2019 Novel Coronavirus Covid-19 Discussion

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#2451744 31-Mar-2020 19:19

gchiu:

mattwnz:

IMO they should also be temperature testing anyone who goes into the supermarket with a scanner, which is easy to do. In China it appears they are now doing this as they return to some state of normality.

The experience shows that this is almost completely worthless as a screening method.

https://edition.cnn.com/2020/02/19/health/coronavirus-airport-temperature-checks/index.html

I have a thermal thermometer at home for quick use before I reach for my old reliable Terumo Blue professional underarm type. Whilst working at the The Children’s Hospital at Westmead, Sydney (The Royal Alexandra Hospital for Children) where I worked as a nurse for 20yrs, a trial was carried out. What we found was two areas of concern using thermal scanning thermometers

1 - results varied by +/- 1 degree (1 degree variance over 38.5 is a huge worry)
2 - you had to ensure the area of skin aimed at, usually the forehead, was perfectly dry, no sweet etc

These thermometers were tested against the usual type of 'underarm'. You never do oral temperatures on young children and children in general and you never use glass thermometers. Underarm or anal is best. But you use a thermometer that has been calibrated for that particular area.

The final decision was that underarm in all circumstances except burns patients where, if accessible, use correctly celebrated anal or use thermal scanner with the knowledge of its inconsistencies.

We also used underarm in the infectious ward. On ALL patients in all areas, we carried out aseptic cleaning procedures after each time of use.

However scanners are good in mass screening circumstances, infectious or otherwise. So long as you realise and understand their inaccuracies and that the results are indicative only and not a certainly.

So in a mass screening situation you could have someone who shows a temp of 38 when it is 37 or 39. Or 36 when it is 37. If you are bundled up then you could show 39 when you are 38. The extra time and effort to verify these inaccuracies, as the above article stated is not really worth it and quite inefficient. Also in this situation of the coronavirus incubation period, you can be asymptomatic upto 14 days and in some people it has been longer.

No, instant self isolation for asymptomatic arriving travellers, with follow up policing and quarantine for those displaying the signs and symptoms.

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tdgeek

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#2451746 31-Mar-2020 19:34

neb:
tdgeek:

I feel if we have a couple of Level 4's we will be well in control. Dampening hotspots more than using the fire.

That's pretty much what the hammer and the dance talks about, in a great amount of detail. Good reading for those who haven't seen it yet.

Thanks I'll read tonight. From a maths view, it does seem to make sense. As I type this, there are many virii in NZ that will never get a chance to move house. Thats the goal.

neb

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#2451797 31-Mar-2020 19:52

For an example of a US state that's still, as of today, totally oblivious to the existence of Covid19, as well as a generally interesting watch if you're into this sort of thing, there's the Youtube channel of Alec Steele, a blacksmith in Montana (I thought it was Minnesota when I mentioned it last week). They seem to update almost daily so it's a good way to gauge the situation there. A video shot today US time (yesterday NZ time) shows business as usual, with a group of plumbers in installing a gas line, people working in the background, etc. Apart from a quick closing comment there's no acknowledgement that they're in the world's worst-hit pandemic country.

freitasm

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#2451806 31-Mar-2020 20:16

Wellington Mayor Update:

Well done Wellington on staying safe, staying home, staying local, and following the physical distancing and Ministry of Health hygiene protocols.

In between Zoom meetings today, I went out for a local run. There were quite a few people out, clearly in their bubble families, everyone consciously keeping a good distance from other people – but that didn’t stop well separated friendly chats going on.

Speaking of distancing, Police Commissioner, Mike Bush, and Director of Civil Defence Emergency Management, Sarah Stuart-Black, both fellow Wellingtonians, have expressed concerns about how busy places like Oriental Parade and Mount Victoria summit have been during this fine weather.

It’s good to get out and get some exercise together but is essential to only do that with people who live in your bubble. Please don’t congregate with other bubbles!

Normally we all enjoy chatting on the street on a sunny day, but with this unseen, deadly virus, we need to keep good physical separation. So please avoid busy places and times because that risks transmission of the Covid 19 virus. Please also don’t travel to hot spots like these for recreation.

We don’t want to have to close the Mount Victoria lookout, but we will be obliged to if too many people are going up there. Again it is just trying to keep us all safe, and get us through the lockdown as quickly as possible.

And now onto a bit of housekeeping – in particular, wet wipes!

Please we need people to stop disposing of wet wipes down the toilet. Please always place wet wipes in the rubbish.

As people rightly become more vigilant about hygiene, the use of wet wipes has increased markedly. Wet wipes, including so called ‘flushable’ wipes are a major problem for wastewater treatment plants and sewerage systems. They don't break down and ultimately dissolve, and can then block the system.

And another housekeeping issue – unfortunately we’ve had to stop our weekly recycling service for health and safety reasons during the lockdown.

You can put your recyclables into your official yellow Council rubbish bags, or even better thoroughly clean and store your recyclables at home until we can resume the service.

