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ANGE:

From Schwartz Media, I’m Ange McCormack. This is 7am.

Many Australians could have been infected with Covid for the second, third or even fourth time in the last couple of months. That’s because a new variant of the virus has caused the biggest wave in over a year.

But while for many the symptoms are milder, and the risks are dropping – what do we need to know about the new variants still emerging? And what evidence do we have about multiple reinfections?

Today, applied mathematician, expert in respiratory diseases, and contributor to The Saturday Paper, Dr James Wood, on the latest Covid wave and what could be in store this year.

It’s Thursday, March 28.

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ANGE:

James, I think a lot, if not everyone listening right now will probably know someone who's had Covid in the last few months. But despite that, it feels like Covid and discussion on where the virus is at is kind of barely registering publicly, it's not really big news anymore. Why do you think that is?

JAMES:

I mean, I think the obvious thing is we had 3 to 4 years of a pandemic and, you know, people are keen to move on from that. I mean, life seems to have gone back to normal. Most people, almost everyone, has had Covid and knows they've had Covid, and many people have had it more than once. And I think if you go through an experience and find that your infection was mild or not too bad and you recover okay, then you think, well, what's the big deal? So a big desire to sort of put this thing in the rear window, but Victoria started going up cases really in kind of term three last year, and everywhere else was a little bit later. And about midway through the wave, this new variant, JN1 or Juno, as some people like to call it, came through quite rapidly.

Audio Excerpt – News Reporter:

“It's overtaking Omicron to become a dominant strain in the US, Europe and now Australia.”

JAMES:

And that caused the last sort of surge over Christmas time and into January and so on.

Audio Excerpt – News Reporter:

“It's been a long time since daily Covid updates, but today, health officials were back in front of the cameras, calling a snap media conference with a warning for Sydneysiders.”

JAMES:

But it was, as far as we can tell, a large wave.

Audio Excerpt – News Reporter:

“It's called JN1, and since arriving down under, Covid infections have been on the rise, thanks to a mutation of the virus's spike protein”

JAMES:

So our wastewater measurements really were probably the largest wave we've had since the middle of 2022.

If you go back to that time, we'd sort of just come out of lockdowns in many states, And then suddenly this new variant, Omicron showed up and we went from sort of being worried about a couple of hundred cases a day to starting to realise that 25,000 cases a day, 50,000 cases a day could be happening and this wave sort of swept through the population. And what we noted at that time were large numbers of hospitalisations and deaths, right? And what we haven't seen in this wave in 2023 is nearly the same scale. So it's probably dropped 4 or 5 fold in terms of the total number of people going to hospital and deaths out of this wave, despite probably a similar number of people being infected. So that suggests that whether it's that our immunity has gotten better or the virus has gotten a bit less severe, the average severity of some infection has gone down.

ANGE:

So James, I'm keen to understand more about the severity of Covid and how this variant is affecting people who get it, because, you know, getting Covid these days is kind of waved off by some people. It's seen as sort of similar to getting a cold. But how sick are people getting from Covid at the moment? What are we seeing there?

JAMES:

It's a good question. It's quite varied across the population, I guess, particularly by age. So, just as a general number for Australia, last year we had about 4500 recorded deaths from Covid-19. It's still a large number of people. On the other hand, the median age of death was about 85. So it's really hitting older people hard, much less so in the younger part of the population. And we're sort of getting some numbers out of the United Kingdom. So they have a large survey where they test around 40 to 50,000 people each week to find out who's been infected and who hasn't. And then they can also use the hospital statistics to sort of say, okay, so out of how many people we think are getting infected, how many are going to hospital. And what they found was about around about 1 in 200, a little bit lower than that, was the sort of the average right across the population, but also that this varied very greatly by age. So that in school aged children, it was at about 1 in 4000. But then if you start to get into sort of the 75+ category, it's sort of up to about 1 in 30. So for a lot of the working age and child population, the risks are pretty low of getting, you know, a severe Covid illness now, or at least compared to earlier in the pandemic. But it remains quite a high risk for people over 65 and particularly over 75, over 85, people in aged care.

