Almost five days have slipped by since I wrote that we needed a COVID19 reset. Since then, the infection trajectory has taken off, as I both feared and expected. The extent of the crisis must surely now be starting to become more apparent to the people of New Zealand.
My argument five days ago was that we needed to tighten restrictions across the northern North Island for a period of four weeks to give the vaccine a chance to catch up. Also, we needed to set hard borders at defendable points alongside the existing soft borders in Auckland, Northland and the Waikato.
Somewhere close to Waiouru is a defendable point in the North Island, with associated border points on broadly similar latitudes across the North Island. I reckon there are five or six border points to totally seal the two parts of the North Island. Cook Strait can provide the hard border between the North and South Islands.
There were over 260 online comments on that article and a consistent message from many was that Aucklanders would not stand for another period of Level 4. That may well be the case. But unless infection prevention measures are increased one way or another, then the outcome is inevitable.
What models can tell us
I have my own simple spreadsheet-based models of what lies ahead. They won’t be greatly different from the models of any of the professional modellers. All of the models essentially do the same thing, which is to analyse the evidence from overseas and explore how that might play out in New Zealand under different assumptions of the infection growth rate.
The fundamental of any disease modelling is to work out the reproduction rate of the disease, which can be expressed in terms of an ‘R value’, or alternatively as the compound rate of growth, or even expressed more simply as the doubling time.
Regardless of the specific metric, the fundamental assumption is that growth is exponential until some new factor is introduced that limits spread of the disease.
My preferred approach starts by looking at the rolling seven-day average of new cases to see how that is changing. Seven days is sufficient to provide dampening of the noise, but to still give messages that are timely. I also use five-day averages to pick up trends more quickly. I also look at three-day averages but typically there is too much noise in these to get any clear messages.
The data tell me that the seven-day average ending 14 October is 49 new cases per day, which is 71% greater than the average of 29 cases per day for the preceding seven-day period ending 7 October. Comparing the 7-day period ending 7 October to the period ending 30 September, cases increased 57% from 18 to 29. That number of 18 cases per day for the seven-day period ending 30 September had essentially not changed in any meaningful way for the three weeks before that.
Go back a little further, and the seven-day average dropped from 66 cases on 1 September to 17 cases on 10 September. That was amazing success for which the specific infected communities can take great pride. They certainly did their bit!
So, what we have is that until 10 September we were winning the battle in spectacular fashion once we caught up with the initial circulating infection, then we held the line for another three weeks through to around 30 September although without making further progress, but since then things have fallen apart greatly.
I note that Dr Caroline McElnay said in her 14 October briefing that the doubling time is now around two weeks. But the latest 71% increase between successive seven-day periods suggests it is less than that. Indeed a 71% increase in a week is approximately a compounding increase of 8% per day and this gives a doubling time of only 9 days.
If I do the same analyses but using five-day rather than seven-days periods, then the estimate of daily growth rate becomes 9% and the doubling time declines to 8 days. Regardless of the exact number, it is evident that the rocket ship has taken off.
I don’t want to scare people unnecessarily, and I happen to think that this latest doubling every eight to nine days may not be maintained, even without further community restrictions, as there could still be an element of noise in that. So, I will now be conservative and assume that the doubling period from here on is indeed two weeks.
That would mean that there are five doubling periods through to Christmas. The last two weeks leading into Christmas could expect to have about 1500 case per day. However, if I reduce the doubling period to 10 days, then the daily case numbers by Christmas increase to about 6000 per day. That demonstrates the power of exponentiation and the sensitivity to specific assumptions. The margins between very different outcomes can be very fine.
As the immunity level consequent to the vaccine increases, these numbers may be dampened somewhat. But the numbers are already moving too fast for the vaccine to do all the hard work. As for further lifting of restrictions in the next few weeks, that surely has to be off the table.
Looking at the R number
The most recent estimate provided in the daily official briefings in response to questions has been that the R number is between 1.2 and 1.3. However, that number needs updating using the figures for the last few days. My calculations are that it is currently at least 1.5 and could be as high as 1.7. It is definitely more than 1.3! That means that on average each infected person has been infecting more than 1.3 other people.
The reason for the lack of precision with estimating the R value from the growth in case numbers is that it is necessary to first make an assumption as to the ‘serial interval’, which is the average number of days between when ‘person A’ becomes infected and when the people that they pass it on to become infected. I am currently using estimates for serial interval of between 4 and 7 days, and they all lead to an estimated R value of 1.5 or above.
One of the flawed assumptions currently in the mainstream media is that a 90% vaccination rate is some magic number that will save us, or at least go close thereto. It will not. It seems to have arisen from modelling results by Sean Hendy.
As soon as Shaun Hendy presented his findings that day at the 1pm official briefing, I said to myself that his outcomes can only come from one very specific assumption. So, I downloaded the paper and sure enough it was clear that it came from the specific assumptions as to the R rate, and with this number constant across different groups of the population.
The figure of 90% is great for an initial target. But we cannot stop there. Our Asian population has now achieved over 98% first vaccination rate. The rest of us need to raise our sights.
Immunological naivety
Something that I have seen minimal mention of in the mainstream media is the impact of immunological naivety.
New Zealand, Australia and Singapore all had great success in keeping the virus out during 2020 and well into the first half of 2021. That means that most of us have had zero exposure to COVID coming into the last few months and hence have very poor natural immunity. The immunological term is ‘naivety’.
It is this immunological naivety that helps explain the very high infection rates that have recently occurred in New South Wales, Victoria, and Singapore. We have that same vulnerability in New Zealand.
In contrast, India had sero-positivity of around 68% by late June 2021. That meant that most people had been exposed to the virus with asymptomatic infections and it was this that eventually helped bring their pandemic under control.
A high sero-positivity rate in specific regions of Sydney may also explain why New South Wales rates have declined so much in recent weeks. But that may well change in coming months as the virus escapes to other unvaccinated demographic groups in New South Wales which still have immunological naivety.
