New Zealand had 26 deaths in over a year of the pandemic. Not 26 per 100k population. Not 26 per day. Twenty six people full stop. Because in fact "We go hard and we go early" works.
Right now they are locked down (since last week) because they had one case in their community, but of course it isn't ever one case and they knew that, since that lockdown began there are now over 100 patients linked to that single infection. Under a lockdown the people who are surprised to discover that they're infected are (mostly) bored at home, not out infecting yet more people.
I think there's a fair chance they'll beat it again, and exit that lockdown as they did earlier ones. Because elimination strategy works.
"We go hard and we go early" works *in a small, remote island nation that is willing to hermetically seal itself off from the rest of the world.
"seal" does -- whether any group is collectively capable of taking chain-of-exposure and its management seriously.
Make your island arbitrarily small and remote but have even a single person who's boating/flying or any kind of unmanaged travel outside the bubble regularly and you'll see infection overrun the island.
Pick an arbitrarily large city within miles of another on a shared continent with an unmanaged pandemic. Have it populated with people who are unified in careful contact management and they'll keep outbreaks scarce and small.
As modest as the NZ economy is it's still a hub for a few industries, and people still wanted to come for business purposes.
Also our politicians are deeply incompetent and were the only ones in Europe (AFAIK) aiming for herd immunity right off the bat, until they eventually ran the numbers on death rates if the ICUs ran out of capacity and realised it was a terrible idea.
2. Is your implication that the UK is so close to the mainland that the covid numbers are high due to people coming over in rafts? In that case the UK should have lower covid numbers because it has a much larger navy covering a the english channel, irish sea, and the north sea. Where as NZ has to cover the entire south pacific.
2. My point is that there's way more people entering, leaving, and going from A to B for whatever reason. Not trying to judge people, just stating a fact here.
But China knows how to do it, and they have much more density than the USA. You just need to be very authoritarian; e.g. marching people under guard to quarantine hotels from airplanes.
https://www.nbcnews.com/news/world/video-appears-show-people...
Yeah, that's not happening in the U.S. Not without starting a civil war.
"Later the policy became even more aggressive, with officials going door to door for health checks, and forcing anyone ill into isolation. A disabled boy reportedly died after he was left without food, water or help when his his father and brother were quarantined."
https://www.theguardian.com/world/2020/mar/19/chinas-coronav...
If by 'strict lockdown' you mean 'Ask people to limit their movements and preferably just stay at home' then maybe that's not quite so draconian.
58x less people than New Zealand. Only accessible by plane and boat.
37 deaths to NZs 26.
[1] Comparison between U.S. states and sovereign states by GDP
https://en.wikipedia.org/wiki/Comparison_between_U.S._states...
And thereby how many more fold damages can result from a catastrophic shutdown of the country, something a small geographically-on-the-periphery-of-the-world nation need not worry about, to the same degree.
Hell I'm even able to connect to communicate you using internet (the exact same kind you get in Oklahoma).
But we'll see how it goes. If New Zealand and Australia persist in this notion that they're going to stay locked down until the virus goes away, particularly with its endemicity now inevitable, I think you will soon find vast swaths of those countries in open, violent revolt.
The game has always been to play it by ear. That's been a great call so far, we've lived normal lives for the last year while incredible scientific advances have delivered vaccines.
This is a long game, and we've done well in the first quarter. I hope the politicians continue making good calls as the game goes on.
Don't assume that because we locked down hard that that will always be the path forward. That's your straw man talking.
Delta is a different beast.
Here in Australia, Victoria managed to get the Reff rate down to ~0.75 during their OG outbreak last year with a strict lockdown. Delta has an R0 that is multiples higher than the OG strain so the same lockdown would not get it below 1. You can look at Victoria's current outbreak for evidence of this.
Now that doesn't mean NZ can't beat it. A part from Auckland, the population density is very low and as long as compliance is high you might be able to just about get it back down again; especially if you manage to keep it out of large households and essential workers.
I just wouldn't base my expectations on what worked last year as Delta is quite a different game.
Also worth noting that peoples' behaviour is very different this time round compared to a year ago. A lot more people are flouting the rules or at least coming up with creative ways to see their friends while technically not breaking the law. After 200+ days, everybody's just sick of it.
