2019 Novel Coronavirus Covid-19 Discussion

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#2564499 15-Sep-2020 17:07

ockel:

Its only when you look at the groupings and discussion [https://www.rnz.co.nz/news/national/426095/covid-cluster-confusion-what-you-need-to-know] that you release we dont have a 177 person cluster but a 115 person cluster and 4 other epidemiologically unrelated clusters.

Add to that the Jet Park cluster including the health worker and you have 6 clusters.

I wish MoH would post an updated cluster diagram that it had on 18 August. Diagrams are so much better for showing information. Sadly I think it would reveal how little it knows about links between the groups.

Think you will find most of those included bodies are at Jet Park. That's the Quarantine facility, vs managed isolation facility - all Positives are pulled from MiQ and go there - with extra nurses and so on.

The nurse appears to have been one of those set for that location. And got it from one of the linked family.

When you re-read the initial tracking statement it makes a bit more sense and didn't sound like it just popped up.

The case of the healthcare worker from the Auckland quarantine facility who was reported yesterday has been genomically sequenced by ESR. The case is genomically linked to three cases that have been in the quarantine facility that are linked to the Auckland cluster. This reinforces exposure at Jet Park being the most likely route of transmission, but the Public Health Unit continues to investigate exactly how the infection occurred. "

To me that reads, they were at Jetpark where a family of + linked to the main one being cared for. And have shared the love as it were.

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wellygary

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#2564505 15-Sep-2020 17:12

mattwnz:

^^Generally there is a lack of information. Why this is I don't know, although they seem to claim privacy reasons a lot.But this affects everyone's lives, so IMO the public should be provided with detailed information, and shouldn't reply on the media to ask questions at stand ups to extract this information.

I would also like to see the maps which the PM held up at one of the press conferences, showing how cases were dotted though out Auckland, so it is quite wide spread. But this is an Auckland outbreak, it isn't just a cluster anymore, and I heard one of the experts saying that they should now refer to it as an outbreak, as that better reflects what this now is.

Its quite clear from the large number of dotted lines that if this was back in the April outbreak it would have been 5-6 clusters at least as there are no epidemiological (contact tracing) links, its only via genomic testing that we have been able to say they are related....

Although this does show that we have improved how we deal with outbreaks ...

The question will be how long will it take for the Cooks to again look at a bubble, If they are sensible they will wait at least 28 days of no transmission, to confirm that this outbreak has finally been eliminated....

I have a feeling that attention in November will again turn to the chance of an Australian bubble for Christmas...

NSW have done well in stamping out the embers that came across the border from VIC, and VIC itself appear to be ahead of their forecasts in getting their outbreak under control,

tdgeek

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#2565511 15-Sep-2020 18:29

mattwnz:

The benefit the UK has, as well is a lot of Europe, is the ICU capacity appears to be a lot higher than NZs, which is only around 500 beds when stretched, and I don't think there have bee any plans to increase it. The UK even setup these huge hospitals, that don't appear to have been needed. Although they did change their approach from herd immunity, to lock downs and social distancing Dyson was also going to be making ventilators for them, but they weren't needed. NZ wouldn't be in as good a situation if covid got a foothold in NZ, due to the way our health system works, where we are using it near full capacity much of the time.

This Auckland gym situation has me concerned, due to the way this virus spreads and the number of people that are considered to be close contacts who must now self isolate. So poentially we may get cases popping up now over the next few weeks, making it another cluster. Think of the cost involved in these people not benig able to go to work etc. Also fancy the level system allowing a health worker, who is working in a Hotel and who is then coming into contact with covid infected people, then being able to workout in a gym in the community with up to 100 people in an indoor environment (separated by 2m), heavily breathing together.

If Auckland was back in level 1, it potentially could have been far worse, based on how many people could be in a gym class. It is a recipe for covid superspreader event IMO, as we know how easily this virus spreads in the air in indoor environments. I don't blame this health worker either, as they haven't done anything wrong here, and it was allowed. The question is why was it allowed for, or is it just another hole that people making the rules didn't think about in depth? Health workers working with covid patients are at higher risk of getting it, as PPE is not 100% effective. I do wonder why we are not using full hazmat suits like they seem to use in China and other Asian countries treating covid patients. Do they know something we don't. eg How contagious it actually is.

How many ICU beds have we used???

Para 2. There is a cost when the virus strikes. There is a cost if we go Level 4 every 5 minutes. While I have no doubt that most Aucklanders played by the rules, enough haven't that exacerbates these clusters.

