Coronavirus - worldwide spread and control

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Australian new case numbers went flat for about five days and now appear to be going down. Its possible this is just reporting lag, but it might be actually turning new case numbers around.
From what I see coming out of Oz, testing is seriously lagging. This is likely a reflection of a choice to... ride the wave, I guess. Lots of comments and reports I see indicate they are trying the herd immunity/modest proposal and basically abandoned rigorous testing as part of the solution.

I hope this is just from limited information and skimming, not quite reading in detail, but everything I see coming out from down under supports that. Not good.
 
This video is interesting if you like watching simulation models and the impact different measures have on the epidemic spread.
He simulates various things like 100%compliance with social distancing versus 90% and 50% compliance.
Also the effect of isolation with the exception of people going to a central location like a supermarket.



So basically, there is going to be a long tail and current restrictions on travel, social distancing and economic activity are going to last months until ~40-60% of the population have been infected.

Unless you can completely isolate a population, eg total travel bans, anything else risks overwhelming healthcare resources, which incidentally, must guide the optimum solution in terms of policy restricting the spread.

Hospital beds per population is 0.4% in Australia and 0.3% in the UK and the USA. The data on worldometer suggests 5% of active cases are in critical condition, which would mean for an average bed occupation of 1 week, 50%(percentage of population who will be infected) *0.05 (bed cases)/1 (bed/weeks) = 2.5% of the population who will require beds = 8 weeks given optimum bed allocation. But what would the numbers requiring ventilators be? It could be longer. Plus if the spread is too slow to not utilise all the ventilators, it will take longer - or if case numbers are volatile, more people will die. Hence with some margin for error, current measures should be expected to be imposed for quite some time - so highly likely to be longer than 8 weeks.
 
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I think the 6-8 weeks may be perfectly realistic. Once the out of home spread mechanism is blocked we just have to wait for relatives to get infected and recover or not - that should take no more than month or so.

What seems to me, as to you, implausible is that any sort of return to normal economic activity could begin for many months because clearing out the last few cases will take a long time and if they are not cleared out the problem will flare up exactly the same within a month or so. Rather few people have been infected as a percentage of the population so there will be no slowing from 'herd immunity' for years.

What may be more realistic is that certain types of business currently shut down may be able to start up again. I am personally waiting for solicitors and council officers to sort out a house purchase. That might get back on track. I also want to buy in some wire mesh fencing for the garden and the timber merchant might be able to one up again. But anything that requires commuting or international travel is going to be hugely problematic. I suspect we will gradually get to know a very different sort of lifestyle with even more emphasis on internet communication. I think that different lifestyle may last five years at least.

I don't think a new runway or high speed train is going to be needed for a while.

"A new pre-print study by a team of Harvard researchers concludes that the idea of a single prolonged lockdown — which many are calling for in the U.S. — is not the most effective or sustainable way to curb the coronavirus epidemic. A more viable, long-term approach is to carry out a series of shorter “intermittent” lockdowns triggered by certain medical care capacity thresholds."

https://www.medrxiv.org/content/10.1101/2020.03.22.20041079v1
 
(post copied to
Resources for help getting food during quarantine and safe handling of food)
Australian new case numbers went flat for about five days and now appear to be going down. Its possible this is just reporting lag, but it might be actually turning new case numbers around.
That might just be the initial wave of cases from the cruise ships washing through, and they account for something like a 1/3 of all cases in Oz. We will have to wait another 10-15 days to be sure.

The current numbers in intensive care are okay (not high) at the moment, and that is a number that is harder to get wrong and so is probably a better indicator of where we are at.

I've soaked all the fruit in soapy water and rinsed. I still have the pumpkin, ice cream cone packet, potato chip to wipe down. So laborious, but I know it should be done.
You don't have to actively decontaminate everything.


Anything that is not perishable (i.e. doesn't need to go straight into the fridge or freezer), and you don't need to use immediately, can just be left sitting somewhere safely out of the way (e.g. spare room) for 3-4 days to let the virus deactivate naturally.

No need to do any more work than necessary.
 
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NZ growth curve.png updated NZ growth curve. Were are now on our sixth day of lockdown, and the curve already seems to be flattening a little. While there may be many case out there undiagnosed, we have not reduced our rate of testing in the last few day, so that doesn't seem a likely explanation for the downturn.

Edit: Updated to April 1 (now on 7th day of lockdown).
 
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updated NZ growth curve. Were are now on our sixth day of lockdown, and the curve already seems to be flattening a little. While there may be many case out there undiagnosed, we have not reduced our rate of testing in the last few day, so that doesn't seem a likely explanation for the downturn.
I think the NZ situation is complicated by a number of factors. One is that the vast majority of cases in the official numbers are from people who have returned from overseas with it or (to a lesser extent) their family members. The government is still telling us that cases from community spread are only 2 percent or so. With the reduction in returnees, it's to be expected that the number of new cases of that type will drop.

The other issue is that testing has been targeted towards returnees showing symptoms and people who have been in close contact with a diagnosed case. Our Prime Minister has today stressed that, now we have more capacity to test, a lot more testing has to be done to identify if we have community spread. The rules guiding doctors as to who is tested have only today been loosened to include people with respiratory symptoms who have no connection with overseas travel.

Our only death from Covid-19 was in a fairly remote part of New Zealand with no hint of community spread and, last I heard, there didn't seem to be any clear link to overseas travel. Medical staff were taken by surprise, and didn't start wearing appropriate PPE for quite some time.

So, I don't think the line on the chart tells us a lot about the real number of cases in New Zealand or about the impact of the 5 days of lockdown.