If you look at how far NZ has gotten in regards to overcoming the virus, it's clearly very far behind most of the world. It's done a good job so far of reducing the harm caused directly by infection, but in many ways it's just tried to lock itself into a time bubble in early 2020. The world is starting to move on, and NZ has put itself in a rather bad position of having to try and catch up. The longer it sticks with this approach, the harder it's going to be.
We've got a few "open 'er up and let it rip" friends and I just don't get it. There are so many potential game changers when you are an island. If a reliable saliva-based test appeared that produced results in say 2 hours we could reduce MIQ and use waiting booths at the airport. Even if it was only 99% accurate we could pool groups of 20 into rooms together while waiting for results. So many possibilities if we continue to think critically instead of politically.
Tests for disease rely on two numbers:
1. "sensitivity" - the proportion of people with COVID who get a positive test
2. "specificity" - the proportion of people without COVID who get a negative test.
COVID, despite the media attention, is a rare disease compared to the number of people tested. Say we have 10,000 people tested for COVID at the airport. We have 99% sensitivity and 99% specificity. And we know 100 people have COVID (1% prevalence) in this group. Our test would find 99/100 of the positive cases. But it would also find an additional 99 false positives! It also misses one true positive case. Which would be disasterous for the quarantine measures in place in Australia and NZ. In short, even a gold standard rapid test is not enough, although at 99% specificity and sensitivity it would be somewhat useful.
This is a lot less intuitive than it looks. The companies pushing rapid antigen tests at the start of the pandemic would have know better, but they chose to lie to the public about this.
What I feel is a real problem in the makes is that you eventually have to open up again but with not enough folks vaccinated.
And suddenly, you are in a situation many other countries have right now.
“Try to gather in groups of no more than six (at a time).” “When you need food, go to the grocery store (as often as you see fit).”
Is anyone surprised that a highly contagious virus was able to escape these “lockdown” measures?
Agreed, yet people still clamor for more of the same ineffective nonsense while dousing their hands in sanitizer and erecting plexiglass barriers in front of everything. We do everything except what would make a difference: fixing indoor ventilation.
It worked for China too, so don’t come with this “small countries” crap. The US is “small” relative to China. Okay… now we get the “easy in a dictatorship” response to which I offer Japan. A democracy, with relatively large and dense population, yet have had relative few cases… although I am sure an excuse can be invented for them too…
Not sure why you'd say nothing.
I know people like to think that doing the per-capita calculation puts every country on an even footing for comparison. But it's kind of silly to straight compare countries with vastly different geographies and economies, regardless of population normalization.
>I think there's a fair chance they'll beat it again
If they are locked down, again, 16 months into this thing, they never beat anything.
They eliminated this virus across Aotearoa. We didn't eliminate it everywhere else (actually almost anywhere else) and infected people continued to arrive at their border, eventually one of those infections (from Australia) leaked into their community about two weeks ago.
Unless your point is some purely nihilist position like "In the end nothing matters" (then why are you posting?) they beat this and now they're going to have to do it again.
In general yes, closing people up inside, in separate rooms, giving them only the needed amount of calories, forbidding every even mildly dangerous sport, and of course driving and cycling, would save many lives. But who wants to live in a world like that?
It’s easy to quit smoking. I’ve done it a dozen times.
(As someone mentioned upthread, this shouldn't be seen as a slight against the people or leadership of New Zealand, who generally seem to understand that lockdowns weren't meant to be a one-and-done measure.)
That's what they beat, and God willing will beat again.
Except no, it is not 9/11. People with a year or two of life expectancy dying is not the same as what happened with 9/11 & not the same as Vietnam. Millions of people die every year in the US, it's what happens to the old, the sick and eventually to us all.
I wish this narrative will go away.
Given the health care resources available anywhere but in Honolulu, things won't be pretty if it keeps climbing.
Currently you can only come here from NSW with express permission and then you have to quarantine at your own expense for 2 weeks. Quarantine requirements kick-in whenever there's a community outbreak in other states/territories and the restrictions ramp up as case numbers grow.
It is easy for Western Australia and Tasmania to isolate because the former has a vast desert between here and the east coast and the latter is an island without an international airport (probably one of the safer spots on Earth). There's no physical reason Hawaii and Alaska couldn't have done the same, but it's probably not politically or socially acceptable.
https://www.ctvnews.ca/health/coronavirus/covid-19-in-the-u-...
It sounds harsh, but I don't see that they've done a lot other than waste 2 years of their life sitting on their hands.
You can't directly compare NZ with places like Germany or the US.
