2019 Novel Coronavirus Covid-19 Discussion

Forums › Health and fitness › 2019 Novel Coronavirus Covid-19 Discussion

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20108 posts

Uber Geek

#2429228 29-Feb-2020 13:34

gzt:
Fred99: I think it's a smart move for everybody in NZ to ensure they've got enough supplies for self-isolation at home for at least several weeks. Should have that anyway - for natural disaster preparedness.

Everybody in NZ? This is the exact opposite of smart and it would screw everyone.

The smart thing is buy what you need when you need it in your normal purchase cycle.

If you actually need to self isolate sure go buy what you need for that online or call a friend to bring it round.

People should already have an emergency box, especially those in more earthquake, volcanic or flood areas eg most of NZ.

mattwnz

20108 posts

Uber Geek

#2429229 29-Feb-2020 13:37

Supermarkets are warning people not to stock up, and shop normally, then there should be no risk of them running out. The problem is that they have run out of some things, which I guess is why people are panic buying. I normally buy in bulk anyway when they have specials on, so I hope they don't start imposing limits.

mattwnz

20108 posts

Uber Geek

#2429230 29-Feb-2020 13:43

Fred99:

tdgeek:

"In my opinion, every person on that flight should be contacted ... that's what the flight manifest ... is for, emergencies like this."

This is the diagram I was also referring to in a previous post. That shows that the governments decision to only contact those two row infront and two rows doesn't appear to match how it potentially can spread in a plane. IMO all people on that plane potentially could have been infected. In 2003 it appears 18 people developed it from that one person from that flight, and it was spread throughout the plane. So IMO all people on that flight should be at least self isolating, which is what that hair dresser has done.

dogstar001

74 posts

Master Geek

#2429233 29-Feb-2020 13:52

IMHO, the govt seems to have little interest in keeping the virus out. They are almost fatalistic about its introduction. If they were proactive in keeping it out they would have already barred passengers from Italy, South Korea & Japan. They only included Iran on the no fly list after we had an at the time probable, (now confirmed) case. Which was after the horse had bolted. Guess its election year & they don't want a dive in tourism.

Tis a shame because NZ's geography means we are in an ideal position to isolate ourselves. So long as we are agressive in banning those from countries where the virus has taken hold.

Young people often show little to no symptoms with the virus. I fear one, young, single, attractive party animal hitting crowded night clubs 4 times a week, could easily spread the virus enough to cause a local contagion. Then we will be closing bars, restaurants, schools & community centers.

I think long term NZ is well placed for an outbreak. We produce food than we need & have plenty of fresh water.

dogstar001

74 posts

Master Geek

#2429276 29-Feb-2020 14:06

Spot on matt

think after plague ship in japan it is reasonable to assume other passengers on this flight will now have the infection. It is also difficult to know which passangers. Realistically an "enforced" quarantine of this flights passengers by the govt is the best approach the govt can take. I would create a emergency fund to pay these people to sit at home. Maybe $1000 per week each. Expect self quarantine to not work as people have Bill's to pay & kids to feed

FineWine

2977 posts

Uber Geek

Trusted

Nurse (R)

Lifetime subscriber

#2429280 29-Feb-2020 14:20

dogstar001: Spot on matt

think after plague ship in japan it is reasonable to assume other passengers on this flight will now have the infection. It is also difficult to know which passangers. Realistically an "enforced" quarantine of this flights passengers by the govt is the best approach the govt can take. I would create a emergency fund to pay these people to sit at home. Maybe $1000 per week each. Expect self quarantine to not work as people have Bill's to pay & kids to feed

I disagree with you on that one. You might as well create a [sic] emergency fund to pay these people to sit at home when they catch the flu. I can hear the coalition partners and opposition screaming on this one, especially SB.

No, if it gets to that stage the government has the Civil Emergencies Act or Emergency Powers Act. If this were to occur I would start panic buying of large bladed Paddles from Hunting & Fishing.

