Lockdowns essential for suppressing Covid but not long term solution

Returning to Covid lockdowns in New Zealand, in particular in Auckland, has meant a return to arguments over whether they are effective or a sustainable means of reducing deaths and long term health problems inflicted by the virus.

People lacking in expertise pushing for so-called ‘herd immunity’ using flawed analysis based on limited data, even if well intentioned, adds to a lot of misinformation.

But while lockdowns are a short term means of preventing large scale infections and deaths, and by preventing barely adequate at the best of times health systems from becoming overloaded. But:

“It is clear that this is not seasonal flu.”

“No country can just ride this out until we have a vaccine.”

Political pundits like Matthew Hooton are not knowledgeable enough about viruses to ton use their usual media ‘opinion’ advocacy to advise us what is the best approach to dealing with Covid.

In Hooton’s latest “armchair epidemiological reckons, I emphasised that he does not have the skills to analyse epidemiological data…he unfortunately makes rookie mistakes again.”

Dr Jin Russell takes issue with the opinion column by Hooton. This gives more insight into dealing with the pandemic than a political pusher.

In my last set of tweets on @MatthewHootonNZ‘s armchair epidemiological reckons, I emphasised that he does not have the skills to analyse epidemiological data. In his latest Herald piece, he unfortunately makes rookie mistakes again.

He includes a table of the 1330 covid cases in NZ; and describes a hospitalisation rate of 4%; with no deaths under 60 years; and “only” a 30% chance of dying in the 80+ group.

I think that most people would see a one in three chance of people over 80 dying from Covid as a very good reason to try to minimise it’s spread. Quarantining all the elderly only is not a viable option, nor i think socially acceptable, nor practical.

The gist is he’s minimising the risk of covid based on NZ MOH data; but this is really flawed.

Flawed in two ways:

1. The only variable he is taking into account in his mortality projection appears to be Age; and

2. Because he accounts only for mortality and not for morbidity associated with Covid-19. Let’s explore these.

Let’s explore these.

1. The only risk factor he highlights is Age. Yes, increasing age increases risk of mortality from covid, as we can see even from our small NZ sample. But that’s not the only risk factor for dying from covid.

This July paper published in Nature analysed other risk factors – Factors associated with COVID-19-related death using OpenSAFELY

Comorbidities such as diabetes, obesity, asthma, and others are known to correlate with increased risk of mortality from covid. Let’s look at these risk factors for the NZ population.

Diabetes: We have very high numbers of people with diabetes in NZ. An estimated 200,000 people in NZ have diabetes; with the prevalence in Māori & Pacific persons three times higher than NZ Europeans.
– MOH: About diabetes

Obesity: New Zealand has the 3rd highest obesity rate amongst adults in the OECD, with 1 in 3 adult NZers obese, and 1 in 10 children. Once again, this is disproportionately found amongst deprived communities; Māori and Pacific families.

Asthma: NZ has one of the highest rates of asthma in the world; the Asthma Foundation estimates 597,000 NZers take medication for asthma (1 in 8 adults, higher for children) with a very high burden of respiratory admissions amongst children amongst deprived families.

The Nature paper also found that people of “Black” and “South Asian” ethnicity were at increased risk of mortality. It’s important to realise that so far our current NZ covid cases are overwhelmingly amongst Europeans.
– see Stats NZ: COVID-19 data portal

In epidemiological terms, we would refer to our NZ dataset of a miserly 1665 cases (cases! deaths only 22) to be a “biased” sample; with a hopelessly small sample size. In other words, we are unable to draw any accurate predictions on how covid would impact our population from the MOH data we have.

We can’t look at our MOH data and make inferences that the virus would have this many in hospital, this many dead or chronically affected, etc, as the sample is too small, and not representative of how covid impacts populations as a whole

This is why review of the literature, and understanding of other factors is so important.

It’s not just deaths that are a problem. There are serious long term health implications for people who get Covid.

Let’s talk about morbidity from covid – what complications can it cause?

A paper published in Nature Medicine describes non-pulmonary complications from Covid-19. If it doesn’t get you in the lungs, how does it harm you? Amongst those hospitalised or seriously unwell, 30% had acute cardiac muscle injury, up to 30% acute kidney injury, 6% stroke, up to 52% signs of liver injury, 8-9% confusion or impaired consciousness.

figure1

See Nature Extrapulmonary manifestations of COVID-19


It is clear that this is not seasonal flu.

