Covid-19 #38: As the Worm Turns

[ithanos]

37 minutes ago, The Anti-Targ said:

The quest stands on the edge of a knife, stray but a little and it will fail to the ruin of us all.

NZ reports 33 cases today. Still too many cases (like 3 or 4) cropping up with no immediate link to existing cases.

That's a worry. All community cases in the past three days, bar 2 or 3 each day, are in the CM DHB. Lets hope the downward trend returns in the next couple days though the new locations of interest don't give me that hope. The inclement weather in Auckland is helping keep people indoors, but you've got a couple weeks before daylight savings starts on the 26th, coupled with the mercury rising, it'll make it more challenging. All the best!

[The Anti-Targ]

 

Quote

Johns Hopkins University's Amesh Adalja told Breakfast he's never agreed with the approach adopted here [NZ] and in Australia...

Adalja added he believes Covid-19 will still exist in a post-pandemic world and that countries will need to learn to live with the virus, expecting to record cases still. 

He says countries will need to develop a "baseline" for the number of cases, hospitalisations and deaths linked to Covid-19 that it deems acceptable moving forward. 

...

"There's an opportunity here to do this right. You've never really had a hard time with Covid-19."

Fricken idiot, despite being highly educated and a smart dude.  

It's all very well for him as an academic to say the govt needs to decide how many deaths we can live with. But what politician is going to survive an election when the policy they are putting in place is going to kill X number of people, at least? Politicians like to say "our actions have prevented X deaths", but whatever relaxation will cause the disease to establish here can't be spun to a death prevention claim. Govts that failed to eliminate or never really tried have only ever had to talk about "this is how we are going to try to limit sever illness and death". So the govt has put itself in a difficult position in having to at some stage say (in effect but not is so many words), "this is how we are going to let some of you die."

Delta has thrown a major spanner in the works for NZ, because the whole plan with elimination was let's get a vaccine that will give us the herd immunity we all thought would be possible with 65%-80% vaccination, and then free up movements and never go back into lockdown. And it was a great plan at the time, and still is a great plan, up to a point. So objectively this guy is wrong in being against the policy from the start, and almost all of NZ's infectious diseases and epidemiology experts would say he's wrong. But we now have a dilemma, herd immunity is not within sight either through natural infection or vaccination without a different vaccine that is orders of magnitude better at preventing breakthrough infection.

Human infectious disease and epidemiology academics are not all that well clued up on the fact that in the plant and animal world we are keeping so many countries free of diseases and pests through international cooperation and rules of movement and trade that the idea of keeping countries free of any given disease is not much of a challenge, when there is a cooperative will to do so. It is possible to do it with COVID too, so long as there is the cooperative will to do it. It is the fact that humans are so damned uncooperative that's the problem, not that it is technically unachievable. And academics proclaiming that indefinite elimination is unsustainable drives that narrative so people become less inclined to want to cooperate to maintain that status.

[Deadlines? What Deadlines?]

8 hours ago, Padraig said:

Denmark took an incremental approach to removing restrictions, which seems to have been the best approach.  Their cases have fallen significantly after their initial Delta surge.  So they seem to be on the right path, as long as they remain flexible.

Spain has now passed 75% fully vaccinated and are close to 80% partially vaccinated (of their total populatation).  Like Denmark, their case rate has also plummeted.  High vaccination rates and moderate changes to restrictions is working.  I hope it continues.  Some countries do seem to have avoided a major surge.  Italy's numbers are declining after only a moderate Delta surge.  Getting the vaccination rate up before Delta hit may have made enough of a difference there.  I'm curious about countries like Poland and Hungary.  Their COVID rates remain really low, despite relatively poor vaccination rates.

 

Spain, like Denmark, also has really low hospitalizations right now. They have the capacity to deal with a surge should they need to impose restrictions again. This is an important detail.

[The Marquis de Leech]

I would point out that a very high proportion of these new infections are children - thus presumably this is Delta spreading within a household.

Frankly, New Zealand's experience is pushing it ever-more towards Indefinite Border Closure.

