Health Analysis

KERRYN PHELPS: COVID is not over!

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(Cartoon by Mark David / @MDavidCartoons)

COVID-19 complacency has resulted in infections and deaths skyrocketing and Dr Kerryn Phelps reminds us that it's far from over yet.

IN A DOUBLESPEAK campaign that would do George Orwell proud, most Australians seem to have been successfully convinced into believing we are in a “post-pandemic world”.

At the risk of mixing my literary metaphors, this is gaslighting on an international level.

Political media statements, reported by mainstream media and adopted by the general public, have been using phrases like “When we were going through COVID”.

This has been aided and abetted by the “COVID is a mild illness” mantra.

Make no mistake, we are still right in the middle of the COVID-19 pandemic, with public health experts expecting a new peak of COVID infection in Australia in late July and through August.

The number of cases, hospitalisations and deaths skyrocketed after most safeguards were removed in December 2021, starting with New South Wales.

Just look at the numbers now.

Australia has reported over 8.2 million cases since the start of the pandemic, the vast majority since January this year.

Australia currently has over 265,000 active cases. More than 3,500 are in hospital.

The death rate is simply shocking. Over 10,000 have died so far, with hundreds still dying of COVID every week. As a comparison, the annual road toll is around 1,300, so the COVID death toll for three or four weeks is approximately equivalent to the annual road toll.

“Living with COVID” is a tricky slogan, designed to lull the population into a false sense of security, go about their business, unrestricted, unimpeded, oblivious.

We need to count more than the numbers of people dying, disturbing as those numbers are. The latest warning comes from clinicians recognising the incoming tsunami of long COVID disability.

In general practice, we have been seeing cases of long COVID for some time and my colleagues in other specialities are seeing it, too.

Sure, you might get a mild initial infection and that could be the end of it, this time. But you might get long COVID. And if you don’t get long COVID with the first infection, you might get it with reinfection. The most common symptoms of brain fog, breathlessness and fatigue are just the beginning, with almost 200 other symptoms now reported.

We will need a big research effort to develop diagnostic tests and effective treatments because to date there are no specific tests to confirm long COVID and no specific treatments. In fact, there has been a lack of effort in identifying and testing treatments.

In the meantime, not getting infected is the only known prevention.

Aged care workers planning to leave in droves, nurses out on strike and leaving the profession, paramedics taking to social media to alert the public that the system is not coping, general practice under pressure, schools unable to replace sick teachers with casual staff, businesses finding it difficult to find staff to keep their businesses running, air travel disrupted.

This is the real-world view of “living with COVID”.

“But don’t vaccines keep you safe,” you ask?  More doublespeak, I’m afraid. It depends on how you define “safe”. 

There is definitely a highly significant reduction in death rates and severe acute disease if you have had three or four vaccines. But these vaccines alone are not going to get us there. They are not going to get us to that elusive state of “herd immunity”. And they are likely to be less effective against future variants.

Sooner or later, the sheer volume of long COVID cases and other realities impacting on the health system, the education system, aged care and the broader economy will mean more and more people will realise the real risk of uncontrolled COVID.

The largely unspoken but blindingly obvious fact is that while the current vaccines do reduce the risk of death and hospitalisations, they do not stop you from getting the virus. They do not stop you from getting very sick from the virus, developing long COVID or transmitting the infection to others. Some people have developed persistent health problems following the vaccine and cannot have boosters and are particularly vulnerable.

Federal and state health ministers met last week and all we heard out of that meeting was about boosters and antivirals. Nothing about plans for suppressing transmission.

Surely they are seeing the reports my colleagues and I are seeing, including COVID-related blood clots, lung damage, brain damage, increased incidence of heart attack, stroke and diabetes, and damaged immune systems? And yes, in people who have been vaccinated.

"Oh, but aren’t there antivirals now?" Well, yes there are. But unless you fit the very narrow criteria (for example, over 65, not fully vaccinated and two serious underlying health conditions), you will either not be able to get them, or you will be given a private prescription that will cost you around $1,200 for a five-day course. This is the reason for the talk about improving access to antivirals.

And you might get multiple infections each year.

The current direction is unsustainable.

Now there is a public debate about whether mask mandates should be reinstated. 

I had a heated exchange with a radio talkback host this week saying he objects to any restrictions. Why is a mask a restriction? It does not stop anyone from moving about freely.

That argument always makes me wonder how things would be if we did not have other public health and safety measures in place to protect public health, like mandatory seat belts in cars, or a ban on smoking in restaurants and offices.

There is already a mask mandate on public transport in some states and that is all but ignored by most commuters. A mandate without enforcement is next to useless.

And it is clear that regular pleas/encouragement/urging by senior health officials to wear masks has been completely ineffectual.

New COVID variants are on the way and they are predicted to have a similarly damaging effect on the lungs as the Delta variant. It is unlikely that the current vaccines will provide adequate immunity to these variants.

Knowing all of this, we shouldn’t need anything more than common sense to have everyone in masks when they are away from home, to require isolation for a few extra days while a person is still infectious and to open windows for ventilation where possible.

To get the number of COVID cases down, there is going to have to be an intervention making some of these measures mandatory.

Businesses wanting to maintain their workforce need to consider widening work-from-home options and the education system will need to consider flexible learning options before the teacher shortage worsens.

Longer-term fixes such as building ventilation standards and air filtration could follow in time, but portable air purifiers are a cheap and quick hack for business.

So the question is where do we go from here? Continuing on this course might be politically palatable in the short term while many in the community are unaware of the dangers to themselves, their families and the systems we all rely upon. But from a public health perspective, it is just not an option.

Sooner or later, the sheer volume of long COVID cases and other realities impacting on the health system, the education system, aged care and the broader economy will mean more and more people will realise the real risk of uncontrolled COVID.

Maybe then there will be enough awareness and community spirit to have everyone voluntarily wear a mask when they are around other people.

There will be a tipping point. At some stage. Meanwhile, we continue this frustrating “debate” about whether to act now, knowing what we know, or to wait for… what?

Professor Kerryn Phelps AM is an IA columnist, former Member for Wentworth, advisory board member and conjoint professor at NICM Health Research Institute, a Climate 200 advisory panel member, a member of OzSAGE and a former Sydney Deputy Lord Mayor. You can follow her on Twitter @drkerrynphelps.

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