On top of that, there is increasing evidence of a post-covid syndrome, with chronic breathlessness and fatigue.

So far, we have understood that we have a very high burden of comorbidities that would make NZers more likely to die or do poorly compared to other countries, and that it would disproportionately affect our Māori, Pasific and South Asian communities. What about other factors?

Hooton doesn’t discuss this at all – a really, really important variable to consider – our healthcare capacity. In March, prior to lockdown, NZ had a total of 153 ICU beds.
RNZ (March 2020) – 153 intensive care beds in country – survey

And, of those 153 beds, just to drive the point home, only 24 were at Auckland City Hospital. Of the 24 ICU beds at our country’s largest hospital, only 6 were isolation beds. Those beds are not empty all the time, they run close to capacity.

So…we had to lockdown.

The number of ICU beds was supposed to be tripled – RNZ (May 2020) ICU beds increase as ministry tries to triple capacity

I’m not sure if that has happened yet, but even if we had the target 358 beds, that wouldn’t even get us close to the figure we would need if things got out of hand.

Our healthcare workforce is VERY thin and PPE stocks are in short supply internationally. I work in paediatrics. During Level 4 lockdown, there were plans to completely reorganise health services to treat covid patients. Thank goodness we didn’t need to go there.

To sum up – Hooton has a LONG way to go to draw any valid conclusions from our MOH data on covid. To form great public health policy, you need more skills than this. You need local understanding of our inequities, health care capacity, and distribution of comorbidities.

You need to be informed by the literature, and come to considered judgements. This is very sloppy opining, what a shame he didn’t contact some of the many very lovely, very experienced epidemiologists and infectious disease experts within his own institution.

As well as business and economic experts.

Covid is too serious and too complex for the pundit political pusher approach.


See also, from WHO Director-General’s opening remarks at the media briefing on COVID-19 – 21 August 2020

Globally, there are now more than 22 million reported cases of COVID-19, and 780,000 deaths.

But it’s not just the numbers of cases and deaths that matter. In many countries, the number of patients who need hospitalization and advanced care remains high, putting huge pressure on health systems and affecting the provision of services for other health needs.

Several countries around the world are now experiencing fresh outbreaks after a long period with little or no transmission.

These countries are a cautionary tale for those that are now seeing a downward trend in cases.

Progress does not mean victory.

The fact remains that most people remain susceptible to this virus.

That’s why it’s vital that countries are able to quickly identify and prevent clusters, to prevent community transmission and the possibility of new restrictions.

No country can just ride this out until we have a vaccine.

A vaccine will be a vital tool, and we hope that we will have one as soon as possible.

But there’s no guarantee that we will, and even if we do have a vaccine, it won’t end the pandemic on its own.

We must all learn to control and manage this virus using the tools we have now, and to make the adjustments to our daily lives that are needed to keep ourselves and each other safe.

So-called lockdowns enabled many countries to suppress transmission and take the pressure off their health systems.

But lockdowns are not a long-term solution for any country.

We do not need to choose between lives and livelihoods, or between health and the economy. That’s a false choice.

On the contrary, the pandemic is a reminder that health and the economy are inseparable.

But there doesn’t seem too be many experts on both epidemiology and economic matters.

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56 Comments

  1. John J Harrison

     /  22nd August 2020

    Pete, agree but the most obvious resolution to this pandemic is staring us in the face.
    Do not try to reinvent the wheel, follow the world class success of Taiwan.
    It is tested, proven and the most successful solution to fight this scourge.
    What greatly concerns me is the fact that hundreds of lives are lost for every Covid death due to suicide, cancer, delayed operations etc.
    In regard to the former the just published coroners annual report suggested a drop in reported suicides over the past 12 months.
    This is arrant nonsense!
    Coroners take up to 18 months to determine if a death is attributable to suicide.
    A far more current and accurate determination is from daily police job sheets.
    Nash is determined to keep these under wraps at all costs.
    I understand that the number of police call- outs to suicides is through the roof this year but relying on a coroners report for most could take until 2022.
    When the police find someone hanging from a tree or gassed in their car you do not need to be a coroner or Einstein to deduce the cause.
    Time for a parliamentary question to the Police Minister next week ?

