Written By:
mickysavage - Date published:
8:42 am, April 20th, 2020 - 172 comments
Categories: greens, health, jacinda ardern, labour, nz first, uncategorized -
Tags: covid-19, Covid19
Big day in politics today. Do we stay at level 4 or do we ease it up?
If it was up to me I would extend it. The new infection rate has decreased rapidly and is at low levels. If elimination is the goal however then the daily infection rate obviously has to hit zero. And I defer to and am happy to by advised by the exerts.
And the problem is that the Government is not quite there in terms of its announced conditions for easing the lock down. From Derek Cheng at the Herald:
… the country’s top health official has conceded that a key measure in determining whether New Zealand should come out of lockdown is a week shy of being “gold standard”.
Director General of Health Ashley Bloomfield revealed that work was continuing “at pace” to improve contact-tracing, even though Cabinet needs robust information for its decision today about whether to ease or extend the four-week nationwide lockdown.
But Prime Minister Jacinda Ardern said the work didn’t necessarily consign New Zealand to the fate of an extended lockdown.
“Don’t read into anything,” she said when asked about the possibility of a longer lockdown due to the ongoing work on the national contact-tracing system.
Contact-tracing, however, remained one of the crucial factors she listed among the key criteria for today’s decision, which will be revealed at 4pm.
Other public health criteria for the decision include the level of community transmission – where the origin of infection is unclear – the amount of testing, border restrictions and the capacity of the health system, including ongoing access to personal protective equipment.
Other key factors Ardern identified were the impact on the economy, the public attitude including people’s and businesses’ willingness to comply with alert levels, and the Government’s ability to work out, communicate and enforce those restrictions.
The portents are good.
But we run the risk of a bounce back of cases if reinfection rates increase.
Also with the greatest of respect the Government has not handled the education sector issues well. The message is far too confused.
This guest article by School Principal Kaye Brunton in the Herald is rather chilling. Particularly where she says:
I think that one of the things that has made New Zealand’s Covid-19 response so successful thus far has been our trust that the Government, and particularly Prime Minister Jacinda Ardern, has had our backs.
Until now we have had the sense that we have been doing this for the greater good and that we are all in this together. That has been at the heart of the Prime Minister’s moral authority to lead us.
As an educator in a tightly-knit low-decile community, I’m immensely concerned about the contradictory and shifting advice on alert level 3. I worry that it puts this goodwill, and the successful Covid-19 response it has driven, at risk.
Not only in that it makes no sense to allow dozens of bubbles to mix at a school — while police will break up groups of adults if they congregate — but also that the cut-off point for this policy is conveniently matched to the age at which children can legally stay home alone. This clearly suggests it is not an education-related or a public health measure, but a plan to get parents back to work.
At least half of our teaching staff are immuno-compromised. Many of our students come from families with immuno-compromised family members (including me, the principal). It simply feels incredibly risky, and the latest “class bubble” approach doesn’t seem much more satisfactory.
Opening schools at level 3 so that parents can return to work while there is still a risk of infection seems to be far too risky. And as Kaye points out the potential consequences for poor communities are worse than for wealthier areas.
Alert level 3 rules that force some families to put their lives on the line, while others are able to stay spectators from the safety of their bubble, are not equitable.
Meanwhile the Financial Times have again praised Ardern in this article titled “Arise Saint Jacinda a leader for our times”.
But the article clearly highlighted that there were ongoing issues particularly with education, issues that have been acknowledged by the Department particularly in this passage:
This is a big complex project that is being undertaken at pace so we know it will take time to get it right.”
We do need to get this right. Which is why I think a further extension to the lockdown is the right thing to do.
The server will be getting hardware changes this evening starting at 10pm NZDT.
The site will be off line for some hours.
I have to agree – having kids go back to school is not going to work. I think a lot of parents won't send them back – especially if they have to travel on public transport.
South Korea had a second bump and so has Iran (if you trust their figures); and Japan are in the upswing of a second bump. We need to get it right.
On stuff I saw that they have a link to an online petition to stop schools re-opening.
https://www.change.org/p/teachers-no-school-or-ece-alert-level-3
I think a lot of parents won't send them back
Parents are not supposed to send them back if there is an adult at home.
But it leaves people with the choice of a) earning income and sending their kids to school or b) not earning income and keeping their kids at home.
No it dosen't
The subsidy was for 12 weeks. Workers are covered.
Something is not quite right about the graph for Australia. On a number of days they have had fewer new cases than New Zealand. On the Worldometer, yesterday they had 26 new cases and NZ had 9. Australia clearly has substantially less new cases per million than NZ, and has been like that over the last 10 days.
Which is why I favour going to Level 3. If it works in Australia, why not in New Zealand?
Kirsty Johnston explains: "
Covid 19 coronavirus: New Zealand vs. Australia – do we really want to be like them?
The takeaway section includes:
…
Read the title of the chart. It explains it quite well.
That is because it is a 7 day rolling average that is designed to even out reporting changes. In this case Aussie have had large numbers of people coming off cruise ships with confirmed cases.
BTW: cases per million is effectively useless as a measure in epidemics. The reason is because a single person can trigger an outbreak. Have a look at the Bluff wedding or the Marist school outbreaks to see what that means.
In an epidemic there are basically three things that count. The infection rate (R0) and its potential to cause outbreaks, the ability of an outbreak to overwhelm treatment resources, having effective preventative or medical treatments, and the issues of co-infections of other diseases when people have depressed immune systems.
Since we have no effective treatments and aren't likely to get them for some time, and this is highly infectious disease because of its behaviour, and has a high proportion of victims requiring extreme medical support – outbreak potential is the only useful measure.
In the aussie case, they have far more unexplained cases – which points to wider spread community transmission.
I really wish that some of the current critics would go and read some really basic material of epidemics. I got this in my technical training as a army medic 42 years ago. For obvious reasons, military forces are very susceptible to epidemics. It hasn't changed since then
At least then we won’t have dumbarse observations like your one.
Usual insult from you Iprent. Typical.
You can't seriously suggest Australia has a whole lot of unknown cases, not when they have a higher testing rate and better contact tracing than New Zealand. In short there is no more likelihood they have undetected cases than NZ. The death rate of the two countries is virtually identical. They do have more in hospital, but that is probably due to different admission criteria that NZ. The death rate is the real comparator since that can't be fudged.
Are Australia reporting the same number of probable cases as NZ? Different countries have different definitions. As you say deaths are probably more reliable, but has very high standard deviation due to low numbers. (NZ's deaths are mostly from one dementia unit and includes some where were "Do Not Resuscitate").
Also Australia expects to maintain their current settings for months (perhaps years). NZ plans to rapidly eliminate the virus and then open up. The tighter the lockdown the faster that can happen.
Ummm I'll repeat what I wrote further down…
What complete rubbish. The time from infection to deaths with adequate medical attention is usually about 30 days. So as an indicator it only points to what things were like 30 days ago.
Relying on trailing indicators if just about the worst possible way to make decisions in anything – but especially epidemics.
//—
And I’d add..
The average time from infection to breathing crisis that would trigger a DNR appears to be about 14 days.
Still a trailing indicator and not particularly relevant for forward indications or cases or deaths.
You only have to look at Singapore (curving up again) or South Korea (getting another wave) or even the early calls of being in control in Italy or the US or anywhere else (apart from Taiwan)
I'd be wary of using death rate as the most reliable indicator. In both New Zealand and Oz it's a very very small number, and therefore easily influenced in either direction by cluster events or lack thereof.
Use the hospitalisation rate.
According to the Australian ministry of health, the hospitalisation rate in Aus should be betwee 2.2% and 0.8% depending on how effective their social distancing methods have been. It's currently around 7%.
I'm always intolerant of stupidity. And your comment was a good example of that.
The current gross testing rate is pretty high – it has ramped up over the last two weeks. And yes. I see the ScoMo is hyping that like crazy after they had a very slack start.
However if you look at the testing rate over the whole period in Aussie, you'll find that it has be both slow to rise, and is particularly spotty in terms of coverage. Part of that is a direct consequence of their federal system and the consequent lack of coordination because of differing objectives (the school lockdowns vs jobseeker federal budget saving being the most obvious).
Basically what I was rubbishing you on was the same thing.
Looking at gross figures and failing to look at the crucial detail is just being a dumb-arse. For instance that outbreak in north-west Tasmania aged care facilities was a clear structural failure of both testing care workers and the need for care workers to jump around like yoyos because they need to hod on to too many jobs.
What complete rubbish. The time from infection to deaths with adequete medical attention is usually about 30 days. So as an indicator it only points to what things were like 30 days ago.