The success in New Zealand seems like the elephant in the room, that the Atlantic article failed to refer to. Not to mention China.
Virus cannot teleport from person to person, so why wouldn't NPIs like real lockdowns with full food delivery and mass testing (unlike mockdowns in some other countries) work?
Lockdowns, or mass hospitalizations/deaths from Covid are a bit difficult to hide from the people living through it, if either of those two things are happening, everyone would hear about it through the grapevine.
Various parts of Beijing and Nanjing have been under relative “lockdown” at various points in time in the last year. I’m pretty sure this has been reported in Western media too (and I’m sure that other parts of the country have too). I have no idea where this idea that “China has zero COVID lockdowns” came from. I suppose it may depend on your definition of lockdown.
I do have doubts that their actual case numbers are too far off from reported case numbers. (Because mass sickness and death, just like lockdowns, would also be obvious to observe.)
We could tackle smoking and obesity similarly to similar effect.
If you want to learn how to get a basketball in the hoop reliably, you’re better off asking a regular guy than a 7 footer who will say “well just put it in.”
But more importantly, how will it end for them? Australia and New Zealand are among the worst corona zealot nations. New Zealand just shut down everything over a single case and the PM told people to not even talk to each other anymore. How will they get out of this? If they looked at the facts they'd understand they will have to open up eventually, might as well do it now. Instead they're now trapped in eternal 'zero covid'.
https://www.9news.com.au/national/coronavirus-update-we-cant...
Australia relied mainly on AstraZeneca and the UQ molecular clamping vaccine for its vaccine strategy, both of which could be manufactured locally. It signed other contracts for vaccines lackadaisically and with a late delivery time.
AstraZeneca is less effective than mRNA vaccines like Pfizer and Moderna, and causes a rare blood clotting condition that's fatal at a rate of 1 per millions. The UQ molecular clamping vaccine failed clinical trials despite being effective because it caused some patients to return a false positive result for HIV. This meant that domestic vaccine production in Australia was limited to one less effective vaccine that sometimes (very rarely) kills the people who get it, which the media have had a field day with.
The government now faces the problem of having millions of doses of a vaccine that few people want, few doses of the vaccines everyone wants, drug manufacturers who've already signed agreements with everyone else, a low rate of infection (due to lockdowns) that means they don't deserve emergency support, and a population that has no idea what's happening because the situation is complicated.
On top of this, the government has made some bad decisions with the roll-out itself. It doesn't allow the age groups most vulnerable to COVID-19 to receive the marginally safer and significantly more effective mRNA vaccines, on the basis that this age group has a clear benefit from receiving AstraZeneca and a lower risk of blood clotting, so there's significant vaccine hesitancy and less effective vaccine coverage among the very group who's most likely to die from the disease. It also didn't allow young people to receive the AstraZeneca vaccine for a long time, and even now requires them to give informed consent to a doctor or pharmacist before receiving it, so the roll-out requires finding qualified doctors and pharmacists as well as nurses, at a time when the medical system is already strained.
I live in slovenia, and we're giving vaccines away to other countries (literally), because people don't want to get vaccinated, and the vaccines are nearing the expiry date.
You can choose the vaccine, and can get vaccinated any day, even without signing up.
Australia is a rich country, once this happened they could have paid whatever it takes to get enough Pfeizer/Moderna. The price almost don’t matter, it is so cost effective it’s insane.
If we could figure out the total cost of this pandemic I’m sure all the vaccines we will take over many years will be a fraction of 1% of the total cost and that is not including human suffering and death.
[0] https://www.theguardian.com/world/2021/jul/10/stuffed-how-au...
[1] https://www.smh.com.au/politics/federal/deal-in-sight-for-20..., and though I have doubts about whether it should cost $400k a bed to build and operate a quarantine facility, it would still be much cheaper than locking down the entire state
We have one of the worst governments in the entire democratic world. We just got insanely lucky that at the start of the pandemic they decided to lay off as much responsibility as possible to the state governments who have mostly been fantastic.
Did they refund the fines of those people who protested or are people still fined and arrested?
"They might as well do it now" is misguided. Would you prefer to release a virus into an unvaccinated or fully vaccinated population?
> "We ask people to stay two metres away from anyone you pass," she said. "Stay local. Do not congregate. Don't talk to your neighbours. Please, keep to your bubble."
