There was quite a bit of talk on Twitter yesterday about new research showing that children do get infected with Covid-19 and do infect others. For more information I went to Dr John Campbell’s Youtube channel and discovered a video addressing this very question:
During the video, Dr John looked at research submitted to the JAMA network. If you click on the JAMA network link and scroll down to the very bottom of the screen, you’ll discover that JAMA stands for the Journal of the American Medical Association:
So what’s the bottom line of this research? Basically it says that children over the age of 5 have the same viral load in their nasal swabs as adults and therefore have the same ability to infect as adults:
Children from 0 – 5 were found to have a much higher viral load, meaning that they were much more infectious:
To state the bleeding obvious, this means that kindergartens and pre-school childcare MUST be closed if we’re to stop the spread of the virus. It also means that school age children are spreaders of the virus too. Given how impossible it is to maintain social distancing in school settings, this means schools must be closed as well.
Finally, although children tend to suffer less from the virus, there hasn’t been enough research done on the effect of the virus on children with co-morbidities – such as auto immune diseases. In my world, this means keeping children with asthma etc., away from any setting where they’re likely to be infected with covid-19. Better safe than very, very sorry.
With so many countries re-opening after lockdown, the risk of a second wave grows every day, especially as research now shows that the standard social distancing recommendations are…far too optimistic.
The research, conducted in Japan, uses lasers and special cameras to capture how the virus is spread, and how far it goes. The video below has some English dubbing and/or English sub-titles. Although the whole, hour+ video is interesting, the segment about the actual research begins at 29:10 and ends at approximately 35:18:
The research shows that even speaking can spread the virus via both large droplets and tiny micro droplets. The large droplets fall to the ground fairly quickly, even in an enclosed space with little air circulation, but the micro droplets remain in the air for over 20 minutes. Because they’re so small, they also spread a great deal further than the recommended 1.5 or 2 metres.
The take home message is that confined spaces – like public transport, office buildings, shopping malls, supermarkets and classrooms – are the perfect breeding grounds for micro droplet borne virus particles.
The good news is that masks do reduce the distance that both large and small droplets can travel. And /that/ is why countries that mandate the wearing of masks in public have less viral transmission than Western countries in which people are ‘self conscious’ about wearing masks. Apparently it’s okay to become infected and infect others, but heaven forbid that we should look silly…
And now a word about the hypocrisy of my government in scolding protestors attending the Black Lives Matter demonstrations:
those protests ALL happened in the open air where normal air circulation [with or without wind] would have dispersed the droplets quickly,
this is in contrast to people returning to work – at the behest of this government – in confined spaces with air conditioning instead of natural ventilation. Does anyone else remember the legionnaire outbreaks caused by contaminated, commercial air conditioning units?
a great many of the protestors wore masks,
this compares to people travelling or working in confined spaces without masks.
the organisers of the protests, at least here in Australia, were handing out masks and hand sanitiser to help reduce the risk of infection,
I’m not aware of any public transport employee handing out masks or hand sanitiser to travellers. Ditto supermarkets. Office buildings etc etc etc.
It’s the height of hypocrisy to say that it’s okay to catch the virus from public transport, or offices, factories, shops, restaurants etc…to save jobs…and the economy…and the effing budget bottom line…but it’s not okay to catch it while protesting state sanctioned murder.
And we all nod wisely and say ‘tut tut’.
I find that more disturbing than I can say. When did we turn into such placid sheep?
First up an important video from Dr John Campbell – remember, he’s a PhD in the medical field, not a doctor Dr – on immunity and the immune system:
The second video is a world, Covid-19 update, and this is where the title of this post comes from:
When Dr John gets to Australia [1:38 of the video] his understated disapproval is embarrassingly obvious. To quote just a bit that I managed to transcribe:
‘Scott in Australia…Scott Morrison…well, it’s not for me to go around judging world leaders but..[snip]…not too much pre-activity in Australia.’
So today I want to talk about my country, my Australia. I know what this crisis feels like on the ground, but until today, I had no real idea of what we were doing about it. The following screenshots are what I found:
The bit highlighted in red – ‘The source of infection for 26 cases is currently unknown’ is the most worrying because it shows that Covid-19 is already out in the community…as at March 18, 2020. And that’s only the cases we know about, perhaps because these are the cases needing medical help.
But what about those cases where people are asymptomatic – i.e. without symptoms – or suffering from only very mild symptoms?
These people are going about their lives, ‘business as usual’, and spreading the infection to god alone knows how many others.
It’s hard to predict how many other people are becoming infected because the ripple effect will be different for each person, a bit like this video of ripples in water:
If you were to slow the effect down and freeze it, you might get something like this:
The big circle in the middle is PERSON 1. If PERSON 1 infects just 3 other people, and each of them infect just 3 more people, you would quickly have 148 people infected. I’m no mathematician so if I’ve got that wrong PLEASE tell me in comments.
