Some U.S. doctors flee to New Zealand where the coronavirus outbreak is under control and science is respected https://www.cnbc.com/2020/10/12/cor...s-under-control-and-science-is-respected.html Some U.S.-based doctors and nurses are fleeing the country because the lack of PPE and coordinated U.S. response made them feel unsafe during the coronavirus pandemic. Some have been feeling burned out for years due to the complex U.S. health system. New Zealand, which led with science, has declared victory over Covid-19 yet again and hasn’t reported a positive case in more than a week. Dr. Judy Melinek knew it was time to make a change when she started to fear for her health and safety. While working as acting chief forensic pathologist for Alameda County in California, she read early reports about a virus in Wuhan, China. By June, after repeatedly sounding the alarm about the need for health workers to have sufficient personal protective equipment, she’d had enough. She also hoped for temperature checks, social distancing and masks, but she noticed that not all of the staff in her office were taking these steps. She couldn’t take the chance of bringing Covid-19 home to her elderly mother, four kids and husband, she said. And then an email appeared offering her the opportunity to relocate to New Zealand, a country that has reported less than 2,000 coronavirus cases and 25 deaths, drawing widespread praise from around the world for its science-led response. Melinek jumped at the opportunity. After a period of quarantine, she’s now living and working in Wellington City, New Zealand. She’s been impressed so far. “There’s a lot more respect for the government and for science here,” she said. Melinek is part of a wave of U.S. doctors plotting a move to New Zealand. A spokesperson for Global Medical Staffing, a recruitment group that helps doctors find short- and long-term positions around the world, noted that inquiries have increased about relocating to New Zealand from the U.S. as more physician jobs have been affected during the pandemic. In addition, more physicians currently employed in New Zealand who already located are choosing to extend their contracts “because of fewer reported cases of Covid-19,” meaning that there’s a slight dip in open roles. Melinek has been open about her decision on social media, and has subsequently heard from half dozen of her peers considering doing the same. She expects the number to keep rising as the pandemic continues. “America will suffer an exodus of professionals to other countries that have responded better, with economies that have recovered faster,” she said. In the United States, where the federal government has largely left the response for the pandemic up to the states, more than 213,000 people have died from the virus. Across the country, some states have largely reopened, despite recent surges in cases. An outbreak that tore throughout the White House has spread to at least 37 people, including President Donald Trump, according to a website tracking the infections. The outbreak has become a political lightning rod in America with Trump supporters often mocking scientists, social distancing rules and mask mandates Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was singled out for criticism by White House aides earlier this year. Even Trump said he disagreed with Fauci and that the infectious disease specialist “made a lot of mistakes,” prompting four former directors of the U.S. Centers for Disease Control and Prevention penned an op-ed warning that “undermining” science would lead to a sharp increase in infections and deaths. New Zealand, by contrast, recently declared victory over the virus after eradicating community spread for the second time. In addition, many public health workers and scientists based in the United States say they have faced online harassment and threats while sharing guidance to the public about measures to keep them safe, including masks and social distancing. New Zealand’s prime minister, Jacinda Ardern, has repeatedly praised scientists, and offered empathy to the public at the most trying times, including during the early lockdown. New Zealand is also a practical choice. It presents an attractive prospect for many doctors and nurses because the country tends to fill many of its openings with overseas workers. It’s known for making it relatively easy for clinicians to start treating patients in a matter of months, although that can vary depending on the role, assuming they have all proof of their training and credentials. And then there’s the beautiful weather and scenery. ‘I’ve been watching how they do it’ Dr. Ryan Radecki also made the move from Oregon to