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2 hours ago, lewelma said:

Fair. The stringency index for NZ has 3 humps that are 2/3rds height, which happened when only Auckland was in lockdown and the rest of the country was completely free (as in 40K person events still happening without masks). I just thought it was an interesting graph. 🙂

But I think that the biggest difference is just that NZ came second with its delta outbreak, so could learn from Australia's successes and failures. No government knows what will work until they try it, so being second was a massive advantage. 

 

I think what works for Delta is what worked for previous variants. My state, QLD, WA and for a while Vic were all able to get it under control through rapid lockdowns. One state premier made a different set of decisions, either through believing that they somehow could do what no one else did or because they wanted to force the issue of zero Covid and opening up, and now every other state is dealing with repeat incursions due to that.  The federal response here has of course been pretty woeful aside from the initial decision to stop flights early. But the same things that worked for the other variants have worked well in every other state of Australia.  Now we are all pulling in different directions - one state building giant quarantine centres and another one talking about open borders to international travellers by Christmas.  
 

The issue here is not really that Delta is so different but that the country is no longer united in a commitment to Covid zero.  

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Interesting bit of detail that has come out today. Apparently 16% of all close contacts only test positive on day 12. I was surprised that it was so high. But given that statistic, they are expecting 50 more cases from the known household exposure events. 

One more bit of data, apparently there has not been a single positive case from the 'close contact' list.  This was the very very wide net the spread which included 38,000 people. All of our cases have come from the 'very close contact' list. So contagious, but not crazy so.

Edited by lewelma
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8 hours ago, lewelma said:

Interesting bit of detail that has come out today. Apparently 16% of all close contacts only test positive on day 12. I was surprised that it was so high. But given that statistic, they are expecting 50 more cases from the known household exposure events. 

One more bit of data, apparently there has not been a single positive case from the 'close contact' list.  This was the very very wide net the spread which included 38,000 people. All of our cases have come from the 'very close contact' list. So contagious, but not crazy so.

Just curious how NZ is differentiating 'close contact' from 'very close contact', since I know it's going to be different than how the US is defining it, where we have crazypants stuff like 'ate lunch unmasked within a few feet, but only for 14 rather than 15 minutes' or 'we rotate desks every 14 minutes so no one can ever say that they were more than 15 minutes next to someone...'  

I figure your definition might actually help assessing real Delta risks among non-household contacts vs the above nuttiness...

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In New Zealand, there are three types of ‘contacts’:

Close Contacts
Casual Plus Contacts
Casual Contacts

https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-health-advice-public/contact-tracing-covid-19

Not sure which ones are which for the very close vs just close.

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Statements from medical boards regarding passing along inaccurate and misleading information to the public:

https://www.abem.org/public/news-events/news/2021/08/27/abem-statement-about-abem-certified-physicians-providing-misleading-and-inaccurate-information-to-the-public
 

Quote

Providing misleading and inaccurate information to the public can be sufficiently egregious and inconsistent with the ethical behavior of a physician who is expected to do no harm .

ABEM recognizes that there are numerous medical issues on which physicians will have legitimate differences of opinions – and that ABEM-certified physicians have every right to express their opinions on those issues. However, making public statements that are directly contrary to prevailing medical evidence can constitute unprofessional conduct and may be subject to review by ABEM.

Should ABEM determine that a physician is promulgating inaccurate information that is contrary to the interests of patients and that adversely impacts public safety, ABEM may withdraw or deny certification for that physician.

https://www.theabfm.org/about/communications/news/joint-statement-american-board-family-medicine-american-board-internal

Quote

The Federation of State Medical Boards (FSMB), which supports its member state medical licensing boards, has recently issued a statement saying that providing misinformation about the COVID-19 vaccine contradicts physicians’ ethical and professional responsibilities, and therefore may subject a physician to disciplinary actions, including suspension or revocation of their medical license. We at the American Board of Family Medicine (ABFM), the American Board of Internal Medicine (ABIM), and the American Board of Pediatrics (ABP) support FSMB’s position. We also want all physicians certified by our Boards to know that such unethical or unprofessional conduct may prompt their respective Board to take action that could put their certification at risk.