ANGE:

So I guess it sounds like there's, you know, quite a lot of Covid going around and for the population in that younger demographic under 65, there's fewer hospitalisations than we had seen before. So I guess that brings me to the question of, you know, is the virus itself getting weaker, or is the public's immunity and response to the virus getting stronger?

JAMES:

Yeah, it's a great question. So that's really, at the moment, I think, not an answerable question. So people are looking at those things, but I wouldn't say it is conclusive data one way or the other. It was the case that when Omicron came through we saw less in the way of severe lung infections so it started to infect more of the upper respiratory tract. And that was a change in severity with that virus, although it was still, you know, nasty. But something like half the population had a Covid infection in 2023. And we sort of see that protection lasting 1 to 2 years in terms of stopping you getting a second recorded infection. For vaccines, the beginning of the pandemic, they worked great, right? So we had like sort of 90 to 95% chance of stopping you getting Covid. What's happened since then is, they don't match the virus as well. So it's kind of like the, the, the vaccine and the virus was almost like a perfect match for each other initially. Now it's more like the viruses are sort of scattered out over this area, and it's sort of only able to partially match them. But what we do see is, much better protection for a period of time against severe disease. So we see older people who've had a recent vaccine, you know, within about 3 to 4 months, they've got about a 60% protection, against things like hospitalisation and death. So this is part of the reason why for people over 60, by suggesting two vaccines a year at the moment, because it's that kind of period of protection, is about six months extra protection that you get at the moment. And we don't know with Covid whether we're going to get one, two or three waves a year at the moment. We think eventually it'll be one, but it hasn't settled down to that pattern yet.

ANGE:

After the break, will there be a rise in covid infections over winter?

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ANGE:

James, you've mentioned how, you know, for many of us, this could be the second or third time we’re catching the virus, if someone catches it this year. At this point, what do we know about the long term health risks of catching Covid again and again? Is that actually something we should be concerned about?

JAMES:

I think the good thing in Australia is that we largely limited infections pre vaccination. And so we didn't get as many people having long Covid symptoms here as like the United Kingdom did, or the US or places that had big waves in 2020, pre vaccination. But clearly it's still something that's been a significant problem. I would say we still don't have great data on long Covid. So in Australia, I couldn't tell you how many people have suffered from it, how many people are currently suffering from it. But we really need to know what that size of that population is. It's not like ten people, it'll be in the thousands. So, you know, that's sort of a group who need ongoing support. I mean, the other thing is just that, you know, it's quite similar to things like chronic fatigue and other things, there's some differences with Covid. But the treatment for that is, basically you have to work on gradually increasing what you can do and, you know, changing your sort of mental approach to dealing with things like fatigue. So we've lacked a focus on those sort of conditions and at the moment we lack effective medications for it. I mean, there's I hope, I think that, you know, because of the large number of people who've suffered through long Covid, that there's enough population there to do good studies on and perhaps find new medications that will help people. But we have relatively little to offer people at the moment. So I think it hasn't been huge here because we don't see it, for example, in workforce statistics. So you know, if you look at sort of ABS data about people, who are taking time off work towards to do with long term health conditions, you don't see some big rise in this over the Covid period that might indicate that. Whereas I think in the UK, they legitimately did see that sort of difference. So it's not a massive thing at the whole population level, but for people who are suffering from it, , particularly the bad cases of it, you know, it's a massive change in their quality of life for months or years.

ANGE:

And James, looking ahead to this coming year, you know, we're in autumn now, winter is on the way. What are the predictions around what Australia might experience this year and how should we prepare for it?

JAMES:

Look, we've had a big wave of Covid, so what that means is lots of people got exposed to it and had their immunity boosted. And you know, that probably gives people 1 to 2 years of protection against another infection, so that's a boost to our population immunity. That alone would say cases should be going down for a while. But the balancing thing is that the virus continues to change and so over time, it will become better able to avoid those immune responses and better able to infect people. And that sort of happens, you know, I have a period of about six months. You see enough change in that to it make a significant difference. And then, of course, we've got winter months coming. And, you know, particularly in sort of our colder regions like Victoria or, you know, the ACT or Tasmania, definitely people get pushed inside more due to winter and the dark, the cold. And one of the things that we learnt early in Covid was that, you know, there was a big difference between indoor mixing and outdoor mixing, in terms of risk of transmission. So I still think that the wave has been large enough that we won't see a significant rise until later in winter or spring this year, and maybe not another wave over summer. I'm very hopeful that's the case. And it would be great if Covid went to a single wave a year, because I think it'd be a lot easier for people to say, okay, it's winter time, like we've got flu and Covid circulating, we can kind of switch on a bit to our risks now. The unpredictable timing has, I think, made it really quite hard. It's really quite difficult to predict more than a couple of months out. But last year already cases were going up at this time of year. So I don't think we'll see an early winter Covid wave this year. I think it'll be late winter, at earliest.

ANGE:

And James, as someone who's, you know, continued to follow Covid closely. I'm wondering, you know, as so much public attention has turned away from the virus, do you think that we've taken and learnt the right lessons from the past few years? What is it we should be doing more of, in your view?

JAMES:

So I have a strong interest, I guess, in public health for respiratory viruses. And we had 4000 deaths from Covid last year. We typically have, you know, somewhere between 1 and 3000 for flu. We could do better with that, I think. And it's sort of a question of how do we do that, sort of understanding that sort of scope of that problem, so that we can kind of measure it better, that we can intervene more effectively. One of the things that we struggle with, I think, is addressing equity disadvantage in these sorts of areas. The people are more likely to get the vaccine are also the people are probably healthier and wealthier, rather than those who maybe need it more. So there's those sorts of issues that I think we need to start doing better with generally. I'm also a bit concerned about, if we had another pandemic soon, and they are unpredictable things you really don't know, you know, until they happen at present that that one's likely. If another one happened now, how much better would be in terms of responses or would we be better? I think our health system and so on, our expertise is stronger, but people would be quite resistant, of course, to things like lockdown type restrictions and so on because of the effects they've seen on their lives, their families lives, seeing kids struggle to go back to school. So, you know, we've got a Covid inquiry, I hope that will land at a time when people are starting to be receptive to what do we do for the future. But when there's waves on, right, like, that's a time when we'd like people at risk to be getting vaccinated and people in their families to be sort of aware of that and consider doing things like doing rapid antigen tests or wearing masks or so on.

But we know that people aren't getting vaccinated to the degree we would like, in the risk groups. And you know, that's the downside of having put it in the rear view, that there's some things we could have acted on already, perhaps, that sort of haven't happened, and there's a risk that they sort of fall to the wayside because there's so many other things to worry about, right? You know, in terms of health policy and planning, there's lots of other things to sort of focus on.

ANGE:

James, thanks so much for speaking with me today.

JAMES:

No worries. Thanks for having me.

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ANGE:

Also in the news today…

The Labor party’s emergency immigration legislation has failed to pass the senate at the government’s first attempt, with the bill instead set to be examined in an inquiry.

The Albanese government had hoped to win bipartisan support after the opposition voted for the legislation in the house of representatives on Tuesday, but that backfired once the legislation reached the senate – when the Greens put forward a motion to send the bill to an inquiry and the coalition voted with them, against the government.

And,

Independent MP Andrew Wilkie has used parliamentary privilege to put documents onto the public record, which he claims prove AFL clubs organised the cover-up of positive drug tests for players.

Wilkie alleged illicit drug use was rampant in the league, and in Parliament yesterday he questioned whether the government had tried to stop him from tabling the documents to protect the AFL.

7am is a daily show from The Monthly and The Saturday Paper.

It’s produced by Kara Jensen-Mackinnon, Zoltan Fecso, Cheyne Anderson and Yeo Choong.

Our senior producer is Chris Dengate. Our technical producer is Atticus Bastow.

Our editor is Scott Mitchell. Sarah McVeigh is our head of audio.

Erik Jensen is our editor-in-chief.

Mixing by Andy Elston, Travis Evans, and Atticus Bastow.

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

I’m Ange McCormack, this is 7am. Thanks so much for listening. And just to let you know, over the Easter long weekend, we're dropping episodes of Read This, our sister show, on our feed. 7am will be back on Tuesday

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