Guest post – is it safe to lower the lockdown level?

Written By: Guest post - Date published: 10:41 am, April 20th, 2020 - 58 comments
Categories: Deep stuff, health and safety, Politics - Tags: covid-19, Covid19

Taken from a comment by Karl Sinclair.

Question: Is it safe to move now from level 4 to progressively lower levels?

Recommendation: Do not move to level 3 until we have:

Robust testing strategies and capabilities in place to trace asymptomatic cases within our essential worker populations etc.
The ability to protect the vulnerable
Reviewed the effect on other countries moves to lower levels, such as Denmark, to gain their lessons learned.

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:

Do we have the capability to move down levels and provide sustained protection to the vulnerable while we wait for a vaccine (if one comes at all?)?
Do we have robust and sufficient COVID testing capabilities and PPE (to allow people back to work and ensure virus free health care providers)
Are NZs testing strategies (essential workers targeted) robust enough to catch the asymptomatic spreaders?
Do we have robust tracking and data base and data reporting capabilities?
Do we have sufficient medical and elderly care capabilities (people, training and equipment)?
Do we know enough about the virus to mitigate risk?
Should NZ hold at level 4 to learn from other countries strategies (Denmark just reduced its level to allow school children back to school, what was the effect)?
What is the confidence of eliminating the virus completely within NZ?
Do we have the right criteria within the levels?

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”

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:

Sweden: Population 10.2 Million, 13,822 COVID positive, deaths 1,511, with 1,054 critical, deaths per million = 150.
Denmark: Population 5.8 Million, 7242 COVID positive, deaths 346, with 76 critical, deaths per million = 60
Norway Population 5.4 Million, 7069 COVID positive, deaths 164, with 63 critical, deaths per million = 30

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.

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:

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:

Otago University Professor and epidemiologist Sir David Skegg comment we will be playing “Russian roulette” with the health of New Zealanders if it makes a lockdown decision without first vastly improving rapid contact-tracing and collecting more information about Covid-19 in vulnerable communities. See

Prof. M Baker – There appear to be gaps in the Government’s data on Covid-19 that must be filled before a decision is made on reducing the lockdown level, two top advisers say.
Sir Peter Glucman has looked at how New Zealand could move from alert level 4 to alert level 2 as quickly as possible, however, it was mentioned in the article: “Given the inevitability of imperfect elimination, and given some probable level of asymptomatic and pre-symptomatic spread, it will be critical to have rapid and highly effective and high capacity contact tracing in place before relaxing restrictions.”
Professor Paul Shaun Hendy, an expert on modelling how the coronavirus spreads says New Zealand’s alert level 4 lockdown should be continued for another two weeks to strengthen chances of eliminating Covid-19.
Paul Romer Nobel Lareate in economics: quote “ He imagines health workers being tested at the start of a shift; the same would go for care workers, pharmacists, police officers and bus drivers. You might add teachers and restaurant workers. Romer wouldn’t bother testing people who already have symptoms: they should be presumed positive and immediately self-isolate. It’s the “asymptomatic spreaders” you need to identify, stopping them in their tracks. The logic underpinning the plan is clear: there will be no point in reopening shops, pubs and restaurants if people feel too scared to visit them. As virologist Prof Nicolas Locker puts it, “You can’t lift the lockdown as long as you are not testing massively.”….. Governments need to realise that what’s coming is not a decision about easing this or that rule of social distancing, but rather a massive political, industrial and collective drive unseen since the last war. It may well mean repurposing factories to mass-produce testing kits. At the very least, it should mean a dedicated cabinet minister for testing.,,,,,,,,,,,,This demands a huge shift by the UK government, which wasn’t even testing people coming out of hospital and going into social care until this week.

Also see Paul Romers tweet.

The twitter thread version of my plan:

0. Stop testing people with symptoms. Presume positive and isolate.
— Paul Romer (@paulmromer) April 10, 2020

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:

Fast Antibody testing (catch asymptomatic)
Fast COVID testing (proves you have it)

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).