The big picture
A key characteristic of the current situation in New Zealand is that most if not all epidemiologists are expressing considerable concern about the current trajectory. That will be because however they tweak their models, they cannot get the models to flatten the curve within current settings.
In contrast, the Government ministers in recent days have been tending to say that the current settings can avoid a health system crisis if we all just try a little harder to be good citizens and obey the current rules. Perhaps the Government has some catching up as to what is now upon us. On the current path, our health system is indeed going to struggle, and everyone needs to think about this.
Right now, in the crisis we find ourselves in, we cannot rely only on the vaccine.
There are of course no easy solutions. Also, there are lags between decisions and effects. Accordingly, daily case numbers within the coming week of well over 100 are probably already well baked in. The experience of Victoria, New South Wales and Singapore demonstrate starkly how quickly numbers can grow.
As time goes by, the range of options and outcomes narrows. It is not going to be nice, but within those constrained parameters, there is still merit in the idea that a ‘stitch in time saves nine’. We do need hard borders and we do need to obey the rules, whatever those rules might be. We need a circuit breaker. At the very least we need to be clear as to the implications of the present path.
*Keith Woodford was Professor of Farm Management and Agribusiness at Lincoln University for 15 years through to 2015. He is now Principal Consultant at AgriFood Systems Ltd. He can be contacted at kbwoodford@gmail.com.
165 Comments
It's not looking pretty, and the impacts will be disproportionately felt amongst Maori and Pacific communities.
And the unfortunate reality is that lower vaccination rates in those communities will make it very hard indeed to get the overall vaccination rate above 85%.
Government is responsible for our current situation. People like Heavy G and his/her supporters taking the mickey out of those of us anti government interference in our lives might want to give that some consideration.
Govt has made you angry, they have put you in your own prison. Told you the only way out is a vaccination. Govt is keeping you there until you obey. They scare you everyday with extreme propaganda.
You now hate those that dont obey.
You hate the women that went north to earn a living ( note the Johns that partook dont get a mention)
You hate the Wanaka couple.
You hate the anti vaxxers.
While you concentrate on them, the govt gets away with not answering questions about He Pua Pua. Or a truly miracle drug that cannot be mentioned. The extraordinary govt debt. Inflation. You know caused by people staying at home and not doing stuff. When you dont do stuff, stuff is not made. What stuff is available becomes expensive. Ta daa. Leaving people locked up with loved ones, they become unloved. Hated. Destroying relationships.
Congratulations for buying into the hate you fullas
You are deliriously funny when you keep trying to defend your choice at any cost, ANY COST… RIGHT?
Well, again, if you follow the science, then you show me your skills to answer this man in an amzing video. And please take careful note of the intro about this man’s qualifications!
https://rivercitymalone.com/health/immunologist-explains-why-covid-vax-…
Yes its pretty shocking. I faced a 30 minute rant the other day from someone who didn't want to get vaxxed but ended up doing it to "Save their business" and now they are very angry because I'm destroying their business because I'm not vaxxed. Nope its the government that are destroying your business by putting up a near impossible 90% vaxx rate target that is NOT REQUIRED and keeping you locked down.
Belle, I have decided a few weeks ago, after reading the letters coming in from typical construction companies trying to throw their weight around and demanding vaccination proof or no access to sites, that this criminally negligent madness has to stop, and has to stop now! I am financially supporting those who now diligently work quietly to take legal action against those who cowardly use any excuse to ‘manage risk’ in the name of pushing vaccinations. I have told my employer that immediate legal action will follow the moment he ask me again for getting vaccinated in order to do my job.
Tonight, I heard another story from a friend working in corrections. A colleague getting the jab 7 days ago, yesterday afternoon he had to be driven to north shore hospital with severe blood clotting, not just in the lungs either… When doctors were asked what they will do about this, after CT scans reveal the entire body riddled with clots, they rush to treat desperately with blood thinning agents. When asked again why this is happening and if they will report this… only silent looks at each other!
I am now outraged that the medical profession is watching the fast mounting evidence but not reporting so many, or making it difficult. If you read and watch the link in my post just above, you will just stop and think, what next? Thank you for being another one of those who will refuse to go away and shut up. We owe it to our children.
Keith,
Came around to your way of thinking not long after your article, when it became clear that contact tracing locations weren't being updated and the vaccination rates were tapering off. The experts whose credibility the government has borrowed in order to poo-poo any suggestion that they may not have been acting fast enough are now in open revolt against them in media channels.
Unsurprisingly now the public are being told it's our fault for breaking the rules, not getting jabbed etc but with no hint of reflection on the L3 change or whether the vaccination rollout should have started much easier. After months of doing the right thing and locking down and getting jabbed as soon as we could, we're now being lectured for not doing enough.
I shudder to think what the decision makers will be saying when the consequences of this flow through. No vaxathon can save us from where we're heading. We're about to find out whether sheer Wellington bloody mindedness is a match for a process of evolution refined over millions of years. I think I know who my money will be on.
The likelihood is that some of us here now - alive and well - won’t be here in 12 months time.
In other words, we’re steering down the twin-barrels of Covid morbidity and mortality.
Anti-vaxxers can suck it up: these dubious individuals are at least partially responsible for the woeful situation now upon us.
TTP
I_O,
This doesn't make sense to me. If Keith and most immunologists are right, then as the health service comes under immense pressure, Labour will, I think, very quickly lose political credibility. If their prime purpose is to get re-elected, then a much harder line with the unvaccinated would surely play well with most voters.
Set a date after which companies large and small can refuse to employ or serve the unvaccinated and if necessary change the law to prevent them being sued. This is a health crisis and must be treated as wartime, during which civil liberties are constrained.
Seems not unfortunately. I heard a journo ask one of the politicians about strengthening the South Island border about a week ago and there didn't seem to be any interest. There is so much focus on Auckland it seems they don't have the bandwidth to think much about the South Island. Perhaps self-interest will kick in and a hard border will be added north of Wellington once the virus is established in rest of the North Island?
