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16167 posts

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  #2485657 18-May-2020 15:02
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tdgeek:

 

The AUS/NZ bubble that everyone wants  (well Peters plus every tourist operator) they seem to think if they scan temp at the airports its all good.

 

https://www.newshub.co.nz/home/shows/2020/05/coronavirus-what-a-trans-tasman-bubble-could-look-like.html

 

When they get two weeks with no cases, get back to us

 

 

 

 

It is election time when people come out of the wood work every 3 years. IMO we should delay the election to prevent poor decisions being made, and remove politics from the game. The last thing we need IMO a this time is a change in government. We need to stick to the plan and keep it going.

 


If temperature scanning was reliable, wouldn't they have done it initially at airports. I do recall hearing them say that it wan't reliable, which is why they hadn't been doing it, and these scanners can have quite a large margin or error. Also won't pick up people who are incubating it. With Oz, they need at least a few months without any new cases, to make sure they have properly eliminated it, but as I posted previously their deputy of health  said that elimination wasn't realistic, so their strategy was suppression, and slowing it down. .  Far safer for NZs economy to quarantine, but people don't want that inconvenience. But I think we ave to realize that if we want to keep the virus out, then the days of uninterrupted travel without quarantine could be a thing of the past in many parts of the world. Quarantine I understand has been part of travel, because illness has always been a problem, killing a lot of people when early settlers brought in illnesses to indigenous people. This is also the problem island nations face, who also largely rely on tourism. . 


4501 posts

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  #2485667 18-May-2020 15:08
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mattwnz:

 

The new cases recently over the last months have been mainly linked to existing cases from known clusters. I understand from the DG that the last CT case was back in April.
But how come these active cases are still able to infect others when we are now down to less than 50 active cases? In China I heard they rounded up all active cases to prevent them infecting others, otherwise it risks creating a very long tail. Obviously in a democracy like  NZ we can't just round people up like that, but we must be able to  keep them totally isolated from people who are not infected. eg Have them live in a hotel and away from family while they get better, or the rest of the family move out to a hotel.

 

 

A chunk of this transmission was staff at hospitals/rest homes having the treat those infected,

 

Its a bit hard to totally keep the infected totally isolated when they require care (due to their age and other conditions, not due to COVID)

 

The rest of it is likely household contacts, and probably appear when they test other household members after the first case is confirmed.... as opposed to while they are isolating after being detected.

 

Packing up the entire "rest of the family" to go into separate isolation once one member is detected, is probably more likely to spread the virus than simply keeping them all together, (Its highly likely they all have it at that point)


 
 
 
 


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  #2485680 18-May-2020 15:11
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mattwnz:

 

tdgeek:

 

The AUS/NZ bubble that everyone wants  (well Peters plus every tourist operator) they seem to think if they scan temp at the airports its all good.

 

https://www.newshub.co.nz/home/shows/2020/05/coronavirus-what-a-trans-tasman-bubble-could-look-like.html

 

When they get two weeks with no cases, get back to us

 

 

 

 

It is election time when people come out of the wood work every 3 years. IMO we should delay the election to prevent poor decisions being made, and remove politics from the game. The last thing we need IMO a this time is a change in government. We need to stick to the plan and keep it going.

 


If temperature scanning was reliable, wouldn't they have done it initially at airports. I do recall hearing them say that it wan't reliable, which is why they hadn't been doing it, and these scanners can have quite a large margin or error. Also won't pick up people who are incubating it. With Oz, they need at least a few months without any new cases, to make sure they have properly eliminated it, but as I posted previously their deputy of health  said that elimination wasn't realistic, so their strategy was suppression, and slowing it down. .  Far safer for NZs economy to quarantine, but people don't want that inconvenience. But I think we ave to realize that if we want to keep the virus out, then the days of uninterrupted travel without quarantine could be a thing of the past in many parts of the world. Quarantine I understand has been part of travel, because illness has always been a problem, killing a lot of people when early settlers brought in illnesses to indigenous people. This is also the problem island nations face, who also largely rely on tourism. . 

 

 

100%

 

It seemed bizarre they mention using a tool to avoid quarantine when its not 99.9% accurate. But to their credit, both PM's have clealy indicated its a future thing, despite tourism biased people and Peters talk otherwise.

 

Now what if "some" tourists come here? I would not see a rush of Aussies coming here, safer to be at home, they have plenty to see . Then local tourism remains expensive for Kiwis, so Kiwis dont trip around as much, so there is probably little revenue gain anyway. Better off to have Kiwis swarming the country, paying reasonable prices


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  #2485693 18-May-2020 15:43
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mattwnz:

 

Obviously in a democracy like  NZ we can't just round people up like that, but we must be able to  keep them totally isolated from people who are not infected. eg Have them live in a hotel and away from family while they get better, or the rest of the family move out to a hotel.

