- Date published:
11:59 am, May 14th, 2020 - 25 comments
Categories: covid-19, Economy, health, police, Politics, uncategorized - Tags: 1918 pandemic, health act, legislation
Listening to some of the complete bullshit about the legislation to move to level 2 just made me realise exactly how ignorant some people are of our history and basic science. Viruses and other diseases simply don’t care about abstractions like ‘liberty’ or ‘inhumanity’ or ‘the economy’ or ‘human rights’. They just want to breed. The behaviour of their host victims is the only thing that matters to a virus, bacterium or fungi. Clearly in the last few days that escaped some unthinking critics.
Covid-19 isn’t dead in NZ. All indications are that it has had a reversal in the level 4 and level 3 containment. But is still popping up when someone starts displaying symptoms or when someone gets a positive test. Even with the best of containment, it will probably continue to do so for years or even forever.
It looks far more like a endemic infectious disease like polio or HIV than a disease like influenza. Influenza or SARS are like the title of the James Dean biography “Live fast, die young” …
Whereas covid-19 looks to be trying to get the same role in humans that it has in bats. It wants to hang around forever in the population quietly breeding. Only occasionally, almost by accident, it gives someone a nasty respiratory cold and pneumonia if they have a depressed or over-reactive immune system. Relatively rarely killing victims. But also giving humans young and old strange blood clots indicating that we don’t know the full range of its behaviour yet. Including long-term effects.
Bats hanging around with no social distancing have far better immune systems than humans. Which means that this zoonotic disease, once it jumps to humans, is like a whole of species experiment to the virus as it adapts to live in us.
That means that our archaic legislation that is designed for short influenza epidemics and isolated live fast and die young outbreaks of measles or diphtheria in a largely immune population simply isn’t up to the task.
Our legislation is out of the ark. It is essentially what was written in the Health Act 1920 in the aftermath of the 1918 influenza epidemic in NZ. The epidemic parts of that legislation were essentially picked up and pushed into the Health Act 1956. But the world of 1956 was far different in NZ to what it is now.
In 1956 we were only getting a total of about 27,000 incoming short-term visitors per year. Most would have come by ship like our immigrants. These days we get close to 4 million incoming short-term visitors annually almost entirely by air, not counting the tens of thousands on cruise liners.
In 1956, private cars were only starting to become used for long-distance travel. I think that the only motorway was the Auckland section between Mt Wellington and Ellerslie. I remember as a kid in the 1960s that the main roads were pretty damn appalling with large sections of State Highway 1 still using gravel. Our main domestic airline NAC, was still running the low capacity world war 2 designed DC3, and charging an arm and a leg for the slow and damn noisy ride. Like 1920, railways were long distance transport of the day.
The Health Act 1956 reflects this. It envisaged the country as separated districts with local district boards of health and their medical officer of health. Each district would largely handle the containment and eradication of their local epidemic with only minor movement from other areas. This basis of the act got tinkered with over the years but fundamentally remained the same as the world changed around it as intercity traffic by plane and road vastly increased, as did the numbers of tourists.
The effect of influenza in 1918 was devastating in the 1.15 million people of New Zealand of 1918.
No matter how the second wave developed in New Zealand, it was many times more deadly than any previous influenza outbreak. No other event has killed so many New Zealanders in so short a space of time. While the First World War claimed the lives of more than 18,000 New Zealand soldiers over four years, the second wave of the 1918 influenza epidemic killed about 9000 people in less than two months.NZ History: The 1918 influenza pandemic – death rates
In Epidemic Preparedness Act 2006, in the wake of the SARS outbreak of 2002/3 recognized that there were some problems with trying to make an act based on the 1920s work in the modern era. So it vested most of the powers of for dealing with epidemics nationally in the Director-General of Health. It was designed to work at a national level with a state of emergency from the Civil Defence Emergency Management Act 2002. But it was still designed for a ‘live fast and die young’ style of disease
But covid-19 isn’t a ‘live fast and die young’ disease like the influenza of 1918 or SARS. Both had a rapid incubations measured in days and single days and influenza had a fairly rapid and robust immune response if you survived. With the 1918 influenza, most areas only got a single epidemic because it spread so widely inside and rapidly that herd immunity was built rapidly. But with both, people who were infected knew about it because those who were infected developed strong symptoms.
Covid-19 is rapid spreader where many of the people who are infectious aren’t aware that they are sick or infectious. With or without the symptoms, people are infectious for long periods of time, giving ample time to spread. We have no real information if this is a stealth-adapted virus that has features that ‘hide’ from the immune system in asymptomatic infected people and don’t produce long term antibodies. Like herpes or HIV or CMV. Quite simply we haven’t seen this virus for long enough to know.
