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16353 posts

Uber Geek


  #2443445 22-Mar-2020 00:15
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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.


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  #2443446 22-Mar-2020 00:21
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Scott3:

 

Did anybody see the Auckland testing clinic's on the evening news today. Seemed very worrying.

The staff were wearing surgical masks & safety glasses, rather than the P2 masks & googles as per best practice for medical staff.

 

 

 

 

Is there any guide on what the best masks are against virus's?  It is interesting that in China they all wear masks, but I don't know how readily available they are in NZ. But in the USA they are wanting factories to start manufacturing face masks instead of what they were previously making, so thy must see a benefit to using them. 


 
 
 
 


neb

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  #2443456 22-Mar-2020 00:39
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mattwnz:

in the USA they are wanting factories to start manufacturing face masks instead of what they were previously making, so thy must see a benefit to using them. 

 

 

For politicians, the benefit is that it looks like they're doing something. For the factories, the benefit is that they make money. For a medical staff trained in using N95 masks it could be a life-saver. For everyone else, it's warm fuzzies. So there are different benefits to different groups, but only the medical staff really need them.

neb

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  #2443457 22-Mar-2020 00:42
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Just noticed that alongside the jump in advertising for face masks there's also been in increase in pitches for Chinese flesh-burning death ray lamps. I wonder how many people are going to end up with serious eye and skin damage from these UVC sterilisers.

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  #2443459 22-Mar-2020 01:20
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https://i.stuff.co.nz/national/health/coronavirus/120429926/gull-to-divert-its-ethanol-stocks-to-hand-sanitiser-production

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Ultimate Geek

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  #2443463 22-Mar-2020 01:52
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tdgeek: ...

 

I feel I am realistic not optimistic. There will be CT here, there will be deaths here.

 

Numbers, that I have comfort with. Our cases per capita is circa 1.7. Thats good. Deaths per capita is zero. Until today, cases were ALL recent travel imports. Its possible that the 2 potential CT today are travel related. 

 

Unlike South Korea and Singapore who are current gold standards, I doubt they are heavily importing cases as we are right now. Our higher daily cases are broadly aligned with travel since last weekends travel block.  ... 

 

 

 

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.  

 

 

 

 


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Ultimate Geek

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  #2443465 22-Mar-2020 02:51
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FWIW full details of Singapore's current border control measures are here https://www.ica.gov.sg/covid-19.

 

 

 

 


 
 
 
 


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  #2443478 22-Mar-2020 05:27
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How many infections do we need to see before we start to see severe disease given that only 20% have moderate to severe disease?

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  #2443480 22-Mar-2020 05:40
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Interesting that in the USA, health officials in New York City and Los Angeles are recommending "doctors avoid testing patients except in cases where a test result would significantly change the course of treatment."

While the "immediate stop to testing non-hospitalized patients for Covid-19" may ease the workload on hospitals, it also means no-one is going to know - ever- how many people are infected in the US. It points to the fact that the US is chronically short of testing kits, and hides the terrifying increase in infections that - a testing regime would show - is now exponential.

 

This week the US will likely have both the fastest increase and the largest total number of infections in the world.
But we won't know.


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  #2443481 22-Mar-2020 05:44
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There have been 52 confirmed cases of COVID-19 in New Zealand to date, and another four probables. Three people remain in hospital, and two of the cases are yet to be linked to overseas travel.

I guess that answers the question.

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  #2443482 22-Mar-2020 05:46
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Sidestep:

Interesting that in the USA, health officials in New York City and Los Angeles are recommending "doctors avoid testing patients except in cases where a test result would significantly change the course of treatment."



So they're so overwhelmed they can't do contact tracing

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Ultimate Geek

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  #2443483 22-Mar-2020 05:57
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gchiu:
Sidestep:

 

Interesting that in the USA, health officials in New York City and Los Angeles are recommending "doctors avoid testing patients except in cases where a test result would significantly change the course of treatment."



So they're so overwhelmed they can't do contact tracing


They've already given up on contact tracing in LA and NY.

However a positive COVID-19 diagnosis meant 'stay home, quarantine yourself'
Now you don't know, won't be tested. 
Is it a cold or a mild case of coronavirus? Should I keep working my job as a McDonalds kitchen-hand, or hospital cleaner, or stay at home?


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Uber Geek


  #2443484 22-Mar-2020 06:06
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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.

 

 

 

 

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.





1129 posts

Uber Geek


  #2443485 22-Mar-2020 06:22
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Sidestep:

However a positive COVID-19 diagnosis meant 'stay home, quarantine yourself'

 

 

... and inform health service! Here, they come at home and test you WHEN needed.

 

What shows up is that medium cases need to be monitored closely since there is not much margin in case it gets worser (often after 5-6 days behind first symptoms) . THEN the time DIRECTLY to the ventilator seems to be very important. This is sometimes hard to be detected 'cause patient says that "it got worser but still going well so far." In true this isn't really the case and needs to be supervised.

 

Again, self-discipline and "stay away from others" seems really to work here so far! It's a slight effect and very early but noticeable. We had a wonderful sunny begin of spring today (sorry to say - it's your autumn). People on streets did the basic things according to the recommendations and really deviated when passing along each other by 2-3 meters. We are a comparable "dense" city with 2450 people/km² and you could imagine, what happens when this isn't obeyed.

 

In the FOOD shops there are markings on ground and staff watch out keeping the rules. You only can enter when somebody has finished and brought back the shopping cart. Before you can use it, a staff member is desinfecting it. There is only a certain amount of shopping carts available and you are not allowed to enter without one. There is a queue in front of the shop (remember the 2-3m) but its not too much waiting time.





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  #2443490 22-Mar-2020 07:47
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Tinkerisk:

 

...

 

Again, self-discipline and "stay away from others" seems really to work here so far! It's a slight effect and very early but noticeable. ...

 

Yeah, this is something I feel we're slow to get; NZ has (had?) the opportunity to be able to minimise spread, given the chance to learn from how things have played out overseas. My sense is there's a key benefit from being proactive, as opposed to reactive - by the time we see firm evidence of CT then it's no doubt got a firm hold in the community and will be harder to get under control. By the time schools close they'll have played a role in that spread.

 

That's why we're looking to essentially self-isolate, despite this not being current requirements (no known exposure). My work is clearly moving to push those who can work from home to do so; my wife should be able to do the same. So we're now looking at keeping the kids home from school. I totally get that's not an option for many if not most households, but if all those who are able to do so do this CT will be reduced.   

 

Now if only something could be done about the idiots who seem to not understand the risk they pose to others (NZ's equivalent to the Florida Spring break freaks)... 

 

I've found the recent episodes of Sam Harris' Making Sense podcast on Coid 19 worthwhile, eg: https://open.spotify.com/episode/07dMeog90t1KRcrqcLMDFs


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