Is Dominic Perrottet premier for NSW or for Sydney? This is a question that arises when considering his determination to open up in spite of the clear risk for many regional areas.
“Regional NSW not only has the fastest growth in COVID cases, it also has the lowest vaccination rates,” notes Professor Kathy Eagar, Director of the Australian Health Services Research Institute at the University of Wollongong, in her latest column.
Kathy Eagar writes:
“The randomness of illness is far too frightening for many to consider – so they are dependent on a fiction, they are special and can control their bodies. From crackpot COVID theorists to antivaxers, hubris and fear haunt the wellness community. ”
The quote from the work comes from Guardian Australia author Brigid Delaney.
The word of the week is tilt, or inability to plan or make plans due to a pandemic and all the attendant limitations.
“What is the program for the coming week? Not really much because of the plandemic ”.
Australian COVID at a glance
Here is an overview of the COVID state in the nation yesterday.
The biggest outbursts of concern remain in NSW and Victoria, but they are heading in different directions.
NSW peaked more than two weeks ago and cases are now down to about a third of what they were at the top. Victoria is not yet at the top and has today recorded the worst day ever – 1,838 cases in one day.
Reff round up
The effective reproduction number or Reff or RO tells you how fast the virus is spreading. When Reff is greater than 1.0, cases increase. When Reff is less than 1.0, the cases drop. Thanks Prof Adrian Esterman for his daily calculation of Reff.
ACTION: 40 cases today. 5-day moving average 34 (15.0 last week), Reff 0.86 (0.81 last week) -ACT has fluctuated all week and is not out of the woods yet.
NSW: 646 cases today. 5-day moving average 591 (1,007 last week), Reff 0.75 (0.85 last week) -Reff and the cases are falling nicely. The move from lockdown puts it in jeopardy.
Vic: 1,838 cases today. 5-day moving average 1,599 (657 last week) Reff 1.21 (1.27 last week) cases are still rising with every 100 people infecting about 121 more. COVID is now spreading across Victoria thanks to covidiot protesters and football fanatics
Qld, SA, Tas, WA, NT: moving average 0, Reff 0
A state average does not tell the whole story
In addition to trends in NSW and Victoria going in opposite directions, we now also see different trends within both NSW and Victoria. Thanks to Juliette O’Brien (covid19data.com.au) for these numbers.
South West and Western Sydney: 259 cases yesterday, making 5,782 cases in the last two weeks. That’s a 48 percent reduction in fourteen days before.
Rest of Sydney: 87 cases yesterday, making 2,158 cases in the last two weeks. That’s a 45 percent reduction in fourteen days before.
Regional NSW: 183 cases yesterday, making 3,073 cases in the last two weeks. That’s a 74 percent increase in fourteen days before.
Here is more detailed breakdown by NSW district.
North and West Melbourne: an increase of 94 per cent compared to fourteen weeks before (but the growth rate is declining).
Rest of Melbourne: a 344 per cent increase in cases compared to the previous two weeks (growth rate is stable).
Regional Victoria: a 489 percent increase in cases compared to the previous fourteen weeks (growth is accelerating).
Although it all looks pretty miserable for Victoria, there is some good news according to Professor Adrian Esterman. Hospitalization typically occurs about seven days after diagnosis.
This chart tracks cases every day with hospitalization a week later. We are now seeing an interruption in which cases are rising much faster than admissions. What we are looking at in this graph seems to be a real vaccine effect.
See also the number of COVID cases after LGA for regional NSW, Greater Sydney and for Victoria.
Swiss cheese model for public health
As states, territories and the Commonwealth prepare to open up our society, our economy and our borders, it is important to keep in mind that the virus will not go away.
A politician lifting a lockdown does not make the country more secure. And just because we are all tired of being locked inside and want to get our lives back does not mean that life will soon become ‘old normal’.
The question for all of us now is about the way we want to live in the new COVID standard. There is no right answer to that. We each have a different tolerance for risk. Some of us want to hide under the doona, others think they are bulletproof. And we are each at different levels of risk.
The Swiss Cheese model is a useful way of thinking about how we handle our way out of the lockdown and manage to live with COVID beyond that.