Expertise matters, and board-certified physicians have demonstrated that they have stayed current in their field. Spreading misinformation or falsehoods to the public during a time of a public health emergency goes against everything our Boards and our community of board-certified physicians stand for. The evidence that we have safe, effective and widely available vaccines against COVID-19 is overwhelming. We are particularly concerned about physicians who use their authority to denigrate vaccination at a time when vaccines continue to demonstrate excellent effectiveness against severe illness, hospitalization and death.

We all look to board-certified physicians to provide outstanding care and guidance; providing misinformation about a lethal disease is unethical, unprofessional and dangerous. In times of medical emergency, the community of expert physicians committed to science and evidence collectively shares a responsibility for giving the public the most accurate and timely health information available, so they can make decisions that work best for themselves and their families.

 

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3 hours ago, Ausmumof3 said:

Death rates in Israel are looking awfully close to the September/October spike last year 😬 though still lower than winter.

I was just reading an article about covid in Israel.  There are a number of people coming back from Rosh Hashana testing positive, even those forging covid tests.  They also just started their school year.

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2 hours ago, RootAnn said:

In New Zealand, there are three types of ‘contacts’:

Close Contacts
Casual Plus Contacts
Casual Contacts

https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-health-advice-public/contact-tracing-covid-19

Not sure which ones are which for the very close vs just close.

They changed the system with delta. Basically the close contacts are now very close contacts and the casual plus contacts are now close contacts. They did this to bring more people into the legal testing and isolation requirements. So my understanding is that this is the new terminology they are using in their daily standups:

People who are identified as Very Close Contacts may live, work or have been in the same place at the same time as someone who is infectious with COVID-19 e.g. they have may travelled on a plane or attend the same school as someone who is a positive COVID-19 case.  

Close Contacts have been in the same place (Location of Interest) at the same time, near someone infectious with COVID-19. 

-----

So there were 38,000 people who have been in the locations of interest, but they said yesterday that they weren't getting it.  You need more direct exposure, like sitting next to a positive case. Some of these places of interest, however, were huge. Like a 100 person lecture hall, they put all 100 people on the close contact list, even if they were across the room. They spread the net wide to make sure they got Every. Single,.Case. The goal is elimination, not suppression.

 

 

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4 hours ago, Matryoshka said:

Just curious how NZ is differentiating 'close contact' from 'very close contact', since I know it's going to be different than how the US is defining it, 

They are making it as simple as possible for people. They post the locations of interest online and the TV news programs run the list (which reminds me of listening to the radio in the morning to hear if my school was closed for snow LOL). Then, if you were in any of the locations during the time noted, you call Healthline. They assess if you are a close or very close contact and give you the legal instructions for testing and isolation. It is under a Health Order by the Director General of Public Health, so it is a legal requirement to do what they say.

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The three hospitals closest to me were all bed blocked at some point yesterday. 

My local hospital, which hasn't been updated or expanded since the 90's, (but which nonetheless saved my ex's life, so they do good with what they have) has had unreported Covid clusters, with at least 5 people dying from Covid they contracted there. 

Multiple schools are shutting each day for cleaning, due to Covid - and most schools have less than 10% of their usual numbers on site. 

#livingwithcovid

On the plus side, in my own suburb and surrounding suburbs, our single vax rates are heading towards 85+%, with close to 60% being double vaxed. I think this is a direct result of the local medical centre being able to vaccinate people since March this year, and since June, the only people they see in person are there for vaccination. It's become a mini hub. 

My part of the locked down LGA has fewer than 2 cases per day. It makes zero sense we are still under curfew, and outdoor limits while a short drive away, people are flocking to Bondi beach. 

 

 

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56 minutes ago, Melissa Louise said:

The three hospitals closest to me were all bed blocked at some point yesterday. 

