2019 Novel Coronavirus Covid-19 Discussion

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#2583333 12-Oct-2020 21:10

"Made in the USA" seems redundant, because where else would this sell?

They didn't go the first version:

"What doesn't kill you, can damage your lungs, heart and brain, and increases the risk of long-term health problems."

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DS248

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#2583368 12-Oct-2020 22:44

SARS-CoV-2 Infection Among Community Health Workers in India Before and After Use of Face Shields

Research Letter, JAMA

https://jamanetwork.com/journals/jama/fullarticle/2769693

Study evaluation has limitations but does indicate considerable benefit for these high risk health workers resulting from the addition of face shields to their personal protective equipment.

The transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to be predominantly through respiratory droplets from infected persons in close proximity to uninfected persons,1 although airborne transmission may also play a role.2,3 Face shields have been proposed to prevent transmission in the community,4 but data are lacking. We describe transmission in a community setting before and after the use of face shields.

Methods
Beginning May 3, 2020, community health workers from a research network in Chennai, India, were assigned to counsel asymptomatic family contacts of patients who had tested positive for SARS-CoV-2 at their residence. The workers were housed in separate rooms of hostels and provided food; they did not visit their homes or public places outside work. Prework training was done with no more than 3 persons attending any session. Workers communicated with each other by phone. All workers’ nasopharyngeal swabs taken on May 1, 2020, tested negative for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction (RT-PCR).

Each worker traveled in a small van with a steel partition to prevent air exchange between the driver and back cabin where the worker sat. Workers maintained constant masking and social distancing when interacting with the driver. Personal protective equipment included alcohol hand rub, 3-layered surgical masks, gloves, and shoe covers. Family members assembled in the front room of each house, and the worker, standing 6 ft away, explained the principles of quarantine, mask use, social distancing, handwashing, and symptoms of SARS-CoV-2 illness. Family members were asked to wear face masks during the conversation, although workers reported that some did not.

On May 16, 2 workers developed symptoms. The remaining 60 workers were monitored, and all workers were tested for SARS-CoV-2 by RT-PCR between May 16 and May 19, and home visits suspended. Contact tracing was conducted. On May 20, face shields made of polyethylene terephthalate (250-μm thickness) were added to the equipment provided. After each visit, the shield was decontaminated using alcohol-based solution, and at the end of the day, soaked in detergent mixed with water. After the introduction of face shields, workers were screened for symptoms and had RT-PCR tests performed weekly.

Family members in the visited homes were followed up for symptoms by daily phone contact with the worker. For symptomatic members, the need for testing was conveyed to local public health officials who subsequently shared the test results with workers. We obtained the number of positive test results in visited households to assess worker exposure.

We compared the number of positive test results before (May 3-15) and after (May 20-June 30) the introduction of face shields. The ethics committee of the community research network exempted the study from review and waived the need for informed consent.

Results
Before face shields, 62 workers (40 women) visited 5880 homes with 31 164 persons. From the 5880 homes visited, 222 persons tested positive for SARS-CoV-2, between May 4 to May 13. Twelve workers (19%) were infected during this period. Eight developed symptoms (fever, cough, sore throat, myalgia, and anosmia) and 4 were asymptomatic. The 12 infected workers were moved to care centers. Four developed desaturation and mild breathing difficulty and were treated with oral hydroxychloroquine and oxygen therapy; all 4 recovered. Contact tracing of the workers who tested positive identified 14 van drivers, who were monitored. All were asymptomatic and tested negative between days 7 and 10 after contact with the workers.

After face shield introduction, 50 workers (previously uninfected) continued to provide counseling, visiting 18 228 homes. Among the counseled 118 428 persons, 2682 subsequently tested positive for SARS-CoV-2. No worker developed asymptomatic or symptomatic infection.

Discussion
This study found no SARS-CoV-2 infections among community health workers after the addition of face shields to their personal protective equipment. Because the first worker became symptomatic 13 days after beginning home visits and workers had no contact with family, coworkers, or the public, there is no known alternative source of infection for the workers except the asymptomatic contacts of SARS-CoV-2 patients. The face shields may have reduced ocular exposure or contamination of masks or hands or may have diverted movement of air around the face.

Limitations include the before-after design; however, the unique living circumstances of the workers minimized other sources of transmission. Further investigation of face shields in community settings is warranted.

kingdragonfly

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#2583389 13-Oct-2020 07:28

Good article

worth repeating from your article:

"Workers maintained constant masking and social distancing when interacting with the driver.

