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Is the current aim to reduce or eliminate exposure to the virus?

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bramling

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Moderator note: Split from https://www.railforums.co.uk/thread...-ingredients-of-items-in-supermarkets.203495/

Yes, but overall the rate of infections will be vastly reduced. There is only so much that can be done; at some point soon the rate is going to have to increase again. We're going to have to accept that; it's just a case of slowing it down a bit so that we have a bit more time to prepare, but it's going to continue spreading and you cannot eliminate all risks in life, only reduce them.

I’m beginning to wonder if this aspiration is being overtaken by events, namely two factors:
(1) increasing suggestion that herd immunity can’t be relied upon
(2) at present a feeling that people devoid of known pre-existing conditions aren’t quite as safe as was previously thought

The second of those *may* be debunked *if* testing shows more people than thought have already had it and survived, but we’re not near that point yet.

Perhaps I was getting the wrong end of the stick, however the feeling I have picked up from TV coverage over this week is that at present we seem to be limping towards a vaccine with not much else up the sleeve. Be that the case I think we will have to take a more pragmatic line than “you might just have to get it and suck it up”. The big problem is that someone can be asymptomstic, carry it, and then unknowingly transmit it to someone who is a much higher risk.

There’s no easy solutions as things stand at the minute.
 
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yorksrob

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The second of those *may* be debunked *if* testing shows more people than thought have already had it and survived, but we’re not near that point yet.

As I understand it, Germany have done a lot more testing and found a greater proportion who have had it without being hospitalized.
 

bramling

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As I understand it, Germany have done a lot more testing and found a greater proportion who have had it without being hospitalized.

That’s what I thought, but then we keep reading or hearing things which say otherwise. There’s studies suggesting infection rates here are low.

For the now it seems we can’t safely assume one way or another.
 

yorksrob

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That’s what I thought, but then we keep reading or hearing things which say otherwise. There’s studies suggesting infection rates here are low.

For the now it seems we can’t safely assume one way or another.

We know that people with the virus have been isolating without being tested, which has skewed our figures.

What does seem likely is that the very optimistic scenarios in which half the population could have already had it, probably aren't the case. But then, I don't think anyone was operating on that basis anyway.
 

bramling

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We know that people with the virus have been isolating without being tested, which has skewed our figures.

What does seem likely is that the very optimistic scenarios in which half the population could have already had it, probably aren't the case. But then, I don't think anyone was operating on that basis anyway.

We don’t know if the people isolating
(1) have Covid19
(2) have something else
(3) have nothing and are taking a cheeky fortnight off work

In the absence of testing we really can’t form any conclusions at this stage, which seems to be the line the government is taking.
 

yorksrob

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We don’t know if the people isolating
(1) have Covid19
(2) have something else
(3) have nothing and are taking a cheeky fortnight off work

In the absence of testing we really can’t form any conclusions at this stage, which seems to be the line the government is taking.

We can conclude that some of them probably have had it, and as you say, until we start testing people who think they have it, we can't be sure.

However some countries such as Germany have been testing a large proportion of people who they think have had it, and they have indeed found that there is a larger proportion of people who have it and who aren't hospitalized than our own figures would suggest.
 

Meerkat

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If immunity doesn’t last then how can a vaccine work?
if neither are going to happen then we are Going to have to get stricter on who gets ICU and just get on with it.
 

johnnychips

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Quite early on in this, on Radio 4, someone said Chinese scientists had infected some monkeys with CV. A month later they tried to reinfect them, but couldn’t, and they were going to try and reinfect them every month. Unfortunately I haven’t heard any follow up to this.
 

Peter Sarf

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We know that people with the virus have been isolating without being tested, which has skewed our figures.

What does seem likely is that the very optimistic scenarios in which half the population could have already had it, probably aren't the case. But then, I don't think anyone was operating on that basis anyway.

Don't worry we will just have to wait and see see what the results are from the big experiment. You know the one the "orange one" is blindly heading for - but the experiment might be ruined by ill advised state governors vetoing it o_O.


We don’t know if the people isolating
(1) have Covid19
(2) have something else
(3) have nothing and are taking a cheeky fortnight off work

In the absence of testing we really can’t form any conclusions at this stage, which seems to be the line the government is taking.

Well I am not faking it. On the face of it I am (1). But it is so mild that I would class it as a below average severity cold. BUT - really descent cough, maybe a temperature and a feeling of lungs under capacity - that is what makes me suspicious. However, if i knew nothing about COVID-19, I am not sure i would be bothered in the least - certainly not worthy of a single day of work sick. Twelve days into it now and still wondering if I am going to wake up gasping for breath and off to hospital. Certainly don't want to give it a risk to someone else.

