Wednesday, January 12, 2022

Australia's top doctors' urge prompt return to schools

Dozens of Australia's top academics, doctors and community leaders have called for schools to reopen in an open letter, as the Omicron wave approaches its peak.

Thousands of students will return to the classroom in the coming weeks for the 2022 school year as Covid infections surge to record levels.

As Queensland delayed its start to term one by two weeks, a group of leading figures have written to Prime Minister Scott Morrison and state and territory premiers, calling for them to reassure families that schools are safe to return to.

The letter urges governments to follow the principle set by the World Health Organisation and the United Nations Children's Fund that in a pandemic 'schools must be the last to close and the first to open'.

The authors describe students as the forgotten voices of the pandemic after thousands had their education disrupted for months at the time during lockdown.

Epidemiologists Catherine Bennett and Fiona Russell, former Australian of the Year Patrick McGorry and Professor of Child Health David Issacs are among the 35 academics, doctors and community leaders who have put their name to the open letter sent ahead of Thursday's national cabinet.

'In the third year of the COVID-19 pandemic we now have evidence that it is safe to allow schools to be open for face-to-face learning,' the letter begins.

'The national cabinet commitment to re-open schools is at risk, however, and needs to be reaffirmed by every jurisdiction, with measures taken to reassure Australian families that schools are safe to return.'

The high-profile people argue that a delay to return to face to face learning is not a proportionate response with data showing Covid-19 is a mild disease in children and that the overwhelming majority recover without adverse affects.

The letter also states there's medical case for face-to-face learning to be suspended despite the vaccine rollout for ages 5-11 being launched this week.

The letter warns of ignoring the obligation to deliver the best education outcomes if the return to the classroom is delayed as it greatly disadvantages the least privileged and causes unnecessary anxiety and harm.

'Children are the 'lost voices' of this pandemic,' it states.

'The right of children to an education based on in-person learning and healthy social interaction with peers is now one of the highest policy priorities for Australian governments to limit the long-term adverse impact of this pandemic.'

Concerns were also raised about children's mental health and increased risk of child abuse, obesity, and delayed social and emotional development.

The authors acknowledge measures such as rapid antigen testing, the wearing of masks and ventilation upgrades need to be implemented to reduce the risk of transmissions in schools and ease parents and teachers' fears about kids returning to school.

'Given the relatively low risk posed by schools and in the absence of evidence that these measures will have a substantial effect on transmission, a delayed roll-out of these measures should not delay in-person learning,' it states.

The letter ends stating Australian children have a fundamental right to high-quality education and the return of face to face learning as soon as possible is in everyone's best interests.


Zero Covid WA? Tell Mark McGowan he’s dreaming

You can call it letting it rip. Or you could call it living with reality. Take your pick. The Omicron variant is clearly so infectious and so highly transmissible, it is a fool’s errand to try and prevent it’s spread by border closures and lockdowns.

Australians are shuffling through supermarkets in scenes reminiscent of the former Soviet Union circa 1980. Supply lines are collapsing as warehouse workers, forklift drivers, truck drivers and shelf stackers are off work either struck down by Omicron or forced to isolate under close contact rules.

The Omicron variant has only just celebrated its second month of existence. In that short space of time, it has travelled around the world and back again, causing havoc wherever it goes.

Two republics and a kingdom

By my reckoning only three jurisdictions have a Zero Covid policy — the People’s Republic of China, the Democratic People’s Republic of Korea and the state of Western Australia, sometimes called the Kingdom of Westralia.

We might also throw New Zealand where the Ardern government has closed the borders with the only permitted entrants having to endure a sort of Kafkaesque descent into bureaucratic hell marked with multiple PCR tests, statutory declarations and finally something obliquely called the MIQ or mandatory quarantine.

China may have low cases of Omicron, but it also has a city of 13 million people, Jian, in lockdown. Quarantine of local residents is strictly enforced. Hong Kong is shut down at night. As with China, entrants to Hong Kong must enter into quarantine for a 14-day period. Hong Kong creates an estimated 20 per cent to China’s GDP. Quarantine rules are starting to see businesses in the financial sector move to Singapore and elsewhere in the Asia-Pacific.

