Where are we with COVID-19?

Dr Victor Luca, 22-Mar-20

Unpublished


The views I have expressed here are solely my own, and do not express the views or opinions of any organization I am associated with.


Wuhan goes into lockdown 10:00am on 23 January 2020.


The novel corona virus known as SARS-CoV-2 gave rise to the COVID-19 infection that is turning our world upside down. The reference to it being ‘novel’ is important because it means that there is no immunity in our community. I can’t stress enough that this is not just like a normal flu!


This is a serious viral infection with a mortality that is much higher than the common flu. In fact, it is many times more infectious and fatal. Mortality depends exponentially on age. The initial stages of viral infection is also exponential if no constraints are applied. I tried to explain the simple mathematics of exponential growth in this community paper on the 28th of January. The thing about exponential growth is that at first it appears that not very much is happening. The initial stage of exponential growth is in some ways the most dangerous because one can be lulled into a false sense of security. It is the nature of exponential growth that when things really start happening, they happen surprisingly quickly. One minute everything seems fine, the next you are in big trouble. As of Sunday 22-Mar-20 we had detected only 66 COVID-19 cases in New Zealand. I use the word ‘detected’ because until recently testing has not been widely available. I calculate that at the present growth rate the number of infections will double every 2-3 days. That means that in 2-3 days from Sunday we will have 132 cases and then 264, 416, 528, 1056 and so on until after 33 days or so we are at well over 1 million infections. In Italy the doubling time has been around 4 days. Here, appropriate countermeasures such as stopping all inbound visitors have finally been applied and it appears that there is no community transmission, yet.


However, with this disease there is no room for complacency. We have to act early and with great speed and conviction. We have to be proactive rather than reactive.

As we all know by now, this virus originated in China and they provided a template for how to control this beast of an infection. The Chinese took draconian social control measures, as only they can. As of this writing, our country is at alert level 2 meaning the Ministry of Health thinks the disease is contained but the risk of community transmission is growing. Government has also asked the over 70s to self-isolate. I am afraid that for fear of not stopping business-as-usual we are being too hesitant in applying countermeasures. We think that there is no community transmission, but what if we are wrong and the virus is already circulating amongst us? That is a great risk that I would not be prepared to take. In my humble opinion, we would be well advised to assume that we already have community transmission and act accordingly. The country should go into total lockdown now, starting with the closure of schools and universities and any other places where people gather in numbers. Experts have already advised we take this latter measure, rightly stating that “schools are breeding grounds”, as is any workplace having a high number of people in a small space.


People need to take this situation extremely seriously, obey the rules as never before and act as one! Time is of the essence. The best way to flatten the exponential curve is to act early.


A petition started by an infectious diseases expert, Professor Michael Baker, of Otago University's Department of Public Health is rightly requesting PM Jacinda to put the country in immediate lockdown is circulating now! You can sign this petition at this internet address: https://bit.ly/civilianpetitioncorona. As of Monday more than 58,000 ordinary folk had signed. A comparable petition for medical professionals was delivered to the PM on Monday morning.

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