My local hospital, which hasn't been updated or expanded since the 90's, (but which nonetheless saved my ex's life, so they do good with what they have) has had unreported Covid clusters, with at least 5 people dying from Covid they contracted there. 

Multiple schools are shutting each day for cleaning, due to Covid - and most schools have less than 10% of their usual numbers on site. 

#livingwithcovid

On the plus side, in my own suburb and surrounding suburbs, our single vax rates are heading towards 85+%, with close to 60% being double vaxed. I think this is a direct result of the local medical centre being able to vaccinate people since March this year, and since June, the only people they see in person are there for vaccination. It's become a mini hub. 

My part of the locked down LGA has fewer than 2 cases per day. It makes zero sense we are still under curfew, and outdoor limits while a short drive away, people are flocking to Bondi beach. 

 

 

Awesome news on the vaccination rates.  The inequalities must be incredibly frustrating.

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1127 for NSW. Epidemiologists are suggesting peak may be close to passed!  Hope they’re right!  It’s a bit uncertain due to the weekend being a typically lower rate anyway. 2 deaths.

22 for ACT and lockdown extended four weeks

445 in Vic and 2 deaths. 1 of those was a man in home care who didn’t know he had COVID.

WA is opening up Pfizer to over 60s.  They have an issue with low vax rates.

 

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2 days now of no community spread in NZ.  All cases from yesterday and today were in households of positive cases, where all household members were isolated and never in the community. Auckland's lockdown has been extended for 7 days to ensure full elimination. 

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We are small town, very conservative, where no one follows any of the recommendations, and a senior at our high school and his Dad both died of covid on Saturday.  They went to the school orientation and got sick 5 days later.  Masks are optional this year and no one is wearing them.  5 kids tested positive today in the elementary school. I hope something changes soon. 😢

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Someone I know working in a Sydney hospital reckons he's seeing people every day coming in with covid and asking to be vaccinated because they're feeling so ill. 

I think there needs to be a really basic campaign based on 'it's too late to be vaccinated once you've got covid'. Because evidently lots and lots of people don't understand that. 

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1 hour ago, bookbard said:

Someone I know working in a Sydney hospital reckons he's seeing people every day coming in with covid and asking to be vaccinated because they're feeling so ill. 

I think there needs to be a really basic campaign based on 'it's too late to be vaccinated once you've got covid'. Because evidently lots and lots of people don't understand that. 

Yep. 

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Covid plan for the winter in England. Currently Scotland already has mask mandates for most public indoor areas but England does not. I expect the booster plan to be similar in Scotland, so as an over-50 I will be offered an mRNA booster six months after my second AZ jab, so in November. I have already booked a private flu jab for October- first appt  I could get.

BBC News - Boris Johnson warns Covid risk remains as he unveils England's winter plan
https://www.bbc.co.uk/news/uk-58560031

Screenshot_20210915-073302_BBC News.jpg

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16 hours ago, bookbard said:

Someone I know working in a Sydney hospital reckons he's seeing people every day coming in with covid and asking to be vaccinated because they're feeling so ill. 

I think there needs to be a really basic campaign based on 'it's too late to be vaccinated once you've got covid'. Because evidently lots and lots of people don't understand that. 

Friend of a friend is a paramedic doing admin and they are busier than they’ve even been and seeing multiple Covid related heart attacks in 20-40 age groups per day. Will probably delete for privacy reasons.

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2 hours ago, Ausmumof3 said:

 

This study referenced and linked is pre-print only but seems to indicate this virus is changing much faster than flu at the moment.

OK, this is the worst thing I've seen in ages 😕 . I don't like the sound of that at all. 

Is this related to how many people are getting infected or is this some natural feature of COVID? 

 

 

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1 hour ago, Not_a_Number said:

OK, this is the worst thing I've seen in ages 😕 . I don't like the sound of that at all. 

Is this related to how many people are getting infected or is this some natural feature of COVID? 

 

 

I think from the comments I’m reading on it they aren’t 100pc sure but probably both from this comment from one of the study authors Twitter feed.  