Some people have been approaching our rubbish truck drivers asking them to remove their recycling. Our drivers are trying to carry out rubbish collection without risking their own health, so please be kind and don’t approach them at any time.

We’ve also had some reports of people dumping their rubbish around the south coast and other areas. This is never ok.

Rubbish collection is an essential service and is still being collected, so there is no reason for this behaviour.

If caught illegally dumping, you can be prosecuted and fined. If you witness illegal dumping, please report it to our Contact Centre team on 499 4444 or email info@wcc.govt.nz

In some great news today, we announced the opening of 38 self-contained units in a CBD building for the city’s vulnerable Homeless community – providing food, shelter, security, and most importantly a safe place to self-isolate during the Alert Level 4 lockdown.

This is outstanding teamwork involving the Council’s welfare team, the Ministry of Social Development, Housing and Urban Development (HUD) and the City Mission.

The cost of the accommodation is to be covered by MSD and HUD. The City Mission will manage the facility – this means 24/7 staffing, food and support functions. Great work together!

More good news - Willis Street between Ghuznee Street and Boulcott Street has now been reopened to through traffic. This part of Willis Street has been closed since just before Christmas due to the pipe-laying work that was necessary after the collapse of the sewer main at the Willis-Dixon intersection.

I want to thank again Wellington Water staff and our fantastic contractors who’ve worked so hard on this urgent project over the past three months. They said the road would be reopened by the end of March and they were true to their word.

Please take care, stay in your bubbles – and let’s beat this virus.

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dogstar001

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#2451809 31-Mar-2020 20:24

neb:
tdgeek:
I feel if we have a couple of Level 4's we will be well in control. Dampening hotspots more than using the fire.

That's pretty much what the hammer and the dance talks about, in a great amount of detail. Good reading for those who haven't seen it yet.

Thanks Neb, great read.

So I guess NZ's strategy should be 4-6 weeks at level 4 to hammer the R0 to about. 5. Then move to level 3. Initially keeping restaurants, cafes, bars, nightclubs, casino's closed. Also ban any sort of event. Then see how that goes. Re-assess in 6 weeks.

MileHighKiwi

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#2451810 31-Mar-2020 20:29

People who throw wet wipes (and other stuff) down the loo make me very angry.

Re the death rate, worldometer.com shows, as of right now, a stat of 203,731 'closed' cases. That number is comprised of 165,892 recoveries (81%) and 37,839 deaths (19%).

Is 19% the death rate, or do you count deaths by total cases, which sits at 4.8% or thereabouts.

What is the correct way to measure it?

MileHighKiwi

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#2451812 31-Mar-2020 20:32

dogstar001: So I guess NZ's strategy should be 4-6 weeks at level 4 to hammer the R0 to about. 5. Then move to level 3. Initially keeping restaurants, cafes, bars, nightclubs, casino's closed. Also ban any sort of event. Then see how that goes. Re-assess in 6 weeks.

To have some semblance of normality return I think some establishments should be allowed to open provided they meet certain requirements around food safety, distancing etc.

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#2451826 31-Mar-2020 20:50

Washington Post: CDC considering recommending general public wear face coverings in public

Should we all be wearing masks? That simple question is under review by officials in the U.S. government and has sparked a grass-roots pro-mask movement. But there’s still no consensus on whether widespread use of facial coverings would make a significant difference, and some infectious disease experts worry that masks could lull people into a false sense of security and make them less disciplined about social distancing.

In recent days, more people have taken to covering their faces, although it remains a scattershot strategy driven by personal choice. The government does not recommend it.

That may change. Officials at the Centers for Disease Control and Prevention are considering altering the official guidance to encourage people to take measures to cover their faces amid the coronavirus pandemic, according to a federal official who spoke on the condition of anonymity because it is an ongoing matter of internal discussion and nothing has been finalized.

CDC guidance on masks remains under development, the federal official said. The official said the new guidance would make clear that the general public should not use medical masks — including surgical and N95 masks — that are in desperately short supply and needed by health-care workers.

Instead, the recommendation under consideration calls for using do-it-yourself cloth coverings, according to a second official who shared that thinking on a personal Facebook account. It would be a way to help “flatten the curve,” the official noted.

Such DIY cloth masks would potentially lower the risk that the wearer, if infected, would transmit the virus to other people....

...Prominent among the people pushing the idea is Scott Gottlieb, an internist and former commissioner of the Food and Drug Administration in the Trump administration. Gottlieb was the lead author of a pandemic-response plan published Sunday by the American Enterprise Institute, a conservative-leaning Washington think tank, and framed as a road map for restoring the economy gradually to normal. The road map said that, during this initial phase of rapid community transmission of the coronavirus, “everyone, including people without symptoms, should be encouraged to wear nonmedical fabric face masks while in public.”

On CBS’s “Face the Nation” on Sunday, Gottlieb was more specific: “A cotton mask — we should be putting out guidelines from the CDC on how you can develop a mask on your own.”

