Covid-19 compared to other pandemics this century

According to microbiologist Siouxsie Wiles, compared to other pandemics this century Covid-19 is a bad roll of the dice.

Stuff: We lost this round of pandemic dice

I think it helps to think of these outbreaks and pandemics as a handful of dice.

The dice represent:

  • The microbe and how it spreads.
  • What symptoms it causes.
  • How it can be treated and prevented.
  • How each dice falls influences how the outbreak plays out.

With Covid-19, we’ve rolled almost the worst possible combination, with a collection of ones.

Covid isn’t as lethal as the likes of Ebola, but as symptoms are often not noticed or mild, and take time to present, Covid can spread before it is discovered.

Wiles details the other pandemics in the last 20 years, and compares aspects of them to Covid.

Sars (2002-2004)

Sars appeared in late 2002, also caused by a coronavirus that spreads through the respiratory route. Unlike Covid-19, people with Sars had a high fever early in their infection. That made it easier to identify infected people and stop human-to-human transmission.

By mid-2004, Sars was gone and hasn’t been seen since. By then 8000 people had been infected and over 800 had died. Cases had spread to almost 30 countries and territories.

Covid-19 also emerged in a globally connected part of the world and at a time of year when lots of people were moving about.

H1N1 (early 2009 to August 2010)

H1N1 was a variant of the influenza viruses from humans, birds, and pigs that caused a pandemic from early 2009 to August 2010. Like normal seasonal flu, H1N1 spread through the respiratory route. But unlike normal flu, it was more likely to cause breathing difficulties in young, healthy people. Thankfully, a vaccine was available by late 2009. It’s thought H1N1 caused about 500,000 deaths. 

That was over about 18 months.

Ebola (December 2013-June 2016)

The largest Ebola outbreak began in Guinea, West Africa in December 2013 and spread to Liberia and Sierra Leone. Ebola transmits through bodily fluids from symptomatic people. That means it’s easier to stop than Covid-19, in which people are infectious before they realise they have the virus.

While vaccines were in clinical trials by mid-2015, the Ebola outbreak was mainly brought under control by stopping human-to-human transmission. It also helped that it was in a part of the world that isn’t quite so globally connected. The outbreak was officially declared over in June 2016. By then over 28,000 people had been infected and over 11,000 had died.

Ebola had a very high death rate for those infected, but was much more easily contained.

Zika (2015-2016)

Zika is the virus that causes babies to be born with small heads. It’s spread by mosquito bite and caused an outbreak in the Americas, Pacific, and Southeast Asia in 2015 and 2016. In many mosquito species, the females feed on people one time before laying their eggs. Zika is carried by mosquitoes that feed more than once. As a result, they spread the virus from infected to uninfected people as they ate. The outbreak was largely controlled by getting rid of mosquitoes carrying the virus.

Current Covid totals (Worldometer):

  • Total detected cases – 25 million
  • Total attributed deaths – 848,925

The closest comparison is H1N1, with about half the deaths. A vaccine was available within the year it began but it still nearly a year to eliminate it.

New Zealand has got off lightly so far, with just 1,729 cases and 22 deaths.

Initially Australia had a comparable result but after a big outbreak in Victoria cases have jumped to 25,166 and deaths to 611.

We have been mostly successful at containing Covid but the current outbreak in Auckland is a concern. It shows how quickly things can change.

As Covid testing surges Ministry limits criteria

One of the biggest concerns over the handling of Covid had been the limited criteria that the Ministry of Health used to allow testing for the virus. This became a bigger issue over the last two weeks regarding testing of people before releasing them from isolation or quarantine.

Criteria were relaxed, and this week there has been a surge in testing numbers, with a record 9,174 tests done on Tuesday (23 June).

There have been reports of long queues at testing stations – this will have been made worse because the number of testing stations have been significantly reduced.

Apparently as a result the Ministry has tightened up on testing criteria again.

RNZ:  Ministry of Health reintroduces high risk criteria for Covid-19 testing

Covid-19 testing for every person with a cough or cold symptom has been dropped by the Ministry of Health.

Under new Ministry of Health testing guidelines, doctors and testing clinics, are urged to instead focus on those at highest risk.

For the past several weeks, anyone with even a sniffle had been told they can be tested for Covid-19.

But that will no longer be the case unless they fall into a high risk group or their doctor advises it.

The high risk group includes anyone who have recently:

  • Had contact with an infected person
  • Been overseas
  • Had direct contact with someone who had been overseas
  • Worked on an international aircraft of ship
  • Worked at an airport or isolation facility

Other people with a cold or flu symptom could still be tested but it will not be a requirement.

The move is expected to put an end to the huge demand for tests in some areas over the past week as cold and flu season hit.

Northland GP Geoff Cunningham was so busy he ran out of swabs.

He was relieved to see the change.

“It would be unsustainable if we were to continue swabbing every minor respiratory tract infection,” he said.

Leading public health doctor Nick Wilson, said the change was the right thing to do because there was no evidence the virus was transmitting in the community.

These are risky decisions basing tests on symptoms, especially because it is well known now that people with no symptoms can carry the virus.

This may be fine for now. But if the virus does get out into the community again it may not be picked up soon enough to contain it.

At least the seem to have comprehensive testing in place for people coming into the country and going into mandatory isolation.

The United States Space Force

They are really promoting a bit of space around Earth as ‘the final frontier’?

I’m not sure whom they are going to be forceful against, but I guess it allows Trump to claim to be the best leader ever of the inner Solar System, if not the Universe.

As powerful as Trump and the US want to be, they are currently struggling to fight off with the tiniest of threats (particles ranging from 0.06 to 0.14 microns), a virus from Earth.

Alert Level 2 again – stay safe, stay healthy and enjoy!

We were in Covid-19 Level 2 semi-lockdown for a couple of days from 21 March before ramping up to Level 3 for another couple of days leading in to seven seeks of level 4 lockdown from 26 March, restricting most of us to our homes most of the time.

In that seven weeks I went out briefly just twice, once for a regular blood test and the other time for a flu vaccination. Both of those trips were into the Dunedin CBD for less than an hour and I didn’t enjoy visiting a partial ghost town.

