Containment and Isolation

SARAH Hoyt’s little COVID-19 round-up at Instapundit makes the point that we really know very little about who is currently infected and that’s partly because most carriers will not experience any symptoms at all – or, at least, none that strike them as serious. Instead of panicking – which I’m not convinced most of us are (despite media click-pushing the story that we are) – we should be concentrating on care for the most vulnerable. That means the already health-compromised and the elderly. As Hoyt says: “Locking the barn door after the horse has fled AND driving down the economy is NOT actually going to help anyone.” She’s not quite right, though, in presenting this as one side of an either/or vis-a-vis containment and isolation. I think the latter can still have consequential efficacy (granted, less so in a country of her native America’s size).

A story that struck me as symptomatic, as it were, of how challenging epidemiological crisis management can be in the modern West was the one reported this week about a good-will excursion of pre-schoolers to an aged-care home. After seventeen children from Banksia Cottage in Macquarie Park visited residents of BaptistCare, all had to be tested for coronavirus when a 95-year-old woman at the facility died of the illness that week after catching it from an infected nurse. Children minded by strangers visiting the elderly minded by strangers. We outsource “child care” and “aged care” and then use the very young to make up a shortfall of joy in the lives of the very old. We tell ourselves it’s a mutually uplifting practice. It’s also a neat trick. Containment and isolation, indeed. What I can’t be sure of is whether traditional stay-at-home cultures are better suited to protecting the weak from COVID-19. If China were more like Australia, would their infected population be double what it is – or are our elderly lucky to be in semi-medical facilities 24-7?

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45 Responses to Containment and Isolation

  1. calli says:

    – we should be concentrating on care for the most vulnerable. That means the already health-compromised and the elderly.

    Done, as far as it is in my power to do so.

    Elderly parents cared for in their own home by me. ☑️

    Offer to take grandchildren in an emergency. ☑️

    In the best of all possible worlds, I would be looking after the youngest right now, but they are far away. Closures of childcare centres and schools will sort the sheep from the goats when parents have to decide who stays home, and which grandparents are about to turn themselves inside out to help.

  2. stackja says:

    calli
    #3345804, posted on March 7, 2020 at 10:01 am

    My Mum stayed home and Dad worked.
    2020 back to the 1950s?

  3. Eyrie says:

    Methinks Sarah is whistling past the graveyard.
    When the Chicom thugs are taking the measures they are taking, they know something they aren’t letting on about.

  4. FelixKruell says:

    What I can’t be sure of is whether traditional stay-at-home cultures are better suited to protecting the weak from COVID-19

    Hardly. The elderly would be getting even more exposure to the little bundles of viruses we call children.

  5. stackja says:

    Typhoid in New York City (1907)
    Mary Mallon, better known as “Typhoid Mary.” She was an Irish-born cook who carried the bacteria that causes typhoid fever, a form of salmonella that can cause fever, diarrhea and death. But Mallon herself was immune to the disease. When authorities figured out that her work as a cook had caused the city’s typhoid outbreak, she was sent to North Brother Island for a three-year quarantine. She promised never to cook for others again. But she broke her word. (She was especially fond of making peach ice cream.) When apprehended in 1915, she was sent back to the island for the rest of her life — 23 more years.

  6. candy says:

    I’m not sure that making pre-schoolers visit an aged care facility is very kind to anyone, other than freaking everyone out.

    As well as being naturally boisterous little kids have heaps of germs that could easily knock off an already frail health compromised elderly person, in normal times let alone when a new virus has developed.

  7. stackja says:

    candy
    #3345830, posted on March 7, 2020 at 10:17 am

    Great grand children visit great grand ma?

  8. Behind Enemy Lines says:

    Containment and Isolation
    Posted on 9:25 am, March 7, 2020 by currencylad
    . . . What I can’t be sure of is whether traditional stay-at-home cultures are better suited to protecting the weak from COVID-19. If China was more like Australia, would their infected population be double what it is – or are our elderly lucky to be in semi-medical facilities 24-7?

    If our residential care facilities were thoroughly prepared, the elderly would be better off in them during this sort of sweeping illness. Since the facilities aren’t thoroughly prepared, they’ll be ground zero for the kung flu. If I had a relative in one who could be cared for at home, I’d be seriously looking at doing so.

    As a side note, I’m presently looking at business options in the field of aged care. We’re about to see the greatest transfer of wealth in Australia’s history, as the boomers head into care rather than being looked after by family. Here’s the big surprise: the boomers’ kids think the transfer of wealth will be to them via inheritance – but it won’t. The transfer of wealth will be to the aged care industry, as boomers burn up their assets trying to live out their longer lives with dignity. And, thanks (as usual) to the government, the way this transfer sorts itself out will be an unholy mess.

    p.s. Calli, good onya

  9. BorisG says:

    I would argue that if the virus originated in Australia it would spread less rapidly than in China and kill fewer people (proportionally) because we are much less crowded society and our habits and practices are much less communal and much more hygienic.