Personal protective equipment included alcohol hand rub, 3-layered surgical masks, gloves, and shoe covers.

Family members assembled in the front room of each house, and the worker, standing 6 ft away, explained the principles of quarantine, mask use, social distancing, handwashing, and symptoms of SARS-CoV-2 illness.

Family members were asked to wear face masks during the conversation, although workers reported that some did not."

kingdragonfly

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#2583416 13-Oct-2020 08:37

Al Jazeera: ‘Unethical’: WHO chief slams herd immunity as COVID-19 response

World Health Organization Director-General Tedros warns that herd immunity is a ‘scientifically and ethically problematic’ strategy for a pandemic.

The World Health Organization chief has warned against suggestions by some to just allow COVID-19 to spread in the hope of achieving so-called herd immunity, saying this was “unethical”.

Tedros Adhanom Ghebreyesus said during a virtual press briefing on Monday that “herd immunity is a concept used for vaccination, in which a population can be protected from a certain virus if a threshold of vaccination is reached”.

He pointed out that for measles, for instance, it is estimated that if 95 percent of the population is vaccinated, the remaining five percent will also be protected from the spread of the virus.

For polio, the threshold is estimated at 80 percent, he said.

“Herd immunity is achieved by protecting people from a virus, not by exposing them to it,” Tedros said.

“Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic,” he insisted, calling the strategy “scientifically and ethically problematic”.

“Allowing a dangerous virus that we don’t fully understand to run free is simply unethical. It’s not an option.”

Tedros pointed to a lack of information on the development of immunity to COVID-19, including how strong the immune response is and how long antibodies remain in the body.

He also pointed out that it has been estimated that less than 10 percent of the population in most countries is believed to have contracted the disease.

“The vast majority of people in most countries remain susceptible to this virus,” he said.
...

frankv

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#2583480 13-Oct-2020 10:26

freitasm:

Press release:

Border exceptions for a small number of international students with visas

“So far around 10,400 exceptions have been granted for people such as essential health workers, other critical workers and family of New Zealand citizens or permanent residents.

“Just last month, new exceptions were announced for some normally resident temporary visa holders, more partners of New Zealanders, and a limited number of veterinarians, deep water fishing crew and agricultural and horticultural mobile plant operators.

Mention of rugby players, film crew, and yachtsmen appears to be studiously avoided. Unless of course these people are considered "other critical workers".

Batman

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#2583482 13-Oct-2020 10:30

Well, you also don't want to die an economic death.

freitasm

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#2583483 13-Oct-2020 10:32

Press release:

First COVID-19 vaccine purchase agreement signed

The Government has signed an agreement to purchase 1.5 million COVID-19 vaccines – enough for 750,000 people – from Pfizer and BioNTech, subject to the vaccine successfully completing all clinical trials and passing regulatory approvals in New Zealand, say Research, Science and Innovation Minister Megan Woods and Health Minister Chris Hipkins.

“Our first vaccine purchase agreement has been signed and it brings to fruition some of the critical work going on behind the scenes to keep New Zealanders safe from COVID-19,” says Megan Woods.

“As part of the agreement, vaccine delivery to New Zealand could be as early as the first quarter of 2021. This is just the first tranche of work in a multi-pronged approach to ensuring we secure vaccines for New Zealanders.

Megan Woods says “Pfizer have said they are making good progress with the development of a COVID-19 vaccine. Subject to clinical and regulatory success, and provided the vaccine is approved for use here in New Zealand by Medsafe, it is possible that some doses will be available to us in the first part of 2021.”

The agreement with Pfizer is complementary to other aspects of the Government’s COVID-19 Vaccine Strategy, such as the global COVAX Facility that could provide up to 50 percent of our population’s needs.

“A key aim of our portfolio approach is to ensure we have flexibility and choice when it comes to securing the right vaccines for New Zealand and our Pacific neighbours.”

Megan Woods said the COVID-19 Vaccine Strategy Task Force is currently negotiating with other pharmaceutical companies, and further announcements are expected in November. “The agreement with Pfizer and BioNTech is the first of a number of negotiations underway as part of our portfolio approach, and good progress is being made in relation to other purchasing negotiations. The additional agreements will ensure that once the portfolio is completed, we will have sufficient COVID-19 vaccines for the whole population,” said Megan Woods.

Decisions on who would receive access to the first available vaccines have yet to be made.