8,100 Police frontline officers
58,206 enrolled nurses
13,883 registered active doctors
859 registered surgeons
62,000 Supermarket workers
2000 Career and 11,000 volunteer Fire Fighters
? Port workers

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:

Immunity (does infection guarantee immunity, if so, for how long)
Time infectious?
Reactivation (like chicken pox you could reinfect people)
Mutation (can the virus mutate and become more deadly)
What’s the combined effects of flu, common cold with COVID 19
How long does it take an individual to recover (long term effects and cost)
Percentage of people susceptible that don’t have pre-existing conditions
Time till development of a vaccine (if ever)

Further Questions:

Could NZ Inc concentrate on developing safe facilities and capabilities (testing health care workers etc) for the vulnerable (elderly and or people with pre-existing comorbidities) going forward regardless? This would act as a safeguard or insurance policy (a controllable) if no vaccine or reliable anti body tests are found allowing schools and businesses to reopen.
Is greater caution required before we move down a level given Japan and other countries are experiencing second waves of the virus.
In terms of NZs technical advisory groups, have we ensured a wide enough expertise to cover off all areas from science, health, economics (designing strategy) all the way through to practical implementation (logistics and operations)? For example, MPI and NZDF will have good practical experience

Take care everyone, the world greatest ever game of whack a mole is about to begin.

58 comments on “Guest post – is it safe to lower the lockdown level? ”

Comments are now closed

Rosemary McDonald 1

20 April 2020 at 10:58 am

I try to read most posts here on TS and I almost always follow supplied links.

I had already, at some weird hour this morning, read the Guardian article you link to where virologist Lena Einhorn rails against the failure of the Swedish authorities to protect vulnerable residents of care facilities.

As in New Zealand, carers have been told that even basic PPE are not necessary unless the particular inmate has The Virus.

As a consequence, the death rate in this population, as here, is (to some, anyway) unacceptably high.

And the failure of the Swedish authorities to rectify this glaring fault in their Covid 19 management strategy is all the more bizarre when they claim (as does our government) that the main aim is to protect these vulnerable populations.

Thank you for adding to this conversation.
- Carolyn_Nth 1.1
  
  20 April 2020 at 11:08 am
  
  On Sweden – the glaring stat to me is that they have a low proportion of testing per million of their population. So how do they know more people haven't died but not been recorded as a C-19 death?
  - Rosemary McDonald 1.1.1
    
    20 April 2020 at 12:07 pm
    
    Exactly. And the threshold for testing here has only very recently been lowered.
    
    I too suspect there is much wider community spread here in NZ, largely due to what we can now, with the benefit of hindsight, see was belated border controls and poor response from WHO.
    
    I grew up in a medical household when we were all on the cusp of the vaccine rollout. The accepted wisdom was 'early and constant naturally acquired immunsation' …supported by good diet and plenty of exercise out in the fresh air and sunshine.
    
    Part of me still thinks this makes sense as vaccines, despite the hype, are not necessarily safe or effective.
    
    The influenza vaccine barely reaches 50% efficacy and this can lead to a false sense of security….especially in vulnerable populations who get the flu jab for free.
    
    I worry that here in NZ there had been too much of our future thinking pinned on the hope of a vaccine…which appears less likely as time goes on.
    
    That's why this seemingly worldwide paradox of governments claiming to have the interests of the most vulnerable at heart whilst at the same time failing to put measures in place to protect this population who require the highest levels of care.
    
    And saying the PPE need to be conserved for future outbreaks….aren't we in the throes of an outbreak now?
    
    Very, very baffling.
    - Karl Sinclair 1.1.1.1
      
      20 April 2020 at 1:11 pm
      
      Hi Rosemary, great to get your comments.
      
      You said:
      
      "And the failure of the Swedish authorities to rectify this glaring fault in their Covid 19 management strategy is all the more bizarre when they claim (as does our government) that the main aim is to protect these vulnerable populations."
      
      I feel your right, it is bizarre.
      
