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Is there anything we can do about surging Covid-19 cases?

Apr 7, 2022 • 16m 15s

Across the country, COVID-19 case numbers continue to rise. Yesterday, NSW recorded more than 24,000 new cases and in Victoria there were more than 12,000. So, what’s driving the spread of Covid-19 right now? Today, Professor Raina MacIntyre on what we’re misunderstanding about the current wave of infections.

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Is there anything we can do about surging Covid-19 cases?

668 • Apr 7, 2022

Is there anything we can do about surging Covid-19 cases?

[Theme Music Starts]

RUBY:

From Schwartz Media I’m Ruby Jones this is 7am.

Across the country, Covid-19 case numbers continue to rise.

Archival Tape -- News anchor:

“The virus isn’t going anywhere. In fact, right now cases are surging, placing ever-increasing pressure on our health system.”

RUBY:

In NSW there were more than 24-thousand new cases of the virus recorded yesterday...

Archival Tape -- News anchor:

“Cases are again on the rise, largely driven by New South Wales, where daily numbers are now in the tens of thousands”

RUBY:

… and in Victoria there were more than 12-thousand.

Archival Tape -- News anchor:

“Victoria’s Covid peak is not even in sight, as our case numbers rise to their highest level in two months”

RUBY:

While deaths and hospitalisations have not hit the highs of January, over two-and-a-half thousand Australians are in hospital and the figure has been rising.

So, what’s driving the spread of Covid-19 right now?

Today, Professor Raina McIntyre, a member of the World Health Organization’s advisory group on COVID vaccine composition, on what we’re misunderstanding about the current wave of infections, and what the long term costs of this moment could be.

It’s Thursday April 7.

[Theme Music Ends]

RUBY:

​​First of all Raina, welcome to 7am - Thank you for coming on, it's great to talk to you.

RAINA:

Thank you for having me.

RUBY:

Raina, I want to start by talking about Covid-19 and children. We are at a phase in the pandemic where infections among children are rising and where schools are a significant source of transmission. Tell me why that is.

RAINA:

Well, it's the combination of the number of people in one space for a long time and the duration that they're in there, which can be a long time in a classroom. If you're in a room with someone else who's infected, the longer you're in there, especially if the ventilation is not good, those virus particles, which come out in the aerosols, those just accumulate. If you think about it like cigarette smoke, it's exactly like that. If you're in a room that is not well ventilated, the cigarette smoke just accumulates and accumulates till you're in a dense cloud of it.

If you're in a setting where someone else who's infected either is or has been, there's been studies that show that an infected person can pass through an indoor environment, whether it's a shop or a classroom or whatever. And the virus can actually linger in the air for hours after that person has left. So if you're in a room with someone else who's infected, what you're doing in that room and how long you're in there for all, determine your infection risk.

And the vaccination programmes for children started in February, and there's an eight week gap between dose one and dose, too, so we essentially sent all the kids back to school in 2022 unvaccinated. Very few have had two doses of vaccine so far, so kids are far less protected than the adults who have very high rates of at least two-dose vaccinations.

RUBY:

Mmm. And can you tell me more about the risks that children face from Covid-19 and what we don't yet know, I suppose, about the long term effects that they might encounter?

RAINA:

So in general, SARS-CoV-2 infection is less severe in children than it is in adults. But when you've got enormous amounts of transmission, you're still going to see substantial numbers of children who get serious infection, who need hospitalisation or ICU and may even die. And we have seen children die in Australia in all age groups, and we've seen even more kids in hospital.

We also know there's now accumulating data that the Omicron variant can be more severe in children, particularly really young children, because the upper airways of young children are kind of soft and floppy compared to adults. And so the American variant affects the upper respiratory tract more than the lower respiratory tract, so they can get things like Croup and, you know, obstruction of the airways through the virus affecting the upper airways.

So we know that there are substantial effects on pretty much all organ systems and also from post-mortem studies that's come out of the National Institutes of Health in the US. We've seen that the virus can be found in multiple body organs long after the acute infection, so the virus persists in the body.

So we don't know what the long term effects of the virus hanging around in your body might be. We don't know what the long term effects on cognitive impairment and development of the brain in children might be. We know that there are what looks like irreversible changes, such as shrinkage of the brain and if your brain shrinks, you can't puff it up again and fix it. That's a permanent change. That's the problem with the neurological system that it's not like, you know, scratching your skin, the skin is going to going to grow back. There's some damage that could be permanent. So I don't think there's any rationale for being cavalier about it and saying, don't worry about it, it's fine. I think, you know, the evidence we've got suggests we should be precautionary.