“Work at the Ministry of Health is currently underway to determine what an Immunisation Programme roll-out might look like. A number of factors will influence who will receive what vaccines and when, such as trial data on the suitability of each vaccine for certain age groups,” says Chris Hipkins, Minister of Health.

“We have set aside $66.3 million for medical supplies and infrastructure to ensure New Zealand is ready to launch a COVID-19 Immunisation Programme as soon as we have a safe and effective vaccine.

“Most of this investment will pay for sufficient supplies to support New Zealand and Pacific Realm countries; supplies such as PPE, needles, syringes and swabs, and freezers to store a vaccine,” says Chris Hipkins.

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mattwnz

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#2583663 13-Oct-2020 14:18

For the last 3 days in a row, testing has dropped right back. Deducting the border and staff testing it doesn't look like much is occurring in the community. Well under what the minister of health required. What is stopping another level 3 lockdown for eg. Auckland when another case gets into the community and can't be traced back to the border due to this lack of testing and case detectionbeing delayed? App usage has also dropped off based on what I have seen and complacency is occurring. Maybe people aren't paying attention to the UK who are heading into new restrictions with what looks like a worse second wave.

I noticed a few days ago the MOH made a big deal that 1 million tests in total had now been done. But that is somewhat irrelevant to how we are doing today. What is important is how many tests are being done now and how many are being done throughout NZ in the community which they have not provided figures on. They only provide total test numbers. Testing is the only way that we even know if we have any cases in NZ. NSW who was seen as doing as well as NZ , appears to be doing significantly more testing than NZ.

tdgeek

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#2583672 13-Oct-2020 14:53

People are complacent, thats true. Its a natural phenomenon. Human nature. Does it matter? Probably not as there "appears" to be not one case in NZ in the wild.

If there are no cases, testing would appear to be a waste of everyone's time, thats probably how many see it. If there was a case in the wild, we would know about it. If a case leaks from the border, testing will be very high as we saw last time.

I dont see testing 12000 people a day for the next two years to be of any use, but you do need it to be there when needed

That's my opinion why testing is low, and its not entirely a problem situation.

trig42

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#2583673 13-Oct-2020 14:56

mattwnz: For the last 3 days in a row, testing has dropped right back. Deducting the border and staff testing it doesn't look like much is occurring in the community. Well under what the minister of health required. What is stopping another level 3 lockdown for eg. Auckland when another case gets into the community and can't be traced back to the border due to this lack of testing and case detectionbeing delayed? App usage has also dropped off based on what I have seen and complacency is occurring. Maybe people aren't paying attention to the UK who are heading into new restrictions with what looks like a worse second wave.

What can they do?

Are you going for a test when you don't think you need one?

I see the 'flu was pretty much non existent this year. I don't know anyone who's had a cold in the last few weeks. I catch Public Transport every day (a ferry, usually 200+ people aboard) and haven't heard/seen anywhere near the usual levels of sniffling, sneezing and coughing this year.

They are saying get tested if you feel unwell. What if you just don't feel unwell?

Not sure what you expect to happen? Catching leaked cases early is pure luck. If/When another case gets through, testing will go through the roof again. We just have to hope that when it gets through, the person/people that have it get tested as soon as they feel ill. I don't think that happened with the August cluster (they still travelled etc., Rotorua, Tokoroa). I think if that had gone another couple of days, we'd have had a Melbourne on our hands.

frankv

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#2583676 13-Oct-2020 15:06

mattwnz: For the last 3 days in a row, testing has dropped right back. Deducting the border and staff testing it doesn't look like much is occurring in the community. Well under what the minister of health required. What is stopping another level 3 lockdown for eg. Auckland when another case gets into the community and can't be traced back to the border due to this lack of testing and case detectionbeing delayed?

When there are low infection rates and no isolation, randomly testing individuals is an expensive (and largely ineffective) way of identifying the presence of covid in the community. Let's say Auckland has a population of a million, and there's one case somewhere in Auckland. If you test at random, on average you'll need to test 500,000 people to find that case (and you won't know if it's the only one). If you can do 10,000 tests per day, and a typical doubling time of 3 days, by day 3 there's 20 cases and you probably haven't found one case through random testing. Day 6, there's 4 cases, day 9, there's 8, day 12 there's 16. And you've done 12,000 tests, 1/800th of the population, so you probably still haven't found a single case through random testing. But probably there's already been 1 or 2 hospital presentations. Unless you couple your testing it with lockdown, the people previously cleared will potentially become infected. So you need to test each person repeatedly.

