2019 Novel Coronavirus Covid-19 Discussion

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#2500671 8-Jun-2020 15:33

neb:
frankv:

I think fudged is a bit strong, with implications of deliberate falsification. The problem is there are varying ways of deciding whether someone died *of* covid-19. In Belgium, they include everyone who had covid-19 symptoms, which leads to an overstatement of c-19 deaths.

A lot of US states are definitely fudging their data, they reclassify both deaths and suspected cases in a manner that makes them non-Covid19 to make things look rosier than they actually are. Google "us states manipulate covid19" for lots of coverage on this.

I think the only accurate way to see the true impact of Covid-19 will be to look at 'excess deaths', comparing the relevant period in 2020 with the average of the corresponding months of the previous five years.
This method will include deaths caused by people with non-Covid conditions who died because they couldn't access appropriate and timely hospital care because the hospitals were overloaded. I think it is entirely appropriate to count these as "Covid-19 deaths".

But this data is unfortunately only accessible with a significant lag, as many jurisdictions tend to report these statistics monthly or even quarterly.

freitasm

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#2500733 8-Jun-2020 17:02

Meanwhile:

"A single coronavirus update snapshot. Florida. FL got a lot of praise for how it handled nursing home cases (very well). Florida pushed opening amid sneering from people who didn't understand its case spread. Now? Last 4 days: Most new cases of any 4-days in the pandemic."

neb

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#2500794 8-Jun-2020 19:48

Forbidden fantasies from Covid19 quarantine, from the Washington Post.

DS248

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#2501042 9-Jun-2020 00:34

freitasm: Press release:

...

There are no active cases in the country, almost 40,000 tests in the past 17 days have turned up no positive results and it’s been 40 days since the last case of community transmission – and 22 days since that person finished self-isolation.

...

“We are confident we have eliminated transmission of the virus in New Zealand for now, but elimination is not a point in time – it is a sustained effort.

I do hope she/they are correct. But I am not confident. Local transmission that is not 'CT' is also an issue.

'No active cases' needs to be viewed in the light that NZ has not been testing overseas arrivals with no symptoms. Apart from Victoria, the bulk of active cases in Australia are imported cases, which are ongoing occurrences there.
NZ has had no imported cases notified in the last four weeks despite over 5,800 people arriving from overseas during that period. Not entirely convincing given only symptomatic people have been tested.
Twenty four out of 31 imported cases in Hong Kong over the last two weeks were asymptomatic at and prior to testing. Many (most?) of these appear to remain asymptomatic.
The rate of testing in NZ has fallen off significantly over the last week - 10 days. Just 800 tests yesterday, and a 7-day average of 1891 = only 378 pm/day. By comparison the average for the last 7 days in Australia is 914 pm/day, 2.4x the NZ figure. Even the three jurisdictions where the virus has been locally eliminated performed well above the NZ per capita rate:- SA (~7 wks since last local case) 1,253 pm/day, ACT (8 wks) 772 pm/day, and NT (> 9 wks) 710 pm/day over the last week.
Despite elimination, SA & ACT still have significant restrictions in place: - limits on gatherings (20 - 50 in most situations subject to 'four square metre rule' and physical distancing of 1.5 metres where possible); entertainment venues, bars & night clubs, etc still closed in ACT 8 weeks after the last local case there; and other industry specific restrictions.
Some jurisdictions including HK have had local cases confirmed after periods of three weeks with no local cases.
Now we have no social distance requirements and no limitations on gatherings after just 17 days with no local cases notified.

Sidestep

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#2501088 9-Jun-2020 06:22

PolicyGuy:

I think the only accurate way to see the true impact of Covid-19 will be to look at 'excess deaths', comparing the relevant period in 2020 with the average of the corresponding months of the previous five years.
This method will include deaths caused by people with non-Covid conditions who died because they couldn't access appropriate and timely hospital care because the hospitals were overloaded. I think it is entirely appropriate to count these as "Covid-19 deaths".

It's a very grey area. Any 'wave' of excess deaths among the elderly will likely be followed by a 'trough' of fewer than normal deaths and will somehow have to be balanced out to see the actual impact. For example:

We moved my 86 y/o Father-in Law into a nearby long term care facility after he'd had a fall in his - completely unsuitable - house and badly broken his hip.
X-Rays last year showed that had healed, but discovered terminal - but slow growing - cancer that had metastasized into his lungs.

My wife took him to his oncologist this January, - he'd developed a cough - we were told he likely had 6-8 months and to 'get his affairs in order' which we did. A pilot most of his life - first in the Military, then as a bush pilot, we'd also arranged for a family gathering and for him to go on a 'final flight' in a vintage aircraft this spring.

The old guy was still sharp as a knife, had my phone on auto-dial so he could call (almost daily) and discuss the sharemarket, news or new aircraft designs. He watched the news about the coronavirus, and when he heard his facility was being locked down– only half joking – suggested I come pick him up and we head for the hills.