To interpret that as anything other than physical distancing measures can only be deliberate obtuseness. You can talk to anyone you want, just pick up the phone.
It's maddening to see someone peddling this narrative in a discussion on HN.
https://www.theguardian.com/world/2021/aug/17/new-zealand-to...
One (1) positive case, entire nation placed on maximum level 4 lockdown where you can't leave your house except for a very short list of permitted reasons.
Read the article you linked to, not just the headline. It explains the additional factors that informed the decision.
The "1 positive case" narrative is nonsense.
Nevertheless, it is still a literally true statement that the entirety of NZ was locked down over one (1) case, because if they hadn't found that one case, they wouldn't have done that.
Do you have a link/links to where you read that vaccines don't do well at stopping the spread? Everything I've read is that vaccines, while not 100% effective at stopping the vaccinated person from infecting someone else, significantly lower the risk of spreading the virus[0]. That risk drops dramatically when both parties involved are vaccinated.
[0] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/keythings..., see Effectiveness --> What we know
Lockdowns do flatten the curve, and while we might have built new hospitals in a parallel universe, in this one we really don't want to saturate the beds (again). I was pleasantly surprised by the "flatten the curve" narrative -- usually the telephone game ensures that this kind of nuance gets buried under simpler, incorrect versions like "if we just lock down for two weeks, this will be over," but this time around I was pleased to see "flatten the curve" start strong and keep its legs.
CDC's initial mask take was wrong, but evidence changed their minds, and that's a good sign. GP, if you want to harp on this, tell me: if I were to dig through your post history would I find a bunch of poorly aged posts about a silent first wave?
Unfortunately, while hospitals can be built, you can't train enough medical professionals to staff the hospital in two years.
More generally, rather like nobody expects the Spanish inquisition, no health care system can cope with a global pandemic. We'd need to 10x health care capacity, most of which would sit unused for most of the time.
Also you are stating I am anti mask when I stated how I recommended mask usage. Do you not read or do you just force your expectations on people?
Sure, go ahead and dig through my history. not sure what you mean by 'a silent first wave'.
However folks should be aware that immunity acquired through natural infection is robust and durable, and also has the same effect of reducing viral load and transmission [2].
It has been documented that people with asymptomatic infection will clear the virus quickly compared to those who are symptomatic [3]. Recent meta-analyses [4] and large population serological studies [5] have estimated the asymptomatic proportion lower bound to be at least ~33%, and the upper bound to be ~65% (even higher for young adults). Considering recent evidence that cases may be massively under-reported, the true asymptomatic proportion could be even higher than suggested [6].
Taken together, these results imply that a majority of the population has been already exposed to the virus, and either through natural infection or vaccination has acquired some degree of immunity that reduces the transmission of the virus.
Analogous to antibiotic resistance, vaccine resistance can evolve if vaccines are used indiscriminately [7][8][9][10]. So the benefits of compulsory mass vaccination may not outweigh the risks of such a policy, given the current state of affairs.
> so why all the fuss to force people to get vaccinated?
It is an important question with tremendously complex factors that go beyond the expertise of most lay people.
[1] Initial report of decreased SARS-CoV-2 viral load after inoculation with the BNT162b2 vaccine https://www.nature.com/articles/s41591-021-01316-7?origin=ap...
[2] Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells https://www.cell.com/cell-reports-medicine/fulltext/S2666-37...
[3] The Natural History and Transmission Potential of Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection https://www.sciencedirect.com/science/article/pii/S266652472...
[4] The Proportion of SARS-CoV-2 Infections That Are Asymptomatic https://www.acpjournals.org/doi/full/10.7326/M20-6976
[5] Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands https://link.springer.com/article/10.1007/s10654-021-00768-y
[6] Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters https://www.sciencedirect.com/science/article/pii/S253104372...
[7] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/
[8] Can we predict the limits of SARS-CoV-2 variants and their phenotypic consequences? https://www.gov.uk/government/publications/long-term-evoluti...
[9] Why does drug resistance readily evolve but vaccine resistance does not? https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016...
[10] The adaptive evolution of virulence: a review of theoretical predictions and empirical tests https://pubmed.ncbi.nlm.nih.gov/26302775/
Should you happen to not mount a robust immune response despite being vaccinated then at that point you will have a viral load similar to an unvaccinated person, but the good news is even if this is the case you will still have much less severe disease outcomes than an unvaccinated person.
