Pearls and Irritations

The basic imperative for controlling an epidemic wherein the inhalation of aerosolised viral particles can cause much illness and death, is to stay away from each other.

As the new year begins Australia’s eastern states are walking on a COVID-19 tightrope. While we can take some solace in the likelihood that COVID-19 vaccines will help us gain ultimate control of the epidemic, that help is many months away. It is essential that all our energies are focused on the here and now. While our COVID-19 situation is so much better in comparison with the raging, out of control epidemics in many countries, our success is fragile.

The 2020 outbreak of COVID-19 in Melbourne, when 700 plus cases a day were being diagnosed with the death rate soaring, forced Melbourne to ‘lockdown’ for more than three months. As we look at our current situation, with 18 new cases in Melbourne more than 150 in Sydney, with one cluster in Western Sydney growing quickly and a small number of newly diagnosed infections in Queensland, we should be nervous.  We do have cases where we have been unable to determine the source of their infection and that is a major concern. Our talented contact tracing teams are stretched to the limit and, as we saw in Melbourne, just two cases that escape timely detection can lead to a major outbreak.

Sometimes I think that rather than talk about the possibility of ‘exponential’ growth’, it is better to look at a line of figures to better appreciate the danger. We are in big trouble when, on average, one infected person infects three others. Three cases quickly become 9 then 27, 81, 243, 729 etc.

As I have explained in a previous contribution herein, the SARS-CoV-2 virus has had the opportunity to multiply in over 85 million of us worldwide and, in so doing, experiment with structural variations that provide the virus with additional advantages. As has been much publicised, new variants that are as much as 70 times more infectious are sweeping across the world.

Such variants have reached Australia.

We continue to have many returning Australians and indeed visiting foreign nationals who arrive infected and must quarantine for two weeks. But, as we have seen, while this is essential it is hard to make a system such as this human proof. Bus drivers transporting airline crew or returning travellers have been infected and effectively imported the virus into the broader community.

We have locked down large segments of our population of late and while certain circumstances demand such a strategy, the health, psychological and economic consequences are serious as are the inevitable border closures which follow.

This brings us to a crucial question:-

Are we in January 2021, looking at all the risk factors we face, doing all that we can to avoid a major COVID-19 outbreak that would demand larger lockdowns, cause more serious illness and deaths and stress our hospitals and health care workers?

No, we are not!

As we have a large segment of our community locked away from the rest of us and even so are seeing cases in non-locked down areas, how can we possibly be comfortable with a decision to allow 24,000 people to come to the Sydney Cricket Ground on Thursday next? I love cricket as do most Australians but compared to the serious epidemic we are fighting the ability to attend a cricket match in person should be irrelevant. This is especially so when everybody can sit at home and safely watch the event on TV.

The SCG Trust has social distancing arrangements in place to thin out the crowd at the match. But individuals are not being lowered by helicopter into the distanced seats! Thousands will take public transport to the venue. The crowd must move through turnstiles, and will no doubt want to visit a bathroom and probably grab a beer and a sandwich, activities that bring people closer together. Excited fans jump up and down, clap and shout. Now we are asking (not requiring) people from Sydney’s western suburbs near the Berala cluster to reconsider attending. We are telling people in Northern Sydney that they may not go to the cricket. Logic?

The government has at last responded to the advice from so many health professionals (P&I December 21, 2020) to mandate the use of masks when social distancing is not possible. It has taken a lot of pressure for the NSW Government to get this crucial strategy in place. The CDC in America, reviewing all studies on the question, concluded that if 90% of us wear masks transmission of the virus would be reduced by 70%.

Certainly, if the Test match is to allow spectators, masks should be worn at all times when not seated but while this would reduce the risk of cross-infection it would not eliminate it. At this fragile time why on earth take the risk associated with a large crowd? The risk/benefit ratio is all in favour of risk.

The same arguments should be brought to bear on the decision to allow spectators to attend the Australian Open tennis in Melbourne at the beginning of February. Over the last few months, the ATP and WTA staged many high profile tournaments sans spectators. The final event of the year held in London had players and a very limited number of their support crew present. The matches were, of course, televised to world-wide audiences.

Anyone who has been to the Australian Open knows that a big part of the fun is associated with crisscrossing the park to dip into matches on numerous courts. The same crowd behaviours that are discussed above for the cricket would apply to the tennis. We are having a very wet summer and it is highly likely that the roof would frequently be closed on the three major courts in Melbourne requiring the use of air conditioning. Surely, after the ordeal Melbourne endured last year, most Melbournians would accept an analysis that concludes that it is just not worth the risk to hold a potential super spreader event.

The tournament could be held and televised. I would argue that given the fragility of our control of the epidemic at the moment, we should be embracing all known risk reduction tactics as we look to a major effort in 2021 to create the needed herd immunity that will see us all enjoy attending cricket matches and the tennis in 2022.

Gladys and Dan, these sporting events are just not worth the risk.

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