    Reply
    • Duker

       /  22nd August 2020

      “follow the world class success of Taiwan.”
      Other countries want to follow NZ success!
      Taiwan has had its infrastructure in place for over a decade and could easily ramp it up again for a new virus after the
      NZ would have to start from scratch and as we know we cant even build a major road like the Transmission Gully motorway without bringing ‘plant operators’ from overseas.
      The idea that we have a system like Taiwan up in running in say a month is absurd. It would take 2 years or more AND take resources from the already stretched health sector. By then a vaccine most likely and being used….as a result the ‘Taiwan method’ is left to atrophy like the other things we had in place after SARS1 like stocks of PPE out of date or no longer usable.

      Reply
    • Duker

       /  22nd August 2020

      “I understand that the number of police call- outs to suicides is through the roof this year but relying on a coroners report for most could take until 2022.” …..facebook tells you so again.
      The coroner gets the cases referred to it by the police , yes there is a fine line by ‘self inflicted death’ and “intent’ to have a self inflicted death which is suicide .
      The coroner will be talking about the cases referred to them BY THE POLICE that appear to be self inflicted.Coroners dont have separate investigators
      In your complete ignorance you have tied your self up in an absurdity by asking about ‘police jobs’….hello. All deaths the police are informed about that arent suspicious or natural causes go to the coroner..hanging from tree included , killed crossing the road falling down the stairs at home.
      Of course your real target is the MP for Napier, Nash. Your wacky ideas would be circulation amoung your political circles in Hawkes Bay and you are used to paddling up a creek we wont name.

      ALL unexpected deaths are down during this year..suicide, road accidents,deaths during elective surgery, deaths from flu/pneumonia.
      The drop in suicides apparently isnt unusual during a major emergency, I dont have the figures but I think that was also the case in Christchurch after the earthquakes

      Reply
      • John J Harrison

         /  22nd August 2020

        Duker, thank for your many compliments.
        Again, you are wrong.
        I have never been on Facebook or Twitter but get my information from the source.
        Have a great day and try not to get so bitter in defending the indefensible.
        I have received a shot of Twitter showing Ardern adjusting her air piece during her answers from the “Pulpit of Truth”.
        We all know she is bereft of answers to probing questions but why would she make it so obvious that someone is feeding her answers in real time ?
        I wonder if this will be allowed in the upcoming debates !

        Reply
        • Duker

           /  22nd August 2020

          Its not indefensible…you are the one full of nonsense that cannot be rationally explained but that is circulating on facebook or reddit or where ever.
          And you are the sort of silly old fart that laps this talk ‘amoung your circle’

          Any way it demolishes your ‘theory’ that there is a trove of hidden information on police ‘job sheets’ that the coroner doesnt know about.
          Some of the largest drops in deaths is from the youngest age groups…a group that a sudden death is something that would immediately come to the attention of police/coroner
          “. In the 15-19 age range, 59 people died compared to 73 from last year and in the 20-24 age range, deaths by suicide were down from 91 to 60”
          https://www.newshub.co.nz/home/new-zealand/2020/08/new-zealand-s-suicide-rate-drops-to-three-year-low.html
          Thats 45 less in that age group alone. Im hoping its a longer term trend now that there is less stigma associated with ‘cant cope’ or other depressive symptoms, and even major celebrities and sport stars can talk about their dark periods etc.

          Reply
        • duperez

           /  22nd August 2020

          You get your information from the source?

          What is the source of your claim, “the fact that hundreds of lives are lost for every Covid death due to suicide, cancer, delayed operations etc.”

          Reply
          • John J Harrison

             /  22nd August 2020

            Duperez, read the MSM.
            I know the facts don’t assist your on- going defense of the indefensible.
            Tough !
            Be kind.

            Reply
            • Duker

               /  22nd August 2020

              The Blog standards require you have provable facts

              5. If I’m making assertions, can what I say be backed up by actual fact?
              I know you believe what you believe, and that’s nice for you, but if you want me or others to believe what you believe, then I’d like to see the data, please. Otherwise I’m just going to assume you are talking out of your ass….