That is where New Zealand has a legislative problem. We can’t stay in a state of emergency across the whole country for a long period of time. As pointed out by many people, you need a functioning economy to maintain the kind of contact tracing and medical systems to deal with outbreaks. But we have no effective legislative framework for doing this over the whole country without draconian state of emergency controls.
Isolation of the type that we have been doing in levels 3 and 4 is something that is effective at slowing or (in our case) effective stalling of the spread of the disease. But it can’t be supported for long.
But we don’t have the required legislation for dealing with a whole of the country epidemic that is slow and long to contain. So that legislation was introduced a few days ago and passed last night in the COVID-19 Public Health Response Act 2020 (note that as of the time of writing some amendments still haven’t been incorporated on the site).
There has been some perfectly valid quibbling that this legislation was rushed through parliament and causes civil liberty issues. But that is because parliament hasn’t been sitting due to covid-19 infection concerns, and this legislation wasn’t already sitting on the shelf ready to go.
Frankly this particular type of legislation should have been done back in the 1980s with AIDs and HIV or anytime after we started getting other ‘novel’ zoonotic viruses entering the human population like ebola, SARS, MERS, nile virus, avian flu, swine flu and many more. About the only thing that is common for these diseases is that they’re different from each other and different from the kinds of diseases that we know from history. Our legislation needed to be more versatile as well – and it isn’t.
Stuff has a pretty good roundup of the valid and spurious quibbles once you get past the inflammation causing dog-whistle headline “Coronavirus: New Covid-19 law gives police power to conduct warrantless searches amid civil liberty concerns“. To me, most of the commentary is just meaningless criticism for criticism’s sake because it says in effect – you should have consulted about this legislation with us.
To me, virtually none of these grand-standers addressed the key problems. The legislation wasn’t already in force because generations of parliamentarians had already failed in their duty of care to provide options to a state of emergency. How do you consult widely when you don’t have a forum available to do it widely – something that usually done in select committee. Which makes this statement and other like it kind of moot.
Chief Human Rights Commissioner Paul Hunt said he had “deep concern” about the lack of scrutiny and rushed process for the Bill.
“For weeks the Government has known that we would be moving to alert level 2. It has not allowed enough time for careful public democratic consideration of this level 2 legislation. There has been no input from ordinary New Zealanders which is deeply regrettable,” Hunt said.
“This is a great failure of our democratic process. The new legislation, if passed in its current state, will result in sweeping police powers unseen in this country for many years.”
“In times of national emergency sweeping powers are granted. There is a risk of overreach. Mistakes are made and later regretted.”
I agree with that and many other statements made in the past few days that this legislation is rushed, hasn’t had a due process, and has flaws. But I can’t see any realistic way of getting widespread inputs from “ordinary New Zealanders”. But in the end, the parts of the Act that he was quibbling about are running a balance between the human rights of those violating orders under section 11 of the act, and the rights of those who’d be afflicted or killed by idiots violating valid section 11 rules.
The legislation has flaws, but the problem really lies with the lack of legislative preparation for anything apart from another influenza or measles style epidemic.
I agree with Graeme Elger’s take (my italics)
Wellington lawyer Graeme Edgeler said the law contained additional safeguards, such as ensuring police reporting why they decided to use the powers.
“But I’m not sure what they would be searching for in people’s homes … What are the level two rules they think people will breach?”
Edgeler,who received a draft copy of the law from the Government, questioned if a warrantless entry power was justifiable for a gathering in a home which broke the rules.
“I think that is where the concern should be,” he said.
“However, I think it is good that there is a new law. This is better than continuing under powers that existed over the past seven weeks, which did not have safeguards and were more extreme and Draconian.”
Personally I’ve seen far too many farcical applications for search warrants by the police that have been rubber stamped by registrars to really ever trust them. They get away with it because neither the courts nor the IPCA actually impose any penalties for police lying and outright stupidity in their applications.
But the important point is the one at the end in italics.
The only realistic alternative under our existing legislation was to retain the state of emergency – which is a really draconian structure. This legislation may be flawed, got a lot of adaption in our house of representatives, and allowed us to move reasonably safely out of a state of emergency.
Hopefully, parliament will now start considering, with public participation, as they did in in 1919 and 1920 how to get reserve powers for this and other possible novel disease responses into legislative toolkit.
In the meantime, we’ll deal with the virus with this imperfect act as a tool.
We're all lucky it isn't more infectious than it currently seems to be. The big unknown is the proportion of the populace who are unwitting carriers, right? Symptomless.
I wonder what the ratio is that creates the tipping point. Perhaps still unknown to science, eh? News this morning of another wave of re-infection overseas is the signal we ought to heed in public policy development.
"Bats hanging around with no social distancing have far better immune systems than humans. Which means that this zoonotic disease, once it jumps to humans, is like a whole of species experiment to the virus as it adapts to live in us."