“Most of this rapid pace of evolution is likely due to adaptation to a new host, but in general, this suggests to me that the S1 domain of spike in SARS-CoV-2 is a readily evolvable domain. 

Circulating mutations like 484K partially escape from antibody responses and although I'd anticipate the pace of evolution to slow as the virus becomes endemic in the human population, I would also expect relatively rapid antigenic drift, just given this data.

We'll of course have to wait to see what unfolds, but I would, at this point, suspect an influenza H3N2-like process of antigenic drift and necessarily frequent vaccine updates in the upcoming years. “

 

 

 

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2 minutes ago, Ausmumof3 said:

We'll of course have to wait to see what unfolds, but I would, at this point, suspect an influenza H3N2-like process of antigenic drift and necessarily frequent vaccine updates in the upcoming years. 

Oh, that's great. 

The flu vaccine gives me a sore arm. Pfizer gave me a headache for 2 weeks 😕 . Doing this every year would be a major bummer. 

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5 minutes ago, Melissa Louise said:

I didn't phrase my qu very well.

What I should have said was, with Delta, if  I'm reducing my viral load through masking etc, will that make any substantial difference to severity of any breakthrough infection?

I'd guess so. It's like a lot of these questions... no, we don't know specifically for this virus, but it's usually true, so you expect it to be true. And it was true for earlier variants, so... conclude what you will. 

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https://calgaryherald.com/news/local-news/alberta-childrens-hospital-to-close-75-per-cent-of-operating-rooms-by-monday/wcm/98e1a54d-90f5-4c90-9253-508daea238b6/amp/?__twitter_impression=true

https://www.cbc.ca/amp/1.6178253

Premier Jason Kenney warned Wednesday, as he announced new restrictions, that the acute-care system could run out of staff and critical-care beds within 10 days.

The critical care triage protocol, a 52-page document developed by Alberta Health Services, describes how the health-care system will cope if intensive care units (ICUs) no longer have the resources to care for every critically ill patient.

 

 

 

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https://amp.abc.net.au/article/100473324?__twitter_impression=true
 

Abc: A Sydney man who spent 399 days in hospital recovering from COVID-19 has urged the community to get vaccinated, saying the virus is real.

Sixty-nine-year-old David Avila Mellado was admitted to Westmead Hospital last year on July 29 after getting infected. Earlier this month, he was finally able to go home.

 

wow!  Amazing not to give up for so long and finally go home.

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https://www.oregon.gov/oha/covid19/Documents/DataReports/Breakthrough-Case-Report.pdf
 

Oregon’s weekly covid breakthrough report. It’s very reassuring in avoiding death, pretty reassuring on avoiding the vent, and it gives me a bit of a pause on my likelihood of avoiding severe influenza like illness—even vaccinated and masked.

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2 hours ago, prairiewindmomma said:

https://www.oregon.gov/oha/covid19/Documents/DataReports/Breakthrough-Case-Report.pdf
 

Oregon’s weekly covid breakthrough report. It’s very reassuring in avoiding death, pretty reassuring on avoiding the vent, and it gives me a bit of a pause on my likelihood of avoiding severe influenza like illness—even vaccinated and masked.

Whenever I look at the info, I can't help but wonder what if everyone who could did get vaccinated....If 20% of those getting covid are vaccinated, and it reduces rate of infection like we are hearing, we'd be looking at 1/5 as many people getting it. That would mean going from 15% positivity to 3% positivity. That's a HUGE difference. How is it people can't see how much better that would be? Instead they say, "well vaccinated people can get it too" as if their brain works on binary, and they can't conceive that FEWER sick people is better than MORE sick people. 

 

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51 minutes ago, ktgrok said:

Whenever I look at the info, I can't help but wonder what if everyone who could did get vaccinated....If 20% of those getting covid are vaccinated, and it reduces rate of infection like we are hearing, we'd be looking at 1/5 as many people getting it. That would mean going from 15% positivity to 3% positivity. That's a HUGE difference. How is it people can't see how much better that would be? Instead they say, "well vaccinated people can get it too" as if their brain works on binary, and they can't conceive that FEWER sick people is better than MORE sick people. 