As for (2) - maybe it is only a cold. Hope not because that means I am still taking a risk when I go back to work. But if it is a cold then how did I catch this common cold if I was wearing a mask, gloves and washing my hands until the skin risks cracking !.

My boss wanted me to stay away beyond the NHS 7 days. He insisted I got another sick note - got that in an email !. But I must be well because I am BORED !. However I will play safe for myself and for those around me. Frankly I do not think my job is that important - the company just appears to not want to shut down.
 

Bletchleyite

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You are supposed to isolate beyond the 7 days if you still have symptoms, other than if you only have the cough and nothing else, as that can continue for some time in a minor form as a post-viral thing. Post-viral shortness of breath is also not unusual and can be permanent (another virus a few years ago appears to have given me permanent asthma). But if you have a temperature you MUST continue to self-isolate until it has dropped to normal.
 

Peter Sarf

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Quite early on in this, on Radio 4, someone said Chinese scientists had infected some monkeys with CV. A month later they tried to reinfect them, but couldn’t, and they were going to try and reinfect them every month. Unfortunately I haven’t heard any follow up to this.

The monkeys they chose were last seen shopping in a food market :E:o.

I am vaguely getting at the recent (fake or otherwise) news that apparently this virus was a lab experiment that got out. Perhaps they had a vaccine and wanted to try it out without wasting time on proper tests. Desperate times call for desperate measures.

It does seem very likely that the figures for deaths in China are drastically under reported. So with their lock-down relaxing there maybe a lot less deaths and hospital admissions because more than we expect have already died and survived. Either that or they will under report.
 
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Peter Sarf

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You are supposed to isolate beyond the 7 days if you still have symptoms, other than if you only have the cough and nothing else, as that can continue for some time in a minor form as a post-viral thing. Post-viral shortness of breath is also not unusual and can be permanent (another virus a few years ago appears to have given me permanent asthma). But if you have a temperature you MUST continue to self-isolate until it has dropped to normal.

That is my feeling. My boss was very worried about anyone coughing even a month ago. For me I would say it peaked at about nine days. But the NHS website seemed to deem me unfit merely because of my cough as I was pleased I could answer OK to the other questions. So I am not going to riski the life/well-being of anyone else. My best reason for going to work would be if it stopped someone else taking a risk that I no longer (think I) have to worry about.
 

Qwerty133

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Frankly I do not think my job is that important - the company just appears to not want to shut down.
This is one of the biggest misconceptions held by the public. The government wants businesses to continue, outside of the limited exceptions that they have specifically closed down, and frankly businesses that have closed for no real need are actively harming the countries response.
 

Mogster

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My workplace provides essential services for the NHS. I’d say the temperature is more of an indication than anything. We’ve had people return to work from isolation with a low level cough, a persistent cough I’d definitely say you should be staying at home.

If we excluded everyone with a low level cough in late winter/spring then we’d have at least 50% sickness. We can’t shut so we have to be pragmatic.
 

Peter Sarf

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This is one of the biggest misconceptions held by the public. The government wants businesses to continue, outside of the limited exceptions that they have specifically closed down, and frankly businesses that have closed for no real need are actively harming the countries response.

That is very true, thanks for reminding me. We are running at about 60% btw.

My workplace provides essential services for the NHS. I’d say the temperature is more of an indication than anything. We’ve had people return to work from isolation with a low level cough, a persistent cough I’d definitely say you should be staying at home.

If we excluded everyone with a low level cough in late winter/spring then we’d have at least 50% sickness. We can’t shut so we have to be pragmatic.

When I felt my chest / back the main thing I noticed was how cold my hand was !. When my cough has died down enough I will try to get back.
 

Chester1

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Moderator note: Split from https://www.railforums.co.uk/thread...-ingredients-of-items-in-supermarkets.203495/



I’m beginning to wonder if this aspiration is being overtaken by events, namely two factors:
(1) increasing suggestion that herd immunity can’t be relied upon
(2) at present a feeling that people devoid of known pre-existing conditions aren’t quite as safe as was previously thought

The second of those *may* be debunked *if* testing shows more people than thought have already had it and survived, but we’re not near that point yet.

Perhaps I was getting the wrong end of the stick, however the feeling I have picked up from TV coverage over this week is that at present we seem to be limping towards a vaccine with not much else up the sleeve. Be that the case I think we will have to take a more pragmatic line than “you might just have to get it and suck it up”. The big problem is that someone can be asymptomstic, carry it, and then unknowingly transmit it to someone who is a much higher risk.

There’s no easy solutions as things stand at the minute.