Yes, the SI ought to have a hard border with the NI now. I'd then open them up to int'l tourists via CHCH arrival only. Must be fully vaccinated tourists who get a neg test prior to departure. Test them again on arrival and then let them spend their money to their hearts content.
The South Island deserves to get its tourists back urgently.
The government appear to be preparing and comfortable that the case load remains within the capability of the health system to deal with. The change in messaging is also stark. In yesterday's communication, for the first time senior health officials stated directly that for 95% of people, Covid-19 is a mild viral illness for which no treatment is required apart from rest and fluids.
So rather than focus on cases (or even deaths), let our dashboard be the condition of the health system. Auckland no doubt will be a petri dish, but summer conditions will work in our favour. We'll be having a wave of exposure as people are at their fittest, with maximum immunity from being vaccinated in the recent past. Vaccination rates are also very good for over 60s across the board. Are the modellers factoring in vaccination rate by age cohort? The differences in risk between a 25 year old (even an obese one) and a 70 year old are vast.
If a whole bunch of young unvaccinated are getting the virus, with the net result mostly being at home with a runny nose, that's not a society-breaking problem for me.
What you described is what Singapore projected in their well-defined Covid19 roadmap.
As of yesterday, 98.6% of the confirmed cases in Singapore are asymptomatic or with mild symptoms, thanks to their high vaccination rate. And they have managed to suppress the severity rate to 1.1%. However, it has translated to a high absolute number with the increase of caseload. They have 1500+ patients in the hospitals and used up 20% of the ICU capacity (they have prepared 1000 ICU beds). Singapore is a much smaller place than us (730 km2 in total) with more people and it makes a big difference, but I think we need to stay vigilant till we are sure we are OK.
One of my mates is working in a covid ward in Australia. His daily experience is something that the media should be publishing so that people know what the impact is rather than pushing for rapid opening up and refusing to be vaccinated.
What he is dealing with is those who are hospitalised in ICU. Everyone is unconscious and slowly shitting themselves to death (apparently at a rate 3-4 times a typical non-covid patient that is unconscious). There are ventilators but when someone's lungs have completely failed they are being put on ECMO.
https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation
The survival rate seems to be similar to those on ventilators. I gather from my mate's comments that once people go on ECMO they are on it for the rest of their life. Translated that means in the short time he has worked there he hasn't seen any recoveries, but plenty of deaths. This is where NZ is heading right now.
He has pointed out that the typical people being admitted to the covid ICU are typically middle aged men who refused vaccination.
I've got a mate working in a covid ward in Aus too, in qld. Her reports are identical. She didn't think twice about the jab. Now it's mandated for staff anyway. She regularly updates me on who's come in, who's dying, off to icu, etc. Overwhelming percentage are unvaccinated in her hospital (on the gold coast).
I have been following the situation in Singapore regularly. They have managed to keep the severity and death rate as low as 1.2% since they opened up. Meanwhile, the absolute number of hospitalisation is going up fast. They are facing challenges but coping well, and I believe they will be on top of it. Having a clearly defined roadmap and preparing the hospital system prior help them tremendously besides the vaccination effort. My concern is our government is creating this perception that the vaccine is the silver bullet right now, which is misleading, dangerous and irresponsible.
Yes, the communication has been generally hopeless as they have aimed to say as little as possible in the hope that luck and vaccination would bail us out. This allows people to fill the vacuum with assumptions, especially after a year of elimination
They have not yet directly stated yet the truth, which is that without a sterilising vaccine, Covid-19 is more or less a permanent part of life now. So why get wound up with daily case counts? This is also why our scientists aren't doing us any favours with their continuing fantasies of elimination - "if we could just do Level 4 lockdowns for a bit longer".
They are now up shit creek as they have to now pivot to the facts that they have chosen for 18 months to downplay. It's going to be a shock to most people that Covid will be in and around us for life now, regardless of vaccination rates.
My take is the caseload communication is also to prepare us psychologically. All the countries that applied the elimination approach resulted in fear towards Covid19, more or less. Even Denmark still communicates caseload stats to the public but in a much simpler way - I am interested in seeing how China is going to convince an extremely paranoid population to accept the reality in that sense.
I am young and healthy and fully vaccinated, so I won't lose my sleep over Mr C. However, being someone who experienced our public hospital ED a few years ago, my biggest concern is if our hospital system is ready for what is to come. Senior citizens (60+) are hit pretty hard in Singapore even with full vaccination and they rely on the hospitals to help them.
https://www.moh.gov.sg/covid-19
SG MOH has a very detailed daily breakdown. Singaporeans run a 28-day cycle. During the past 28 days, 98.6% had no or mild symptoms, 1.1% required oxygen supplementation, 0.1% required ICU care, and 0.2% has died.
So it is running at the 2020 global average IFR - 'Acknowledging residual uncertainties, the available evidence suggests average global IFR of ~0.15% and ~1.5-2.0 billion infections by February 2021 with substantial differences in IFR and in infection spread across continents, countries and locations.'
Given all the vaccination there one would think the IFR would be lower.
profile,
The paper you refer to by Ioannidis obtains its data from papers published prior toy 14 January 2021. The data itself will have a considerably earlier date cut-off to get into papers published by that time. This is very much pre-Delta and even pre some earlier variants. There is a lot more data now available on IFR rates.
Death rates in many countries now exceed 0.2% of the total population. These population death rates set the minimum IFR assuming everyone has been infected. Given that not everyone has been infected, the IFR has to be higher than this.
The Ioannidis paper has only been cited twice which is indicative that other epidemiologists do not regard it highly, and with good reason. It provides an early estimate which time has proven wrong.
KeithW
Proven wrong? That is a big call to take on Ioannidis! The data is interesting as it was largely pre vaccine. That is the point. Going by the England data his paper is holding up quite well.