Today won’t be much different for me, work from home as usual. I will probably resume working from the office next week.

Tomorrow I will visit some relatives, seeing them for the first time for months. I’m looking forward to that.

Visiting other relatives is currently on hold as one of them is waiting for the results of a Covid test (Update – fortunately negative). I think it is unlikely that that will be positive but to be sure the test had to be done, and as a precaution contact with that family is on hold.

It is most likely just a cold or flu, but anyone else catching either cold or flu has to get tested, just in case, and should voluntarily isolate – a child won’t be welcome at school with a runny nose or cough, and I would be obligated to stay away from work if having any symptoms that could possibly be Covid.

I’m looking forward to getting out and about in the weekend. I will be staying away from shops and cafes and restaurants even though some will presumably be opening. I see no reason to take the risk of mingling with a possible surge of people getting ‘back to normal’.

First outing will be to a beach. Picking one that will be less crowded will be a bit of a punt. Other than that I don’t know what I’ll do. Fortunately the weather forecast is looking very good, both Saturday and Sunday are predicted to be clear sunny autumn days.

Otherwise I will be easing cautiously into Level 2. I see no need in taking unnecessary risks.

Obviously everyone will make their own choices over the next week or two.

Stay safe, stay healthy and enjoy!

Missouri trying to sue China over Covid-19

The US is ramping up attempts to sue China over the over the Covid-19 coronavirus, with Missouri the firsy state to file a suit.

Fox News: Missouri files suit against China for ‘enormous’ consequences of coronavirus ‘deceit’

Missouri became the first state to file a lawsuit against China on Tuesday, accusing the country of being responsible for the severity of the coronavirus pandemic and seeking damages to make up for “the enormous loss of life, human suffering, and economic turmoil” resulting from the disease.

The suit in the Eastern District of Missouri follows at least seven federal class-action suits that have been filed by private groups, with one filed in Florida saying that China knew “COVID-19 was dangerous and capable of causing a pandemic, yet slowly acted, proverbially put their head in the sand, and/or covered it up in their own economic self-interest.”

It also comes on the heels of 22 Republican lawmakers on Monday requesting that the Trump administration bring a case against China to the International Court of Justice (ICIJ) for the country’s actions during the pandemic.

The text of the lawsuit lays the blame for the pandemic’s consequences squarely at China’s feet.

The suit makes numerous claims of wrongdoing by China and the other defendants related to the Chinese government it seeks to hold responsible, including an “emerging theory on the origin of the virus … that it was released from the Wuhan Institute of Virology, which was studying the virus.”

The suit is based on ‘an emerging theory? That sounds bizarre, particularly as that ‘theory’ is far from proven.

But U.S. officials and the intelligence community have confirmed to Fox News that they have taken the possibility of the coronavirus being man-made or engineered inside China as some sort of bioweapon off the table and have ruled it out at this point.

Officials say the Missouri suit seeks to present good-faith claims about actions China likely took that led to the pandemic. They also emphasize the Chinese government took other actions to worsen the spread of the coronavirus that have been proven with near certainty.

Because Donald Trump said? Even if they can be proven, responsibilities could be complex. Maybe it would be easier to just sue someone in the US.

Why Trump Deserves More Blame for the U.S. Coronavirus Crisis Than the WHO or China

The United States now claims nearly one-third of the world’s COVID-19 cases, making it the center of the coronavirus pandemic. Instead of leaning on the World Health Organization for support, last week President Trump announced that he would be halting the U.N. agency’s funding, accusing it of bungling its early response to the coronavirus.

“This is lunacy. Truly,” responded Jeremy Konyndyk, a policy fellow at the Center for Global Development who previously served as the director of USAID’s Office of U.S. Foreign Disaster Assistance, where he coordinated the country’s humanitarian responses to the 2014 Ebola outbreak in West Africa, the 2015 earthquake in Nepal, and the war in Syria.

Fundamentally, this is not about what WHO did or did not do. It’s not about what WHO did or did not say. What it’s about is turning WHO into a political scapegoat to distract from this administration’s failures to prepare.

WHO’s own information, WHO’s level of alarm, WHO’s characterization of the risk, were always well out ahead of the Trump administration. At a time when the U.S. government was still saying the risk to the American public was low, WHO was saying that this absolutely had pandemic potential.

The administration is clearly grasping for anything it can to distract from its own poor performance. If they can blame this on WHO, or if they can blame this on a lab accident in China, that somehow alleviates them of their responsibility. That is very clearly the play.

The lab thing is a useful target for them because it can’t be disproven.

But at the same time, the U.S. government is obviously doing everything it can to spin this up as a story. The National Security Council is reportedly pushing the intelligence community very hard to try and find anything that would suggest that the lab was the origin.

We have the administration trying to put the story out into the ecosystem, pushing it through favorable media outlets and personalities on the basis of very little. If they had something stronger, we would see it. They wouldn’t be sitting on it.

And now Missouri has taken this and is using it in a lawsuit.

I don’t know how a US state can sue China. If they can this could open a big can of worms. Many Covid cases on New Zealand came from the US. Italy was another source.  But proving where actual damages were caused could be difficult.

There’s a lot still being discovered about the spread of Covid in the US.

Autopsies find first U.S. coronavirus death occurred in early February, weeks earlier than previously thought

Tissue samples taken during autopsies of two people who died at home in Santa Clara County, Calif., tested positive for the virus, local health officials said in a statement. The victims died on Feb. 6 and Feb. 17, respectively.

Initially, the nation’s earliest coronavirus fatality was thought to have occurred on Feb. 29, in Kirkland, Wash., a suburb of Seattle that rapidly became a hot spot. In March, health officials there linked two Feb. 26 deaths to covid-19, the disease caused by the new virus.

The Santa Clara County fatalities push back the earliest coronavirus-related fatality by weeks, with the new findings potentially altering the timeline of the U.S. outbreak.

Even if China can be sued over Covid there’s a lot yet to be discovered or proven.

If somehow China could be found liable, this would set a bad precedent for any future viruses that could emerge from anywhere in the world – and finding where they originate could be impossible to prove. But if there was a risk of huge damages for a country that first discovered a virus, it could deter it from revealing it, or at least cover up evidence.