      Questions
      
      1. Do you think that across the world (and within NZ) the protection of the vulnerable has still not got to a suitable standard
      
      2. That we (NZ) need to throw resources at this so that, so to speak the devil does not get in the door as a new study shows care homes in Europe are where over half the fatalities occur.
      
      https://www.euronews.com/2020/04/17/coronavirus-care-homes-could-be-where-over-half-of-europe-s-covid-19-deaths-occur-says-new
      
      3. Given potentially the current lack of PPE and capability in NZ, how would you approach making the vulnerable safe now until better capabilities arrive (how would you use your number 8 wire approach)
      
      Take care
- Treetop 1.2
  
  20 April 2020 at 11:21 am
  
  I have reflected on some comments yesterday on Open mike. We did all we could and within reason is the position which I feel the government needs to take. The emphasis is on "we did all we could."
  
  To not make PPE available for home carers falls short, when it comes to the we did all we could test.
  
  I have had years of dealings with government departments and I am still dealing with a lot of shit. All I have ever asked of them is, the we did all we could test.
  - Rosemary McDonald 1.2.1
    
    20 April 2020 at 12:14 pm
    
    I too spent time in reflection and discussion and am left with the impression that this contradictory stance by the Ministry of Health is actually part of a plan.
    
    Sorry to say this but if this thing tracks as suspected, those uncomfortable projections done by Treasury and the like on 'long term care and fiscal sustainability ' could begin to look a lot less fiscally gloomy.
    
    They should be transparent and say this…because I suspect a fairly high percentage of the population would would not find this too unacceptable.
    - Treetop 1.2.1.1
      
      21 April 2020 at 10:15 am
      
      Incorrect statements need to be corrected or ammended when new information is known.
      
      It is hard to make accurate projections on care post Covid-19 due to the systemic complications of the viris, this cannot be said when it comes to being prepared with PPE for a pandemic.
  - Karl Sinclair 1.2.2
    
    20 April 2020 at 1:23 pm
    
    Hi Treetop,
    
    You said: "We did all we could and within reason is the position which I feel the government needs to take"
    
    I feel your pain and agree. I don't envy the Governments task in all of this. Respectfully to the Government, we are not children, tell us the truth about our capabilities. I know there is a need to Keep Calm and Carry On, however, dont sugar coat, NZ Inc (we) are all in this together. Its surprising when Kiwis really have the problem nailed, they can come up with solutions….
    
    Just on your point that "We did all we could", do you think we could further utilize untapped potential in our communities, universities, businesses etc….. If coordinated well it could provide alternative input to the Government. I think sometimes our GOV has a inward looking approach that uses a select few.
    
    Image all the Universities in NZ having a competion to come up with solutions?
    
    Be safe
    - Treetop 1.2.2.1
      
      20 April 2020 at 8:00 pm
      
      I would start with untapped potential in yourself first.
      
      What is it that I am capable of doing myself?
      
      This is then not relying on another person. There are new skills which can be acquired gardening, sewing, painting, baking, cooking, meditation, an exercise regimen, a DIY hair cut or being the family hair stylist.
      
      Being resilient is certainly being tested socially and economically. Most of us will manage providing we have realistic expectations and adapt to a slowed down world. Having the basics, a home, food, education, healthcare, employment or having connections is essential.
      
      Input from the university of life, from the homeless, chronically un well and unemployed, is just as important as from university educated people.
  - Karl Sinclair 1.2.3
    
    20 April 2020 at 1:25 pm
    
    Hi Treetop,
    
    You said: "We did all we could and within reason is the position which I feel the government needs to take"
    
    I feel your pain and agree. I don't envy the Governments task in all of this. Respectfully to the Government, we are not children, tell us the truth about our capabilities. I know there is a need to Keep Calm and Carry On, however, dont sugar coat, NZ Inc (we) are all in this together. Its surprising when Kiwis really have the problem nailed, they can come up with solutions….
    
    Just on your point that "We did all we could", do you think we could further utilize untapped potential in our communities, universities, businesses etc….. If coordinated well it could provide alternative input to the Government. I think sometimes our GOV has a inward looking approach that uses a select few.
    
    Image all the Universities in NZ having a competion to come up with solutions?
    
    Be safe
Ad 2

20 April 2020 at 11:16 am

Didn't the PM already spell out the Cabinet decision-making criteria for making the decision on Friday?