'27 August 2021
As of 15 July, Public Health England’s modelling group, with the MRC Biostats Unit, estimated that overall infection mortality rate is approximately 0.096%.'
Hence England had a lower age adjusted death rate in 2020 than the vast majority of post war years.
https://questions-statements.parliament.uk/written-questions/detail/202…
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarr…
Presumably that rate from PHE is allowing for a vaccinated proportion of the population.
It's interesting to look at excess deaths for an indication of the overall impact, and an estimate of IFR in widely infected countries.
Excess deaths in Lithuania and Mexico are around 0.4% of population, India around 0.3%
UK is around 0.17%.
Israel is at 0.06%
Definitely seems to be a trend for lower rates in the places that got faster vaccination.
Profile
Using data from Worldometers, which is drawn from official statistics, the case fatality rate for the UK is 1.65%, calculated as 138,379 deaths from 8,361,651 cases.
This same number of deaths from a population of 68.3 million people gives a population death rate of 0.20%
The IFR (infection fatality rate) for the UK must lie somewhere between these two figures of 0.2% and 1.65%, depending on the assumption as to how many non-reported cases occurred.
If everyone in the UK had been infected then this would indicate the IFR is about 0.2%.
If the UK has managed to identify all cases, and there are no unreported cases, then this would indicate that the IFR is around 1.65%.
Neither of those assumptions will be correct and so the true IFR will be somewhere in between those limits.
USA data calculated on the same basis gives a minimum IFR of 0.22% and a maximum of 2.2%
For Brazil the minimum IFR calculated on this basis is 0.28% and the maximum is around 2.9%.
IFR rates do vary between countries, being lower in countries where the population is predominantly young.
Within these ranges for each country, the IFR depends totally on the number of non-reported including asymptomatic cases. The only way of estimating this is from sero-positivity, but sero-positivity analyses are always likely to pick up lots of false positives. This is particularly an issue in the early stages of population infections when the true rate is low and the error rate, typically from other somewhat similar viruses that circulate in the community, comprises a large proportion of total sero-positivity.
KeithW
Immunological naivety is interesting and makes sense in the case of NZ. I don't know if this describes countries that has exposure to previous SARS outbreaks as there were arguments that SEA countries exposed to SARs had stronger immunity to Covid. Delta has shown that to be wrong. And I agree that the lack of awareness and understanding about the severity among NZers doesn't help us modify our attitudes and behaviors accordingly.
Surely the raw infection number is now less important in the face of growing vaccination rates? The key metric is now hospital admissions and ICU beds used. The only way to convince some people to get the jab is if there is a clear and present danger they will catch the virus, locking down slows the virus but also slows the rate of vaccination.
Btw I think the authorities need to be far more forthcoming with information relating to the location of infections and how people were infected. If certain areas are a red zone people need to know so they can avoid them, waving your hands and saying "North Shore" isn't very helpful. Also there is a vague sense that outside is safe, inside not so much, maybe people need to be told that they should be paranoid sharing a car but less concerned going to the supermarket.
Keith : far from being sad or dismal ... this is indeedily doo great news ! ... Covid has busted out , as eventually it would ... we've had ample time to be vaccinated ...
... let's reopen to the world ...
And , let's get Jacinda off the 1 o'clock podium of Labour propaganda ...
... MIQ hotels for unvaccinated covid sufferers / Hospitals for everyone else who requires them ... sorted !
The media is partly responsible for creating this fear.
For example a few nights ago on One news the presenter (Melissa) said 11 people died of COVID in Melbourne yesterday and 3 of those had been vaccinated.
She didnt say if those people had other health issues or their age.
People like her are fanning the fires.
The fourth estate does not exist anymore. It is simply a money making machine that does not give a toss about real journalism.
Show me one reporter in NZ that has asked any number of critical questions that evaluate the true preparedness of the health system and why it was, and still is not? Or show me one reporter, just one, who consistently (or at all), asked what else could or should be done besides vaccinate?
Seriously, look at Israel instead of Denmark, Norway,Sweden, Florida, Texas & others, and then ask yourself, will be exact the same very soon? I think so. And then what?
In most European countries you need a clear test before you get into a restaurant or hairdresser. And guess what, in even smallest rural towns you get a rapid antigen test result within 20 mins on your sms, a PCR test result on sms in about half a day. No lockdowns required anymore. Oh... you say! Could we perhaps convince the government that large companies who want to import tests on their own accord now because they don't want to wait anymore? No, too hard. But it was oh so easy to approve under urgency an experimental vaccine, no trouble...
A disgrace and we are truly beyond third world in that respect.
IN Europe You're supposed to have a rapid antigen test to get into restaurants hairdresser etc. but nobody is following those rules. I went to a hairdresser, and restaurant last week. Nobody asked for any test because nobody cares, and that's in Germany where everyone follows the rules. I'm off to Poland next week so let's see how much they care.
I’m optimistic and saying Minhealth are still effective at containing subclusters as they pop up.
They currently have a cluster of about the same proportions as Assembly of God, in this case a few hundred in poor housing in Manukau. They contained the AOG cluster and can do it again. Hospitalisations will be fewer as the new sub cluster ages are 15-30 undoubtedly younger than those nearer to GOD.
So all is good although the mental Heath of Auckland is deteriorating.
I take your point and other outbreaks are guaranteed, but likely just the same sort of numbers.
We should fix the housing problems and stop thinking we can reduce ventilation and use Heat Pumps, that probably means more sophisticated ventilation including Heat Recovery systems.
Community Coronavirus is doing good work by motivating the last few reluctant people to be vaccinated, why stop it now? Once it's scything through communities vaccination rates will soar across the rest of the country, at the moment second doses are rapidly catching up to first doses because government messaging is failing to reach many New Zealanders.
Got to get it done now if we want to save Christmas and New Year. I think we should open the internal/external borders to expedite the process.
