Short 🧵In the bundle of things we can do to help manage the coming COVID challenges, being fully vaccinated in really the most important. Then testing, isolating, masking, living an outdoors life & getting treated early if eligible. And you can only get treatment if you test! I have just gotten my fourth (bivalent) dose, having been ferried by COVID infection, a cortisol shoulder injection, a couple of colds and generally being busy. But now is the *perfect* time for that third or fourth dose, especially for older folk.

🧵It's clear were in the 'trough' part of COVID-19 activity now, with fewer cases and hospitalisations than we've seen for months. That's very welcome, of course. It may also be that the coming wave is lower and slower than the waves we've seen in 2022, for different reasons. 1/5 Most previous waves have been driven predominantly by new variants of concern. The coming 'wave' - if that's the term - may be driven more by the waning hybrid immunity (recent infection + vaccination) than by any particular variant. Make no mistake, the variants will come. 2/5

COVID Vaccines 🧵:
The great majority of us have had at least two COVID vaccine doses, most of us have had three, and many have had four. But this pandemic isn't over because viruses try to evade controls. Some simplistic commentary implied vaccines=the end of the pandemic. 1/4 COVID vaccines have been incredibly beneficial. 20 million lives saved globally and counting. They are terrific at protecting against severe illness. But they wane, and new variants get around their ability to protect us from infection. 2/4

MPX/Monkeypox:
@WHO has declared MPX a Public Health Emergency of International Concern (PHEIC). I think that's appropriate to give it the focus, priority &resourcing globally. It is not as deadly as some first feared, but produces significant & sometimes disfiguring illness. 1/ There are over 16,000 cases in 74+ countries globally and numbers continue to increase rapidly. Australia has seen fewer cases but we can expect more & local transmission. Those affected are primarily MSM / men who have sex with men but potential for others to be infected. 2/

#Omicron - what's known and not (yet) known. There's been a lot said about this but the thing to really emphasise is that we are still in very early days of understanding this Variant of Concern, as WHO has designated it. 1/7 It clearly seems to be out-competing the Delta variant in Southern Africa. This may be due to higher effectiveness in transmission, immune escape or (perhaps most likely) a bit of both. In any case, that's a strong reason to watch it very closely and urgently understand more. 2/7

The return to school means we have to do everything we reasonably can to protect children, teachers, carers and their families from COVID-19 transmission. That means vaccination, ventilation and virus detection. 1/6 abc.net.au/news/2021-09-2… Ventilation starts with assessments, including structural and CO2 monitoring to gauge the risk of indoor transmission. Many issues of poor ventilation can be managed with picking the right rooms to open to first, and others through the simple opening of doors and windows. 2/6

I love freedom. Who doesn't love freedom? I want freedom from being amongst the over 4 million official (and likely 10 million actual) COVID deaths globally. And freedom from being amongst the over 13 million current active cases. Or millions of current Long COVID cases. 1/ Long COVID doesn't make you free - debilitating fatigue, ongoing shortness of breath, neurological and psychiatric symptoms for weeks to months. We've avoided a huge potential burden of illness in Australia but the 30,000 cases we've had still represents so much suffering. 2/

A few months ago, a number of countries were in a state of 'no COVID-19 transmission' that Australia enjoys today. Many of them - Mongolia, Timor-Leste, Vietnam, Laos, Singapore and Taiwan - had enjoyed that status for months, or indeed since Feb 2020. They are now all experiencing outbreaks or established community transmission. Singapore and Taiwan are now going into restrictions or lockdown to get on top of it. Why does this matter? Because we can't take being free of COVID for granted - especially as variants emerge.

THREAD: With over 350,000 cases of COVID-19 reported daily in India, it's clear that the pandemic is far from over globally. The true *daily* figure is probably over two million. I'm very glad that there is now urgent consideration of critical support to the Government of India. This is also a stark reminder that we will need high vaccination coverage to truly protect the Australian population. With all over-50s becoming eligible to receive - as I have - the AstraZeneca vaccine, I really hope we see increasing uptake from here on in.

Lots of confusion about quarantine vs isolation. Quarantine = the period when you may be incubating illness or the period following exposure before you may develop illness. This period applies to close contacts and international travellers who may have been exposed overseas. 1/x Quarantine is 14 days (REGARDLESS of test results) because someone in quarantine could become positive at ANY POINT in this timeframe. A negative test is no guarantee that you won't become positive later in the 14 day period. You may. You may not. 2/x

This is rightly worthy of celebration. After the toughest year for many Victorians, it’s important to recognise this achievement. It took all of us to get here and it was a long and painful journey but we held the course. I can’t thank Victorians enough for that.

https://twitter.com/vicgovdhhs/status/1332068932270903297

Many have suffered enormously through recent months and many more continue to struggle. We should never forget that, and so we must continue to reach out to help each other. Over 800 Victorians tragically died. Parents, grandparents, people we love and miss.

My advice to the Victorian Government was and continues to be that to slow the spread of coronavirus, schools should undertake remote learning for term two.
1/3 This is because having around a million children and their parents in closer contact with each other, teachers and other support staff has the potential to increase cases of coronavirus not just in schools but across the community. 2/3

Thread:
Victoria has been working on its #pandemic preparedness for #COVID19 for some weeks. It's clear that with local transmission in several countries that a pandemic is very likely, if not inevitable. We are working rapidly on planning and surge with our health sector. (1/6) We've provided guidance to practitioners and many communications materials but are now focused on the models of care that will need to be in place - clinics, phone triage, home care, right through to ICU and aged care. There are dozens focused on this across the sector. (2/6)