故にと言うことなのか、政府のやっている事を手放しで称賛する傾向あるいは積極的ないし現状追認の消極的な支持をする傾向、野党の主張は矮小化して何でも反対する傾向が少なくともネット上では観察される。
国際的比較の観点で日本の対応が他国と違う現状においても、その事実をあえてとらえず、単に将来起こるかもしれない医療リソース枯渇問題をとなえるばかりで、そのために初期対応で失敗していることを無視し、本質的な議論はしない。
COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures
J Rocklöv, PhD, H Sjödin, PhD, A Wilder-Smith, MD
Journal of Travel Medicine, taaa030, https://doi.org/10.1093/jtm/taaa030
Published:
28 February 2020
https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm/taaa030/5766334
Abstract
Background
Cruise ships carry a large number of people in confined spaces with relative homogeneous mixing. On 3 February, 2020, an outbreak of COVID-19 on cruise ship Diamond Princess was reported with 10 initial cases, following an index case on board around 21-25 January. By 4 February, public health measures such as removal and isolation of ill passengers and quarantine of non-ill passengers were implemented. By 20 February, 619 of 3,700 passengers and crew (17%) were tested positive.
Methods
We estimated the basic reproduction number from the initial period of the outbreak using (SEIR) models. We calibrated the models with transient functions of countermeasures to incidence data. We additionally estimated a counterfactual scenario in absence of countermeasures, and established a model stratified by crew and guests to study the impact of differential contact rates among the groups. We also compared scenarios of an earlier versus later evacuation of the ship.
Results
The basic reproduction rate was initially 4 times higher on-board compared to the R0
in the epicentre in Wuhan, but the countermeasures lowered it substantially. Based on the modeled initial R0 of 14.8, we estimated that without any interventions within the time period of 21 January to 19 February, 2920 out of the 3700 (79%) would have been infected. Isolation and quarantine therefore prevented 2307 cases, and lowered the R0
to 1.78. We showed that an early evacuation of all passengers on 3 February would have been associated with 76 infected persons in their incubation time.
Conclusions
The cruise ship conditions clearly amplified an already highly transmissible disease. The public health measures prevented more than 2000 additional cases compared to no interventions. However, evacuating all passengers and crew early on in the outbreak would have prevented many more passengers and crew from infection.