Almost EVERY NZer has a mobile phone. That's what the EBS (emergency broadcast system) is for... The govt needs to reach as many through that means. Right now it's a lot of fluffy Youtube and TV ads, radio, etc. Basically reaching the same audience who have been reached...
100% agree. We are locking the borders so the rest of the country has time to get vaccinated, but they aren't getting vaccinated due to a lack of urgency.
I'm rooting for the gangs and prostitutes to hasten the inevitable. We need a better geographic spread of cases to put the fear of god up people.
Vaccination and infections are the only ways I know of to increase sero-positivity. And I know which of those I prefer.
However, what high sero-positivity does show in situations where vaccinations rates are low is that a lot of people have had asymptomatic infections. This is likely to be the reason that India appear to be achieving some level of 'herd immunity'. It may also explain the reason that the new case numbers have been declining rapidly in Western Sydney, which is where most of the NSSW cases have been.
KeithW
STOP BEING ALARMIST!
Look at the US, UK, Norway, Israel, Malaysia and India. Delta cases were skyrocketing but just like that, the numbers peaked and plummeted. That's often the case with variants - they may be more transmissible but they burn out faster too...
India at its peak had 400,000 cases a day, now it's down to 40,000. Malaysia had a peak of near 30k a day, now it's down to below 10k. They have had borders and level 3 lockdowns as well.
While it's happening, it seems bad, but it will pass and taper off. Meanwhile, we SHOULD vaccinate as many as possible:
- to avoid future lockdowns,
- to avoid overloading the healthcare system and
- to reduce fatalities (because the ones who die most are the un-vaccinated).
But we do have the vaccine now, whereas the US, UK and Norway didn't before. That's why everyone who can should get vaccinated. Not for the lizard people or overlords or big tech, but to protect fellow Kiwis. What ever happened to the good old WW II-style national pride and caring for your fellow citizens?
It has. A lot of us have said over the course of the pandemic that the only achievement we'd get was to delay or smooth the outcomes over time. Eventually nature and maths prevails.
We might end up with a lower headline death count, but in life-year terms we haven't bought much extra at the population level, because most of the would-be victims are on the way out anyway.
Ironically countries where Covid has been the most rampant, care the least about it now. Life in the UK is more or less back to normal. Vaccine passports quietly dropped after 5 minutes, most people don't mask. Our gilded cage has made us terrified.
Here is Dr Bloomfield this morning
https://www.newstalkzb.co.nz/on-air/mike-hosking-breakfast/audio/dr-ash…
:(
The good Dr is interesting to hear when not interrupted.
The two this morning must be co ordinated? But what of our PM, is she the only one defending elimination. Where is she when needed?
Asked when home isolation might start, Hipkins said: "We're at that point now. If a case was identified out of the cases today who could safely isolate at home, we'd be telling them to do that - particularly if they're asymptomatic."
https://www.nzherald.co.nz/nz/politics/exclusive-covid-19-delta-isnt-go…
This seems be happening in the abscence of our PM. Folded in 2 days, its confronting. Where and how is she now? Its completely over, gone.
This from Luke:
What we are now seeing is the real-time dismantling of the whole edifice of regulations and controls that have governed and sustained the elimination strategy. The pace of the change is clearly being driven by the reality of the outbreak and the continued increase of case numbers.
https://i.stuff.co.nz/national/politics/opinion/126685369/covid19-the-e…
Found her. The PM in Taranaki and ..... talking about Vaccine Certificates.
On Monday, we'll be making decisions again based on the step downs we've talked about, but later in the week is when we'll be setting out what our new framework using vaccine certificates will look like," Ardern said.
https://www.newshub.co.nz/home/politics/2021/10/prime-minister-jacinda-…
We know for instance that in the future, if someone for instance who is vaccinated happens to have COVID, that they're much more likely to have a much more mild or even asymptomatic experience.
So quick everything is bet on the Pfizer. If it works the country to be renamed the Pfizer Archipelago.
Yes, the comment by Dr Bloomfield that they are now putting less effort into finding missing links reflects the reality that the infection is now sufficiently widespread that the MOH focus now is on containment ('flattening the curve') and that elimination if off the table.
KeithW
In the words of Ministry of Health spokesperson a couple of days ago:
"90-95 percent of people who get Covid-19 will have a mild to moderate viral illness which requires no treatment but will need monitoring, usually at home."
Those itching for a bloodbath amongst the unvaccinated might be disappointed.
We don't need hysterical modeling to throw up numbers designed to terrify people. We just need to look across the Tasman and see what is happening in Australia. Real life evidence trumps all these garbage assumptions. NSW daily case numbers are dropping rapidly, as the covid wave naturally subsides and vaccination rates reach 80%. They have already begun to open up. Melbourne cases are still climbing, but hospitalisations and deaths are half that of what was predicted. Covid deaths are 85% lower in 2021 than in 2020. In about 10 days the Melbourne case numbers will probably start dropping as well, as the wave starts to subside naturally.
Its just getting embarrassing to see this Govt floundering, when NSW and VIC Premiers are providing clear leadership. Obviously bereft of ideas or plans, how about Labour simply adopt the Australian plan? No intelligent thought required, just copy it. And get on with it. All this dithering about with Level 3(1)(a) changes is a joke. Hit 70% vaccination rate and then open.
This was bleeding obvious months ago. It's great that we are waking up to the fact that we are not an exceptional country and Jacinda is the opposite of an exceptional leader. The sooner we get it over and done with the sooner we can start being a normal part of the world again.
Young people have had their hopes and dreams torn to shreds. Businesses have been destroyed. Our childrens educations have been severely disrupted. Citizens abroad have been locked out of their own country for years. The extreme housing inflation and a massive national debt will screw the younger generation the rest of their lives.
All of this to give the greedy, mollycoddled and generally ungrateful older generations the time to get vaccinated. I have zero sympathy for what's coming to those older folks turning their nose up the vaccine after what we have had to go through to buy them the time.
