How the current public health strategy is not working in Australia
Despite a massive increase in Australian infections and death in 2022, a new Prime Minister and cabinet dismantled the remnants of the public health response to #COVID in Sept. 2022 (abc.net.au/news/2023-01-2…).🧵1/
Despite a massive increase in Australian infections and death in 2022, a new Prime Minister and cabinet dismantled the remnants of the public health response to #COVID in Sept. 2022 (abc.net.au/news/2023-01-2…).🧵1/
An unrolled one-page web view for this long thread that may be easier to read or share can be found here (
https://twitter.com/jeffgilchrist/status/1619665991566524416). 2/ #LongCovid #LongCovidKids #Australia #DavosSafe
This 🧵 summarizes an interview by Laura Tingle on Australia's latest COVID strategy with Professor Brendan Crabb from Melbourne's Burnet Institute, frontline doctor Nada Hamad who is also suffering from Long COVID, and economist Richard Denniss from The Australia Institute. 3/ 
Before Omicron, Australia was able to maintain very low levels of COVID transmission and therefore hospitalization and death compared to most of the world. 4/
You can see Australia maintained much lower levels of hospitalization compared to Canada until Aug. 2021 when the Delta variant hit at the end of 2021, and then cases skyrocketed and had more similar hospitalization patterns to Canada afterwards ( ourworldindata.org/explorers/coro… ). 5/
There were about 15,000 deaths in Australia in 2022 compared to 2,000 deaths in the two years before that, a 10x increase compared to the 2021 death toll making COVID the 3rd leading cause of death in the country ( ourworldindata.org/explorers/coro… ). 6/
The current approach in Australia is to "let it run" in the wider population while trying to protect those who are deemed vulnerable (e.g. elderly, immunocompromised) which is clearly not working since they are on their 4th wave in just the past 12 months. 7/
Dr. Crabb says that Australia will need to change to an anti-transmission strategy which he believes is highly achievable and can be done without significant disruption. 8/
Dr. Denniss points out that the right information is not even being collected to properly assess the impact of COVID on the economy. 9/
If the average person with COVID takes 5 days off work when they get infected then for every million cases of COVID, that is 5 million days of sick leave. If 10% of people getting infected develop Long COVID, that is 100,000 people from that group. 10/
Industry in Australia is not set up to handle usually healthy middle aged people taking long amounts of time off work which will result in significant impacts on labour supply. 11/
He gives an example that the number of people being off sick would be similar to the amount of skilled migrants Australia is trying to bring in to fill current gaps. So COVID is causing a similar level of skills shortage most days of the week now. 12/
Dr. Hamad explains that the healthcare system already did not have much excess capacity before COVID and were already close to the limits of what could be offered. 13/
She says the biggest thing with COVID they hadn't taken into account was not the deaths but the morbidity and all the complications people suffer after infection. 14/
It is essentially a new chronic illness, even if you don't take into account Long COVID, but just from the other complications that people come into the hospital for after infection hasn't been accounted for. 15/
The impact on healthcare workers has been disproportionately higher with most being most women who often have to take care of their own families who become ill with COVID in addition to themselves. 16/
Dr. Hamad says, "I certainly don't think the narrative that we are in a post-COVID world and we can go back to everything being like it was before is a realistic one." 17/
From a major study in Nature on Long COVID they found that it has real mechanistic, molecular, and cellular underpinnings ( nature.com/articles/s4157… ). 18/
Dr. Crabb states, "It's sobering the nature of that damage not just to the respiratory tract where the virus infects but to other organs and tissues in the body, your brain, your heart, the blood vessels that go to all tissues in the body... " 19/
"Most significantly your immune system itself, which renders us potentially susceptible to other infections which might be a key reason why we are seeing surges in other infections." 20/
The only real way to prevent Long COVID is to not get infected by COVID in the first place. This is another reason why it is important to change the strategy to anti-transmission. 21/
Reinfections are very important to avoid, as every time you get infected, you have another chance of developing Long COVID. 22/
Dr. Denniss points out that just like COVID can affect all different parts of the body, the virus also affects all different parts of the economy and the budget. 23/
If hundreds of thousands of people are regularly off work sick, then either the incomes of these people will be lower or the profits of the organizations they work for will be lower, which means government revenue will be lower. 24/
COVID will continue to be a drag on economic growth for as long as the virus is impacting us. With so many more people with ongoing illness, the government will either need to start spending more on healthcare or people will have to accept even lower standards of healthcare. 25/
Dr. Hamad explains that right now we don't really understand exactly what it means to have 3, 4, 5 or even 8 recurring infections but what we do know is that even 1 infection can have long-term impacts. 26/
Aside from Long COVID some studies have found that the majority of people (70%) have at least 1 organ affected longer-term (2 months to 1 year) and 33% have multiple organs involved. 27/
She points out that if we had known earlier that asbestos and smoking significantly increased the risk for causing lung cancer, we wished we would have done something sooner. It is much better to prevent rather than try to cure after the fact. 28/
There are simple things that can be done to help reduce the risk, such as trying to improve ventilation, masking and boosters. 29/
It is not about limiting your life entirely but about living your life slightly differently to minimize that risk instead of accepting blindly, an unknown risk that is likely going to affect most people because most people have been infected with COVID. 30/
Vaccines still seem to be providing very good protection from severe disease *if* you have received a booster in the past 3-6 months. Click "Show replies" 👇 to continue. 31/
More research should be done in this space to develop better vaccines that can protect against all variants and protect against transmission. 32/
Dr. Crabb highlights that Australia is currently in the worst public health disaster since the second world war. Life expectancy is no longer increasing and 17% more Australians are dying than would be expected. 33/
In order for people to understand just how serious the situation is, Dr. Crabb believes the Prime Minister needs to stand up and tell people they are changing tack, that COVID is exceptional, and the current strategy isn't working well enough. 34/
With a reduced transmission strategy thousands of Australian lives can be saved and hundreds of thousands from Long COVID and encourage citizens to come with them on that journey. 35/
It is not about changing rules, but a change in mindset and making everything that is required available (e.g. high quality masks, tests, vaccines) and promoting the use of ventilation and filtration devices in our buildings. 36/
Testing needs to be made available as you can't get treated if you can't be tested and you can't protect those around you can't get tested and know you are positive. 37/
"It is not hard to make a big difference but it will require an attitude shift from the top to achieve anything given the bind that we are in." says Dr. Crabb. 38/
Last year a group of 386 multidisciplinary experts from 112 countries published recommendations to reduce the threat of COVID-19 and future pandemics/epidemics so now is the time to actually start implementing those (
https://twitter.com/jeffgilchrist/status/1608809251572715521). 39/
The wealthy already know how to protect themselves from COVID and don't think it is mild, so it is time change so everyone can be #DavosSafe (
https://twitter.com/jeffgilchrist/status/1618223851212767232). 40/
If not, we will continue to see more and more real-word examples of people suffering from long-term impacts from infection such as to the brain and neurological complications (
https://twitter.com/jeffgilchrist/status/1617492887461318656). 41/
A real-world example of a young woman 28 years old disabled from the pandemic, infected in March 2020 before the vaccines were available with only a mild illness at first but then she never got better ( thetyee.ca/Analysis/2023/… ). 42/
There are also real-world examples of the impact of COVID infection time from cardiovascular complications you can read about here (
https://twitter.com/jeffgilchrist/status/1586043132134576128). 43/
There is actually an updated version of this graph since I last save it. You can always get the latest version here ( ourworldindata.org/explorers/coro… ).
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