At the end of February he hadn't called for a couple of days, so my wife called the home - was transferred to a duty RN who said he'd developed breathing difficulties, brought up health directives and end-of-life care, and said they'd moved him from our agreed M1 (excluding resuscitation) designation to C2 (care and comfort only) Obviously not good. My wife wanted to go and see him, was told it wasn't possible - which she saw as a challenge to be overcome.

The following day the facility doctor grudgingly said 'one family member' could go in - as an exception - and subject to wearing PPE.
When my wife got there he was sedated with hydromorphone, on oxygen, and passed away very peacefully a few hours later. Though he was never tested for COVID-19, and it's not mentioned as a cause of death, on the Doctors advice, she then took a leave of absence from her job to quarantine at home.

We were soon contacted by a literal ambulance chasing lawyer's firm re. joining a class action suit - which we have no interest in pursuing.
I have no doubt he died 'of' COVID-19, but not 'because of' C-19. We're philosophical, though we did loose our, likely short, remaining time with him.

Contrast this to a friend's experience, who lost her Dad just last week.

He was 95 years old - an Auschwitz survivor and artist, who had developed mild dementia, and moved into a higher-end facility, where he could continue to paint and sculpt while receiving the best of care.
C-19 was killing residents there by March, and our friend flew back to Canada to be with him.

By the time she'd completed her 2 week quarantine in mid-April there'd been 20 deaths in the facility, it was totally locked down and there was no chance of seeing her Dad in person, she did manage a phone call every few days, and was able to wave to him from outside the building.

By the end of last month it seemed the worst had passed, but random cases have kept popping up, and she got a call saying he'd developed a fever and cough.
She was allowed a phone call with him, heartbreakingly, he told her he didn't want to die alone. She was still refused access to the home, and 4am the following day received a call saying he'd died.

In this case I'm sure C-19 killed him (though the tests are apparently inconclusive)
So two very similar - but different - cases. Both seem to have been 'affected' by the coronavirus, though they'd only show as 'excess deaths' in a comparison.
We'd be fine with my F.I.L not being labelled as a C-19 death, though our friend expects her Dad will be - and is joining one of two Class Action Lawsuits against the facility which will - likely in several years - provide some clarity.

So glad to see NZ is now case-free and, fingers crossed, will be spared the grief, anger and recriminations that this disease has brought on in so much of the world.

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#2501101 9-Jun-2020 08:15

Let the party's begin!

Oh, that's right - they never stopped! (Around here at least)

KrazyKid

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#2501293 9-Jun-2020 11:27

DS248:

NZ has had no imported cases notified in the last four weeks despite over 5,800 people arriving from overseas during that period. Not entirely convincing given only symptomatic people have been tested.
Twenty four out of 31 imported cases in Hong Kong over the last two weeks were asymptomatic at and prior to testing. Many (most?) of these appear to remain asymptomatic.
The rate of testing in NZ has fallen off significantly over the last week - 10 days. Just 800 tests yesterday, and a 7-day average of 1891 = only 378 pm/day. By comparison the average for the last 7 days in Australia is 914 pm/day, 2.4x the NZ figure. Even the three jurisdictions where the virus has been locally eliminated performed well above the NZ per capita rate:- SA (~7 wks since last local case) 1,253 pm/day, ACT (8 wks) 772 pm/day, and NT (> 9 wks) 710 pm/day over the last week.
Despite elimination, SA & ACT still have significant restrictions in place: - limits on gatherings (20 - 50 in most situations subject to 'four square metre rule' and physical distancing of 1.5 metres where possible); entertainment venues, bars & night clubs, etc still closed in ACT 8 weeks after the last local case there; and other industry specific restrictions.
Some jurisdictions including HK have had local cases confirmed after periods of three weeks with no local cases.
Now we have no social distance requirements and no limitations on gatherings after just 17 days with no local cases notified.

I agree that testing at the border has been limited - nice to see that all people will be tested twice going forward, as they arrive and again just before the leave quarantine.
You would like to think the 14 day isolation would have seen any infectious period pass safely for such asymptomatic cases.

The evidence seems to be inconclusive that asymptomatic cases are infectious anyway.

I am not worried about the 17 days as much - They last few cases were nurses/ isolated patients family members and historical cases. The unknown CT seems much scarier to me, and that was last found in late April.

Yes our testing rate is low now, but then again if our case rate is low do we need to do such broad testing. Unlike Australia we had an extreme lockdown and so hopefully stopped transmission more thoroughly.
Australia seems to be trying for elimination without the lockdown. They also have a sort of national approach to easing the lockdown where states are staying roughly in line.

It is the sentinel testing program I want to hear details of.
What is NZ doing to find those missed or new cases? We should be doing more than just testing those who are feeling unwell and bother to say anything.

One last thing - it seems Taiwan is about at the same stage in removing limits to gatherings as us. They main difference is that they are all wearing masks still.

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DS248

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#2501308 9-Jun-2020 11:51

KrazyKid: ...

"Yes our testing rate is low now, but then again if our case rate is low do we need to do such broad testing. Unlike Australia we had an extreme lockdown and so hopefully stopped transmission more thoroughly."

Our 'case rate' is not as low as it is in SA, ACT and NT. No local cases of any type for 7 - 9+ weeks. Yet they are still testing at ~2+ times our current rate.