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

tdgeek

29643 posts

Uber Geek

Trusted

Lifetime subscriber

#2429285 29-Feb-2020 14:38

mattwnz:

"In my opinion, every person on that flight should be contacted ... that's what the flight manifest ... is for, emergencies like this."

This is the diagram I was also referring to in a previous post. That shows that the governments decision to only contact those two row infront and two rows doesn't appear to match how it potentially can spread in a plane. IMO all people on that plane potentially could have been infected. In 2003 it appears 18 people developed it from that one person from that flight, and it was spread throughout the plane. So IMO all people on that flight should be at least self isolating, which is what that hair dresser has done.

Yes, Freds post shows it clearly. That was deadly SARS, but SARS was not as infectious as this one today.

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mattwnz

20108 posts

Uber Geek

#2429286 29-Feb-2020 14:44

dogstar001: Spot on matt

think after plague ship in japan it is reasonable to assume other passengers on this flight will now have the infection. It is also difficult to know which passangers. Realistically an "enforced" quarantine of this flights passengers by the govt is the best approach the govt can take. I would create a emergency fund to pay these people to sit at home. Maybe $1000 per week each. Expect self quarantine to not work as people have Bill's to pay & kids to feed

I see the government have now done a U-Turn today, and will now be contacting all people on the plane, which is what they should have done previously, instead of those just a few rows in front and behind.

Self Isolation isn't the same as self quarantining. If you look on the governments website, self isolation is more about limiting other people to exposure in time, rather than full isolation and just staying at home. Personally I don't think self isolation is going to be very effective, especially as it relies on peoples common sense. The government has said that the risk of community transmission is 'low', so time will tell if they are right or not.

What does self-isolation mean?

Self-isolation means staying away from situations where you could infect other people. This means any situation where you may come in close contact with others (face to face contact closer than 1 metre for more than 15 minutes), such as social gatherings, work, school, child care/pre-school centres, university, polytechnic and other education providers, faith-based gatherings, aged care and health care facilities, prisons, sports gatherings, restaurants and all public gatherings.

If you are a visitor to New Zealand, this means you should avoid sitting in a restaurant, or participating in any type of tour group.

More info at https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-health-advice-general-public/covid-19-novel-coronavirus-self-isolation

Mahon

473 posts

Ultimate Geek

#2429306 29-Feb-2020 15:13

This virus is way more transmissible than the usual influenza strains and 10-20 times more deadly, with no vaccine for at least 12 months.

It is pleasing to see this government finally taking it more seriously. The health of our citizens does out way the financial health of the nation. A pandemic is imminent regardless of what politicians may be saying. I do hope our Government is making all necessary arrangements to be able to treat hundreds of infected people that need hospitalisation in isolation. Also there is currently a global grab and snatch going on for drugs that will ease the respiratory symptoms of seriously ill patients as most are made in China especially the generics.

I have little faith in our health minister as he is delivering very little of what he promised and we are well behind nations such as UK and Australia in treatment of many cancers. Maybe he is listening to Trump way too much.

vexxxboy

4239 posts

Uber Geek

#2429307 29-Feb-2020 15:18

Mahon:

This virus is way more transmissible than the usual influenza strains and 10-20 times more deadly, with no vaccine for at least 12 months.

It is pleasing to see this government finally taking it more seriously. The health of our citizens does out way the financial health of the nation. A pandemic is imminent regardless of what politicians may be saying. I do hope our Government is making all necessary arrangements to be able to treat hundreds of infected people that need hospitalisation in isolation. Also there is currently a global grab and snatch going on for drugs that will ease the respiratory symptoms of seriously ill patients as most are made in China especially the generics.

I have little faith in our health minister as he is delivering very little of what he promised and we are well behind nations such as UK and Australia in treatment of many cancers. Maybe he is listening to Trump way too much.

how is it 10-20 times more deadly , i thought the death rate was around 2-3 % compared to around 1% for the normal flu

Common sense is not as common as you think.

