'Near extinction' of influenza in NZ as numbers drop due to lockdown
rnz.co.nz
rnz.co.nz
And just last night NZ time, we had the results of the elections. Current government won by a landslide. And surprisingly a Greens candidate won in Auckland Central. On mobile - but Chloe is just great for Auckland Central!
Being an island and having a government that doesn't openly reject science certainly helps but they still needed to actually get it done. Which they did. Now they are in the comfortable situation that they can quarantine visitors and sit tight until there is a long term solution. Meanwhile their economy can function pretty normally.
In Portugal I know folks that drove from London, Paris, Utrecht (Netherlands) and even Moscow to avoid the no fly laws so they could vacation here. I personally know 3 families that drove from Moscow to the Portuguese south during the lockdown period. (And I am sure based on the foreign plates I saw, various orders of magnitude more did so as well).
This is not to say it was all the foreigners, but it is much easier to control a pandemic if you can close all the borders (Madagascar anyone?) and have a smaller population. (This is also not to say NZers shouldn't be praised, but just a land border with 2-3 countries would probably see a lot of these efforts go to waste)
In Vietnam, when there was a new outbreak in Da Nang, the whole city was isolated from the rest of the country. Flights grounded. Roads closed, with checkpoints. Trains stopped. This lasted for several weeks until it was clear that situation was under control.
Some Canadian provinces had setup measures to prevent unnecessary travel.
Having 24/7 border patrol between two land connected countries setup and agreed over 20+ crossing points isn't something easy to do, specially during a pandemic where those agents are also needed elsewhere (and there were border patrols along the mains roads, but not close to all).
Compare to only entering by airplane where you can a) prevent planes from landing by just sending an email (exaggerating) and b) anyone that lands goes through a funnel where you can easily quarantine them.
And you can't compare a city, with 1,285 km2 with a country of 92,212 km2 (and other countries even more) and talk about border controls. Portugal also did the same to a city with some success but still there were flaws in the patrolling.
If a country can’t close a road, how would it hold up during an attack or war?
This should be a well trained, standard procedure.
Canada is in between mainland US and Alaska. US citizens were allowed to drive thru without diversion. Some didn’t follow the rules and made unnecessary detours. They were fined $600,000 for that. You just need a couple of these cases to make the news to deter people from skirting the laws.
Da Nang also had small road leaks at first. Then those who were diverting via those roads were caught and punished. Roads were closed.
The major factor that accelerates spread is the frequency/duration of interactions between different people.
So a country such as NZ, that has:
- a much smaller population
- a much less dense/more spread out population
- geographic isolation from the rest of the world
- its population split across two islands
- a small fraction of the international and domestic passenger movements that the US, Europe and Asia have
- a very small number of infection cases in the country when the world suddenly woke up to the scale of the problem in mid-late March
- a centrally managed national health system (and government)
- a cohesive and compliant society
... will have a vastly easier (like, exponentially easier) time controlling the virus.
NZ deserves credit for handling it well before it got out of control and they're deservedly enjoying the benefits now.
But the conditions that made it even possible for NZ to achieve this apply in very few other places.
I can't actually fathom a way the US could have contained the virus the way NZ did, no matter who was in power federally ("just be like China" obviously can't happen).
(FYI I'm an Australian living in Melbourne, which has partially similar conditions to NZ but has spent the past 4 months battling a "second wave" and enduring a brutal lockdown which is just starting to ease now. That was after we'd seemed to have beaten it in May, and the rest of the country has stayed on top of it. So I know what it looks like to win and lose against this virus. Though even then, our case numbers and fatalities are far lower than the US and many European countries.)
US 2020 Q1 -5% Q2 -34.3% NZ 2020 Q1 -1.4 Q2 -12.2%
https://www.stats.govt.nz/indicators/gross-domestic-product-... https://www.bea.gov/sites/default/files/2020-07/gdp2q20_adv....
you are wrong by only one order of magnitude
NZ population: 4.89
NZ tourists: 3.7 (2017 figure)
US population: 328.2
US tourists: 79.26 million international visitors to the U.S. This figure includes visitors from overseas, Mexico and Canada.
