Yesterday I wrote about the differing standards that the Government is using to classify people as “recovered”. We even went as far as to contact the Ministry of Health media spokesman to make sure we were saying the right thing and not misleading anyone as to our assumptions.
For the record, Peter Abernethy confirmed what the definition of recovered was:
This is something Dr Ashley Bloomfield has talked about in the daily stand up, which [is] someone free for 14 days after being ill.
So it was with some surprise that yesterday, during the daily briefing Dr Ashley Bloomfield said something completely different:
He stated that now it was 48 hours without symptoms as the basis upon which to claim people are now “recovered”. Bizarrely he added that this was “international practice”. This was even stated on the Ministry of Health website:
But even stranger, the explanation has now been removed completely, along with this tweet sent after the briefing:
It seems that things at the Ministry of Health are disappearing down the memory hole as they scramble to answer even basic questions. This sort of weapons-grade bull-dust is usually the sign of a coverup and actually makes one disbelieve anything they have to say.
Confused? We are, so we went back to Peter Abernethy and his responses were extraordinary.
We are no further along towards understanding just how rigorous or indeed, as seems to be the case, lackadaisical our testing regime is.
Dr Ashley Bloomfield stated in his press conference that 48 hours with no symptoms is the criteria for “recovered” and that it is “international practice”. But is it?
We know that the US CDC, an organisation Dr Bloomfield also stated he was following closely for the use of masks, has different and much more scientifically rigorous criteria for classifying someone as “recovered”:
The CDC defines recovery from COVID-19 as an absence of fever, with no use of fever-reducing medication, for three full days; improvement in other symptoms, such as coughing and shortness of breath; a period of seven full days since symptoms first appeared. Two negative swab tests on consecutive days are considered as the all-clear – meaning self-isolation can end and a patient can theoretically begin having contact with others, including at work.
So the United States doesn’t do what Dr Ashley Bloomfield states is “international practice”. We asked a renowned former Harvard and Johns Hopkins Epidemiologist and this is what he had to say:
So, most countries require some sort of negative test to determine if someone is “recovered”. It appears that we are just sending people out into the world with no real assurance that they are recovered. Only that they have shown no symptoms for 48 hours. We have been unable to find any other country that is doing this. This certainly isn’t the case in South Korea, nor the United States, and Dr Eric Feigl-Deng says most countries need a negative test of some sort.
What about the European Centre for Disease Prevention and Control? What do their criteria state?
Despite of some differences in practice, a consensus exists to combine a) the evidence for viral RNA clearance from the upper respiratory tract with b) the clinical resolution of symptoms. Discharge criteria for confirmed COVID-19 cases ECDCTECHNICAL REPORT3
At least two upper respiratory tract samples negative for SARS-CoV-2, collected at ?24-hour intervals are recommended to document SARS-CoV-2clearance
For symptomatic patients after the resolution of symptoms, samples should be collected at least seven days after the onset or after >3 days without fever.
For asymptomatic SARS-CoV-2-infected persons, the tests to document virus clearance should be taken at a minimum of 14 days after the initial positive test.
The table lists what other countries, including China, are doing as well:
Dr Ashley Bloomfield states that “our goal is to get the number of cases right down again and as soon as we can we will want to step down from Alert Level 4 to Alert Level 3”. Surely they have criteria and aren’t thinking about this on a day by day basis. Presumably, the criteria are something like ‘less than x cases per day for at least y consecutive days’ or similar. If there isn’t such a criterion then they will be able to game it easily by testing unlikely candidates. Or they will not tell people the criteria and therefore never come out of Level 4. Transparent means letting us know the criteria.
It seems that Dr Bloomfield is failing at Statistics 101 which says that you must define the measurement. What we appear to be seeing is Statistical Lies 101, gaming the measurement.
We were unable to find a single other country that uses the “international practice” that Dr Ashley Bloomfield states we are using. Essentially, New Zealand is sending people home and out into the world with nothing more than a hope and a prayer that they are indeed “recovered”.
Peter Abernethy did finally email us, though his response has proved the lie that Dr Bloomfield said when he claimed that his classification of “recovered” is “international practice”:
Please see detailed information below. We will also be clarifying the information on our website from Ashley’s standup today on this. We have simplified the information on the website so there is only one reference to it (link below)
COVID-19 came to our attention less than three months ago. Our knowledge of this novel coronavirus is constantly improving and the Ministry of Health continues to work with our technical advisory group to update the COVID-19 case definition, as required. More here: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-information-specific-audiences/covid-19-novel-coronavirus-resources-health-professionals/case-definition-covid-19-infection
Advice to health professionals sets out when people can be released from isolation.
https://www.health.govt.nz/system/files/documents/pages/updated-advice-for-health-professionals-novel-coronavirus-covid-19-30march_2020.pdf
This is the current criteria being used in New Zealand which is largely in line with the approach in Australia – though they require 72 hours of being symptom free.
The Technical Advisory Group is providing advice that is pertinent for the New Zealand setting. They have not recommended clearance testing in addition to the clinical criteria for clearance, i.e. at least 10 days since onset of symptoms and at least 48 hours since symptom resolution, though that is at the discretion of the clinician where the patient has been in hospital.
The Technical Advisory Group meets again tomorrow and this is one of the things that will be discussed with them.
I read those documents so you don’t have to. Suffice to say the situation is far from clarified. In fact, it is now even more confusing:
Clear as mud. But note, there is no testing to ACTUALLY determine whether or not they are returning negative tests, which IS “international practice”. Despite being asked to provide a list of countries following Dr Bloomfield’s “international practice”, Peter Abernethy has only provided one country, and they use 72 hours in contradiction to the CDC and the EU-CPDC standards. Bizarrely, the Ministry of Heath guideline to medical practitioners actually expressly recommends NOT doing additional tests, again in contravention of actual “international practice”:
It is obvious that the Ministry have been caught on the hop and have now devised a third, equally dangerous, definition for “recovered” that has no scientific or epidemiological testing for actual recovery from the illness. There remains a very high chance that those who have been declared as “recovered” were in fact still contagious, and we will soon see numbers skyrocket.
The fact that the Technical Advisory Group is going to meet this morning about this tells me that we simply cannot, and should not believe any of the numbers produced thus far. This is not rocket science. Why on earth do these people still think that New Zealand is not like every other country? They are meeting to reinvent the wheel, except in our case it appears that the wheel will be square, lack axles and won’t be fit for purpose. Why not simply adopt either the CDC or the EU-CPDC criteria and stop faffing around with pointless committees?
I remain very worried about this country, that we are going to have an Italy scale catastrophe on our hands. The public relations snow job has to end. The mere fact that there seems to be no scientific or epidemiological criteria for classifying people as “recovered” is as alarming as it is dangerous. The amount of time it takes to get answers is worrying. The quality of those answers is dismaying.
For all intents and purposes, we are seeing message control and massaging of numbers that bears a closer resemblance to what happened in China than what should be happening in a transparent, Western democracy.
Without proper criteria, published and transparent criteria, we won’t be leaving Level 4 lockdown any time soon. There simply is no path to Level 3 without proper epidemiological criteria.
We are on the cusp of a disaster, and the Prime Minister still has her ‘jolly hockey-sticks’ approach to press conferences. It must end. We aren’t being told the truth. We deserve the truth. We CAN handle the truth.
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