There has been a lot of talk about the coming second wave of COVID-19. There are hints that it is already starting and renewed outbreaks in China, Korea and other countries have demonstrated how easily this could occur. Here is what it will mean for you and how you can both protect yourself and the community.
What normally happens during an outbreak is that the rate of the disease rises until it peaks and then it drops off. Sometimes, not every time, but often enough to be worried out it, a second wave of infections can occur. This can happen for many reasons, including changes of behaviour when people return to normal pre-outbreak standards, or the disease could be reintroduced to the population from elsewhere.
The fact that the disease is highly contagious and causes no to very mild symptoms among many of the people who get it, means that the disease could be widespread in the population and we don't know it. In addition, quarantining people returning to Australia from abroad for 14 days will miss some people who have longer incubation periods. This is why we have seen a recurrence of the disease in China and South Korea.
What have we learnt about Coronavirus (and what we still don't know)
Since the start of the pandemic, a lot of data has been collected and research being actively done. This doesn't mean that they know everything about the disease or that what has been learnt is completely correct. Research takes time, and this is something that has occurred only over a few months.
One of the most important things learnt is how this disease spreads. Unlike other Coronaviruses or similar diseases, this one can last a long time in the air in tiny droplets of water. Normally viruses are torn apart, but with the Coronavirus, this is not the case.
As a result, one of the biggest risks is being in enclosed spaces with lots of other people where there is little or no ventilation. The easiest way to think about this is how if someone is smoking outside, the breeze dissipates the smoke but indoors it accumulates. Which explains why gatherings in the home have been the source of renewed outbreaks of Coronavirus in Victoria.
Of course, the disease can still be spread by our hands, and this is why washing your hands or using hand sanitiser is still very important. I have noticed how few people use hand sanitiser in shops and restaurants, even though they are now everywhere.
There is also growing evidence, based on testing everyone in a specific area, that a lot of people get the disease without any symptoms at all. What is still uncertain is how infectious asymptomatic people are. But it does point to the fact that the disease can be moving around the community without us knowing. Given that younger people tend to have the least symptoms, it could be moving through the community without anyone being aware of it.
Another issue is how long will immunity last. With Coronaviruses, normally immunity lasts for a few months. Though you can also have an extended period where the disease is less severe if you get it again. In other words, in a few months, people who have had the disease could get it again, keeping the disease alive in the community.
COVID-19 in Australia: By the numbers
There is a lot of confusion around the number of cases in Australia. This is mostly because the mainstream media happily dumps all the numbers together. At the time of writing this article, Australia had recorded 7410 cases. However, the majority of these, over 62% or 4621, were from people who were infected abroad. These cases should be eliminated when trying to understand the extent of the problem in Australia.
The remaining cases, 2786, were contracted locally and give a much better indication about the nature of the problem. Most importantly, only 630 cases were acquired from unknown sources, also referred to as community transmission. These numbers really show how small the number of infections was in Australia.
What is often not talked about is the long-term effects of the disease. Many people who have experienced have had Coronavirus, even those who are asymptomatic, have long-term health effects. Studies on this at the moment are preliminary, so the extent of the problem is not known yet.
Should there have been a lockdown
One of the questions that has been raised and will be returned to many times in the future is if we can manage COVID-19, what was the point of the lockdown? We even see reasonable success stories, like Japan, that did so without having a strict lockdown approach. Then, of course, Sweden tried the same thing and failed.
One of the main reasons for a lockdown in Australia was that we didn't have the infrastructure and systems in place to handle an outbreak. Tests were in limited supply, as were face masks and hand sanitiser. In addition, the training and preparation of a range of key people, from nurses through to police, was not adequate. The lockdown occurred to make sure that Australia could prepare, as much as it was to stop further outbreaks.
What is the government plan for the second wave
The current plan by the Australian and other governments is to better manage the disease when it occurs. Now Australia is an position to handle an outbreak, even a fairly major one. The COVIDSafe app, along with other contact tracing, means that we are in a strong position to handle any outbreaks. We are seeing this happen already, individual schools or aged care facilities are being quickly shutdown on even the smallest suspicion. This is very different from what it was like at the start of COVID-19, where an institution might spread the disease, simply because they were not ready to respond properly.