I had a look about and according to the things I can find, New Zealanders travel abroad about twice as much as US Americans. And keep in mind that pretty much everywhere a New Zealander can go is more infected than NZ.
We also have a lot less international clout than the US and less money. This matters.
As a country we have less people per square km than the US, perhaps by half. But the US is not vastly more populated the New Zealand when examined as a whole, and USA is nowhere near the top when you order countries by population density.
Our population is about 1/66th (5 million versus 330 million) that of the US, but our death toll is 1/8,900th (25 versus 224,000). I don’t believe the reasons you list explain this. In protecting its citizens New Zealand has done better than the average and the US has done worse.
https://www.traveller.com.au/the-worlds-biggest-travellers--...
The US reports annualized decreases.
Can anyone explain why colds have not come down as well? I don't understand what they mean by reservoirs.
As a related question, I've read that we all have cold viruses inside of us all the time, and they can be triggered by an immune weakness (such as by being in the cold outside). I've also read that you get a cold only because the virus is transmitted to you from someone else (which is more likely in the cold months when we're huddled together). Which is it? Can you develop a cold from a pre-existing internal virus with zero contact from another person?
Also, outside the quarantine zone, no one in New Zealand is in the hospital with Covid.
A slowly building immunity among the lowest risk group seems like a better long term strategy, and put the old and at risk people into something like New Zealand.
Either way as a country that depends on tourism you can’t be infecting tourists
Seems like life is back to normal and the lockdown is over in NZ
That's a lot of people who need rejobbed
A strong vaccine candidate within the next 6 months is a strong likelihood, along with antibody-based therapeutics. So the plan is to hold out, keep the internal domestic economy moving forward - the tourism hit was going to happen anyway, so might as well have everything else as operational as possible.
Herd immunity is not a strategy, it's just what used to happen before we understood that we could actually reduce the impact of disease on our lives.
There's zero evidence to support this assertion. First there's zero evidence that it's "strong", whatever that means. Second there's zero evidence that we'll have it in the next 6 months. Remember, it also has to be safe, not just "strong". Ensuring that takes a lot of time.
NZ may be isolated for a long time. But given the alternatives, that’s the approach I’d take too.
Oh, wait. We are...
(These are all honest questions, I’m not leading. I don’t know where to find this information summarized.)
Even relatively less dangerous viruses, like influenza, have strong vaccination programs, and relatively more dangerous viruses (measles, mumps, smallpox, etc.) are only words I know because of the vaccines I got as a child. I can't think of a disease with a nontrivial mortality rate that we don't aggressively vaccinate and have public health measures to prevent. Can you?
Destroying civilization in the off chance that it might help is the approach that’s worrisome.
The resultant unwinding of commercial real-estate debt hasn’t even begun. The deflationary spike and follow-on “riding the dragon” of inflationary response by central banks hasn’t even begun.
When we finish consuming our personal reserves, and begin in earnest to try to supply food and lodging to the, what, 50% of the population not “employed” by government, what do you guess is going to happen.
It will be illuminating, at least, to those who think they understand how civilization works...
This was the standard of care for chickenpox (herpes zoster, aka shingles) until 10 or 20 years ago, for example. Sure, the mortality rate is lower, especially among healthy children.
You're off by a decade and possibly two. I'm older than 20, I was vaccinated for Chickenpox. The vaccine has been commercially available for 35 years.
So I'd reiterate the question.
There may have been a vaccine 35 years ago (I'll take your word for it), but it was not the standard of care even ~25 years ago.
(And to be clear, I'm not advocating for exposing people to COVID, at all. You asked a very broad question upthread with an easy counter-example — chickenpox — and I provided the counterexample.)
Planet-wide.
I can only imagine that NZ is indeed sitting this out till a vaccine is available, because if countries that had herd immunity as a goal in the first place to not have that goal anymore, it probably means it isn't feasible.
That being said, I don't see how _any_ country is able to do anything other than sit this out. Everyone in the US, NL, even DE (which is doing okay in Europe) or NZ and TH (with no local infections) cannot do anything else than to wait for a vaccine to be available or before we just accept this as a reasonable risk.