I don't think it has changed simply because there isn't a chance of stopping it spread through poor countries. It spreads too easily to make eradicating it realistic without a vaccine. If its circulating in dozens of countries it will keep arriving in the UK. I think the government's strategy is to try to get a package of measures which both keeps the "R" infection rate per case slightly below 1 but that is also economically sustainable, which is a huge challenge. At an R of 0.9 cases and deaths would drift down but be prone to spikes if people arrive in the UK with it. I think the natural R value is 2.5 i.e. if we took no measures then every person with it would on average infect 2.5 people.

The German study of their first town that got infected showed 15% immunity after 3 months. If that was reflected in the UK it would mean herd immunity in about one years time. Some of other studies have shown lower rates of antibodies. Part of the problem estimating immunity is apparently that younger healthier people can get it asymptomatically and fight if off while developing few or no antibodies. The studies that suggest very low immunity rates seem to get a lot of attention from The Guardian and Independent but thats probably because the idea of herd immunity has become associated with the Tories. If we don't get immunity for a year or more by catching it, then a vaccine will be really hard to develop and we are really screwed unless some affective treatments can significantly lower the death rate.
 

johnnychips

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The monkeys they chose were last seen shopping in a food market :E:o.

I am vaguely getting at the recent (fake or otherwise) news that apparently this virus was a lab experiment that got out.

Sorry, I should have stressed that this monkey experiment was performed in China well after the outbreak started there. And I did say it was on Radio 4, not Karen on FB.
 

nlogax

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The monkey experiment was a tiny test and not peer-reviewed. It introduced Covid-19 to four rhesus macaques and after a month reintroduced the virus to two of them. While on the face of it the results were positive, this was by no means conclusive. If anything they raised further questions about the virus and its longevity in hosts long after they could be declared healthy and free of infection.

https://www.genengnews.com/news/covid-19-reinfection-not-a-concern-monkey-study-suggests/

Now, a collaboration of Chinese scientists has dug deeper into whether or not reinfection with SARS-CoV-2 is possible with a small monkey study. The team looked at whether or not non-human primates, rhesus macaques, can become reinfected with SARS-CoV-2. The work was posted on the preprint server bioRxiv on March 14 in a paper titled, “Reinfection could not occur in SARS-CoV-2 infected rhesus macaques.” Their conclusion: there may be no reason to worry about reinfection.
 

edwin_m

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I don't think it has changed simply because there isn't a chance of stopping it spread through poor countries. It spreads too easily to make eradicating it realistic without a vaccine. If its circulating in dozens of countries it will keep arriving in the UK. I think the government's strategy is to try to get a package of measures which both keeps the "R" infection rate per case slightly below 1 but that is also economically sustainable, which is a huge challenge. At an R of 0.9 cases and deaths would drift down but be prone to spikes if people arrive in the UK with it. I think the natural R value is 2.5 i.e. if we took no measures then every person with it would on average infect 2.5 people.

The German study of their first town that got infected showed 15% immunity after 3 months. If that was reflected in the UK it would mean herd immunity in about one years time. Some of other studies have shown lower rates of antibodies. Part of the problem estimating immunity is apparently that younger healthier people can get it asymptomatically and fight if off while developing few or no antibodies. The studies that suggest very low immunity rates seem to get a lot of attention from The Guardian and Independent but thats probably because the idea of herd immunity has become associated with the Tories. If we don't get immunity for a year or more by catching it, then a vaccine will be really hard to develop and we are really screwed unless some affective treatments can significantly lower the death rate.
I hope the widespread immunity idea is true and that someone manages to do some proper sample testing with a working antibody test kit as a matter of urgency, because at the moment nobody really has a clue and it's hardly surprising the government doesn't want to map out the exit strategy because they don't have a clue either. However in the absence of that information I believe we have to stay on the side of precaution.

The official figure for casualties increased approximately tenfold since the lockdown was imposed, and has now levelled off at a rate the NHS can cope with but hasn't appreciably fallen. If lockdown is relaxed too much they we could be back to a similar rate of growth but from a much higher base. With the incubation period being what it is, by the time that started showing up in the figures enough people would have been infected to overwhelm the NHS a couple of weeks afterwards. That wouldn't happen if the actual figures were much higher than the official ones so a large part of the population was immune, but we don't know and we can't take that risk. If the figures are broadly as most experts say, then at a similar rate of infection herd immunity would take several years of fairly stringent lockdowns unless an effective treatment drug or vaccine appeared in the meantime.
 

