International COVID-19 Megathread

[Pericles]

For New Zealand, an alert system has been announced for coronavirus. This link shows in more detail how the alert system works. There are alert levels for both nationwide and regionally, so it's possible that certain regions of New Zealand could end up being locked down. New Zealand is currently at Alert Level 2 (the levels go from 1-4). Also, New Zealand has 52 coronavirus cases with almost all being directly from overseas arrivals and no clear community transmission so far.

So for Alert Level 2, these are the measures that take place with it "Entry border measures maximised, Further restrictions on mass gatherings, Physical distancing on public transport (e.g. leave the seat next to you empty if you can), Limit non-essential travel around New Zealand, Employers start alternative ways of working if possible (e.g. remote working, shift-based working, physical distancing within the workplace, staggering meal breaks, flexible leave arrangements), Business continuity plans activated, High-risk people advised to remain at home (e.g. those over 70 or those with other existing medical conditions)"

This seems like an interesting idea and a good way to inform the public about where things are at-I heard on the radio that a business owner was saying this provides more certainty and there had been a lot of worry with rumours of a nationwide lockdown (which so far is not happening in New Zealand).  Have other countries adopted similar systems?

[Pericles]

New Zealand is going into a 4-week lockdown tonight. We are relatively early in the outbreak, with just over 200 cases and no deaths so far. Most of those cases have also been from overseas arrivals too. However, a few have been from community transmission. I think the government has made the right move to try and contain it early, and I hope we've gone early enough. It seems that Jacinda Ardern is trying to follow the approach taken in countries like Singapore and Taiwan, rather than let things escalate as they are in Europe. So far I'm impressed with her handling of this crisis, she comes across as a calm and responsible leader.

[Pericles]

People talk about herd immunity at 60%, but even at 15-20%, the virus will slow down travel considerably.

The issue with herd immunity is that even if you accept about 1% dying from an infection, there isn't enough data on long term effects of the disease. Cured doesn't automatically mean healthy again. There are reports from younger people with no pre-existing condition having breathing trouble months later as well as studies that show the disease can cause heart and brain issues. Also, herd immunity only works if immunity lasts for at least a year or so, and there are some indications just a certain percentage of patients are immune for a longer period of time.

Yeah, the best solution was to eliminate community transmission with a hard and early lockdown and closed borders like NZ did, and then wait for a vaccine or treatment while the science becomes clearer. The risk there of overestimating the virus' dangers are less than the risk of it having turned out that the dangers were underestimated. Indeed, even the standard fatality rate estimates result in far too much loss of life to be acceptable to any responsible government. The second-best option, where elimination is not possible, is to suppress the virus to limited transmission and cope with social distancing restrictions until a vaccine or treatment arrives.

[Pericles]

We are getting a second spike in Europe, but the deaths curve is no match? It's almost minimal in comparison to the 2 week trailing death curve of the first wave.

Why is that?

Since the spread is among the young, it may be a delayed death curve as the deaths won't come 2 weeks after the initial spike in cases but around two weeks after the new community transmission infects the old and vulnerable. Just as Florida's new cases were peaking for instance, deaths barely started to rise. It is also harder to see because Spain's death reporting system has been screwed up for months. Still, their death toll yesterday of 184 deaths was the highest since May 8.

[Pericles]

I think at the peak of the first wave in the UK, the actual daily infections were around 100,000. Now, they are picking up a lot more cases, so they think that last werk it was 27,000 daily infections. That seems about right based on the current death rate (which is also, sadly, supposed to rise due to the infections that have already occurred recently but haven't yet resulted in death). Plus, I presume the government isn't sending infected people into care homes without testing them this time.

[Pericles]

If the variant is actually roughly as contagious as is claimed, and the UK government only recently discovered this fact, then I don't think their response has been that bad honestly. Their earlier actions, like loosening the lockdown too early and their initial Christmas plans, were mistakes. However since Johnson's cancelling of Christmas, their actions seem reasonable (even if they could have been done earlier, but that partly depends on how much they knew about the variant at each time). It's a low bar, but this response isn't as bad as their responses to the first and second waves. Governments seem to be taking it seriously and having a good precuationary approach with the travel bans. If it is contained, it could give some insight into how the early days of the pandemic could have gone differently.

[Pericles]

Russia apparently has "corrected" their death toll, German Tagesschau reports. Official numbers now say 186,000 people died from Covid in Russia, was 53,000 before.

Interesting, the only surprise is that they admitted it. On a per capita basis, that death toll is slightly higher than most major countries including the US and the UK, but close enough that it doesn't necessarily mean Russia did even worse (but still did terribly of course).

[Pericles]

Focussing solely on case numbers is misleading - hospital admissions are a better indicator.

Hospitalisations are a lagging indicator though, case numbers almost always lead to a rise in hospitalisations in the next few weeks. Waiting for deaths and hospitalisations means being behind the curve, and is more costly on every measure.

