Five days ago I published an opinion piece here on Newsroom about the Covid-19 virus. My modest goal was to point out how completely unintuitive exponential growth is. I wanted to encourage our Government to reconsider allowing large events like Pasifika and the Christchurch Memorial from going ahead.
I got lots of good feedback (thanks Mum!), but many people also pointed out that I was a university drop-out, was not an epidemiologist (whatever that is) and, worst of all, that I was independently wealthy. Each factor apparently disqualifies me from expressing an opinion, but I think this particular combination really wound some people up. Some of you were not very nice and it hurt my feelings. I was again reminded why I maintain a low profile here in New Zealand.
Unfortunately for me (and you) I feel compelled to write a second piece. Some people have suggested this is a weakness I may have inherited.
I choose to be a big boy, to be brave, to put myself out there (only briefly, I hope) because I strongly believe New Zealand is not yet taking the full suite of actions we should be to limit this pandemic. New Zealanders are not yet taking this serious enough. (Eds: Sam wrote this article and it was published just before Jacinda Ardern announced tougher new border restrictions and plans to limit large events.)
Thinking Fast or Slow
We’ve now observed that the mortality rates in countries with inadequate or overwhelmed health systems is many times that of countries who manage to slow the spread of the virus. Simply put, if we don’t get ahead of it and everyone gets sick at once then a lot more people will die.
South Korea is an example of a country that acted early and implemented massive widespread testing, social distancing practices and effective quarantining protocols. Their population largely complied. They have “flattened the curve”, ensuring their health system is able to treat acute cases. They have saved untold lives in doing so. As at today South Korea has 7,979 known cases and has had 71 deaths. That’s 1 death for every 112 known cases. There were just five new deaths yesterday. A month ago, South Korea had 28 cases.
Italy, by contrast, acted a bit slower. Lots of people got sick at once and the healthcare system is overwhelmed. In Italy they are prioritising younger patients for care and ventilators and older patients are being left to die in the hallways. As at today, Italy has 17,660 known cases and has had 1,266 deaths. That’s 1 death for every 14 known cases or eight times the death rate of South Korea. Italy had 250 deaths yesterday. A month ago, Italy had 3 known cases. Italy added 2,547 new cases yesterday, bringing them to 17,660 cases. A daily growth rate of 17 percent. At that growth rate, they remain on track to double their cases every 5 days.
At this stage, New Zealand is behaving way too much like Italy for my liking.
Italy has now woken up and shut the whole country down. You are not allowed in or out of Italy. You are not allowed out of your house. Every school, university, movie theatre and almost every store in Italy is closed right now. Everyone must stay at home. This is what the Chinese did and how they managed to stop the spread.
More quick maths!
We know that cases of Covid-19 in countries without adequate protocols will double every five days. At this rate, in 30 days cases will double six times, or by a factor of 64 (because 2 to the power of 6 is 64). In 60 days, cases will have doubled 12 times.
Doubling 12 times doesn’t sound too bad until you realise that 2 to the power of 12 is 4,096.
So, a single case becomes 4,096 cases in 60 days if everyone is going about daily life as normal, attending concerts, parties, school, and flying off to meetings. Pictures of Tom Hanks on Instagram hugging Australians (before he self-quarantined) suggest he could easily hit a target of 4,096 new infections in 60 days.
New Zealand’s ‘winning streak’
New Zealand has proven amazing at keeping cases down to just five despite open borders, open schools, and lots of hand shaking going on. The Ministry of Health says we have had no new cases for six days. That is quite the winning streak. (After this piece was written on Saturday, the Ministry said one more case was found of a man in his 60s who got Covid-19 while travelling in the United States).
Shouldn’t we have had at least a doubling of cases? Shouldn’t we be up to at least 10 ?
Let’s look at some other winning streaks …
Italy had a five-day winning streak (Feb 15th – Feb 19th) with just three cases. Current cases are 17,660.
Spain had a nine-day winning streak (Feb 15th – Feb 23rd) with just two cases. Current cases are 5,232.
Germany had a ten-day winning streak (Feb 15th – Feb 24th) with just 16 cases. Current cases are 3,675. Straight talking German Chancellor, Angela Merkel, just told citizens to expect 2/3rd’s of citizens to get infected.
The United States had a six-day winning streak (Feb 15th – Feb 20th) with just 16 cases. Current cases are 2,269 but they haven’t really been testing everyone and health experts now tell us it is no longer practical to stop infections and we should expect about 70 percent of Americans to get infected.
… implementing measures early – earlier than is comfortable – is the only way we’re going to minimise the likely number of victims.
Experts are telling us people can be carriers and contagious for at least two days before they even become symptomatic. But our borders, offices, schools, movie theatres and restaurants are open.
Given these sobering facts from countries that are also wealthy and high functioning, I think the Government gets to identify with just just one of the below situations. You can’t believe in both at the same time.
Situation 1: New Zealand is exceptional. You believe we can contain it. You believe community transmission is unlikely because you believe we’ve found all the cases. You therefore believe our health system will cope because cases will be few. You believe no infected people arrived here this morning from Europe, Asia, United States, Australia (now 199 cases, up 27 percent since yesterday) and made it out of the airport.
Situation 2: This is a global pandemic. You believe it is inevitable that Covid-19 will get into New Zealand and we will have community transmission. You believe the likely result is that 60 percent or 70 percent of the population will get it. You believe the only way to ensure our health system copes and we minimize the death rate is to slow the spread. Early detection, early response.
We know that countries who act quickly and comprehensively to slow the spread of the disease have much lower mortality and morbidity rates. The number of people who die is starkly different because it is the difference between a health system that is busy but functioning and one that is overwhelmed.
The impact Covid-19 will have on our economy – on jobs, on small businesses, on businesses with too much debt, on our national airline – is going to be awful. But this is the situation we find ourselves in and it demands even bolder leadership. We know that implementing measures early – earlier than is comfortable – is the only way we’re going to minimise the likely number of victims.
The good news is that every business I am involved with has already starting work from home protocols, shutting down travel, cancelling meetings and conferences. We’re already moving at speed but we need the Government to get ahead of the curve if the actions we are taking in our businesses are going to count for anything.
Side-note: I did not end up going to WOMAD.
* Sam Morgan is the Founder and Chairman of the Jasmine Foundation.