Para 3 I like your posts but in my honest opinion you are way over the top. Yes, if one case pops up we go Level 4, test 200,000 in a week, arrest everyone. While I was very much against the "poor economy" evanglelists, where we are now, the economy matters. No, Im not suggesting we do what one party wanted in March, "this is too much" But we have done very well. The issue in AKL are the flouters and I support mass arrests. Its going fine, given that the human element means many are over it. You can either accept the tail will be long for that reason, or we go hard and arrest everyone. Its quite possible that if this wasnt an election year, no matter who was in Govt they may would go harder, enforcement wise, but that will never be known.

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#2565515 15-Sep-2020 18:33

wellygary:

The question will be how long will it take for the Cooks to again look at a bubble, If they are sensible they will wait at least 28 days of no transmission, to confirm that this outbreak has finally been eliminated...

Yep, everyone, well some parties wanted a bubble with OZ what seems to be months ago, and the Cooks.

The fact that we didn't, proved correct.

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#2565542 15-Sep-2020 19:48

tdgeek:

How many ICU beds have we used???

His point is ICU beds do not exist for Covid patients alone.

It is shared between everybody in the country.

Cancer operation, heart surgery, attempted suicide, kid with hole in heart, road traffic accident, assault, child birth, other sickness and everything in between, already takes up most of the ICU beds, sometimes almost all the ICU beds, at any given time.

The point he's making is, if you throw in a few covid patients here and there you might get a problem.

Of course you won't believe it but I'm just trying to translate what he said.

ockel

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#2565552 15-Sep-2020 20:04

Batman:

tdgeek:

How many ICU beds have we used???

His point is ICU beds do not exist for Covid patients alone.

It is shared between everybody in the country.

Cancer operation, heart surgery, attempted suicide, kid with hole in heart, road traffic accident, assault, child birth, other sickness and everything in between, already takes up most of the ICU beds, sometimes almost all the ICU beds, at any given time.

The point he's making is, if you throw in a few covid patients here and there you might get a problem.

Of course you won't believe it but I'm just trying to translate what he said.

As posted by an Australian doctor in March (at the start of the crisis):

https://www.theguardian.com/world/live/2020/mar/15/coronavirus-latest-updates-trump-tests-negative-as-spain-orders-nationwide-lockdown-uk-us-australia-italy-europe-global-economy

In Australia, Dr Adam Visser, the director of critical care at Toowoomba hospital in regional Queensland, has posted an impassioned plea for the Australian community to take individual action to help “flatten the curve” and keep intensive care units from being overwhelmed by Covid-19 cases.

I’m an intensive care specialist in a small city.

Coronavirus isn’t just like the flu, but it’s only really very dangerous to the elderly or the already unwell. Quite a lot of people in their 80s will die, but most of the rest of us will probably be OK.

If you’re in your 70s and you get Coronavirus, you’ve got a really good chance of survival. If I’ve got a bed for you.

If you’re in your 60s and you have a heart attack, you’ve got a really good chance of survival. If I’ve got a bed for you.

If you’re in your 50s and need bowel cancer surgery, you’ve got a really good chance of survival. If I’ve got a bed for you.

If you’re in your 40s and have a bad car accident, you’ve got a really good chance of survival. If I’ve got a bed for you.

If you’re in your 30s and have terrible pre-eclampsia as a complication of pregnancy, you’ve got a really good chance of survival. If I’ve got a bed for you.

If you’re in your 20s and have a bad reaction to a party drug, you’ve got a really good chance of survival. If I’ve got a bed for you.

I have 7 beds equipped with life support machines. We have a plan to increase to about 25. Getting more isn’t a matter or more equipment or more money, that bit is easy. There are not enough skilled staff, even if we all work double shifts every day for six months (and we probably will).

If 50% of my city gets infected, that’s 75,000 people. If 5% of them need life support (which is the estimate), that’s 3750 people. For 25 beds.

And then I might not have a bed for you.

So it’s up to you to flatten the curve. Wash your hands. Stay home.

Visser finished his post asking the prime minister to “lock down” Australia to halt the spread of Covid-19.

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mattwnz

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#2565617 16-Sep-2020 00:43

Batman:

tdgeek:

How many ICU beds have we used???

His point is ICU beds do not exist for Covid patients alone.

It is shared between everybody in the country.

Cancer operation, heart surgery, attempted suicide, kid with hole in heart, road traffic accident, assault, child birth, other sickness and everything in between, already takes up most of the ICU beds, sometimes almost all the ICU beds, at any given time.

The point he's making is, if you throw in a few covid patients here and there you might get a problem.

Of course you won't believe it but I'm just trying to translate what he said.