Chester1

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I hope the widespread immunity idea is true and that someone manages to do some proper sample testing with a working antibody test kit as a matter of urgency, because at the moment nobody really has a clue and it's hardly surprising the government doesn't want to map out the exit strategy because they don't have a clue either. However in the absence of that information I believe we have to stay on the side of precaution.

The official figure for casualties increased approximately tenfold since the lockdown was imposed, and has now levelled off at a rate the NHS can cope with but hasn't appreciably fallen. If lockdown is relaxed too much they we could be back to a similar rate of growth but from a much higher base. With the incubation period being what it is, by the time that started showing up in the figures enough people would have been infected to overwhelm the NHS a couple of weeks afterwards. That wouldn't happen if the actual figures were much higher than the official ones so a large part of the population was immune, but we don't know and we can't take that risk. If the figures are broadly as most experts say, then at a similar rate of infection herd immunity would take several years of fairly stringent lockdowns unless an effective treatment drug or vaccine appeared in the meantime.

While the number of death per day hasn't fallen the number of cases and the number of people in hospital due to Covid-19 has fallen, just not for long enough to make an impact on number of people dieing each day. The government scientists seem confident that the "R" value is between 0.5 and 1, the problem they have is calculating a precise number and what a package of loosening measures would increase it to.
 

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While the number of death per day hasn't fallen the number of cases and the number of people in hospital due to Covid-19 has fallen, just not for long enough to make an impact on number of people dieing each day. The government scientists seem confident that the "R" value is between 0.5 and 1, the problem they have is calculating a precise number and what a package of loosening measures would increase it to.

Another interesting question is how much further you could reduce it and what measures could reduce it right down. Could we, for instance, by banning going out for any reason at all for 2 weeks barring medical treatment that would be a 999/A&E job in normal circumstances, or if you work for the NHS, Police, Fire Service or a utility, bring the numbers right down? It wouldn't be fun, but it might be worth the effort if it was effective. It'd probably need announcing say 2-3 weeks in advance to allow people to shop and make work plans, though.
 

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I hope the widespread immunity idea is true and that someone manages to do some proper sample testing with a working antibody test kit as a matter of urgency, because at the moment nobody really has a clue and it's hardly surprising the government doesn't want to map out the exit strategy because they don't have a clue either. However in the absence of that information I believe we have toThe official figure for casualties increased approximately tenfold since the lockdown was imposed, and has now levelled off at a rate the NHS can cope with but hasn't appreciably fallen.

When we look at casualty figures what are we actually looking at though? With the age of most of the fatalities and Covid being a reportable illness it’s difficult to calculate a realistic excess deaths figure.

What is known is that the virus is mostly (but not only) affecting those approaching or exceeding life expectancy. 10% of people aged 80 will die within a year, 2/3 of cases with Covid on the death certificate have serious co-morbitities. The focus is now on care homes but once again the true picture is hard to see clearly as you are dealing with an elderly population and around 2000 people die in UK care homes each week.

From the charts used in the governments Covid briefing yesterday the numbers of people being treated in hospital for Covid peaked around the 8th April and have decreased since, particularly in London but the charts showed the same trend across the UK. In London the numbers of people in hospital had fallen from nearly 5000 on the 8th to around 3500 yesterday which looks quite significant. Hopefully the numbers will continue to fall.
 

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Another interesting question is how much further you could reduce it and what measures could reduce it right down. Could we, for instance, by banning going out for any reason at all for 2 weeks barring medical treatment that would be a 999/A&E job in normal circumstances, or if you work for the NHS, Police, Fire Service or a utility, bring the numbers right down? It wouldn't be fun, but it might be worth the effort if it was effective. It'd probably need announcing say 2-3 weeks in advance to allow people to shop and make work plans, though.

That would work as demonstrated by Wuhan but only if enforced. The Government's recent statement that parks should stay open indicates they know there are limits to patience and how much it can enforce the lockdown.

When we look at casualty figures what are we actually looking at though? With the age of most of the fatalities and Covid being a reportable illness it’s difficult to calculate a realistic excess deaths figure.

What is known is that the virus is mostly (but not only) affecting those approaching or exceeding life expectancy. 10% of people aged 80 will die within a year, 2/3 of cases with Covid on the death certificate have serious co-morbitities. The focus is now on care homes but once again the true picture is hard to see clearly as you are dealing with an elderly population and around 2000 people die in UK care homes each week.

From the charts used in the governments Covid briefing yesterday the numbers of people being treated in hospital for Covid peaked around the 8th April and have decreased since, particularly in London but the charts showed the same trend across the UK. In London the numbers of people in hospital had fallen from nearly 5000 on the 8th to around 3500 yesterday which looks quite significant. Hopefully the numbers will continue to fall.