Missouri and the US would be better concentrating on minimising the effects of Covid. Maybe they are concerned about lawsuits being filed against states or against the federal government for not doing enough soon enough. But going to court won’t do anything to deal with the virus.

And if Trump pushes states to reopen for business too soon will he be liable for legal action?

Covid-19 – Ireland acted sooner than UK, double the testing, less than half the deaths per 1m

A comparison between Ireland and England in dealing with the Covid-19 virus and their casualty rate seems to reinforce the importance of timing in locking down countries, and in testing rates.

Irish Central (March 17): Britain and Ireland’s differing approaches to Covid-19

The United Kingdom may be Ireland’s closest neighbor, but the two nations could hardly be further apart in how they are approaching COVID-19. 

They are virtually polar opposites and Britain’s approach could deeply impact the Republic of Ireland, especially since the countries share a significant border in Northern Ireland.

The UK has lagged behind Ireland (and indeed the rest of Europe) in implementing stringent measures to curb the spread of Coronavirus.

From a Twitter thread by historian and writer Elaine Doyle @laineydoyle (edited):

I don’t understand the British media. I really, really don’t. Basic things: Ireland and the UK started this pandemic with roughly the same number of ICU beds (6.5 per 100,000 for Ireland, 6.6 per 100,000 in the UK). If anything, the UK was slightly better off.

Image

(ICU beds is just one indicator of country preparedness. Germany and Austria have relatively low death sates compared to Italy, France and Belgium, but so do Portugal and Finland).

As of today, there have been 320 deaths from the coronavirus in Ireland, and 9,875 deaths in the UK.

So we adjust per capita – how many deaths per 100,000 people?

As of Saturday 11 April, there have been 6.5 deaths per 100,000 people in Ireland (now 6.8).

There have been 14.81 deaths per 100,000 people in the UK (now 15.6).

Guys, people have been dying at more than *twice the rate* in the UK.

That the UK’s closest neighbour, with almost the *exact* same starting line in terms of its health system, is having a wildly different outcome? Not saying Ireland’s a paragon of virtue! Loads to discuss & critique & make better!

But wait, it’s worse! Because if you compare the per capita death rate between Ireland and *England*, rather than the UK as a whole, England has almost *2.5* times the number of deaths as Ireland (14.81 deaths per 100,000 vs 6.5 deaths per 100,000).

So you have two English-speaking countries, with close cultural and historical associations, both with underfunded health systems, & comparable levels of ICU beds (almost half the EU average) going into the pandemic.

But England has more than 2.5 times the deaths? Why?

If you’re arguing over whether Boris & Co’s ‘herd immunity’ policy (& the resulting delay in lockdown) had any effect on death rates – here’s your angle, lads. You have a real-time A/B test happening *right in front of you*.

Because Ireland closed down earlier. Much earlier.

While Boris was telling the British people to wash their hands, our Taoiseach was closing the schools.

While Cheltenham was going ahead, and over 250,000 people were gathering in what would have been a massive super-spreader event, Ireland had *cancelled St Patrick’s Day*.

The four-day Cheltenham Festival is a meeting in the National Hunt racing calendar in the United Kingdom. It place annually in March at Cheltenham Racecourse in Cheltenham, Gloucestershire – Wikipedia

Daily Mail: Cheltenham Festival organisers say Boris Johnson’s trip to England-Wales Twickenham rugby match was one reason they didn’t cancel race meeting blamed for coronavirus spread  – since the festival took place hundreds of people have complained of getting symptoms of the deadly virus.

In Ireland, we watch a lot of British media and news, and let me tell you, it was like living in bizarro-world.

Because our Irish TV news was filled with very direct, serious pronouncements about what was coming. But when we switched to the British TV channels… *crickets*.

Particularly vivid for the weekend before Paddy’s Day. Rolling restrictions in Ireland, so no groups > 100, but pubs not yet closed. Video emerged of people singing in a pub in Temple Bar => public outcry, #shutthepubs trended, Health Minister comments, voluntary closure ensued.

 

I remember watching that video being posted on Twitter that Saturday night, and feeling sick to my stomach. How many people were being infected, at that very moment, singing along to the Stereophonics? It was such a huge crowd.

I assume there were people in Cardiff who felt the same way I did. But the difference was: I was supported by my government. You weren’t.

And that cost lives.

The Stereophonics gig was on the 14 March. Median 5-7 days to get sick, and let’s allow another 14 days to get seriously ill. The people infected at the Stereophonics gig were in hospital last week.

The people *they* infected will start dying next week.

Pandemics roll along exponential curves. The NYT (using @brittajewell’s calculations) showed it beautifully here:

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@brittajewell used US figures, & showed that if you started to stay home *this week* (March 13, at the time of publication), you could prevent 2400 infections. But if you started to home *next week* instead, you prevented 600 infections. (Those figures were based on US infection numbers at that point, with 30% growth rate per day. It’s not the UK.)

It’s weird, right? Exponential curves are really counter-intuitive. When they go up, they go up FAST. Timing matters, a lot. By staying home *this week* rather than *next week*, one person could prevent an extra 1800 infections. One person!

And as @jkottke pointed out, assuming a 1% death rate, that’s 18 lives saved. 18 lives saved, by the choices of one person to stay home for the week starting 13 March, rather than the following week. That Stereophonics gig? Was on 14 March.

Ireland cancelled Paddy’s Day on 9 March, initiating a series of rolling, controlled restrictions, from school closures & large group bans (12 March), to closure of non-essential businesses & social distancing, to full lockdown. It was precise, clearly communicated, controlled.

The UK closed their schools on 20 March, a full week after we closed ours. Full lockdown came to the UK on 23 March.

And while there was some muddied, confused advice in the UK between times (avoid non-essential travel from 16 March? don’t go to the pub, but then again, they’re still open, so maybe do?) – there was an abrupt about-turn, after the Imperial College report came out.

The comparisons aren’t neat between the two countries, because the processes (and nomenclature) were different. Technically, the UK went into lockdown *before* Ireland; but that’s not a fair comparison, as we were already operating our ‘Delay Phase’ from 12-27 March.