    But since the virus is here now, these predictions will be tested soon. I advocate mild containment measures such as canceling crowded events, encouraging companies to allow work from home where possible. Maybe even close schools. We already see these measures impmented in Italy and it is hard to see how Australia can avoid this scenario.

  10. Ed Case says:

    As well as being naturally boisterous little kids have heaps of germs that could easily knock off an already frail health compromised elderly person, in normal times let alone when a new virus has developed.

    Children aren’t getting sick from Corona-Beer but are they carriers?
    If yes then the chalkies and childcare unions might be getting frantic calls from their members.
    2020 could turn out to be a great time to be a kid.

  11. candy says:

    Great grand children visit great grand ma?

    One kid is much easier to manage in that setting. Containment.

  12. Struth says:

    AND driving down the economy is NOT actually going to help anyone.”

    That’s a stupid thing to say.

    The socialists of this world would rather destroy the place than have Trump in again, and doesn’t global warming bullshit prove what the are capable of and willing to do.
    They are out to destroy us FFS.
    Stupid and naïve.

  13. RobK says:

    2020 could turn out to be a great time to be a kid.
    I think I know what you mean, but many may will learn some hardship.

  14. stackja says:

    Candy I know of a lady who has, at last count, 32 great grand children.

  15. Young Freddy says:

    One of my Granddaughters comes home from her day care with some damn thing just about every week (it seems), she’s always got something. She’s going to grow up to be a tough little nut, but I’m not sure Nanna and Pop can put up with it for much longer!

  16. Chris M says:

    When the Chicom thugs are taking the measures they are taking, they know something they aren’t letting on about.

    Exactly. Tens of thousands dead there now, likely into six digits. They aren’t doing all this just to save face.

  17. Pyrmonter says:

    We could also revert to a two field crop rotation system as well. But that didn’t save the victims of the Black Death.

  18. mareeS says:

    I cough a lot due to having been on a respirator in ICU for weeks, sustained lung damage. Now people look as if I have the plague. Same with son, who is a bit asthmatic and now carries his inhaler visibly.

    People are really freaked out by this virus, maybe for good reasons, but a cough is no indication.

  19. Twostix says:

    She’s going to grow up to be a tough little nut, but

    This isn’t true.

    She’ll grow up more prone to chest infections be resistant to antibiotics and have gut problems through over use and be generally less physically developed than kids who grew up not sick all the time.

    Sorry.

  20. Twostix says:

    Daycare centres are literal incubators for antibiotic resistant diseases.

    It take a toddler seven to ten days to get over an infection.

    Daycare kids get two to four serious infections per year on average (50% more than non-daycare kids).

    Parents with kids in daycare aren’t taking off 20-40 sick days a year from work to isolate their child (double for two).

    They “have” to go back to work, so send them in still sick and contagious cranked on antibiotics. And around and around it goes.

    Sending an army of daycare kids to an aged care facility is lunacy.

    This is all well studied…

    Children attending child care centres experience a greater number of illnesses than do children cared for at home. Wald et al3 reported that children attending centres had 51 per cent more episodes of infection, and 134 per cent more days of illness than children cared for at home. Another study found that Swedish children in child care required 40 – 80 per cent more medical consultations for acute infections than did children who remained at home.4 Excess illnesses may be related to upper and lower respiratory tract infections including middle ear infection.5-7 Gastroenteritis is also an important cause of illness among children attending centre based care.8 The important pathogens, especially among toddlers, are enteric viruses, particularly rotavirus,9 bacteria such as Shigella and the parasites Cryptosporidium10 and Giardia.11 Hepatitis A, also an enteric virus, has been responsible for outbreaks in child care centres in Australia,12,13 although not to the extent described in Phoenix, Arizona, where 42 per cent of notified cases in the community were associated with child care

  21. Twostix says:

    Literal incubation centres….

    Antibiotic-resistant E. coli
    In a series of studies investigating fecal colonization of children with antibiotic-resistant E. coli in seven
    child-care centers, 19 percent of 79 children in diapers were colonized with trimethoprim-resistant E. coli. All of the strains were multiresistant (109). This rate was higher than that noted among adults, including those receiving trimethoprim, and suggested that diapered children in child-care centers may be a reservoir for this organism. A subsequent study compared diapered children in 12 child-care centers with diapered children not attending child care and with medical stu-
    dents (table 7) (11). The prevalence of fecal colonization with trimethoprim-resistant E. coli among children in the child-care centers (31 percent) was higher than in the comparison group of children (6 percent).

  22. Porter says:

    If China were more like Australia, would their infected population be double what it is – or are our elderly lucky to be in semi-medical facilities 24-7?

