I appreciate though that the Reff drops significantly when 70% of people are vaccinated, even though vaccines don't guarantee sterilising immunity.
For real though, if this happens - holy hell, that'd be amazing. I'm just wondering if 'optimal' TTIQ is what we'll see. Which is fine because the modelling gives scenarios for partially effective TTIQ as well
Great questions on #thedrum put to Prof Lewin. She confirms that once we are at 70-80% vaccination, whether we start off with 30 cases, or 100's of cases, we're in essentially the same situation. 'We're catching the same curve, just getting to the peak quicker', to paraphrase.
She's pretty clear on this. @bairdjulia asked the question a few times to confirm.
Re kids: Prof states modelling examined benefits of targeting different population w/vaccinations, and impact on transmission/hosp/deaths. 20-29, big pay off. 12-15's not as much. Affirms they SHOULD be vaccinated. But modelling says it shouldn't impact opening up plans.
I’ve told hundreds of people now that they’ve tested positive for Covid. I’ve had to decide when they were tipping over from being mildly unwell, to requiring oxygen in hospital. I’ve had to tell their family members that they’ve gone from being unwell to being critically ill.
Many time when I have these conversations, I witness people experience vulnerability, fear and uncertainty that is well founded.
Seeing maskless protesters spout lies that minimise the harms of this disease feels like a massive insult to the suffering I have witnessed.
We must hold it together for 3 months. If, I stress, if, we get the outbreaks around Aus under control, we can't risk another. That's playing russian roulette with 5 full chambers. Bolster quarantine chain. Strategically vaccinate, including contacts of quarantine workers
Currently household members of quarantine workers are eligible - not enough. we must reach out to them, incentivise it. Include their social contacts too. Pay them a grand each. Who the fuck cares? Do you know how much we've spent on submarines that don't submarine very well?
If NSW is the only place with numerous unidentified chains of transmission, surely its in the interest of all states to divert majority of vaccines to NSW to end this outbreak? 1-2 mil doses of Pfizer in next month of lockdown could radically change transmission dynamics.
Vic is getting this outbreak under control- what’s the biggest risk after its sorted and lockdowns end? Probably the reservoir of 100s of covid cases across the border. Same for QLD. Same for any state that literally doesn’t have Resident Evil style laser beams at the borders.
There probably is a mathematically optimal point to that balances the benefits of vaccinating nsw to control outbreak vs the benefits to other states from vaccinating their own populations to protect against leaks. point is - the 2 SHOULD be balanced, wherever the sweet spot is.
Lockdown with couple of cases- this is delta life. It’s obvious now- tracing alone can’t RELIABLY control outbreaks. If we somehow avoid permanent seeding of Covid, there’s one way to avoid future lockdowns.
Bolster the shit out of quarantine chain till Aus is highly vaccinated.
Mandate, enforce, audit airborne precautions and vaccination for workers.
Incentivise contacts of quarantine chain workers to get vaccinated with Pfizer. Their families. Their mates.
Big difference between making people eligible, vs actually reaching out and getting it done.
The travel cap has been cut in half and that may help. In the meantime ventilation should be audited regularly with air purifiers to be used widely.
spending a few hundred million means nothing when we are trying to save many lives and billions of dollars per week.
So a few weeks ago, I met someone (not a patient) who said 'Hmm I don't think I'll get the vaccine, I heard it may cause infertility' - (a comprehensively debunked piece of misinformation).
Well, yesterday I overheard him saying something that made me laugh with joy.
That first time we spoke, I asked him where he'd heard this claim of infertility (he couldn't remember). I told him I'd heard something similar too, and looked into it. I told him where the claim originated, and why I didn't believe it. He went 'huh'.
I didn't know for sure if he was persuaded by this. In a way I was too late - two other people I know were now also repeating this false claim. Where did they hear it from? From him. Misinformation was miles in front of truth.
But I also had time - I knew I'd see him frequently.
With 6 days of zero cases, its stupid to assume Vic has achieved elimination. But 1-2 weeks from now, if we find ourselves staring at a line of donuts on the calendar, it'd be stupid to rule it out. At this point National Cabinet may want to reconsider the #covid19aus strategy.
Now, some would say they already should consider it, but I have very low expectations of our federal government.
'Wouldn't elimination mean doing the same thing we've already done?' I'd say yes and no, \mostly no. We could have a national standardised approach to #testtraceisolate & thoroughly reassess Infection Prevention Control in high risk settings (factories/food/health/aged services)
These 1 hour limits need to be reviewed. Should test all customers even without symptoms. Most of those infected (if any) will test positive by day 5. No isolation required unless this becomes a cluster. #covid19aus
This is something both New South Wales and Victoria should strongly consider. We have so few cases that being aggressive with cluster management comes with almost no cost. #dropthehammer on every potential cluster.
Folks the one hour time limit is completely arbitrary. Not supported by any meaningful data.