New Zealand during the pandemic after seeing an opening for an emergency medicine doctor at Christchurch Hospital, a large research and teaching hospital on the South Island. A big part of the appeal for him is that New Zealand has started reopening schools, so Radecki’s kids can return to in-person education. It’s also an opportunity to experience a health-care system with universal coverage. “I’m happy to be working in a system that provides world-class care,” he said. “We spent more in the U.S., and our outcomes aren’t better, so I’ve been watching how they do it.” Radecki isn’t certain how long he’ll stay in the country, adding that depends on the outcome of the U.S. election. He’s become increasingly concerned over misinformation about the virus that he’s seeing in the United States. “You see so many people downplaying it back home, perpetuating the spread of the virus in crowded bars, while physicians are suffering,” he said. Dr. Kris Sargent, a rural family physician currently working in Alaska, joked about needing an escape route for years before applying for a contract role in New Zealand. He would consider moving there permanently, but is still paying off debt from medical school in the U.S. and doctors don’t get paid quite as well in New Zealand. Medical school also tends to be cheaper there. It didn’t take long before Sargent heard that he’d got the job. Starting in January, after a period of quarantine, he’ll be the physician on call in a town called Katikati with about 4,700 residents. What he’s looking forward to most is a break from the “anti-science philosophy” he has experienced in the U.S., particularly since the start of the Covid-19 outbreak. Moreover, many of his patients are low income and struggle to afford care. “I couldn’t help them the way I wanted to, given the fear that so many of them have about going bankrupt, and all the time we have to spend babysitting insurance companies,” he said. His colleague, Susan Goodwin, is a nurse who made the move to New Zealand back in February before returning to the U.S. She said the planning and preparation took about 10 months, so she had hoped to be there for at least a year, but she made the difficult decision to come home at the start of the pandemic to care for her parents. In her short time in the country, Goodwin said she felt better equipped to take care of critically ill patients simply because she had more time to do so. In the U.S., she’s often caring for at least two intensive care patients at once, and sometimes more. In New Zealand, it was only one patient. “Every system has its strengths and weaknesses,” she said. “I personally found it a better run system in that everyone was able to access health care without fear of financial ruin.” ‘A lot of us are disillusioned’ For John Daniel, a pediatrician based in Missouri, moving to New Zealand would be an opportunity to take a break from the U.S. health-care system. He treats “sick babies and sick kids,” and has watched many of his patients dealing with the crushing burden of medical bills. In addition to that, he fears a rollback of reproductive rights. On a personal note, he also spends far more hours in the day than he cares to haggling with insurance companies. “It’s the corporatization of medicine,” he said. “A lot of my time is spent on the phone with insurers calling us to say they think the kid is ready for discharge, while we say they are sick and it’s too soon for them to be pushed out the door.” Moving to New Zealand, where public hospitals are free of charge, would present a welcome change for Daniel, he said. The island nation offers universal health care, plus a public option. Many locals also have some form of private insurance. He may someday be joined by Dr. Shikha Jain, who previously worked in New Zealand with her husband as a locums tenens, or physicians who fill in for other physicians on a temporary basis. Jain has talked about her experience online and says many of her colleagues have reached out recently to get advice on relocation. “There’s many more talking about it now than even five or 10 years ago,” she said. For now, Jain said she plans to stay in the United States to advocate for change to the current system. In her view, the pandemic has laid bare many of the problems with the status quo, including the gaps in coverage and the lack of protections for the most vulnerable. But she understands the reasons why her fellow health-care workers are considering fleeing overseas during the pandemic. “A lot of us are disillusioned and feel underappreciated because we’re expected to put our life at risk, but we didn’t even have enough protective equipment to keep us safe,” she said.