Health capacity and reinfection were criteria, but so too was economic impact, and social stress.

There won't be any shortage of datapoints to make the collective judgement.
Wayne 3

20 April 2020 at 11:18 am

So what is your recommendation? Level 4 for another 2 weeks, another 4?

Because that is what the Cabinet will ask. They will want actual recommendations, not just a series of questions.

And then they have to make a judgement, because reputable people are suggesting Level 3 and others are saying stay at Level 4, at least till ANZAC day.

And despite what Iprent thinks, it is perfectly reasonable to look at the Australian experience.
- Poission 3.1
  
  20 April 2020 at 12:27 pm
  
  Rather then look at the problem as an epidemiological problem,it is necessary to examine it as a physics problem.
  
  The significant parameter is transport,hence constrain CV for transport by lockdown,and social distancing.As far as known CV does not have wings so transport is by aerosol,and adhesion to rough surfaces such as clothes,face ,hair etc.
  
  Increased interaction at present is a fail.
- Tricledrown 3.2
  
  20 April 2020 at 12:49 pm
  
  Wayne big business and National are bullying the govt creating a panic .Rushing to open the economy to early will cost way more in the long run.Having enough testing and tracing resources is most important.after years of cost cutting /underfunding under the Key govt we will be overwhelmed if Covid gets out of Control.It could be as simple as a warmer climate in Australia has reduced the spread. Because this is a new virus we don"t have all the answers yet.Rushing to open the economy would be more economically disastrous.
- Karl Sinclair 3.3
  
  20 April 2020 at 1:46 pm
  
  Hi Wayne, thanks, great comment, you highlighted:
  
  "Because that is what the Cabinet will ask. They will want actual recommendations, not just a series of questions. "
  
  Take your point, but is that not what Cabinet are supposed to do? or at least the ruling party?
  
  If, looking at the current state of NZs capability take into consideration this:
  
  A capability (s) is made up of people, training and equipment, it takes time and effort to develop the protocols/standards associated with the training and equipment. It takes time get the right people and buy the equipment (say test kits). This does not even take into consideration the testing of the capability to iron out the rough spots. The rinse and repeat process of capability development (people, equipment, training) can be used to make our elderly care facilities safe.
  
  Should we go move to level 3 now, personally, from observation no.
  
  If you asked me to put a time frame, your going to hate me……
  
  It depends (an MIT professor said to always answer lawyers this way)
  
  For example on RNZ news at 12 they said the gold standard of testing was only a week a way.
  
  Well given that, we need to wait at least one week, but how many weeks do we need to wait until it is a fully functioning capability that cover the required numbers to support meaningful sentinel testing? If we move from 4 to 3 we may blow our gains.
  
  Right now, totally making it up, if in the drivers seat and listening to other posts/news, I would go for 2 more weeks at level 4.
  
  Take care
barry 4

20 April 2020 at 11:30 am

Based on best available estimates 2weeks of level 4 is about as effective in eliminating the virus as 4 weeks of level 3 with less risks of a super-spreader mucking things up.

Based on a survey of the countries that are doing best there is one thing that works (and it is cheap): MAKE EVERYONE WEAR MASKS.
- joe90 4.1
  
  20 April 2020 at 11:38 am
  
  MAKE EVERYONE WEAR MASKS.
  
  So where does everyone get an effective mask from?
  - barry 4.1.1
    
    20 April 2020 at 12:25 pm
    
    In Taiwan they seem to be able to manage. It doesn't need to be an N95. We are not trying to protect the wearer.
    
    Ardern was keen on telling people to behave as if they have the virus. Any reasonably sturdy cloth or surgical mask will prevent passing on the virus through coughing, sneezing, talking or heavy breathing. Combined with hand washing, mask wearing very much reduces the likelihood of passing on the virus to anybody but very close contacts.
    