The actual spread of the virus will be far more complicated than my pretty little diagram, but if we already have 26 cases for which there is no known source, it means the spread through the community could be far, far worse than the figures imply. Many sources I’ve read say the actual number should be the official figure multiplied by 10 or even 20.
But of course, the governments figures would be suspect anyway because they haven’t done anywhere near enough testing. Only those with clinical symptoms of Covid-19 who request help are being tested. Those who only suspect they may be infected aren’t tested at all.
I tried to find out how much testing Australia has done and is doing, but the government sources provide next to no information. The following quote is from The Guardian:
‘Speaking at the council of Australian governments meeting on Friday, Australia’s chief medical officer, professor Brendan Murphy, said supply problems with coronavirus testing kits was a “temporary issue” but one that was hampering the scale of testing in Australia and across the globe.
“It’s a temporary issue, but it relates to the fact that a number of countries, where these consumables are made have probably put export controls over them to keep them for their own use,” he said. “We will work through it. We’ve got world-leading medical technology and will fix that issue, but it has caused a temporary issue with the scale of the testing that we can do at the moment.”
So the take home message seems to be that we don’t currently make enough [or any?] test kits in Australia, but medical manufacturing is ramping up to produce home grown test kits.
The question, however, is how long will these homegrown test kits take to manufacture? The CDC in the US tried to do the same thing, and failed. Just exactly how are we, with a fraction of the resources, going to do better?
A related question is: why didn’t we start this process earlier, like when the deadly potential of Covid-19 first became apparent?
So… nowhere near enough testing happening in Australia. But then what data are the modellers basing their advice on?
The lack of testing is like the general of an army saying, ‘don’t bother sending out reconnaissance; we know the enemy is out there.’
But where is the enemy?
How many of them are there?
Do we know where they’re going?
The lack of adequate testing is not only hindering our ability to fight this pandemic, it’s leaving individuals with the frightening idea that everyone is potentially a carrier.
We’ve already seen the panic buying. Some of that is profiteering by disgusting people who should be hung up by their balls, or whatever part of their anatomy that hurts the most. But by and large, most of the panic buying is by people like me who take the threat seriously and want to protect their vulnerable loved ones.
Frankly, when #ScottyFromMarketing gets on his high horse and says ‘dont do it!’, like some kind of stern, all-knowing father figure, my first instinct is to flip him the bird. How dare he?
Despite the evidence of China, South Korean, and Italy, the Australian government is still treating us like mushrooms and pretending that we can do better than every other country on Earth.
Past experience has shown that by ‘better’, this government means ‘survive the virus without damaging the economy too much’. First stimulus package – protect industry and ‘jobs’. Second stimulus package…protect more jobs??
How about a commitment to give those made unemployed by the virus enough to live on [so they can self-isolate without starving to death]?
How about taking control of the distribution of essentials like food and medication? If people with existing conditions can’t get their normal medication, many will die. And you can’t protect the vulnerable when they have to break self-isolation to stand cheek-by-jowl in long queues to buy food and other essentials.
The logistics of keeping people alive are being left to the marketplace, but the for-profit sector is making hay while the sun shines. The one exception to this is IGA. I’m not sure if all IGA stores are doing the same thing, but my local store has already instituted a strict rule for customers:
1 of each product per customer
At the very least, every single distributor of essential items should be doing the same.
And how about providing real information so that fear and confusion does NOT lead to hoarding? So far, the messaging from the government has been either pathetic or contradictory. To get through this, we need to work together, but we can’t work together when we don’t have leaders we can trust.
I’m prepared to make sacrifices, but only if I believe that the government is more concerned with my survival than my contribution to the economy. At the moment a part of me believes that #ScottyFromMarketing is still enamoured of Boris’ bogus ‘herd immunity’ strategy…and bugger the consequences.
We can’t fight what we can’t see, and we can’t follow leaders we don’t trust.
Like many Melbournians, I was immensely relieved to hear that the Grand Prix had been cancelled due to Covid-19, but I was puzzled, and angered, by the Federal government’s continuing mixed messages about the virus. On the one hand Scott Morrison says the authorities will put social distancing interventions in place, but not until Monday [March 16, 2020]. And they won’t apply to schools, universities and public transport.
Why give the virus a whole weekend to turn up at the ‘footy’ and in churches and concert halls and theatres etc etc etc.
If these interventions are meant to stop the rapid spread of the virus, why wait?
Why encourage people to ‘go to the footy?’ And why not close schools, universities and public transport?
Is the delay all about the money?
