Less than three days ago, I gave credit to the Government for moving ‘hard and early’, in a paraphrase of Prime Minister Jacinda Ardern’s words. I thought there was a realistic chance that the travel restrictions and limits on mass events might be sufficient to hold COVID-19 at bay. I no longer think that is going to be sufficient.
My change in thinking arises because of the increasing awareness I have as to the number of tourists who have still been entering New Zealand in the last week from high-risk countries. Also, there are several thousand Kiwis who, aided by AirNZ laying on wide-body jets, managed to get into New Zealand on Sunday night without being required to self-isolate. I am also influenced by concern that not everyone who should self-isolate is going to do so.
I take note of the Prime Minister’s statement of Monday 16 March in regard to cancelling mass events with more than 500 people. I doubt greatly whether that will make a crucial difference. That group size is far too large.
I also note the Prime Minister’s words about Taiwan, where they have had some but not total success without shutting schools. However, in Taiwan, students at their desks are separated by plastic partitions. Also, it is standard practice for parents to test the temperature of their children before they leave for school in the morning and this data is fed into the school’s on-line database. These sorts of behaviours, and there are others, are profoundly different to how we operate in New Zealand.
There is now a very high probability that within the next week we will see evidence for community transmission. This transmission will have already occurred now, but the incubation takes a while to show up. By then at the very least we need to have all steps in place to press the lockdown button. Even that may be too late.
The real question is whether to do it in the next few days when no one has died or is seriously ill, or wait until we are surrounded by illness and death.
A serious lockdown would mean no schools, cinemas, nightclubs, gyms, bars, shopping malls or church services. Workers in essential trades such as plumbers and electricians would still be able to attend to breakdowns, together with essential maintenance of infrastructure. Office workers could only work from home. Supermarkets would stay open as would pharmacies. Of course, health-care workers would continue to carry out all duties.
The one exception might, at least in the short term, be schools. The social consequences of shutting schools are profound, but that is what much of the world is now doing.
All of the above sounds awful and it would be very stressful. But this is what Italy, Spain, France and Germany are already doing. The USA and Canada are also rapidly shutting down.
As for the United Kingdom, there are frightening tales coming out of the United Kingdom in the last two days from their officials and politicians that the UK Government intends to rely on herd immunity. This means allowing and even encouraging all young and middle-aged people to become infected, with all people over 70 years of age required to stay in their homes for four months while this is going on. I kid you not.
The herd immunity theory relies on the assumption that once enough people are infected and thereafter develop immunity, then the transmission rate from person to person will drop below a level of one and the disease will thereby die out. However, with increasing evidence for very high transmission rates, with each infected person on average possibly infecting between four and six additional people, there is a very high risk that the strategy will fail. This is because the herd immunity may not be effective until as much of 85 percent of people have been infected. In any case, it is not only old people who die from this disease.
The reason the UK is thinking of doing this is because they fear they have already lost the war and have no other option.
If we act quickly in New Zealand then there is a good chance that we could quickly eliminate the disease from our country. But if we pussy-foot around then the UK scenario could well come into play.
If we look at Italy, which let the disease run ahead before bringing in draconian measures, then the death rate is now approaching eight percent of all cases, with this death rate climbing further each day. This is a very different story than was evident some one-to-two weeks ago.
Every other European country is destined to follow the same path as Italy unless they can succeed with their total lockdowns. With hindsight, they have all been too slow.
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If New Zealand goes for a strong control process then everyone would have to self-isolate in family or other living groups. Act quickly and there is a good chance we could eliminate the disease in three to four weeks, or at least be getting close.
Right now, there is a mass flow of Kiwis coming home, all of whom are meant to go into self-isolation on arrival. This is more likely to work in an environment where everyone is self-isolating and hence those who cheat can be identified. In any case, once group events are completely stopped, then the opportunities for super-spreading by any self-isolation cheats are greatly reduced.
By the end of the month these incoming Kiwis will be down to a trickle. It would be reasonable and realistic for anyone coming in thereafter to require approval and to undergo a Government-administered quarantine at their own expense. If Kiwis want to come home, then now is the time for this to happen.
