Wednesday 14 February 2024

COVID-19 2024: I suspect there has long been a debate in government & public health sectors from which the Australian public in large measure appears to have been excluded


How the road to widespread abandonment of effective communicable disease control began.


In January 2020 the SARS-CoV-2 virus, commonly known as COVID-19, entered Australia and by 7 April 2020 there were 5,844 confirmed COVID-19 cases across the country, with 44 deaths [North Coast Voices, COVID-19 confirmed cases count for Australia, states and territories from 29 March 2020]. 


Infection numbers continued to rise and as of 29 July 2021 the national total confirmed infection number stood at 33,732 - with 2,857 mostly locally acquired active cases - and the death toll from COVID-19 was listed as 920 people with the highest number of deaths occurring in the 80-89 year age group.


Eight days later on 6 August 2021 the Sydney Morning Herald reported:


NSW Premier Gladys Berejiklian said the state must learn to live with COVID-19 as the number of people in hospital with the virus doubled within a week and the nation’s chief medical officer called for a circuit-breaker to halt the spread across Sydney.


As NSW reported a record 291 new cases on Friday, Chief Medical Officer Paul Kelly said low vaccination rates, non-compliance and the speed of diagnosis highlighted the need to reconsider the state’s strategy.


On 23 August 2021 then Australian Prime Minister Scott Morrison announced the 'national plan to live with COVID'


Prime minister Scott Morrison has said Australia must 'learn to live with' Covid-19. 'Once you get to 70% of your eligible population being vaccinated, and 80% ... the plan sets out we have to move forward'. Morrison said once those vaccine targets are hit, it is not about case numbers any more and people need to change their mindsets. 'Because if not at 70% and 80% then when? Then when?,' he said. 'This can not go on forever, this is not a sustainable way to live in this country,' Morrison said.


Needless to say by 31 December 2021 'living with COVID' à la Gladys and Scott saw the national confirmed COVID-19 infection numbers grow to 395,504 men, women and children with 137,752 mostly locally acquired active infections and, 2,239 deaths.


For it seemed that 'living with COVID' might have been Morrison's coded phrase for forced herd immunity and, like many of Morrison's schemes this one doesn't really appear to be working that well - unless the intention was to abandon the old, sick or vulnerable to this disease.


So this is where we are at today.....

 

In February 2024, as part of its fragmented public reporting of COVID-19 infection in the state, NSW Health announced that from 1 January 2024 to 3 February 2024 a total of 17,140 people ranging from 0-4 years up to 90+ years tested positive to COVID-19 via a PCR test, a total of 523 of the people were local residents in the Northern NSW Local Health District. With an est. 28% of the 17,170 requiring hospitalisation in the first week of January rising to 35% by 3 February. [NSW COVID-19 WEEKLY DATA OVERVIEW Epidemiological weeks 4 & 5, ending 03 February 2024]


Confirmed COVID-19 Infection by Age Groupings, 1 July 2023 to 3 February 2024

[ibid] Right click on image to enlarge


Note: The highest age group infection rate per 100,000 for the entire 6 months is a Bright Pink line representing those aged 90+ years and the second highest is Bright Blue representing those aged 65-89 years. While for the last four months and four days the third highest infection rate is represented by Red which indicates small children 0-4 years of age.


At state and national level total COVID-19 deaths have been increasingly hidden from the view of the general public in undifferentiated or hard to quantify mortality graphs and, on 20 October 2023 Australia’s Chief Medical Officer declared that COVID-19 is no longer a Communicable Disease Incident of National Significance (CDINS) following the end of winter in Australia.


On 8 February 2024 La Trobe University sent out a media release discussing a study led by Dr Joel Miller, Associate Professor of Mathematics and Statistics at La Trobe University, found that locking down the most at-risk group of people for a significant period, while simultaneously promoting infection in other groups in order to reach herd immunity, could be the best way to protect the high-risk groups. [my yellow highlighting]


However, increasing the exposure of one group to a disease would create an ethical dilemma and potentially result in the most disadvantaged groups in the community – usually with the least political power – becoming the highly-infected group.....


ABC News, 11 February 2024:


Steve Irons' older brother Jim was only supposed to be in hospital for a short while. A retired stockman from Maryborough, Queensland, Jim was diagnosed with leukaemia just before Christmas in 2022. He was flown to Brisbane for testing, then back to Maryborough Hospital, where doctors were putting together a plan for him to be treated at home.


But a patient in the room next door to Jim's had COVID, Steve says, and on January 14 last year, Jim tested positive too. "After four days, when the hospital told me he was no longer infectious, I took the risk and decided to visit him," says Steve, who'd flown up from Tasmania. "I sat with him for three days, playing country music, reading to him."


And then, on Saturday January 21, Jim Irons died of COVID-19 pneumonia and acute myeloid leukaemia, aged 79. It still distresses Steve to know his brother would have lived longer had he not caught a dangerous virus in a place he should have been safe. Once Jim had COVID, he says, hospital staff kept his door closed and donned masks and gowns when they came into his room. But hindsight is 20/20. "For me, to put him next door to a COVID patient caused his death," Steve says. "It didn't have to happen that way. If they'd had a separate COVID ward … with formal routes of entry, cleaning, controlled ventilation, Jim could still be with us now."


Twelve months later Australian hospitals have become a strange new battleground in the fight against COVID, with doctors and public health experts concerned that too many patients are catching the virus — and an alarming number are dying — as a result of inadequate infection control. Until recently, tools like contact tracing, testing, N95 respirators and good ventilation were mainstays of COVID management in healthcare settings. But in many hospitals they've been wound back or ditched in tandem with other community protections, putting patients and healthcare workers at risk and deterring others from seeking treatment.


Health departments insist the risk of catching COVID cannot be eliminated completely, and that hospitals maintain stringent measures to prevent infections and manage outbreaks. But senior healthcare workers in several states say vulnerable people — including transplant and oncology patients and others with compromised immune systems — are contracting COVID because even basic precautions are not being taken: a consequence, they say, of hospitals' failure to address airborne transmission, and the pervasive myth that COVID is "just a cold".


The 'Robodebt' of medicine

Of course, evidence clearly shows COVID is nothing like a cold, particularly for hospital patients who are at higher risk of severe illness and death. Shocking data released under Freedom of Information laws last year revealed 5,614 people were suspected to have caught COVID in Victorian public hospitals between 2020 and April 2023, with more than one in 10 confirmed or suspected to have died as a result of their infection. In Queensland, similar data shows an average of 13 people caught COVID in hospital every day in the 18 months to June last year, with one patient dying every two days.


"The data we are aware of indicates that there is a large problem here," says Associate Professor Suman Majumdar, chief health officer for COVID and health emergencies at the Burnet Institute. "The key policy aim in Australia is to protect the medically vulnerable and there is no more vulnerable group than people in our hospitals and aged care."


Whilst patients who catch COVID in hospital might be older and sicker, Dr Majumdar says, "this is a patient safety issue". "These are preventable infections and therefore preventable deaths and we need to take action to reduce them by setting targets, tracking progress and reporting transparently like we do for other hospital acquired infections."....


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