The vaccines are incredibly effective against all current variants.
This is simply not true. In countries with accurate tracing like Singapore and Israel, it's apparent that the vaccinated aren't significantly less likely to get infected than the unvaccinated. Check figure 10 on https://www.moh.gov.sg/news-highlights/details/update-on-loc... ; the unvaccinated only make up around 10-20% of cases. They also only make up 10-20% of the population; if the unvaccinated were more likely to be infected, we'd expect them to constitute a larger proportion of infections.
It is fair to say that vaccination reduces the chance of infection. "Very rare", however, is not how I would characterize it.
https://www.bloomberg.com/news/articles/2021-07-30/cdc-scale...
Data from Israel suggests that efficacy may be much lower than initially believed, but still much better than nothing.
https://www.sciencemag.org/news/2021/08/grim-warning-israel-...
If I understand correctly, there isn't a lack of literal beds/space; it's a lack of personnel. Basically hospitals are unable to staff themselves at the levels needed to accomodate being basically 100% full. This is compounded by the fact that hospitals are struggling to retain healthcare workers, who are burnt out, and the fact that healthcare isn't something that someone can easily switch to.
[0] I don't know the right word for it, but a small room usually used for short-term (<few hours) evaluation of a patient before passing them along to the next phase, like admitting to a ward or sending them home or etc.
[1] https://vancouversun.com/news/covid-19-kelowna-general-hospi...
[2] https://www.kgw.com/article/news/health/coronavirus/oregon-e...
[3] https://richmond.com/news/national/with-no-beds-hospitals-sh...
A bed that isn't staffed with a nurse is no more useful then laying in your bed at home.
So why are they calling this the pandemic of the unvaccinated?
- https://www.washingtonpost.com/opinions/2021/08/21/how-unvac...
- https://www.healthline.com/health-news/risks-of-the-delta-va...
- https://abcnews.go.com/Health/statistics-show-risks-vaccinat...
and the list goes on and on.
I have personally seen unvaccinated family members get sicker...plus countless of people mentioning the same.
Then we re-opened everything and vaccinated (and others) stopped wearing masks. So in effect, coronavirus is spreading as if there were no masking or social distancing since those have ended. And by and large it is the unvaccinated who are paying the price.
I might be wrong, but at least my explanation is plausible.
So every single tool in the quiver is about reducing Rt below 1. A lockdown will give you a few points. Vaccines will give you more. Masks give you more. Social distancing give you more. None of them get you all the way there. Some are more temporary than others, so have to be implemented at the right times.
So...
> they don't do very well at stopping spread, so why all the fuss to force people to get vaccinated?
The do help limit spread. Going from "they don't stop spread entirely" to "why force people to get vaccinated?" is like saying "body armor doesn't prevent being killed, so soldiers shouldn't wear them". Plus, there's the aspect of it being contagious - vaccines make it less contagious overall. Vaccines reduce Rt.
> we still haven't built a significant amount of hospitals?
The goal was never to permanently increase supply of hospitals, it was to reduce the demand for them, by putting measures into place to reduce Rt.
> anti-mask at the beginning
During that time, scientists thought that COVID was chiefly droplet-transmitted, so the emphasis was on distance, washing hands, hand sanitizer, etc. In an environment where people were already hoarding toilet paper, then if it had been true that droplets were the only source of transmission, masks were overkill, wouldn't do a lot to reduce Rt, and also had the risk of limiting supply to people who needed them. After it became clear that it was also aerosol-transmitted, the scientific recommendations changed, because then it was clear that masks would help reduce Rt.
As for Germany... Delta has a higher Rt than the Wuhan strain. Their lockdowns were effective.
Hindsight is always 20/20, early on the virus was not believed to be airborne, only spread through relatively large droplets from coughing/sneezing which you'd likely only encounter in close contact with an actively ill person. Plus, Fauci had the responsibility to preserve masks for those that would be exposed directly to infected people - the medical workers and first responders.
The first lockdown in the USA was mid-march, and the mask guidance had already changed by the beginning of April as we understood more about how the disease spread.
Early guidance (and news coverage) also recommended sanitizing surfaces to prevent the spread of the disease, but surface contact was later found to be a less significant mode of transmission.
As far as making the vaccines political, well they don't have to be. some research has shown that they don't do very well at stopping spread, so why all the fuss to force people to get vaccinated? just say do it for yourself if you want to, politics removed.