 

One should think that, I think. Currently in my area there are triage tents, people dying in ERs waiting to be seen, National Guard deployments to hospitals, cancer and heart surgeries being postponed, and anti-maskers trying to storm schools so that they are all on lockdown. Oh, and a looming deadline where a lot of healthcare workers are going to quit rather than get vaccinated. 
 

 

 

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4 hours ago, ktgrok said:

Whenever I look at the info, I can't help but wonder what if everyone who could did get vaccinated....If 20% of those getting covid are vaccinated, and it reduces rate of infection like we are hearing, we'd be looking at 1/5 as many people getting it. That would mean going from 15% positivity to 3% positivity. That's a HUGE difference. How is it people can't see how much better that would be? Instead they say, "well vaccinated people can get it too" as if their brain works on binary, and they can't conceive that FEWER sick people is better than MORE sick people. 

 

Exactly. I look at this graph of cases per 100,000 people for vaccinated vs unvaccinated (below), and it looks clear to me that if everyone was in the vaccinated group, breakthrough infections would drop even more, because chances of encountering an infection would be so much lower with only 1/5 as many people being infected. Not to mention it’s appearing vaccinated people don’t spread as much if infected.  I really think we’d have a good shot at getting the reproductive number well under one, causing the outbreak to fizzle. It may be we don’t find out for sure until NZ is fully vaccinated and opens up. 

D66D1D14-B794-45C7-949E-721F21678BB8.jpeg

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4 hours ago, ktgrok said:

Whenever I look at the info, I can't help but wonder what if everyone who could did get vaccinated....If 20% of those getting covid are vaccinated, and it reduces rate of infection like we are hearing, we'd be looking at 1/5 as many people getting it. That would mean going from 15% positivity to 3% positivity. That's a HUGE difference. How is it people can't see how much better that would be? Instead they say, "well vaccinated people can get it too" as if their brain works on binary, and they can't conceive that FEWER sick people is better than MORE sick people. 

 

I don't think the numbers work out that way; there is a difference in whether 20% of the people who are getting COVID are vaccinated versus think that 20% of the people who are vaccinated get COVID and 80% of the people who do not get vaccinated get COVID.  So, you can't conclude that 1/5 as many people would get COVID.  And the positivity rate depends upon how wide of a population you are sampling.  If you are only sampling people who are symptomatic or have had exposure, the positivtiy rate could remain high despite falling case rates. 

Another thing that complicates looking at the numbers is whether we are talking about the number of people who have COVID at one point in time versus the number of people who ever have COVID.  It is possible that a high vaccination rate greatly decreases the number of people who have COVID at one time (which helps the medical care being overwhelmed perspective) but does not greatly decrease the number of people who have COVID sometime over a period of months or years.   

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This on the other hand from Vic is … ouch!

 

Mr Andrews outlined the figures put forward by modelling by the Burnet Institute, saying there was no turning back despite the dramatic expected surge in cases and deaths

"On or about the 15 December, cases will peak at about 4,500. Towards the end of December, admissions to hospital will peak at about 3,150, and in January, deaths due to COVID-19 in the Delta variant will peak at around 2,200. These are sobering numbers," he said.

"We are opening up, no doubt about that, and there will be no turning back. We have got to normalise this, we have got to pass through and beyond this pandemic."

Mr Andrews reiterated it was only modelling and a forecast, not a definitive verdict.

"What I'm saying is, modelling is important, it informs you, but it doesn't write the plan. You have to update it, you have to take actual numbers and replace your assumptions with actual data. We will do that, we will refine things, we will consistently update this roadmap," he said.

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54 minutes ago, Ausmumof3 said:

I’ve been giving this some thought and I feel like this modelling seems a bit on the pessimistic side?  Anyone else think that?  

I  couldn't decide between pessimistic or realistic. I can understand some of the decisions that the Vic government is making better after reading this.

 I am very sad. 

 

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