Relying on trailing indicators if just about the worst possible way to make decisions in anything – but especially epidemics.
I'll bet that Farrar came up with that. It reads like a numerical illiterate talking point.
Compounding your insults I see. Again typical.
As is typical of you, you don't know how to conduct a reasonable debate. The points I was raising are perfectly reasonable, and don't require the level of insult that you seem to think is OK.
Frankly if you took that approach in any meeting that I have ever been involved with, you would be asked to leave the room, by whoever was running the meeting.
I'd point out that so far you haven't dealt with a single objection I've raised. Something that you seem to have had a tendency to do on this topic.
If the points that you raised were perfectly reasonable and arguable then you'd explain why the points I raised to explain why your points were so much crud would be easy. But you simply haven’t addressed any of my points as I have with yours. You have just diverted on to another of what I consider to be worthless points of illiterate spin.
Discussion and robust debate is a two way street. It does not consist of sprouting what others consider to be spurious diversion talking points that bear no relationship to reality, then refusing to answer objections to them. Discussion and debate is simply not a broadcast medium.
It certainly doesn’t mean that you can avoid robust debate by simply proclaiming insult. That is a dickhead troll move.
Perhaps I should start discussing your behaviour in further depth?
God fucking help us if the knee-jerk Nats were in power.
Talking of DPF he has a post up on his experiences being tested for COVID-19
https://www.kiwiblog.co.nz/2020/04/pretty_damn_good_testing.html#comments
That is good to hear with the turn around. But it was in a pretty urban area.
I'd love to see some figures on the mean, median, and divergence of times for testing by area/DHB. It'd give me more confidence in moving to a level 3.
The worrisome thing when you're looking at offshore trends, where there haven't been strong lockdowns, is the clear way that the the disease progresses out of the urban areas to the suburbs and then to rural areas (the latter is more a nascent trend than strong at present).
The key to containment with no vaccine and no effective treatment is testing, and that requires fast testing responses throughout the whole country. Which gets a bit hairy when you're looking at our provincial towns with their small testing and medical capabilities, and the long trips to alternate facilities.
I usually use Invercargill and its single testing facility (last I heard) as an example. Next facility is probably Queenstown or Gore if you're lucky – all at least 2 hours drive away.
And people can literally go from semi-ok to dying without ventilators in a couple of hours based on the reports from Italy and NY.
“The death rate is the real comparator since that can’t be fudged.”
Actually there has been a lot of uncertainty around the covid-19 death rate in some countries. Some only counting deaths in hospital etc. And for example, Ecuador
Wayne,
According to the worldometer, NZ has done more testing per million than Aussie
Tests per million NZ = 17,897 Aussie = 16,510
The contact tracing app in Aussie is voluntary and many don't want to take it up because of 'big brother' fears, am not sure how accurate or well covered their tracking currently is do you have info about it?
All I know is that they are lower than Singapore, and Singapore only had an installation rate of less than 20%.
https://www.newscientist.com/article/2241041-there-are-many-reasons-why-covid-19-contact-tracing-apps-may-not-work/
Ummm. Looks like that online article has been updated since I last read it. It stated 17% in Singapore 3 days ago.
Wow, thanks for that info that is a small uptake.
Maybe the uptake is related to how much people trust Scotty from Marketing.
Probably also because younger Singaporeans cellphone users are intensely aware of distances for RF generally. At least that was my observation when I spent 5 months there in 2018.
I never had to explain the 32 foot rule for conventional bluetooth, or what difference BLE made, or what ver 4 or ver 5 bluetooth meant. All I had to do was tell them the spec for bluetooth, wifi, NFC, and even some of the more industrial protocols for engineers and they’d figure out how they could use it and what the limits were.
It was kind of freaky compared to here – where I seem to continually tell people why they can’t get connected.
They live on their phones to an extent that makes kiwis look lackadaisical. I think it comes from their much greater use of MRT usage (rail system)
Thanks for sharing Iprent, how fascinating. Singapore locals sound like they are extremely tech savvy with their devices. That would also make a difference in the uptake of an app, being able to understand and 'drive' it.
And even they aren’t in to it judging by the numbers.
Personally I’m down with just a piece of paper and a pen at the end of the day 🙂
I suspect it is because they know their devices and their capabilities.
Personally I started to think about what would be required to make a useful app. It’d be hard to build something useful. Bluetooth and BLE broadcasting isn’t easy to code or make reliable contacts between phones. They’d have to do it at the layer of permanently running bluetooth scans, and interrogating the mac address. That is ridiculously expensive in battery time. Has a lot of issues
If they used GPS and uploaded that to a server it’d be easier. It has a res about 4 metres in the open when you leave the chip running. Doesn’t use nearly as much power as BLE.
But GPS isn’t available at even a moderate resolution inside buildings. Think 16-32 metres inside metal or reinforced concrete, and usually 2D signals rather than 3D. That makes building levels hard to figure out.
I usually put GPS receivers by windows when developing for that reason. Not to mention that running the GPS aerial and chip all of the time would still be a battery drain. Normally the phones only do read GPS periodically or when you’re looking at an open app using the GPS api.
Not impossible. But also not easy to make useful. But cellphone users are really sensitive about their battery draining.
etc…
But yeah. Not a useful approach. They’re be better off writing an app that just stores the data already collected by phones for longer on the phone. Just pull it off when people become probable cases. That would at least give you a rough track to base interviews on.
Getting a app that on-site contact tracers could suck any available info from phones or make direct notes to the server would be useful.
Any comments on this proposed Covid Card?
It's a dedicated device that just records the ID number of other Covid Cards it comes within Bluetooth range with.
https://www.stuff.co.nz/national/121093089/government-considering-covid-card-for-contact-tracing
edit: link with better info about the actual card:
https://www.stuff.co.nz/national/health/coronavirus/121083996/coronavirus-new-zealand-considering-100m-contact-tracing-covidcard
It'd be better because it is a single function system. presumably using Bluetooth Low Energy (BLE).
But I think that you'd need GPS or a motion sensor in there as well so you could change the broadcast rate when it is stationary. That saves battery life a lot when you code it well.
The key to would be battery life and size.
If it is truly credit card size, then there simply isn't a lot of room for a lot of battery. And it will be broadcasting a *lot* of the time. If it is thicker then more battery space.
The chips will be pretty small. But adding a aerial and some kind of charging jack and associated charging circuitry. sucks up room. I'd hope that they use a lithium-polymer battery and a fast charger.
I'd be surprised if they could make it last long enough for a full active day unless it is rather too bulky to fit in a credit card space in a wallet.
There isn’t enough detail in the article to make a good assessment. And you’d really need to run it past a system engineer. Like what level of water proofing – like when people go running and sweat on it. Drop damage.
Better idea than a phone though. You’re not cutting into something that people buy for a different purpose.
Wayne Australia spends 30% more per head on healthcare .National reduced health spending by more than 10% per head of population over 9 years.
The seven day rolling average has been updated on the Graph in the article. See
https://www.ft.com/coronavirus-latest
It now has NZ well below 10 cases (NB Confirmed cases not including probable).
Great trend but I agree one case can cause a "V" bounce very easily.
@Lprent – Is there anything you haven't done?
Yep. Damned annoying that I'm probably not going to get time to do them either.
Been wanting to spend a summer season working in Antarctica since I was 20 (ie 40 years ago). But I've always been too busy or network addicted to do it. Now I'm probably too old and potentially medically unable to go (blasted stent).
Want to do some of the newer (ie put in after 1990) tracks in the South Island. But my right big toe won't allow me to do them unless I can use a mountian e-bike and a power jack every 30km or so.
Always wanted to do some gliding. But never carved out enough time to do it.
But I'm a sort of workaholic where work is defined as both being employment and play. I am seriously fast reader who is always starved of enough to read. And I have a naturally retentive long-term memory (and a bloody awful short-term one).
Not sure how you can say cases per million (or per capita) is useless in an epidemic. It is the only way to make a fair comparison between countries as to how they are performing with the epidemic.
Absolute numbers are important for each individual country, but when making a fair comparison between countries it is difficult to do it any other way with out per capita measures.
The circumstances between countries are pretty meaningless because they depend too much on on the circumstances of the country. And you really have to specify what in the hell you're trying to achieve with the data. If it isn't just simple minded dimwitted Trumpian style point-scoring, then I'd expect a statistic would be of use for helping make policy decisions about the best way forward….
So lets look at this on that basis because "fair comparison" would have to be described as a totally useless reason for gathering statistics. It is the rough equivalent of comparing dick sizes rather than the effectiveness of actual performance.