But I would argue the crucial difference lies in that two-week period: from 9 March, when we cancelled Paddy’s Day, to 23 March, when the UK govt finally (and abruptly) wheeled about, and went into lockdown.

And because the UK government delayed, distorted and distracted for those two weeks, the UK people ended up on the wrong part of an exponential curve, when lockdown started. And now, the UK has over twice the number of deaths per capita than Ireland.

But wait, it’s worse! HOW how HOW can it be worse.

Because: testing.

Because the UK figures only include deaths, in hospitals, from people who had already been tested positive for COVID-19. That sentence has a whole pile of clauses and commas, doesn’t it? Let’s break it down.

It means that a person could die *in a UK hospital* of the coronavirus; and all their doctors could agree that yes, they definitely died of coronavirus; and their *death cert* says that yes, they did, in fact, die of coronavirus –

… and they wouldn’t be included in UK figures.

Because they weren’t tested.

And you have to have a positive test, before death, to be counted in the UK deaths.

The UK isn’t testing nearly as much as it needs to.

And Ireland is testing a *lot* more. We have a drive-through testing centre in the sacred sporting grounds of Croke Park – think turning Wembley Station into a testing centre, and you get somewhere close.

Ireland is still building its testing capacity, but we’ve been explicitly following the South Korean model of test, test, test (and contact trace). And we’re using our time in lockdown to build our testing network.

The aim is to have 15,000 tests per day, or 105,000 tests per week – that is, testing 2% of the population a week. 15,000 tests is about 7 months of flu testing for Ireland – and we’re planning this, every day, for months and months.

We’re not there! We had to grab Germany for a dig-out, we fell so far behind! There’s loads of teething problems! Like I said at the top of the thread: I’m not saying that Ireland is a paragon of virtue here.

Of course no country has dealt with Covid-19 perfectly, it was a rapidly evolving with big decisions needing to be made quickly that had huge health, economic and social ramifications. Not easy for any country to get things right.

And to date, Ireland has performed 8.69 tests per 1,000 people. ourworldindata.org/covid-testing# The UK has performed 4 tests per 1,000 people.

Currently Worldometer shows Ireland with 10.73 and the UK with 5.2 (New Zealand 12.68).

So: to my UK friends, let’s lay it out there. You’re testing at half the rate that Ireland is, and your loved ones, your family, your friends are dying over twice as fast.

So timing and testing have been very important.

And that’s still a wild underestimate of how bad things are, because your low testing rates are artificially depressing your death figures; whereas Ireland’s high testing rate is (comparatively) inflating ours (or, more fairly, accurately recording them in our figures).

Failed by your government, and failed by your media.

Failed, by news reports that (correctly!) talk about how horrific the death toll is in NYC, while eliding the horrors of nearly 1000 people dying in a single day at home.

Failed, because it didn’t have to be like this.

Failed, because there are lessons and exchanges to be found here, but in those 2 weeks when so much could have been done, your media didn’t pay any heed to what was happening beside it.

Because your media didn’t report on the contrast between Boris’ choices and ours.

Failed, because your media STILL isn’t reporting on the contrasts in death rates between us, and why that might be the case.

It’s too late to get the timing of even cancellations and lockdowns right, but not too late to ramp up testing.

Failed, because in this long-standing, complicated, skewed relationship between us, we can see you clearly, and you seem to barely see us at all.

And it breaks my heart.

But there’s still time. Time to flatten your curve. Time to build testing. Time to develop a robust contact tracing system. Time to *use* your lockdown as it should be used, while we do the same. Time to be our partners in this, as we all must be, in a globalised pandemic.

The best time to plant an oak tree was 20 years ago; the second-best time is now.

The best time to stop this pandemic was last January. The second-best time is now.

And while we’re working this ground together, remember that over the fence, in your neighbouring allotment, we’re tackling the same tasks as you. It might be worth taking a peek over the fence sometime, to see what we can share.

The UK seems to be similar to how France was, not counting deaths in rest homes.

Business Insider: Hundreds of coronavirus deaths are taking place in UK care homes but not being included in the official death toll

BBC: Warning over daily death figures

Over the weekend, NHS England released new figures broken down by the actual date of death.

And these reveal that between 11 March and 1 April there were about 300 more deaths than previously thought during that period.

Separate figures, published by the Office for National Statistics (ONS) also suggest the number of people dying with coronavirus is higher than the daily totals indicate.

The ONS examined registrations and found deaths in the community not included in the daily hospital deaths figures.

In the week to 27 March, for the 501 deaths recorded in hospitals the ONS also found 38 deaths linked to coronavirus in the community.

Also from BBC:

Larissa Nolan (Irish Mirror:  7 April): UK and Ireland’s responses to Covid-19 crisis are worlds apart

For far too long, the Brits’ approach to this crisis was to stick their fingers in the ears, close their eyes and go: “Lalalalalala”.

Like many others in Ireland, I watched on; worried for relations and friends in England. What were they at over there?

British political leaders have subsequently made some attempts to address it, but it’s too late now. The “denialism” – as a senior British scientist called it – is too strong.

Reports from the weekend show Britons still gathering, regardless. Attitudes are ingrained. Behaviours have been set. Outcomes are following accordingly.

Here in New Zealand we don’t have such a stark contrast in approaches with our larger neighbour, Australia, except for timing. Covid-19 seemed to become established in Australia a few days sooner than here, particularly in New South Wales, but we lockdown harder and about the same time as Australia.

Current deaths in New Zealand 4, in Australia 59.

 

Why were we slow to increase Covid-19 testing?

A number of Governments around the world have been criticised for their lack of testing for the Covid-19 virus. This may have helped the virus spread undetected in communities.

Some countries like Italy and Spain had so many serious cases to deal with they didn’t have sufficient resources to test.

The US and UK were both slow to ramp up testing.

It is apparent in some places that the horse had bolted before comprehensive testing at the stable was started.

The spread of the virus and the actions taken by countries including here has been a rapidly changing situation, perhaps governments have struggled to keep up with demand, or perhaps governments are just too slow to act in emergencies like this (although the modern world has not experienced a virus like Covid-19).

New Zealand was also slow off the mark, limiting testing to people with Covid symptoms AND some link to international travel. Last week testing rates were increased, but only yesterday it was announced that the criteria for testing would be widened.  But even the highest risk group, travellers coming into the country, were not all tested (I suspect that there were too many too handle at the time).