Fred99

13684 posts

Uber Geek

#2429312 29-Feb-2020 15:40

vexxxboy:

how is it 10-20 times more deadly , i thought the death rate was around 2-3 % compared to around 1% for the normal flu

Flu is around 0.1% (1 in 1,000) globally - though probably considerably less in NZ and other first-world countries - where the health system is capable of saving lives in severe cases of flu. There's also the other problem in that with seasonal flu, there's a high level of immunity from vaccination or previous infection from similar strains. There's probably no immunity at all to Covid 19, just a hypothesis that children may have some cross-immunity - but they're also capable of becoming asymptomatic "super-spreaders".

The argument that mortality rate is overestimated for Covid-19 due to the number of undiagnosed mild or asymptomatic cases is true, but exactly the same problem exists with determining true mortality rate for flu. I'm pretty sure I've had seasonal flu several times - but I've never been to a Dr and had it diagnosed, so "my cases" don't exist on any record.

mattwnz

20108 posts

Uber Geek

#2429313 29-Feb-2020 15:43

vexxxboy:

how is it 10-20 times more deadly , i thought the death rate was around 2-3 % compared to around 1% for the normal flu

Normal flu kills less than 0.1% (based on US stats) not 1%. 1% is 1 in 100. 0.1% is 1 in 1000 people, so huge difference. Also 1 in 6 people who get this virus require hospitalization, which I think is where a big part of the problem is, due to the strain it will put on the health system.

I think part of the problem is that the public have been led to believe that this isn't much worse than normal flu. But it is.

Sidestep

1013 posts

Uber Geek

Lifetime subscriber

#2429333 29-Feb-2020 16:35

NZ's fate's really tied more to other country's efforts to contain this than it's own. Can NZ really just shut it's borders for maybe a year until a vaccine is developed?

Mitigation efforts - like social distancing (staying home, school closures, banning large gatherings) - to slow the outbreak will be critical so that health care systems aren't overwhelmed.
That way it can be managed - by confirmed medical diagnosis and quarantine, hospitalisation and oxygen therapy, mechanical ventilation or, for those who require it, ECMO

If we look at this based on the percentages from overseas studies - let's say 6400 people get diagnosed with this, and one in 8 need to be hospitalised..

800 go to hospital - I'm pretty sure that main and regional hospitals have some sort of contingency plan for an increase in pneumonia and pneumonia-related complications as well as figuring out plans for isolation facilities and an increase in temporary beds. So far so good.

But acute respiratory distress syndrome (ARDS) develops in 20% of them - so 160 of our 800 cases go to intensive care.

A 2016 study showed 29 Adult ICU's in NZ - 6 tertiary level ICU's, in large hospitals - the rest - provincial level, a total of 204 beds. Some of them will be in use, so we'll pop a few cases in hallways.

A crucial issue is a potential lack of ventilators, they've turned out to be important in the treatment of patients, particularly those over the age of 65, who appear to experience the worst effects, and of that 160, about 10% require endotracheal intubation and mechanical ventilation (16 patients) half of those (8 patients) will need ECMO support.

In China, hospitals - after the first wave of deaths - were quick to put patients on ECMO. Jiao Yahui, an official with the Chinese National Health Commission (NHC) said;
“we have been urging doctors to use ECMO at an early stage to help restore patients' blood oxygen saturation and reduce fatalities,"

It appears NZ has a total of 7 adult ECMO machines - 6 in Auckland City Hospital ICU, 1 in Liver Services, plus 2 Paediatric ones in the Starship and 1 transport unit for bringing patients in by air. Auckland Hospital has NZ's only Extracorporeal Membrane Oxygenation machine team.

