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Now is the winter of our discontent. Letter No. 1

Sunday, 22/03/20; An Australian Chest Physician’s Reflections on the Covid-19 Pandemic. “Now is the winter of our discontent.”

Letter No.1 by Dr Roger KA ALLEN

Fellow Earthlings, we are being hit by a tsunami whose wave is building in height by the minute. The numbers of stricken double every three days. Italy has lost 17 doctors so far, 2600 medical staff infected and lost 793 dead in one day (22/03/20) which worse than the daily losses on the Western Front by our forces in WW1 and more than we lost in Vietnam and Afghanistan combined. We have been invaded by invisible aliens and so far the death score is Aliens 0: Humans 13,071 (probably out of date now).

A bit over a week ago our PM was going to the football despite an outcry by the sensible. What was the Chief Medical Officer doing? AMA members have been proposing we call out retired physicians to help although we know older people have the highest death rate only more so in health workers. Go figure! Canon-fodder for the bullet-proof?

We have been behind the eight ball for months while Corona unfolded in December in China.  We all looked on watching like spectators at the Colosseum watching lions eating, not Christians, but Chinese. Foreigners don’t matter.  We were outside the barrier. Pass the pizza and Chianti as the next victim is being led in now and the lions are still hungry.

Next we were told we could congregate in groups of 500 or less (not 501!), then 100, then 2 metres-square individual boundaries (social distancing).  Next thing it will be no more than one in a group. In Germany it is groups of two.  I even had to tell a group of doctors last week that to continue important clinical meetings was madness. They stopped. One hospital had sanctioned such meetings while the other had not.

Inconsistency of policy is rife and at all levels of society from Canberra down. One state is closing schools while the others are not. Tonight the PM announced long overdue measures which are just Stage 1. A day ago I received an email from a gymnasium I attended some years ago to say they were going to reduce aerobics classes to 25 and that they would ensure “social distancing” in the gymnasium. I wrote to them in shock and incredulity and told them they were mad. Tonight (Sunday 22 March), the PM shut down gyms. This should have happened weeks ago.

I will not digress to other countries other than to say that many have been incredibly slow to react. The USA in my opinion is a basket case which is even exacerbated by its lack of a cohesive national health system, disjointed state and insurance functions and overly-expensive health charges compared to other developed countries. The UK on the other hand which has a national health system were in complete denial about the need to shut things down quickly and as result, the virus is on the Italian trajectory only two weeks behind. There was even an article in the New England Journal (20 March) about the British approach; “Covid-19 and the Stiff Upper Lip” i.e. carry on regardless, business as usual. It’s only a monster. Just lie there and “Think of England” as we are British. Things there as result are going shambolic and it could have been reduced in severity by prompt action.

Now some Australian states are closing borders with only essential services operational while people today have been still drinking coffee in cafes, going out to eat, at parks and at the beach e.g. at Redcliffe while we have long since bunkered down and go outside only for absolute essentials.

Many people just don’t get it, while our politicians, few of whom have scientific or medical backgrounds, have been in denial but slowly awakening from their slumbers and inertia. The screws are finally tightening but the horse has already bolted; too little, too late. For example, only yesterday several cruise ships disgorged people in Sydney despite regulations to the contrary. Twenty-five have the virus and there is a ship load of trouble now wants to disgorge into Perth, WA while another 35 people were infected at one wedding. This reminds me of “Dad’s Army”.

If we are to avert an Italian and Spanish catastrophe here, we have to do things better and smarter. Only a few days ago the Chief Medical Officer stated that perhaps we need to have two days’ food at home while the populace ignored this and started panic buying long before as they did not believe the advice and they were right. Indeed the other reasons the shelves were empty was due to a council ordinance that prevented trucks delivering food after hours!

Measures should have been enacted weeks ago here. Dr Norman Swan, ABC Health Reporter remains the shining light, the human face of medicine and should be the Chief Health Officer in my opinion. We need to have confidence in medical leadership. The school issue remains another non-scientific issue based on ideas more than facts.

Tomorrow (now today) my wife who is a psychiatrist and I are in our rooms at the Wesley Hospital to work where telephone consultations are being rapidly adopted wherever possible to reduce travel and risk of exposure to all of us. This has been a timely Medicare initiative.

This is worse than the dystopic “The Walking Dead” series where the “Walkers” or zombies had to bite you to cause infection and death. This can be just inadvertently breathing in viral aerosols in the air long after the infected person has left the room, or a touch of a surface e.g. a petrol-pump handle or a piece of fruit in a supermarket as the virus can remain viable for days (three to nine days depending on the journal article ). I see people with masks on constantly touching their masks (why?) and people out shopping touching each bit of fruit or produce. Why? This is not to say that the infected are “Walkers” for that is not my drift but that the infection is even more contagious and guns and knives won’t work.

We have been led by politicians who change directives by the hour while we as a family have been ahead of their directives for weeks on the basis of scientific facts and advice from medical colleagues with expertise in this area. We saw the writing on the wall weeks ago. We saw Italy on the news each night and the deaths of hundreds each day. We must do the same if we are to avoid this. I feel it is a case, as in WW1 of “lions led by donkeys”. I hope I am wrong as we as a nation need decisive, inspired and intelligent leadership.

We are at war. The last time we had such a pandemic was one hundred year ago and it passed eventually after 20 million deaths and 500 million affected and it probably came from China too. However, we are much more connected now by globalisation and that has led to the rapidity of the spread. Here today, yesterday another hemisphere away. I predict that this is going to be a bleak winter as we head into the flu season here as well. “Now is the winter of our discontent”. Richard III.

My Advice

Bunker down. Stay home. Only go out for absolute necessities. Leave your shoes at the front door. Remove clothes and shower when you get home. Sequester work clothes and put on new clothes at home. Wash fruit and produce in cold, soapy water. Be “paranoid” about the things you buy from shops as they may have the virus on surfaces. Wipe them down. Don’t hoard things but slowly build up reserves of food in a proper and socially responsible way. Don’t get duped into false prophets and gimmicks. There are no foods which will boost you immunity as you can’t “boost” it anyway. If you have a balanced diet that is enough. Get the flu vaccine when available and make sure you have had your scripts filled but just enough for a month as over-supplying drugs will lead to shortages. Remain calm but still be concerned. Don’t put anything but toilet paper and excreta down toilets lest you want a sewerage blockage catastrophe in your house, street or neighbourhood. Plumbers might be sick or short-staffed too to come.

Be kind and thoughtful to neighbours, the elderly, disadvantaged and infirm. Maintain an Australian sense of irony and humour and look forward to the light which one day will emerge from this long tunnel and which will change life in the future for the whole of Mankind. Above all, practice altruism as you may one day depend on the altruism of another for your next meal or your very survival. Unity of purpose is strength. Go well.

More soon by me on why this happened, mechanisms, drugs, vaccines etc.

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