This isn't hard to figure out. Just for instance (and there are many of these types of these correlations), COVID-19 affects kids very little and young healthy under 30 people don't get much of an issue.
So that means that countries or regions with large percentages of kids and healthy young people won't compare well on a 'fair' comparison with countries or regions with high percentages of elderly like Northern Italy or where the middle age population has health problems because on inadequate underfunded and effectively inaccessible widespread health care complicated by obesity (ie most southern states in the US – which look like they're going to hit really bad).
Sure, a relative value between states and regions tells you that something different is happening. It simply doesn't tell you what nor does it inform you if the policies followed are worth pursuing.
Since what you're trying to look at is how effective a policy is in realtime to determine which policy to follow and why it is better than another- they're nigh well useless.
The usual way to get around this is to statistically normalise the population – ie dissecting the underlying population into equivalent segments and accounting for the differences and then looking to see what differences the policy makes. Doesn't really work for new disease epidemics because the really interesting places like dense urbanised populations like Northern Italy or New York or Wuhan get so overwhelmed during the local epidemic that statistics are an afterthought to keeping people alive.
This isn't hard to see in history – that is why virtually all epidemics with high fatality rates both modern and ancient only have estimates of their dead. In the case of NZ with the 1918 pandemic, it was an estimate that got pulled out of the available paperwork (death certificates) by a historian decades later. These days computers help. That just means only months later (Wuhan) or weeks later (New York) for deaths and years later for cases.
It also means that the associated information required to normalise populations on cases isn't going to be accessible. People are coming into get tested without a medical record for instance.
And that assumes that the test themselves weren't corrupted by lack of or effectiveness of testing regimes. Think of the useless anti-body test that the UK brought millions of. Or that the first couple of rounds of inadequate swab testing in the US wasn’t directly screwed up by a president more interested in numbers rather than quality control (essentially the CDC made them in labs because it’d have taken too long to change the production lines in their manufacturing facilities for Trump’s presser timeline)
So people who actually deal with early epidemics instead look at what the local responders in other areas say what they did and what worked and the statistics that they can measure. Which essentially is who came to hospital or a testing station to get tested and what the tester was told. For instance you don’t even have to look at the lies people say about their medical history – a high proportion of people almost automatically lie about their age when asked. What techniques worked and what didn’t and the vague ideas about why tha might be.
And as far as I am concerned only a simpleton wanting to manufacture a message for their fellow simpletons would ever look at unchecked and unnormalised statistics and use them for a “fair comparison”.
Historically that someone tries that particular propaganda technique also usually points to a bigot trying to start a pogrom or other apartheid technique to divert attention from their own inadequate performance – Donald Trump being the obvious example or to gain power – Hitler being the obvious one for that.
Here in New Zealand we are including in our numbers cases confirmed by lab test and probable cases. Probable cases are those that returned a negative test but have symptoms and history that make it very likely they have COVID, as well as close contacts of known cases that start showing symptoms that we don't even bother testing and just consider them COVID cases.This seems sensible considering the high false negative rate of testing.
Australia may only count lab confirmed cases. Which would account for their much higher hospitalisation rate, while the other stats are similar to ours.
Yes, Aus stats are confirmed cases.
Aus DoH COVID19 current situation
Thanks for that.
So it's reasonable to infer that while the official stats show NZ and OZ have roughly similar numbers of cases per capita, the reality is OZ probably has a lot more cases per capita than we do because of their tighter case definition compared to our inclusive definition.
Their community transmission numbers look scarily high compared to ours.
Yes I was going to make a comment along those lines – that is the Aussie numbers are solely lab confirmed cases, whereas ours include the numbers in the family bubble (If you have it then you can probably assume that the rest of those you are in constant daily contact with, will have it too). Take for example the numbers advised 3 days ago – 8 cases – only two positive and 6 probable (all within the same clusters).
Every country has a different technique for counting. As you note elsewhere the US statistics are seriously under-reporting the number of COVID-19 deaths by not counting the almost 200 per day increase in the number of people who are dying at home in NYC alone. China recently revised its COVID-19 death toll, and so on.
Further to the above, each State in Aussie have adopted different rules within the guidelines issued by the Federal Govt. I think the State most similar to NZ is WA. It has effectively closed its borders – even to Australian citizens in other States. It is remote. Perth, its capital, is the most remote city on earth. Their COVID -19 cases are like ours almost exclusively related to imported infection from returnees and a Cruise ship now quarantined in Fremantle. The population of the state is more distributed than NZ but the density around Perth is very similar to a NZ scenario.
They are currently in a stay at home regime very similar to what our Level 3 would be. The schools are open for the children of essential workers and vulnerable students. My daughter teaches in a high school and my son-in-law manages a small hospital for the after care treatment of brain injured people. so both are essential workers. That means my g'children both attend school during the school term. In the case of my g'daughter in a school of around 800 students there are around 10 attendees and they work in the same classroom doing the same online work as their at home peers. The same situation at my g'sons school which a large primary of over 1000 students and only around a dozen of the students attend to work in the classroom in online learning. At my daughters high school the numbers are around 30 attendees. The teachers are not idle, they are developing the online lessons and marking and assesments still goes on.
Australian hospitalisation rates are way higher which suggests they are missing some infections.
Yes I understand that – that is for Australia as a whole – but as I try to point out, each state is different, and the one state we should be looking at to give us an indication of how a level 3 could affect us here, is WA. The eastern states were thrown that wobbly with a large number of infections coming off the incubator Ruby Princess. WA initially refused to allow the Cruise Ship there to berth, but the few passengers who have been allowed to disembark, have been effectively quarantined or quickly transported elsewhere to their home states or NZ. Most of their active and new cases are associated with that ship which is still berthed in Fremantle, and the non Australian and NZ passengers still remain on board.
Our new cases and deaths look the same per capita as Australia (the latter on small numbers) but the per captia hospitalisation rate in Australia is much, much higher. Presumably it's the definition of cases but it also could be about who is catching it – once older people start catching it then they start spreading it to older people because retirees interact with other retirees.
Many of the Australian cases, particularly in the Eastern states, are those off Cruise ships which have as a demographic older passengers and few younger people.
https://www.dailymail.co.uk/news/article-8162555/Cruise-ship-passengers-coronavirus-let-treated-Australian-hospitals.html
Including probables is because at best the nose swabs are only around 60-70% accurate, info gleaned from nurses who have been C-19 prepared and accuracy rises to only low 90 percentile when taken from intubation tubes. Good luck with sticking a half metre long swab down somebody's throat in a PaknSave car park.
Stats chat had an interesting discussion about testing and prevalance
https://www.statschat.org.nz/2020/04/19/counting-rare-things-is-hard/
Adrian don't tell trump… he was waving around swabs and qtips at the presser today, claiming they were wonderful and will soon be made in america.
I'm not sure if it is that clear.
And Australia has also been variable by State.
My big issue with level three is the degree of confusion it may engender, and, of course, the schools.
Continuation of level 4 for two weeks then, depending on cases going down and tracing capability, a loosening up of what businesses, and people can do, while keeping safe, seems the best option.
The, economic hit, has already occurred. Can't think of many businesses, and employees, who will be much worse off with level 4, for two more weeks, compared with the very real possibility of having to go back to level 4, if the virus gets away again. If it takes off many people with underlying conditions, or vulnerable households, will have a stark choice of work, and risk infection, or no pay. Including small business owners.
Which is why I favour going to Level 3. If it works in Australia, why not in New Zealand?
Which is fortunate for NZ that you are not part of the decision making.
Look at the reproduction rate in comparison.Local transmission in AU is larger then 1,which says that it is not under control.In NZ it is .89,which suggests that containment is possible.
https://www.abc.net.au/news/2020-04-10/coronavirus-data-australia-growth-factor-covid-19/12132478
0.7 and 0.48 respectively over a 7day rolling average appear to be the current figures.
0.48 was in the press conference today for NZ. Umm can’t find the link for aussie. But it was in the same sets of analysis that the conversation was referencing 3 days ago.
https://theconversation.com/latest-coronavirus-modelling-suggests-australia-on-track-detecting-most-cases-but-we-must-keep-going-136518
That has to be the stupidest comment you have made on this site.
Do you enjoy parading your stupidity and ignorance?
[Check your name in the name field, thanks]
This comment was directed at Wayne at 6.
This is not the first time reply has land my response in unintended places. No I do not think LP is an idiot. I am certain that Wayne is a tragic loser.
[Can you please correct your user name at your client side, thanks?]