I expect these sorts of issues (who is tested and how many tests are done), along with others, mean that the lines for most countries need quite a lot of extra information in order to be interpreted well and compared. (still really interesting to look at though)
 
"A new pre-print study by a team of Harvard researchers concludes that the idea of a single prolonged lockdown — which many are calling for in the U.S. — is not the most effective or sustainable way to curb the coronavirus epidemic. A more viable, long-term approach is to carry out a series of shorter “intermittent” lockdowns triggered by certain medical care capacity thresholds."

Which is what we have just tried and proves to be not only a catastrophe but achieves more or less nothing because we still only have less than 1% of the population infected. It will be month before the cases in hospital so far are dealt with and recovered (or not). I fail to understand how people can get their arithmetic so wrong.
 
NZ's Ministry of Health has published their latest modelling reports (and they aren't pretty though we still have a chance to avoid the worst):

https://www.health.govt.nz/publication/covid-19-modelling-reports

Related article:

In the worst-case scenario modelled, almost 150,000 New Zealanders would be hospitalised with Covid-19 and more than 35,000 would lose their lives.

The Ministry of Health has released its mathematical models that project the severity of the Covid-19 outbreak based on different measures imposed on the populous. The modelling delivers “a clear warning of the consequences of not acting swiftly and decisively”, it said.
More at: https://thespinoff.co.nz/science/31...-ministry-of-health-releases-covid-19-models/

On a different topic, @Jonathan Edwards will be interested to see Air NZ's CEO shares his predictions regarding International travel:
Foran said for the foreseeable future, the only Air NZ planes heading overseas will be “limited international services to keep supply lines open”.
More at https://thespinoff.co.nz/business/31-03-2020/full-scale-of-damage-to-air-nz-becoming-clear/
 
This is interesting. Anthony Costello thinks setting up testing centres + tracing, is even more important than lockdown; and could help with suppression in 6-8 weeks:



I read this and thought sounds reasonable. I Googled "Anthony Costello" and found that he should know a thing or two!

One of the questions I have @Jonathan Edwards @Simon M or others is that we need to test to identify people who are current infected with the virus/infectious - I think this requires the PCR test (looking for viral RNA). I assume that this (PCR test) was the basis for the control of the virus in South Korea. However, here I've heard experts who either deliberately, or accidentally, fudge the issue of testing; they talk about testing for antibodies --- those who have developed antibodies have beaten off the virus --- they are not hosting the virus/infectious.

I almost forgive politicians who talk about "pregnancy type tests ---X zillion arriving next week" these are antibody tests and they do not identify those shedding virus/infectious i.e. they cannot be used to control transmission. The role of a Minister is to represent Government policy in the best possible light; in this case that involves a certain amount of obfuscation regarding testing --- many of us don't expect our politicians to be clear when it doesn't show them in a good light!

The Republic of Ireland introduced drive through (PCR) testing, to identify members of the public who are infected/infectious, weeks ago. They have also taken over hotels* to accommodate those who are infected/infectious --- breaking transmission. Seems a little bizarre that the Government hasn't explained why they are not testing to identify people who are infected/infectious.

*https://www.rte.ie/news/2020/0329/1127114-hse-briefing-covid/
 
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Seems a little bizarre that the Government hasn't explained why they are not testing to identify people who are infected/infectious.

I am afraid that the scientific experts buy in to the idea that it is better to bullshit to keep people happy because people are so stupid they will not be able to cope with the reality. I think the advisors should wake up to the fact that a lot of ordinary lay people have more common sense than they do.

It has struck me a few times in the last week that maybe what is needed is to set up 'neighbourhood watch' type groups to establish the virus status in small geographic areas and then pool these through an easy access website. Government seem to be incapable of making use of modern technology and old fashioned human ingenuity in this way. Local communities could do well to source food in a domain that is known to be virus free. Those communities could enlarge and coalesce as more is known.
 
Its a group of UK psychiatrists trying to claim as much of the pandemic space as possible.
Related to this:


He writes:
Could the “don’t overreact” advice from behavioural science have led politicians to drag their feet in dealing with the crisis, as some clearly have? Again, it’s hard to say — but it’s very possible that the broad message got through to the decision-makers.
 
Which is what we have just tried and proves to be not only a catastrophe but achieves more or less nothing because we still only have less than 1% of the population infected. It will be month before the cases in hospital so far are dealt with and recovered (or not). I fail to understand how people can get their arithmetic so wrong.

The other issue which you have highlighted @Jonathan Edwards is that doctors may refuse to work in these conditions/circumstances. Doctors will have to decide you go on a ventilator (young healthy) you do not (older/underlying condition/s). After they have gone through this peak then if we do not introduce effective controls (testing & tracing contacts, personal protective equipment, social distancing --) then the doctors will have another round of who gets the chance to live --- they may refuse to work in those conditions.

The absence of adequate ventilators in the UK was know months ago --- Wuhan, Italy ---. Testing and tracing --- should have been implemented.
 
article on why I wish my fellow psychologists and “behavioural scientists” would just stop talking about the coronavirus: https://unherd.com/2020/03/dont-trust-the-psychologists-on-coronavirus/ …
great article

Decision-makers should, before using psychology research as the basis for policy, know just how weak and contentious so much of it is. And everyone else should stay at home, wash their hands — and beware psychologists bearing advice.
 
The UK has the capacity to process tens of thousands more tests for coronavirus but has failed to organise itself properly, a former director at the World Health Organization has said.

Anthony Costello, a global health professor at University College London, called for the UK to make use of testing machines in every university and big hospital around the country, setting up mobile testing units like Ireland, which is testing far more people per head of population.

There is growing political concern that the UK was still only managing to test 5,000 people a day by Sunday morning, despite aims to increase tests to 10,000 and then 25,000 a day - which is still far short of the 70,000 a day that Germany is managing.
https://www.theguardian.com/world/2...est-tens-of-thousands-more-people-says-expert
 
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