Despite my cynical anger, there was something about all of this that simply did not add up, especially as the Premiers of all states and territories appear to be in agreement with #ScottyFromMarketing. As my state, Victoria, has a Labor government, I would have expected the Premier, Daniel Andrews, to be more caring of people’s lives than old Scomo.
It was at this point that I remembered an episode of The Drum I had watched just a few days ago [the 12th of March, 2020]. On this episode, the panel of The Drum included a guest, Professor James McCaw, a mathematical biologist and Infectious Diseases Epidemiologist from Melbourne University. Apparently, Prof. McCaw and his colleagues have been modelling the spread of the Covid-19 virus and have been advising the Federal government.
Keep that point in mind, ‘advising the Federal government’.
During the course of the discussion, the panel talked about interventions such as forced social distancing – e.g. cancelling the Grand Prix – as a way to avoid getting the virus and jet propelling it through the community.
To explain the reasoning behind social distancing, they displayed this graph:
Those of you who have been following the Covid-19 virus online will be familiar with graphs that look very similar. The sharp peak is what happens if the virus is allowed to spread without interventions. The flattened, ‘fat’ curve is what happens when you slow the spread of the virus via interventions. The important thing to note from this graph is that a slow spread allows hospitals to cope with the influx of desperately ill people infected with Covid-19.
So far so good. But if interventions slow the virus, and slowing the virus is good, why would mathematical biologists and infectious disease epidemiologists have to model anything? Isn’t it obvious?
Going back to Professor McCaw, I think I’ve found the answer, or at least understood it. This is what the Professor had to say about the virus and interventions:
“The really important thing to be aware of, though, is by avoiding that transmission [i.e. of the virus] all of the people who may otherwise have gotten ill, they are all still susceptible. So as society returns to normal…the population is still equally susceptible, and this is where the mathematicians have a role to play.”
ABC, The Drum, March 12, 2020, at minute 19:55
You can find that episode of The Drum on iView If the link doesn’t take you to the right episode, look for the episode aired on March the 12th, 2020.
So, what exactly does all that mean?
I am no expert so my reading of Professor McCaw’s comment may be completely wrong, but this is how I finally understood it:
the whole world is going to get this virus sooner or later, so…
if Australia stops the virus from spreading, we’ll simply postpone the deaths until a later,
but if a lot of the most healthy people get the virus, they are likely to get only a mild version that does not need hospitalisation.
this will leave the hospitals free to deal with those who do get very sick,
so it makes logical sense to allow this younger, healthy group to get sick, recover and become immune before interventions are put in place,
then, once this first pass of the virus is over, and a vaccine is available, the uninfected members of the population can be protected as well.
From a theoretical perspective, this ‘strategy’, if that’s what it is, would stagger the victims of the virus, making the epidemic manageable. I guess it would also have less of an impact on the economy.
But even in theory, this strategy can only work if the authorities actually know how many cases of Covid-19 there are in the community so they know when to apply the breaks via more draconian interventions. It also assumes that everything else needed to apply the breaks is already in place, ready to go.
Given the lack of widespread testing, I don’t think the authorities do know. I think they are guessing on the basis of how quickly the virus has spread in other countries and extrapolating that to Australia.
More worrying still is the lack of clear, public messaging. People are getting their information from social media, and they’re scared and confused. Getting them to go along with drastic social interventions ‘when the time is right’ can only succeed if everyone understands and agrees with those interventions.
Australia is not a ‘command and control’ country. How are the authorities going to enforce these interventions? Using the police? The armed forces?
People working in the GIG economy, the underemployed and those who think they are immortal will continue doing what they think they need to do for themselves.
This is human nature. Expecting people to behave like robots may work on paper; it will not work in the real world. In the real world, individuals who ignore the interventions could easily infect far more people than the ‘strategy’ anticipates. This will skew the timing and effectiveness of the interventions so when they finally do come, they may not work at all. Or they may not work well enough, allowing the curve of the graph to continue shooting up like a rocket.
But practical considerations aside, nowhere in this strategy is there a recognition of all those who will become collateral damage, the ones who will catch the virus, get sick and die.
According to the statistics, children under the age of 10 don’t die of this virus, but those over the age of 10 do start to die. It’s a small percentage, but it exists:
So who are these children and teens likely to be?
Right from the start, we’ve been told that people with pre-existing conditions will be most vulnerable to the virus. Well guess what, children and teens have pre-existing conditions too. They have asthma, diabetes, multiple sclerosis, cystic fibrosis, Crohns, ulcerative colitis, leukemia, cancers of all sorts… the list goes on and on and on.
What part of the strategy protects these vulnerable young people when they go to school or university or travel by public transport?
And then there are the older age groups. As we age, almost all of us develop some type of chronic disease. I’m pretty fit and healthy, but I’ve had cancer. If the virus gets out of control and the hospitals can’t cope, will I be triaged to die because I am less likely to survive than someone younger?