    I was initially skeptical, but there is enough evidence now to say that the single most important factor in Taiwan's success has been the fact that everyone wears a mask in public.
    - barry 4.1.1.1
      
      20 April 2020 at 2:06 pm
      
      https://www.stuff.co.nz/life-style/beauty/how-to-guides/120801748/coronavirus-how-to-make-a-protective-facemask-during-lockdown
      
      or try:
      
      http://www.pharmacydirect.co.nz/Face-Masks/
      
      https://new.grabone.co.nz/health-nutrition-dental/other-natural-medicine/p/disposable-face-masks-1
      
      http://www.healthcareessentials.nz/category/2326-masks
      
      https://www.annahstretton.co.nz/products/face-mask-pack-of-3
  - Alice Tectonite 4.1.2
    
    20 April 2020 at 12:37 pm
    
    So where does everyone get an effective mask from?
    
    Same place they buy their hand sanitizer from…
  - Peter ChCh 4.1.3
    
    20 April 2020 at 12:42 pm
    
    joe90 "where does one get an effective mask from?"
    
    Simple answer: China. They effectively stole our supplies of PPE.
    
    Chinese government controlled companies were systematically stripping PPE from pharmacy and supermarket shelves here and in Australia as far back as January (I wondered at the time why these disappeared so early in the crisis). China is no friend of anyone. Sooner we form an alliance with Taiwan and recognize it as the country it is, the better.
    
    Just one reference form a web load of the evil practises of the Chinese Empire:
    https://www.stuff.co.nz/business/120927408/new-zealanders-caught-short-after-masks-sent-to-china
joe90 5

20 April 2020 at 11:34 am

Do we have to let history repeat itself?

One big lesson: You can’t give up early on social distancing.

[…]

In a lot of cities, similar premature pullbacks produced a lot of “double-humped epi curves,” as Markel described them: Officials instituted social distancing measures, saw flu cases fall, then pulled back the measures, saw flu cases rise again, and reactivated the measures.

Notably, the second spike in deaths only appeared when cities removed social distancing measures, Markel’s study found: “Among the 43 cities, we found no example of a city that had a second peak of influenza while the first set of nonpharmaceutical interventions were still in effect.”

The PNAS study, which looked at 17 US cities, reported similar findings: “no city in our analysis experienced a second wave while its main battery of [nonpharmaceutical interventions] was in place. Second waves occurred only after the relaxation of interventions.”

https://www.vox.com/policy-and-politics/2020/3/24/21188121/coronavirus-covid-19-social-distancing-1918-spanish-flu
- Tricledrown 5.1
  
  20 April 2020 at 11:47 am
  
  Given masks need to be changed regularly where are they going to come from
  - swordfish 5.1.1
    
    20 April 2020 at 4:35 pm
    
    https://www.facebook.com/renilda.almanzor/videos/3014389155258670/
    - swordfish 5.1.1.1
      
      20 April 2020 at 4:44 pm
      
      https://twitter.com/escapedmatrix/status/1246230749625319429
- Karl Sinclair 5.2
  
  20 April 2020 at 2:16 pm
  
  Joe 90, good article, I liked this exert from it.
  
  The most successful approaches in 1918, Markel found in his 2007 study published in JAMA, followed those three components. First, they were early — particularly before the flu got to an inflection point in which the virus infected a certain amount of people and spread rapidly. Second, they were sustained — lasting until the virus really seemed to go away, and quickly redeployed if the virus came back.
  
  https://www.vox.com/policy-and-politics/2020/3/24/21188121/coronavirus-covid-19-social-distancing-1918-spanish-flu
  
  I liked the bit in bold, which would infer they had the resources and capabilities ready to go, does NZ Inc?
  
  Also reading this from your quoted article makes me ask, does our modern day society have the stamina and motivation like the 1918 society described below in your referenced article:
  
  "3) Seeing the effects of outbreaks drove people to serious action
  
  The question, given the reality of how long social distancing may be necessary, is how people are going to get through this. Even beyond the damage to the economy and the loss of income involved, people are going to miss out on a lot of the experiences that enriched and validated their lives before. Experts worry social distancing, even if it’s necessary, just won’t be sustainable for weeks or months.
  
  But people did do social distancing for weeks and months during the 1918 flu pandemic.
  