 

 

Keeping people isolated in a hotel isn't easy... it would have to be one small bubble per room. Who is going to clean their rooms? Deliver food? Every person who goes into that room needs PPE. Sharing PPE from one room to another risks spreading the infection, so PPE needs to be removed before going somewhere else.

 

Locking them in with a supply of cleaning products and food is a breach of human rights (you can't treat prisoners this way), and you still have to deal with breakages, illness, etc.

 

 


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  #2485695 18-May-2020 15:51
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Interesting to see that Latvia, Lithuania, Estonia are opening their borders to each other. They're all in the controlling phase, with Estonia not quite doing as well as the other two.

 

 


16167 posts

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  #2485721 18-May-2020 16:06
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frankv:

 

mattwnz:

 

Obviously in a democracy like  NZ we can't just round people up like that, but we must be able to  keep them totally isolated from people who are not infected. eg Have them live in a hotel and away from family while they get better, or the rest of the family move out to a hotel.

 

 

Keeping people isolated in a hotel isn't easy... it would have to be one small bubble per room. Who is going to clean their rooms? Deliver food? Every person who goes into that room needs PPE. Sharing PPE from one room to another risks spreading the infection, so PPE needs to be removed before going somewhere else.

 

Locking them in with a supply of cleaning products and food is a breach of human rights (you can't treat prisoners this way), and you still have to deal with breakages, illness, etc.

 

 

 

 

 

 

When we are down to under 50 people , it is perfectly manageable now. PPE shouldn't be any issue either, as we never had a major outbreak. Cost shouldn't be an issue either, compared to the risk it presents IMO, as  cost/benefit .  When this is going to cost the best part of 100 billion if not more by the time it is over according to one of NZs top economists, the last thing we need is a long tail risking a secondary wave, now the levels have been relaxed. It is really about cleaning up the tail as part of that final eliminatio process IMO.  
Some of the infected I imagine would already be in quarantine as returning travelers who have now tested positive, so I would expect them to still be in quarantine until they have fully recovered. So the way they are being treated would obviously be the blueprint to follow. 

 

I don't know if there has been any information about how many people who have returned to NZ, have tested positive and are still in quarantine facilities. But am guessing that it could be a fair few, and they would be getting treated very well.


16167 posts

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  #2485731 18-May-2020 16:19
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wellygary:

 

 

 

Packing up the entire "rest of the family" to go into separate isolation once one member is detected, is probably more likely to spread the virus than simply keeping them all together, (Its highly likely they all have it at that point)

 

 

 

 

The issue I see is, that I understand each of those people in a household that has someone infected,  can now go shopping / go to school / restaurant / funeral  etc and has the potential to spread it into the community silently. It was fine under level 4, and even under level 3, as bubbles were isolated. But now under level 2 we don't really have bubbles, and things are almost back to normal from what I have observed. It is really about identify where the holes are to prevent a repeat of past errors, as relaxation of the rules in other countries, even some that were doing better than NZ, has led to second waves. We probably won't know for a few more weeks if there have been any outbreaks caused by other people in bubbles of existing cases.


 
 
 
 


687 posts

Ultimate Geek

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  #2485741 18-May-2020 16:42
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frankv:

 

mattwnz:

 

Obviously in a democracy like  NZ we can't just round people up like that, but we must be able to  keep them totally isolated from people who are not infected. eg Have them live in a hotel and away from family while they get better, or the rest of the family move out to a hotel.

 

 

Keeping people isolated in a hotel isn't easy... it would have to be one small bubble per room. Who is going to clean their rooms? Deliver food? Every person who goes into that room needs PPE. Sharing PPE from one room to another risks spreading the infection, so PPE needs to be removed before going somewhere else.

 

Locking them in with a supply of cleaning products and food is a breach of human rights (you can't treat prisoners this way), and you still have to deal with breakages, illness, etc. 

 

 

 

In HK and Taiwan all people testing positive are at least initially put into hospital (presumably specific quarantine wards); ie. where care can be safely provided with low risk of transmission.  Previously Singapore also but since recent large upsurge in migrant worker cases, people (or more likely migrant workers!?) with mild symptoms or asymptomatic have been placed in isolation in community care facilities.  But prior to this, they had ~2,900 under hospital care at one point.  