I have a lot of sympathy for the people that are vaccinated but can’t get the health care they need due to either lockdowns or the lack of capacity due to COVID-19 patients. I also have a lot of sympathy for businesses that are getting absolutely screwed over. The fact that there is no clear guidelines as to what you can and can’t do regarding mandating vaccination is outrageous. Whatever they choose they are open to legal action. It shows a complete lack of understanding and competence. I’m disappointed but not suprised
It all feels like we have been successful in kicking the can down the road but much less successful in preventing the inevitable disaster that is coming. We bought some time at a significant cost but it doesn’t appear we used the time well. The vaccination program has been slow to start and ramp up. We haven’t really invested in building our capacity to live with COVID-19. This is going to be the key issue over the next few months.
"kicking the can down the road but much less successful in preventing the inevitable disaster that is coming" Sadly it pretty much sums up the way successive NZ Govts have dealt with a bunch of issues - housing, productivity, infrastructure, education and skills mismatch etc etc. Hopefully this situation may give citizens - who get what we vote for - a kick up the **** to think longer term and push our elected officials to do so.
Slowing the community spread is all that can be done now mainly by personally applied restrictions rather than government mandated levels x.
Get vaccinated, stay home as much as possible, put all NZ at 2.5, get businesses back operating, expand hospital icu, and don’t get freaked out by the modellers.
NZ-wide community spread is inevitable. Some provincial cities already have cases not yet officially counted and transmission according to the police and locals.
It's interesting to note that though Singapore have very high cases, serious cases are only 1.5%, ICU admissions around 0.2% and excess deaths 0.1%.
It demonstrates the effectiveness of the vaccine at combating serious effects.
It's now last chance saloon for anyone still unvaxxed. There is a high chance of encountering Covid in the coming weeks and months.
When the virus becomes endemic, lock-downs are silly policy with regards to immunological naivety. Lock-downs better at stopping the spread of sero-positive people than the virus. Lock-downs segregate the population and each time the virus jumps to a new population it kills at the maximum number of people, because there are no sero-positive people in the new isolated population. With less sero-positive people in a population the virus is unimpeded.
Victoria has had the most strenuous lock-downs and movement restrictions in Australia. Victoria has the worst Covid outcomes in Australia.
I just question whether there was ever the genuine opportunity to adequately increase our healthcare response / capacity. We are a low wage economy compared to Australia, UK, Europe etc, which is where many of our medical grads end up.
If we were always going to be blown out of the water by this, which I suspect we were, and if we were always going to have vaccine hesitancy, which I think we were, then is there any better scenario than whats going on. At this point anyone who wanted to has been vaccinated, pretty much with 2 doses by nowish, and if the more recent initiatives are encouraging those on the fence to get off it, then great. We still have low case numbers, the hospitals are still coping, that won't change in the 3 weeks between a fence sitters first dose and second dose now.
I don't know what the answer is as to whether it would have ever been possible to truly "optimise" and control the outbreak in this country, but at this point, I don't want to be in extended lockdowns trying when the truth of the matter is that at some point in the next 6-9 months basically every person in the country will be exposed to the virus environmentally. The hospitals will be a cluster whether its fast or drawn out. If I was a mother of a particularly health vulnerable child, I would start completely isolating now and hope that NZ rips the bandaid off quickly, and that full natural immunity is gained by the population via the quickest path.
Hi Keith I have the r value in the last week of between 1.52 and 1.65 so we are broadly in agreement. Although the impact of reducing restriction is only coming through in the case numbers in the last few days.
Its clear we are at an inflection point or even just past it (inflection points being level 3 where I had r at around 1.2 to 1.4 and last weeks loosening of restrictions further. I think it’s possible if r is at lower end of current estimate and restrictions aren’t further eased that we peak at about 600 cases a day before vaccination reduce r below 1. If r is at higher end of estimate cases blow out.
I come from an engineering background.
James108,
I agree that a maximum daily case rate of 600 is possible, based on very specific assumptions. But the inherent assumptions are multiple, and the outcome number can vary greatly depending on the specific assumptions that are used. There is lots of uncertainty as to what lies ahead, but right now none of the likely outcomes is reassuring.
KeithW
I'm so tired of this COVID bs and the constant fear-mongering by the govt, media and so-called experts, saying COVID will kill us if we don't eliminate it first
We fret endlessly over a virus that has killed only 28 people, and when i say only I mean in context of the other 32,613 total NZ deaths in 2020 according to the stats NZ own website,
28 is not even a blip... thats 0.08% of all deaths it falls into the 'rounding-error' category, R multiples talk about infection rates, but the actual risk of dying is still very low fo the majority of people - especially if they are vaccinated
Meanwhile freedoms are being trampled on, Auckland has been locked down at home for nearly 2 months, small businesses that are the lifeblood of the economy are struggling or simply failing... and there are more pressing tragedies like >600 suicides p.a.
Enough of the fear already... ''what if's", r multiples... are pure fantasy based on flawed theoretical assumptions
Next up we can turn our logic onto the Prison system. We spend all this money and resources keeping people locked up, even though virtually none of them commit crimes while in prison. What a waste!
I work in a patient safety role in a Hospital - I'm worried that if this kind of logic proliferates we'll have to start letting a few errors slip through just to prove we are still needed.
Fascinating. I feel for you being in the hospital setting, have you participated in covid care? What would your thoughts be on two things.
Early treatment of symptoms, before and especially around day 8. This is to avoid patients needing O2.
Engaging with GPs and their obtaining protocols from MoH and their being able to treat symptoms, and early symptoms rather than the wait & watch brief everyone seems to have.
I honestly can’t wait for the answer, but suspect it will not be forthcoming. Your brilliant question is one that the media should have been asking daily and relentlessly at the press conferences. But there is simply not an ounce of honesty or integrity in any health organisation in NZ I believe. Otherwise we would have had the answers to your questions long before now.