Personally I think accepting the risk is the most likely situation. I do not have much confidence in a good vaccine being available in 2021, personally I'll get back on the plane in 2021 and just accept the risk. I als know that this is something a lot of people will not accept, but we cannot lock up the world economy for a few years for a virus where the fatality rate for healthy people is so low.
Tactical lockdowns with a strategic approach of maintaining rapidly escalating procedures on a hair trigger is the approach NZ's been taking, and thus far, it's afforded them a much better quality of life compared to the rest of the world.
It's whack-a-mole, but shit, it's cheaper and more effective than whatever it is we're doing in the US.
FTFY
Source: https://www.nytimes.com/2020/10/10/health/coronavirus-obesit...
Unless of course you're worried about the side effect of making a large number of people seriously ill, but if you don't see a way of doing it without causing a ridiculous number of people to fall ill then perhaps it isn't the best choice?
But if you're talking about infecting a large part of the population deliberately then it seems to me you should try to do it as quickly as possible because isolating the vulnerable part of society from the rest is not a sustainable situation.
And well, if we're talking about infecting a large part of society anyway then health and human lives are apparently already expendable to some extent.
Which is why the “Lock down hard to flatten the curve” thing never really made sense to me. If you prevent all transmission you’ll just drag out the pain. I thought cases are just going to shoot back up when you open so what’s the point?
(Turns out I was wrong though. Delaying cases was very valuable. People getting sick now are much more likely to survive.)
I very much want to read discussion on your first paragraph.
Sure, NZ's approach cannot be replicated everywhere else, but the fact is they have this under control and their people can (now) go about their lives.
Decisive action taken early to avoid excessive sacrifices later. And a population that was on board with that decisive action. Many lessons in leadership to learn here.
Here in central Canada I just keep watching the government and populace respond to things two to three weeks late, and half-assedly. Schools were shut down decisively in early March but it took almost two weeks after that to close obvious things like _shopping malls_ and _gyms_. No mask mandates in most cities until August. And apparently we learned nothing from the spring because the second wave is leading to the same inept and slow inaction. 70+ cases alone linked to one gym (a spin studio) near me but that region is still allowed to have gyms (with maskless participants!!) open.
So it's possible that when more normal interchange with the rest of the world resumes, NZ (and others) will have some "very bad" traditional cold/flu seasons. (It may feel like Covid, but not be.)
No, not really. I understand where you're comming from but this is a myth, that even some generalists doctor contribute to.
Yes the immune system can "register" a new pathogen and how to produce antibodies for them, but honestly we have vaccine for (almost) every sickness that can put a non-immunodepressed down if the immune response is too late, and adequate serums and care when a vaccine isn't available.
But your immune system do not "decay" if not stimulated. At all, and it might even be the opposite (the effect is within the error margin of the studies for now).
> we have vaccine for (almost) every sickness that can put a non-immunodepressed down if the immune response is too late
The 40-60% effectiveness of annual flu shots would beg to differ. And more often it is your immune response being wildly overreactive and attacking healthy cells that causes problems, not a “late response”
> But your immune system do not "decay" if not stimulated.
Sure it does, for one that’s the whole point of booster shots; your immune response to certain pathogens can decay over time (wether acquired from vaccine or naturally).
Additionally the “Hygiene Hypothesis” suggests our world being so clean, and our immune systems not being challenged, has led to a large spike in allergies (like peanuts) as the body searches for anything to attack.
https://www.vox.com/2014/11/6/7163713/peanut-allergy-symptom...
See also the strong evidence around a "boosting" effect from circulating chickenpox cases. Namely, that the availability of the chickenpox vaccine, by reducing the amount of environmentally-circulating chickenpox virus, is now preventing natural reinforcement of adults' immunity via asymptomatic encounters, and thus leading to more (painful, symptomatic) cases of shingles, especially among people in their 30s/40s:
https://www.sciencedaily.com/releases/2015/08/150811103555.h...
https://www.lshtm.ac.uk/newsevents/news/2020/adult-exposure-...
https://www.webmd.com/skin-problems-and-treatments/shingles/...
It makes having a well balanced discussion of the news difficult when articles that offend some political sensibilities have such a high barrier to entry in terms of how much they get flagged that they have no chance to survive in the first 50 posts (COVID related or otherwise).