Over 90% of deaths from Covid-19 are of either over 70s or people with pre-existing medical conditions. Of the latter the average number of conditions is 3! That means deaths of relatively healthy under 70 year olds (i.e. most of the population) have been about 1000. There is too much fear amongst young healthy people, yes we could die from it but it really is extremely unlikely.
 

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Another interesting question is how much further you could reduce it and what measures could reduce it right down. Could we, for instance, by banning going out for any reason at all for 2 weeks barring medical treatment that would be a 999/A&E job in normal circumstances, or if you work for the NHS, Police, Fire Service or a utility, bring the numbers right down? It wouldn't be fun, but it might be worth the effort if it was effective. It'd probably need announcing say 2-3 weeks in advance to allow people to shop and make work plans, though.

The horrible point is that if we reduce the R value too much with effective lockdown then we just prolong the period taken for most of the population to have herd immunity. That is assuming herd immunity is a valid outcome of course. What it does do is keep people out of harms way until a vaccine appears. But that could be 18 months away. So I have to reluctantly conclude that we may need this virus to take its course through the population as fast as we can without the NHS sinking. Which is still going to kill a lot of people and also cost the economy.
 

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That would work as demonstrated by Wuhan but only if enforced. The Government's recent statement that parks should stay open indicates they know there are limits to patience and how much it can enforce the lockdown.



Over 90% of deaths from Covid-19 are of either over 70s or people with pre-existing medical conditions. Of the latter the average number of conditions is 3! That means deaths of relatively healthy under 70 year olds (i.e. most of the population) have been about 1000. There is too much fear amongst young healthy people, yes we could die from it but it really is extremely unlikely.

Young people might well be almost guaranteed to survive *BUT* the problem is they will infect people who have less chance of survival. Also a young person might not be dying of COVID-19 but, if they have an accident and young people do tend to have accidents, they will not get the help they need in an overrun hospital - which could then prove fatal. Talking of overrun hospitals - more people will die of COVID-19 if they cannot get a ventilator.

So lets stay home, protect the NHS and save lives.

Otherwise the actions of the young could prove very dangerous and very selfish.
 

Chester1

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The horrible point is that if we reduce the R value too much with effective lockdown then we just prolong the period taken for most of the population to have herd immunity. That is assuming herd immunity is a valid outcome of course. What it does do is keep people out of harms way until a vaccine appears. But that could be 18 months away. So I have to reluctantly conclude that we may need this virus to take its course through the population as fast as we can without the NHS sinking. Which is still going to kill a lot of people and also cost the economy.

It could be a lot longer than 18 months away. There is a lot of blind faith that science will find a way etc. It may very well do but we can't rely on that. I suspect that herd immunity through infection will be what ends the crisis. The government's mistake will then have been relying on it too early, not the decision itself.

New Zealand and Australia are really going to be in an economic mess later this year if there is no vaccine or effective treatments. They were too successful locking down and sealing themselves off from the rest of the world. They maybe able to eradicate the virus in their own countries and it will be politically unacceptable to reopen their borders. Businesses have lobbied for them to allow travel between the two first and it might have to stay that way for a long time, which would have huge economic consequences.

Edit:

Young people might well be almost guaranteed to survive *BUT* the problem is they will infect people who have less chance of survival. Also a young person might not be dying of COVID-19 but, if they have an accident and young people do tend to have accidents, they will not get the help they need in an overrun hospital - which could then prove fatal. Talking of overrun hospitals - more people will die of COVID-19 if they cannot get a ventilator.

So lets stay home, protect the NHS and save lives.

Otherwise the actions of the young could prove very dangerous and very selfish.

I am!!!!

I am not saying young people should break the lockdown! Just that they should not be terrified of catching it! They should be isolating to help those who are vulnerable not out of fear, which is damaging to their mental health.
 

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Another interesting question is how much further you could reduce it and what measures could reduce it right down. Could we, for instance, by banning going out for any reason at all for 2 weeks barring medical treatment that would be a 999/A&E job in normal circumstances, or if you work for the NHS, Police, Fire Service or a utility, bring the numbers right down? It wouldn't be fun, but it might be worth the effort if it was effective. It'd probably need announcing say 2-3 weeks in advance to allow people to shop and make work plans, though.

You'd create another round of panic buying, and risk spreading even quicker as a result.
 

JonathanH

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New Zealand and Australia are really going to be in an economic mess later this year if there is no vaccine or effective treatments. They were too successful locking down and sealing themselves off from the rest of the world.

No, I simply see them needing to impose a 14 day quarantine for any visitors for the foreseeable future. Is that such a hardship?
 
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