Every 90 mins someone in New Zealand dies of Heart disease -- its about the same for Cancer - the 60 billion or so we have spent tackling covid ( or pet projects) in wage subsidies, all the lost income from taxes, could have been better spent buying the machines, training the staff and providing free MRI scans for everybody over 50 - and this would save far more lives with early identification of issues, finding cancers before they become stage 3 or 4 - If you wanted to be vaccinated -- you easily could be by now - lets stop throwing money away at a billion a week and instead spend it on our health system to tackle the LARGEST killers by far -- and many of those are also very preventable deaths!
That was my point above, we are throwing all our resources at something that is far less serious than other issues...
The fear is causing people to think and react emotionally without context
Hence the dismissal and hate comments from people only seeing what they focus on
Time to just forget about lock downs and lock ups, the Delta is here to stay and the only controls and measures should be the vaccine, masking (in public places) and good sanitation practices.
For those that have chosen to not get the vaccination or want to break masking or sanitation rules, let them be.
If they end up sick as, then they have choices - get what they can from the Health system or suffer quietly.
Time to get back to normal operations, business and life.
You are a brave man Keith, after suggesting Aucklanders head back to level 4 last week I thought you might slink off. But no, you defended your position with gusto. And you are back for more. I see opinion seems more in your favour. Sigh.
Just a thought. Do any of the experts, including yourself take into consideration the self isolation aspect. So ok at this point most of NZ doesnt really think the numbers are high enough to be entirely serious about taking care. As numbers increase, people will be more careful, I dont see anyone mentioning this in their numbers.
I mean we the people arent stupid. As numbers ramp up we wont need government to tell us to be careful or demand isolation. We are quite capable of determining risk ourselves. What bothers me is could we be so 'over' distancing by the time the real thing hits....can we sustain distancing and isolation, even if we ourselves know we should ?
I guess my question is this, is human behaviour figured into the statistics these guys come up with?
Edited to say after a reread I thought I might sound a bit rude Keith. I really dont mean to be. I appreciate your efforts here.
Another question Keith. I have a close relative that has turned up with big clots in the lungs. The Doctor has determined it was the jab. The Doctor suggested this person contact the nz adverse events register. I was surprised the doctor put it back onto the patient. Do you have any thoughts on the true numbers of adverse events against those registered. I see as at 21 sept it was circa 70000. I do understand that would include several events per person for some people.
Belle, this may help, although AZ vaccine has caused clots, there is no evidence of this with Pfizer
https://www.medsafe.govt.nz/safety/Alerts/COVID-19-vaccine-blood-clots…
The number of cases of thrombosis reported following vaccination is lower than the expected number occurring without vaccination. There are over 3,000 cases of thromboembolism and more than 10,000 cases of stroke requiring hospital treatment per year in New Zealand.
Lol lower than expected doesnt mean no evidence Dan. Imagine if they had had absolutely terrible expectations. Then lower than expected could still be terrible.
I imagine my cuzzie is feeling terrible right now. But heh no one gives a rats about it. Not a politician. Not the health professionals. Not all those radio announcers and media personalities. On zb this morning they made fun of people who were affected badly by the jab. I wonder how the relatives of that lady that died feel about that.
Look at it this way. With no vaccine, there will be a certain number of people who get blood clots.
The vaccine won't stop people getting blood clots who were going to get it anyway. When thousands get the vaccine some will get blood clots at the same time coincidentally.
Medsafe know the usual number of blood clots over a given timeframe. That is the "expected" level.
Less people have reported blood clots after the vaccine than usually would without the vaccine.
But I guess that's cold comfort to your cuz coz blood clots are no fun. Sorry to hear it, and I hope they come right soon.
Don’t you think with thrombosis being prevalent in frequent travelers, that this reduction should be expected? Certainly with air travel dropping to about zero. Well, if you can use such fortunate coincidence to your political advantage… why not? Good on ya Medsafe! Our trusted source of a single truth… my arse!
Well, if your relative’s good doctor was pressured by the political environment of the medical council showing no reluctance to force uniform compliance to authoritarian policy lead by big pharma supporters, then no surprise he didn’t want to be seen to go against the trend. What I am curious about is, do GP’s actually have a duty of care to report and then keep following up on those symptoms?
Ok, now we have just about pushed the vaccinate or die as the only avenue to preventing death of any type, expect to see them suggest things to help reduce the very comorbidities that people get sick and/or die of as a consequence of catching Covid.
Exercise, especially in the sunny outdoors, eat healthy foods, live in healthy homes that have good indoor air quality etc.
Free KFC and alcohol as an incentive.
Don’t you dare mention the unmentionable. You know, just like all these reductions in illnesses and various statistics… easy to come by when you are not flying, driving, working and be locked in your home… perhaps suicide rates might be up by now though? Or violence, except it is not reported so readily because there is nowhere to go under level 3 or 4! hmm… The one key thing I have started to do now is to financially support NZDSOS and a few others including overseas doctors who now fight in court, without their usual income by the way, to show the ugly and inconvenient facts of this vaccination psychosis.
https://www.medsafe.govt.nz/COVID-19/safety-report-30.asp scroll through and you will find the link to each individual case. Over 70000 now. I had a look at a few. Many in the 10 to 40 range with nasty side effects. These age groups would hardly feel a covid infection. What the hell are the mad vaxxers doing to our youth? Its criminal.
So, 70000 reports from 23000 people, after 5,000,000 doses given.
0.4% of doses are reporting adverse effects.
Of those, the vast majority are dizziness, headache, nausea, sore arm, legargy.
800 serious reports, 0.016% of doses. Or 1 per 6000 people.
1 death, or if you prefer 75 reported deaths. 0.0015% or 1 in 66,000
Meanwhile Mexico, Lithuania, India etc, have excess deaths of 0.3%+ or 1 in 300.
You're welcome to your own decisions, but I know what I prefer.