[The Anti-Targ]

I don't think the public mood is there to support indefinite border closure, and I don't even know it's there for indefinite border restrictions that are a little bit less than closure but still keep the aim to maintain elimination. If Auckland had gone to level 3 today, and then to level 2 next week, the public support for more lockdowns might have remained. But with at least 2 more weeks of lockdown, in Auckland, and maybe 3 not enough people are going to be willing to put up with a repeat that will be inevitable at least once within the next 12 months.

If this government persists on that track without a large majority in support for it, they will lose the 2023 election to the suite of parties who will campaign to fully re-open the borders ("if you're vaxxed your safe, if you're not then that's your problem, individual responsibility and all that" both statements being false, at least for some, but simple enough for a slogan to carry a party to victory). And with that mandate from the public, even though the public won't really appreciate that it will mean death for some of those who voted for it, and some of those who didn't, the next government will have a get out of gaol free card for all the deaths the opening of the border will bring.

[Fragile Bird]

Interesting story out of China: their latest outbreak is being linked to a man who travelled to Singapore. He was in quarantine for 21 days upon his return and tested negative multiple times. Then there was an outbreak at the school his children attended, and he tested positive, on Day 37.

[Mlle. Zabzie]

35 minutes ago, Fragile Bird said:

Interesting story out of China: their latest outbreak is being linked to a man who travelled to Singapore. He was in quarantine for 21 days upon his return and tested negative multiple times. Then there was an outbreak at the school his children attended, and he tested positive, on Day 37.

That is the official story.  I have to say, I have some doubts on that timeline.

[rotting sea cow]

There have been several cases like that. Like the Argentinian ship that was out at sea for 50 days or so before having a COVID outbreak.

[Zorral]

‘Their Crisis’ Is ‘Our Problem’: Washington Grapples With Idaho Covid Cases
Hospitals in Washington State, already strained, are taking on an influx of Covid patients from Idaho, where the governor has refused to require masks or vaccinations.

https://www.nytimes.com/2021/09/13/us/coronavirus-hospitals-washington-idaho.html

Quote

 

SPOKANE, Wash. — Surgeries to remove brain tumors have been postponed. Patients are backed up in the emergency room. Nurses are working brutal shifts. But at Providence Sacred Heart Medical Center in Spokane, Wash., the calls keep coming: Can Idaho send another patient across the border?

Washington State is reeling under its own surge of coronavirus cases. But in neighboring Idaho, 20 miles down Interstate 90 from Spokane, unchecked virus transmission has already pushed hospitals beyond their breaking point.

“As they’ve seen increasing Covid volumes, we’ve seen increasing calls for help from all over northern Idaho,” Dr. Daniel Getz, chief medical officer for Providence Sacred Heart, said in an interview. As he spoke, a medical helicopter descended with a new delivery.

At a time when Washington State hospitals are delaying procedures and struggling with their own high caseloads, some leaders in the state see Idaho’s outsourcing of Covid patients as a troubling example of how the failure to aggressively confront the virus in one state can deepen a crisis in another.

On the Washington side of the border, residents must wear masks when gathering indoors, students who are exposed to Covid face quarantine requirements, and many workers are under vaccination orders. On the Idaho side, none of those precautions are in place.

“It’s ridiculous,” said Cassie Sauer, the president of the Washington State Hospital Association. “If you have your health care system melting down, the idea that you would not immediately issue a mask mandate is just bizarre. They need to be doing everything they can possibly do.”

Last week, Idaho took the extraordinary step of moving its hospitals in the northern part of the state to crisis standards of care — the threshold at which facilities facing overwhelming caseloads are authorized to ration their resources, perhaps withholding or delaying optimal care for some patients. . . . 

 

Another way we good white supremacist no maskers anti vaxxers  of Idaho got of stickin' it to those gdded liburrrrrrrrrrrrrrrrrrrrals in Washington, hardee har har.  We kill 'em with our covid more way than one!  Hardee har har!

[Fragile Bird]

Forget about Idaho - did you see that a hospital in upstate NY may be restricting deliveries in the maternity ward because so many nurses refuse to be vaccinated?