              6. If I’m refuting an assertion made by others, can what I say be backed up by fact?
              7. Am I approaching this subject like a thoughtful human being, or like a particularly stupid fan?
              https://yournz.org/2012/09/21/good-blog-commenting/

              Many chances on this to have some provable facts for your assertions … ‘each time more talking out of your ass”
              Hopefully the moderator will make you put up or shut up.

    • Corky

       /  22nd August 2020

      Hawk’s Bay has seen a big jump in suicides.

      Reply
    • Griff.

       /  22nd August 2020

      What greatly concerns me is the fact that hundreds of lives are lost for every Covid death due to suicide, cancer, delayed operations etc.

      Fact.
      In New Zealand Number of deaths overall are down.
      https://www.stuff.co.nz/national/health/coronavirus/122476223/coronavirus-while-covid19-takes-lives-around-the-world-new-zealands-response-has-led-to-fewer-deaths-from-all-causes

      Nearly 1200 fewer people have died this year than had at the same point in 2019, data from Stats NZ shows.

      You are gibbering ..not surprising .
      What does surprise me is how many up ticks you get from such easy proven nonsense.
      This gives two possibility’s
      Either we have more gibbering nutbars than just you .
      Or you are upticking your self .

      Reply
      • John J Harrison

         /  22nd August 2020

        Griff, so what if overall deaths have decreased.
        You have willfully missed the point wildly reported over the past 6 months.
        Never up or down ticked anyone in my life – as Pete may be able to confirm.
        The fact that I am so popular is that the “ pixie dust “ is rapidly receding from the easily led.
        They now see nothing but an empty vessel parroting what she is told by her staff.

        Reply
        • Griff.

           /  22nd August 2020

          Adding more bullshite to divert from your bullshite only impresses others who live in Lala land.

          According to your empty gibbering quoting from www facts pulled from your arse we should be seeing many more than 2,200 extra deaths.

          the fact that hundreds of lives are lost for every Covid death

          Meanwhile an actual demonstrable fact from the real world sane people live in not your imagination .
          Official statistics number of deaths from all causes at this point are 1,200 lower than last year .

          We have had documented cases of tick wanking before on NZ blogs. The method used is simple .
          https://au.pcmag.com/internet-3/51503/how-to-hide-your-ip-address
          Note: I gave two options.
          I believe the truth lies somewhere in between. We do also have idiots who uptick nonsense .

          Reply
          • Duker

             /  22nd August 2020

            I think we have a new name for male blowhards like the female version ‘Karen’
            Its ‘a Jeffers’ from John J

            Reply
        • Jack

           /  22nd August 2020

          Oh shit, I discovered recently that I can give myself two upticks by using my phone then the computer. Did that recently because I felt quite desperate for some love, despite my bravado re my cult comments. Sometimes my hand is shaking so much from harassment that it slips and I accidentally give myself a down tick. Then I have to stop myself from trying to explain and becoming more of a troll.
          Oh, the pains of a person who keeps getting trespassed from church and looks for love in the wrong places.
          It happened again today – the church council chairman trespassed me just for saying something nice to him. I feel great though. I’m sure that Alan here would be proud of me for that – don’t care a stuff, he’s a wanky socialist. Knows the Bible better than me, but is a hearer of the word and not a doer. Loser.

          Reply
          • Kimbo

             /  22nd August 2020

            Wow, that level of clumsy and obvious trolling makes Blazer look like a considered scholar! 😉

            Reply
            • Jack

               /  22nd August 2020

              Ah…Kimbo’s attention!
              Notice that. Didn’t come easy. He kept away from my guest post.
              It’s not only Socialists who can be mean as (thinking of Calvinism here)…or are you having a light hearted joke with me Kimbo?
              Skip kirk tomorrow and have a goss in Open? You can try telling me off again, test out my healing process.
              My parents played Scrabble almost every day, until Dad’s stroke. I love them, but the Presbyterians wrecked our relationship.
              I break Pete’s rules in other ways too. We’re supposed to only write what we would say to a person’s face. I’m not a swearer.
              Compared with the first trespass notice this one is easier, but the vitriol is just as astounding. I still can’t get my head around the fact that these people raised me and I love them intensely, yet I am so different – and they talk about Jesus Christ too.