[Pericles]

This really is a catastrophic failure. The EU had to get their populations vaccinated before the UK variant sends the numbers back up, yet they have gone through months of lockdowns for very little gain. Now, it will be very hard to sell the lockdown being even longer and stricter to the public. The pressure to relax restrictions will be overwhelming when the science points the other way, because the EU were too incompetent to prepare properly for the threat.

[Pericles]

https://twitter.com/business/status/1392010361809874949

The Chinese vaccines seem to be  effective at preventing deaths but not very effective at preventing cases. 2/3 of Seychelles is  vaccinated yet 1/3 of cases are still among the vaccinated.

It’s very worrisome, and definitely begs the question as to how effective Sinopharm actually is, and also whether this is just Sinopharm, or if the same logic extends to other vaccines, such as JJ and Moderna.

If it was, we'd be seeing evidence of it in places like the UK and Israel.

Speaking of Israel, have you heard the latest joke from there? "The rest of the world's dealing with Corona and we're back to normal."

Perhaps, but it is early and the UK cases are starting to rise a bit (tiny compared to last wave) so I would watch.

That's not true.

[Pericles]

Anyone else concerned about the massive spike in reported cases in the United Kingdom?  Over 25,000 cases in one day despite 50% fully vaxxed.  Weekly average 20,000. Here in Canada they would freak out and shut down over that.  Seems like we are stuck in a perpetual cycle.

A bit, the Delta variant is unhelpful, but with the vulnerable being double-jabbed it looks like vaccines have broken the link between infection and serious illness/death. That's the most important thing, so hopefully Covid is just a normal disease now and the UK can return to normal on 19 July. They did expect cases would surge as they reopened, so the lack of a spike in hospitalisations is a great sign.

[Pericles]

54,674 new infections reported in the UK today. That's... something.

That's... totally irrelevant.

As long as the healthcare system is not at risk of collapse, and most people aren't dying (especially younger ones), no one should care.

Same reason we don't panic about influenza cases. Not a high risk to the system, and not many deaths.

What if a vaccine resistant variant develops?

To be fair, the odds that it would develop in the UK are pretty unlikely. It was mainly bad luck that it was the UK variant rather than the French or German variant, since there's lots of Covid in many countries. Plus I believe the variants develop in severe cases so if those are reduced hopefully the risk is reduced too.

[Pericles]

Australia is in a perpetual (well until they're mostly vaccinated) lockdown because they locked down after a lot more than one case.* NZ saw that, knows we can't take risks with Delta, and so we'll get this done in the next two weeks and have our freedom back. Remember, this has been a world-beating approach in the pandemic so far, with hard and early lockdowns we have had more freedom than most countries and much less deaths.

*Australia has to lock down though because Delta is so contagious that there's no way an outbreak could be controlled when most Australians are unvaccinated.

[Pericles]

I still don't understand how America's vaccination hesitancy is large enough to overwhelm healthcare systems-deaths should be much lower since most vulnerable people are protected (even more than the average vaccination rate). The wave is clustered disproportionately in the South, but even then, 76% of over 65s in Mississippi are fully vaccinated.

[Pericles]

I still don't understand how America's vaccination hesitancy is large enough to overwhelm healthcare systems-deaths should be much lower since most vulnerable people are protected (even more than the average vaccination rate). The wave is clustered disproportionately in the South, but even then, 76% of over 65s in Mississippi are fully vaccinated.

The Delta variant.

My understanding is Delta is more contagious but not necessarily more lethal?

But Mississppi infections are not hugely up on last year, they're up a bit and testing is about the same so you'd expect deaths to be way lower than last year with the wonderful vaccines.

[Pericles]

Any country that tries to impose any sort of major lockdown this winter on a *mostly vaccinated* population is going to encounter significant resistance. Almost everywhere, vaccines have been sold as a de facto "passport to freedom" and people won't take kindly if they think they have been sold a pup.

That sucks, because lockdowns will be necessary thanks to the Delta variant.

A vaccinated adult is less likely to die from coronavirus than a bee sting, even with the delta variant around. Lockdowns will not be necessary, and any country using them should instead look to vaccination.

Thousands of fully vaccinated people have died in the US alone. Just read FacesofCOVID like I do.

A very small fraction of the death tolls since vaccines became available, especially once you exclude those who died less than 3 weeks after their first or second jab. For example, in the UK for the first 6 months of this year, out of an adult population that is now nearly 90% vaccinated, only 252/51,000 (disgraceful) something deaths were of those double jabbed 3 weeks or more. And 73% of those were extremely vulnerable. If you're double jabbed, it's been 3 weeks, and you're not very old and/or unhealthy, you're fine and should be able to live a normal life and treat Covid like any other disease. The vaccines are truly wonderful.

[Pericles]

What is going on in the UK? I am very concerned given that even with their higher vaccination rates, their numbers are still so high. More importantly, why did cases in India and the US fall while they haven’t for the British? What is going on?