Hopefully the Government is already working on the scenario that I have laid out above. It would come as a shock to most New Zealanders, but community attitudes have been undergoing a remarkable transformation in recent days. If we were to act quickly – certainly before the end of this week – then we may well have achieved freedom from the virus by the end of Easter. The international drawbridge would then have to stay up, but life could go back to becoming relatively normal within the country. I think it is worth a try.
The risks from not doing this are now too great.
*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, and has had a longstanding interest in epidemiology. He can be contacted at kbwoodford@gmail.com
86 Comments
The folly of the self created housing crisis (thanks JK), which has led to multiple occupants crammed into drafty, cold and unhygienic homes and garages will come home to roost.
Throw in a NZ winter and the thought is terrifying.
NZ could yet make Italy look like a picnic.
Yes, then you've mentioned is the one being selected 9 yrs later on? ... given mandate to fix of such rotten issue like you've said. Except? we can see why even avid Nat supporters have to ditch it. We can still eat Lab meat albeit not in a good shape, Nat meat? it's very deadly to consume.
JK denied the problem whilst exacerbating it with his pro immigrant foreign buying. He completely ignored the fate of the poor in NZ just so he and his mates could sell their homes for more profit. Never has a NZ prime minister done such a selfish thing to their own ppl. Then he invented the NZ title of SIR... and made sure he was the first recipient!!! The man should be in prison.
John Key did not create the housing crisis it has been brewing for 30 years. But over crowding does worsen the spread of contagious diseases.
I think it is reasonable though to expect that when NZ has a crisis (like the GFC, Christchurch earthquakes and Covid) that as well as addressing the immediate impact that the country 'builds back better'.
So JK should have used the time the GFC gave him to build adaptive systems so that NZ cities could cope with rising housing demand. But he fluffed it. When the GFC passed. A low interest rate environment, high immigration numbers and a few other factors stimulated a house price boom not a affordable house building boom.
thankfully he managed to keep debt at incredibly low levels - just over 20% of gdp - as opposed to the 100+% that teh UK Japan america italy spain etc all - and left the current government with one of hte healthiest financial takeovers ever - which government can ever say they inherited structural surpluses - growing into the new term!
All means when jacinda announces a 25 Billion borrowing rescue package -- she has the scope thanks to JK -- his financial management of the GFC is lookign better and better every day!
Unfortunately, if National hadn't shut down Labour's original super fund our Superfund would now be worth 500 billion instead of its current 50 billion, and the fact that it has even this much is solely due to Michael Cullen. National's stupidity in this matter has left NZ in a worse position to deal with crises.
this is a very detailed assessment of the real effects of this virus across several countries and uses historical data to "reverse analyse" what was really happening while the official number were being reported.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die…
NZ is in this situation now, where "real" numbers are way higher than reported numbers simply because reported numbers are only the result of testing that only occurs currently in the final stages after the infected persons have been rapidly distributing the virus amongst contacts for several weeks.
It highlights that absolute isolation NOW is the best way to minimise harm in the longer term, that means EVERYONE in any way possible should absolutely minimise all and any social or business interaction.
Anything less will result in a peak that will swamp our meagre resources and result in a much higher mortality rate.
As for Jacinda doing virtually nothing and then claiming she has done as much as Taiwan and "look at them" i am sorry that just is the most ridiculous statement ever uttered. Taiwan rapidly and conclusively did take "Hard and early" action and employed vast resources of technology and communication to get ahead of the spread, and did by that means achieve a reduced peak and thus mortality, Jacinda in comparison did "Nothing and Late"
That link is a great read. I'd highly recommend everyone who had 20 minutes to spare read through to get a better understanding of the risks involved, as well as the solutions that can prove effective.
Too many people right now are saying "we only have 150k infected, its nothing in the scheme of things", while failing to appreciate how exponential growth works.
a huge issue here is that NZ is not actually testing anyone! -- look at tracey martin -- know to be in a meeting and room with someone who tested positive but all we are doing is self isolating not testing -- Our data is hugely incomplete -- we could well have had a hundred of thousand cases -- but if most of these were fit healthy 20 or 30 somethings -- its a cold - got over it -- moved on -
We need to be testing way more people than we currently are to accurately chart the growth patterns
No, NZ is not in that situation because we don't have community spread of the virus.