Yeah, that's the guts. One big science experiment happening globally. Darwinism in action! I hope our bodies are naturally fine-tuning our immune system into optimal response mode – in reaction to tiny doses of the virus breathed in. That's what ought to happen. Nature doing effortlessly what vaccination helps us to do. But if the input is greater than homeopathic scales of activity and our immune systems are already sub-optimal then nature can't cope.
Yes and no. It does mean that we have very little idea about how many people in any global (or NZ) population have had it already.
I'm waiting for the report that say for a reasonable sized sample that the known symptomless infected (ie from swabs) always show specific antibodies or at least a sizeable percentage do. So far the indications seem to pointing to a low percentage. If that is the case then :-
…won't happen. It would mean that small viral loads in the environment will be handled by the first line generic immune responses and that you'd have to get a large dose to trigger the secondary auto-immune 'learned' responses.
But generally swab testing hasn't been that wide and the antibody tests look pretty cowboy for false positives and false negative. Which is probably why no-one is putting out that info yet
Haven't seen that yet – went straight from writing this post to working this morning without the morning news read.
"Lebanon on Tuesday became the latest country to reimpose restrictions after experiencing a surge of infections, almost exactly two weeks after it appeared to have contained the spread of the virus and began easing up. Authorities ordered a four-day, near-complete lockdown to allow officials time to assess the rise in numbers."
"The reemergence of coronavirus cases in many parts of Asia is also prompting a return to closures in places that had claimed success in battling the disease or appeared to have eradicated it altogether, including South Korea, regarded as one of the continent’s top success stories." https://www.washingtonpost.com/world/as-some-countries-ease-up-others-are-reimposing-lockdowns-amid-a-resurgence-of-coronavirus-infections/2020/05/12/6373cf6a-9455-11ea-87a3-22d324235636_story.html
Also: “In the Chinese city of Wuhan, where the pandemic first emerged, authorities on Tuesday ordered the testing of all 11 million inhabitants after a cluster of six new infections emerged, five weeks after the city had apparently rid itself of the disease.”
Also: “Iran, the epicenter of the disease in the Middle East, with more than 110,000 reported cases, has ordered a county in the southwestern province of Khuzestan to reimpose a lockdown after cases spiked there. But the government is still planning to proceed with the reopening of schools later this week, despite a marked jump in new infections since restrictions were eased in late April.”
Which leads us to a tug-of-war between the people & the health authorities. “India and Russia eased their restrictions Tuesday even as the number of infections in both countries continued to soar.” Russian roulette & Indian roulette.
Yep. In no particular order…
The more you look at this particular virus and read about the bat colonies, the more you realise that this is an old virus. At 30k base pairs and with a high stability in its self-correction code, I suspect that it has multiple different strategies. It doesn't need to play the mutation game to look for a different identity.
The rate of change in the virus may be small , on average. We are at 4.4 mill known cases, likely lots more.
Who knows that person with the 7th mill case has a small mutation that means the virus attacks the health of younger people more easily …. those older people dying quickly without passing on arent a good evolutionary path.
But it looks like it is attacking younger people already – but at a lower probaility.
Most of the criticism of the legislation came in the form of low information social media reckons from the same usual suspects who were all suddenly epidemiology experts as well for the last month.
It was clear to me that these entitled dimwits had no clue as to the powers the government currently had under a state of emergency – despite being parked on their arse for four weeks at home with time on their hands and an all to obvious internet connection with which to favour us with their musings – but that didn't stop half-arsed social media hysteria that really was a poster child for a definition of fake news.
Yeah. I haven't bothered looking at the usual morons in the media – after all there is only so much stupidity from hosking or heather watshername or soper et al that I can stand.
I was getting this third hand over the last couple of days from my partner reading from people she knows on facebook and querying me about it. They were obviously getting it from people who knew fuckall about reserve powers in legislation and what a state of emergency or a fighting a disease actually entailed. Not that I know that much. Just army medic, a few history papers touching on it, and a lot of general history and civics reading.
Eventually she irritated me enough to look up the original bill and the (mostly) resulting act to answer her questions on the detail. And motivate me to write this post to point out why this legislation needed to be put in place in a hurry.
After all the only real alternative was to remain in a state of emergency with limited safeguards and oversight.
We just didn't have a good transition state out of SOE built into epidemic handling legislation.
So we have 3 months with this legislation, and then we can either roll it back if not needed, or (more likely) rewrite the problematic parts to reflect the developing situation.
I agree that warrants do not provide much protection. The important part is the reporting, so we can judge whether the powers are used appropriately.
A problem is that you don't know what powers you need until you need them. In the end the legislation is only as safe as the police force enforcing it. In general we are happy for the police to have powers so long as they are not used against us.
With a max automatic chop out time of 2 years.
Entry into houses. Surely it would be used only if there are obviously a crowd inside. No doubt entry would be preceded by a knock on the door. But police knowing that they had further powers if needed would not leave them dangling impotently?