  Markel gave one potential explanation for that: People were already very familiar with the risk if they didn’t social distance. Back then, disease epidemics and pandemics of all kinds were common. Just about everyone knew someone — from parents to aunts and uncles to children — who died of disease."
  
  Cheers
XRN 6

20 April 2020 at 11:44 am

The government has earlier stated lockdowns work in blocks of two weeks, being the understood length of time for the virus to "run it's course".
- Peter ChCh 6.1
  
  20 April 2020 at 12:48 pm
  
  Yes, so logically level 3 will be for two such cycles, or a total of four weeks (barring a rapid rise in cases).
  
  I see Ireland is looking at bars being closed for up to 18 months, and the UK until Christmas, Micheal Gove stating that bars and hospitality in general will be the last to be freed from restrictions.
  
  https://www.dailymail.co.uk/news/article-8235181/Pubs-UK-shut-Christmas.html
Wayne 7

20 April 2020 at 12:41 pm

My prediction is that Level 4 will be extended till next Monday midnight. In terms of work days for most businesses that could open, it is only two work days (Thursday and Friday) that are lost, but it extends the lockdown by five days. So a reasonable approach.

It is already evident that people are starting to practise Level 3 anyway and that will increase this coming weekend. I would say we are reaching the limit of what people will readily accept. In terms of social distancing public practise will be close to Level 3 by next Monday night.

Professor Hendy was essentially suggesting this on Morning Report.We will know in just over 3 hours.
- Poission 7.1
  
  20 April 2020 at 12:58 pm
  
  Hendy is suggesting that an extension of two weeks,could allow for elimination.Do you want us to stumble with the end goal in sight?
  
  https://www.stuff.co.nz/national/health/coronavirus/121123513/coronavirus-modelling-expert-says-lockdown-should-be-extended-two-weeks
  - Stunned Mullet 7.1.1
    
    20 April 2020 at 1:12 pm
    
    I'm reminded of George Box's famously attributed comment on modelling.
    
    "All models are wrong, but some are useful"
    
    A lovely review of him in the link below
    
    https://rss.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1740-9713.2010.00442.x
  - Wayne 7.1.2
    
    20 April 2020 at 1:46 pm
    
    Hendy on Morning Report also said Monday night would be a reasonable compromise. He would prefer 2 extra weeks but that next Monday night would be OK.
- observer 7.2
  
  20 April 2020 at 1:25 pm
  
  I'd predict the same: the exact date is less important than knowing the date. It won't be an open-ended Level 4 extension.
  
  As mentioned on the other thread, the framing has been so successful that the NZ public are effectively volunteering for an extension of the lockdown, rather than rebelling against it as we're seeing in other countries.
  
  The hard part of today's announcement will be the end date for the next period: the PM can (and doubtless will) emphasise that it is only provisional, but whatever date is given (e.g. 2 or 4 weeks after Level 4 ends), that will become the new expectation of "release".
- Sacha 7.3
  
  20 April 2020 at 1:47 pm
  
  I would say we are reaching the limit of what people will readily accept.
  
  Yet most New Zealanders support continuing Level 4 for longer according to the media stories I've seen this last few days, some based on polling.
  
  Which 'people' are you thinking of?
bill 8

20 April 2020 at 1:33 pm

Unless testing and tracing systems are up to scratch, then coming out Level 4 would be a bit silly – not just in terms of leaping backwards in relation to possible eradication, but also in relation to health service capacity.

Anyway. A few bases I want to cover.

Have a look at the first graph in the post and tell me that the peaks aren't 'table top mountain' peaks. In other words, in terms of infection rates/deaths, we fly up the cliff face and then spend a long time plodding down off the escarpment. And that's not quite the impression being given by media speaking of 'peaks'.

Sweden with its voluntary distancing might be getting higher death rates now, but the important number will be in the final death rates. And we won't know how Sweden has compared to (say) other Nordic countries until some time in the future. (jist sayin')

Lastly.

