In 2019 Greta Thunberg caught the attention of the world when she thundered about “fairytales of eternal economic growth”.
Now in 2020 we have a new fairytale: coronavirus is the dragon, spreading its fearsome wings and breathing fire while the world cowers in its tower.
Our response? Hunker down and wait for the vaccine in shining armour to rescue us. Or an effective treatment of some kind, something a little better than hydroxychloroquine or dexamethasone (or a glug of Drano). Which maybe doesn’t count as a knight. More a squire, perhaps, armour somewhat tarnished.
But the knight is a long way off. Despite positive noises about 90 vaccines in development, some starting clinical trials — with the reassuring name “Oxford” in at least one of these stories — they remain for the moment just that: stories.
It’s one thing to show that you’ve produced antibodies in a gerbil or a bilby or whatever animal was unfortunate enough to meander into the lab but another to get to the point of proving it is both safe and effective in humans. Quite another again to manufacture and distribute the billions of doses needed.
Helen Clark, former New Zealand prime minister and recently appointed leader of the independent global inquiry into the pandemic, says: “I’m told from Geneva that the most optimistic scenario for a widely available vaccine would be at least two and a half years.”
The knight isn’t even on the horizon.
It’s possible a treatment may come sooner. Recently we have the positive news that the anti-viral Remdesivir, originally developed to treat ebola, has been approved for COVID-19 patients. The benefits for the severely ill can be significant, as can be the side effects. It’s also several hundred dollars an ampoule. There’s someone here on horseback, but it’s only a squire — and his armour definitely needs a good polish.
So for now and the foreseeable future we are left with the same choices as when this all began: lockdown, close businesses, restrict movements, socially distance and so on. Sure this will continue to be effective at stopping the virus spreading, but how long can we do it? It may be the right theoretical response from a health perspective, but at what cost to society and the economy (not to mention mental health)?
It’s time to seriously consider other options. Stephen Duckett, health economist at the Grattan Institute, recently argued we should switch to an elimination strategy.
While the idea has appeal, I fear the COVID genie is not only out of the bottle (or was it a dragon?) but has no intention of slipping meekly back inside. It spreads too effectively, too covertly, to be able to stamp it out in a population of 25 million, let alone stop it from sneaking in from overseas.
Should we protect our vulnerable while allowing others to get on with life, taking appropriate precautions? I’m beginning to think we need to consider this in whatever form it might take. More would get sick, and more would die. But influenza kills hundreds of thousands each year (despite an annual vaccine) and we manage.
More than 1000 people die on our roads every year and countless more are injured, but we continue to drive. We protect our vulnerable as best possible (driving tests, licensing, safety features) and legislate where needed (speed, alcohol, drugs) and get on with life.
Success with COVID-19 is predicated on the vaccine/treatment fairytale coming true at some point. We can all hope this is the case, but as my wife was taught about contraception at school in the 1970s: “Hope is not a method.”
It’s certainly not a method for framing our long-term strategy. It’s time to look at what options to consider if the knight fails to turn up.
Yeah – But, the seasonal flu killed ~900 Australians last flu season in what was, globally, a ‘big’ flu year.
In the US, it took out ~34.2K. Compared with COVID-19, which has topped 135K and showing no signs of slowing down anythime soon.
You see where I’m going with this, if we take the approach business lobbyists like AI Group boss Innes Willox is advocating, and just lift all those pesky, business-unfriendly restrictions.
And yeah, around 1,000 people die on our roads each year. But, despite that being a really, really low number – given just how high the risks actually are – we still spend squillions annually on improving road safety and have adopted a national zero road deaths policy.
While I totally agree a vaccine is a long way of, if we ever get one – humanity had never managed to develop an effective conroavirus vaccine – it’s too early to allow people who ‘aren’t vulnerable’ to ‘get on with their lives.’
First, everyone is vulnerable. Just some are more vulnerable than others.
Second, there are lots and lots of fit and healthy young/er people who are getting this virus, and health professionals are only beginning to understand the short, medium and life-longterm imapcts. Some of which are deadly, and which can affect even those with the mildest symptoms.
Third, just how are we going to ‘protect the vulnerable’? Including those otherwise fit and healthy people with no underlying health conditions who’d really rather not get it, and risk having to manage moderate to serious health complications for the rest of their live, thanks very much.
Flight Centre CEO thinks that, as long as we keep washing our hands, we should just lift all restrictions – including mandatory quarrantine – and just learn to ‘live with the virus.’ Which, clearly, means allowing who-knows-how-many-people to die. Presumably, as long as those people aren’t him or his oved-ones.
As Stephen Duckett points out, elimination *is* feasible. You just have to put in place tight enough restrictions, for long enough, so that the virus dies out in the population. Which happens, when it can’t find any new warm bodies to infect within it’s inclubation timeframe – mostly 14 and up to 21 days, with a 28 day outlier 9from memory).