This is despite medical experts and academics calling for far more testing.

The prime minister Jacinda Ardern has been criticised for possibly misleading the country over testing. Her first official release on Covid-19 was Saturday 14 March (just two and a half weeks go).  From Major steps taken to protect New Zealanders from COVID-19

  • Every person entering New Zealand from anywhere in the world will be required to self-isolate for 14 days, excluding the Pacific [i]. ‘
  • These restrictions will all be reviewed in 16 days’ time.
  • Existing travel ban retained for China and Iran
  • Cruise ships banned from coming to New Zealand, until at least 30 June 2020
  • Strict new health measures at the border for people departing to the Pacific
  • A range of measures to assist those in self-isolation to be announced next week
  • Government will work closely with the aviation sector to encourage airlines to remain active in New Zealand, limit impacts on the tourism sector and exporters
  • Directive on mass gatherings to be announced early next week

There was no mention of testing in her statement.

Tuesday 17 March she did mention testing in Economic package to fight COVID-19

“We will be investing in more health staff, more virus testing, more medicines, facemasks, extra intensive care capacity and equipment at hospitals, and more money for GPs. If we can manage the virus we can mitigate the damage to the economy.

The same day in Parliament from 2. Question No. 2—Prime Minister

Hon Simon Bridges: Why are people being denied coronavirus tests when they are displaying symptoms?

Rt Hon JACINDA ARDERN: I reject the assertion they are. I want to read—

Hon Simon Bridges: Well, they are.

Rt Hon JACINDA ARDERN: I would like to read from the case notes provided to doctors. Under the case definition, it says, “Note”—this is for clinicians—”that due to the ongoing changing global and domestic situation, clinical judgement should apply as to whether someone who doesn’t quite meet the current case definition should be tested or not.” Any person who a clinician thinks needs a test should get a test.

Hon Simon Bridges: So does she deny the email to me from a Wellingtonian and his partner who had all the symptoms and were denied the tests yesterday?

Rt Hon JACINDA ARDERN: Again, as I’ve just said, that decision sits with doctors. I will read, again: “due to the ongoing changing [environment], clinical judgement should apply as to whether someone who doesn’t … meet the … case definition should be tested or not.” I cannot be clearer. Any person a doctor believes should be tested can and should be tested. We have the capacity to do up to 1,500 tests a day. My understanding is that we have hundreds of tests currently being processed for which we will have the results tomorrow.

Hon Simon Bridges: Why doesn’t she just guarantee that those who show the clear symptoms will get the testing, as Prime Minister of our country?

Rt Hon JACINDA ARDERN: I’ve just given you the exact advice that is for doctors. Doctors make those decisions, not politicians, but what they have been told is that anyone who they believe should be tested should be tested. I cannot be clearer than that. I cannot make those judgments, but they can, and they should.

Hon Simon Bridges: Why is she only suggesting ramping up tests now after the World Health Organization has called for countries to test, test, test?

Rt Hon JACINDA ARDERN: The member is utterly incorrect. We’ve had the capacity to test up to a thousand a day for a very long time.

Hon Simon Bridges: Is she concerned that a comparable country like Norway has tested 8,000 people and we’ve tested less than 600?

Rt Hon JACINDA ARDERN: Again, the member seems to be upset about where our global standing currently is in terms of case profile. We have, currently, a small number of cases, that have been confirmed through testing. But I expect that we will have many hundreds more tests conducted. In fact, I understand we have hundreds currently being processed this very day.

Hon Simon Bridges: Isn’t the reason we only have a dozen confirmed cases and not dozens and dozens and dozens because under her Government, since the start of the year, we just haven’t done many tests?

Rt Hon JACINDA ARDERN: That is an appalling, appalling statement to make. The implication that tests are being determined by politics is appalling. Doctors are making the call, and they are being told that if they believe they should test, they should. I cannot be clearer about the advice that has been provided by the Ministry of Health; it is in black in white—in fact, it is in bold.

Hon Dr David Clark: Is the Prime Minister aware that Norway currently has 1,200 confirmed cases of the virus, and is in Europe, which has been described as the epicentre of the outbreak?

Rt Hon JACINDA ARDERN: Yes. In those cases, you would expect, therefore, that the contact tracing and symptoms would therefore lead to the other testing outcomes that they have. It seems extraordinary to me that the suggestion seems to be that there is disappointment about where we are. Hundreds of tests are being processed today. Very unfortunately, we will see—[Interruption] We will see more—

SPEAKER: Order! Order! Can I just ask members on both sides—this is a very serious issue, and petty calling back and forth from both sides ill behoves the House.

Hon Simon Bridges: Does she accept that the reason, say, Norway has many more confirmed cases is because they have done many, many thousands more tests, and that’s where we needed to be weeks ago.

Rt Hon JACINDA ARDERN: No, I reject that, and I again confirm I have just been advised there are 500 tests currently being processed. That capacity has always existed, but we have allowed doctors to make that decision, not politicians.

Hon Simon Bridges: Will she apologise to New Zealanders who have been previously denied a test under her Government last month, the month before, and as little ago as yesterday?

Rt Hon JACINDA ARDERN: No one who a doctor believes should be tested should have been denied a test.

Ardern said “there are 500 tests currently being processed”. The average tests over the past week is 1,777 daily as of yesterday when more testing was called for by Ardern.

That same day from Question No. 10—Health

Dr Shane Reti: Does New Zealand coronavirus testing align with Centers for Disease Control and Prevention recommendations to test all older people with symptoms who also have heart conditions; if not, why not?

Hon Dr DAVID CLARK: The member will have heard from the Prime Minister earlier in today’s House session that all primary-care workers who are so qualified are being encouraged to test if they have any clinical suspicion.

Dr Shane Reti: What is the weakest point in the health system for coronavirus management, and how can we help?

Hon Dr DAVID CLARK: It’s misinformation, and members of the Opposition can help by making sure that they are pointing people toward the Ministry of Health website, where the most up-to-date and correct information is on hand. They can share that widely, and I would appreciate it. Thank you.

