Corona Virus notebook (you are prepared, aren’t you?)

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This is going to be quick. Overnight three things happened: the stock market fell and the EU protested Trump stopping flights, the panic buying hit the USA, and a couple of eyewitness accounts from Italy with recommendations.

Firstly, Adam who translated that: you are not allowed to go anywhere but the supermarket and pharmacy and then back home.

I predict that they will close their borders within a couple of days. The Italians are also beginning to say that the elderly should be denied hospital beds. In other words, if you’re old then you’re on your own. In Italy of course that is not true as their society values the elderly and they look after their own. In Anglo countries? Not so much.

You had better make sure that your pantry is stocked. If you haven’t done so already then you’re a bit silly at best. Trump today closed the US border with Europe for a month. Traveling at the present time is not such a great idea just for the fact of being stranded, and you don’t want to be a stranger in a strange land when this sort of thing goes down and you find yourself stuck without a support network.

We are prepared, but I tell Kea to get a little bit extra when we are doing the shop. I estimate we have two or three weeks worth of food in the pantry and we have the garden coming on to the point we can do an autumnal harvest fairly soon (and the glasshouse crop is following along nicely) but we started this weeks ago. Taleb is correct: prepare early and don’t sit there saying “I’m not afraid”.

I pay attention to Taleb: he’s bright and experienced. I also pay attention to the SDL, because he’s about as bright as anyone else. I do work in health, and I’m assuming that all workers will be seconded to the front (acute medical) line.

Now, you are certainly welcome to bluster and posture about how you aren’t afraid of no virus, or pontificate concerning the probabilities that corona-chan is just a hoax, and so forth. I don’t mind that sort of thing. Everyone deals with these situation in a wide variety of different ways. Personally, I find the bluster-prone to be as needlessly annoying as the panic-stricken.

But what I do mind is actively telling people not to prepare for 2-3 weeks of quarantine, and here is why. Preparation is necessary if you are planning to stay home and keep the excursions outside to a minimum, we all understand that. But what most people fail to keep in mind is that if you, or anyone in your family, even gets knowingly exposed to the virus, (much less actually comes down with a case of the Wu-flu) you will be facing the same 2-3 weeks of home quarantine, only then it will be too late for you to obtain the necessary supplies. And then you will become an unnecessary burden on someone else to keep you supplied.

Kea can’t handle certain things, so we’ve stocked what she can eat without getting sick. I need to get enough contact lens stuff — my supplier was out on Monday.

Prepare now. We still, in the Antipodes, have a window of opportunity.

UPDATE.
McDonalds (which makes good coffee) has banned the reusable “keep cup” beloved by eco warriors and virtue signallers.

From Radio NZ, the leader of the senior doctor’s union, and a public health academic.

Association of Salaried Medical Specialists executive director Sarah Dalton told Morning Report it was reasonable for DHBs to talk to staff about leave plans but “personal leave should be dealt with on a case-by-case basis”.
“We’ve been concerned about a lack of staffing [at hospitals] for a long time now.”
She said there weren’t enough senior medical doctors and dentists in hospitals.
“We’re already stretched. An epidemic or pandemic is going to cause real stress.”
Dalton said it came down to both parties being reasonable about taking annual leave.
Patients waiting on elective surgeries might be pushed down the list to prioritise Covid-19 cases, she said.
“We’ve already got surging acute demand, putting pressure on elective lists, a lot of people are waiting a very long time to be seen. We already know that women with non life-threatening gynaecological conditions just aren’t being seen or not getting the treatment that they need. I don’t think that’s acceptable for a public health system.
“I think we need more investment. It would be great if we could get some political consensus around this because a lot of that development requires more than one electoral term to fix.”

University of Otago senior lecturer in infectious diseases Ayesha Verrall told Morning Report public health management to prevent or contain a large outbreak would need to be managed over a couple of years.
“It is very difficult for any country to have enough ICU beds to cope with a large outbreak like this,” she said.
“One of the worrying things about coronavirus is that the rate of people who have severe illness, critical illness, that need to go to intensive care is high at 6 percent, so that’s much higher than other comparable illnesses.
“It would put a stress on any health care system as it did in Wuhan, China, and as is now in Italy.”
She said maintaining flu hygiene and getting flu shots were some of the ways to contain the infection.
Apart from the health management, on the administrative side of things she said the system would need to be able to ramp up contact tracing if and when 20 or 40 cases cropped up.
“Those should be manageable scenarios with the right public health resources in place … that’s where we need to focus now.”
She said work was underway to increase capacity and availability of ventilators at hospitals.
“This looks like an illness that needs a prolonged time in hospital. Some people are in ICUs for a week or over a week, and needing hospital stay after that.”

Radio NZ

From today’s JAMA: need to disinfect surfaces at work.

“In addition to recommended masks for patients and other barrier precautions, enhanced hand hygiene and surface decontamination are key to safety. The coronavirus is known to live on surfaces for hours or days,7 but it is also effectively killed by available disinfectants when properly used. Masks, goggles, gloves, and other barrier precautions will fail to protect caregivers who later encounter contaminated surfaces and fail to wash their hands. Health care personnel must focus on meticulous hand hygiene, avoiding contaminating workspaces. Clinical staff should clean workspaces and personal items such as stethoscopes, mobile phones, keyboards, dictation devices, landlines, nametags, and other items with hospital-provided disinfectants or alcohol-based disinfectants.5 It is sensible for environmental services workers to increase the frequency of cleaning of commonly touched surfaces such as light switches, countertops, chair arms, escalator railings, elevator buttons, doorknobs, and handles. Active decontamination is not merely a technical issue, it also is reassuring to stressed and concerned caregivers, patients, and visitors.
The consequences of delayed recognition of a patient with COVID-19 are significant. Contact tracing for exposure to a case of COVID-19 is no longer routinely recommended, so health care workers must consider themselves at elevated risk of exposure. Health care workers must self-monitor, report signs of illness, and not engage in patient care while exhibiting infectious symptoms.

Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA. Published online March 12, 2020. doi:10.1001/jama.2020.3972

UPDATE NOON.

Things are moving fairly quickly. In my view, this is the correct decision: cancel festivals that have attendees from the Pacific Islands: the islands have low populations, are isolated, and have few doctors and nurses.

Auckland’s Pasifika Festival has been cancelled amid concerns about the risk of the virus being transmitted to the Pacific Islands by festival attendees.
Auckland Mayor Phil Goff said the decision to cancel Pasifika was made after discussions with the Prime Minister Jacinda Ardern and the Samoan High Commissioner
Overnight, the Covid-19 cabinet committee met and considered the issue, and its advice was to cancel, based on concerns from the Ministry of Foreign Affairs and Trade and the Ministry of Business, Innovation and Employment.
“While the latest Ministry of Health advice is that New Zealand does not have a community outbreak of Covid-19 and the risk of a community outbreak remains low, Auckland Council and the Cabinet Committee’s specific concerns are about the risk of the virus being transmitted to the Pacific Islands by attendees of the Festival,” Goff said.
“The history of the spread of contagious infections from New Zealand to Samoa, with last year’s measles epidemic which took 82 lives, weighed heavily on our decision.
“It is disappointing for all of us as Aucklanders, and particularly for our Pacific communities, that the festival will not be going ahead this weekend,” he said.

Radio NZ News