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Italy hospitals already on the brink

The Why

More and more people keep asking me why I’m so concerned about the latest Corona virus family outbreak presently being referred to as COVID-19 given its reported to have resulted in far fewer deaths than the Common Cold and only really appears to be affecting the Elderly.

Using the US as an example given they should be one of best prepared,  if not a world leader in managing such an outbreak, I’ve created a simple video summary of 5 major areas of concern:

Firstly, experts estimate this outbreak to be at least 10 times worse then any season flu outbreak.

Second: A vacine is over a year away

Third:  Extreme failings in both Testing and Notification continue to this day.

Fourth:  No clear plan from Governments on how to proceed

Fifth:  Extremely contagious with estimates ranging up to 50% of the population expected to  become sick.

COVID-19 is only just beginning to grab a foothold across the world, only yesterday being declared a worldwide pandemic by the World Health Organisation, and we are still no where near the peak of the outbreak yet, in fact we likely are atleast  3-7 months left from hitting that.

Also while the average age of patients killed as a result  of contracting the virus is  approx 80 years, a number of people over 40 are still requiring medical attention they are just much more likely to recover, and while children don’t seem to be getting sick from the virus in any great numbers, no-one really knows why yet, and they can still infect others.

The Coronavirus Family

Coronaviruses are a group of viruses that cause diseases in mammals and birds. In humans, coronaviruses cause respiratory tract infections that are typically mild, such as some cases of the common cold (among other possible causes, predominantly rhinoviruses), though rarer forms can be lethal, such as SARS, MERS, and COVID-19. Symptoms vary in other species: in chickens, they cause an upper respiratory tract disease, while in cows and pigs they cause diarrhea. There are yet to be vaccines or antiviral drugs to prevent or treat human coronavirus infections.

Covid-19 differs to other similar well known corona viruses in a few major ways, you’ll likely have heard of its brother SARS as that was widely covered in NZ back in 2003,  MERS less so as that was largely restricted to the Middle East

Testing and Reporting Issues

Large numbers of countries right from the start have had huge difficulties detecting the virus, and even now months on are still not testing or possess faulty testing equipment meaning a number of infection volumes are being under reported or not reported at all.
case in point in just NZ alone there were two false negatives reported before a third test confirmed NZ’s 1st case which would never have been detected if not for a medical workers insistence to proceed with a third test that the virus was actually detected.

 smaller cities in developed countries are still having difficuties testing let alone poorer countries that don’t even have the ability to detect potential cases let alone confirm them. Largly why Africa and South America has so few reported cases etc.

I mean even America has had big testing issues.
which is why they had been under reporting numbers even now.

Non-Linear Growth

Another thing that most people are overlooking is that case growth is exponential not linear, so small numbers now does not mean there will not be many many more in future, just look how quickly South korea, Italy and Irans case numbers increased into the thousands from only a hand full a few weeks ago.

raw data taken fron this website

6th of Feb is when i began capturing data

from this you raw data and the graph above you can see a few things.
1. Italy went from 3 reported cases to over 10,000 within a month
2. Iran despite having no reported cases, somehow now has 8,042 (likely indicative of testing/recording deficiencies early on)
3. South Korea while getting a large number of cases reported before both Iran and Italy, managed to get control of there case numbers through enacting quarantine like measures sooner much like China where the Virus originated from

New Zealands Advantage in an Outbreak, will we make the most from it.

In New Zealand we regularly benefit from watching other more frequently visted and populated countries deal with virus outbreaks before they even hit our shores.  However in an every increasingly connected world with every decade this advantage gets lessened.

in the Case of COVID-19 originating from China it was clearly evident after month 1 that vigerous quarantine measures where the only way to stop the virus spereading throughout the entire country.

Despite China demonstrating that was the only way to stop the spread in its tracks, and the WHO recommending the same, the rest of the world was incredibly slow to act.

note the drop off in cases from Feb 14 onwards approx 2 weeks after China locked down the province a the heart of the outbreak Hubei province

Ongoing Major Concerns and questions

Medical Supply Shortages

Shortage of personal protective equipment endangering health workers worldwide

WHO calls on industry and governments to increase manufacturing by 40 per cent to meet rising global demand

The World Health Organization has warned that severe and mounting disruption to the global supply of personal protective equipment (PPE) – caused by rising demand, panic buying, hoarding and misuse – is putting lives at risk from the new coronavirus and other infectious diseases.

Healthcare workers rely on personal protective equipment to protect themselves and their patients from being infected and infecting others.

But shortages are leaving doctors, nurses and other frontline workers dangerously ill-equipped to care for COVID-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons.

Months into this Outbreak a vacine is not even remotely  close and global medical supply shortages are becoming more and more of an issue in preventing its spread.

Missing Core Ingredients

With China becoming the Primary Manufacturing hub for so many industries including many Drug ingedients, a severe outbreak their has many more roll on effects then  most people realise, As US reports drug shortages from China have already begun

with the world is so inextricably linked these days there are numerous single point of failure where core ingredients in live saving medications and essential electronic components are produced by only one or 2 main sources, so any impact to these business or their suppliers.  can create extreme shortages of essential electronics required in medical equipment or ingredients in manufacturing of life saving mediacations, the impact from this will only just start to take effect as existing supplies begun to run out like the US FDA have already reported or like what was reported in Utah last week or australia for some examples

Government and Health Workers contracting the virus

we are lucky the death rate is so low for this strain, however the fact that so many health or goverment officials involved in handling this outbreak have so easily become infected is cause for immense concern if not this time then regarding future outbreaks certiainly.

UK health Minister gets the virus

Iran Vice President Is One of 7 Officials to Contract Coronavirus

over 3000 health workers have contracted the virus in China

Will we have enough Hospital Beds in NZ?

to try and answer this question the best data comes from Singapoure.  Dashboard avilable here
Singapoure is the only country that seems to be providing high quality data, which shows of its 178 confirmed cases 82 (46%) are currently in hospital 12 of which are in intensive care while the remaining 96 (54%) have been successfully discharged with a  Median days spent in hospital for recovered cases of a 10 days.

this is hugely significant and worrysome if the data from Singapoure is even remotely accurate this is a major reason why we should be concerned in NZ,  particularly when our own hospitals are already reportedly not up to handling the pontential number of cases we could be treating in the coming months, should our outbreak worsen.

Despite having only 5 cases to date, NZ is far from out of the woods just yet.

Thanks to Ivan NO and Dave Fleming for your assistance regarding additional resources.

Reference sources

Full Length Video Reference links

Joe Rogan interview with infectious disease expert.

Exponential Growth of case numbers

60 minutes Australia

Coronavirus outbreak: U.S. infectious disease specialists testify to House Committee