There are a couple of Canadian nurses who have drunk the kool-aid and attended US anti-vaccine rallies, and are giving speeches and heading up rallies across Canada to protest vaccination requirements at hospitals. My nurse friends are angry and disgusted and would like to see them thrown out of the professional ranks and stripped of their licenses.

[Fragile Bird]

2 hours ago, Mlle. Zabzie said:

That is the official story.  I have to say, I have some doubts on that timeline.

There are reports from around the world regarding similar situations. I don’t think they’re all lying. When stories first emerged, people said “the test must have failed”, or “they must have done the test the wrong way”. But maybe the virus is so far up the nose in some people the swab doesn’t reach it. 

[Padraig]

After the initial vaccinations were approved, I imagine people expected we'd see a number of others added by now.  But Novavax has had numerous issues productionising its vaccine, Curevac had poor efficiacy results and now Valneva has had its contract cancelled by the UK government (although its approval wasn't expected until the end of the year).

https://www.bbc.com/news/business-58499064

Quote

The UK had about 100 million doses on order, after it increased its request by 40 million in February.

The firm said that the UK government served notice over allegations of a breach of the agreement, which it "strenuously denies".

I haven't seen details on this alleged breach.  I don't think they have been released.  Talks have continued with the EU for a year on an order but nothing has ever been formally signed (although it seemed close a few times).  Not sure what happens with that now neither.

Not good news anyhow.

[Zorral]

24 minutes ago, Fragile Bird said:

Forget about Idaho - did you see that a hospital in upstate NY may be restricting deliveries in the maternity ward because so many nurses refuse to be vaccinated?

I did.  Insanity reigns inside and outside the hospitals.  Particularly this, after all the reports of how bad it is for pregnant women to get covid.

Then the other covid story today that particularly struck me -- a California couple died, leaving 5 young children, one a 3 week old baby.  Ya, like you betcha we're responsible for our own lives and kids, don't need no gummit tellin' us what to do.

 

[The Marquis de Leech]

9 hours ago, The Anti-Targ said:

I don't think the public mood is there to support indefinite border closure, and I don't even know it's there for indefinite border restrictions that are a little bit less than closure but still keep the aim to maintain elimination. If Auckland had gone to level 3 today, and then to level 2 next week, the public support for more lockdowns might have remained. But with at least 2 more weeks of lockdown, in Auckland, and maybe 3 not enough people are going to be willing to put up with a repeat that will be inevitable at least once within the next 12 months.

If this government persists on that track without a large majority in support for it, they will lose the 2023 election to the suite of parties who will campaign to fully re-open the borders ("if you're vaxxed your safe, if you're not then that's your problem, individual responsibility and all that" both statements being false, at least for some, but simple enough for a slogan to carry a party to victory). And with that mandate from the public, even though the public won't really appreciate that it will mean death for some of those who voted for it, and some of those who didn't, the next government will have a get out of gaol free card for all the deaths the opening of the border will bring.

Jacinda pursuing anything other than Elimination will lose her 2023. The public (apart from David Seymour) are right behind Elimination, even if it means extended lockdowns. After all, we can see the alternative... Sydney.

We have to keep the border closed, because anything else means the destruction of our health system. People understand that.

[Zorral]

https://www.npr.org/sections/health-shots/2021/09/12/1036356773/i-got-a-mild-breakthrough-case-heres-what-i-wish-id-known

Quote

 

....The vaccines aren't a force field that ward off all things COVID-19. They were given the greenlight because they greatly lower your chance of getting seriously ill or dying.

But it was easy for me — and I'm not the only one — to grab onto the idea that, after so many months of trying not to get COVID-19, that the vaccine was, more or less, the finish line. And that made getting sick from the virus unnerving.

After all, there were reassuring findings earlier this year that the vaccine was remarkably good at stopping any infection, even mild ones. This was a kind of bonus, we were told. And then in May the Centers for Disease Control and Prevention said go ahead and shed your mask if you're vaccinated.

"There was so much initial euphoria about how well these vaccines work," says Jeff Duchin, an infectious disease physician and the public health officer for Seattle and King County. "I think we — in the public health community, in the medical community — facilitated the impression that these vaccines are bulletproof."

