It is no longer reasonable to dispute that COVID-19 is a global pandemic. That term should not necessarily be linked to the notion of a global disaster. However, it does mean there is no safe haven from COVID-19.
Here in New Zealand there is still a chance that we can contain the disease but our current containment policy is not going to work. The only way it can work is if mandatory home-isolation is a requirement for all those returning from overseas. That means no international visitors who cannot demonstrate that they can self-isolate in either a home or equivalent environment, with all other people in that household also self-isolating.
There is only one place in the world where the disease is on the wane, at least in the meantime, and that is China. Daily new cases there are now down to around two percent of what they were a month ago. More than 97 percent of world-wide new cases each day are currently from outside China.
The example for New Zealand to watch closely is Singapore. They have done an outstanding job of controlling the disease, despite more than 30 separate importations of the virus by travellers. Most cases have been caught very quickly and total cases are still only 150, despite so many primary cases.
The Singapore authorities have been both rigorous and totally transparent as to the situation and that seems to have helped greatly. However, whether the disease or the authorities will eventually dominate within Singapore remains uncertain. This remarkable infographic summarises the disease pathways within Singapore.
The disease is currently running fastest in Europe, with over 2000 new cases there per day. It is now obvious that the disease in Northern Italy was not contained and it is now running rife across all of Northern Europe, and also spreading out rapidly from there. Italian authorities have now barricaded Milan and the North from the rest of Italy, but it is too late.
There are also puzzling questions as to why the death rates are so high in Italy, already at five percent of total cases with another 11 percent in intensive care. In rapid outbreaks, the death rate always lags the number of cases and so the Italian death rate, which has been increasing each day, is likely to further increase.
We know that coronaviruses rely on RNA replication, which means the replication is error prone and mutations are likely. It is possible that the Italian variant has higher inherent mortality risk.
At the level of individual returnees to New Zealand from overseas, the risk of being infected is still less than one chance in many thousand. But it is at the level of the total population of returnees that the risks have to be assessed. Currently, the biggest risk that New Zealand is not dealing with is from Europe
Restrictions on travel from Europe need to be immediate. It should have already occurred.
The evidence that cruise ships can become hotbeds of viral activity is now very clear. It only needs one person out of several thousand on a ship to be incubating the disease and from there it exponentiates. I find it remarkable that cruise ships are still coming to New Zealand and visitors coming ashore.
Disease progression in North America is only about one week behind Europe. Travel restrictions from there are also needed.
Australia also needs close scrutiny. Currently there are already 80 cases, and the incidence per person of population is three times that in New Zealand. Australia could well go out of control in coming days. Another week and it may well be too late.
To some people this may all sound extreme. Indeed, putting restriction on Australian travel to New Zealand may still be a step too far for the politicians, but community understanding is changing rapidly as the COVID-19 black swan bears down. In particular, awareness is now starting to develop that unless there is containment our health services are going to be overwhelmed.
Community understanding will increase rapidly in the coming days as both Europe and the USA tell a stark story. American freeways in places like Washington State, which is a minor hotbed of the disease, are now close to deserted. Further south, Stanford University is already only offering its courses online. The non-stop train services from New York to Washington DC have already stopped through lack of demand. These are just the first steps.
If we do things right, then New Zealand still has a chance of getting through the next few months without a major breakout of disease. To repeat a phrase I have used before in relation to COVID-19, a stitch in time saves nine. The alternative is that normal life will grind to a halt, as we are seeing in Italy and about to see elsewhere in Europe and in North America.