There's 0 evidence of that to date. If community had been happening for "several weeks" as you claim, we would already have picked this up with admissions of people to hospital and people would have been presenting to GPs and getting tested within the last 2-3 weeks (the criteria for testing people were loosened around 6th March).
Yes it's possible community spread has just started happening in the last 7-10 days and it hasn't been picked up yet. But community spread happening for 3-4 weeks already - which is what the graphs in that article are highlighting - is just not plausible.
You're also forgetting that the social climate NOW is totally different to how it was 6 weeks ago, so if people in the last week or so, or next week, become suspicious that they might have caught coronavirus they'd quickly report it to authorities and testing would be carried out. Also large public events are getting canned every day so the chances of infection spreading quickly amongst large groups of otherwise unassociated people is dropping substantially.
Well.. what about those on holiday? Or those who have been away a year? or two? Ten?
What about those who have been NZ Taxpayers for 20 years.. then went overseas? As opposed to those who left at 18-20 y/o?
In theory, I tend to agree with you... but where do you draw the line?
Honest question: what happens with Air NZ having canned flights on most trans-tasman routes. So we have a family member booked to come home as his Aussie university is all online for the first semester. Was booked to the nearest airport in the South Island, where we would have picked him up. But now would have to get one or two domestic flights from Auckland. How does that work with self isolation?
Good piece. We need to get ahead of events, not respond to them. This means adding containment strategies right now to the existing attempts to 'keep it out', and resolutely tightening the screws in both. Better too hard than too soft. We can ratchet things back when appropriate, but we can never catch up once we're behind.
Agreed -- time to stop all short stay visitors from even entering the country -- nobody coming for 3 weeks or a month is seriously going to self isolate for two weeks - and if they can then their business could probably have been done by skype zoom or some AVL link -
close it now to any non essential travel or returning citizens and hold on tight - longer we keep it out more chance of developing a vaccine - or understanding the transmission better
Just to be clear: you're recommending immediate country-wide self-isolation. It's kind of interesting to think about that in terms of a (then) immediate action on Mbovis, which would have meant no stock movements aside from to the slaughterhouse. It's just interesting to think on how disruptive that would have been. Instead we took a track/trace and test approach.
it is a moot comparison i think. I do not think that NZ government was worried with overwhelmed hospitals for cows. This is not to say that NZ government handled Mbovis competently. Just that comparing Mbovis with this is not practical as the risk parameters are very different.
Interesting comparison Kate. I have read that Air NZ flights to/from Australia are down 80%. So it is possible for NZ our international borders might be an effective fire break against Covid 19.
I think the questions over the next few weeks is will our borders hold? And did we already have community transmission within NZ coming from movement prior to Monday when we implemented a strict 14 day quarantine at the borders policy?
There is speculation supporting each position. Currently we lack proof.
Keith I think is saying as a precaution a temporary further lockdown period is justified, while we assess if there is community transmission in NZ.
I get the feeling we have not implemented any form of track/trace and test regime for this virus. It does mystify me as to why not. That's what I find ironic given we were supposed to have a human infectious disease/pandemic plan. Funny how we implemented NAIT years and years ago for animals. Sort of shows our farming bias. Here's what Singapore did about human infectious disease tracking;
https://www.wired.com/story/singapore-was-ready-for-covid-19-other-coun…
Exactly, Kate. There's no ID'ing, no phone data tracking that we know about, no geo-fencing, nothing except a raft of veiled threats, assurances that already over-stretched DHB's will 'call and check', and other obvious blather. It's a Potemkin Village trajectory: zilch behind the happy-clappy façade....OTOH, I'm no big fan of a Social Credit Score, ubiquitous facial-recognition, Skynet, either. Gotta be a middle path.....
Agree Kate.
There is an inconsistency in this response.
This is still a political response in that they have to been seen to do something, and then framed it 'as having the toughest border controls in the world.'
So when it does get out of control via community spread, then it ain't their fault.
For every 'look at how good I AM' moment, there is a cover story(to be produced as needed) to distance themselves for when the shit does hit the fan
There is some tracking mechanisms being put in place (in a haphazard way) but it doesn't seem to be matched with much testing. My parents live in a retirement village (they are healthy and live in an otherwise normal unit). All visitors to the village must sign in. My parents report much less vehicle movements in and out of the village.