Also the fact is that we have only needed a small number of ICU beds at any one time so far, because we locked down early, and got it right before numbers were about to go exponential. Modeling showed that we weren't too many days away from a major outbreak earlier in the year. So the number needing ICU treatment and deaths , is based on having less than 2000 confirmed cases in total so far.

But even with this new outbreak, quite a number of people have needed ICU care. Unfortunately I don't think there are public stats as to how many people have needed ICU treatment in total, only stats on who is in ICU treatment on any one day. At least from what I can see.

However say 5 need ICU treatment on any one day from just this very small outbreak, ( recall one day there were 4 in ICU), then you only need to multiply the number of active cases by 100 to get us to our ICU capacity. Plus we would have to clear the hospitals to make room and free up staff. So goodbye to other treatments that NZers may have been waiting many months for. Victoria wouldn't have been far away prior to their lockdown. What happened in Victoria could easily happen in Auckland.

IMO I am not sure if we will eliminate it now without another lockdown, as it appears some people haven't done what they should have done, and stayed isolated, and without a lockdown to force people, I think it could rumble along for months. The numbers today were encouraging, but the testing numbers have dropped right off again.

It was interesting to hear on the radio this morning on the Hoskings show, the DG said that modelling showed that the odds of a Covid infection being seeded in the North island outside of Auckland, was between 30-40 percent. IN the south island it is 10-20%. The PM mentioned yesterday that is 25% across both the north and south islands of a case being seeded outside of Auckland.

IMO this sounds very high, and wonder which they didn't tell us this before the Auckland border was lifted. I wonder if people would have been so keen to open the Auckland border if we had known that the modelling showed this reasonably high risk, especially in the North Island. I noticed that the PM was quick to point out that people also wanted to travel into Auckland, so it wasn't just Aucklanders wanting to get out.

There seems to be so much pressure on the government from the media to drop things down to level 1. Maybe it is partly to do with all this Rugby stuff, which didn't impress me, don't these people realise that we are int eh middle of a pandemic?.

But only a few places in the world are in a level 1 environment, and level 1 can increase the infection rate R0 by a lot. At the moment, apart from seeing things roped off in shops like Bunnings due to Covid, level 2 doesn't make much difference to me, and I would prefer some social distancing remained to protect us against any other cases sneaking out, causing us to go straight back into level 3 again. Level 2 seems to prevent that occurring, as people are recording where they are going and scanning in, allowing contact tracing to work. Contact tracing doesn't seem to work well in level 1, if people don't even need to scan where they are going.

mattwnz

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#2565618 16-Sep-2020 00:52

ezbee:

Việt Nam goes 12 straight days without community COVID-19 infections
https://vietnamnews.vn/society/772341/viet-nam-goes-12-straight-days-without-community-covid-19-infections.html

""
The total number of COVID-19 cases in Việt Nam remained at 1,063 on Monday as no new cases were reported, marking 12 straight days without community infection in the country, according to the National Steering Committee for COVID-19 Prevention and Control.
""

Good on them, rejoining Taiwan and many Pacific Islands , and well we have 1 day of 0 local cases and counting.
Hopefully we don't get too much more of the tail.

It is encouraging. I don't have much knowledge on Vietnam, but do they do a lot of testing, and are these numbers likely to be accurate?

Batman

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#2565625 16-Sep-2020 06:37

mattwnz:

It was interesting to hear on the radio this morning on the Hoskings show, the DG said that modelling showed that the odds of a Covid infection being seeded in the North island outside of Auckland, was between 30-40 percent. IN the south island it is 10-20%. The PM mentioned yesterday that is 25% across both the north and south islands of a case being seeded outside of Auckland.
IMO this sounds very high, and wonder which they didn't tell us this before the Auckland border was lifted. I wonder if people would have been so keen to open the Auckland border if we had known that the modeling showed this reasonably high risk, especially in the North Island. I noticed that the PM was quick to point out that people also wanted to travel into Auckland , so it wasn't just Aucklanders wanting to get out.

those are very serious numbers.

to put in perspective for people -

if you were told that if you buy this car there is a 40% chance it will breakdown on your next long drive - will you buy it?

if you were told that if you let your kid play in that playground there is a 25% chance he'll break his leg - will you let him play?

tdgeek

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#2565628 16-Sep-2020 07:08

mattwnz:

then you only need to multiply the number of active cases by 100 to get us to our ICU capacity.going.

Well, thats quite a stretch.

tdgeek

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#2565633 16-Sep-2020 07:13

Batman:

tdgeek:

How many ICU beds have we used???

His point is ICU beds do not exist for Covid patients alone.

It is shared between everybody in the country.

