I have been watching with some alarm as the UK and Australia respond to #covid19
Both countries have responded badly, although today the UK did a 180 turn.
So here is a thread for Aussies 🇦🇺 on why you should ignore the government. Don't wait for them to tell you to act...
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Both countries have responded badly, although today the UK did a 180 turn.
So here is a thread for Aussies 🇦🇺 on why you should ignore the government. Don't wait for them to tell you to act...
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First up: the UK announced an approach of "herd immunity", where enough of the population is infected (and then immune) so as to provide a buffer to protect the vulnerable.
THIS IS NUTS, but Australia followed and it was in the press on the weekend
afr.com/policy/health-…
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THIS IS NUTS, but Australia followed and it was in the press on the weekend
afr.com/policy/health-…
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But we *don't even know* if you can have long-term immunity to the SARS-CoV-2 virus!
Maybe like the flu, everyone who gets it now will be susceptible to a different strain again in a few months... along with another wave of fatalities.
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Maybe like the flu, everyone who gets it now will be susceptible to a different strain again in a few months... along with another wave of fatalities.
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Worse than that, the maths just doesn't work. It leads to massive death.
The UK strategy was based on having 60-70% of the total population getting infected. Hospitals just can't cope.
Let's run the numbers for Australia....
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The UK strategy was based on having 60-70% of the total population getting infected. Hospitals just can't cope.
Let's run the numbers for Australia....
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60% of Aus population is 15 million people infected. The WHO estimates that 5% of cases are critical infections, requiring a ventilator to survive.
So that's 750,000 critical infections requiring ventilators at some point.
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So that's 750,000 critical infections requiring ventilators at some point.
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Australia has around 2,000 ICU beds fitted with ventilators.
(according to this story quoting the intensive care society: smh.com.au/politics/feder…)
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(according to this story quoting the intensive care society: smh.com.au/politics/feder…)
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Imperial College re-did the UK calculations over the weekend. The herd immunity strategy would lead to 250,000 avoidable deaths EVEN IF YOU IMPLEMENT SOCIAL DISTANCING FOR OLDER PEOPLE.
imperial.ac.uk/media/imperial…
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imperial.ac.uk/media/imperial…
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Just look at this chart from the UK modelling (previous tweet). Even with case control, quarantine, and strict social distancing for older people, hospital capacity is totally swamped. At the peak, there are 50,000 more critical cases than hospital *surge* capacity!
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And so Boris Johnson has now completely reversed course on “herd immunity” and appealed to UK engineering firms and production lines to re-tool and help produce more ventilators for the country.
bbc.co.uk/news/business-…
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bbc.co.uk/news/business-…
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Along with talk of "herd immunity" there is also this idea of "flattening the curve" to slow the rate of transmissions. This is basically right in theory, but a bit misleading in practice...
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...to flatten the curve to be within hospital capacity (see chat, tweet 9), you have to basically eliminate the curve entirely. That isn't a curve, it is a flat line.
There is no "slow" version. There is just total containment. This blog summarises: medium.com/@joschabach/fl…
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There is no "slow" version. There is just total containment. This blog summarises: medium.com/@joschabach/fl…
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And to achieve total containment, you have to think about community transmission.
This page has some great simulations... ultimately you need extreme social distancing to achieve containment.
washingtonpost.com/graphics/2020/…
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This page has some great simulations... ultimately you need extreme social distancing to achieve containment.
washingtonpost.com/graphics/2020/…
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And ultimately, it was a new study on community transmission, published just today, that prompted me to write this thread.
79% of all cases come from an undiagnosed carrier. Who are these undiagnosed carriers? Maybe you!
science.sciencemag.org/content/early/…
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79% of all cases come from an undiagnosed carrier. Who are these undiagnosed carriers? Maybe you!
science.sciencemag.org/content/early/…
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This study, based on Chinese data (where they did a lot more diagnostic testing than Australia!) found that for every 1 diagnosed case, there are 5 un-diagnosed carriers circulating in the community.
science.sciencemag.org/content/early/…
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science.sciencemag.org/content/early/…
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So multiply published stats by 6x. That's roughly how many people are circulating. Most will show very mild or no symptoms. You might have it! But 5% of people will die if they get it and aren’t hospitalised.