Closing the borders has been a doddle for the DPRK, having all but done so since 1953. Hard borders then have become virtually impassable now, but it has come at a terrible cost. 90 per cent of the country’s imports come from China and this has declined by 80 per cent. In June 2021, The DPRK leader, Kim Jong-un took a break from the endless propaganda to tell a Korean Worker’s Party meeting that the “people’s food situation is now getting tense.”

Last month, South Korea’s intelligence services reported that Kim had ordered all North Koreans to devote every effort to farming, and to secure “every grain” of rice. Most, if not all, foreign aid and UN workers have left the country, effectively shutting down any humanitarian response.

Australia’s hermit kingdom

Western Australia and WA Labor’s anointed ‘state dad’, Mark McGowan should be taking note. Australia’s own hermit kingdom has just over a thousand Covid cases stand compared to New South Wales’ half a million. Western Australia continues to thrive economically. It was the only state in the Commonwealth not to go into a pandemic driven recession. That’s the good news and has created a sense of comfort in isolation.

But that isolation has led, in part, to a slow vaccination take up with the state running around ten per cent below the vaccination rates in eastern states and that delay will impact on booster shots to provide enhanced protection against Omicron.

If McGowan stays true to his word, WA will start opening up in February, once the state’s reaches the mark of 90 per cent aged 16 or older fully vaccinated.

Omicron is coming to Western Australia. There is no stopping it. Zero Covid policy merely delays it, kicks it down the road. Worse, it promises to extend the peak period of infection and transmissibility across the entire country, prolonging supply breakdowns and causing more economic harm than is necessary. The state of Western Australia and it’s dad is about to discover that Zero Covid under the Omicron variant is a dangerous fantasy.


Queensland health boss issues ‘keep calm, carry on’ message despite Covid case warning

Despite escalating Covid case numbers, the chief health officer has advised healthy, vaccinated Queenslanders to go about their lives as normal, declaring the state is in an enviable position because of high vaccination rates.

Queenslanders must go about their lives as normal despite escalating case numbers and warnings more people will suffer from Covid-19 over coming weeks, the chief health officer has declared.

Authorities are expecting case numbers to reach a “short, sharp peak” in the first week of February when the health system is expected to come under the most pressure.

Queensland recorded 20,566 cases on Tuesday – some of which were discovered on Monday but were not reported due to a technical glitch – and one death, a man in his 70s who had other medical complications.

Chief health officer John Gerrard said Queensland was in an enviable position with just 27 patients in intensive care units and six on ventilators across the state.

“To put that in context, I was in Tokyo at the beginning of the pandemic dealing with the Diamond Princess outbreak where we had 700 people infected with Covid-19, of which over 30 were on ventilators in intensive care units,” he said.

“In Queensland we have well over 100,000 people that are infected … and we have just 27 people in intensive care units.

“The lesson is the vaccines are working, they’re specifically working in preventing people from getting critically ill and reducing hospital admissions.”

Dr Gerrard said it proved people must get vaccinated to “continue our lives as normal” despite rising case numbers and hospitalisations.

“What is happening here is inevitable,” he said. “We‘ve made this minor change at the start of the school year, but I think as far as possible, most of us should be continuing our lives as normal.

“As far as possible I think most of us should be continuing our lives as normal, I don’t think we should be allowing our lives to be disrupted too much at this stage by this virus.”

He said “notable exceptions” included those who were unvaccinated, immunocompromised and elderly.

Queensland Health was unable to say how many patients in the intensive care unit were unvaccinated.

Health Minister Yvette D’Ath confirmed Queensland was sticking with its reopening road map – which stipulates life will move a step closer to normality when the double-dose vaccination rate reaches 90 per cent within the next few weeks.

“People from interstate hotspots, at 90 per cent double dose, still have to be fully vaccinated but will not have to do either a rapid antigen test or a PCR test and international arrivals who are fully vaccinated won’t need to quarantine,” she said.