Two days after that a nurse I know who works in an age care hospital had flu-like symptoms and south a test but ws told she didn’t need one, and could return to work the following Saturday.

Also on 17 March – Jacinda Ardern urges clinicians to do more COVID-19 testing: ‘We have the capacity’

The Prime Minister is urging clinicians to conduct more testing for the coronavirus COVID-19 insisting New Zealand has the capacity to do 1500 tests per day.

“Our capacity is significant. We’re ramping up the ability to have up to 1500 tests per day,” Jacinda Ardern said on Tuesday. “That test number you’ve been seeing per day happening in the community is growing day on day.”

It comes after the World Health Organization (WHO) pleaded for countries to ramp up testing of every suspected coronavirus COVID-19 case as it warns children are dying of the illness.

Several more media releases by Ardern didn’t mention testing, including the big announcement on Saturday 21 March – Nation steps up to COVID-19 Alert Level 2

Two days later on Monday 23 March from Prime Minister: COVID-19 Alert Level increased:

We will continue to vigorously contact trace every single case. Testing will continue at pace to help us understand the current number of cases in New Zealand and where they are based. If we flush out the cases we already have and see transmission slow, we will potentially be able to move areas out of Level 4 over time.

Ardern made several more media statements since then with no mention of testing.

Wednesday 25 March from Returning New Zealanders will be tested for Covid-19

New Zealand borders will be open for returning New Zealanders but all of them will be screened at their port of arrival, Prime Minister Jacinda Ardern has said.

“All incoming passengers will be tested and anyone found systematic will be quarantined in a facility. All others will be asked to go into self-isolation. The Police will monitor them and anyone found violating the order will be fined and quarantined,” she said.

Yesterday (31 March) – Covid-19: More testing needed, Ardern says

The number of tests for coronavirus is set to ramp up, with health officials relaxing the testing criteria as Prime Minister Jacinda Ardern called for more testing to be done.

New Zealand’s testing regime has been under scrutiny for some time, with people complaining of being turned away despite medical recommendations they get tested.

The matter was at the fore during the inaugural meeting of the epidemic response committee earlier on Tuesday, where Director-General of Health Ashley Bloomfield indicated a change was coming.

Now, Ardern has confirmed the technical advisory group overseeing the case definition of Covid-19 had agreed to expand it to include people who had symptoms potentially indicative of the virus, but without a link to overseas travel or a close contact who had tested positive.

The new advice would be circulated to Healthline, GPs and community clinics, with the Prime Minister expressing a desire to see testing levels ramp up further.

“I want more tests, we’ve built the capacity for more tests, more tests will only allow us to get a better picture of the spread of Covid-19.”

However, she pushed back when asked why the Government had not made such a change earlier, saying New Zealand had already been conducting a high level of tests relative to other countries.

The rapidly spreading and dangerous Covid-19 pandemic is an unprecedented health emergency and has been very difficult for governments to deal with. One thing we should get is open and honest information. Questions remain about the slow lift in testing for the virus.

3,500 tests are now being done per day with plans to lift it to 5,000 a day but we may need more. This is being discussed now on RNZ:

Michael Baker, an epidemiologist from the University of Otago, tells Morning Report that although the shutdown has been very tough on people, it’s the right move from the government and they acted in a nick of time to get Covid-19 under control.

Prof Baker says that as we start to test more, we could see the number of cases rise dramatically.

He said more about testing, may have to wait for the audio.

Minister of Health David Clark is just being asked about this on RNZ,

The Minister of Health David Clark tells Morning Report the government asked the Ministry of Health to revisit their criteria for testing.

“We need to continue to ramp our testing, absolutely, and we are,” David Clark says.

He acknowledges there are valid questions that need answers about testing but that should be directed at clinicians who decide on who should be tested. He is waffling around the question.

He said current testing capacity is 3,700 per day.

Clark is already being questioned about the number of ventilators, he doesn’t sound assured or confident answering but says we have the capacity for about 500 ventilators with about another 200 ordered.

Public and private hospitals have about 750 ventilators between them.

It is a relatively low number per capita – with only 4.7 intensive care beds per 100,000 people compared to 35 per 100,000 in the United States and 29 in Germany.

Doctors have warned if Covid-19 pushes up demand so that 3000-4000 patients need ICU treatment at any one time, current capacity would be overwhelmed.

https://www.rnz.co.nz/news/national/413111/covid-19-nz-sources-more-ventilators-amid-rampant-global-demand

Business and the economy versus the ill, elderly and others

There’s no doubt that Covid-19 will have a very large impact on businesses and employment and livelihoods in New Zealand, and our economy will take a big hit. This will have happened regardless of the actions taken by the Government. It’s debatable what would be worse, doing more or doing less to limit the spread and infection rates.

It is also likely there will be deaths here. There are currently 368 confirmed and probably cases. Many of those will be mild to moderate and are being treated at home. Some are more serious and require hospitalisation.

Even with the relatively stringent lockdown cases are expected to rise for the next 7-10 days (or more if people flout the restrictions on movement away from home).

There is no doubt that without the level 4 lock down there would be a lot more spread, many more people catching the virus, and a real risk of quite a few deaths.  This shows how easily it can spread even with restrictions:

Marist College, Auckland – 18 confirmed cases, 1 probable
Private wedding, Wellington – 10 confirmed cases, 2 probable
Rest home, Hamilton – 11 confirmed cases

Older people and people with existing medical conditions (especially lung or heart) are particularly susceptible to Covid-19, but this is hardly surprising, they are also more susceptible to other viruses and illnesses. Younger people seem to generally have milder symptoms – but they can still spread the virus.

There have been suggestions that the virus should be left to take it’s course, to build ‘herd immunity’. This must accept an inevitable casualty rate – people would die, possible quite a few people.

It has been suggested elsewhere and also here that it isn’t a big deal that old people and people with illnesses might die of Covid-19. They die of other things anyway, Covid will just knock them off a bit sooner.

From Australia Victoria’s first two coronavirus deaths were cancer patients caught in Alfred hospital outbreak

Victoria’s first two coronavirus deaths were cancer patients at The Alfred hospital, and a further five cases of COVID-19 have been confirmed among patients and staff.