Gottlieb and his allies acknowledge that an improvised mask, including something akin to a bandanna or even a surgical mask, does not provide protection from infection with the virus. It could, however, limit the amount of respiratory droplets emitted by the person wearing the mask. Epidemiologists believe that infected people can spread covid-19 even when they have no symptoms.
...

Tinkerisk

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#2451829 31-Mar-2020 20:52

We currently have a case here in Germany that is making waves. One infected man left the officially ordered quarantine and was found to have infected 10 people with COVID-19. According to the currently activated Disease Protection Act, he must now face a penalty of up to € 25,000. If this causes the death of a person, there is a risk of several years in prison.

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mattwnz

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#2451831 31-Mar-2020 20:55

kingdragonfly: Washington Post: CDC considering recommending general public wear face coverings in public

Should we all be wearing masks? That simple question is under review by officials in the U.S. government and has sparked a grass-roots pro-mask movement. But there’s still no consensus on whether widespread use of facial coverings would make a significant difference, and some infectious disease experts worry that masks could lull people into a false sense of security and make them less disciplined about social distancing.

...

I thought this was in interesting article about masks where they interviewed George Gao, director-general of the Chinese Center for Disease Control and Prevention (CDC). Again there are conflicting pros and cons. But obviously anything like this has to be used properly.

https://www.sciencemag.org/news/2020/03/not-wearing-masks-protect-against-coronavirus-big-mistake-top-chinese-scientist-says

neb

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#2451836 31-Mar-2020 21:01

MileHighKiwi: Re the death rate, worldometer.com shows, as of right now, a stat of 203,731 'closed' cases. That number is comprised of 165,892 recoveries (81%) and 37,839 deaths (19%).

Is 19% the death rate, or do you count deaths by total cases, which sits at 4.8% or thereabouts.

What is the correct way to measure it?

Interpreting that is very complex because we don't have anywhere near 100% test coverage and even for the tests we have they're not 100% accurate. So the best you can do, and this is huge simplification, is to think of the deaths as approximately accurate but the recovered figure as a (very) lower bound. This makes the actual death rate a lot lower.

As for "what is the correct way to measure", that's such a complex topic that it's probably not worth thinking about, just go with the official rates which have (usually) been created by expert statisticians using decent-enough models.

kingdragonfly

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#2451841 31-Mar-2020 21:04

My understanding is that everyone entering Oz country is now being quarantined https://www.theguardian.com/world/2020/mar/30/treated-worse-than-criminals-australian-arrivals-put-into-quarantine-lament-conditions , so not just those who don't have self isolation plans, or are showing symptoms.

Regarding this quote from the article

“When the food arrives it is vacuum-sealed, unidentified food,” Olivia said. “It’s really, really bad. It’s been heated up, you can feel that it’s warm but all the chunks of meat were cold.”

Each time food has been delivered, no allowance has been made for Paula’s dietary requirements.

“When we tell the hotel she cannot eat the food, they just send up cucumber and tomato for Mum. She’s literally starving. And I know that sounds very over the top, but she got off the plane yesterday morning and all she’s been offered since is cucumber and tomato.”

For breakfast on Monday, they were given a bread roll, a small croissant and a container of porridge to share between three.

She is not literally going to die of starvation. In times of old, chain-gang prisoners in the deep US south were fed cornbread, cold fat meat and black molasses, for years on end. They did develop temporary dietary deficiencies, but even with the extremely high physical regimes, they didn't starve to death.

Even though it may be less than ideal, she will survive the 14 day quarantine. I'm sure her conditions will improve now that she aired her grievances.

I'm guessing "mum" wouldn't be the best person to take camping.

neb

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#2451842 31-Mar-2020 21:05

dogstar001: So I guess NZ's strategy should be 4-6 weeks at level 4 to hammer the R0 to about. 5. Then move to level 3. Initially keeping restaurants, cafes, bars, nightclubs, casino's closed. Also ban any sort of event. Then see how that goes. Re-assess in 6 weeks.

It's a plausible strategy, subject to further data becoming available. There are just so many unknowns about this that it's risky to push anything as the solution, but it seems like a good option, and allows life to slowly return somewhat to normal. It does however rely on active monitoring and tracing a la South Korea, which may be a lot more difficult in NZ. We'll see in the coming weeks.

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#2451844 31-Mar-2020 21:06

freitasm:

Wellington Mayor Update:

How about an update on something more important, like rates.. who cares if you had zoom meetings and went for a run :|

dogstar001

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#2451845 31-Mar-2020 21:07

MileHighKiwi:
dogstar001: So I guess NZ's strategy should be 4-6 weeks at level 4 to hammer the R0 to about. 5. Then move to level 3. Initially keeping restaurants, cafes, bars, nightclubs, casino's closed. Also ban any sort of event. Then see how that goes. Re-assess in 6 weeks.

To have some semblance of normality return I think some establishments should be allowed to open provided they meet certain requirements around food safety, distancing etc.

Agreed, restaurants in particular. Especially if they space their tables far enough apart & the staff wear PPE

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