It's hard to keep dialing up and down your risk calculations. So if you'd hoped to avoid getting sick at all, even slightly, it may be time for a "reset," Duchin says. This isn't to be alarmist but to clear away expectations that COVID-19 is out of your life, and keep up your vigilance about common-sense precautions.

With more people vaccinated, the total number of breakthrough infections will rise, and that's not unexpected, he says. "I don't think our goal should be to achieve zero risk, because that's unrealistic."

How high are my chances of getting a breakthrough case these days?
It used to be quite rare, but the rise of delta has changed the odds.

"It's a totally different ballgame with this delta phase," says Dr. Eric Topol, a professor of molecular medicine at the Scripps Research Translational Institute in La Jolla, Calif. "I think the chance of having a symptomatic infection has gone up substantially."

But he adds, "Quantifying that in the U.S. is very challenging" because our "data is so shoddy."

The vaccinated still have a considerably lower chance of getting infected than those who aren't protected that way. Look at data collected from Los Angeles County over the summer as the delta variant started to surge in Southern California: Unvaccinated people were five times more likely to test positive than those who were vaccinated....

....

How careful do I need to be if I want to avoid a breakthrough?
Looking back, I wish I'd taken some more precautions.

And my advice is different now when friends and family tell me they want to avoid having a breakthrough case such as mine: Don't leave it all up to the vaccine. Wear masks, stay away from big gatherings with unvaccinated people, cut down on travel, at least until things calm down....

 

[HoodedCrow]

The vaccine may stop long term problems, or not. It’s our best shot. I used my vaccine passport today. We have a downloadable version for now that can be shown on our phone. I confirmed my identity through on line photos. It’s mildly difficult.

[Zorral]

Funny isn't it, how the antivaxxers complain about nazis and freedum around vaccination mandates and proof of vaccination, yet believe that voters must be mandated to show papers before voting.

[The Anti-Targ]

2 hours ago, The Marquis de Leech said:

Jacinda pursuing anything other than Elimination will lose her 2023. The public (apart from David Seymour) are right behind Elimination, even if it means extended lockdowns. After all, we can see the alternative... Sydney.

We have to keep the border closed, because anything else means the destruction of our health system. People understand that.

The latest rhetoric coming out of Jacinda is she wants to bring lockdowns to an end by getting a high vaccination rate. And some experts being given prominence in the media, such as Graham Le Gros, director of the Malaghan Institute of Medical Research and the programme director of the Vaccine Alliance are trying to prime the public for the country having to "live with the virus", skirting the subject of the impossibility of herd immunity, and that it will bring deaths. making it sound like we will be as safe as elimination if we get vaccinations high enough. But high enough means 95%, which is not going to happen.

Perhaps the govt's internal polling is starting to show too many people getting sick of lockdowns and not wanting to have them long term, and who want to be able to travel more freely. I don't think even ideologues like David Seymour would keep beating the lockdown skeptic drum if there was not political mileage in it.

[The Marquis de Leech]

Seymour beats that drum because if he can hoover up the 15% of the population who want the plague to run free, he's laughing. The Nats have to be much more cautious.

Really, a choice between lockdown and Sydney is no choice at all, and it'll only become more apparent come Christmas, when the corpses in the Northern Hemisphere start piling up again. I fully agree with Bernard Hickey that we're looking at long-term border closure. My only quibble with him is that I think plenty of people would actually be just fine with opting out of an increasingly insane international environment.

[Deadlines? What Deadlines?]

11 hours ago, Zorral said:

Another way we good white supremacist no maskers anti vaxxers  of Idaho got of stickin' it to those gdded liburrrrrrrrrrrrrrrrrrrrals in Washington, hardee har har.  We kill 'em with our covid more way than one!  Hardee har har!

Meanwhile, in Canada...

6 hours ago, Zorral said:

Funny isn't it, how the antivaxxers complain about nazis and freedum around vaccination mandates and proof of vaccination, yet believe that voters must be mandated to show papers before voting.

And if it was Isis who was killing  1000+ Americans a day, these same idiots would be clamoring for martial law and locking up brown people and foreigners without trial.