As of August 15, the mandates ended for the seven-day isolation period and masks in health settings, with the Health Minister Dr Ayesha Verrall saying wastewater testing showed little trace of the virus.

Dr Verrall acknowledged many would still feel vulnerable.

“So it is on all of us to think well if we’re visiting an aged residential care home for example, that we do follow the recommended procedures there.

“Te Whatu Ora will continue to encourage people to wear masks when they go to hospital — they won’t be mandated.”

Covid cases accounted for just over 2 percent of hospital admissions, Dr Verrall said.

Last step on wind down
Prime Minister Chris Hipkins told RNZ Morning Report this was the last step in winding down covid-19 restrictions.

“We waited until after the winter peak period. The health system overall, while it’s been under pressure and it’s still under pressure, had a much better winter this winter than last winter.”

He said it was on the advice of the director-general of health and there was never a perfect time to make changes to health settings.

General Practice New Zealand chair Dr Bryan Betty said practices like mask wearing and self-isolation should be encouraged for all viruses, not just Covid.

He told Morning Report people needed to continue with the lessons that were learnt from covid but which were applicable to all viruses that were spread from person-to-person such as influenza and RSV.

“Voluntarily staying at home if you do have a flu or a cold so you don’t spread it, and I think masking in public areas of health facilities voluntarily is something we should still keep in play.”

Health providers should consider ensuring masks were worn in places where sick people gathered such as hospitals or GPs’ waiting areas, Dr Betty said.

Vaccination still important
Vaccination would still play an important part in reducing infection and re-infection, he said.

“We do that every year for influenza, we are potentially going forward going to be recommending that for covid, especially for vulnerable populations.”

Employers should be considering how to support workers so they do not come into work sick, he said.

Employers should give people with colds, the flu or Covid the opportunity to work from home if they can to avoid spreading the illness around the workplace, he said.

University of Otago epidemiologist Professor Michael Baker also urged people to stay home when they were sick with covid-19, even though all of the health restrictions had been lifted.

Professor Baker told Morning Report that covid had transitioned from a pandemic threat to an endemic infectious disease.

“Unfortunately that means it’s there the whole time, it is still in New Zealand among the infectious diseases, the leading cause of death and hospitalisation and we know that those infections and reinfections are going to add to that burden of long covid.”

Still vital to isolate
People must remember that it was still vital to isolate when they were sick and not go to work or school or socialise which spread the virus, he said.

People should also continue to wear masks in medical facilities and in poorly ventilated indoor spaces, he said.

New Zealand had come through its fourth wave of infection for the Omicron variant, he said.

“We are going to see new subvariants or lineage of the virus arrive, they will be better at escaping from our immunity, our immunity will wane of course unless you get boosted.”

The government needed to look at how to reinforce those behaviours that prevented covid from spreading now that the mandates had been removed, he said.

“I mean this could be running media campaigns or developing codes of practice say with employers, Business New Zealand, I mean this is a chance for them really to show leadership about how they’re going to support the workforce in New Zealand, self-isolating when they are sick.”

Hospitilisations and mortality rates showed that covid-19 continued to have an impact and watching those rates would indicate whether the mandates had been removed too early, he said.

Integrated approach needed
New Zealand needed to develop a coherent, integrated approach to dealing with all respiratory infections which were the infectious diseases that had the biggest impact, he said.

“They have a big drain on our health resources and so we do need to look at better surveillance for these infections that will tell us what’s happening and also really it’s just having a culture of limiting transmission of these infections.”

That meant staying home when sick and using masks in indoor environments with poor ventilation, he said.

Auckland Council disability strategic advisory group chair Dr Huhana Hickey said getting rid of masks at health care centres was extremely dangerous for immunocompromised people.

“The problem for immune-compromised people is we’re frequent flyers, but we’re being asked to go into a situation that puts us all at risk of not just dealing with what’s making us sick but risking getting covid, which could kill us.”

Hickey said scrapping the seven-day compulsory isolation period could result in more workers returning while still infectious, which she believed would mean immunocompromised people were likely to stay home.

“If they cannot stay home and employers require them to work, they’re going to spread covid as well, so that means I don’t go to restaurants now because I don’t know if the waiter’s sick, I don’t know if the chef’s sick.”

Minimal impact of numbers
University of Auckland mathematics professor and covid-19 modeller Michael Plank expected the lack of mask and isolation requirements to have a minimal impact on case numbers.

He said the main drivers of infection were people who were asymptomatic cases or had not tested yet.

“I’m not sure than an isolation mandate is going to have a particularly large effect on infection rates in the long term.

“If we look at other countries that removed isolation mandates, like Australia, there’s really no evidence of a surge in numbers.”

Restaurant owners embraced the government’s decision.