Do we really want Graeme Edgeler to be the most vocal public advocate on what is is not legal.
This is his most recent case.
New Zealand Bill of Rights Act 1990, s 26
BETWEEN CHIEF EXECUTIVE OF THE DEPARTMENT OF CORRECTIONS Applicant AND MARK DAVID CHISNALL Respondent
The PPO or ESO or extended Supervision Order is only made after application to the High Court.
This case already went to Appeal and Supreme court and is using a new angle .
Edgeler wants to let the House burn down rather than have a procedural process by the Fire Brigade go unchallenged.
This Chisnal case and his post parole provisions have produced a slew of court cases
https://forms.justice.govt.nz/jdo/Search.jsp#/search and appearance by Edgeler
I have been giving the reason for why blood clots show up in Covid-19 some thought.
It might be helpful for a ANA to be done to measure the level of antibodies which is done for an autoimmune. Also a full ENA panel to be done to see what the autoimmune condition is.
There is a condition seen in systemic limited scleroderma called GAVE or watermelon stomach which dilates blood vessels and they can ooze like a grazed knee or worse. A person can become blood transfusion dependent and low iron levels were the only symptom I had even though I had off the chart ANA and the ENA panel for systemic limited scleroderma.
Immunologist certainly have got their work cut out for them in understanding what Covid-19 is doing to the immune system. It is clear to me that Covid-19 is systemic, what I find shocking with it is how rapid the effects of a complication are.
Almost all of the complications (at least that I've read about) appear to be to related to the persons auto-immune responses getting way too enthusiastic.
It is something that is common with all new diseases jumping species. Over time the two wear together. The virus evolves to reduce excessive responses. People with excessive responses get winnowed out of the population. Medics wind up with specific responses to prevent the response.
When I look at peanut allergy and bee stings some people can have a serious allergic reaction. I know that the body produces histamine to combat the allergic reaction. There are mast cell conditions which have increased histamine and anti histamine is the treatment. A serum tryptase test is done to establish the level of histamine. Some pathologists do a histamine test when a person has died suddenly to exclude an allergic reaction.
You can have a mast cell condition without having a food or substance allergy.
A Dr Theoharides is a mast cell expert. I would like to see what he has to say about Covid-19.
Nope, histamine is part of the allergic reaction, which is why you take anti-histamines.
By all accounts, the ‘cytokine storm’ triggered in some patients by COVID-19 is very different from an allergic response although it may involve overlapping parts and components of the immune system(s).
Yep 40+ years ago I used to be allergic to bee-stings to the point of needing anti-histamines around. Essentially after I got a bee-sting the area would start to swell virtually immediately, and keep swelling. If it was up around the throat (as my first one was) I also started to have problems breathing.
I just read the histamine page in wikipedia… Yikes..
Good thing I haven’t haven’t had a bee-sting since my late adolescence.
But what are histamines?
They're chemicals your immune system makes. Histamines act like bouncers at a club. They help your body get rid of something that's bothering you _ _ in this case, an allergy trigger, or "allergen."
See above link as reference
I am not disagreeing that histamine is part of the allergic reaction.
I disagree. Our body only makes histamine, singular; there are no “histamines” as such.
How do you explain histamine occuring naturally in some food food?
See above link.
I don’t understand what you’re asking me to explain. Histamine, singular, occurs naturally but it is also formed during fermentation and bacterial metabolism in certain fish, as per your link.
My point is that there is only one natural histamine, called histamine 😉
Ingested histamine does not necessarily have the same effects as locally released endogenous histamine, after a sting, for example. Inhaling a histamine spray, in a controlled setting, has a direct effect on the airways and they contract (congestion); I had to do this once myself.
I do not think there is a difference between histamine the body produces and histamine produced in food.
An immunologist told me that most people have histamine levels in the low digits so it is obviously produced in the body. From what I have read there are some foods which are high in histamine which need to be avoided in people who are histamine intolerant which affects about 1% of the population.
The immunologist also told me to try and control my histamine level by avoiding high histamine food.
Knowing the cause of the elevated histamine level is what is important. I will not go into the causes.
Well, yes, histamine is histamine, obviously. Where it is absorbed or released and where it reaches a certain concentration and which receptors it binds to in which tissues and on what cells is a completely different story though. Water on your skin is fine; water in your lungs is not.
That article you linked to was misleading in talking about histamines in the plural sense. I still have no idea why they did this and what they meant by it!? There is only one histamine, which is a specific compound. It is not a class of compounds as such, like hormones, benzodiazepines, cannabinoids, or alcohols, for example.
You might be interested in Dr Theoharides an expert in histamine and mast cells. What he had to say about Covid-19 I found interesting. His treatment would raise a few eyebrows. Whether he is right or not needs to be put to the test.