People with serious diseases are being turned away from hospitals or asked to reschedule appointments/visits because hospitals are overwhelmed with COVID patients (and healthcare workers are being pushed to the limit). Vaccines are a public health decision, not a personal decision.
This isn't about hindsight. Coronaviruses are not an unknown and airborne spread should have been assumed unless ruled out. And it was assumed by many: Taiwan immediately mobilized their military to ramp up mask production, even before the WHO admitted there was a problem.
> Plus, Fauci had the responsibility to preserve masks for those that would be exposed directly to infected people - the medical workers and first responders.
Then he and other leaders should have communicated that. Treating people like dumb idiots that you need to lie to to get what you want results in those people mistrusting your future recommendations, e.g. to get vaccinated.
That's the hindsight I'm talking about. The WHO declared that it was not airborne at the beginning of the pandemic, as did the CDC, and it took a long time for them to change their guidance. Even independent aerosol researchers didn't release their findings until April, but that was after the CDC had already asked people to wear cloth masks.
Treating people like dumb idiots that you need to lie to to get what you want results in those people mistrusting your future recommendations, e.g. to get vaccinated.
You have more faith in people than I do -- the truth is that many of the public are dumb idiots and if you say "We want you to wear cloth masks to protect either other, but please dont use N95 masks, we need those for first responders", the first thing that will happen is that there will be a run on N95 masks, leaving none for first responders. Which happened anyway, my older sister ended up sewing homemade masks that my younger sister used in her job in healthcare because they had to ration N95's.
But supply chain issues for PPE is a whole different problem, and I'm not sure we've solved it.
“Seriously people — STOP BUYING MASKS!” he wrote in a tweet that was later deleted. “They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
This is a good article about the changing position on masks: https://www.latimes.com/science/story/2021-07-27/timeline-cd...
Here are a few other sources I found with a quick google search:
https://www.aaha.org/publications/newstat/articles/2020-03/c...
https://www.marketwatch.com/story/surgeon-general-wants-you-...
marketwatch.com/story/the-cdc-says-americans-dont-have-to-wear-facemasks-because-of-coronavirus-2020-01-30
What happened subsequently was a shift to cooperative masks whose benefit is primarily reducing transmission from the wearer.
These two things are both discussed under the header of "masks" but they are very different interventions. It's less that the position changed, it's more that what authorities were actually talking about changed.
You can fairly argue that this counts as a messaging failure and I'd agree, but a lot of people seem to be missing what the issue actually was (especially some who set this up as dishonesty or an attack on expertise).
I for one, am glad that N95s haven't been mandated. I found them extremely irritating when I had to wear them because of high pollution in Beijing. The masks we wear instead, in comparison, are much more comfortable.
They later had evidence that COVID was aerosol transmitted - masks for everyone make more sense in that scenario.
I don't think 2 years is enough to just "build new hostipal", let alone staff them, supply them to hospital standards, and start taking business.
It's not land that's short, it's talent.
It totally is enough time to build one. Staffing is more problematic, but if it was a state-run hospital you could've converted a lot of national guardsmen into nurses in the meanwhile. You don't need a lot of talent to handle most Covid cases, just people able to follow the protocol.
Does this have any basis in facts? My understanding is keeping a covid patient alive in the ICU is incredibly demanding.
This is not a "standard" hospital, this is basically comparable to a warzone... so containers, drywall, and considering that most people there don't need a specialist, they can reuse doctors, that have nothing to do during the lockdowns (eg. in my slovenia, government-employed orthopedic doctors had someone else check them in daily, to get paid and get covid extra-pay, while never showing up for work and working in private practy all that time).
There was never anything even remotely close to a total lockdown here. Too afraid that telling people not to got to work might hurt the economy.
What Germany got "right" was mostly things done long before the pandemic, e.g. investment in a large number of hospitable beds, as well as public health insurance and flexible sick days guaranteed by law so sick people can actually afford to stay at home.
> They don't even share a porous border with Mexico/South America.
LOL the US border is mostly ocean and the part that is through land is much more controlled than the "borders" in the EU.
> Or how about how everyone was anti mask in the beginning, including the CDC, WHO, and my very liberal coworkers. When I said it would be advisable to wear a mask when in crowded places March, 2020 - I was heckled for not following the science.
Yeah, that was one of the biggest atrocities of the pandemic. Not only is it immorral to give false medical advice, this has also been responsible for more people (rightfully) mistrusting later recommendations. There should be leaders stepping down over this.