The Restaurant Association surveyed more than 200 of its members, and 84 percent said they supported the idea.

But many planned to introduce their own requirements, chief executive Marisa Bidois said.

“Thirty nine percent of the respondents said they intended to mandate a five day isolation period for their employees,” she said.

“So that’s something they’re going to implement themselves as an internal policy.”

Many hospitality workers would also be expected to test themselves proactively.

“We also had 42 percent of respondents planning to require employees with any symptoms to undergo testing before returning to work.”

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

It seems not a day goes by without learning someone in our inner circle of family, friends and colleagues has covid. When we ask how unwell our acquaintance is, the responses vary from “they’re really crook” to “you wouldn’t even know they had it”.

This is in line with studies that report moderate to severe illness in a minority of people (usually older with other risk factors) and that up to one in three positive people exhibit no symptoms.

Given the ubiquitous presence of this highly infectious coronavirus in our community and the high rate of asymptomatic illness, those who have not been diagnosed with covid might wonder, “how would I know if I had been infected?”

And, “does it matter if I have?”.

How covid is diagnosed
Most people know they’ve had covid because they had a fever or upper respiratory tract symptoms and/or were exposed to an infected person AND had a swab test (PCR or rapid antigen) that detected the covid virus (SARS-CoV-2) in the upper airway.

At the beginning of 2022, many people with consistent symptoms or high-risk exposures were not able to access PCRs or RATs to confirm their diagnosis, but instead presumed themselves positive and quarantined.

It is possible to diagnose past infection in those who never tested positive. A blood test can look for SARS-CoV-2 antibodies (also known as immunoglobulins). When we are infected with SARS-CoV-2, our immune system launches a precision counter strike by producing antibodies against viral targets, specifically the Spike (S) and Nucleocapsid (N) proteins.

Covid vaccination induces a similar immune response against the S protein only. The S antibody “neutralises” the invader by preventing the virus from attaching to human cells.

These antibodies can be detected within one to three weeks after infection and persist for at least six months — potentially much longer. A blood test that shows antibodies to S and N proteins indicates someone has been previously infected. Detection of antibodies to the S protein only indicates vaccination (but not infection).

The problem with antibody tests
Before you rush off to get a covid antibody test, there are a few notes of caution. There is still much to learn about the characteristics of the immune response to covid infection.

Not everyone mounts a detectable antibody response following infection and levels can decline to undetectable levels after several months in some people.

Because there are other circulating seasonal coronaviruses (such as those that cause the common cold), tests may also pick up antibodies to non-SARS-CoV-2 strains, leading to “false positive” results.

Commercial and public hospital pathology labs can perform SARS-CoV-2 antibody testing, but the interpretation of results should be undertaken carefully.

So, antibody testing should really only be done when there’s a good reason to: say, when confirming past infection or effectiveness of vaccination is important for the current care of an individual.

Diagnosing a post-infectious complication or eligibility for a specific treatment, for example. It could also be useful for contact tracing or for assessing the background population rate of infection.

Antibody testing a population
“Seroprevalence studies” test for the presence of SARS-CoV-2 antibodies in repositories of stored blood that are representative of the general population, such as from a blood bank. This data helps to understand the true extent of covid infection and vaccination status in the community (and informs our assessment of population susceptibility to future infection and reinfection). It’s more useful than daily reported case numbers, which are skewed towards symptomatic individuals and those with access to swab testing.

New research from the World Health Organisation, which is yet to be reviewed by other scientists, reported the results of a meta-analysis of over 800 seroprevalence studies performed around the world since 2020. They estimated that by July 2021, 45.2 percent of the global population had SARS-CoV-2 antibodies due to past infection or vaccination, eight times the estimate (5.5 percent) from a year earlier.

There are plans to conduct fresh seroprevalence studies in Australia in the coming year, which will update local data and help us understand to what extent the omicron wave has washed through the population.

Even after ‘mild’ cases, a new study by this @CurtinUni expert finds “long COVID” symptoms may persist. This includes “brain fog”, fatigue, and problems with concentration and memory. https://t.co/4lckYrks0Y

— The Conversation (@ConversationEDU) March 7, 2022

Does it matter if I have had covid and didn’t know?
For most people, knowing your covid infection status is unlikely to be more than a topic of dinnertime conversation.

While some studies have pointed to a less robust and durable antibody response following mild or asymptomatic infection compared with severe illness, it is not known how this influences protection from reinfection. Certainly, the knowledge we have antibodies from past infection should not deter us from being fully up-to-date with covid vaccination, which remains the best protection against severe illness.

There are reports of people with mild or asymptomatic covid infection developing ‘long covid’ — persistent or relapsing symptoms that last several months after initial infection. Symptoms can include shortness of breath, physical and mental fatigue, exercise intolerance, headaches, and muscle and joint pain.