 

Given our current low numbers (only 45 active cases and reducing daily), it should be comparatively easy for hospitalisation of all positive cases (or after a few days if mild/asymptomatic).  Should minimise in-household transmission and potentially cut short the long tail of cases we are seeing with some clusters, with huge attendant financial and health benefits.  Hospitalisation would also mean any deterioration in a persons condition should be picked up more quickly. Potentially as more info comes to light in regard to transmissibility, it may be possible to shorten the period under hospital care (eg. recent data from Taiwan indicating very low transmissibility more than 5 days after symptom onset).

 

Under pandemic conditions, I fail to see any significant breach of rights especially as it protects an individuals family and society at large (and potentially the patient themselves though better health care).  If need be, provide the remaining family with support.  Cost would be trivial compared with the savings.  Clearly specific arrangements would be needed where infants and very young children are involved but that can be dealt with on a case by cases basis.


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  #2485768 18-May-2020 16:57
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mattwnz:

 

NZ is lucky to have life almost back to normal. From what I can see we took the right approach. Sweden compared to Denmark shows that even without many restrictions, the virus existing in a community will mean that the economy will suffer anyway. Better for it to be as short as possible in order to get rid of the virus, than spend years with it, with the elderly essentially under house arrest, until a vaccine comes along, if it comes along. The UK PM indicated a vaccine  may not eventuate, and he now knows more than most about the virus.  

 

 

With our borders and location Australia and New Zealand are probably the two luckiest countries in the world when it came to elimination/eradication. We were much more easily able to to do what most countries could not do, that is stop continued the importation of the virus. Some countries have no choice but to live with the virus to a greater or lesser extent.

 

I'm not sure he knows more than most. From what I've heard he's just echoing what health professionals have been saying there is no guarantee of a vaccine. The ones I know personally have said there is never a guarantee but they are confident there will be a vaccine. It's just a matter of who comes up with one first. Their pick is China as they speculate the Chinese will be prepared to take some testing short cuts in order to be first to market, and I guess there will some degree of bragging rights/face saving going on.





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3174 posts

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  #2485786 18-May-2020 17:23
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Technofreak:

 

mattwnz:

 

NZ is lucky to have life almost back to normal. From what I can see we took the right approach. Sweden compared to Denmark shows that even without many restrictions, the virus existing in a community will mean that the economy will suffer anyway. Better for it to be as short as possible in order to get rid of the virus, than spend years with it, with the elderly essentially under house arrest, until a vaccine comes along, if it comes along. The UK PM indicated a vaccine  may not eventuate, and he now knows more than most about the virus.  

 

 

With our borders and location Australia and New Zealand are probably the two luckiest countries in the world when it came to elimination/eradication. We were much more easily able to to do what most countries could not do, that is stop continued the importation of the virus. Some countries have no choice but to live with the virus to a greater or lesser extent.

 

I'm not sure he knows more than most. From what I've heard he's just echoing what health professionals have been saying there is no guarantee of a vaccine. The ones I know personally have said there is never a guarantee but they are confident there will be a vaccine. It's just a matter of who comes up with one first. Their pick is China as they speculate the Chinese will be prepared to take some testing short cuts in order to be first to market, and I guess there will some degree of bragging rights/face saving going on.

 

 

The oxford trial in England sound promising, they have already tested it on Monkeys and it worked  with no side effects, but as they said it doesnt mean it will work on humans but  it is promising,





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16167 posts

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  #2485793 18-May-2020 17:50
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vexxxboy:

 

 

 

The oxford trial in England sound promising, they have already tested it on Monkeys and it worked  with no side effects, but as they said it doesnt mean it will work on humans but  it is promising,

 

 

 

 

Testing is really the key and getting approval that it is 100% safe. We don't want the 'cure' to be worse than the virus, which has occurred in the past.


348 posts

Ultimate Geek


  #2485795 18-May-2020 17:51
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Ref travel. I don't honestly see anyone travelling to North America, South America and Europe for a long time to come (the end of 2021 minimum) until levels are down to where we are.  If travel is for work then all in favour of a mandatory 14 days quarantine at an approved facility on return at the travellers cost. It's then up to the business to assess the value of sending people off-shore (bearing in mind they could work remotely on return from their quarantine location.

 

We shouldn't rush into Australia too soon either. A better  approach would be to establish NZ/South Pacific travel. May not do much for our economy but would do a lot to maintain/improve our relationships with our island neighbours by allowing them access to facilities in NZ, migrant workers to return, NZers to holiday etc. Less financial benefit more about doing something that's right.


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Ultimate Geek

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  #2485800 18-May-2020 18:18
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Stuff article: Why aren't all new arrivals to New Zealand tested for Covid-19?