> As far as making the vaccines political, well they don't have to be. some research has shown that they don't do very well at stopping spread, so why all the fuss to force people to get vaccinated? just say do it for yourself if you want to, politics removed.
I agree, forcing people to get vaccinated (and that includes excessive restrictions to those not vaccinated) is not the way to go.
It‘s probabilities. The vaccinated kid who dies after getting infected because of transmission via unvaccinated.
Although interestingly, not everyone gets the annual flu shot. So maybe this will turn out to be the same.
Easier to take personal responsibility than depend on the government or whoever is meant to parachute in all the beds and doctors to save us from our own misunderstanding of exponential growth curves.
Personal responsibility is fundamental, that's what makes the collective measures work efficiently. But there are simply things that are near impossible to do personally. Are you going to build a personal ICU for your family just in case? Are you going to train as an ICU nurse, a respiratory disease specialist, and are you also building a personal protective equipment factory for yourself too? Of course not.
Though we need a bit of both. Depending on cheap just-in-time shit from China is great when you are dealing with a local flu outbreak in the local preschool, but not great in a pandemic. And the efficient solution is that everyone stocks up a few at home, and collectively we stock up a few billion in the country and then distribute it when and where needed instead of everyone trying to stock up thousands at home. (And so on for other aspects of protective measures.)
What I am upset about is why there was no plan to fast-track induction and graduation of nurses/paramedics/physicians with a minimum employment guarantee of 5 years by the govt so that folks are incentivised for a medical career.
There was never going to be an "easy" way to combat this pandemic, and experts have been quite clear about this from the beginning. A really successful strategy would have required a careful combination of several types of interventions, close monitoring of the situation as well as fast and effective adjustments to policies, and probably also a certain dose of luck.
Germany did a lot of things right and a lot of things wrong (though in certain instances, people might reasonably disagree about which is which), and Germany was also a bit lucky that we had many hospital beds and a social structure that is maybe a bit less conducive to infections (fewer inter-generational households). I think that Germany did well enough to avoid the worst effects of the pandemic (hospitals never got to the situation where they were fully overwhelmed, although it seemed close a few times) due to somehow people getting their shit together at the last minute every time, but I'm certain that a strategy with fewer deaths and less economic damage would have been possible.
The main problem that I see in Germany is that the government (or governments, if we include the regional ones) never had a real plan on what to do. Such a plan doesn't need to be inflexible, it can react to different situations and new scientific evidence, but it still should have been possible to establish some basic principles instead of stumbling through this pandemic almost blindly.
As an effect, we went into (more or less restrictive) lockdowns several times that prevented the worst, but a combination of other measures could have had a better impact: going into stricter, but shorter, lockdowns instead of months of weird "semi-lockdowns" with tons of exceptions (a lot of time was wasted especially last Summer), finding better solutions for schools and universities (such as better tools for remote teaching, and air filters), buying vaccines earlier, forcing employers to allow people to work from home (this was done eventually, but much too late — this was basically only because the industry lobbied hard enough, while at the same time, restaurants and museums had to close down completely), allowing certain lower-risk activities during the lockdown (such as outside terraces for restaurants), etc.
I'm not saying that all of these things would have worked, but we certainly could have tried more (or, in certain cases, earlier).
I am pretty sure people not getting sick in the first place is the priority, rather than making enough infrastructural medical capacity for something that is preventable. It's not like you can just magic up more doctors either.
> you want to lock down then we need a metric that you are trying to achieve by the lockdow
Well, this is obviously the vaccine
> Germany masked, distanced, and locked down better than anyone could expect, and here they are sitting with 4 million cases, 100k dead and are still in the pandemic. They don't even share a porous border with Mexico/South America
Are you saying you advise lockdowns (especially in winter) and then saying lockdowns are ineffective?
Building greater capacity and staffing should be the focus.
The lack of capacity has been the justification for lockdowns since after summer 2020, and likely will be in some areas in the future. Its about periodic and seasonal things that occur while COVID is also taking up some bandwidth, not about whether it stops the spread at all. The messaging has been lackluster and hyperbolic and conflicting the whole time and will continue to be.
Sorry about your experience, its not worthwhile to stay frustrated on crowd reactions, this is a fast moving scenario and consensus will never be reached on the various overlapping chapters.