That kind of soul destroying triage is already happening in Italy.
And what of remote Indigenous communities? They are already behind the eight ball when it comes to health. How are they going to survive when they are often hundreds of miles from the nearest doctor let alone hospital?
We are people, not numbers, yet the silence about us has been deafening. Self isolation is fine, but where are the systems that will make it effective?
I went to Coles [supermarket] this morning. I arrived at 7am, thinking I’d be almost alone in the store. Thank god I was wearing my mask because there was a conga line waiting outside the entrance. What were they all waiting for? Toilet paper.
Coles is now doling the toilet paper out, one packet at a time, but to get a packet you have to stand in a queue next to people who may already be infected but not showing any symptoms.
Toilet paper aside, whole families packed the aisles of the store, stocking up, and every single cash register was open and working at a feverish pace. Instead of being in and out in ten minutes, it took me an hour and a half to get my shopping and leave. The whole time I stood there, flanked by overflowing shopping trolleys, I was acutely aware of the people around me. I didn’t hear any sneezing, but someone did cough behind me. Just a little cough… Probably just clearing their throat… 😦
Professor McCaw’s models may work on paper, but as they are currently being implemented, they are ensuring that the most vulnerable in our society pay the price if things go horribly wrong.
My thanks to Don Charisma for posting the latest Dr John Campbell health video on his blog.
For those who haven’t yet heard of Dr John, he’s a retired UK nurse/teacher/researcher who is analysing the latest data about this virus and explaining it to us. He has a Youtube channel, and this is his latest video:
I strongly recommend watching the entire video because it is full of information relevant to different countries, but here are the bits of particular interest to me.
Confined spaces and aircon
There was some meticulous research done [in China] on the spread of infection in a bus. I don’t know what it is about the air conditioning in the bus, but it basically doubled the radius of infection to 4.5 metres. In simple terms, the virus from an infected passenger travelled much further than previously thought.
Note: the radius of infection is basically how far droplets containing virus will spread in the air before falling to the ground.
Virus survival on surfaces
Another thing that worried me is the information about how long the virus survives on surfaces such as metal, cloth, paper etc. It can survive – on surfaces – at 37C for days. That’s roughly 10C more than previously thought. That means this virus is hardier than we imagined. It also means that every infected person has the potential to infect people he or she is never in physical contact with.
Think about all the shopping trolley handles we touch, how many counters in shops, how many door knobs, tables, chairs… The list is endless, which means we have to be super vigilant, not just to protect ourselves, but to protect those we love. Do NOT soldier on, you could kill someone.
And finally, a word about government intervention. The countries that have been proactive about stopping the spread of Covid-19 are doing better than those which have not. We need to learn what works and do it in our own countries.
One thing which has worked particularly well in South Korea is ‘drive through testing’. You stay safe inside your car – your own little bubble of protection – and drive away without having to come in physical contact with others who may or may not be infected.
When I saw news footage of people waiting in long queues [here] to be tested, my first thought was, “well, if they didn’t have it before, they may well have it now”. Gatherings of people who may already be infected is such a bad idea…
Daniel Andrews [Premier of my state of Victoria] has declared that his government is going to take more stringent measures against the spread of Covid-19. I’m glad, but I still think that allowing Moomba and the Grand Prix to go ahead in Melbourne was a bad idea.
I understand that we do not yet have the level of community spread that triggers more ‘stringent’ measures, but we also don’t have the community awareness required to take this threat seriously. Traditional, normal public gatherings like these simply reinforce the idea that we’re ‘safe’.
We’re not safe, and we have to get used to that idea. We have to get used to taking precautions such as wearing masks and gloves, washing our hands religiously, staying away from crowds and air conditioned centres. We have to start doing these things now so that when things do get worse, they’ll get worse at a slower rate.
I cannot stress enough how important it is to slow the spread of this virus.
The following is a screenshot of a thread I read on Twitter last night. It’s from Northern Italy and describes a health care system teetering on the brink of collapse. Yet Northern Italy has a world class health system.
We have world class hospitals in Australia too, but people with the pneumonia stage of the infection need ventilators. These machines are capable of breathing for the patient until they are capable of breathing on their own again. But if everyone gets sick at once, how many are going to miss out on ventilators because there aren’t enough to go around? How many will die?
Deaths by age
Going back to the Dr John video, the stats showing the break down of deaths by age show that small children appear to be remarkably resilient:
From the age of 10 onwards, however, young people do die from Covid-19 as well. 0.2% of deaths amongst young people may not sound like much, but they are still people, real people.
Do you really want your ‘she’ll be right’ attitude to result in the death of your brother, sister, best friend, lover, wife, husband?
Or what about your parents? Aunts? Uncles? Grandparents?
We have to slow the spread of this virus, and we have to start now.