"One last thing - it seems Taiwan is about at the same stage in removing limits to gatherings as us. They main difference is that they are all wearing masks still."

Another main difference is that they have had no local cases of any type for 8 weeks.

And yes, the wearing masks in confined spaces is a significant factor.

DS248

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#2501313 9-Jun-2020 11:58

KrazyKid: ... Taiwan is about at the same stage in removing limits to gatherings as us. They main difference is that they are all wearing masks still.

BTW, a good link. Thanks

They have also now set up a website to share information on Taiwan’s major measures taken to combat COVID-19 (https://www.cdc.gov.tw/En/Bulletin/Detail/D_pNFk_E60Za2fvlnlcpTg?typeid=158).

Link to the new website is https://covid19.mohw.gov.tw/en/mp-206.html

Oblivian

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#2501327 9-Jun-2020 12:14

If it wasn't already apparent. You can't use testing rates on monday and tuesday as exemplary artillery to doing bad.

They've ALWAYS been low on monday and tuesday. And Dr Bloomfield gets questioned on it errrry time. Only to find it often jumps to 3000 on wednesday (it did the week I got tested on a monday). Apparently the lag from nature of people venturing out/weekend testing capabilities (couriers and not all centres open).

The results are as quick as next morning (friend got a test 1pm yest, results by 1030am)

Sidenote, Australia is still pumping out alerts for DOMESTIC travel despite cautions for people testing positive after the fact. ANZ has been at reduced capacity, and people are still flying and we aren't picking any up like that. They're up to 55% of normal as of next month on routes.

freitasm

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#2501410 9-Jun-2020 12:27

Meanwhile (from The Guardian):

The world has recorded its highest daily jump of cases (136,000), according to the WHO chief, Tedros Adhanom Ghebreyesus, who said: “More than six months into the pandemic, this is not the time for any country to take its foot off the pedal.”

“Although the situation in Europe is improving, globally it is worsening,” he said.

Nearly 75% of the 136,000 cases were reported from 10 countries, mostly in the Americas and South Asia.

The WHO emergencies chief, Dr Mike Ryan, said retrospective studies of how the outbreak has been addressed could wait, adding: “We need to focus now on what we are doing today to prevent second peaks.”

Ryan also said infections in central American countries including Guatemala were still on the rise, and that they were “complex” epidemics.

“I think this is a time of great concern,” he said, calling for strong government leadership and international support for the region.

Maria van Kerkhove, the WHO’s technical lead on the virus, said that a “comprehensive approach” was essential in South America.

“This is far from over,” van Kerkhove said, adding that asymptomatic transmission of the virus “appears to be rare”."

wellygary

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#2501455 9-Jun-2020 12:42

Interesting

We have an Ashley-update today, apparently it was supposed to be a statement. Perhaps we have a new case (imported?)

https://www.health.govt.nz/news-media/news-items/covid-19-media-update-9-june

DS248

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#2501457 9-Jun-2020 12:43

Oblivian: ... You can't use testing rates on monday and tuesday as exemplary artillery to doing bad. ...

It was not just Mon - Tue. The 7-day average number of tests in NZ for last week was only 41% of the corresponding AU figure.

Oblivian: ... Sidenote, Australia is still pumping out alerts for DOMESTIC travel despite cautions for people testing positive after the fact. ...

Yes, that relates to a person from Victoria who had an exemption to enter QLD. He later tested positive. Agree it odd he had exemption from quarantine. QLD state borders are closed with exemptions for specific situations only. But why no quarantine, especially coming from Victoria?

freitasm

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#2501458 9-Jun-2020 12:44

DS248:

Yes, that relates to a person from Victoria who had an exemption to enter QLD. He later tested positive. Agree it odd he had exemption from quarantine. QLD state borders are closed with exemptions for specific situations only. But why no quarantine, especially coming from Victoria?

Interesting... It's almost like people do dumb things in dumb ways.

wellygary

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#2501465 9-Jun-2020 12:56

freitasm:

DS248:

Yes, that relates to a person from Victoria who had an exemption to enter QLD. He later tested positive. Agree it odd he had exemption from quarantine. QLD state borders are closed with exemptions for specific situations only. But why no quarantine, especially coming from Victoria?

Interesting... It's almost like people do dumb things in dumb ways.

Dumb in a Big way

"He said the Melbourne man, in his 20s, flew to Brisbane on June 1 when he was infectious and then took a second flight the next day to Bundaberg, where he picked fruit and lived in shared accommodation. Mr Miles said the man, who had been in contact with a known COVID-19 case in Melbourne, spent one night in Brisbane to socialise with about 15 family and friends on the south side of Brisbane. The next day in Bundaberg he worked one day with a number of colleagues. "Clearly there's a lot of work for our contact tracers to do," Mr Miles said.

"There's two flights, the contacts in Brisbane, who will have to be tested and quarantined, those who travelled on the transport from Bundaberg airport and those in the shared accommodation and those working with him on the farm."

https://www.abc.net.au/news/2020-06-06/coronavirus-cases-queensland-fruit-picker-public-health-alert/12309468

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