Wellington, We Have A Problem …

It’s March 12. COVID19 is making its way around Europe. It has established footholds in the USA. Although some countries seem to have been largely successful in containing the spread of the virus, I think with the global declaration of pandemic by the WHO today has finally named the elephant in the room, the world’s worst kept secret. But it’s out there now.

So, what next?

Use Clinical Observation Patterns More

In countries that are preparing for a wave in cases, I think it’s important to take the hint from patterns of clinical observations, as well as data from testing results. The problem with waiting for this testing data to make decisions, is that this virus spreads quickly. By the time you have the data and gone through the processes necessary to make the decision, the situation has changed. and you are constantly playing catch up.

It’s also becoming clearer that there is a possible chance that transmission is occurring pre symptomatically. That is, people may be passing the virus to others before they experience any symptoms themselves, and then take action like staying at home. Therefore, places may see spread occurring even before people come forward for testing, if that testing is available to them. The risk maybe lower, but is seems possible. And at the moment, many people are not being tested, because the criteria for testing is quite tight indeed.

This might be a time to use the international collaboration effort, where doctors on the front line are sharing what they are seeing, and how quickly the number of cases escalate. Use these clinical observations as well as testing data. This gives us a chance to stay ahead of the curve, rather than just reacting to it.

Pay People When They Have to Stay at Home.

Note that I say ‘stay at home’, not ‘self-isolate’. I think there’s too much confusion and not enough impact with ‘self-isolate’. The UK Govt thinks so too – they’ve stopped using ‘self-isolate’, because their focus group testing showed that a message to ‘stay-at-home’ had more impact. Of course, add some more guidance, like if staying at home with others, don’t be in contact with them for more than 15 minutes and be sure to stay at least 1m apart, to account for people living in families, or in shared accommodation. But stay at home is a far simpler, less ambiguous message.

Both the Ireland and the UK Governments have said that they will pay people if they need to stay at home for 14 days, in an attempt to ‘flatten the curve’ and spread out the load that may be presenting in the health system, so that it lessens the risk of that health system being overwhelmed at any one time.

Why are we not doing this in New Zealand? You know what happens here: people run out of sick leave, then they run out of holiday leave. Then they go back to work because they can’t afford not to be at work. And what about all the freelancers, or self-employed? What happens to them? Because sure as anything, if they need to pay the bills and get money for food, people will be likely to present at work when they aren’t feeling well. We need to do something here. Urgently. Remember, the northern hemisphere is exiting winter. They hope to get through the next month or so when ‘flu cases start to lessen. In the southern hemisphere we are heading into ‘flu season. We really don’t want to be dealing with peaks of both ‘flu and COVID19 cases at the same time. Flatten that curve. Pay people to stay at home.

International Travel

In 10-14 days time, all reasonable indicators are leading me to expect that the situation in many countries will have changed for the worse. India has announced that it’s pretty much stopped issuing any incoming travel visas in their attempt to manage incoming virus traffic. Expect to see more of this from the Whitehouse very shortly. This has already had a massive impact on travel to and from NZ. Don’t expect it to get any better any time soon.

Social Connection is Important, Even More So When Staying At Home

Remember to reach out to each other is safe ways. We are being asked to ‘self-isolate’ / stay-at-home during a stressful event, when we know that the biggest protector in times of stress and crisis is social connection. Reach out safely. Don’t wait til its too late.

Remember, most people who contract the virus get better. Most people don’t have serious symptoms. But for some, its very serious indeed. Take care of yourself, look out for each other. Prepare, don’t hoard. Check in on your neighbours, safely. We’re in this for a while yet.

And thanks to colleagues who have helped shape my thoughts on this post.

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