before exploding into exponential growth in numbers of cases.

Once we register significant CT it will be too late. By then we will have a 'hidden' backlog of CT cases that will only show up over the next 2 - 3 weeks. And based on overseas experience (plot below) exponential growth can mean up to 10 fold increase in cases each 8 days.

==

I agree South Korea and Singapore, along with Hong Kong, Japan, and especially Taiwan (& possibly others?) are the current gold standards. But your assumption that they are not as 'heavily' importing cases as we are right now seems to be wild speculation, which is not helpful in understanding what is working. Singapore & Hong Kong are global commercial hubs. With the exception of Taiwan, none of those countries have (or at 19 March, had) blanket bans on entry of foreign nationals and Taiwan only implemented that on 18 Mar. The others only restrict entry from a limited number of specific countries or areas. What most of them do have is more rigorous 14 day quarantine requirements, and along with other strong measures. I would be very surprised if the numbers of people flowing into Singapore, Hong Kong, and Japan did not significantly exceed the numbers coming into New Zealand.

https://edition.cnn.com/travel/article/coronavirus-travel-bans/index.html

==

Re plot below, it does not look good for the US. Already 17,000 ('non-repatriated' only) - 19,000 (total) cases as at 20 March and many areas only started testing and strong isolation type measures in the last few days. They are still very much in the exponential growth phase , even accelerating over the last couple of days very likely due to increased testing. The backlog of 10+ days of exponential CT prior will only show up in the next couple of weeks. Within ~7 days there will likely be over 100,000 cases, with US having a good chance of becoming the first country to exceed the number of cases in China. And 10 days from now it could be approaching 300,000 or more, assuming the testing is up to it. The numbers after that will depend on how effective their current measures are, and on how much unmeasured CT there already is. Any new restrictions will only start impacting confirmed cases ~2 weeks from now. Unless they can reign in the current exponential growth in numbers, then 1 million cases could be only a bit over 2 weeks away. Recent restrictions in NY and CA do give some hope of drawing that out though?

Taiwan not shown because they only reached 150 cases on 20 March, two months after their first case.

As far as Im aware we were testing for CT all along. If you present to a GP or Healthline, and have one of symptoms A and B and one on C and D you get tested

We are bringing in 60 flights a day, into AKL alone, as of recently they are all Kiwis or residents. Contact tracing is the key, and that will apply with CT clusters that will turn up. Soon these flights will dry up, so no imports. We have already had CT, in the form of local transmission, these have traced back to travellers so we already have CT in that form, just not the unknown infection form, yet. But they get found. Testing is not overwhelmed neither are hospitals, in fact hospitals have hardly been touched, 4 cases from a day or so ago, none prior to that. If people take the right precautions and they stay in their region, and they are aware they need to self isolate if they feel they might have symptoms and they then contact he health system, that will work. Its up to the people

Another option is to lock everyone at home for 21 days. And/or ban all flights from now.

Fortunately each of us live in houses not apartments, and we aren't a 5 minute drive to the next town of 500,000 people surrounding us. Despite the laxness of many Kiwis, its going fine. Plenty of resource to deal with a cluster. As long as the people play ball for a change. Our strength is that hardy anyone live sin NZ and we arent forced to live like sardines. But the people need to step up, too many don't care. When there is a CT in their town and no one know where it came from or where its been, then they will manage themselves better, and that will make a huge difference. Yeah 53 cases, its blowing out. Or is it? Its blew out when we "closed the borders" which we didn't. We asked tens of thousand of Kiwis from stricken parts of the world to join us. So we happily imported more cases, and that's ok, this is their home. We will have CT clusters all throughout NZ, so people, do the right thing if you want to contain it.

FineWine

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#2443510 22-Mar-2020 09:18

As a follow-on from my previous post: NOTICE: retired Doctors and Nurses

You may have seen News articles concerning the temporary recruitment of Doctors and Nurses during the COVID-19 crisis where Australasia's largest medical recruitment agency, MEDWORLD, has teamed up with the MoH, Medical and Nursing boards to assist medical personal to temporarily come out of retirement.

Here is their website: #UniteAgainstCovid19

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

tdgeek

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#2443512 22-Mar-2020 09:26

blackjack17:

We can't keep our boarders shut forever. If we do stamp it out in NZ, we can go back to business as usual provided we don't let anyone into the country without an enforced quarantine period.

