• Dr. Young Lee

9 months later - COVID19 pandemic

Hi everyone! It's been a while since I've sent an update. I really do enjoy being able to touch base with all of you, and to give you some of my opinions about what's happening and what might happen in the future. As you all know - we are incredibly fortunate in New Zealand to be able to open the economy full bore domestically - with virtually no restrictions. This is a luxury that very few countries in the world have. In fact - you can almost count this on one hand.  We should really be grateful for the 3 factors that have allowed this to happen: 1. Geography - we are an island nation. It takes a lot of effort for the virus to get here.  2. Government that listens to science and is not nuts. After looking around the world - yeah this doesn't happen all the time. 3. You - a compliant population. New Zealanders by far and large trust the government and are willing to follow instruction.Thanks everyone for not being a jerk. Local updates: Several testing locations have closed. Due to a fall in the number of tests done a week (about the 1500-2500 range, from a high of about 9000), testing stations have been consolidated. An up to date list of locations in Auckland can be found at: As usual, I'd like to answer a few questions in an FAQ format.

When should I get a test for COVID19?

If you have any respiratory symptoms, including a cough, runny nose, shortness of breath or loss of smell, AND you might have been exposed to someone who has traveled - please head to your local testing center and get tested.  If you haven't been exposed to travelers, but have symptoms and want to get tested anyway - please feel free to go to the local testing centers. We are able to test people at our clinic - but it's best if we don't. We have to don PPE  gear and if you are infected, it makes the clinic a potential hot spot. 

What are the chances of catching COVID19 in the community currently? 

Extremely low. But not zero. There are no documented cases of community transmission. All cases have been imported so far.  Our greatest risk of infection are the people working around returning travelers - such as airport, hotel staff and quarantine workers such as security and the police. They can get infected, not realize it and bring it home to their families and communities. They probably have some sort of testing regime. 

Should I wear a mask?

Currently - no. There is no need to. However - we should be ready to become a mask wearing culture at the drop of a hat. The moment we have a single community transmission - New Zealanders should mask up to reduce transmission of the virus. Wearing a mask reduces your risk of giving the virus to someone by 30% to about 7%, and reduces your chance of catching a virus by about 1/3. There is now very little argument that mask wearing is useful. It's not full proof but hey it works. 

What's happening in Melbourne?

Australia is now experiencing their second wave of infections. Melbourne is seeing about 700 new infections a day. This appears to be due to a break in their quarantine procedures. Whether it was due to security guards who got infected or not - it goes to show that there needs to be constant vigilance. All workers involved in quarantine and flight need to have regular symptom screening and testing. They also really need to not have sex with people coming back. I'm hopeful that it's unlikely to occur in New Zealand. The more likely scenario here is that someone gets infected doing their job - are reasonably asymptomatic and end up infecting their family members and other people in crowded places before they realize. 

Being vigilant means the following:

1. No exceptions to the 14 day quarantine rule. This includes compassionate leave etc. It also means that we do not give special exemptions to any group for business purposes etc. Hong Kong has had their 3rd wave because they gave exceptions to certain groups such as freight workers. 

2. Adopt mask wearing the moment community transmission starts. Government needs to make sure that they are reusable masks available in sufficient quantity for the public. Reusing masks is OK if you dry them. 

3. Government needs to introduce new laws allowing authorities to enforce testing, mask wearing and vaccinations. We currently cannot legally do any of the above - which frankly is nuts. 

Anyway - I would recommend that everyone forget about going to Australia this year. Maybe next year, but this year is effectively toast. With 700+ cases/day, it's going to take Melbourne at least 6-8 weeks to eliminate COVID19 if the public follows the lock down. As the entire country is not going to go into lock down, there will likely be a slow spread through NSW and a possible partial lock down there too. 

When will vaccines be available?

Too early to tell. There are promising signs of multiple vaccines passing phase I trials. These means that the vaccines have been tested on healthy humans who have not shown any major side effects and that they produce an immune response. 

Phase 2 and 3 trials are now being done simultaneously to cut down on the amount of time needed to determine if the vaccine works and if it's safe in larger groups of people. 

Dr. Fauci, the COVID19 health director in USA has stated that best case scenario there will be results at the end of the year that will tell us if any of the vaccines work. Early next year will be the earliest time for vaccines to be available - but it's likely that it'll be in small quantities and the richer countries will probably keep them.

Russia has stated that they want to start vaccinating people as soon as possible - but this is very dangerous without proper trials. If you give people a vaccine that makes them sick or kills them - good luck trying to get them to take a second one even if it's much better.

It's likely that there will be multiple vaccines that will be some what effective. Often the first few vaccines that turn up will not be that effective. Subsequent ones tend to be better. 

New Zealand should probably not expect to be on the vaccination list for a long time, we are probably talking about a 1-3 year horizon here depending on how effective a vaccine is and whether it lasts more than a year. 

The initial vaccines will be most useful in areas with a very high incidence - so we are talking about USA, South America, Africa, Russia, etc. 

We are bottom of the list here, so don't expect anything much.

Will the September elections likely effect our COVID19 strategy?

I suspect not. We are fortunate that both major parties - Labour and National - are quite centrist parties that will very likely listen to scientific advice and act conservatively. There was very good bipartisanship in the initial phases of the lock down being introduced. 

So whoever you vote for - we won't get nut jobs. So have fun voting. If your party gets in - congratulations. If not - better luck next time. But just remember how lucky we are compared to the Americans. :)

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