        • Jack

           /  22nd August 2020

          Yes, as I’ve said elsewhere cult escapee Jacinda is short on creativity. Those slogans are shallow. Now, compared with me (cult escapee walking with the Good Shepherd) – my creativity still flows. Not especially great at Scrabble though.
          I wrote some new and unique things regarding the cross. I’ll bet not one church leader in NZ is presently up with these life giving concepts. Biblical too! Kiwis could unite against the virus successfully (and with ease) if more of us were carrying our crosses.
          Kimbo, I challenge you – you will not know what you are talking about unless you read my books with a genuine Christian heart and mind in Christ.
          There, you started it, one troll after another. You can be quite mean to others here I’ve noticed and you are very righteous (compliment). And quite a few of us use Blazer. Ho hum. Very Kiwi. But what we need in NZ is Kiwi Kirk. In this (the understanding of what is your cross to bear) I am right – and I’d bet my bottom dollar Kimbo is wrong. If not wrong, ignorant.

          Reply
  2. Blazer

     /  22nd August 2020

    Hooten couldn’t pick a winner if his job depended on it.

    Ask Muller.

    Reply
    • Duker

       /  22nd August 2020

      A Hooten is a kitchen hand at Hooters, Hooton is the former national party flack

      Reply
      • Corky

         /  22nd August 2020

        In fact Dr Jin’s anayalsis is flawed. Hooten is right..whether he undestands that or not.

        She is on steadier ground when she mentions this:

        ”Comorbidities such as diabetes, obesity, asthma, and others are known to correlate with increased risk of mortality from covid. Let’s look at these risk factors for the NZ population.”

        The point is the time is coming when Covid or economics won’t come into the picture. Survive or die will basically be it. You don’t need to quote stats and studies to work out how that works.

        Reply
  3. I think that the 30% was of those 80+s who catch C19, not of the total number of 80+s.

    There has to be some way to protect them that doesn’t involve total isolation and/or keep the rest of us in isolation.

    Reply
  4. Alan Wilkinson

     /  22nd August 2020

    The fact that health and economics are co-dependent doesn’t mean economics can be ignored in favour of health.

    Neither are the unknowns all on the downside. It seems most likely there is a significant level of natural immunity in the community and there are a growing number of treatment options that reduce severity and need for ICU or hospital care as well as long term health impairment.

    Reply
    • The PDTs mustn’t have worked out that without a robust economy, there is no tax money for things like health. Lockdown going up and down like a tart’s knickers will decrease revenue; we can’t keep borrowing money indefinitely.

      Reply
  5. david in aus

     /  22nd August 2020

    A shoutout to NSW health, they are managing to control an outbreak seeded from Victoria without a lockdown. One positive case in the last 24 hrs.

    They obviously spent the last few months planning for this and had an effective trace and treat program. NSW’s outbreak was worse than NZ’s.

    Meanwhile in Victoria and NZ they have to resort to lockdowns.

    Reply
  6. John J Harrison

     /  22nd August 2020

    David, dead right.
    Only a decreasing number of Labour luvvies believe the PM’s daily statements from the “ Pulpit of Truth.”
    When the NZ Herald confirmed that her innumerable statements over the past 4 months were COMPLETELY UNTRUE then you have to question if we are living in a third world country in darkest Africa.
    Now we find Ardern ,with a degree in communications, requires an ear piece providing verbal support from her staff when answering questions from journalists.
    Our government is becoming more farcical by the day.

    Reply
    • Blazer

       /  22nd August 2020

      ‘ you have to question if we are living in a third world country in darkest Africa.’

      At least you don’t resort to…hyperbole…John.

      Reply
      • John J Harrison

         /  22nd August 2020

        Blazer, was the NZ Herald right or wrong to state as a fact that Ardern had continually lied ?
        Third world dictators do so on a daily basis.
        When it directly affects our personal and economic health it is timely that the NZ Herald bought this to everyone’s attention.
        I realize it is difficult for you to accept.
        Tough !
        Be kind.

        Reply
        • Blazer

           /  22nd August 2020

          ‘Third world dictators do so on a daily basis.’…

          Well you make a valid point…Donald Trump the leader of the ‘free world’ would never ..lie….would he?

          Reply
        • Fight4nz

           /  22nd August 2020

          “ was the NZ Herald right or wrong to state as a fact that Ardern had continually lied ?”
          Wrong if it printed anything so patently absurd. But right wing MSM will do anything to get its masters back in the seat of power. That’s all that matters to the fascists.