The borders are not shut

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Fred99

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#2443518 22-Mar-2020 09:35

According to Bloomberg, then according to Trump, the US is going to come up with a plan to boost the US economy by 2 trillion dollars. About 10% of GDP.

kingdragonfly

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#2443525 22-Mar-2020 09:42

If anyone finds Zoono claims misleading, I suggest complaining to Commerce Commission as misleading or false advertising.

From the website:

Kills 99.99% of germs & continues to work all day

Zoono will not wash off and your hands can be washed and dried, as normal during the day without washing off this protective shield.

This protective germ shield will not wash off no matter what! You can continue your normal activities with peace-of-mind.

To me, it sounds like this company is cashing in on the scare.

https://comcom.govt.nz/make-a-complaint/complaint-form

Sideface

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#2443528 22-Mar-2020 09:48

NOTE THAT THE FOLLOWING ARTICLE RELATES TO THE US MEDICAL SYSTEM - NOT TO NEW ZEALAND

The Washington Post - In hard-hit areas, testing restricted to health care workers, hospital patients

As cases spike, health officials are saying the battle to contain the virus is lost and are hunkering down for an onslaught, directing scarce resources where they are needed most to save lives.

March 22, 2020

Health officials in New York, California and other hard-hit parts of the country are restricting coronavirus testing to health care workers and people who are hospitalized, saying the battle to contain the virus is lost and the country is moving into a new phase of the pandemic response.

As cases spike sharply in those places, they are hunkering down for an onslaught, and directing scarce resources where they are needed most to save people’s lives.

Instead of encouraging broad testing of the public, they’re focused on conserving masks, ventilators, intensive care beds - and on getting still-limited tests to health care workers and the most vulnerable.

The shift is further evidence that rising levels of infection and illness have begun to overwhelm the health care system.

Health officials are struggling with a complicated message - more people can get tested, but those with mild symptoms should stay home and practice social distancing.

Some go so far as to warn that widespread testing at this point could threaten the U.S. response by burning through precious supplies just as a tidal wave of sick people descend on the system. ...

The Americans have done too little, too late - thanks in part to Mr Stable Genius 😟

Be glad that you live in New Zealand with a very different public health system.

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Fred99

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#2443529 22-Mar-2020 09:50

tdgeek:

We will have CT clusters all throughout NZ, so people, do the right thing if you want to contain it.

This.

FWIW, many of my son's friends went out to some party/gig last night. They're in their 20s and apparently either think they're bulletproof - or perhaps they just don't care:

They need to be shown articles like this - they need to have the &%^$ shaken out of them - because for many, the truth is not sinking in:

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy sh*t, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.”
This is knocking out what should be perfectly fit, healthy people.

“I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”

They suddenly become unresponsive or go into respiratory failure.

gchiu

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#2443530 22-Mar-2020 09:50

The govt needs to publish the analyses on which their decision making is based on.

We had a good chance to stamp out this virus in NZ but the NZ Pandemic plan is based on the Influenza virus, and the sars-cov-2 is much more highly infectious with a comparatively long asymptomatic and infectious pre-symptomatic phase. We needed to have adjusted our plan.

I think Michael Baker is right, but who exactly is advising this govt? Are they being advised by the people who were advising Boris Johnson? I think I'd like to know what data is being used to decide whether we die or not.

gchiu

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#2443532 22-Mar-2020 09:53

The Iwi shutting down their borders are doing the right thing ..except they can't allow even residents back until they've been quarantined outside their containment area. Which is what WE should have done to all travellers returning to NZ. Maori lost 5% of their population during the 1918 pandemic.

tdgeek

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#2443533 22-Mar-2020 10:00

gchiu:

The govt needs to publish the analyses on which their decision making is based on.

We had a good chance to stamp out this virus in NZ but the NZ Pandemic plan is based on the Influenza virus, and the sars-cov-2 is much more highly infectious with a comparatively long asymptomatic and infectious pre-symptomatic phase. We needed to have adjusted our plan.

I think Michael Baker is right, but who exactly is advising this govt? Are they being advised by the people who were advising Boris Johnson? I think I'd like to know what data is being used to decide whether we die or not.

Should we have closed our borders in January? Meaning everyone including Kiwis and residents?

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#2443534 22-Mar-2020 10:02

The first border tightening should have been NZers only. The second should've been no one.

Too late now.

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