There are 91.16 per cent of Queenslanders with one dose and 87.85 per cent with two doses.


‘Personal responsibility’ is no match for Omicron

Annabelle Warren wants more regulation. She seems to think that more isolation is needed

In the context of this pandemic, I consider myself a responsible person. I am a specialist doctor, triple vaxxed, healthy, in my early 30s, and I have previously worked in a COVID-19 ward – but my “personal responsibility” hasn’t protected me from COVID-19.

A misplaced reliance on this strategy is failing us all, especially our most vulnerable.

Despite being cautious, wearing masks in public indoor settings and moderating social contact, my brush with COVID-19 came at a five-person lunch eaten outdoors, with friends who were fully vaccinated and each returned a negative rapid antigen test that morning. Unfortunately, the next day someone reported an unwell partner and a positive rapid test, and I had become a contact.

The lunch was under four hours and mostly outside, so I didn’t meet the revised definition of a close contact. I cancelled plans despite the official advice to simply monitor for symptoms, but did not formally isolate.

Two days later I felt dry in my throat. I had “responsibly” bought two boxes of five rapid tests before Christmas in anticipation of demand, costing over $100. The result that day was negative. On that basis, I popped to the supermarket wearing an N95 mask to buy supplies. The following day, four days after my exposure, I developed a dry cough and chest tightness and this time the two red lines read positive.

I was unsurprised but still shocked. At that time, PCR testing sites were overwhelmed with five to six-hour waits. The advice was “don’t get tested”. “Manage at home” seemed to mean “you’re on your own”.

As someone who has worked hard in the public hospital system for many years caring for others, I felt cast adrift. At least as I am on annual leave, there were no workforce consequences. Now that I have been able to report my rapid test result, I have been connected with COVID Positive Pathways symptom monitoring, which supports people to isolate at home.

So this is COVID-19, we meet after two years. I am so lucky that our collective sacrifices with lockdowns and (eventual) access to good PPE have delayed my encounter so I am fully vaccinated, with my risk of severe disease reduced more than 90 per cent, despite the delayed rollout. But by failing to correct course and reintroduce restrictions on large gatherings when Omicron started to flare, our advantage was squandered. Australia now has one of the highest rates of COVID-19 infection in the world.

As I write, I’m now on day three of illness and I have a fever, dry cough, fatigue and my face and arms feel numb. I know that I have every reason to remain a “mild” case. I couldn’t be in a more privileged position to “personal responsibility” my way through this, but I’m scared.

I’m terrified I’ve given COVID-19 to my partner by not isolating adequately. I’m concerned for my medical and nursing colleagues under unprecedented strain, and I worry about anyone who needs any sort of medical care in the next six weeks as the proverbial hits the fan.

Negative rapid tests don’t mean no COVID-19, and they don’t mean you are not infectious. Personal caution in excess of current guidelines did not spare me infection. None of us are safe while transmission rates skyrocket, especially those in our community who are vulnerable due to older age, medical conditions, disability or being unvaccinated.

Despite the false reassurance, access to rapid tests was crucial to my knowing I was at risk the next day so I could limit movement, and in confirming my diagnosis early so I could isolate. People shouldn’t have to line up and spend hundreds of dollars – they should be free, and freely available. No one’s putting sticks up their nose for fun – or if they are and it prevents transmission, good on them.

In my case, the current close contact definition was insufficient and by following that advice, I ended up inadequately isolating. Lax isolation criteria to get people back to work is a false economy that will logically lead to a greater number of staff isolating with infection down the track. Similarly, the reduced isolation period of seven days for cases should be continually reassessed to ensure it does not increase transmission risk.

Our leaders made a conscious decision about a poorly understood new variant to “let it rip” into our hard-fought equilibrium, so they should have had a plan to manage the consequences. Instead, it’s a disaster. Sunscreen is useless if everything’s on fire, and no one’s holding any hoses right now.

A misplaced reliance on “personal responsibility” has been a failed tactic in the face of Omicron that falsely lays blame for a policy vacuum at the feet of individuals. Now is not the time to abandon the public health measures that we know mitigate spread.




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