79% of cases come from an undiagnosed carrier. Maybe it's you!!
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79% of cases come from an undiagnosed carrier. Maybe it's you!!
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Of course, if there are relatively small numbers (say, less than 100 cases?) it may be possible with thorough measures to contain the virus, eg by diligently tracing every person that an infected person comes into contact with.
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Back in Jan, Sth Korea did this to contain their first 30 cases. But the 31st person ignored advice to get tested, went to lunch and to church, infecting many others.
The outbreak at that church is linked to over half of all of South Korea’s cases!
graphics.reuters.com/CHINA-HEALTH-S…
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The outbreak at that church is linked to over half of all of South Korea’s cases!
graphics.reuters.com/CHINA-HEALTH-S…
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Unless you can precisely control every case, there will be broad community transmission. Australia has passed this tipping point: community transmission is happening.
But it varies. ACT has 2 known cases, maybe they can contain through case management. NSW has almost 200.
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But it varies. ACT has 2 known cases, maybe they can contain through case management. NSW has almost 200.
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The frustrating thing is that over the last few days I watched the UK stuff it up, realise they were on a course for major disruption of the health system (and major death!), and do a complete 180. Australia is a few days behind, it seems yet to catch up on the policy front.
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The Aus rate of growth is middle-of-the-pack, perhaps b/c of lower density or early action on borders.
But the trajectory still leads to 50,000 cases in three weeks' time (PLUS maybe 5x that amount of undiagnosed cases circulating in the community)
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But the trajectory still leads to 50,000 cases in three weeks' time (PLUS maybe 5x that amount of undiagnosed cases circulating in the community)
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Aussies should start practicing social isolation today. Avoid school, avoid work (if you can work from home), avoid sport training, avoid cafes, avoid friends.
Definitely avoid older people and people who have pre-existing health conditions (you might have it already!!)
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Definitely avoid older people and people who have pre-existing health conditions (you might have it already!!)
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The basic message for Aussies is DON'T WAIT for the government to tell you what to do about COVID-19
#auspol is too slow.
Stay at home. Avoid *everything*. Don't accidentally infect your grandparents.
/end
#auspol is too slow.
Stay at home. Avoid *everything*. Don't accidentally infect your grandparents.
/end
I should clarify: when I say "leads to 50,000 cases" that is based on current growth rate... but I think (hope!) that this rate won't continue.
Even though I criticise current response, it is at least *something*, and should slow the growth. I would be shocked if we hit 50k
Even though I criticise current response, it is at least *something*, and should slow the growth. I would be shocked if we hit 50k
Update: each day, Australia is slowly tightening its policy framework. Yesterday DFAT told people to come home, today, stronger domestic guidelines.
Moving in the right direction (but worth noting we now have more cases than Singapore and Hong Kong)
Moving in the right direction (but worth noting we now have more cases than Singapore and Hong Kong)
And of course, despite all the above, tighter social distancing is *not* an excuse for panic buying and hoarding!
Further update: someone has done much better work than my back-of-the-envelope looking at #COVID19 and Australia's ICU capacity. (@MeganHiggie, I think)
medium.com/@megan.higgie/…
medium.com/@megan.higgie/…
A lot of Aussies today are talking and Singapore, Hong Kong, Taiwan...
They jumped into total crisis mode back in January!
Australia has *more* cases than these countries. Their strategies from 2 mnths ago are good for a diff stage of infection to where Aus is now
They jumped into total crisis mode back in January!
Australia has *more* cases than these countries. Their strategies from 2 mnths ago are good for a diff stage of infection to where Aus is now