    Maybe not. Children will still bring infections home from schools and child care centres, as they do now.

  23. Porter says:

    Me to elderly parents earlier this week: Would you like us to get you anything before they clean out the shelves?
    Mum: No we will do our shopping as normal on Saturday
    Me: OK let us know if you can’t find anything you need.
    Mum: There are three supermarkets close by. If we can’t find anything we want, we will just go to the other ones.

    We await update this afternoon.

  24. Porter says:

    Just had the phone call:
    Mum: Guess what! No one had any toilet paper.
    Me: No problem. I bought some extra earlier this week as I thought you may get caught short.

  25. Leo G says:

    Tens of thousands dead there now, likely into six digits. They aren’t doing all this just to save face.

    Unlikely. I tend to believe the more recent Chinese data, even though they have been withholding information about the source of the outbreak. Accordingly, fewer than 1% of Wuhan residents have been infected to date. Also in Wuhan there now appears to be only about 1 new case for every 5 to 15 new discharges.
    The WHO has been reporting that, contrary to the speculation in social media, there is not a lot of asymptomatic circulation of this virus in the wider population. Investigators are only finding the disease in the cases and their close contacts.

    “I think the key learning from China is speed — it’s all about the speed. The faster you can find the cases, isolate the cases, and track their close contacts, the more successful you’re going to be…” – Bruce Aylward, World Health Organization Joint Mission to China, 3 March

  26. Anon Mahnà says:

    her native America’s size

    Sarah Hoyt was born and raised in Portugal, which makes Portugal her native country. The USA became her adopted country.

  27. Chris M says:

    I tend to believe the more recent Chinese data… fewer than 1% of Wuhan residents have been infected to date.

    Haha sure, they shut down production in the whole country for that. Just wanted to see blue skies for a change.

  28. candy says:

    Candy I know of a lady who has, at last count, 32 great grand children.

    That’s pretty amazing, stackja. A lot of birthday cards to remember. Actually just to remember all the names!

  29. Mitch M. says:

    I tend to believe the more recent Chinese data… fewer than 1% of Wuhan residents have been infected to date.

    I don’t trust any China data. That includes scientific research published in China because several years ago a study found shockingly high rates of data fabrication etc.

    I’ll wait for figures from advanced nations.

  30. Mitch M. says:

    This isn’t true.

    She’ll grow up more prone to chest infections be resistant to antibiotics and have gut problems through over use and be generally less physically developed than kids who grew up not sick all the time.

    Sorry.

    I read a related paper this morning. What doesn’t kill us makes us stronger is a very bad idea for growing bodies. Malnutrition, infections, accidents, all can have lifelong consequences. Keep your children safe but don’t smother them. That’s a difficult balancing act but a critical one.

  31. BorisG says:

    Haha sure, they shut down production in the whole country for that…. I’ll wait for figures from advanced nations.

    You won’t be waiting for very long. The virus is right here and in many other countries.

    For instance there are 670 confirmed cases in Germany. Deaths: none.

  32. BorisG says:

    You don’t have to believe Chinese days.

    About 400 Australians evacuated from Wuhan. Infections: none.

    That gives you an idea how widespread the infection is in the Wuhan area.

    Looks like less than 1% of Wuhan population were infected a month ago.

  33. David Brewer says:

    All the data on the number of coronavirus infections are complete crap in the sense that they only measure recorded cases – people who have been swabbed and found positive at the time they had coronavirus.

    Missing is the number of people tested and found not to have the virus, and, even more important, the number of people tested at all, at any time.

    To give an idea of the difference this makes, the BBC let slip yesterday – after reporting that cases had risen sharply in the UK – that testing had been greatly extended. As a result, a grand total of 23,000 individuals had now been tested. They neglected, however, to point out that the other 67.53 million UK residents have not been tested, and that even some of the 23,000 who have may have had the virus either before or after they were tested. Moral: an awful lot more people have had this thing than is reported, and most of them have had it so mildly that they didn’t notice, or at least never got sick enough to be tested.

    Same story in New York. Yesterday, recorded coronavirus cases went up from 22 to 33. But

    Gov. Cuomo addressed the increase in cases, explaining the state is testing more individuals.

    “The more you test, the more positives you will find, and remember, we are predominantly testing people who have a higher probability because they are in the chain of contact with people who have already tested positive,” Cuomo said…

    Cuomo, who described the virus as “like a flu on steroids,” also emphasized that “more people are dying from the flu than dying from coronavirus.”

  34. David Brewer says:

    For more figures on the number of tests (though slightly out of date), see here. Not a single country in the list has yet tested even half of one per cent of its population.

  35. BorisG says:

    Moral: an awful lot more people have had this thing than is reported, and most of them have had it so mildly that they didn’t notice, or at least never got sick enough to be tested.