6535 doctors in NZ have signed an open letter advocating for vaccination, get the vaccine.
https://interactives.stuff.co.nz/2021/10/doctors-for-covid-vaccination/…
In China they test entire cities to see the level of infection. We base our cases on who gets sick and decides to turn up for a PCR test. If you are concerned about virus spread, then you need to have an accurate measure of who has the virus. The virus circulates in the vaccinated as well as the unvaccinated. The unvaccinated will most likely show symptoms, where the vaccinated will probably be asymptomatic. If you are not showing symptoms, then you are not likely to get a test and no one will know you are a spreader.
The government has made people shake in their boots about how deadly Covid is. This is the reality:
The Ministry of Health confirmed the woman in her 90s died in North Shore Hospital overnight on Friday. She had a number of underlying conditions.
I feel you've bought into the fear a bit Keith. I normally enjoy your articles, but this one portrays far more anxiety and dread about a basically pretty benign disease - very old people excepted.
No one under about 60 has anything to fear. And yet we're shutting down our country in response.
I'm angry that my teenage kids are having their educations stuffed up, their sports stopped and their social contact also stopped, so that some 85 year olds with serious illnesses don't catch Covid and get really unwell or die.
6535 doctors in NZ have signed an open letter advocating for vaccination, get the vaccine.
https://interactives.stuff.co.nz/2021/10/doctors-for-covid-vaccination/…
The trouble with trying this type of logic, it just leaves over 21,000 doctors who didn't sign the open letter.
I'm not saying that they are wrong, but if you can get to the right answer using the wrong logic, then you can get to any answer you want without any logic.
How dare you imply that the all doctors who did not sign this letter would disagree with vaccination!!!! The letter is supported and endorsed by the: New Zealand Medical Association, Australasian Faculty of Public Health Medicine, Pasifika Medical Association, College of Intensive Care Medicine, Association of Salaried Medical Specialists, Public Health Association of New Zealand, Royal Australasian College of Physicians, Thoracic Society of New Zealand, Royal New Zealand of General Practitioners, Council of Medical Colleges, Royal Australian and New Zealand College of Obstetricians and Gynaecologists, New Zealand Society of Anaesthetists, Royal New Zealand College of Urgent Care, Royal College of Pathologists of Australasia, Royal Australasian College of Surgeons, Cardiac Society of New Zealand and Australia, Paediatric Society of New Zealand, Haematology Society of Australia and New Zealand, Speciality Trainees of New Zealand, The Royal Australian and New Zealand College of Psychiatrists, New Zealand Society for Oncology, New Zealand Orthopaedic Association, New Zealand Society of Paediatric Surgeons, Urological Society of Australia and New Zealand, New Zealand Association of Musculoskeletal Medicine, New Zealand Clinical Immunology and Allergy Group, Australian and New Zealand Society of Geriatric Medicine, New Zealand Society of Gastroenterology, New Zealand Rural General Practice Network, Royal Australasian College of Medical Administrators, Royal Australian and New Zealand College of Opthalmologists, New Zealand Rheumatology Association, Royal Australian and New Zealand College of Radiologists, Australian and New Zealand Association of Oral and Maxillofacial Surgeons, New Zealand Association of General Surgeons, New Zealand Association of Plastic Surgeons, Transplant Society of Australia and New Zealand. ........ what more of a consensus do you need?
Two things, 1) You need to read the article you link to which states: 'There are more than 6,000 names on this page. All of them are registered medical professionals with the New Zealand Medical Council.' But there are 28,927 registered medical professionals on the register.
And 2, yes I dare point out the logical fallacy that you make.
The question you might want to answer is why did the others not chose to put their name forward in support.? Was it they weren't asked or they were asked but refused to? If it's later, why did they refuse?
It's actually scientifically dishonest to present the data in this manner. It would be more appropriate to say '21% of registered medical professionals show their support for vaccination in an open letter.'
To not present the data correctly as you imply, ie this 21% of medical professionals are speaking on behalf of all of them, actually Red Flags the possibility the data is being presented with a bias that may not be representative of the whole.
I hope these medical professionals are better at diagnosing medical symptoms than they are at presenting data.
If you give up that easy then it further suggests that the data sample is not representative of the whole.
Remembering that there is more diversity within groups than there is between groups.
But as I said in my original comment, the 6,000 could be representative of the whole but by representing only the number of 6,000, it incorrectly implies it is the whole.
6,000 Nazi doctors probably supported Adolph. Keith's article is also garbage. The NZ Covid IFR is 0.1%, as per the uncontested median of 30 peer reviewed papers; Prof J Ionnaidis. As this is lower than the flu, our health system will thus not be overwhelmed.
Our country is sinking into an abyss of authoritarian nonsense. Medical apartheid and control will also just make it easier for our PM to introduce other socialist controls, unless we resist. The UK has 50,000 cases a day with no vaccine yellow stars or over run hospitals. Grow up Keith.
What is indisputable, from the MOH numbers, is that 0.2% to 0.4% of Covid infections result in hospitalisations.
That means covid infections are little more than a normal flu for 99.6% of people.
According to Pfizer’s ARR of 0.84% means the vaccine will only reduce the overall infection rate by 0.84%.
It's obvious vax or no vax most of the population will just shrug it off like every other seasonal flu we've had for the last 40 years.
All flu vaccines target last season’s flu it's effective in helping people in specific demographics but for the general population (99% of people) it is inconsequential.
Initially Pfizer referred to their product as a experimental gene therapeutic (they have since removed any reference to this classification).
It is becoming apparent from the American VAERS system that there are serious side effects from the vaccine in very very rare cases, and there seems to be an especially serious correspondence with increases in heart disease.
Because no long-term studies have been completed or even planned, we don't know what the long term consequences of an unproven vaccine technology are.
Who’s to say if in 10, 15 or 20 years teens today could start having heart problems and other serious health problems, would we even know in 2040 to correlate a spike in heart diseases to a vaccination from 2021?
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