That has to be the stupidest comment you have made on this site.
We should do what australia does? yeah Right.
[Check your name in the name field, thanks]
Yes. Agree with another couple of weeks for the reason given.
I tried saying that on Twitter last night and responses were mixed.
One guy was adamant that the conditions were right for level 3 in keeping with the government guidelines on levels. He got several likes. Others agreed with me.
I understand this is likely because there are some people itching to ease their living restrictions. So, if the government extends the lockdown for a week or two, they need to sell it to the doubters.
I'd also like to be able to roam the city and regions like I did before the lockdown, but, shit happens…! Sometimes we just need to suck it up.
Agreed. I'd much rather endure two more weeks of Level 4 than have to scrub everything and start all over again because of a resurgence. I understand the monied interests here in NZ would love nothing better than for the serfs to get back to toiling in the fields and generating the revenue they so adore, but better safe than sorry. (And imagine the outcry if we do go to Level 3 and then experience a resurgence. "Jacinda is the Anti-Christ! She should have known! Why didn't she do the exact opposite of the thing we were all peevishly demanding she do in the first place?! Boo! Sucks! Communism!")
I'd rather avoid that if at all possible.
Also, the photo at the top of the post is priceless. Social distancing equals Communism… how do you even arrive at a conclusion like that without spending your formative years wasted on solvents?
Nah, its just stupid as…
There's a mass of them in the US. Has anyone ever done a thesis on… from whence came America's stupid as?
Well you could posit that their insularity could play a part.
Would be interesting though.
I put it down to a narrowly focused, education system.
Yep. It focuses on America as if the rest of the world doesn't exist. It's visible in their obsession with flag flying. Other countries are happy with one or two back drop flags. The US of A has to have dozens of them. Gotta be bigger'n better than everyone else is their motto. Except this pandemic is showing them up for being a good deal worse than everyone else.
It is more than that.
While Asian countries, not always successfully, have tried to encourage more creativity, critical thinking, innovation and keenness to learn, in their State schools. The USA, and UK, have been heading back towards the utilitarian, rote standards driven, approach.
The rather good State school system the USA had, post WW2, has been decimated, since the 70's.
Back in the 60s and early 70s, my father used to lament that America was deliberately "dumbing down" their Educational standards. I presume the aim was to make the population more compliant.
Sixty years on and…. drumroll… we see the ultimate outcome.
After "the 60's" showed how inconvenient, too much, "critical thinking" could be, to those in power, I suspect?
I think it was a Soviet foreign minister who said, " how is it your people believe your (Government) propaganda, and ours, don't".
My pick, for what it's worth (and I'm certainly not as well informed as Nick Smith [sarc]) is that the cabinet will compromise with a week's extension and then we'll see sort of decision.
But the economy-minded right wing fuckwits will be up in arms!
ditto.
They'll use the attainment or otherwise of this "gold testing standard" not expected to be fully up and running before the end of this week.
Because the Australian Health System is much better funded than the NZ health system.Thanks to Nationals Stinking sinking lid policy from 2008 to 2017. Australia has a better contact tracking as a result.
[lprent: Fixed your handle. Could you check it on your next comment and correct the saved value on your client side. ]
As we await the decision on whether to ease the lockdown, let's check where we're at compared to others:
Here we've included probable and confirmed cases in our counts, many places only count confirmed cases.
We're at 1,431 total known cases 18 of which are serious or critical, of which 507 are still considered active, and 9 deaths.
The worst hit country in terms of deaths per capita is Belgium. If we scale Belgium's numbers to our population, we would have 16,006 cases 454 of which would be serious or critical, 10,114 would still be active, and 2360 deaths.
The worst hit defined large area I've found data for is New York City. Scale their numbers by population and we would have 73,570 cases, 19,614 hospitalisations, and 7,505 deaths. (no split out of active/recovered cases).
I'm kinda relieved to be where we are, and I'd much rather the decision was biased to staying on our current track, thanks very much.
https://www.worldometers.info/coronavirus/#countries
https://www1.nyc.gov/site/doh/covid/covid-19-data.page
AND the lowest state in the US has 3 d per million cf the 2 for NZ
When it takes a couple of hours to get to a medical centre to be tested then it's not going to happen.
If you die at home with covid and you weren't tested then it doesn't count as a covid death in the USA (IIRC).
That's why excess deaths (this years deaths minus last years deaths), rather than covid deaths, is going to be an interesting statistic when the data comes in.
Do Aus count people who die outside hospital, or who weren't diagnosed when alive? Do we?
We certainly do count COVID deaths outside hospitals. Dunno about Oz, but certainly there's other places that don't.
https://www.stuff.co.nz/national/health/coronavirus/121074675/coronavirus-southland-case-nzs-first-coronavirus-home-death
a covid death cannot be counted without a positive test….are all deceased tested?..I suspect not. The UK have been accused of not identifying all rest home deaths in their statistics…they wont be alone in that.
I get the impression the health authorities here are going to significant lengths to ensure all COVID deaths are found and recorded as such, no matter where the death happened. We still have the available resource to do that, because of the early lockdown.
Where the system is overwhelmed, like in Italy or New York or UK, I can kinda understand how determining exactly what caused every death isn't a high priority right now.
Agree there appears to be a desire here to identify all covid deaths possible….that will not be the case worldwide….the statistics need to be read with that in mind.
Saw a statistic today where 1 in every 5 tests in NYC is positive! Now that is real scary. The very air that you breathe…
https://www.theatlantic.com/technology/archive/2020/04/us-coronavirus-outbreak-out-control-test-positivity-rate/610132/?fbclid=IwAR2ExB4yV4opHfn3jJnvjaqwTpaquryxz0r-KIExeUkcjVoGwvOI70J1hYI
Err, re-read it, Macro. That 20% positivity rate is for the US as a whole. New York state is 41%, New Jersey is 50%.
Here in NZ we're around 1 in 55 positivity rate.
Yes – you are right! Even more scary.
Makes you wonder if the 'flattening of the curve' of new confirmed cases and confirmed deaths in USA, is just the increase in new cases out-stripping the testing capacity…
Care home cases and deaths are counted in Oz like NZ. UK and other European countries seem to be just in hospitals, but not consistent stats. As Andre says above, NZ also records cofirmed and probable cases, whereas in most other countries, including Oz, just record confirmed cases, so inflates NZ's numbers a bit.
My wager is on going to Level 3 on the Tuesday after ANZAC Day.
That is certainly on the cards and new case numbers are low. But until we get them down to zero it is still risky …
Aye but the bell curve to measure against is not only the health curve, but the curved sharp collapse of the economy.
Every fresh day of not working people are getting poorer, more people are laid off, more mortgages are under stress …
… and the pressure on the governments' social licence gets more brittle.
Which will be much worse if we go to level three, and there is a resurgence.
The pressure to take of the parachute before we hit the ground, even though it has worked is, in my view, irresponsible.
The effect on business, and the economy will be much worse, if we have a resurgence, than another fortnight of lockdowns.
When to restart schools and ECE, is a particular worry. As any Teacher can tell you, schools are spreading grounds for colds and flu, in normal circumstances,
We have part of our family in business, currently closed due to the virus, as well as money invested, so can understand the arguments behind getting up and running again.
But, the choice has never been, the economy or health. Countries which have favoured, "the economy" have a pile of bodies, young health workers included, and their economies are looking more stuffed, than ours.
We are going to have a high risk of temporary outbreaks over the next year and have to go into temporary lockdowns whether in 3 or 2..
Our economy is according to the IMF going to be one of the most stuffed already. No need to make it worse with a sustained Level 4, when Level 3 is similar and most people get to work again.
The choice is how a government hits a sweet spot in a triangle with three sides:
– Health
– Economy
– Society
Prime Minister Ardern has already stated that the health plan has worked.
It's time to hear about the economic recovery plan.
That's how you sustain the third leg – society.
It's community transmissions that worry me much more than if all new cases were within the bubbles of known cases. If all new cases within the last two weeks were known direct close contacts within the bubbles of existing cases, and we had a mechanism for ensuring the bubble integrity around known cases, then we could comfortably ease up right now. But there was the Whanganui case reported yesterday…
https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12325827
The health risk is miniscle given the current trends re fighting the virus and assuming those trends continue over ANZAC weekend.
Whereas the risk to society at large (eg mental health) and the economy (unemployment et al) increases daily and is huge.
In my opinion its unrealistic to stay in lockdown until we reduce the risk of the disease spreading to around 0%. Equally its unrealistic to expect a 100% eradication outcome.
Getting to zero, may not be as important as the capability to locate and isolate new cases?