    That is undoubtedly true but what difference does it make? If there are millions of people who have this virus but are not sick and thus cannot transmit the virus, how does it change anything?

    There have been reports that asymptotic carriers can spread the virus but I think this is bullshit. You need to sneeze or cough to spread your germs. Maybe it can be spread by breathing but I suspect only in very close proximity. For all intends and purposes asymptomatic carriers are as good as virus free.

  36. Diogenes says:

    Mrs D and I decided to do the equivalent of a chicken pox party and go to Sydney Casino. Observation… very few orientals crowding on the train at E-Ping , or ontp the light rail at Central, also the Casino seemed dead in comparison with other vidits

  37. David Brewer says:

    That is undoubtedly true but what difference does it make? If there are millions of people who have this virus but are not sick and thus cannot transmit the virus, how does it change anything?

    It makes nonsense of the figures being quoted about the infectivity and death rate from the disease.

  38. BorisG says:

    It makes nonsense of the figures being quoted about the infectivity and death rate from the disease.

    Maybe. But not the number of fatalities.

  39. Chris M says:

    For instance there are 670 confirmed cases in Germany. Deaths: none.

    Yes the death rate lags the infection rate by 2-3 weeks Boris. As you can see here infections in Germany only started to rise 9 days ago (click Germany). With good treatment it can be minimised, problem is when the medical system becomes overwhelmed with cases.

  40. BorisG says:

    Yes the death rate lags the infection rate by 2-3 weeks Boris. As you can see here infections in Germany only started to rise 9 days ago (click Germany).

    That’s not infection rate. That’s detection rate. These people had been infected before they were testes, some maybe weeks ago.

  41. Chris M says:

    You are right Boris, at the monet in the west at least they are scanning lots of people who have had contact so picking it up early but that will mostly end in a week or two as the number rise. People with no or minimal symptoms aren’t going to die of course so 2-3 weeks from onset of significant symptoms that lead to pneumonia.

  42. Bad Samaritan says:

    I have no sympathy for old codgers at all. If they are the most-vulnerable….and this CV is a real problem, then they should all be wearing masks all the time.

    If anyone here reckons CV is an actual danger then they will be wearing a mask at all times. If not, then it’s either a deliberately self-inflicted problem….or else you do not actually believe CV is an issue at all.

    Health resources should be aportioned in a similar way a triage station does it in battle or at a disaster etc. There should be a very clear set of priorities: maybe a flow chart. Something like…Aged or infirm = No Care. Go to bed and take paracetamol etc. Younger = Maybe. Young and in distress = Intensive Care to get over the distress. Young and no distress = Let’s see what happens. Etc.

    FFS. This is a massive beat-up.

    Old codgers have had a life. They are almost at the end. Give someone younger a chance. that’s it.

  43. PeteD says:

    Supposedly there’s been a coronavirus quarantine hotel collapse in Quanzhou (Fujian Province).

    Yet there’s officially no cases of current infection in that whole province.

    Our media seems rather oblivious to that.

  44. David Brewer says:

    The reported number of fatalities is also crap, at least in most of the world, since there is practically no testing outside developed countries:

    As I write this essay on March 5th, there are more confirmed coronavirus infections in Harris County, Texas (five) acquired by Americans who traveled to Egypt than there are confirmed cases within the entire country of Egypt (three). Why? Because Egypt has only tested a few hundred people in this country of 100 million. There are more confirmed coronavirus infections in the city-state of Singapore (three) acquired by Singaporeans who traveled to Indonesia than there are confirmed cases in the entire country of Indonesia (two). Why? Because Indonesia has only tested a few hundred people in this country of 265 million.

    Nor would it surprise me if a large proportion of the thousands who have died from respiratory failure even in developed countries in the last few months had coronavirus. Check those testing figures again. In the United States, as of 1 March, they had only tested one person in a million. More than that would have carked it of flu in the previous three months.

    So, the death rate figures are crap, the infectivity figures are crap, and the total number of deaths figures are crap.

    The panic about this, at least in western countries, is also crap. It is based on the death rate and infectivity numbers, which appear higher than usual for flu, but which are steadily falling as numbers tested rise. This happens every time with new flu strains. There is nothing special to worry about, despite the global conniptions being experienced.

    The only reliable and useful information we have so far is about the characteristics of those who are tested positive, and especially of those who die. The latter are predominantly over 75 and/or with significant health problems already. Absolutely typically for flu deaths every year.

    The hysteria is the same just about everywhere. Last night’s Spanish news had about 10 minutes on it. The death toll had risen by two – both nonagenarians in poor health anyway. France and USA are the same – one, two or a handful of reported coronavirus deaths a day, practically every case being someone who was at death’s door already. What a beat-up!

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