Duker commented on this:

Bingo! It seems like northern Italy all over again, the sick people get sicker and the elderly have less chance to recover.
It’s a fact of life and one day it will be my turn.

I’m quite disturbed by this attitude.

It’s a fundamental fact of life that we will all die, eventually.

But it is also a fundamental facet of a decent society that we don’t just do nothing to prevent old and ill people dying of any new virus or disease, treating them as expendable.

We put huge budgets and resources into health care to try to keep everyone alive as long as reasonably possible.

People who get old often live to get quite a bit older after having illnesses.

My father had most of his stomach removed in the 1980s, had a bowel cancer operation in the early 1990s, his lungs were fag fucked with emphysema, but he still had a fairly good life up until 2000.

In the mid-90s he was given a choice of having chemotherapy which would give him a 60% chance of not dying of cancer, or doing nothing and lowering his chances to 40%. He chose not to have chemo because he didn’t want to suffer through the treatment with a close to 50/50 chance it wouldn’t save him anyway. But this was his choice, and I think a sensible one.

If a Covid-like virus had hot the country then and I was given a choice of saving my business (I was a sole trader than) or saving his life I would have chosen his life. I had already changed jobs and moved so I could support him as his health problems increased (just after he had a mild stroke).

I’m sure there are many people who would put people before money in this way.

I think it would be terrible to let Covid-19 spread freely in New Zealand to try to reduce the impact on business and the economy.

I also think it would be misguided. If we didn’t have a lockdown and Covid-19 ran rampant here, as it almost certainly would, there would likely be hundreds if not thousands of deaths and many more hospitalisations. That in itself would be expensive.

If our hospitals were swamped with Covid cases – I presume no one things they should be left to suffer and die untreated – it would increase deaths by other causes because of lack of resources and treatment.

And if New Zealand was ravaged by Covid-19 there is no chance of tourism  recovering, no one would want to come here. New Zealanders would be banned from travelling to many countries. It’s likely exports would also be affected, air and sea transport would be badly compromised, and New Zealand would be an unpopular source of goods.

Internally if the virus was uncontrolled it would also have a major impact on travel and business. Many people would willingly keep away from places and businesses that were a risk to their health and life.

The main difference would not be economic impact, it would be whether the economic and employment was in a well controlled situation or chaotic and uncontrolled.

It’s debatable (and impossible to know) which would be economically worse, doing a lot to limit Covid-19 as we are, or doing much less or nothing.

Regardless of the economic factors and effects, we can’t just treat the elderly and the ill as expendable to try to save a few jobs and possibly (but probably not) keep the economy healthy.

“But the flu’ is trotted out by Trump and some here – but we have a choice of vaccinating against the flu and minimising our risks. We can’t do that with Covid. And because we could potentially die of something else, the flu (more often of complications), of cancer, of heart disease, is a very poor reason to not protect against a new threat.

If I was in a decision making position I certainly would put the health of citizens – especially the old and the ill – ahead of the economy. I back and applaud our Government and unanimous Parliament doing this.

No matter what the financial impact of Covid-19 measures, businesses will survive, new businesses will fill gaps, the economy will recover.

No one recovers from death.

 

Day 2 of isolation – time to ponder our way of living

So far for me isolation at home is easy. I have very good company, and I have spent all days this week working from home anyway, so yesterday was much the same.

I’m enjoying working from home, but after a busy start to the week as clients were busy setting themselves up to work from home and rushing to get payrolls done before closing offices, it was noticeably quieter yesterday. I have other work I can do, but I don’t know if it will last four weeks.

Some messages from NZ First MPs.

A reversal:

Guardian environment editor – Coronavirus: ‘Nature is sending us a message’, says UN environment chief

Nature is sending us a message with the coronavirus pandemic and the ongoing climate crisis, according to the UN’s environment chief, Inger Andersen.

Andersen said humanity was placing too many pressures on the natural world with damaging consequences, and warned that failing to take care of the planet meant not taking care of ourselves.

Leading scientists also said the Covid-19 outbreak was a “clear warning shot”, given that far more deadly diseases existed in wildlife, and that today’s civilisation was “playing with fire”. They said it was almost always human behaviour that caused diseases to spill over into humans.

To prevent further outbreaks, the experts said, both global heating and the destruction of the natural world for farming, mining and housing have to end, as both drive wildlife into contact with people.

I’ve heard others make links between the virus and climate change and the environment and I think it is dubious at best.

Sure if the human population was a tenth what it is and no one travelled apart from walking then viruses and other contagious diseases would spread less quickly and less far, but I don’t think modern humans are any more responsible for naural mutations than past civilisations.

Aaron Bernstein, at the Harvard School of Public Health in the US, said the destruction of natural places drives wildlife to live close to people and that climate change was also forcing animals to move: “That creates an opportunity for pathogens to get into new hosts.”

“We’ve had Sars, Mers, Covid-19, HIV. We need to see what nature is trying to tell us here. We need to recognise that we’re playing with fire,” he said.

“The separation of health and environmental policy is a ​dangerous delusion. Our health entirely depends on the climate and the other organisms we share the planet with.”

Maybe, but 7.8 billion people need somewhere to live and need food to survive.

The Covid-19 crisis may provide an opportunity for change, but Cunningham is not convinced it will be taken: “I thought things would have changed after Sars, which was a massive wake up call – the biggest economic impact of any emerging disease to that date,” he said.

What sort of change? Reversing population growth?

Here from Newsroom: Covid-19 may be just what climate change needs

Big jolts wake us up and force us to act today. Gina Williams looks at how the Covid-19 pandemic might give us the chance to redesign our society to combat climate change.

Things like no cars, no meat, no international travel, no business or commercialism?

Right now use of cars is limited of course, but they help us keep in our bubbles going to supermarkets to get food. If everyone had to walk to a local dairy for provisions it would be much harder to lock down the virus.

Nature has always had ways of checking and limiting and reducing species of plants and animals that grow too prolifically.

Should we just let Covid-19 to knock the population  back? That would be getting back to nature, letting nature take it’s course.

There’s been a bit of idealist opportunism alongside the rapid sweep of Covid-19. Now is not a good time to make maajor knee jerk changes. We are in survival mode. lets get through the next year and then see what we should be doing differently.