Unfortunately, in China patients have had to stay on these long-term (the death rate would be higher if they'd been taken off early) some for over a month.
Long term complications include permanent lung damage -pulmonary fibrosis - acute cardiac injury, arrhythmia, shock, and acute kidney injury requiring ongoing hospital care.

So NZ can afford about 6400 cases a month.

kingdragonfly

11092 posts

Uber Geek

Subscriber

#2429382 29-Feb-2020 19:59

Newshub: Two Gilmours stores won't open on Sunday after 'overwhelming customer demand'

Wholesale food and beverage company Gilmours won't open two of its Auckland stores on Sunday after "overwhelming customer demand".

Confirmation of a coronavirus case in Auckland on Friday prompted extraordinary panic-buying across the city on Saturday, with Gilmours saying it was forced to shut its North Shore Cash and Carry store on Saturday due to demand.

Wholsesale food and beverage company Gilmours won't open two of its Auckland stores on Sunday after "overwhelming customer demand".

Confirmation of a coronavirus case in Auckland on Friday prompted extraordinary panic-buying across the city on Saturday, with Gilmours saying it was forced to shut its North Shore Cash and Carry store on Saturday due to demand.

"Some stores have limitations in place for extremely high demand and low stock products, including items such as hand sanitizer and antibacterial products."
...

Mahon

473 posts

Ultimate Geek

#2429384 29-Feb-2020 20:07

Sidestep:

NZ's fate's really tied more to other country's efforts to contain this than it's own. Can NZ really just shut it's borders for maybe a year until a vaccine is developed?

Mitigation efforts - like social distancing (staying home, school closures, banning large gatherings) - to slow the outbreak will be critical so that health care systems aren't overwhelmed.
That way it can be managed - by confirmed medical diagnosis and quarantine, hospitalisation and oxygen therapy, mechanical ventilation or, for those who require it, ECMO

If we look at this based on the percentages from overseas studies - let's say 6400 people get diagnosed with this, and one in 8 need to be hospitalised..

800 go to hospital - I'm pretty sure that main and regional hospitals have some sort of contingency plan for an increase in pneumonia and pneumonia-related complications as well as figuring out plans for isolation facilities and an increase in temporary beds. So far so good.

But acute respiratory distress syndrome (ARDS) develops in 20% of them - so 160 of our 800 cases go to intensive care.

A 2016 study showed 29 Adult ICU's in NZ - 6 tertiary level ICU's, in large hospitals - the rest - provincial level, a total of 204 beds. Some of them will be in use, so we'll pop a few cases in hallways.

A crucial issue is a potential lack of ventilators, they've turned out to be important in the treatment of patients, particularly those over the age of 65, who appear to experience the worst effects, and of that 160, about 10% require endotracheal intubation and mechanical ventilation (16 patients) half of those (8 patients) will need ECMO support.

In China, hospitals - after the first wave of deaths - were quick to put patients on ECMO. Jiao Yahui, an official with the Chinese National Health Commission (NHC) said;
“we have been urging doctors to use ECMO at an early stage to help restore patients' blood oxygen saturation and reduce fatalities,"

It appears NZ has a total of 7 adult ECMO machines - 6 in Auckland City Hospital ICU, 1 in Liver Services, plus 2 Paediatric ones in the Starship and 1 transport unit for bringing patients in by air. Auckland Hospital has NZ's only Extracorporeal Membrane Oxygenation machine team.

Unfortunately, in China patients have had to stay on these long-term (the death rate would be higher if they'd been taken off early) some for over a month.
Long term complications include permanent lung damage -pulmonary fibrosis - acute cardiac injury, arrhythmia, shock, and acute kidney injury requiring ongoing hospital care.

So NZ can afford about 6400 cases a month.

The issue is that any more than a handful canNOT go to hospital as we dont have enough isolation/quarantine rooms. If infected patients go to normal wards/rooms they will infect everyone they come in contact with. Be interesting to see what the Health Ministry intends to do if we get more than a handul of serious cases.

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