If you're okay with Rt > 1 until hospitals are close to overwhelmed, then it means you were okay with allowing a doubling rate for a dangerous disease. It makes no sense. If you're destined to put mitigation measures in place eventually, why not just do them sooner and save a lot of suffering?
correct, it makes sense because now people have a choice about whether the prevalence of the disease will land them in the hospital. the mere prevalence is not the issue.
the subset of people that don't have a choice had the same issue before COVID existed, aka: the same distribution of immunocompromised people always existed.
this makes the calculus simply that it is back to business as usual, until ICU capacity is nearing full, that is. Since ICU capacity isn't only due to COVID cases, but due to all emergencies and injuries, then society as a whole needs to slow down to reduce the likelihood of emergency incidents, while also expanding ICU capacity to avoid future disruptions. The core of my supposition is that developed nations are not developed if emergency services are unavailable, and that governing system can prioritize reacting to that.
So no, you don't want business as usual until ICU capacity is near full. If you do that, you're basically destined to overwhelm ICU capacity.
If you increase ICU capacity, that solves nothing, because you're still satisfied with business as usual until ICU capacity is near full. No matter how big you make ICU capacity, Rt>1 means you will hit that capacity eventually. That's what exponential growth means.
The only answer is to move Rt<1, and you might as well do that sooner rather than later.
I mean... for a little while until enough of the patients die. I mean that's whats happening.
ICU capacity due to COVID is filled overwhelmingly by unvaccinated people who had a choice in the matter for 9 months straight. If there wasn't a choice I would agree with you.
What is occurring now is completely tolerable to continue to allow to occur and is the consensus in all states, across the entire political spectrum.
We couldn't find a lot of places more far away from Mexico frontier in the entire US that NY. It was the first place seriously hit. It was hit for months while the Mexican border was showing... nothing. Do you have a logical explanation for that?
People being detained for months in really crowded places, as can be seen in all videos taken... they had covid when were deported? Well.. This is hardly a surprise to me.
We are talking about one vector over the last few months. The state of NY over a year ago is a non sequitur. Illegal immigration has probably increased close to 3x since then. Besides which, my understanding of the high mortality in NY is that it was mainly due to Cuomo emptying out hospitals of covid patients and sending them to nursing homes.
I think we are only in the business of arguing the counterfactual of what percentage of them get covid from interactions with law enforcement vs otherwise.
In fact, I am arguing for increased capacity to handle the corona virus long term. short term measures like trying to lock down borders is going to have little meaning in the long run, and hurt a lot of people.
Are both of those insults?
NYC locking down all summer and then 'opening up' in September seemed top of the list to me. It's not that I thought they should have stayed locked down the entire time, its that they should have opened in the summer so they could lock down in the winter if they really needed it. But seriously though, locking down in the summer to only open up in flu season, really?
Or maybe the whole 'if we just lock down for two weeks, this will be over' tops the list of stupidity. or the fact people still want to lock down despite how epically they have failed. Germany masked, distanced, and locked down better than anyone could expect, and here they are sitting with 4 million cases, 100k dead and are still in the pandemic. They don't even share a porous border with Mexico/South America. To no fault of their own, they are hardest hit by the pandemic, and the US sharing a border with them the way it is meant no rosy outcome was in our future.
Or how about how everyone was anti mask in the beginning, including the CDC, WHO, and my very liberal coworkers. When I said it would be advisable to wear a mask when in crowded places March, 2020 - I was heckled for not following the science.
Or what about the fact we are 2 years into this and we still haven't built a significant amount of hospitals? if we had to lock down because of lack of hospital beds, well we better f'ing demand they have enough hospital beds, like real soon. This is why the lockdowns should have came at a price, you want to lock down then we need a metric that you are trying to achieve by the lockdown, we need timely updates on your progress to that metric, and we need an action plan such that this will never happen again (such as building more hosptials - hey, how about just opening the thousands we shut down in the last 5 years to make hospitals more profitable!). my views on that were called 'myopic'. so we gave them lockdowns without restrictions, and nothing was done. here we are in the same situation, odd.
As far as making the vaccines political, well they don't have to be. some research has shown that they don't do very well at stopping spread, so why all the fuss to force people to get vaccinated? just say do it for yourself if you want to, politics removed.
edit: just to be clear - I am not anti vax, I am vaccinated and I recommend to everyone to do the same. There is unrefutably evidence the vaccine prevents sever cases.