NZ did it. QLD, WA, SA, TAS, the NT, the ACT did it. It’s possible even NSW did it – or was close.
Yes, elimination is *not* eradication and there is always the risk that someone, somewhere will slip up and the genie will get back out of the bottle. A bit like ideology, I guess, based on the Treasurer’s assessment of what you need to do when you’re dealing with an ‘unprecedented’ crisis.
But as long as we continue to be vigillent, it should be able to be quickly contained – and re-eliminated – before it has time to get out of control. And vigillence is going to be required for the foreseeable future, regardless of strategy AUS adopts, because we simply can’t let our health care system collapse under the weight of demand from COVID-19 cases.
Apart from anything else, we need to be able to keep caring for those who need treatment for one of many health conditions that are *not* COVID-19. And we’re not seeing a decline in any of those, except, ironically, seasonal influenza.
So can we at least give elimination a try? We can think about what the alternatives might look like while we see whether it works.
Our options are few and far between, so elimination needs to be on the table. We can manage international arrivals with quarantine centres easy enough, and have an update on Covid-free nations where folks have a test on arrival and are asked to self-isolate until the results are in. Meanwhile the nation can return to near-normal after a sustained 4 week effort to nail it.
It might sound like nails on a chalkboard to Morrison and the rest of the ‘open up’ camp, but realistically, it’s the only option we know will work.
While I agree it has to be on the table, Chris, and I’m for giving it a go, I think 4 weeks of sustained effort is optimistic and I’m also loathe to go so far as to say we know it will work.
Theoretically, yes. But it all comes down to what individuals do…
More than anything, a process of ‘elimination’ requires a rational and responsible population.
It would appear that, on the face of available evidence, there is a very large portion of our community which does not fit those criteria and it seems to be that these deficiencies are widespread across all strata and age groups in our society.
Taken to a logical conclusion, if a significant portion of the population did possess these qualities, much of what passes for commercial endeavour would not exist, religions would be too tiny to be of significance and most of our elected ‘representatives’ would be living on the dole and subsisting on survival rations.
Not sure whether to laugh or cry…
“Please explain.”
Sorry, no. Given the list of long-term and permanent health consequences of getting Covid, we should be going hard on the elimination route and making sure it can’t get back into the country.
Otherwise flare-ups like we see in Melbourne are just going to keep coming back again and again.
There is no way to “suppress” this that doesn’t involve hundreds and thousands of new cases per day being the end result.
This type of thinking is now the real worry for us; its all too hard, let’s give-up and let it rip and just accept the consequences; like the Swedish/USA/Brazil strategy which has delivered really fantastic outcomes for them I don’t think — the double whammy of massive deaths and stuffed economies.
The messaging today from the NSW Premier and deputy is also along these lines too; our hospitals are now ready so there is no need for restrictions (ie. We don’t care if people get sick because our hospitals can cope, except there is no effective treatment). The sentiment was also the same from our hapless PM this morning. Unfortunately I don’t have dual citizenship to escape this madness and our borders are closed (except for the rich and idle) besides.
I must say I have heard more rational arguments from young people along the lines of benefitting the development of the human race in a Darwinian evolution sense or fascist eugenicists.
A more rational and logical article could have raised the questions whether diverting resources to vaccine development may delay the development of more effective population level responses such as treatment or prophylatic measures to effectively eliminate community transmission. Why is it that only vaccines are seen as a likely saviour, and not the whole suite of measures?….We still have potable clean water and sewerage systems as very effective public health measures.
Here’s an idea, why not have one State as the ‘let it rip’ policy State with hard borders yet let people choose to move into or out of that State (with quarantine etc) over an interim period? I’d suggest NSW. I would wonder whether businesses might then reconsider their ‘no more restrictions its bad for business’ demands.
” Why is it that only vaccines are seen as a likely saviour, and not the whole suite of measures?”
See my previous comment, Mark.
Views such as mine are not popular, which is self qualifying.
Dunning-Kruger writ bold.
As for the influence of ‘businesses’ they seem unable to appreciate the depths that their beloved ‘economy’ will sink to if mass incapacitation of the population occurs due to both the virus itself and the overwhelmed health services becoming unable to provide for all the other requirements of the general community.
No customers, no business.
“Simples”, as they say.
Depressing isn’t it? Despite businesses and bodies corporate not having a vote (yet) I know from personal experience (including having had to defend writs successfully), that it is possible for people to effectively counter their undue influence in our democracy. However, it takes much effort, personal costs and wears one down. On the other hand, unlike people, businesses can maintain their pressure over very long periods of time and inevitably get their way, once they have worn down individual natural people.
Doesn’t Dunning-Kruger only apply to incompetents?
I was refering to the mass of people who are simply not capable of locigal thought, Mark.
There are so very many of them.
And, I do not preclude ‘business’ people, who seem incapable of viewing the world in other than ‘bottom-line’ terms.