Pearls and Irritations

Here is the big so important question. As we prepare to ease some restrictions, will we, in contradistinction to many communities in other countries, embrace the long-term behaviours that must be normalised to allow us to live as safely and productively as is possible in a Covid-infected world? We need to look closely at the efforts of those in many countries for their track record is dismal.

This week, an important, measured and timely urging from the WHO to not use ‘lockdown’ strategies as the primary means of control of the current pandemic has been dangerously misinterpreted by numerous commentators and politicians who have long criticised governments for using this tactic.

In the US, the disastrous and worsening Covid epidemic currently features 50,000 new infections and an average of 1000 deaths per day, the highest in the world. Public health experts agree that for many US states, only a period of lockdown would bring their epidemic under control. The politicisation of the epidemic in that country seems to have ruled out such an evidence-based imperative.

However, in misinterpreting the WHO message, President Trump exuberantly announced at his latest rally that he had been right all along in opposing any shutdown tactics. Here at home, Alan Jones on Sky News this week congratulated himself for the supposed vindication of his long-held anti-lockdown stance. Both gentlemen and many others who voice similar opinions are misleading the public and in so doing undermining public acceptance and confidence in a crucially important strategy.

In fact in the statement referred to above provided by the World Health Organisation’s special Covid envoy, Dr David Navarro, he emphasised that: “Lockdown is justified to buy you the time to reorganise, regroup, rebalance your resources and protect your health workers.”

The corona viruses responsible for this epidemic must leave an infected individual for a new host within about two to three weeks to survive. Staying put would result in either the infected individual’s immune system killing the virus or the virus killing the host.

Faced with a raging epidemic, with numerous cases of spread within a community, some weeks of lockdown are essential. Keeping away from each other will minimise the availability of new hosts for the virus. There is no shortage of evidence that with good compliance this tactic works.

Of course every effort must be made to minimise the lockdown period given the economic, psychological and social toll that is an inevitable by-product of the initiative. The huge challenge is to perpetuate the advantages provided by the lockdown. Which brings us back to the major point in Dr Navarro’s message.

His intent was to emphasise that we will share this world with this deadly corona virus until an effective and safe vaccine is readily available. We must place more emphasis on using proven post lockdown strategies that will allow us to minimise the dangers of this reality.

Accurate, readily understood information is the key to achieving the public discipline required. We must normalise tactics that balance our need to work and play while embracing public health measures that minimise our risk of infection. If we don’t we, will all too soon be forced into another lockdown that will be far harder to bear than the first.

This is the reality. In so many countries at the moment (Israel, the UK, France, Spain and many more) the benefits from a period of lockdown have been lost as complacency eschewed adherence to social distancing and the use of masks, and so on.

Dr Margaret Harris, a spokesperson for WHO commenting on the misreporting of Dr Navarro’s comments, said, “A lot of countries have had to go into lockdown. Right from the start we have said that what we’d really like to see is strong tracking, tracing, community hand-washing and mask wearing so that you don’t have to go into lockdown.”

However, many continue to reject the implementation of the public health measures proposed by the WHO and most experts. Given the economic and psychological stress associated with attempts to contain the pandemic, proponents of the ‘let it rip’ approach aimed at producing “herd Immunity” to contain the spread of virus have been vocal of late.

They argue that the most compassionate approach that balances the risks and benefits of reaching herd immunity is to allow those who are at minimal risk of death to live their lives normally and build up immunity through natural infection, while better protecting those who are at highest risk. Available evidence makes such an approach unacceptable.

At his latest media briefing, WHO director-general Dr Tedros Ghebreyesus addressed what he called “some discussion about the concept of reaching so-called herd immunity by letting the virus spread”.

“Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic. It is scientifically and ethically problematic. Letting Covid-19 circulate unchecked therefore means allowing unnecessary infections, suffering and death,” he said.

In truth we still do not know whether infection results in immunity from the corona virus. We have a number of examples of individuals experiencing a second Covid-19 infection months after the first.

The isolation needed to protect the most vulnerable (people over 65), especially those with existing health problems, in this paradigm is regarded by most experts as unachievable. To seek herd immunity is to experience swamped hospital facilities, many infected health professionals and a lot of people who have been infected and been left with serious, even life-long, health problems. In the most heavily infected communities such as Brazil, South Africa and the US, no sign of herd immunity has emerged.

Dr Trump however thinks the ‘herd immunity’ approach is the way to go and he has been advocating this approach at his rallies. His total failure to help Americans tame their terrible epidemic may be his undoing on November 3. Certainly despite (or perhaps as a result of) his recent brush with Covid-19 he continues to show no regard for the health of those he crowds into his rallies without requiring supporters to social distance or wear masks.

Last week, Fox News anchor Laura Ingraham, in defending Donald Trump’s disparaging of the wearing of face masks, suggested that it was “personal freedoms” that were being undermined by efforts to enforce mask wearing and social distancing and that this was unacceptable in a democracy. This attitude is surely indefensible but on display in many demonstrations opposing Covid restrictions around the world including Australia.

The premiers of NSW and Victoria have, of late, been angered by flagrant examples of public flouting of public health guidelines necessary to minimise the spread of the virus. Seldom does the anti-social behaviour of just a few people have the potential for causing enormous harm to thousands in their community as was clearly demonstrated in the breakdown of quarantine security in Melbourne.

Here is the big so important question. As we prepare to ease some restrictions will we, in contradistinction to many communities in other countries, embrace the long-term behaviours that must be normalised to allow us to live as safely and productively as is possible in a Covid-infected world? We need to look closely at the efforts of those in many countries for their track record is dismal.

Most countries have not maintained the required discipline and are paying a heavy price in the form of a second wave of infections often worse than the one initially experienced. We must be different. No country is better placed to keep Covid-19 manageable. Only an understanding and implementation of strategies required to protect each other and a palpable display of solidarity will see us succeed where others have failed.

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