> 98%.
> What if I told you that confirmed flu surveillance across the world has dropped year over year by 98% since April?
> This is the deep dive story with data, graphs and charts showing how the world's most consistent nemesis has (almost) completely vanished.
Edit: it is classified as community.
https://www.rnz.co.nz/news/national/428619/watch-live-ashley...
NZ doesn’t rely on cross border lorry drivers either, and is far enough away that any boats are quarantined
You can't land just anywhere on an island, but you can take lots of roads into large countries on a continent. Islands have much more control over arrivals than landlocked countries with lots of neighbors and very integrated road & train networks.
So islands will ship everything already, whereas most land-countries move a lot of goods with trucking, and spread the disease that way, even when land-borders are closed.
International travel can be closed off with little repercussion.
But China is also kicking ass. Everyone in a city gets tested if there are even a few cases. Thailand also seems to be doing ok. Italy also has it under control for now.
There are clearly strategies that would work for non-islands.
Contrast NZ with the UK. That train wreck has hit an island that should have done better.
Then slowly grow this village this way and celebrate life without masks and social distancing.
Of course, there would be a Covid outbreak at some point in time. Would that be the end of paradise or might there be a way to get back to zero infections? 14 days of full isolation of a whole village seems like something that might be possible.
What do the digital nomads among you think about this?
1. https://en.wikipedia.org/wiki/The_Masque_of_the_Red_Death
Reframe it to literally moving to a village of 1,000 people that are all random folks. You wouldn't move to that village unless you were a loner.
The population got on board with the lockdown so it was short and effective. The US efforts in that regard are ineffectual so the half-assed lockdown and mask wearing will need to continue indefinitely until there is a vaccine, which is the only hope left.
This raises some questions about the flu though, right? The COVID lockdown effect mostly stopped the virus getting a toehold in the country. Does this imply that the flu is mostly imported too?
Maybe the short, sharp lockdown did stop the flu, but it feels more plausible to me that the ongoing severe border controls are what's keeping it down while the country more or less goes about life as normal.
Both measures together likely stopped the flu just as they stopped the coronavirus. Keep in mind that both the flu and Covid are transmitted in the same way, respiratorily, but the flu is much less contagious, so eliminating transmission of the coronavirus is almost certainly also going to eliminate transmission of the flu.
Australia saw a similar effect, the flu season in NSW was one tenth of what it normally is.
Look at the pre-election videos covering campaigning in New Zealand -- crowds of maskless people, politicians hugging supporters etc. Stadiums full of rugby supporters. Not a COVID transmission risk, but wrt the flu it's obviously no different from a regular season -- except for the borders.
In San Francisco people are distancing a lot more. It's understandable why we have more COVID cases, but when winter rolls around it'll be very interesting to see if the same difference in flu cases is seen. A non-uniform distribution of reservoirs might be something we can conclude with borders closed.
Edit: I am not sure why I am being downvoted. I am a kiwi, flu vaccinations were very strongly encouraged this year.
Having no germs in childhood increases the risk for allergies. Maybe something similar happens with the cold?
The long version could add in the damage to things like cafes, restaurants etc with Covid. Dark times.
Instead of overseas visitors spending in NZ and rich NZ'ers spending their tourist dollars overseas .... the richer NZ'ers are spending locally.
Turns out not as different as the doomsayers predicted.
That was the stupid part, and predictable.
> It's not magic, it's just hiding in a cave.
Exactly! Great strategy, so simple to implement and saves the most lives.
We're producing and exporting and importing just fine thank you.
Borders are closed to casual visitors, not goods.
Yup, that can (and just has) create opportunities for the virus to enter.
But that is a risk that can and is being managed.
But you do. See you got it here:
> Only option I can see is to maintain isolation until a vaccine is available
What puzzles me is why you don't see this as the only good strategy for any country that has the capacity to attempt it. It's the strategy that saves most lives.
There are currently 10 countries in the Pacific, including NZ, that have no COVID cases. They could form a bubble and allow travel between them.
Yesterday kiwis were allowed to fly to Australia and enter the general population without quarantine.
