What a brief meeting says about Australia's slack response to public health communications.
“My mama always said, ‘Life was like a box of chocolates. You never know what you’re gonna get.'” – Forrest Gump.
It’s true. Well, almost. My sister happened to be at an intimate soiree with Tom and his wife Rita in Sydney. Then these pearl-toothed, virus-shedding, star-spangled film stars announced that they were diagnosed with Covid-19.
Tsk. More people spoiling our sun-kissed Aussie way of life with this Woohoohan virus. Like recessions, or climate change fantasies, or Amber Heard’s dog, we really don’t appreciate foreigners bringing anything other than their money, and taking our coal home with them.
So what did my sister do? Well, she panicked (albeit in a dignified way). Suddenly, life was in slo-mo. Ominous Jaws soundtrack, then shrieking Psycho violin crescendo. A new reality.
She felt fine. But Tom and Rita got tested, so shouldn’t she? First she tried to find out what to do by going online, and calling friends. No obvious source online, and no friends really knew. No clear info from the government. Confusion.
Then she heard that Covid-19 tests are the new orange, as de rigeur as a 24-clutchpack of toilet rolls and a flask of hand-gel.
So she walked up to the local hospital, where a long line of orderly citizens was becoming a post-Apocalyptic mob. Medical staff, who looked as though they’d rather have Tasers than stethoscopes, were patiently telling the crowd that if they felt ok, they should go home.
What? Go home and just wait to die?? What about the cossetted Tinseltown couple? She walked home, un-tested, and just as baffled.
Then she found out that not only were Tom and Rita afflicted with Covid-19, but another guest called Jamie had it too. So Tom and Rita gave it to Jamie! Or Jamie gave it to Tom and Rita. Or Jamie and Tom and Rita all got it from a fourth unidentified person at the party. Or Rita had it and gave it to Tom who gave it to Jamie? Or all three got it elsewhere from three separate sources and BYO-ed it to the party??
Or I gave it to my sister and she thoughtfully took it the soiree. Who knows?
This little tale reveals something about the likely presence and spread of Covid-19 in Australia (and in most other countries), except star performers like Singapore, Hong Kong and Taiwan.
The only reason Tom and Rita got tested was because with even a little sniffle, they were important enough to be able to get a test quickly. Then Jamie got a test because he heard Tom and Rita were ill, and he’d been at the party.
Jamie’s got the bug, and Tom and Rita, but we don’t know about my sister because she shows no sign of illness (she did get an e-mail from health authorities, which shows that the surveillance system is functional at some level).
She might be harbouring the virus, and may sicken in a couple of days or a week, or she might be inadvertently spreading it. Or maybe she dodged a bullet – who knows?
It would have been better for her if she had caught it now. Firstly, because merely saying you caught Covid-19 from Tom Hanks carries dine-outable kudos in Sydney, and maybe even an ‘expert’ guest spot on a chat show.
Secondly, and possibly more importantly, it would have been better to fall sick now while the number of cases remains limited, and you can be tested and hospitalised if necessary (we know that the vast majority of people will acquire mild symptoms and quickly recover without needing to even see a doctor).
This is because Covid-19 is not just the ‘flu. The latter is an annual, somewhat measurable affliction for which our health systems are prepared, whilst the former remains an unknown quantity (with variables such as morbidity, lethality, transmissibility, mutability still to be defined by scientists). With both happening at the same time.
This is why containment matters. Containment measures slow the spread (nothing will really stop it), providing important time for the health system to deal with critical caseloads. This is the business you hear about ‘flattening the curve,’ the big bump of numbers that can overwhelm a health system (numbers of beds and ventilators, and overworked and sickening staff).
Will it behave like the Spanish ‘Flu (infecting about 27% of the then world population of roughly 1.9 billion, and killing something between 17 million and 50 million people, or one in every 40 people at the upper end of the highly contested estimate)?
Because C-19 is currently characterised by these elusive variables, its potential mortality rate can’t be accurately established right now. We’ll have to wait until this is all over, which means waiting until the virus has spread across the world’s population in the next year or 18 months, and has been observed through various seasons and climates, and in populations characterised by very different social, political, and economic circumstances.
(You can be certain, however, that if it overwhelms the Italian healthcare system, then it won’t be favourable to millions of refugees and displaced caught in camps with little or no access to healthcare, shelter, or hospital beds and ventilators).
I guess this won’t be a Spanish ‘Flu. The big question around the once-in-a-century pandemic that educated health professionals knew must come one day (and we’re not really sure if this is it), is whether a combination of modern medicine and science, pandemic awareness and preparation, health and behavioural communications, and the political response to an outbreak, will combine to contain and lesson the up-front impact.
Will this combination outweigh the potentially disastrous effects of an unknown, highly contagious virus now assisted by the transit assets of a globalized world (planes, trains, and automobiles)?
My bet (and I know as much or as little as any schmuck who reads), is that after an initial blitzkrieg, the vast benefits of the modern world, and the incalculable advances in science, medicine, computer power, communications, and norms of international cooperation will combine to handle this.
The greatest weakness in this chain is the political response, which in turn affects how we communicate around the pandemic, and how we rollout the one thing that we know that works to stop a pandemic long enough to get on top – containment through isolation, quarantine, cordons sanitaires, social distancing, and washing our bloody hands.
I also think (but don’t know) that like the U.S., the Australian response is late, and that the Tom and Rita example exposes the fact that Covid-19 has been with us for some time. As such, testing is of limited value for surveillance/containment purposes now.
The fact is that modern life is less and less like a box of chocolates, and that you can know what you’re going to get when the system works.
The big question for Australians is whether our government will now move boldly enough to contain the current spread, by banning large gatherings and instituting the host of measures we see rolling out across the world.
The measure will be obvious in a short time, perhaps one or two months when we’ll know if we kept that curve flat.
In the words of Forrest Gump, “stupid is as stupid does.”