I agree. And our capability in this regard is getting better by the day.
Level 3 after ANZAC weekend with a big disclaimer that the move to level 3 is subject to the numbers continuing to improve.
Mine is too – but still with some pretty severe restrictions.
The nightmare scenario will be that we open up to a system where contact tracing gets impossible. That requires some severely limited bubbles.
BTW: I think that the tech solution of phones talking to each other with bluetooth is just daft. Good way to eat a battery and not that useful because of all of the range of potential false positives and negatives errors.
Workplaces should now be in a position to be ready to separate employees and to maintain the attendance 'paperwork'. If they don't then the solution is simple – the police shut the workplace down immediately until the employer explains why and how they will improve..
Hopefully with quite a lot more attention on school and day care operations as well. It is a worrisome area because kids (as always) are the perfect carriers.
At this stage forcing teachers to babysit attendees whilst also doing remote teaching to allow parents to go to work really isn't going to be workable. Everyone is going to wind up doing the online course anyway. All it does is expose teachers and their families, and the families of kids at schools.
I'd certainly be looking to want to know which workmates have kids attending schools, because until I'm sure that there isn't community transmission – they are my personal pariahs. I don't want to be near them.
After 38 years of tuning loops my instincts are telling me this; it's going to be a long slow process to get this one to sit down to zero. Just sitting at Level 4 and waiting for it to get there naturally could take another month.
While you've been scathing of the Australia approach above, the shape of their curves are very much the same as ours.
New Zealand Australia
What these strongly suggest is that Australia is getting a very similar control response at Level 3 as NZ is at Level 4 … based on the confirmed new infections rate.
It is similar. If you exclude that outbreak in Tasmania, it is just running a week or so behind NZ.
If you include the unconfirmed but probables as NZ does, then Aussie R0 would climb much closer to 1.0. The problem is that unless you get the R0 down close to 0.5 across all cases – then the local flare ups can take the local systems by surprise (Tasmania and one of our aged care facilities being prime examples).
Even in a level 4 system those outbreaks can spread a lot wider. So you have to be absolutely confident in your detection and tracing systems. In a level 3, especially the ones where essential workers will be crossing whole states and mixing into much larger bubbles.
You only find out after the fact with a disease like COVID-19 if you got it right because of the long asymptomatic but virus shedding period – usually starting 1-6 days after infection and often lasting up to 12 for the asymptomatic people who don't require medical care.
I wasn't so much scathing of Australia (I think you might be referring to my little argument with Wayne earlier today). I was scathing about comparing apples with oranges.
NZ doesn't have a federal systems complicating responses. There isn’t ANY ambiguity about who is calling the shots here – there are just some idiots who would like to be critics. Nor is there are there any mixed messages about what is expected of people or what the support levels will be like and who should provide it. Consequently there is also a very strong acceptance about what we should each do.
Plus the demographics are different. As you’ll be acutely aware NZ and aussie aren’t very similar despite the accents. And they are becoming less similar as we export citizens that like aussie rules to there.
Aussie didn't have nearly as many tourists as a percentage of the population as we have over summer.
It has a much lower density of population even in the urban areas. But we also don't have those enormous cities either with their hidden outbreak risks either. We just have Auckland.
The effective mobility is way lower because of the distances because many kiwis seem to spend a lot of time outside of their home city inside the country. Especially the more at risk provincial centres with lower per capita medical support.
So we can do a much tighter shorter abrupt lockdown with coherent single focus policies, and expect to come out of it way faster than Aussie is likely to be able to do. We also have a much lower probability of a second and third wave because we took the plunge deeper in the first place.
I’m pretty confident about expecting a shift to level 2 in 3-4 weeks – in essence normal life with border control, travel restrictions between regions, and slight social distancing. But I’m also confident that we’re only going there if there is only a teeny chance of ever infectious wave at level 2.
I’d expect we’ll be back at level 1 after a 3-4 weeks there assuming we don’t see a vector that hasn’t been considered – say about my birthday in early June. I don’t expect normal borders for years.
All of the medical/genetic evidence to date indicates that COVID-19 isn’t like the 1918 influenza – think more like HIV than flu. I’ll now be willing to bet that it just sets up shop in the body once contacted rather than dying out. It seems to act more like an endemic disease than an infection and mutation based disease like H1N1.
It probably repeats faster in a population that it has become resident in because most people seem to get light immune responses if they have mild symptoms – so expect it to come around every 6 months or year. And it will remain dangerous if immune responses get depressed for any reason – like flu, smoking, vapers, drinking to excess, obesity, or simple depression. It is a classic population winnowing disease causing (from the virus perspective) accidental deaths.
Looking at aussie, I think it will be a lot slower to dampen it out, and I’m not so sure that aussies across all states and regions will be as willing as Kiwis to act for the common good.
All good points. I have to note that several Aus states, notably QLD have already gotten to zero new cases.
From a control perspective the characteristics of this epidemic are non-trivial. I may well have blithered on above, but the truth is there's a massive difference between controlling a machine or process, and having to get this right for a whole country, even if some of the underlying concepts are similar.
We have designed worksheets to be filled in every day with medical information, whether they have essential workers in their household, printed in multiple languages, quite detailed stuff. Also we know how every single person gets to work and back. It's really highly managed and enables a very fast trace.
But that's what you have to do if you are going to get people earning for food and rent and electricity again.
I'll try and enlarge on my comment above. A large fraction of my working life was spent looking at time series trend data and trying to mentally derive a feel for the underlying process parameters. I'm ignoring the death rate data because as you say, it's delayed way too much; the one that counts is the new confirmed cases rate because it has the least amount of delay.
However it's also inherently flaky data because it depends on community testing tools that are not consistent between countries and are still subject to quite high false positive and false negative results.
But for the purposes of making a quick and dirty guess it's reasonable to reduce all processes to a simple first order rise time plus time delay model. On this basis I'm seeing a first order rise time of about 14 days and a time delay of 7 days. To make matters harder this is also an integrating process, with a highly non-linear response.
In other words if we dropped from Level 4 to 3 today … and assuming the control action was not already saturated and … it would take about 7 days to see the new case rate change and another 14 days for it to settle out to a new steady state. The trick here is that being an integrating process there is no stable steady state so interpreting the curves is much harder. Much harder.
Many years back I discovered all this the hard way; a steam control valve on a paper machine had a separate safety valve that tripped at a pressure not all that much higher than the operating range. Because it was separate to my system and no-one had ever bothered to tell me about it, I had a very nasty surprise one day when all hell broke loose. When steam safety valves trip, not only does everyone in the mill know about it, the whole damn town does.
The correct response was to slam the steam supply valve (the one I did control) shut at fast as possible. This is analogous to going to Level 4.
But leaving it there until the steam safety valve closed was also a mistake. The safety had a huge hysteresis, it didn't close again (it was purely spring operated) until we'd dropped to under half the trip level. Waiting for that to happen took ages as the steam had a very large vessel to empty. And once you had got it down to this safe level it took more ages to get the pressure back up into the operating zone again. This naturally made the production manager very unhappy, and in a paper mill you don't want to make someone with the nick name 'Smokey the Bear' unhappy.
The machine operators, of course had seen all this before and thought it a hell of a hoot, and casually took manual control of the steam supply valve and then gradually opened it up to 25%, then 40% over a period of time they knew worked. So much for my clever control algorithm.
My bet is (with the caveats around safety and capacity to manage new outbreaks in place) is to go to Level 3 this week for at least another 2 -3 weeks. It's still very restrictive and will tell us several things … is Level 4 overkill (ie saturating the control action) OR if we do see a response, then we will learn some valuable modelling parameters that is relevant in the NZ context that can guide our future decisions.
Sometimes you just have to bump the process a bit more than you’d like in order to ultimately learn how to control it optimally.
I realise this all sounds a bit cold and technical … this virus quietly terrifies me and the human cost is brutal. I have a 90 yr old father whom I cannot visit and I just know how terribly vulnerable he is.
Pretty much. I think I replied above. Those lags in the feedback system are the key with any system like this.
There is a risk in going to level 3 next week. But any outbreak should be containable – if required by putting regional or town levels back up.
There will a risk in going to level 2 in mid-May. But any outbreak will be containable because the systems for constraining it will that much better and we will have the capacity at the control level to drop resources into areas and saturate the tracing.
Level 1 – more in the air. That damn near required only a handful of cases in level 2 and the population doing as much to control level 2 infections as the professionals. In other words when checking for instances of COVID-19 is as natural to us as what most of us oldies do when examining any rash to see if it is measles.
