‘Become mentally prepared to live your life differently’

Biosecurity expert Prof. Raina MacIntyre explains how the best course of action against COVID-19 is improving hygiene and preparing for major social changes

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Biosecurity expert Prof. Raina MacIntyre explains how the best course of action against COVID-19 is improving hygiene and preparing for major social changes

With facts and figures being thrown at us from all sides, it can be difficult to narrow down on crucial information about the novel coronavirus. Prof. Raina MacIntyre, head of the Biosecurity Research Program at the Kirby Institute, UNSW Medicine, sat down with PAWAN LUTHRA to help sift through the facts.

What are the symptoms of COVID-19 and what should one do if you think you are showing symptoms?

The most common symptom is fever, followed by cough and shortness of breath. If you have been in contact with someone with COVID-19 or have returned from overseas, you may be at risk.

There is a phone number you can ring that is publicised by the state and the federal health departments (Health Direct on 1800 022 222). That’s the best thing you can do. It’s best not to go to a general practitioner (GP) first because you could end up infecting other people.

There’s much discussion that the medical establishment will fall short in terms of equipment, beds and frontline staff. How serious is this?

There is a bit of shortage of testing kits at the moment. The government is working hard to get that rectified. There’s also concern that if too many people are infected, it will overload the health system, that we may not have enough intensive or hospital beds, or we may not have beds for people with other diseases like heart attacks or strokes.

That’s what we’ve seen in Italy where their health system has been at the brink of collapse. They have had no beds to treat people, they’ve had to ration intensive care, and only allow people under the age of 60 to get a care bed.

What went wrong in Italy?

Epidemics spread very quickly. Italy, only a few weeks ago, had a few hundred cases like us. We could just as easily be in the same situation by the end of April. You have to act fast to implement social distancing and other such measures to control the disease, or it will continue to increase exponentially.

On an international level, what are you predicting?

In the US, they had some problems with testing at the beginning and that set them back. We’re really seeing impacts on health systems. Doctors are at the frontlines trying to deal with the epidemic, but they don’t have enough equipment and could be infecting their families. It’s quite a serious situation in the US – and Europe, that’s at the epicentre of all this.

And what about how India has been going ahead?

India has reported relatively small numbers of cases. Whether there has been under-detection (of cases), we’re not sure. They’ve got a good lab in Pune with all the diagnostic capacity but we’ll have to wait and see how it pans out.

It’s important in India that they identify all cases completely, isolate them, track down contacts, and quarantine them. They’ve already placed various travel bans and that will help.

Do you think history will be kinder to China than it has been so far in the way they handled the situation? I believe you were by far the only person saying their drastic measures have worked?

Yes, they did work. You can see from the data, the fact that the epidemic curbed. On the way up, they implemented the lockdown and within one incubation period of the infection (which is the time it takes to see the effect) you can start to see the numbers drop off. Now there’s fewer cases being reported in China. Obviously as they re-open businesses and start resuming life, there is risk of another wave. But they did control it successfully.

Should the Australian government announce a lockdown?

It’s difficult in democracies to take the extensive measures that were taken in China. It is possible to implement drastic social distancing methods and we’ve got laws to support that in Australia. So we may see lockdowns, we may see schools closing. I think things will get worse in the next few weeks and we still have the worst of it ahead of us.

Why is it important?  Should social distancing be the main emphasis to flatten the curve?

Yes, it’s one of the few precautions we have – other than identifying cases and putting them in a hospital room where they can’t infect other people and quarantining all contacts if they’ve been infected too. We’ve implemented travel bans and social distancing because we don’t have a vaccine yet. That means we’re reducing the amount of contact people have with each other in society.

This is particularly important for Indians because they’re social people, they like large gatherings. There’s physical contact like hugging, kissing and so on. Everyone’s going to have to become mentally prepared to live their life differently and work differently than we’re used to.

It’s particular to Indians also because they live in multi-generational households with older people. You must be careful because you don’t want to end up infecting older people in the household who are then at risk of the most serious outcomes and death.

So take precautions if you are a senior citizen, or living with one.

If you’re living with an older person, someone with heart disease or lung disease, someone who is immunosuppressed, or someone with cancer, you need to restrict the number of people coming into the house.

If you’re having a social event, you want to contact your guests and ask them if they’re sick. If they are, you’re going to have to ask them not to come. You’re going to have to get used to saying things like that which are uncomfortable, in order to protect vulnerable people.

What about families with infants?

Infants are not as high risk, but they can get infected. Again, you should be social distancing, reducing exposure in public, and avoiding travel. It’s not worth the risk at this time.

What should you do if you’re an international student or have recently arrived from overseas?

If you’re studying here, most universities are already going into online mode. Follow instructions and avoid going for face-to-face lectures. Do your learning online and avoid crowds. If you must travel, reconsider the need.

It’s going to be a very difficult time because many things we take for granted in society will be disrupted.

Any thoughts on how long before a vaccine can be discovered?

At the minimum, it’s going to be 12 to 18 months before we can start vaccinating people. It needs to be tested for safety first, so that’s the quickest time we can expect.

The Kirby Institute does a lot of modelling – has there been modelling on how the economy will handle this? When will we see a pick up?

Unlike the 2008 financial crisis which was an actual financial problem, this is a health problem. We would expect that once we’ve recovered, things will bounce back.

Do we have some sort of timeline as to when there will be a peak?

Generally, you see a peak and then a decline. We will see a peak this year, maybe in the middle of the year or sooner. It depends on the measures we take. If we implement more drastic social distancing measures soon, we might see the peak later.

Is the virus weather-dependent? There’s a lot of information floating around that there could be more cases of COVID-19 as it gets towards winter.

Coronaviruses do better in cold weather, but that’s not the major factor driving this epidemic. We still see intense transmission in hot countries like Singapore and Thailand.

We have to ask: do facial masks work?

There are a number of studies looking at the use of face masks in community settings like universities and in the household. It works if you wear it and combine it with health hygiene.

Any last suggestions for the South Asian community?

Transmission is both respiratory and through contact i.e. breathing it in or touching something that’s contaminated. Keep spatial separation with other people; avoid that and be mindful of frequently touched surfaces like doorhandles and elevator buttons.

Be meticulous about your hand hygiene and learn how to wash them properly. There’s an excellent video put out with Sachin Tendulkar demonstrating the correct technique.

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