But maybe with most of us confined to our homes with a lot less to do this could be a good time to contemplate the situation we and our society become, and to consider better ways of living.

There already seems to have been renewed interest in growing more food at home and cooking and baking from raw ingredients rather than relying on fast food and packets.

We will also have to work harder on relationships. Many of us will be spending a lot more time with a few people close to us for longer than usual.

There could be an opportunity for online nutrition advice and relationship counselling – but perhaps we should be working things out for ourselves more rather than relying on paid for quick fixes that often don’t work for long or at all.

 

Covid-19 up, markets down, down, down

The Covid-19 virus is getting worse in some places, especially Italy but it is also getting a hold in Spain.

And following a bad week on sharemarkets in the last two weeks there are even bigger drops this week, with the Dow Jones slumping.

At the same time oil prices have crashed by more than 20%.

The spread of the virus seems under control in New Zealand for now, but the economic effects are significant with Air New Zealand scaling back operations and many businesses under stress.

We may benefit from plunging oil prices, but our stock market (and Kiwisaver investments) is suffering, and it is likely to follow \world markets down and get worse today.

And problems around the world are much worse, especially currently in Italy where they are shutting down a lot of the country to try and stop the virus spreading.

Reuters: EU seeks to tackle coronavirus as Italy locks down north, prisoners riot

EU leaders will seek a coordinated response to the coronavirus after global markets plunged on Monday and Italy sealed off much of its industrial north, where six prisoners were killed in a riot over curbs on visits.

Joining the global rout, triggered by a 22% slump in oil prices, Wall Street’s main share indexes dropped 7% and the Dow Jones Industrials crashed 2,000 points – which would be its biggest ever one-day ever if there is no recovery by the close.

More than 110,000 people have been infected in 105 countries and territories, and 3,800 have died, the vast majority in mainland China, according to a Reuters tally.

With Italy’s economy already on the brink of recession, bars and restaurants in Lombardy were ordered to close or to restrict entry and maintain a distance of at least a meter between people on their premises.

Major sporting events in Italy, including top-flight Serie A football, will be played without spectators for a month.

This must have a major impact in the Italian economy. And the virus is spreading in Spain.

In Spain, schools were closed in the town of Labastida near Vitoria in the Basque country after nearly 150 cases of coronavirus were identified in the region.

Spain has reported 999 cases in all, most of them in two areas around Madrid and around Vitoria in the north. Prime Minister Pedro Sanchez said it had prepared an emergency plan to deal with the economic consequences of the virus.

It is improving in regions that were first hit.

China and South Korea, Asia’s second-worst-hit country, both reported a slowdown in new infections.

Mainland China, outside Hubei province, center of the outbreak, reported no new locally transmitted coronavirus cases for the second day on Monday, but a top Communist Party official warned people against dropping their guard.

South Korea reported 165 new coronavirus cases, bringing the national tally to 7,478, while the death toll rose by one to 51.

The New Zealand Government is rolling out economic measures.

Beehive: Cabinet approves Business Continuity Package in response to COVID-19

Cabinet today approved the development of a Business Continuity Package to help support the economy through the disruption caused by COVID-19.

The Business Continuity Package includes:

  • a targeted wage subsidy scheme for workers in the most adversely affected sectors.
  • training and re-deployment options for affected employees; and
  • working with banks on the potential for future working capital support for companies that face temporary credit constraints;

As part of the package:

  • The Treasury and IRD have been directed to develop tax policy options in line with the goal of reducing the impact for affected businesses, to support businesses to maintain operational continuity.
  • The Treasury and MSD have been directed to develop policy options to support households to maintain incomes and labour market attachment.

The detail of this package is now being worked through. It will be discussed again at the Cabinet COVID-19 committee on Wednesday, and the Government expects to be in a position to make further detailed announcements next week.

So a bit of dabbling so far.

“New Zealand is well-placed to respond to COVID-19. We have been running surpluses and our net debt position at 19.5% of GDP is well below what we inherited, and well below other countries,” Finance Minister Grant Robertson says.

But if world markets crash they will drag us down, and that could have a major impact.

Newshub: BNZ becomes first major New Zealand bank to predict a recession

BNZ is now using the much-dreaded R-word, saying it’s more than likely there’ll be a recession this year.

“Everyone sort of panics when they hear the word recession,” BNZ head of research Stephen Toplis said. “It’s like the whole world’s going to fall in.

That may be happening now.

CNBC: Oil nosedives as Saudi Arabia and Russia set off ‘scorched earth’ price war

Oil prices fell through the floor in early trading Monday, tanking as much as 30% after Saudi Arabia slashed its crude prices for buyers. The kingdom is reportedly preparing to open the taps in an apparent retaliation for Russia’s unwillingness to cut its own output.

  • Oil prices are down nearly 50% for the year after OPEC+ talks collapsed and Saudi Arabia announced slashed prices in an apparent price war with Russia.
  • With previously agreed OPEC+ production cuts expiring at the end of March, Saudi Arabia and Russia can theoretically pump as much crude as they want.
  • An oil price war will have massive geopolitical consequences, pummeling markets already shaken by the new coronavirus, COVID-19.

Reuters: Wall Street pounded by oil crash, virus fears

Wall Street’s main stock indexes plummeted about 5% on Monday, as a slump in oil prices and the rapid spread of the coronavirus amplified fears of a global recession on the anniversary of the U.S. stock market’s longest bull run.

The energy .SPNY index plunged 18.2% to its lowest level since August 2004 and crude prices were on track for their worst day in three decades as Saudi Arabia and Russia moved to significantly ramp up production after the collapse of a supply cut agreement. [O/R]

Companies listed on the S&P 500 have now lost more than $5 trillion in value in a sell-off sparked by fears that the coronavirus epidemic could tip the global economy into recession.

That report is out of date, Wall Street has got progressively worse through the day, with several trading haalts to try to pause the slide.

At 2:15 pm Monday in New York the Dow Jones is down 7.3% for the day.

The NZX already dropped 2.94% in Monday trading and will be affected by international markets today. All we can do is wait and see what happens.

And all the New Zealand Government can do is try to limit the damage here, but the may be chasing a bear.