          Reply
          • John J Harrison

             /  22nd August 2020

            Fight4nz, they baldly stated that her innumerable comments over months were COMPLETELY UNTRUE.
            Read before you write.
            Never, ever has anyone stated that the MSM is “ right wing.”
            Do you not read Newspapers, watch TV etc ?
            You are so off the mark it is laughable.

            Reply
            • Fight4nz

               /  22nd August 2020

              “ Never, ever has anyone stated that the MSM is “ right wing.””
              I did, because it is a fact. You can comprehend that that’s why you have just cited it as the basis of your argument?

        • Duker

           /  22nd August 2020

          They never said anything of the sort… you have made it up
          “was the NZ Herald right or wrong to state as a fact that Ardern had continually lied”
          Its the continual fabrications from your [low intelligence] mind.
          Put that with your earlier nonsenseclaim Nash is in some sort of conspiracy to cover up suicides.
          A full time bullshit artist in other words , no wonder you attend national party functions, birds of a feather. No wonder the voters of Napier Council could see through you from 2004 when you went to 11th and unelected from 3rd the previous election

          Reply
          • John J Harrison

             /  22nd August 2020

            Duker, typically you have willfully mislead your fans.
            I served 3 terms at the NCC.
            How many public office’s have you been successfully elected to ?

            Reply
          • John J Harrison

             /  22nd August 2020

            Duker, do yourself and everyone else a favour.
            Open a bottle of plonk and enjoy it.
            I was never 3rd or 11th – as if this has anything to do with the price of fish.
            As your PM says — “ be kind.”

            Reply
            • Blazer

               /  22nd August 2020

              Still on the Blenheimer flagons John.

              Hell you make ‘Merv’ look like a snowflake!

            • John J Harrison

               /  22nd August 2020

              Blazer, scoffing on a 2009 Coleraine while dining on a Venison rack prepared by my two Thai “ caregivers “.
              Eat your heart out.

            • Blazer

               /  22nd August 2020

              09m Coleraine is wasted on you John…are you sponsering the 2 ladyboys?

    • duperez

       /  22nd August 2020

      John J Harrison, if it is true to say our government is becoming “more farcical by the day,” how would you rate your contribution to various discussions using the same measures?

      Reply
  7. Alan Wilkinson

     /  22nd August 2020

    Officious stupidity?
    https://www.stuff.co.nz/national/health/coronavirus/300088747/coronavirus-returning-family-has-to-restart-quarantine-after-hotel-bubble-breach

    If no one in the family tests positive during or after the 14 days how does it make any difference whether they mixed with each other or not?

    Reply
    • Ask Megan Woods or Ashley Bloomfield or the PM…

      C19 is the jobsworth’s dream come true. They seem to be revelling in it. Finally, the jobsworths at all levels have official support and they are making the most of it, like the woman in Hamilton who wouldn’t let anyone into the Sallies opshop without signing in (this was last week when only pubs, cafes and restaurants had to have sign in) and having a huge dollop of sticky hand sanitiser splattered onto them from her heavy hand. I had a large bag of donations and couldn’t be bothered carting them home again, so let the silly moo have her way.

      Reply
      • Blazer

         /  22nd August 2020

        I see you’ve learned a new word…jobsworth’s……talk about …modern…English.

        Hopeless.

        Reply
        • Jobsworth is not a new word to me or anyone else; it’s been around for decades. Do try to keep up. It’s English, taken from the sort of officious person who’s likely to say that it’s as much as their job’s worth to make any allowances at all and sticks to petty regulation enforcing. The sort of people who give tickets to emergency workers who are technically illegally parked.

          Is Hopeless your new user name ? You keep signing posts with it.

          Reply
    • Alan Wilkinson

       /  22nd August 2020

      This is the sort of nonsense that should be taken to judicial review.

      Reply
      • John J Harrison

         /  22nd August 2020

        Alan, you have to be joking .
        Ardern leads a government with zero appreciation of accountability.
        Last week she stated that they were not seeking to blame anyone ( for the innumerable stuff – ups ).
        If they did the blame for all the lies we have been told, total management dysfunction and overall incompetence would sheet right back to the PM.
        Now we couldn’t have that, could we ?

        Reply

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