However, the likelihood of developing this condition appears higher in those who suffer a heavier initial bout of covid illness. This might be linked with higher viral load at that time.

Bottom line
As we enter the third year of the covid pandemic and given that up to one in three infections may be asymptomatic, it is likely many of us have been infected without knowing it.

If you are experiencing lingering fatigue, brain fog or other symptoms that could be long covid, you should talk to your GP. Otherwise, knowing our covid infection status is unlikely to be of much practical benefit. Antibody testing should be reserved for specific medical or public health indications.

Being up-to-date with covid vaccination is still our best defence against severe illness moving forward.

Dr Ashwin Swaminathan is a senior lecturer at the Australian National University in Canberra. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

By Andrio Adiwibowo in Jakarta

After beating the Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS) epidemics in the past, we may think we will win the battle against the 2019 novel coronavirus (2019-nCoV).

But this optimism is turning into pessimism.

First, several developed countries known to have the best infection control in the world have confirmed cases. It started with Japan and South Korea and peaked when the United States announced its first confirmed case on January 21.

READ MORE: China battles coronavirus outbreak – all the latest

Instead of declining, the number of people infected is on the rise. Developed countries like Canada, France and Australia had reported infections. At this stage, the game seems to be over.

The situation at ground zero is even worse. As reported by Al Jazeera, there have been 106 deaths in China alone, while across the world the figure of infected people has exceeded 4520 within only three weeks, mostly in China.

Worse, Wuhan has gradually lost its ability to defend itself.

Outside China, a new case has been confirmed almost every day in 14 countries. In Indonesia, there has been growing concern about whether the coronavirus epidemic has reached the country, after two suspected cases were reported in Jambi and Bandung, West Java. The patient being treated at Hasan Sadikin Hospital in Bandung has traveled to Wuhan.

Enemy in backyard
“Hence, the enemy has arrived in our backyard. The question now is whether the previous SARS and MERS epidemics have taught us any lessons.

The reproductive number (RO) measures how infectious a disease is. According to Maimuna Majumder, an expert from Harvard Medical School, and a 2020 paper by Jonathan M. Read et al, the 2019-nCoV has the highest RO ever recorded.

For comparison, the RO for the average flu and SARS are 1.3 and 2.0, respectively, while the RO for the 2019-nCoV can reach 3.8. This explains why the number of confirmed cases is so high.

Indonesian health authorities have too much confidence in using thermal scanners to defend against the 2019-nCoV. It worked for SARS, but this time around it has failed to detect the person from Jambi, who was a returning traveler.

We should remember that we are dealing with a virus that can mutate. First, the virus is an organism known to have a seven to 14-day incubation period. During this period, a carrier does not show any symptoms that can be detected by a thermal scanner. That’s why carriers can pass undetected.

Experts say the 2019-nCoV can mutate and has a longer incubation period, making it difficult to detect. The virus is mutating but unfortunately our technology is not up to date.

Maintaining momentum is crucial to dealing with coronavirus infections. Unfortunately, emergency action was not taken immediately on January 1, when 41 cases were reported.

Golden period
The golden period of three weeks passed without any significant action taken, such as quarantines or a travel ban. Measures taken after this golden period may do little to stop the infection from spreading.

The dark side of Wuhan lies in the Huanan market, the center of this epidemic. The 2019-nCoV is assumed to have been transmitted from wild animals sold in the market.

The ongoing epidemic exposes the big picture of China’s health problems. Despite having 5G technology, people in China have maintained a tradition of consuming bushmeat, ranging from camels to bats. The SARS epidemic started from human consumption of civets that were carrying the virus.

As of Sunday, it had been confirmed that 33 out of the 585 samples collected from the market contained the coronavirus. To prevent such epidemics from recurring, not only must the virus be killed but the practice of consuming bushmeat must also be stopped.

Indonesia’s capacity to win the battle against the novel coronavirus is represented by the country’s epidemic preparedness index (EPI) and infectious vulnerability index (IVI). Based on a study by Isaac Bogoch et al, Indonesia, represented by Denpasar, scores 0.563 in the IVI, which is the lowest among the 18 cities across the world surveyed.

This is a serious issue considering that Denpasar is the country’s top tourist destination for foreigners.

Furthermore, Ben Oppenheim et al have categorised Indonesia under EPI cluster 3, with vaccination coverage of only 5 percent. These facts serve as a reminder that Indonesia needs to strengthen its arsenal to win the fight against the new coronavirus.

Hopefully, smarting from our mistakes, we can do something to improve our defense against not only the coronavirus but also other viruses that may strike in the future.

Dr Andrio Adiwibowo is a lecturer at the School of Public Health, University of Indonesia (UI).

Article by AsiaPacificReport.nz