Image courtesy of Epidemiologist @MarcelSalathe & Designer @NCasenmare at Wikimedia
Australia acted quickly and professionally, with government leaders cooperating effectively and listening to experts, while reaching out to many different stakeholders to handle the crisis. Our total of 7460 confirmed cases and 102 deaths is tiny compared with many other countries.
As a result, many people have quickly become complacent. It is rare to see anyone using hand sanitiser when they enter shops, malls or public buildings, and even rarer to see people wearing masks. While we are not eating out as much as before COVID-19, this is probably more to do with the economy than fear of going to restaurants.
While the government has lifted many restrictions, it doesn't mean we should be complacent. The disease is still in the community, so we should make choices to stay safe. For example, in Victoria, a lot of the new infections were the result of gatherings at home.
So, download and use the COVIDSafe app. Wash your hands or use hand sanitiser. If you are going anywhere crowded, put on a face mask. Minimise your exposure as much as possible. In other words, you don't have to spend your weekend browsing the mall. Instead, decide what you want beforehand and seek that out.
Also, respect people who choose the safest options. After all, if they are protecting themselves, they are also protecting you at the same time.
The economic balance
There is an issue with pandemics and other outbreaks. Protecting people has to be balanced against the economy. Restaurant owners are often just getting by, tourist zones are really struggling, and live music venues along with most of the entertainment industry has been devastated. There is a flow-on effect for the whole of the economy, not just those directly affected.
I am anticipating at least one comment about staying home and not going out. However, it is valuable to the greater community to have a holiday, even if it is a just long weekend away, to eat out at restaurants instead of using Uber Eats, go shopping in local stores and so on. Just make sure you stay safe when you do.
What is an acceptable number of deaths
Ideally, we don't want to have any preventable deaths, yet there are still lots of things out there that can kill us. The temptation is to look at influenza deaths for comparison, with 2019 being the worst year on record in Australia with over 800 deaths from the flu. Just a reminder, if Australia had responded to COVID-19 as badly as the UK and the US, we would have had over 10,000 deaths.
I think it is better to compare road deaths to COVID-19 deaths. After all, the cars kill lots of people, yet that is balanced by the economic and lifestyle benefits of private car ownership. In 2019 there were 1182 fatalities on Australia roads.
In other words, even with a well-managed response, we can expect people to keep getting Coronavirus and with some people dying. What matters is that Coronavirus can quickly escalate, so that a few cases quickly spread out into the community, which causes a large number of deaths. This is what we as a community should be trying to prevent.
I am going to keep repeating this (sorry, it can be annoying, but it is important). You also have to play your part in keeping the numbers down. You drive at the speed limit, have your car regularly serviced, you pay for your flu shot every year and take days off if you have the flu, and you will wash your hands, cover your mouth with your elbow when you cough, avoid crowds and even wear a face mask when it is called for.
One important concept is the social bubble. This means having a group of people that you meet in person, rather than connecting with lots of other people. For example, at work, you might spend time face-to-face with your team, but you might use video chat to communicate with other stakeholders. At home, you have your circle of friends and family, and that circle might avoid meeting too many other people.
When will it all be over
At the moment, no one can really say even remotely when the COVID-19 pandemic will be over. The disease is widespread in many countries, and while multiple vaccines are being developed and treatments are being tested, these may not work effectively. Also, with Coronaviruses, natural immunity typically only lasts for a few months. Which means that even if a vaccine is developed that works, it may only for a short time before you need booster shots. That is if they can create one that works at all.
We sat out the first wave of COVID-19 in Australia, but to keep sitting out the pandemic until it is over may not be plausible. Instead, we have to accept that there will be more cases and there will be deaths. Rather the strategy is good disease management along with responsible behaviour from the public which will keep the number of cases low and manageable.
For the foreseeable future, Coronavirus is just something that we will have to live with. The government guidelines are something that any responsible person can follow, but we also have to play our part and go one or steps beyond that, ensuring that are washing out hands, wearing face masks when it makes sense and just being sensible about what we do. This not only protects ourselves and our loved ones but also protects the community.
Yup adds up with the wide reading I have done. Bottom line is its here for the foreseeable future so we have to learn to live with it and manage our lives to accommodate it. Thanks for an excellent easily read article.