Thread by @DrEricLevi

What did Melbourne, Australia do to get our covid numbers down from 700+ a day to zero in the last 48h?

Here’s a list:

5km travelling limit
1 hour outside the home
Leave home only for essential work, essential activities, medical, care, health/exercise reasons.
Curfew 8pm-5am

Schools online.
Schools open for vulnerable kids or those whose parents are essential workers.
All activities online.
No social gatherings, except for funerals, etc.
Reduced hospital activities.
Pre-operative swab for all operations.

Operating theatres at 50% capacity plus emergencies.
Splitting of teams.
All meetings online.
No retail. Essential retail only (medicine, building maintenance, etc)

What did we learn? People got creative:

Zoom health classes.
Zoom parties.
Online cooking classes.
Restaurant take outs and deliveries.
Restaurant home cooking classes.

Strong community response:
Faith communities buying groceries for people.
Charity organisations feeding immigrants and international students.
Increased courier and logistics industry.

Changed hospital admission profile:
We had much less admission for bronchiolitis, pneumonia, middle ear disease complications, trauma, etc.

Yes I note there is increased mental health and domestic violence presentations.

No increase in rate of suicide. I need to underline this as there are claims that suicide is increased. But our suicide numbers from the State Coroner has remained stable.

Changes in the way we interact at work. It makes us realise that there is an inherent resilience in people and of course we all did what we can to help.

My patients are all understanding of every change that happens to hospital regulations.

Lots of things we could have done better:

Assist the poor, marginalised, immigrants, refugees, international students. The community here picked up the deficit.

Manage Aged Care Facilities better. There was a lot of chaos when outbreaks occurred in ages care facilities and staff.

Consistency and consensus in PPE.
Consistency in messaging.

Finally, what I feel we can do better at:

Nurses and health care workers are our most valluable asset in a health disaster.

Do not lose their trust.

Do not lose their heart and health.

ADDITION:

So many people wanted a timeline. Here’s a rough timeline on movements vs infection numbers from @buildmeaplanet

ADDITION:
I also failed to mention universal masking, physical distancing and hand washing.
Because I thought they were all given but I forgot that many of my readers come from countries where masks is a political statement not health protection against an airborne virus.

ADDITION:

Of course the lockdown was tough and costly.

What’s the alternative? Well we just have to look at the thousands of deaths and the overwhelmed health services around the world. In addition, indirect deaths from untreated non-covid conditions.

ADDITION:

Every layer of protection was employed. Personal to shared (social) responsibilities.

Swiss cheese model courtesy of @MackayIM

ADDITION:

It’s not the weather (we were in winter).

It’s not population density (outbreak was in Metropolitan Melbourne, like London, Seattle, Montreal, etc).

It’s not just the science (the whole world had access to the same evidence).

It’s public health & leadership.

ADDITION:

It’s the people.
It’s the people.
It’s the people.

People placed community above self. We got creative in supporting each other.

There’s still more work to be done though. We could do better in certain areas.