It might be the case that NZ is in the very unusual position of being able to possibly eradicate the virus. I can't see that being the case for places with already high numbers of infection. But assuming there is no vaccination on the horizon (a reasonable assumption), and assuming 'the rest' of the world remains chronically infected – what then for a Covid free NZ? How's that work?
- pat 8.1
  
  20 April 2020 at 1:37 pm
  
  " But assuming there is no vaccination on the horizon (a reasonable assumption), and assuming 'the rest' of the world remains chronically infected – what then for a Covid free NZ? How's that work?"
  
  It works a hell of a lot better than if we dont eradicate the virus here….the specifics can wait
  - bill 8.1.1
    
    20 April 2020 at 1:50 pm
    
    I agree. But still…I wonder if people are giving it any thought, and how they might feel about living in Noah Land, aye? 😉
    - pat 8.1.1.1
      
      20 April 2020 at 1:56 pm
      
      Pretty sure many are…theres plenty of evidence of agendas at play
- Peter ChCh 8.2
  
  20 April 2020 at 1:43 pm
  
  A trade and tourism union and free travel area with other similar countries, such as Australia and Taiwan would be a start.
  
  Agree re Sweden: interestingly, the infection rates for all the Nordic countries, despite their vastly different approaches, are almost identical. Yes, testing rates and methods may play into that, but so does the demographic profile and so many other variables.
  
  Hugely disagree re 'no vaccination on the horizon (a reasonable assumption)'. Its now a global effort, many many trials now progressing through the animal testing stage and about to enter the human testing stage. This virus no doubt will lead to a quantum leap in scientific knowledge.
  - pat 8.2.1
    
    20 April 2020 at 1:51 pm
    
    "Agree re Sweden: interestingly, the infection rates for all the Nordic countries, despite their vastly different approaches, are almost identical."
    
    Best you go look again…Sweden considerably worse on all measures.
    
    https://www.worldometers.info/coronavirus/
    - Peter ChCh 8.2.1.1
      
      20 April 2020 at 2:00 pm
      
      Using the figures above in the article, Infection rates, that being as a percentage of the total population, are all about .0013 for all the Nordic countries.
      
      Death rates are irrelevant, as reflect demographics, level of health care, heath care policies and so on.
      - pat 8.2.1.1.1
        
        20 April 2020 at 2:28 pm
        
        2 key stats ..infections per million and testing per million
        
        Sweden has the lowest (by far) testing rate yet has the highest detected case rate (double that of Finland)
- Sacha 8.3
  
  20 April 2020 at 1:49 pm
  
  Have a look at the first graph in the post and tell me that the peaks aren't 'table top mountain' peaks.
  
  It's a logarithmic graph, not a linear one.
  - bill 8.3.1
    
    20 April 2020 at 1:54 pm
    
    Can you explain how that works in terms of what I'm seeing?
    
    Am I simply not understanding how the graph should be interpreted, and the virus is perhaps fading as fast as it arrived? (All I’m seeing is a very slow decline in numbers for Italy, the US, UK, France…)
    - Sacha 8.3.1.1
      
      20 April 2020 at 1:57 pm
      
      Just tends to flatten out the tops, is all.
      - bill 8.3.1.1.1
        
        20 April 2020 at 2:08 pm
        
        You're comment is hardly explanatory Sacha.
        
        Is my basic interpretation right, or is it way off the mark because of an incorrect reading of the graph? Or put another way, does the fact of the graph being logarithmic or linear make any meaningful difference to what I wrote?
        
        Sacha 8.3.1.1.1.1
        
        20 April 2020 at 2:10 pm
        
        The peaks are probably sharper than they look here. Sorry, day job intervenes.
- Sacha 8.4
  
  20 April 2020 at 2:12 pm
  
  Unless testing and tracing systems are up to scratch, then coming out Level 4 would be a bit silly
  
  Totally agree.
bill 9

20 April 2020 at 1:47 pm

From the first three to four minutes of this link.

The Netherlands has tested its blood banks for the virus, and the results indicate that infection rates in the Netherlands are far higher than is being picked up by testing out in the general population.. Assuming the blood banks are a representative cross section of society (ie- absenting a reason to suspect that people donating blood should have a higher infection rate) – then the death rate as a percentage drops considerably.

