With the next variant just around the corner, the rush to reduce the isolation period for COVID sufferers may see us slam headlong into it, warns Professor Kerryn Phelps.
IN CASE YOU HAVEN’T NOTICED, national cabinet (lower case deliberate) is meeting this week, and some politicians and misguided commentators are trying to soften you up to accept that it is a good idea to reduce the isolation period for people infected with COVID-19, from seven days to five days.
Spoiler alert! It isn’t.
This is an exercise in short-term thinking, putting expedience ahead of common sense.
We know that at five days, over half of infected people will still be infectious. Some are still infectious at ten to 12 days. Seven days was always a compromise and really should have come with the caveat to wear an N95 mask out of the house for another week.
Even the Health Services Union got on board, suggesting it might be a great idea to abandon isolation altogether. That union represents people working in the healthcare sector, apart from doctors and nurses.
Imagine the impact of a policy like this. People working in the health system around already sick and medically vulnerable people, going to work while infectious with a virus that as of today, has already killed almost 14,000 Australians. They in turn infect patients and co-workers.
There is a lot being said on social media and opinion pieces about the “new eugenics”, “burning off the dry tinder”, “ health supremacism” and “ableism”. These terms are reflections of the profound concern by those with a social conscience that current attitudes of “let it rip”, “survival of the young and healthy” and “living our best life and who cares about anyone else” are leaving many in our community behind.
Medically vulnerable people are missing out on community life, on being able to safely go to their workplace, to the theatre and to family events.
We warned some time ago that there was an over-reliance on vaccines as the solution to end the pandemic. The current vaccines are not able to stop transmission or infection, COVID illness, or long COVID. The next variant is just around the corner and if safeguards continue to be wound back, we will slam headlong into it.
Patients who are already dealing with acute or chronic health issues and need to safely access health care are having to make choices about whether it is safer for them to forego investigations or elective surgery or to risk exposure to infected staff and patients in hospitals and healthcare settings.
At the risk of stating the obvious, acutely sick healthcare workers cannot work. But if they are well enough to work but infectious, that presents a danger to others. They may infect vulnerable patients who could become sicker or die, or co-workers who may not be able to work while they are sick, further depleting the healthcare workforce. There is surely an occupational health and safety issue here, too.
Hospitals and healthcare services should be safe places for the most vulnerable, yet there is no national plan for zero transmission in those facilities. That should be a priority for national cabinet and for every state public health unit.
Some states have actually wound back protections, supplying less effective surgical masks instead of higher quality N95 masks for hospital staff and having no checks on whether visitors coming in and out of hospital wards are symptomatic or likely to be infectious.
Is it really too much to ask everyone to wear a mask and to isolate while they are infectious? Judging from the trolling when I ask that question, apparently, it is for some.
Everyone in our community needs to come to grips with the unpleasant and inconvenient reality that COVID infection, even mild COVID infections, can cause a condition known as long COVID.
No matter how invincible you might feel, or how well you came through your last COVID infection, the next one could result in severe illness or long COVID and have you join the ranks of the chronically unwell or medically vulnerable.
The other issue which should be obvious but apparently is not is that our highly trained health workforce is not an infinite resource.
There are currently still over 3,000 people hospitalised with COVID in Australia. “Bed capacity” is misleading. Beds are useless without staff to look after the people in the beds. If healthcare workers die or become too unwell to work, reduce hours or decide to retire early, they are not easily replaced.
Victorian Premier Daniel Andrews has announced free training for nurses and midwives. This is a welcome announcement, but training and experience take time — over a decade in many cases.
I have sympathy for the loss of wages for people who have used up their sick leave, but the answer is not to create more sick workers or imperil the lives of patients needing to access health services. The answer is greater community protections to reduce transmission and income support for healthcare workers who need to isolate when they have tested positive for COVID.
As I read recently on Twitter, nobody is asking you for a kidney. Is it really too much to ask everyone to wear a mask and to isolate while they are infectious? Judging from the trolling when I ask that question, apparently, it is for some.
Whatever happened to the good old days? You know, before 2019, when public health meant just that. When we thought about the health of every member of our community, when wellbeing was an aspiration, when prevention meant something, when we celebrated diversity and inclusion of people with various abilities and when we valued the wisdom and experience of our elders.
What have we become?
The answer will be seen in the outcome of the national cabinet discussions.
Australia, take a look in the mirror.
Dr Kerryn Phelps AM is a GP, author and commentator, an IA columnist, former AMA president, former Wentworth MP, and former Sydney Deputy Lord Mayor. You can follow her on Twitter @drkerrynphelps.
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