(Updated 26/10/20)
"Hi Gary,
I would say NZ can definitely do what Sweden has done, except learn from Sweden’s mistakes and do a better job of protecting the elderly, by allowing the disease to circulate among the young and healthy so that herd immunity builds up while taking stringent measures to prevent spread in to care homes for the elderly.
Additionally, it would be very easy for the government to recommend that everyone take a vitamin D supplement 3000-5000 IU, since that seems to offer a large amount of protection and significantly decrease the risk of severe disease. People living in care homes should definitely all be getting a supplement.
Best wishes,"
Sebastian
02/10/20
Gary:
Dr Sebastian Rushworth is a frontline emergency doctor working in Stockholm, Sweden. He has written extensively on Sweden's experience with COVID19. Sweden is almost over the pandemic, with the country pretty much back to business as usual.
Whether or not it is intended, most of the rest of the world, New Zealand excluded, is grudgingly following Sweden's lead. The virus has been spreading. The curve is flattening. For New Zealand, we are not building any immunity.
I have been saying for some months now, that NZ can be out of its isolation within a month or two if we were to action what Dr Rushworth is advocating, plus the measures in this escape plan:
The key to living with all infectious diseases, current and future, is to improve population immune health. The fact is that we are now a species with declining robustness. As a population, we are becoming increasingly vulnerable to all diseases, degenerative and infective and not just COVID19.
Think about this: even a tiny positive shift in population health means that it will dramatically reduce the number of people at the most vulnerable end of the population curve, especially if we target those most at risk of all disease. These are the elderly, those living in poverty and those with chronic health issues. We could include shift workers as well and anyone on medication such as for asthma, diabetes, depression and cardiovascular disease.
A small aside: old age is not really a risk factor. An older person who is well-nourished should have a robust immune system, primed over many years by countless exposures to pathogens. The problem for many of the elderly today is the combination of malnutrition plus excessive medication.
This article is relevant:
A person with robust health has little to fear from all but the worst of infections. Our strategy for this and future pandemics must include measures to improve population health. As suggested by Dr Rushworth, this may be as simple as ensuring each New Zealander has adequate daily nutrients such as vitamin D, zinc, vitamin C and selenium - there are many more. Simple! Refer to this article.
For those who are the most vulnerable, such as the elderly in rest homes and the immune-compromised, we might go one step further by administering a very low-dose prophylactic anti-viral and do so for as long as it takes for population herd immunity to happen. This would be voluntary for all. There is no need at all for compulsory medical procedures.
To do this properly, politicians and health bureaucrats need to get out of the medical clinics and, instead, empower our doctors so they can make decisions that are best for each of their individual patients. Read this:
Even if we keep hanging out for the panacea in the form of a vaccine while remaining in isolation, improving the health of all New Zealanders is still a straightforward decision. It is not avoiding COVID deaths alone that we should focus on; it is all-causes mortality (heart disease, cancer, Alzheimer's, etc). What I am advocating will reduce all causes mortality, including COVID when we allow it to run through the community - vaccine or no vaccine.
Let me ask you these questions:
What happens for New Zealand if they do not develop a safe and effective vaccine in the next year? How long can we hold out without going broke?
No vaccine is ever 100% effective for everyone: a COVID19 vaccine is most likely to perform like the seasonal flu vaccine which varies from 15 to 60%, so where does that leave NZ?
A vaccine is least likely to work for the elderly and immune-compromised and best for the young, fit and healthy. Will a vaccine really protect the elderly and others who most need protecting?
How many will die if we rely solely on a vaccine and we open our borders?
What I'm doing here is cautioning on the singular reliance on a vaccine - the "panacea" - to save us. We need a more realistic and comprehensive plan.
Fall into line, do not ask questions, we know what is best for you!
We are being told - no; we are being ordered - that we must follow the official plan and do so without question and there will be no shift in the plan. This really bothers me. The blanket and rigid refusal to consider alternatives to the official plan is just stupid. This dogged inflexibility is setting this country up for a costly failure of the most epic proportions.
I'm into my 45th year of working full time in health and it has reminded me of this repeatedly: about 70% of all health advice will later be partially or fully wrong.
Think about the changes to nutrition advice for heart disease in recent years - dramatic! Do you remember, recently, when experts were telling us that eggs were bad for our hearts and margarine was good? How wrong were they?
Our official plan for COVID19 is not immune to the fact that we are always getting it wrong. Scientific knowledge is never absolute. It is forever developing. Many of us think our COVID strategy is already very wrong. It might have been right in March, but not now. Public health plans must be flexible and always developing. They must be organic, not inanimate and rigidly unforgiving pieces of work.
But I guess spending billions of your money and mine while hanging out for the "panacea" that will cost us more millions is much more politically expedient, less likely to confuse voters and far less likely to upset party donors. It is easier than having to wrestle with sticky issues such as calls for a Sugar Tax, giving tax relief on fruit and vegetables, or shifting NZ to a high-wage economy. It is easier than measures to remedy the impact of stress, poverty and nutrition-related issues on health.
The elephant in the room is this: a healthy person, regardless of age, has little to fear from COVID19, so why aren't we more aggressively investing in health?
The first step is for the Government to consult the best and most innovative brains in the world and not just those within their impenetrable iron-clad echo-chamber bubble. Hundreds of New Zealand health professionals, including many doctors, are excluded from the conversation. They would like to contribute. This has to change.
I wrote this to Dr Rushworth in Sweden:
"Sebastian, here in New Zealand there is great reluctance to even consider going down the Swedish path. The following is being used as ammunition against doing so, saying that the average of two COVID deaths per day in Sweden is unacceptable. Refer here: https://www.covid19insweden.com/en/?fbclid=IwAR0V1rk-kyWMMIgXFjq65CVuOtaQL1tGSFxd3qqdlqxAC7a6wCwFyygvUwY Would you mind commenting? Thank you."
His reply:
Sebastian Rushworth, M.D.:
"Saying that two covid deaths per day is unacceptable is ignoring the facts that everybody dies, and that everybody has to die of something. What about the other 250 people who die every day in Sweden? Why are covid deaths the only deaths that matter? It makes zero sense. More people are dying of pneumonia and influenza every day…