It is a balancing act. We are less than 14 days away from knowing if the measures are working. Most people will have canceled travel plans so it is less likely new cases will be coming to NZ. Invoking harsher measures too early, runs the risk of people getting bored of them and breaking the rules. People will get desperate at some point.
Any tourist arriving from now has boarded a plane to NZ since yesterday has known that they would be expected to self isolate for 14 days on arrival. So could assume that they are intending not to. Or they are just masochists .
Close the border now to all except returning New Zealanders.
We are at best month behind Europe in scale.
Figure out how many tests we can do a day and just do them. Anyone with symptoms matching CV19 can be tested. Prioritise those who have travelled recently then by symptoms. Do the maximum number of tests each day. Just one unknown case located and isolated could prevent hundreds of infections.
MOH Figures now. 14/03 415 tests, 15/03 434 tests (+19 in one day) 16/03 516 (+82 in one day).
Italy 20/02 4 Cases. 15/03 24707 cases.
No tourist is going to turn up and self-isolate for 14 days so safe to assume if they are still coming they aint gonna self-isolate.
Time to put the walls up and say the borders are closed. Next will be restrictions on domestic travel.. which must be close in Australia
Hi Keith, you note that Italy is approaching 8% mortality rate.
When I look at current numbers I see 2158 deaths / 27980 cases = 7.7%
But when you look at it as 2158 deaths / (2158 deaths + 2749 recovered, i.e. a final outcome) the mortality rate is 44%.
I'm suspicious that the numbers being noted as recovered are all over the show though. When drilling in country by country, there are huge swings. Some of which may be explained by the timeline of the virus spreading, but still, it's hard to get a handle on what's really happening out there.
I have been wondering the same thing. When reviewed historically we would obviously calculate mortality as Deaths / Total infected.
But while active, it would appear to make more sense to calculate via final outcome. i.e. Deaths / (Deaths + recovered)
So based on https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda759… total mortality is about 8.35%
Have a read of this. He does an good job of analyzing mortality rate.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die…
I rang the Covid 19 helpline this morning as my husband and I have been suffering from a terrible cough and breathlessness for two weeks. We have not had any fever but I gather that this is now not considered a necessary symptom. After a wait of over an hour I finally got through to someone who asked if I had travelled overseas or been in contact with a known case. As I hadn’t I do not meet the criteria for testing. (They did confirm that fever was not a necessary symptom if you have a cough.) My daughter goes to Otago Uni and says her lecture yesterday was full of students with terrible coughs. She says next to no one is using the hand sanitiser the Uni has put out. I know it’s likely this is only a cold but what if it’s not? How do we know there is no community transmission,as we keep being told is the case, when hardly anyone is being tested? Do we have to wait until hospitals start realising that they have more than the normal number of pneumonia patients coming in? It was all too clear where this was headed weeks ago and the government has been woefully slow in responding - only a week ago Ardern was telling us all to carry on as normal! I work in a retirement village so will not be taking any chances of passing this on to residents but do worry as it now seems to be confirmed that asymptomatic transmission can take place. The retirement village is asking visitors to fill in a form confirming that they are not sick and haven’t recently been in any of the category 1 countries. Otherwise it’s pretty much business as usual with a bit more hand washing. This is a ticking time bomb.
I'd recommend you demand a test once you have chills and/or persistent fever. Meantime, if you have a persistent cough, you could seek antibiotics from your GP - but do phone ahead and explain your situation. How are you to know whether or not you have been in contact with a known case - that's a bit of a dumb question to ask. I'd say, I don't know.
Retirement villages should be on lockdown now - relatives should visit via Skype/Messenger. All staff should be mandatory tested on a weekly basis to my mind and at all times wear face masks to prevent spread. We just need to look at the Washington State case study;
https://www.businessinsider.com.au/coronavirus-deaths-washington-nursin…
Exactly. Or if what you got in the first place (i.e., a throat infection which turns bronchial) was bacterial in nature. It's a guess in the dark, but an overall immune system boost can't hurt. I got what I think was an H1N1 virus when in Hawaii - saw a doctor anbd asked for ABs. He said they wouldn't help. I said I didn't care, I wanted them - and I got them. Along with an asthma inhaler (and I've never had asthma), and codine-based cough syrup and a two week supply of paracetamol. Throw everything at it was my idea. And I survived, came right in about a week.