So testing is valuable only for high risk people -- close or possible contacts of someone who is known to to be infected. So border & hotel staff.

So don't stress. Low rates of testing is sensible, when there's low infection rates and no lockdown.

ezbee

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#2583684 13-Oct-2020 15:28

mattwnz

Understand the concern here, though the way flu has been squashed and colds reduced it may be difficult.

Incidentally looking for some info on the cruise ship favorite norovirus, I see a UK report.
April is their latest stats saying this was 69% down in community, vs last 5 years and hospital outbreaks 1 vs last five year average of 34 !
https://www.gov.uk/government/statistics/norovirus-and-rotavirus-summary-of-surveillance-2019-to-2020

Have not found Aussie or NZ data.

Anyway

Given the unhinged response to the increased public health advertising before the last outbreak.
Advertising that may have helped prompt people to come forward right at start of that outbreak.
I can understand practical issues while there is election underway.

Delay of election has created a hole. Everything is highly politicized until this is over.

Hopefully next week we can get back to reminding all of NZ to be vigilant.
We can get actions reviewing border, ports and logistics infrastructure testing.
There is something nagging re unknown Americold source.
We had recent news of Airport freight staff in major drug smuggling bust, for another twist on groups that might not care for biosecurity rules.
Ports another area of activities that may avoid regulatory checks.
Get numbers up with some random surveillance of vulnerable populations.

Its something for whole of New Zealand.
That sleepy port town that just gets the odd fishing vessel or coastal trader with crew that are doing a crew change.
Auckland as weather gets warming is visiting all of you.
Making up for lost time, RV road trips at top of bucket lists, even selling up to become your neighbor.
Coming to you to pick fruit etc.

mattwnz

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#2583701 13-Oct-2020 15:39

frankv:
mattwnz: For the last 3 days in a row, testing has dropped right back. Deducting the border and staff testing it doesn't look like much is occurring in the community. Well under what the minister of health required. What is stopping another level 3 lockdown for eg. Auckland when another case gets into the community and can't be traced back to the border due to this lack of testing and case detectionbeing delayed?

When there are low infection rates and no isolation, randomly testing individuals is an expensive (and largely ineffective) way of identifying the presence of covid in the community. Let's say Auckland has a population of a million, and there's one case somewhere in Auckland. If you test at random, on average you'll need to test 500,000 people to find that case (and you won't know if it's the only one). If you can do 10,000 tests per day, and a typical doubling time of 3 days, by day 3 there's 20 cases and you probably haven't found one case through random testing. Day 6, there's 4 cases, day 9, there's 8, day 12 there's 16. And you've done 12,000 tests, 1/800th of the population, so you probably still haven't found a single case through random testing. But probably there's already been 1 or 2 hospital presentations. Unless you couple your testing it with lockdown, the people previously cleared will potentially become infected. So you need to test each person repeatedly.

So testing is valuable only for high risk people -- close or possible contacts of someone who is known to to be infected. So border & hotel staff.

So don't stress. Low rates of testing is sensible, when there's low infection rates and no lockdown.

The question is, is everyone who has cold and flu symptoms getting a tested? As things have opened up more again more people theoretically should get cold and flu symptoms. My neighbour has been sick in bed with a cold for the last week but I don't know if they bothered to get tested,but they are isolated. Many people will just think they have a cold, when they should be getting tested.
Prior to the last lockdown, I understand they changed the rules around getting a test, so theoretically that initial person who got tested probably shouldn't have been tested under the rules at the time as they had no connection to the border. So I think we were very lucky they did pick up that case when they did.

Oblivian

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#2583705 13-Oct-2020 16:02

This is the only sure fire way of doing it.

As suggested. Lock them all in. Test everyone in short period. You can't say no. (love to see that fly)

https://apnews.com/article/virus-outbreak-international-news-pandemics-asia-china-77da12921617c2c4ed225cdde17b30fd

As the smart body suggests, target scale should be set by the avg infection rate. Not a mythical magical number that sounds good. Ours is currently 0%, lower test numbers aren't currently a danger. The others are at least 4% and can't keep up with tracing as a result. They're most certainly not ahead. We still appear to be.

Batman

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#2583711 13-Oct-2020 16:11

second covid vaccine trial paused, this one by J&J, 1st one was the Astra Zeneca one

https://edition.cnn.com/2020/10/12/health/johnson-coronavirus-vaccine-pause-bn/index.html

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