Today is the 15th day since New Zealand launched its large scale experiment in regard to combating COVID-19, so it is time for a scientific post which examines how our experiment is going. In doing this, we have to remember that experimental conditions here are quite different from those in other countries. In addition, this sort of post reminds me how I have two parts to my brain – there’s the relatively dispassionate science part, and the part that connects strongly to individual humans. It’s like having a dessert stomach – I can switch the science brain on and calmly deal with numbers of deaths and decimation of economies. If I think about individual cases when I am looking at health statistics, it is impossible to make sense of the data. How to blend the two brain aspects is something I continuously struggle with…it appears to me that Jacinda Ardern is exceptionally good at it.
New Zealand’s numbers of tests, cases and deaths related to COVID-19 are all looking good too:
- Testing (see comparison to 1 week ago):
- NZ has scaled up testing to an average of 3500/day over the last week, nearly 4000 total yesterday.
- We have done over 10,000 tests per million people 6 weeks after our first detected case cf South Korea doing 6,150 tests per million people by 8 weeks after their first detected case.
- Yesterday only 0.7% of tests returned a positive, far below the supposedly acceptable 4%.
- Confirmed/probable COVID-19 cases:
- New Zealand is definitely ‘flattening the curve’ early in its development, as you can see in the first graph below, in comparison to all the other countries pictured. It looks like we might emulate South Korea, but at around 1,000 cases, as opposed to 10,000 (note that this does not include probable cases, which NZ reports on internally).
- Our daily new cases (see second graph) have dropped in number over the last four days and stopped their continued upward trend from the time we went into Level 4 alert on 26 March.
- Our numbers are at the best scenario end of the original epidemiological models.
- New Zealand only has 1 death so far, 14 cases in hospital, 4 in intensive care.
In the worst case scenarios predicted in February and March, we could have seen 4,000 New Zealanders as confirmed cases, with up to 400 deaths by now (as in my post of March 24). We are clearly doing way, way better than that. However, as our Prime Minister reiterates, our achievements are no cause for complacency nor relaxing of our rules at this time. We remain in lockdown of Alert Level 4 for 4 weeks, no matter how good our numbers are. In addition, before the end of Alert Level 4 we will be adding rapid contact tracing via technology (see my comments and concerns of two days ago) and mandatory 2 week quarantines in a government-operated facility for all new arrivals to New Zealand (only New Zealanders have been allowed to enter since 19 March and everyone has been asked to self-quarantine).
Early in my posts I suggested, based on points raised by my friend Simon, that we should pay attention to the Swedish experiment. Sweden has refused to mandate the degree of reduction of activities across its country. Sweden has asked its citizens to practice social distancing (I really wish this term could be changed to ‘physical distancing’ but I think we are too far down the track in using it), vulnerable citizens to stay home, banned visits to retirement villages, and closed high schools and universities. Monday 6 April they encouraged businesses to let employees work from home. However, they have left restaurants and bars and primary schools open, and gatherings of up to 50 people are still allowed.
If we believe the figures in the confirmed cases graph above are useful, there seems to be little difference in the trends and number of confirmed cases in Norway (population around 5 million), Denmark (population less than 6 million), Sweden (population around 10 million). There is a problem, however, Sweden is not providing information on its rates of testing – see the graph below which compares testing rates. New Zealand ranks well in this, but Sweden isn’t on it because, although they reported on 31 March that 3,650 people per million had been tested, reports have not been put through to our-world-in-data since.
A clue that Sweden may be under-reporting cases is that their number of dead is now substantially higher than Denmark or Norway and appears to still be climbing rapidly (New Zealand doesn’t appear on the confirmed deaths graph below because we don’t yet have 5 deaths). According to Worldometers, 719 people are in hospital and 19 are in critical care (Sweden had about 2,200 hospital beds in 2017 and 480 ICU beds in 2020). There is a media mention that decisions are already having to be made about who to treat in Stockholm. Population distribution will have a significant impact on the speed of increase of case numbers; in rural areas number of infections are not at problematic levels, potentially because people simply don’t come into contact that regularly, as compared to Stockholm. This highlights a major issue in the bulk data available – infection rates are related strongly to numbers of contacts between people, which differs societally, rural vs urban, location of early clusters etc. etc. Enter a new approach, estimating ‘Rt’ – the real time reproductive rate of the virus in different places and at different times. I think I need to write about this in another post, as a scientist it sounds like the right answer to how the country will decide on forward actions.
In conclusion, we can see that New Zealand is clearly progressing well, in our goal of flattening, or squashing, the curve. Based on case numbers, all the Scandinavian countries appear similar, but based on deaths there may be something different going on in Sweden. Another question one could ask of Sweden is, how badly hit is the economy already? Businesses haven’t yet been forcibly shut down, but are the changes in people’s behaviours already having a major impact? This is one of the rationales used by many for lockdown; economic slowdown will happen whichever path a country chooses, and better to choose it deliberately than accidentally. Sweden continues to provide an experimental control, but if the local epidemiologists and medics are heard, possibly not for much longer.
Jacinda Ardern’s message and practice of kindness and thanking people seems to be getting out there – this spotted at the start of the Kawarau Gorge.