Now that’s Perfectly understandable at a time when testing resources are in short supply - you need to draw the line somewhere - but this is not a problem right now.
Questions for tomorrow's presser, pls consider! 1/ Vic CMO said y'day we might be the only nation using n95 masks on COVID wards. Considering it's widely known that Singapore, S.Korea, HK etc adopted this practice in MARCH, is it concerning that our top med officer isn't aware?
2/ How's the trial of isolating 'contacts of contacts' progressing in Kilmore progressing? Do you have plans to roll it out elsewhere? Are you considering significant $ incentives to encourage people to comply, as it might be difficult to convince contacts of contacts to isolate?
3/ Workplaces: Looking for infections in hi-risk settings is critical when we open. Gov announced asymptomatic testing of 95 such businesses 2 weeks ago.
But atm, owners can only ask 25% of workforce to be tested per month. How can we increase this? Can new antigen tests help?
Stunning claim today by senior Vic health official today "We have the strongest PPE guidance...in the world.. one of the only, if not the only place I'm aware of where people are wearing them (N95 masks)... in our COVID wards".
But then: (1/n) abc.net.au/radio/melbourn…
What's the initial source of the Box Hill outbreak? Was it a patient, or a staff member who was previously working on a COVID ward? Do we know?
(This is relevant as staff's masks were not fit tested when working on the COVID ward. Nor were they 'co-horted') #covidvic#springst
@healthcare_19@NeelaJan@an_leavy any news about origin? cmo dismissed that fit testing would've made a difference as he said outbreak was on general ward. but that assumes infection didn't originate from HCW who had been working on covid ward prior.
If the origins are uncertain then how can the Chief medical Officer state that fit testing of masks is irrelevant to the box hill outbreak, as he did this morning on abc radio???
How do we upgrade?
Testing - be far more flexible with our criteria for testing in outbreaks, ESPECIALLY with CASUAL contacts. And for both close/casual contacts we need to consider testing on day 5 as we know home based quarantine is flawed. Once lockdowns are over, tata.
Testing (more) - every casual contact/anyone who stepped foot on a ward during a hospital/aged care based outbreak should be tested on day 5, not people who spent more than 29 min there. Somehow this got through to Vic gov after days of questioning.
Even @DanielAndrewsMP, not medically trained, sees the issue in a testing criteria of min. 30 min exposure in hospital outbreaks. The equivalent of dropping a Tim tam on the floor and saying “10 second rule lol” Why’d it take tweets/ journos asking to get this changed? #covidvic
DHHS is TOO RIGID with their approach. You don’t need to test every casual contact at a high exposure site. But you SHOULD test if
> there have been positive cases at that site who were casual contacts (Chadstone)
> indoor setting, small no. of ppl
> aged/healthcare #covidvic
This is totally impractical with 700 cases a day. And yet a no-brainer with 6-15 cases a day.
Fed gov caused the aged care disaster but I don’t ask for leadership changes in the middle of a pandemic.
Most docs, esp me, were v angry at Jenny Mikakos’ Multiple insults to the profession. No chorus of ‘resign’. We know the bigger problem is systems not people. Plus...
Let's exaggerate: Imagine each of the 9 location had 2000 people exposed as casual contacts.
Imagine we asked them to get tested, & 100% *actually* turn up on the SAME day.
That's 18K tests.
We were testing 30K/day recently.
Not saying we must test all, but can test *much* more
This is why those 30 minute limits on hospital outbreaks (which was insane) don't make sense.
This is why it *not* testing all the customers of the butcher in the infectious periods (1000 ppl max) when there was evidence of 2xCASUAL contact transmission doesn't make sense.
'proportionality' was not a great excuse in and of itself for either of these 2 examples.
Which is why, despite citing 'proportionality' a few days ago to justify the 30 min limit (maybe it was deputy?), CHO made the right call and asked for it to be changed today.
Comparing NSW to VIC now is a bit tricky - Both states are achieving similar case numbers, but Vic is worse than it looks right now, barely achieving the same result with lockdowns. Open up = drastically worse. RE: what is truly unique about Vic vs NSW approach -
No doubt Vic contact tracing was inadequate, likely due to a highly centralised structure of DHHS vs localised health model NSW. Lack of local knowledge and inefficiency come with this.
And although our CHO is highly competent, despite same job title as his interstate counterparts, did not have same rank in hierarchy.
1) The staff infected at Box Hill on the covid ward - were their masks fit-tested ????
2) Box hill outbreak - staff are confused by messaging re: testing. They've heard 'all staff at the facility will be tested' publicly, while internal memos tell ask not to get tested unless they spent >29 min on ward/work regularly on the ward/direct contact w confirmed case
Specific quote attributable to anonymous senior staff member "should i go to work as planned as I have been told not to test as have most of BHH staff. Yet you say we will be tested first".