There was a time when the Reserve Bank thought that the entire economy was manipulable by hand upon instrument as your paper factory.
They actually made a machine to illustrate what they do called the MONIAC: Monetary National Income Analogue Computer, and it's still there if you want to find it.
https://www.rbnz.govt.nz/research-and-publications/videos/making-money-flow-the-moniac
It as invented by Bill Philips, one of our best-ever economists, and one with a pretty NZ-type rural hard guy ackground.
A.W.H. (Bill) Phillips was not your stereotypical economist. Born in 1914 as the son of a Kiwi dairy farmer, Phillips left New Zealand before finishing school to work in Australia. His jobs included being a crocodile hunter and a cinema manager. In the Second World War, Phillips served in the RAF’s technical branch and was captured by the Japanese, becoming a prisoner of war. He received an MBE in 1946 for his war efforts. Phillips ended up at the London School of Economics (LSE) and became very interested in Keynesian theory. It was at this time that he built the Moniac machine. In 1958, Phillips published his seminal work on the relationship between inflation and unemployment. He moved back to Australia in 1967, before passing away in Auckland in March 1975.
At the London School of Economics, Phillips was interested in the circular flow of money model. With his knowledge of hydro-mechanics, Phillips realised that he could build a machine that would take the static circular flow model out of the textbook and into a dynamic 3 dimensional setting, by using water to represent the flow of money. Using a diverse range of materials including bits and pieces from obsolete Lancaster bombers, the first Moniac was created in his landlady’s garage. It was built at a cost of £400 – over $32,000 in today’s money.
The machine was unveiled in a seminar at LSE in 1949.
The machine proved popular with economists around the world. More Moniacs were built and sent to four other British universities, to Melbourne University and Harvard Business School.
Training sessions were held as far away as the Central Bank of Guatemala. The Moniac was never a huge commercial success however, as the advent of computers took economics (and Phillips) in another direction.
Still, open a valve here, redirect a fluid here: hey presto economy!
Great story … I recall seeing this remarkable kiwi invention at some time. Is it still on display in the foyer of the NZ Reserve Bank?
The huge conceptual leap that Phillips made was to bring the idea of dynamics to economic modelling. Steven Keen made the point that many economists are not well trained in mathematics, and especially not in this aspect. (Engineers by contrast live and breath dynamics, it's our bread an butter.)
Keen has his detractors but over the years he's put a lot of effort into a fully dynamic economic model that he named after his favourite economist … Minsky. I may be biased, but if ever economics is to become more of a science rather than just a political framework, this is the direction it has to head in.
I think it's still there.
After our May budget and Australia's one in October, both countries are going to increasingly resemble a steam-engine economy.
It's easy to overlook just how effective the 4-level alert system has been. A masterstroke, actually.
In many other countries the talk is of lockdown vs no lockdown. There is a variety of rules (as in NZ) but no overall framework that the people buy into. So the debate is scattergun.
Here the levels have become part of the language. Not only in the media, but people's everyday conversations. Like many things that seem obvious, it really wasn't – until it was introduced.
I agree with you, observer.
One of the most important things about the position we are in is that we have options.
The leadership, to this point has navigated us to a point that they are calling the shots proactively. They are not reacting in a very dynamic situation.
Ironically, the conservative approach has served us well, despite the whining from conservatives.
I also agree. That they took the time to set the system up and introduce it in ways that meant we were prepared on lots of levels was nerve wracking, and probably a risk, but in hindsight they did amazingly well.
It's also very successful framing.
The debate is almost entirely "3 or 4 announced today?". And the sub-question: "level 3 delayed until after ANZAC Day?". That's pretty much it.
As any Sir Humphrey fan would point out, the question is more important than the answer. "Would you like the nuclear power plant built in the North Island or South?". Well, I choose South, because I live in the North. Never mind what the real question should (obviously) be.
NZ is certainly staying in lockdown for at least 2 more weeks, even if the number ascribed to that lockdown changes. And all the indications are that public opinion will accept that extension – because of that number.
Yes, good framing, which will buy time until people are starting to realise that L3+ is not all that much different from L4 when it comes to personal freedoms. It’s the genius of a McD’s toy or new packaging of an old product.
Slowly but surely, they will tweak/adjust the rules within the framework and then prepare us for L2+. The Government has more wiggle room than we realise 😉
Nice article Micky Savage, have been giving it some thought, here is a response:
Question: Is it safe to move now from level 4 to progressively lower levels?
Recommendation: Do not move to level 3 until we have:
Put it like this, would you fly in a plane that had this many design unknowns and lack of ground support?
PROBLEM STATEMENT:
COVID 19 is making it difficult for country to return to “normal life”. Safety levels have been put in place to help us return to normal. The effects of these levels are both positive and negative. The positives being the increase in lives saved, improved health outcomes, and an economy recovering quicker. The negatives (are effectively the opposite) can be seen in terms of loss of income, economic decline, and associated poor health outcomes (even loss of life) if people cannot get back to work.
Some might say this is a “wicked problem”, a balancing act, that will require precision and timing.
Key questions to ask before moving to level 3:
These questions will remain relevant to New Zealand as at some point we will need to get back to work and open our boarders. Essentially we have the moral imperative (momentum) to develop and invest in a capability to protect us from pandemics now and into the future. We need to find solutions.
Dr Chris Smith, consultant clinical virologist at Cambridge University in the UK said recently on Radio New Zealand: “this will be very difficult to eliminate Covid-19 completely from circulation in New Zealand when so many cases are believed to be asymptomatic”
https://www.rnz.co.nz/national/programmes/saturday/audio/2018743157/chris-smith-virologist-on-latest-covid-19-science
THE IMPORTANCE OF QUALITY TESTING & REVIEWING OTHER COUNTRIES APPROACHES (before going over top of the trenches)
Sweden, Norway and Denmark may provide good comparison with New Zealand as population size/density, quality of health care and geography are to a degree similar (however, these countries are part of Europe, where an island nation). Other countries could be studied. The following data was taken from worldometer on the 19 April 2019 for all 3 Nordic countries (https://www.worldometers.info/coronavirus/?utm_campaign=CSauthorbio?):
Denmark and Norway have been seen to implement firmer restrictions than Sweden. Sweden may serve as an insight into how many would die or become critical if a “lighter” approach is taken by New Zealand (mimics a move to level 3 or 2). Can New Zealand sustain 1,054 critical patients or let alone 1,511 deaths that Sweden has? Comparing approach and consequent fatality and infection levels between Sweden, Denmark and Norway may help us to refine a strategy (taking into consideration the lag before the benefits of the measures are seen) as the latter two countries took a more strict approach.
An older exert from a web site called “The Local” on the 31st March 2020 compared the Danish, Norwegian and Swedish approaches.
https://www.thelocal.com/20200331/the-nordic-divide-is-denmark-norway-sweden-right-or-wrong-on-coronavirus
An interesting comment from Swedish state epidemiologist Anders Tegnelll:
“If Sweden's health system is overwhelmed, then Denmark and Norway will feel their tougher policies were justified. But the real test of Sweden's strategy will come later, when Denmark and Norway start to lift their lockdowns. Can they return to normal without the infection flaring up again? Will they be hit by a second wave this winter? Will any additional deaths Sweden sees over this Easter be the price it pays for having fewer over the coming years? "This is not a disease that you get rid of. And if you don't get rid of it, what are you waiting for?" Tegnell said. "You can either wait for some kind of immunity to develop in your population, or you can wait for a vaccine. And the vaccine is, most likely, at least a year away."
The current graph comparing the Nordic countries can be found here:
https://ourworldindata.org/grapher/total-deaths-covid-19?time=2020-04-01..&country=DNK+FIN+NOR+SWE
What exactly are the capabilities being put in place by these countries to keep the vulnerable safe? An alarming report dated April 20th 2020 from the Guardian discusses the lack of protection for the elderly in Sweden. Selected abridged quotes highlight: https://www.theguardian.com/world/2020/apr/19/anger-in-sweden-as-elderly-pay-price-for-coronavirus-strategy :
Lena Einhorn, a virologist: “They have to admit that it’s a huge failure, since they have said the whole time that their main aim has been to protect the elderly,” she said. “But what is really strange is that they still do not acknowledge the likely route. They say it’s very unfortunate, that they are investigating, and that it’s a matter of the training personnel, but they will not acknowledge that presymptomatic or asymptomatic spread is a factor.”
the reason why Sweden has a much higher number of cases in care homes than in Norway and Finland is not because of the homes themselves, but because of Sweden’s decision to keep schools and kindergartens open, and not to shut restaurants or bars. “It’s not like it goes from one old age home to another. It comes in separately to all of these old age homes, so there’s no way it can be all be attributed to the personnel going in and working when they are sick. There’s a basic system fault in their recommendations. There’s no other explanation for it.”