 

https://www.stuff.co.nz/travel/news/300014461/coronavirus-why-arent-all-new-arrivals-to-new-zealand-tested-for-covid19

 

...

 

A Ministry of Health spokesperson said "there is no doubt that at present people who are returning to New Zealand are the most likely to bring Covid-19 with them — given the significant outbreaks that are occurring in most parts of the world."

 

As such, every traveller entering New Zealand was screened for Covid-19 on arrival, they said.

 

If a person was symptomatic on arrival, they would be tested and placed in a quarantine facility for 14 days. 

 

Those without symptoms — like Perkins — would be placed in an approved managed isolation facility for 14 days

 

New arrivals were contacted daily to find out if they have any symptoms. Those with symptoms were tested, the spokesperson said.  

 

The spokesperson said while there was capacity in the laboratory system to test all those going into isolation, "it is better to test at the right time in the illness — which is when they have symptoms".

 

 

 

Nonsense. 

 

Another area that needs strengthening.  Over half (17/29) of imported cases over the last month in HK were asymptomatic at time of testing.  Fifteen of those were confirmed positive the day after arrival, one the second day after arrival, and one on the 10th day after arrival.  So just 1/17 infected but asymptomatic people did not test positive from the sample taken on arrival? (And the majority of symptomatic people were confirmed positive either on the day of arrival or the day after; ie. sample taken, tested and results reported on day of arrival or following day)

 

The HK data suggest that tests taken at time of arrival will identify the large majority of positive cases

 

Otherwise, as per the Stuff article ... 

 

Perkins said there were 150 arrivals to the hotel on Saturday and nearly 60 more on Sunday, sparking concerns that "statistically in the mix, someone could have it". 
...
While all guests at the hotel had been practising social distancing, they were all using the same lifts and were going on daily walks together, just as she was preparing to leave, she said. 

 

 

 

Meaning people in the hotel can potentially be infected, even in the last few days of their isolation simply because of MOH failure to test all incoming passengers and separate out all positive cases.  Given the huge cost we have incurred through L4 & L3, this is unacceptable. The number of additional tests required would be trivial. 

 

Based on the HK experience, there seems to be a significant likelihood that there will be infected asymptomatic arrivals here (as basically confirmed also by the NZ data below).  Given now strong evidence that many people are infectious for at least 3 days before symptom onset, MOH are actively allowing infected and non-affected people in close proximity, using common lifts etc.  Totally unnecessary when the HK data show that the large majority of infected cases can be identified and separated out within a day of entry.

 

==

 

The NZ data also indicate that there are asymptomatic people arriving here who are infected.  For the last 10 imported cases in NZ, the median time between arrival and 'Date notified of potential case' was 4 days, with likely another day or two until the test result is received.  That suggests many not showing symptoms, and not tested until 4 days+ after arrival.  For earlier cases it is even worse.  For 30% of the last 20 imported cases, the time between arrival and 'Date notified of potential case' was 8 days or longer.   
 

 

 

 

 


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  #2485806 18-May-2020 18:46
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mattwnz:

 

vexxxboy:

 

The oxford trial in England sound promising, they have already tested it on Monkeys and it worked  with no side effects, but as they said it doesnt mean it will work on humans but  it is promising,

 

 

Testing is really the key and getting approval that it is 100% safe. We don't want the 'cure' to be worse than the virus, which has occurred in the past.

 

 

They've already got to phase 1 clinical trials in humans for "the Oxford vaccine".  I believe that millions of doses are being manufactured in India, in anticipation that it might be approved in maybe 4 months.  Problem with phase one is that it's probably limited to a few volunteers, they can't "test" efficacy by infecting them with something potentially lethal deliberately - so I think they're testing with volunteers who work in hospitals - but say 100 in the trial, if maybe one or to might be expected to get infected over months, if none get infected then it's statistically meaningless - much larger trials are needed - when safety is better known.

 

I believe that there also at least one prospective vaccine that's progressed to phase 2 clinical trials in humans in China. 

 

I also believe there's some data indicating that immunity may be reasonably long-lasting in humans, something to do with activation of memory B-cells when exposed to the antigen.  It's complicated -  I don't understand it very well.

 

It's really looking quite promising - at least in terms of the possibility of there being an approved vaccine in record time.  But to put that in perspective, I think the quickest "new" vaccine took 4 years (mumps IIRC).


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  #2485816 18-May-2020 19:10
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Technofreak:

 

 

 

I'm not sure he knows more than most. 

 

 

I was more meaning that he has first hand experience, due to almost dying from it, and being right at the coal face. Plus he would also have also seen exactly what doctors had to cope with. 


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