I can't answer all of that, but it may be because England lifted all of its restrictions while most European countries kept some minor ones. A lot of the current cases are also from secondary school children, where their vaccine rollout seems to have been poor (https://www.theguardian.com/world/2021/oct/08/covid-rates-rising-in-secondary-schools-in-england-ons-data-shows), though I'm not sure how that compares with other countries. Except for NZ, which is at 68% first dosed among that demographic so I'm sure that is better than the UK.
https://www.theguardian.com/commentisfree/2021/oct/07/england-vaccine-just-plus-europe-covid

[Pericles]

The UK does have one of the highest testing rates in the world, and a lot higher than even last Christmas. So this does skew the picture a bit both with how they're doing comparatively and how bad the situation is compared to how it was there. I still don't think their current death rate is a good outcome though.

[Pericles]

I'm wondering whether England actually made a better call than other European countries. England's chief medical officer said when they made the call for their Freedom Day that "“At a certain point, you move to the situation where instead of actually averting hospitalisations and deaths, you move over to just delaying them. So you’re not actually changing the number of people who will go to hospital or die, you may change when they happen,”. For people who never get vaccinated, they will inevitably get Covid at some point. So, the objective could reasonably be just to spread up the infections among those people so that the peak at any one point is never so high that it risks overwhelming the health service and denying patients-including non Covid patients-quality care. So European countries that kept some social distancing restrictions may have just pushed the wave back so it now peaks higher than England's, and their healthcare system's are more stressed. However, restrictions that also have the effect of increasing the vaccination rate, such as vaccine passports/certificates, are sensible from this point of view because it actually lowers the amount of people who die and the stress on the healthcare system.

This is of course different to the pandemic pre-vaccination when delaying infection actually saved lives by buying time for people to get the vaccine. It's also not the same in the US, too many areas have too low of a vaccination rate that greater restrictions may be needed to protect the healthcare system (though the places with the most restrictions in the US don't tend to be the ones that need them). This also presumes that the current waves are primarily unvaccinated patients and that there isn't a big risk of a lot of vaccinated people getting seriously ill.

[Pericles]

I bet SirMohamed has not left his house even one time since March 2020 and is probably waiting until Covid is completely eradicated off earth before leaving his house next.

Funny he is probably screaming against everyone who is leaving their homes while someone who has to leave their home to doordash all his needs and wants on his doorstep.

I see, you try to make this personal, which is kind of ridiculous. I'm fully vaccinated and will take a booster shot next month. What I'm doing is taking some precautionary steps like wearing medical masks in indoor stores and indoor restaurants while not sitting at the table, work mostly remote and avoid larger gatherings. I'm not that worried about myself or my wife, but I have no desire to spread the virus to anyone more at risk than myself.

The entire point here is that some places like Austria, parts of the Netherlands and Germany, the virus spread has apparently gotten out of control to a point where hospitals are on the brink of collapse. We have to live with the virus, but when too many - mostly unprotected - people get infected at the same time, too many will actually become sick and need ICU treatment. How are hospitals supposed to deal with this? Doesn't matter? Tell that to medical personell which already understaffed and underpaid. Or to the cancer patient, who can't get treated in time. At some point these countries have to measure their options and at least impose contact restrictions for unvaccinated people.

If 85-90% are vaccinated or have immunity, the problem wouldn't exist. As long that isn't reached, the virus will continue to spread in fast pace and cause major problems for hospitals.

Now seems like a good time to add that in New Zealand, 91% of those eligible are first dosed and 85% are second dosed. We perhaps were the strictest in the world by waiting for Auckland to get to around 90% before the lockdown ends on December 3. Every region in New Zealand is at 84% first dose or above.

[Pericles]

I was going to travel international next month, partially to trigger the online left, but that may not be possible if the US implements a quarantine requirement on returning travelers.. even those with three covid shots .. ugh

If you were already going to take time off to travel, is 7 extra days really a deal-breaker?

[Pericles]

Another vaccine approved for Europe. It's a protein vaccine similar to most flu vaccines. Some in the media think it may convince soft vaccine skeptics to get a shot. Novavax is already working on an adjusted version for Omicron.

https://twitter.com/dwnews/status/1472919018164166656

It's not a one shot vaccine, right?

[Pericles]

Great Britain for the first time in a while reports over 100,000 new cases in a single day. Omicron is dominating now.

First time full stop - we didn't do mass testing during the first wave, but it was estimated to be around 200,000 at the peak there.

Wouldn't infections have been higher in the second wave though? Care homes were better protected then, and hospitals had better treatments, so the death toll being even higher had to be because infections were so overwhelming even though they skewed a bit younger.

[Pericles]

Obviously you don't try eliminate it forever because the cost is not worth it even if it were achievable compared to simply living with it as a normal disease. However, how you live with it is the real question, the Covid case loads and death tolls in many countries remain above what you would tolerate from seasonal flu. We will get there and some countries sooner than others, but I think it's about easing into it rather than expecting it all be solved in a single day.

[Pericles]

Official COVID death toll: 5.4 million

Economist estimate of actual deaths: 18.6 million to 21.7 million.

Technically it's 11.7-21.7 million with 18.6 as the median, but it's an incredibly sad number. It will take a long time to accurately quantify the true toll of the pandemic, if that ever happens. I suppose the best that can be done is to step up every effort to prevent another pandemic like this or worse in our lifetimes.