If the time comes that they're willing to let their elders die so the wealthiest among them can travel or fOr tHE eCoNOmY, they can always open up their borders.
What they have is a choice. They had their elections last night and governing party was re-elected by a landslide, which means the people are happy with their current strategy.
> waiting for a new invention as part of policy is idiotic.
Saving lives and buying time is not idiotic.
The majority of people in New Zealand are 0th of 1st generation immigrants. The majority leave the country at least once a year and have multiple citizenships.
>Saving lives and buying time is not idiotic.
Yes, Queen Victoria buying time for the invention of penicillin is idiotic.
The 2018 census in particular has 28% of current NZ citizens of being 0th generation citizens. They have something like 30% for people with one 0th generation parent: https://www.stats.govt.nz/assets/Uploads/2018-Census-totals-...
So it's closer to 60% of citizen being attached to another country.
The Australian general population? That's fine, it's getting back in to NZ that's the issue.
There will come a point where lives will be sacrificed in order to get economies going again. It's harsh, but true.
Has NZ's economy escaped unscathed? I'd imaging that tourism is quite a large part of their GDP; but if I as a tourist have to quarantine for two weeks on arrival there's really not much point in visiting NZ at all.
Once the rest of the world starts operating again, vaccine or not, NZ will have to follow and relax their isolation. They're hoping that by the time that comes there'll be a vaccine or better treatments. But there's no guarantee of that. The rest of the world will be in the position where those who would have died from Covid have already probably died, but NZ won't.
People who've survived COVID can get it again and die the second time:
Most people now who get it aren't dying. The number of positive test cases is skyrocketing, but deaths aren't. There'll come a point where only death rates will used to judge whether lockdowns should continue or not, not infection rates.
17/Oct 45 (Not all data in yet)
10/Oct 37
3/Oct 22
26/Sep 14
By not having an epidemic, they continue to have the initiative to choose next steps, rather than having to react to the virus
And, they could progressively open their borders to those presenting with negligible carrier risk. Sufficiently voluminous & cheap testing can keep traveller risk very low, as well as the growing number of travellers who are recovered-immune & vaccinated.
If there's a vaccine in 2021 it will turn out to have been a good bet.
And why do so many people have almost near certain confidence that there will be a vaccine?
We have never made a successful beta corona virus vaccine, some doctors think it impossible because of the the nature of respiratory viruses.
Also, there’s the Hokitika Wildfoods Festival in NZ (https://en.m.wikipedia.org/wiki/Hokitika_Wildfoods_Festival), where everyone dresses up in costumes and voluntarily eats foods that one might resort to during an apocalypse. Highly recommended.
I've watched quite a few wheat fields I grew up near become dairy pasture.
China’s Global Lockdown Propaganda Campaign
https://www.tabletmag.com/sections/news/articles/china-covid...
A couple quotes from the middle of the article:
> In March, Chinese state media began describing the strategy of “herd immunity”—allowing the coronavirus to spread among the young and healthy—as a violation of “human rights,” an Orwellian formulation given that lockdowns are essentially a blanket suspension of rights.
> Initially, British Prime Minister Boris Johnson also opted for herd immunity. But on March 13, suspicious accounts began storming his Twitter feed and likening his plan to genocide. This language almost never appears in Johnson’s feed before March 12, and several of the accounts were hardly active before then. Britain locked down on March 23.
Flu vaccines work, they just don't work perfectly. Many years you'd still get sick, the severity is just attenuated by the flu vaccine.
https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
> recent studies show that flu vaccination reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to the flu vaccine.
[1] https://medicalxpress.com/news/2020-03-universal-flu-vaccine...
[2] https://clinicaltrials.gov/ct2/results?cond=&term=FLU-v&cntr...
It's more likely that COVID just out-competed the normal flu. https://twitter.com/kylamb8/status/1317186379483406337
"Out-competing" another disease requires them to both be present in the population they're competing over. This was never really the case for COVID-19 in New Zealand -- the country went for months with no identified cases of community transmission.
Elsewhere in the world we're seeing similar 98% drop in flu cases, starting even before the preventing measures.
Seriously, the discussion in comments in https://twitter.com/kylamb8/status/1317246961255370752 is really good, no matter the ones particular viewpoints.