RUBY:

Yeah, well, what precautions should we be taking then, right? And I think by that, I really mean, what should our governments be encouraging and asking of us at this point in the pandemic?

RAINA:

So I think that the approach taken by many countries is a vaccine-only strategy, right? We've offered the vaccine to you. It's now up to you. Take personal responsibility. Well, two doses of vaccine does not protect against Omicron. My current best studies are pretty consistent on that, you know, doesn't protect against symptomatic Omicron. So you really need that third dose. We only have it for 16 and up in Australia. What about a third dose for 12 to 15 year olds? And what are we going to do to get the rate of third dose vaccination, up from about 70 percent to 95 per cent like it is for two doses?

So those are things we can do to improve the protection from vaccines. And then we can add layered protections, including testing and tracing. You know, the WHO is saying we have to keep testing and investing in the testing infrastructure. We can't just abandon testing and tracing.

Archival Tape -- ABC Melbourne Radio host:

“Perhaps the biggest change for many of us that we have to get our heads around is the fact that now it is up to us to do our own contact tracing…”

RAINA:

Another reason for not abandoning testing and making testing inaccessible is that you can't use antivirals. You know, the promise of antivirals is that it will make it mild, you know, and it'll stop people developing severe disease and going to hospital. But you have to be tested to diagnose the disease. You have to be tested early or the antivirals are not effective. They have to be given in the first five days of the infection. And you know, at this stage, we just don't have that infrastructure for rapid turnaround testing.

Archival Tape -- Morning anchor:

“School is back in New South Wales and Victoria, and the students ease back into lessons post-lockdown. They'll be noticing some new additions to their classrooms.”

Archival Tape -- Morning anchor:

“Air purifiers are being rolled out across the two states to help prevent the spread of COVID…”

RAINA:

And then you need attention to safe indoor air, which is as simple as measuring and mitigating. You know, it's not an expensive thing to fix. And I think at the very least, we should be. People should be empowered with the knowledge of how the virus transmits so that they can do what they need to.

Archival Tape -- QLD Health:

“If people want to wear masks, particularly in crowded environments, they should do so and they shouldn't feel awkward about doing so-...”

Archival Tape -- News anchor:

“…and many say they will”

Archival Tape -- Vox pop 1:

“I wear it everywhere I go so I think people will just continue doing it themselves regardless of what the government says…”

RAINA:

And then masks, you know, I think we can't ignore the virus and hope that it'll go away. That's not what's happened and it's not what's happening.

We have to acknowledge that it's here, that it is a severe disease and that we need to address it and mitigate it.
And once we do that, we have a prospect of a much better way forward.

RUBY:

We’ll be back in a moment.

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RUBY:

Raina, a lot of the measures that you're talking about seem quite simple and the things that could arrest the spread of COVID 19 that we've known about for a long time. So I suppose the question is why are they not being enforced? Why have the various governments across Australia seemingly backed away from any of these control measures? Because, as you say, it wasn't so long ago that we were testing and tracing every case that we could find, but that's obviously no longer happening.

RAINA:

Mm. I mean, you know what? I'd like to know what the people of Australia want. You know, I don't think any of the decisions that have been made have been based on what the people of Australia want.

I've seen some say, a survey published by The Sydney Morning Herald where they asked people, you know, do you want people to be wearing masks in the shopping centre? And actually the majority of people said yes.

So who was it for dropping of the mask mandates? You know, I don't think it was based on polling of the people of Australia on what they wanted. You know, maybe we should be polling people and asking them, “Do you want to be told if you've been in contact with someone with COVID? Do you want the QR codes back?”

I mean, we invested all that infrastructure in setting up those pretty good systems really in Australia, so why are we just abandoning at all?

RUBY:

So what are the consequences then of this approach, Raina? What lessons can we learn from what has happened elsewhere - in places like Britain and Sweden?

RAINA:

So, you know, in the U.K. and Sweden, they've taken the approach of just pretending it's not real and just keeping on going as if it didn't exist as if there was no pandemic. And I just read today that Heathrow is has been absolutely crippled because their case numbers are soaring in the U.K. and something like 15,000 passengers were stranded at Heathrow yesterday, because hundreds of flights were cancelled, because there was no staff to operate the flights and no staff to operate the baggage handling carousels. So, you know, when you let it rip every workforce is going to be affected, you're going to be facing staff shortages and critical infrastructure is going to be at risk.