You could argue that it is all the CCP's fault for trying to suppress the problem in the first place in the name of social harmony. While strict quarantine type measures should be used as appropriate, the authoritarian style of government is not required all the time. There is a difference.
Yeah...ok...that sounds great: https://www.bbc.com/news/world-asia-china-51403795
As of today, there are three countries having the situation under total control.
They are South Korea, Singapore and Taiwan.
None of the them is using the CCP style of response. In fact, Singapore and Taiwan have shown the world how to manage this pandemic in a proactive manner. To be fair, CCP should get praise for what it has achieved, but they are not the only answer.
Eating exotic animal is arguably claimed to be China cultural rights for centuries, once you've observed this RNA covid19 mechanism, who said? there won't be covid20-22? - which all shall borne out from China - No leadership style can ever cure.. the great dear people .. dietary habit.. some old philosopher from there even died from this 'Confuse us' traditional believe... Oh dear strong leader.. lead us away from this.
NZ government has been remarkably relaxed about the virus. With how inadequate government response have been, it will be a miracle that NZ comes out of this pandemic unscathed. There have been at least two confirmed cases who have traveled all over the country before quarantining themselves. It is already a miracle that they have not infected anyone else.
MoH says that since the outbreak NZ has tested a total of 524 cases. I guess a few of those are doctors and nurses and other important people (who are not tested as representative of the population, but because they are crucial to the system)
MOH have reported 524 Tests. Not clear if that is 524 people. Or multiple tests per person. Someone should ask them at the next press conference. They stated early March that they could do hundreds of tests a day. So why didn't they just test anyone with matching symptoms? Worst case they get hundreds of negative tests. But they could refine techniques to get faster and better at testing. Because there is a good chance they will need to be testing at that level in the near future.
3 more cases today. All traveled in NZ before being quarantined. The level of testing is a complete JOKE! People coming from overseas should be provided with protective gear to reduce the likelihood of infecting others while travelling in NZ to their quarantine location. A miracle that we do not have more people that 11 so far. In South Korea one sick woman infected so many and things got out of hand so quickly! Almost too good too believe that NZ is spared.
However with only 524 cases tested, how do we know? The system is already overwhelmed. They do not say how many people have been tested after calling the dedicated health line. So people who are sick are simply not even tested.
To be absolutely honest with you, the level of testing that the government has done, is what I would have expected from a poor country with no resources. Once again NZ health system prove itself as too slow, too stingy and too unaccountable.
Dr Campbell
From flattening the curve to stopping the curve, a la Sth Korea.
Cases in France doubling every 3 days.
https://youtu.be/WOSwYGhmnwo
And
https://youtu.be/EuWo5lmWuZI
Thanks, Keith. Regarding Taiwan, I watched an interview with their Vice-President recently. According to him, Taiwan has been preparing for this sort of event in the past 17 years, since the end of the SARS saga. Taiwan got hit hard during the SARS outbreak, they learned the lesson and put a thorough plan in place.
Keith what do you mean by 'we could quickly eliminate the disease from our country?' For how long?
My understanding is that 'Flattening the curve' does not mean eliminating anything, but controlling the rate of infection so our health system can cope, and that in time we get herd immunity.
The UK were criticized because they were going to try and achieve this by community spread. Although I think they have just changed their mind on that.
However, as quoted by Dr Siouxsie Wiles regarding UK's au natural attempt at herd immunity:
'University of Auckland microbiologist Siouxsie Wiles is also horrified at the thought of attempting herd immunity without a vaccine.'
The point is the virus will come through the population at some stage if we ever are going to be part of the real world.
Thus the goal must be to control the rate of infection within our ability to treat those that have it and to continue that until we have a vaccine that will give us herd immunity.
The FDA has just announced a trial vaccine is being tested now but it is at least a year away from public availability if it works.
So what this means we have at least a year of lockdown before we see any change. And that is without the possibility the virus could take off via community spread.