Cancer operation, heart surgery, attempted suicide, kid with hole in heart, road traffic accident, assault, child birth, other sickness and everything in between, already takes up most of the ICU beds, sometimes almost all the ICU beds, at any given time.

The point he's making is, if you throw in a few covid patients here and there you might get a problem.

Of course you won't believe it but I'm just trying to translate what he said.

I can read, but thanks. My point, which you wont believe as its all about the frenzy, is that when we had a full national outbreak it was no issue. Its no issue now, even though its in an area that covers 1/3 of our population, where there have been multiple mass gatherings and protests

These doomsday discussions would apply in the next pandemic IF it all went the same way as this one, i.e. learning and adapting on the fly from a Pandemic Plan that was not designed for this. But the next one won't, for obvious reasons

GV27

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#2565642 16-Sep-2020 07:47

https://www.rnz.co.nz/news/national/426138/covid-19-close-contacts-not-getting-into-isolation-fast-enough

Contact tracing for Covid-19 has improved since the start of the latest outbreak but other targets were still not being met.

Tracing teams were far exceeding their goal to reach 80 percent of an infected person's contacts within 48 hours, reaching 95 percent on average. But the contacts were still not getting into isolation as quickly as authorities had expected.

The target is for 80 percent of close contacts to be in isolation within four days of being exposed to the disease. Latest figures show only 56 percent of close contacts meet that deadline.

Epidemiologist Michael Baker said that particular measure is critical.

"Typically after three to four days you'll be potentially infectious if you've got the virus. It's so important to get these contacts quarantined - and quickly - because that's the whole reason for doing it."

Most other figures show the public health system was responding well, he said.

Suspect these figures are skewed by non-compliance with the Roskill cluster. I'm also not sure Kiwis fully understand what 'isolation' means - it means you and the people you live with can't go to the shops/supermarket or visit people, even if they were previously in your bubble. I feel like there could probably stand to be a bit more communication around what you actually need to do if you're identified as a close contact.

tdgeek

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#2565643 16-Sep-2020 07:53

GV27:

https://www.rnz.co.nz/news/national/426138/covid-19-close-contacts-not-getting-into-isolation-fast-enough

Contact tracing for Covid-19 has improved since the start of the latest outbreak but other targets were still not being met.

Tracing teams were far exceeding their goal to reach 80 percent of an infected person's contacts within 48 hours, reaching 95 percent on average. But the contacts were still not getting into isolation as quickly as authorities had expected.

The target is for 80 percent of close contacts to be in isolation within four days of being exposed to the disease. Latest figures show only 56 percent of close contacts meet that deadline.

Epidemiologist Michael Baker said that particular measure is critical.

"Typically after three to four days you'll be potentially infectious if you've got the virus. It's so important to get these contacts quarantined - and quickly - because that's the whole reason for doing it."

Most other figures show the public health system was responding well, he said.

Suspect these figures are skewed by non-compliance with the Roskill cluster. I'm also not sure Kiwis fully understand what 'isolation' means - it means you and the people you live with can't go to the shops/supermarket or visit people, even if they were previously in your bubble. I feel like there could probably stand to be a bit more communication around what you actually need to do if you're identified as a close contact.

You would think that since March we would all know that, its been drummed in continually

shk292

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#2565717 16-Sep-2020 10:08

mattwnz:

ezbee:

Việt Nam goes 12 straight days without community COVID-19 infections
https://vietnamnews.vn/society/772341/viet-nam-goes-12-straight-days-without-community-covid-19-infections.html

""
The total number of COVID-19 cases in Việt Nam remained at 1,063 on Monday as no new cases were reported, marking 12 straight days without community infection in the country, according to the National Steering Committee for COVID-19 Prevention and Control.
""

Good on them, rejoining Taiwan and many Pacific Islands , and well we have 1 day of 0 local cases and counting.
Hopefully we don't get too much more of the tail.

It is encouraging. I don't have much knowledge on Vietnam, but do they do a lot of testing, and are these numbers likely to be accurate?

I'd be interested to know how many inbound passengers are arriving at Vietnam's borders every week. My guess would be "very few". Ditto for the Pacific islands. That's our Achilles Heel - the number of people flooding into NZ and the inescapable law of probability that says it will cause outbreaks. But we have chosen to enable relatively easy travel into NZ despite the pandemic so that is a consequence we have to live with and minimise.

Batman

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#2565722 16-Sep-2020 10:21

more about the event that temporarily paused the Astra Zenica vaccine trial

https://edition.cnn.com/2020/09/15/health/covid-19-vaccine-trial-astrazeneca-nih-fda-kaiser/index.html

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