So, you know, you can't really enjoy these freedoms when 10, 20 per cent of your workforce is sick. In business as usual about 2 per cent of a workforce anywhere is off sick. But what we're seeing is, you know, 10, 20 per cent of the workforce off sick. That's what we saw in January when we were having, you know, supermarket shelves empty because of the they want people to unload the product off the shelves and bring it to the supermarkets. So that's the kind of flow on effect of not controlling transmission.

RUBY:

Hmm. And Raina to one assumption that seems to sit under a lot of the response to COVID 19 in Australia now is that we will get to the point where the virus is endemic. So I was just hoping that you could explain to me what it actually means for a virus to be endemic and whether that's likely to happen or if that is a misreading of the kind of virus that COVID 19 is.

RAINA:

Look, there's science and then there is, you know, made up stuff. And during this pandemic, we've seen a bunch of people posturing and posing as experts who actually don't have even a fraction of the requisite knowledge, who have misused terminology like ‘herd immunity’, ‘endemic’ and so on. And it's become normalised sort of disinformation has become normalised in public discourse. You know, endemic is a technical term. It has a technical meaning. An infection like malaria is endemic. SARS-CoV-2 is an epidemic infection, it has a mathematical definition and a technical definition, and it means that case numbers can rise very rapidly in a short period of time, especially for a virus like this where immunity wanes both from vaccines and natural infection.

RUBY:

Raina, it seems like what you're saying is this is not an endemic virus and it never will be, but it seems like the response that we're seeing to it is assuming the opposite.

RAINA:

Yeah it’s an epidemic virus and epidemics have the tendency to disrupt society that can disrupt your health system, they can disrupt your workforce, they can disrupt schools. And you know, what we're going to see is just recurrent disruption and reactive knee-jerk reactions rather than, you know, trying to, you know, if we accept that we need to do more than just give people vaccines and forget about it, then we can actually manage it. So it's less disruptive.

RUBY:

Hmm. And so what do you think is likely to happen now? Rana, what will the next phase of this be?

RAINA:

Well, it depends partly on whether new variants emerge, which probably there will. Based on what's happened already and what characteristics those new variants have. It depends on how quickly our vaccines can catch up. It depends on how agile we are with the vaccine policy and whether we add some of those other layered protections, you know, which I like to call ‘vaccines plus’. And that includes ventilation, safe indoor air, masks. It really depends on policy choices.

RUBY:

Hmm. So essentially, though, Raina, from here, it's really up to the government to decide how they want to respond and that will dictate what happens.

RAINA:

Public health is the role of government. That is their core responsibility. It is what we, the taxpayers, pay our taxes to the government for.

We should expect services in return and the most basic of those is a right to public health.

RUBY:

Thank you so much for talking to me

RAINA:

It’s a pleasure

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RUBY:

Also in the news today…

Australia will develop hypersonic missiles that can travel at least five times the speed of sound under a new agreement with the United States and Britain.

The deal was struck under AUKUS, a trilateral defence pact between the three countries, signed last year.
The agreement comes after the federal government announced last month that it will invest one billion dollars to build new missiles and guided weapons in Australia.

And, vaccine mandates in public venues across Queensland will be lifted next Thursday. People will no longer need to prove they have two doses of the vaccine at cafes, pubs, clubs, cinemas, galleries and libraries.
Similarly, people in the Northern Territory will no longer need to prove they're fully vaccinated to enter a licensed venue. The state has also scrapped its vaccine pass system, effective immediately.

I’m Ruby Jones, this is 7am. See you tomorrow.

Across the country, COVID-19 case numbers continue to rise. Yesterday, NSW recorded more than 24,000 new cases and in Victoria there were more than 12,000. While deaths and hospitalisations have not hit the highs of January, over 2,500 Australians are in hospital and the figure has been rising.

So, what’s driving the spread of COVID-19 right now?

Today, Professor Raina MacIntyre, a member of the World Health Organization’s advisory group, on what we’re misunderstanding about the current wave of infections, and what the long term costs are.

Guest: Professor Raina MacIntyre.

Background reading:

Why Australia’s daily Covid cases are on the rise again in The Saturday Paper.

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7am is a daily show from The Monthly and The Saturday Paper. It’s produced by Elle Marsh, Kara Jensen-Mackinnon, Anu Hasbold and Alex Gow.

Our senior producer is Ruby Schwartz and our technical producer is Atticus Bastow.

Brian Campeau mixes the show. Our editor is Scott Mitchell. Erik Jensen is our editor-in-chief.

Our theme music is by Ned Beckley and Josh Hogan of Envelope Audio.


More episodes from Raina MacIntyre

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668: Is there anything we can do about surging Covid-19 cases?