I'll say that again, 'at least a year of lockdown.'
Yes that is my assessment too. 2020 is a write off for the whole globe. Lockdowns of various descriptions and effectiveness will be everywhere. Sometime hopefully by the beginning of 2021 a vaccine will have gone through the following process;
1. Invention,
2. Testing,
3. Production and
4. Administration
So that population groups gain herd immunity.
Only after NZ achieves herd immunity will the health emergency response be over and the rebuilding phase (building back better) then becomes the dominant issue.
Without hyperbole: at least 200,000 NZers will die in the next 2 months if nothing is more is done.
If the borders are fully shut today and there is at least a 3 week full social distancing shutdown we can probably keep cases under 2,000 and deaths minimal maybe under 50.
Statistically there are probably already 500 plus unknown cases circulating in the community.
Dithering is costing lives. Do the math. Action on health not economics is needed right now.
Do facts matter anymore?
Current Cov19 fatalities are 7,158 of which 5,384 (75%) occurred in just two countries, China & Italy.
Global totals are 23.4 per million population while the outlier Italy has 462 & China 56 per million.
Consider that between 291,000 to 646,000 people (from 47 surveyed countries) die from respiratory complications related to the flu each year (Lancet Dec. 2017).
What's that mean for us?
The probability for NZ likely ranges between the global average & the worst case, i.e. 117 to 2310 fatalities.
For perspective, in 2017 NZ recorded 33,342 deaths with the big killers being 9330 cancer & 6000+ for heart disease while it's estimated to be around 500 for flu.
Unless I'm missing something Cov19 is nothing extraordinary.
However, we are expected to believe this flu is the cause of our global economic malaise.
Over 6 trillion of share market dollars lost & blamed on it, $139,000,000 per fatality, so far.
Finance & banking in disarray.
International trade collapsed.
Entire industry sectors decimated.
GDP free-fall
Travel & freedom curtailed.
Tax payer funded government bailouts being rolled out.
No doubt much more to come
Might the cure may be worse than the bite?
Fear is way more contagious & damaging.
Keep it real!
Yes facts do matter, especially the comparison of.
Fact. Don't compare rates of a couple of months, with yearly figures. It's far to early to extrapolate. If you are worried about the expense per death, then you will be less worried when it the death toll goes up, otherwise why the comparison.
Fact. The Spanish flu also showed low mortality number in the first few months as did the first world war. But look at how that comparison turned out
The economic death we are experiencing is just symptomatic of how unhealthy our financial system is. It's the equivalent of morbidly obese person. Its financial immune system is highly compromised.
If it wasn't coronavirus today, it would have been something else next week.
Just one more (coronavirus) wafer Mr Creosote
Ministry of Health Media Release today. Our current capacity is 770 tests for COVID-19 each day and we expect that to be around 1500 per day later this week.
Same Media release. Completed test so far this year 571. As of yesterday 514. That is only 57 more tests over a day. Meanwhile anecdotal reports all over the place of symptomatic people being refused testing because they don't meet the criteria. WTF.
Rubbish. Life will stop, terminally, for many people if this advice is not headed. To the extent that many of these deaths can be avoided (I.e. those that result from a collapsed healthcare system), we owe it to ourselves to pull out all the stops. I’ve essentially lost my job already, but I understand why, and I can live with it.
Another ignorant and completely uninformed comment. No-one is suggesting isolation for 18 months. To achieve a manageable series of peaks, you need certain restrictions to be used at certain times - now is the time for complete lockdown until we see the magnitude of the first wave.
Liked Keith optimism, except? what happen to the whole world? countries that on series of catching up on the full lock down? - Now, we can seems started to comprehend that world is one fluid interconnected systems, we dependent each other on this little blue ball.
By way of contrast.
Singapore.
https://mobile.twitter.com/MsMelChen/status/1239604019460558848
In spite of MOH boasting in early March that they had the ability to test hundreds of people per day. They have failed to report so far any day where they have broken double figures for tests. Now, it is reported in the media that they have 500 tests underway as of today. Are there suddenly 500 new people in the population that match the symptom profile for CV19? Or have they only just had the testing capacity come online. Either way, this is scary. I hope all of those tests come back negative. But if they don't?
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