It recognizes that no single intervention is perfect for preventing the spread of coronavirus. No intervention is 100 percent, each intervention has gaps. Multiple layers of protection help limit the spread of the virus. Each layer has holes, and the risk of infection increases when the holes are flush.
The more layers you have in place around you, the more you are protected. If only our governments had sensible conversations with the public about our appetite for risk going forward and about how all the layers are connected. Well, I can always dream.
Dr. James Reason, introduced the “Swiss Cheese Model” in 1990, and this meme was created by Dr. Ian Mackay from the University of Queensland.
NSW and the magical 70 percent double vaccination rate
The brand NSW Premier has spent the last few days preaching how amazing it is that we have achieved 70 percent and announced various easing of restrictions. The next bar will be when 80 percent of the eligible population is double-vaccinated.
Below is a table showing current vaccination rates based on NSW statistical areas. They are listed from highest (Baulkham Hills and Hawkesbury) to lowest (Richmond-Tweed). Far West Orana is the only part of the regional NSW that has hit 70 percent.
Regional NSW not only has the fastest growth in COVID cases, it also has the lowest vaccination rates. Hmmm … a naughty friend suggested that we use a government for the whole of NSW, not just for Sydney. Ouch!
There is growing international evidence that COVID vaccination booster shots will be required. This is based on evidence that the effect of the vaccine decreases over time. Some countries have already implemented third dose increase programs. One of the first was Israel.
Third dose booster shots pose an ethical challenge. How can high-income countries roll out the third dose when many many millions of people in low-income countries are waiting for their first dose?
This is the position adopted by the World Health Organization (WHO), which argues that countries should not introduce third-shot augmentation programs until all people in low-income countries have been offered vaccines.
Whatever it is, the Australian Technical Advisory Group on Immunization (ATAGI) has today issued its national recommendations for a third dose.
ATAGI at this stage only recommends a third dose for people who are severely immunocompromised. ATAGI does not (yet) recommend a third dose for everyone – but in my opinion it is inevitable.
See the ATAGI list of who should receive a third dose.
Crackpot COVID theorists, antivaxers and fitness fanatics
My quote for the day is from Brigid Delaney and her excellent article on crackpot theories, the wellness industry and COVID.
I really liked this article because it helped me understand why some otherwise sensible people have been so vaccine resistant.
The randomness of disease is far too frightening for many to consider – so they are addicted to a fiction, they are special and can control their bodies. This leads to a belief that a powerful natural immune system is the best defense against COVID, not a vaccine.
Some of the same thinking – that we have the ability to determine our own health status through lifestyle choices – can be seen in organized health promotion programs.
The common wisdom in public health for decades now (supported by good evidence) is that infectious diseases are a thing of the past. In a high-income country like Australia, that was certainly the case – until COVID.
Non-communicable diseases (NCDs) – heart disease, diabetes, cancer, mental illness, etc. – have been the main causes of ill health for decades, and the focus has been on healthy living as the main tool to control NCDs and limit the demand for health care. .
But the sad reality is that no matter how healthy our lifestyle is, we will all die. And sometimes illness and death are just random.
It is a very frightening thought in a society that is increasingly death-denying and which promotes a belief that we are each responsible for our own destinies.
My article in SMH today: Take the liberty slowly, or the cycle of lockdowns starts all over again.
The White House has announced $ 1 billion to buy rapid, home-based coronavirus testing. So now we want ROTS in the White House. Come on Australia, hurry up.
Why anti-waxers, conspiracy theorists and right-wing extremists have come together on COVID-19: Right-wing, anti-waxers and conspiracy theorists seem to have found fertile ground, especially among men who feel alienated, afraid of employment and who spend a lot of time on scrolling social media and encrypted messaging apps.
Buy a llama not a dog. Lama antibodies have ‘significant potential’ as covid therapy – study.
‘Miasma’ was on my shortlist for today’s words: The 2,000-year-old airborne disease theory that blinded COVID experts.
From next week, those of us who live in NSW can welcome visitors to our home again. Here’s a good idea.
Croakey thanks and acknowledges Professor Kathy Eagar for this column, which is based on a regular COVID update that she sends to her emails, combining a mix of evidence, observation and funny humor. Follow on Twitter @k_eagar
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