“The worst thing is that it is us, the staff, who are taking the infection in to the elderly,” complained one nurse to Swedish public broadcaster SVT. “It’s unbelievable that more of them haven’t been infected. It’s a scandal.”
Although the above is just an exercise is New Zealands testing strategy going down Sweden’s path or is it more like Norways and Denmarks?
Numerous epidemiologists and scientists in New Zealand (and abroad noble prize winners) have been pressing for obtaining sufficient quality accurate test data to make informed decisions. Presume this also means sampling strategies and good data (not just random samples from selected supermarket chains but sentinel testing strategies) to ensure we improve our confidence in the data before changing levels. Various quotes:
Also see Paul Romers tweet: https://twitter.com/paulmromer/status/1248712889705410560
Can we as a country honestly say New Zealand has the capability to protect our vulnerable and at the same time get our country back to work (move from level 4 down)? We might be lucky and have eliminated it, however, various experts say there is a high probability we won’t and at some point New Zealand will have to get back to work.
What can be gleaned from Paul Romer Nobel Lareates words above is that in the New Zealand context, we need to ensure a meaningful surveillance testing strategy and adapting new testing technology as it emerges (this appears to be what is happening in the USA). This testing can allow for creation of safe communities, workplaces, supply chains etc. It can also be used to protect the vulnerable by testing all people that work or deliver goods/services to care facilities before they enter.
For example, people can be tested before entering a workplace. Testing (if fit for purpose) will allow for the protection of the vulnerable such that it could buy time until a safe vaccine is developed and/or NZ is COVID free.
Testing (accuracy and quality still under review) to get the people back to work and protect the vulnerable being discussed in the USA and around the world include:
Building on Paul Romer Nobel Lareates ideas for NZ, its presumed essential workers level 4 and 3 who are the most likely transmission points could be tested. An example of the numbers involved in NZ is given below (a statistical subset of each work function could be taken if we do not have the capability).
Think permutations and combinations of possible infection!!!!! Is astronomical the hiding place this virus can be in
Before we open schools we need to be cognisant of the numbers involved: Primary Pupils = 475,797, Secondary School Pupils = 286,886 and teachers = 70,000 Also there is approximately 60,000 pre-schoolers.
In addition to the above testing data needs, the risk attributes of virus listed below need to be determined to help develop a meaningful strategy:
Further Questions:
Take care everyone, the world greatest ever game of whack a mole is about to begin
[this comment is now a Guest Post https://thestandard.org.nz/guest-post-is-it-safe-to-lower-the-lockdown-level/ – weka]
Thanks Karl. Very thoughtful comment. Mind if I convert it into a guest post?
Go for it
Fascinating social comment there that L4 involves all being in this together and that L3 erodes that unity. It prioritises those who are lucky enough to work in industries which come out of restriction and also places a greater number of people in harms way.
At L3 we will no longer be in this together.
Yep. Another reason for them to take their time and get this right on the prep and messaging front as well as the health front.
Yes. And there's yet another reason for them to take their time and get it right… the joy of watching The Hosk go into a complete meltdown and has to be sedated.
Warning: tongue in cheek.
Haha, more likely it will just be more fodder for him to bash the govt and clickbait.
There's another scenario here, that we have different areas moving from L4 to L3 at different times. Looking at DHB region, some places have very low levels of infection eg the West Coast, which is also geographically segregated (four roads in and out, plus some rail).
I think we should extend for another week or even two, but it's still possible at that time that some places will stay at L4. No idea if they will manage that by DHB region or some other criteria.
I think a big part of the success, so far, of the Governments approach, is they have kept it broad and simple.
We've already seen the hash our inept media make of anything. Even the announcement. "Prepare for level three", has left them confused.
Good point.
Part of the problem here is the rush. Four weeks for the initial lockdown wasn't long enough, and now there is all this pressure to make changes before we are ready (that includes the MoH and the govt).
There's also the pressure that we will have a steady return to normalish, and I'm not convinced this is real. Lots of people still catching up with this, and still a fair amount of denial.
In that sense, if the govt had had more time to prepare for L3, then maybe it wouldn't be so confusing. Likewise regional levels.
Agree.
They (media) seem confused about many things that they should not be, if they had like many NZers have been, familiarising themselves with the wording of the levels etc.
We now have 'shock, horror' at health and safety conditions that builders may be putting in place as a response to this preparation to move levels. There have been many commentators world-wide saying social distancing may be a new norm. Our media don't seem to have picked up on this.
I have been throughly disappointed with question time after the daily announcements. My only exception to this has been the reporter who is asking about Maori issues. His questions, to me, sound well thought out and relevant to his publication. His question on tangi elicited a caring response from PM about not having a tragedy following a tragedy
The nadir was the person asking on and on about people dying without loved ones that elicited a sad response from DG Health about having lost his parent/s.
They all know that if they indicate they want to ask a question that 9 times out of 10 they will get it. The screaming questions out all the time is not needed and even less needed is one media person (female) who continues asking her question after another has been given the go-ahead. A couple of days ago she actually finished asking her question while talking over the top of someone else trying to ask.
They could have been a force to be reckoned with and worthy of the care that democracies have traditionally had for the fourth estate.
But……
PS I think had they got a sample of the posters here asking the questions that they would have made a better job. We could even ask questions from other than our usual viewpoints. The writing here is better too!
The government's position needs to be: We did all we could, and this needs to be within reason.
There needs to be a 2 week extension at level 4 or a 3+ level which consists of schools and ECE centres remaining closed. No one can predict the number of cases in 2 weeks if schools and ECE centres open for essential workers. ECE teachers are not nurses or cleaners and they will be expected to be a nurse or a cleaner in order for a daycare to meet hygiene standards and minimise transmission. I have always found it hard for a child under 2 to blow their nose with support and instruction. When it comes to Covid-19 being in poo ECE/school toilets will become a source of transmission.
It is unrealistic to expect the essential workers who have children who require timely supervision to be both a teacher and a worker. Reducing hours on full pay will help this group and a package could be worked on.
Grandparents may be in a better position to help out knowing that children are in a slightly bigger bubble and not a ECE/school bubble.
I think the government have done a very good job in managing Covid-19. I have one main concern that people returning from overseas are isolated or quarantined for 21 days and are tested on day 21. I am aware that testing is not 100% accurate.
We did all we could, within reason, is all that can be done.
another week at 4 to take care of ANZAC day and another week after that possibly less if zero new cases are found…..we do not want to negate hard yards put in so far.
I agree with MS position for another two weeks of level 4. Let's face it, if the economy is tanked already, letting maccas open the drive through, builders back to work sites and seeing some kids back in school, it won't change the countries overall outcome in the long term.
I fear the backlash from the right, the media and the business lobby will have put undue pressure on the government to take the 'correct' decision, so level three is probably going to happen.
Since we have a public holiday this weekend a fortnight extension means a loss of 9 "normal" working days.
At the moment cases seem to be dropping, in steps, by a factor of around 0.4 every 4-5 days. 70-30-10. Giving this another 3 rotations will hopefully get us lose to zero for the last few days. The untraced contact in the Whanganui case is a worry though – can we look forward to a bump there in 5-10 days.
If we are out for another fortnight (I hope) then I can see people returning to more standard patterns of behaviour in that time where possible. i.e shopping for groceries weekly or bi weekly not stocking up for 6 months in one go, collecting mail regularly etc.
I'm also at a loss as to why we will get such an economic positive bump from an extra few days trading. Sure there will be a run on take out whenever we come out – and some other backlogged buying but that bump will happen regardless.
Reasons to go down to L3:
Reasons to stay @ L4:
Given that the proposed L3 is more like L3+, I think we’ll change to this new level on Wednesday. However, personally, I would extent it by another week, at least.
Good post. I personally would like to err on the side of caution also.
You could probably still tolerate some new cases while heading towards elimination, if they are only occurring within already-isolated known infection clusters (i.e. 2 people in that family already have it, and then a 3rd person gets it in that family – and the whole lot are isolated).
I'm probably going stir-crazy living alone, but nonetheless I'm not sure it's right to go to level 3 just yet.
Basically, right now we are at about the same new daily case numbers as when the govt saw fit to go into L4.
Difference in favour of L3: they knew then there were lots of people freshly returning from highly infected lands. Now we don't.
Difference against L3: almost all our new cases are community transmission.