Anyone know if New Zealand has tested it's banks of donated blood and compared the rate of infection detected there to the infection rate from general testing? And if that has been done, how do the numbers compare?
- Carolyn_Nth 9.1
  
  20 April 2020 at 2:14 pm
  
  They have certain protections in place in NZ for blood donations eg no contact with C-19 positives, no sickness symptoms, at least 4 weeks since returned from overseas, etc.
  - bill 9.1.1
    
    20 April 2020 at 2:23 pm
    
    Hmm. So perhaps in the interests of getting an accurate picture, any testing would have had to have been done on the 35 day stock that existed prior to March 23rd?
    
    I dare say blood was never taken from people who were 'feeling off' – and that would apply in the Netherlands and elsewhere too.
    
    Anyway, the findings in the Netherlands are interesting….and (just thinking this through as I type) – shouldn't NZ's donated blood be tested given that Covid doesn't necessarily mean that infected people exhibit symptoms?
- Rosemary McDonald 9.2
  
  20 April 2020 at 2:31 pm
  
  It's a wee bit of a worry that decisions are being made on the basis of inadequate data.
  
  I am very suspicious of the results of the pop up paknspend testing.
  
  Personally, I'm dead keen for Level 3 as life in Lockdown for Peter and myself sees us in a less than safe living environment. For various reasons. Level three would herald the start of the'moving back to our own safer living space' process which in itself might take two weeks or more before we can go 'home's and ultimately be safer.
  
  Putting self interest aside however, the facts are that this government has not enough data to truly know there is little if any community transmission AND with what information we do have it would seem that having frail old folks and high needs disabled sacrificed to the Virus Gods might actually be part of a worldwide plan.
  
  I am hating Level 4. BUT, I simply don't trust that the government does in truth have the interests of this vulnerable group at heart and they might actually be safer at Level 4.
  - weka 9.2.1
    
    20 April 2020 at 4:14 pm
    
    do you know if mechanics will be back at work under L3 and under what conditions? eg essential repairs only?
    - Rosemary McDonald 9.2.1.1
      
      20 April 2020 at 4:48 pm
      
      I don't see why mechanics can't work now, tbh, allowing self interest a free rein. In my experience the average truck and car repair shop is hardly cuddle central. Social distancing is most definitely order of the ordinary pre Virus work day. Smoko might have to be altered…but the actual work would create less of a transmission issue than what I observed last time I ventured into a supermarket.
      
      But that's just my biased opinion.😉
      
      Here's hoping.
      - weka 9.2.1.1.1
        
        20 April 2020 at 4:59 pm
        
        the govt wanted to limit driving, so I can see why normal mechanical business would be classed as non-essential under L4. Call outs eg AA were still going afaik, but I don't know if they were doing repairs. You'd hope so.
        
        Still sucks you weren't given access to your bus.
        
        lprent 9.2.1.1.1.1
        
        20 April 2020 at 5:12 pm
        
        Starter motor (or possibly the battery) clapped out on the car last night when my partner was going to the supermarket.
        
        But it is local, so she walked there, and I followed her on the e-bike with dual panniers and a backpack.
        
        But I’d point this out about mechanics…
        https://www.stuff.co.nz/motoring/120787609/how-to-take-care-of-your-car-during-lockdown
        
        Are mechanics still available to use?
        
        Yes, technically mechanics fall into the essential services column, However, a lot of smaller shops will have closed over the lockdown period and all driver-testing and WoF-only VTNZ branches have closed until further notice.
        
        AA Roadside has confirmed it will be operating over the lockdown, albeit with some changes.
    - lprent 9.2.1.2
      
      20 April 2020 at 5:14 pm
      
      see https://www.stuff.co.nz/motoring/120787609/how-to-take-care-of-your-car-during-lockdown
      
      Mechanics were essential already. But a lot of them, especially the smaller ones, closed down.
Mark 10

20 April 2020 at 3:06 pm

And don’t forget the dairy operators.

in my area none of dairy owners wore masks or had any precautionary measures (Perspex dividers etc.) taken other than a one customer in the shop at the time.

how we could allow dairy’s operating like this beyond any logic.