ANTIBODIES only last for 8 to 12 weeks.. before they wane and no longer protect you. Richard Quest: After recovering from Covid-19, I thought I was safe. Now my antibodies are waning https://www.cnn.com/2020/10/14/health/quest-covid-recovery-antibodies-intl/index.html I recovered from Covid-19 back in April. I was fortunate: My symptoms, while nasty, were minor compared to others. I had the hacking dry cough and I was fatigued to the point where I would spend many hours on the sofa. But I never had breathing difficulties, nor required hospital treatment. Whenever the question of catching it again has come up since, I airily and hubristically said, "Oh, I've had it, and have antibodies to prove it." At least I did until Friday, when my third antibody test came back negative. I was in shock. Even though it's not clear antibodies do actually offer immunity, I had treated my previous AB positive tests as a shield I could wave, crying, "Been there. Done that. I'm OK." Rightly or wrongly. Now my precious protection had vanished. I called the testing center. "Surely some mistake," I said grandly. "I have previous tests to prove it." The center, having not seen a case of a re-test losing antibodies before, went back to the lab to see what was going on. The lab responded, "Oh no, Mr. Quest does have antibodies, just not enough to register on the scale." I had registered as 1 on the 'scale,' and only those above 1.4 are considered to have enough antibodies to classify as positive. I needed to know more, so immediately launched into a whirlwind of googling, then battled through a scientific article on the Abbott SARS-CoV-2 IgG antibody test. IgG refers to immunoglobulin class G antibodies in your blood, which when washed, mixed and tumble-dried with other chemicals (as well as a load of other things I didn't understand), produces an antibody index, where the cut-off point is 1.4. And I had been cut off. Over the past five months my evanescent antibodies had dwindled to meaningless, and with it my bravado claim to protection. Now it seemed I was back to square one: vulnerable to Covid again. When I told my infectious diseases doctor in New York, he wasn't one bit surprised. He referred to the latest studies showing that antibodies do indeed weaken and dwindle over 90 days -- no one has had a chance to do much research beyond that yet. But, as my doctor continued, that's only half the body's defensive mechanism. T cells, an important part of our immune system's attack force, have virus memory. They will lay quiescent until (or if) the body comes into contact with Covid-19 again, at which point my immune system will fire up and start producing antibodies once more. It was, my doctor said, "highly, highly unlikely that you will get Covid again this year ... medically improbable." I was then quickly admonished that none of this should lead me to abandon social distancing, hand washing and other anti-virus measures. Resilience, but no immunity? I relate all of this because it's another example of our collective tortuous journey with this disease. The circuitous progress of the pandemic creates fear, then hope, then back to fear again, seemingly with no end. I have seen many Covid recoverees quietly parade their antibody status as if it is a shield for life. Yet I would bet good money that if they took another test they would also discover that their armor has cracked, or has holes in it. I only discovered the curious case of my dwindling antibodies because I get tested frequently because of my travels for work. I like to think common sense tells me that I can't catch Covid again in the short term -- otherwise we would have heard of many more cases of re-infection. So far there have only been a few outlier cases and they tend to have unique circumstances. Yet common sense must now be trumped by that hoary but voguish cliché: the "abundance of caution." I will only take common sense so far. This is all teaching me that what was fact yesterday, doesn't mean it's the same today. Experts are saying we know a lot more about Covid now than we did six months ago. That is true at the helicopter level, where governments make national policies, and also at the grass roots, as I go about my life. My new reality is that I no longer have the antibodies of which I was once so proud. I may have a resilience based on T-cell memory and I am unlikely to be infected again, but I may! I just wonder what other "certainty" is going to crumble into the dust next. While I wait to find out, I will follow the rules.
Not surprising... Japan supercomputer shows humidity affects aerosol spread of coronavirus https://www.reuters.com/article/us-health-coronavirus-japan-supercompute-idUSKBN26Z0PI A Japanese supercomputer showed that humidity can have a large effect on the dispersion of virus particles, pointing to heightened coronavirus contagion risks in dry, indoor conditions during the winter months. The finding suggests that the use of humidifiers may help limit infections during times when window ventilation is not possible, according to a study released on Tuesday by research giant Riken and Kobe University. The researchers used the Fugaku supercomputer to model the emission and flow of virus-like particles from infected people in a variety of indoor environments. Air humidity of lower than 30% resulted in more than double the amount of aerosolised particles compared to levels of 60% or higher, the simulations showed. The study also indicated that clear face shields are not as effective as masks in preventing the spread of aerosols. Other findings showed that diners are more at risk from people to their side compared to across the table, and the number of singers in choruses should be limited and spaced out. There has been a growing consensus among health experts that the COVID-19 virus can be spread through the air. The U.S. Centers for Disease Control and Prevention (CDC) revised its guidance this month to say the pathogen can linger in the air for hours. The Riken research team led by Makoto Tsubokura has previously used the Fugaku supercomputer to model contagion conditions in trains, work spaces, and class rooms. Notably, the simulations showed that opening windows on commuter trains can increase the ventilation by two to three times, lowering the concentration of ambient microbes. “People’s blind fear or unfounded confidence against the infection of COVID-19 is simply because it is invisible,” Tsubokura said.