I can certainly see reason to keep it going another week or two, until we get a few days without new cases. Maybe not a full fortnight new-case-free, but a couple of zero days before L3 would be very promising.
Where do you get "almost all our new cases are community transmission" from?
There was the report yesterday of one suspected community transmission in Whanganui, but I get the impression from most reports that all the other recent cases have been linked to close contacts of known cases.
I saw somewhere yesterday ? that there are 4 cases overall that they don't know the source of ?
Mighta been this piece from Thursday?
Personally, I wouldn't be as worried about suspected community transmission cases from weeks ago, those chains of transmission have likely broken by now.
But a community transmission in the last few days is a worry. It suggests either there's unknown pockets of infection still out there, or it transmits more easily than previously believed from brief casual contacts like supermarket shopping.
Yep that looks like it. Appreciate the point about the older cases not being such a concern. Still Greymouth might enjoy an opportunity for the exciting experience of lining up for mass community testing to check if anyone there still has it.
Yes there were still 4 cases out of the 1400 odd that they were still unable to link to the origin of the infection. All the new cases yesterday were linked to a known source as were the cases the day previously. The people tracking the disease have been steadily tracking the cases and reducing the number of those with an unidentified source daily. Quite outstanding work really. The "gold standard" that AB wishes to achieve is that they will be able to track the contacts of all new cases within 3 days. They are just about there, but it will also require all of us to be able to provide good reportage of our close contacts should we be required to do so.
Or it may just be a teenager visiting someone they don't want Mum and dad to know about.
Fair call.
Got my knots twisted between imported/domestic vs Knowncontact/communitytransmission.
Important though this decision is and a difficult one for any government to make – some governments/political leaders have/will have to make far more heart wrenching decisions around the way forward than this.
It's a tribute to all that this decision is being made in circumstances that are, on a global scale, in a pretty good place.
Thanks LP for your article – I think your analysis is spot on.
…and having just seen the update for Sunday with nine new + probable cases, I think that it is not sufficiently low enough to take the risk of a preemptive switch to Level 3.
If the level is reduced, I'm going to be really interested in what provisions are made for those in a bubble with a known case. Given that those people are an uncomfortably high probability of being asymptomatic carriers that also produce false negative test results.
Clearly the best public health answer would be for those people to maintain self-isolation for at least two weeks after the recovery of the known cases in their bubble.
But that's pretty rough psychologically to not be able to enjoy the lifting of restrictions everyone else would be enjoying. It would also be rough financially for any of those that would otherwise be able to return to paid work but cannot because of having been in a bubble with a known case.
Yes, rough, but we’re all in the same boat now. I’d say that self-isolation is not good enough and they (their bubbles) should be quarantined for 14 days so that the rest of the country can move relatively safely to L3+. Maybe re-frame it as ‘enhanced self-isolation’. It doesn’t make sense to let their bubbles expand. Any new cases under L3+ will be effectively quarantined too just as Kiwis arriving at the border. I think we should still try to eliminate this from our soil.
Under L3 this applies to hundreds of thousands. Replace,"having been in a bubble with a known case" with, "working in an industry were social distancing is not possible".
It's lottery stuff under L3. We are no longer in this together.
Boss rang last night, we won't be going back to work until Level 2, but will still be paid. Half of his staff have school age children and he wants to do what's right by them.
How awesome is that. Even though we could all work from home without too many issues, he still makes sure the kids are being looked after first. That's really buzzed me out 🙂 As he is a workaholic and his youngest child is in her 20's.
Thanks Boss for putting the kids first 🙂
You are right, people like that who make decisions like that should be celebrated.
You're lucky. My boss expected me back next Monday. Had to remind her that 1. It's a public holiday, and 2. lock down doesn't actually end until Tuesday.
Regardless of the fact I shouldn't even be working until level 1, and I'm getting the wage subsidy, so that means 8 more payments, it has at least, in light of her pre covid decision to reduce my hours to cover the minimum wage increase, made up my mind for me to get out and find another job and take advantage of the great rebuild.
Don't suppose your employer is looking for staff? lol
He will be looking for one more soon, but they have to be a local, that's really important for him. Bless him 🙂
Awesome 🙂 I think there are going to be some good opportunities out there for people when it's over. Am looking forward to new innovations being executed that people have been dreaming up while in lock down. There's some clever people in our little country, how lucky we are to live here 🙂
Ha, it would be sure be a bit of a commute from the Waikato.
Simon Bridges is speaking about the decision on TV. Which just proves that the media coverage has been totally biased towards the government. It would be much fairer to National if they kept him off.
Hilarious observer! And too true.
Salty Simon.
He liked having that road all to himself.
And he says the government hasn't prepared well enough. What more could the government have done to 'prepare' properly? The guy's craving relevance. National must keep him on.
https://www.stuff.co.nz/national/121141080/coronavirus-simon-bridges-says-the-government-isnt-ready-to-lift-lockdown
Simon has got the maturity, foresight, and patience of a puber on his first date.
Grim Reaper David Seymour from the Act death cult tweets:
"The Prime Minister’s decision to lift the lockdown comes too late. The fact that New Zealand will spend another week in lockdown is a clear-cut case of government failure with great costs for the private sector".
The health department hasn't got it's tracing up to speed so you get another week of detention at a cost of another $10 billion dollars. Sounds like the micro plasma bovis team is on the job.What a bunch of muppets.They can't even get the annual flu vacine out to those who need it.
It isn't even a week, and it's an obviously practical way to transition over the holiday weekend, with restrictions being reduced over that time. And if we're losing $10 billion over 3 working days then NZ's economy must be the greatest it's ever been. Can't wait to earn $3 billion a day from next week!
lol…10 billion huh…where did you pluck that figure from?
From Joyce’s ear canal.
The deep hole that Simon Bridges popularity rating is in?
The dank pit where Rimmer keeps his human empathy?
suspect it was further south
A nasal swab?
4 foot long
Ouch! That would have hurt. I hope he’d lost his sense of smell before that.
probably…he has no taste
My model is very susceptible to the inputs I put into it. Probably only going to cost approx $4 billion. Like saying there will be 20000 deaths but there is only 9
it is 15 % of the workforce reopening in a restricted market…and over a long weekend….you have no model, just an absurd number
How could the model predictions be so off?
I know!
Oh, and BTW, there are 12 deaths so far.
Maybe if the Nat government hadn't under-funded the health system so much, it might have been in a better state to respond to the testing and tracing requirements of a pandemic…? Rather than having to play catch-up very quickly?
Well if everyone's in lockdown, who needs it?
Seymour won't need his Euthanasia bill with his policy all the sick and elderly won't need it.
According to Simon "the medicine is worse than the cure"…..What???? LOL LOL!!
Yes, a charming piece of confusion.. The guy is supposed to be a university graduate, but cannot even regurgitate that the medicine is worse than the disease.
Oh dear. Long may he remain National's major mouthpiece!
I believe the saying is actually "the cure is worse than the disease". Only saying as you are usually so fucking pedantic.
All true, but in that old saying 'cure' is being used rather archaically as a synonym of medicine in the sense of treatment, whereas nowadays 'cure' has more the meaning of 'healing'. Simon has supposedly been highly trained as a lawyer, but seems disastrously unable to work out the meanings of words.
Jacinda/Cabinet did the right thing going to Level 3 starting Tuesday 28 April. It was always the right time to shift things as things needed to stay Level 4 during Anzac weekend. I think Level 3 is overall a good move. I would have preferred more retail opportunities. The one move that doesn't make sense is education. It is very confusing and I can't help but think things should have opened at Level 2 not level 3.
Jacinda has proven herself to be a very good leader. I would be interested to know who her advisers are behind the scenes because they've been doing a very good job. The communication has been very clear and our Level system is excellent and clear compared to other countries. I have noticed a slight trend for her to ramble a bit as of late especially at the start of any announcements. Someone may want to advise her to rein things in.
She knows some of the kiddies take a bit of time to start listening.
Journalists like Soper should learn to listen instead of asking that which has just been explained by Jacinda.
todays best quote from twitter
"I remain very impressed by Jacinda's ability to not begin any answer to media questions with "oh for fuck's sake…""
so true!
Ian your well out of your depth 5 days more lockdown 2 days of business works out @ about 600,000,000 NZ dollars in wage subsidies then 10 business days at level 3 some where near $1 and 2 billion depending on how many went back to work.Facts please boy who cried Wolf..
I am also impressed. Composed, coherent, always well-focused on topic..
Jacinda is really good.
Want to make your day?
Check the comments on Bridges' FB post.
Oh priceless! That is so funny