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COVID SNAPS: on the Premier for Sydney, booster shots, and some random plandemic insights

Is Dominic Perrottet the Premier for NSW or for Sydney? It’s a question that arises when considering his determination to open up at speed, despite the clear risk to many regional areas.

“Regional NSW not only has the fastest growth in COVID cases, it also has the lowest vaccination rates,” observes 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 contemplate – so they rely on a fiction they’re special and can control their bodies. From crackpot COVID theorists to antivaxxers, hubris and fear haunt the wellness community.”

The quote of the work comes from Guardian Australia writer Brigid Delaney.

The word of the week is plandemic, or the inability to plan or make plans due to a pandemic and all of the accompanying restrictions.

“What’s the program for the coming week? Not much really on account of the plandemic”.

Australian COVID at a glance

Here is a summary of the COVID state of the nation yesterday.

The major outbreaks of concern continue to be in NSW and Victoria but they are heading in separate directions.

NSW peaked more than two weeks ago and cases are now down to about a third of what they were at the peak. Victoria is yet to peak and has today recorded the worse day ever – 1,838 cases in one day.

Reff round up

The Effective Reproduction number or the Reff or the RO tells you how quickly the virus is spreading. When the Reff is greater than 1.0, cases are increasing. When the Reff is less than 1.0, cases are decreasing.  Thanks Prof Adrian Esterman for his daily calculation of the Reff.

ACT: 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) – the Reff and cases are decreasing nicely. The move out of lockdown puts that at risk.

Vic: 1,838 cases today. 5-day moving average 1,599 (657 last week) Reff 1.21 (1.27 last week) – cases are still increasing with each 100 people infecting about 121 more. COVID is now spreading throughout the whole of 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 full story

As well as trends in NSW and Victoria going in opposite directions, we are now also seeing different trends within both NSW and Victoria. Thanks to Juliette O’Brien (covid19data.com.au) for these figures.

NSW

South West and Western Sydney: 259 cases yesterday making 5,782 cases in the last two weeks. This is a 48 percent reduction on the fortnight before.

Rest of Sydney: 87 cases yesterday making 2,158 cases in the last two weeks. This is a 45 percent reduction on the fortnight before.

Regional NSW: 183 cases yesterday making 3,073 cases in the last two weeks. This is a 74 percent increase on the fortnight before.

Here is more detailed breakdown by NSW district.

Victoria

Northern and Western Melbourne: a 94 percent increase compared with the fortnight before (but the growth rate is slowing).

Rest of Melbourne:  a 344 percent increase in cases compared to the previous fortnight (growth rate is stable).

Regional Victoria:  a 489 percent increase in cases compared to the previous fortnight (growth is speeding up).

While it all looks pretty miserable for Victoria, there is some good news according to Professor Adrian Esterman. Hospitalisation typically occurs about seven days after diagnosis.

This chart tracks cases each day with hospitalisation one week later. We are now seeing a disconnect, with cases rising much faster than hospitalisations. What we are looking at in this graph appears to be a real vaccine effect.

Also see COVID cases numbers by LGA for regional NSW, Greater Sydney, and for Victoria.

Swiss Cheese model of public health

As states, territories and the Commonwealth prepare to open up our communities, our economy and our borders, it is important to keep in mind that the virus is not going away.

A politician lifting a lockdown does not make the country safer. And just because we are all tired of being locked up and want to get our lives back, it doesn’t mean that life will be getting back to ‘old normal’ anytime soon.

The question for each of us now is about the way we want to live in the new COVID normal. There isn’t a 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 bullet proof. And we are each at different levels of risk.

The Swiss Cheese model is a helpful way to think about how we manage our way out of lockdown and manage living with COVID beyond that.

It recognises that no single intervention is perfect at preventing coronavirus spreading. No intervention is 100 percent, every intervention has holes. Multiple layers of protection help limit the spread of the virus. Each layer has holes and the risk of infection increases when the holes align.

The more layers you have in place around you, the more you are protected. If only our governments were having sensible conversations with the public about our appetite for risk going forward and about how all the layers fit together. Oh well, I can always dream.

Dr James Reason, introduced the “Swiss Cheese Model” in 1990 and this meme was made by Dr Ian Mackay from University of Queensland.

NSW and the magic 70 percent double vaccination rate

The brand NSW Premier has spent the last few days proclaiming how great it is that we have achieved 70 percent and announcing 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 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 cheeky friend suggested that we need a government for the whole of NSW, not just for Sydney. Ouch!

Booster shots

There is increasing international evidence that COVID vaccination booster shots will be required. This is based on evidence that efficacy of the vaccine declines over time. Some countries have already implemented third dose booster programs. One of the first was Israel.

Third dose booster shots present an ethical challenge. How can high income countries roll out third doses 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), who argue that countries should not introduce third shot booster programs until all people in low income countries have been offered vaccine.

Be that as it may, the Australian Technical Advisory Group on Immunisation (ATAGI) has today issued its national recommendations on a third dose.

ATAGI is only recommending a third dose at this stage to individuals who are severely immunocompromised. ATAGI is not recommending (yet) a third dose for everyone – but in my view that is inevitable.

See the ATAGI list of who should get a third dose.

Crackpot COVID theorists, antivaxxers and fitness fanatics

My quote of 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 illness is far too frightening for many to contemplate – so they rely on a fiction they’re special and can control their bodies. This leads to a belief that a powerful natural immune system is the best defence against COVID, not a vaccine.

Some of this same thinking – that we have the ability to determine our own health status through lifestyle choices – can be seen in organised health promotion programs.

The common wisdom in public health for decades now (supported by good evidence) is that communicable diseases are a thing of the past. In a high income country like Australia, that was certainly the case – until COVID.

Non-communicable diseases (NCD) – heart disease, diabetes, cancers, mental illnesses etc – have been the major causes of ill health for decades and the focus has been on healthy lifestyles as the main tool to control NCDs and to limit demand on the health system.

But the sad reality is that, regardless of how healthy our lifestyle is, we will all die. And sometimes illness and death is just random.

That is a very scary thought in a society that is increasingly death denying and that promotes a belief that we are each in charge of our own destinies.

Recommended reading

My article in the SMH today: Take freedom slowly or the cycle of lockdowns will start all over again.

The White House has announced $1 billion to purchase rapid, at-home coronavirus tests. So now we will have RATS in the White House. Come on Australia, hurry up.

Why anti-vaxxers, conspiracy theorists and the far-right have come together over COVID-19: The far-right, anti-vaxxers, and conspiracy theorists appear to have found fertile ground, particularly among men who feel alienated, fearful about employment and who spend a lot of time scrolling social media and encrypted messaging apps.

Buy a llama not a dog. Llama antibodies have ‘significant potential’ as covid treatment – study.

‘Miasma’ was on my short list for the word of the day: 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 into our homes again. Here is a great idea.


Croakey thanks and acknowledges Professor Kathy Eagar for this column, which is based upon a regular COVID update that she emails her networks, combining a mixture of evidence, observation and pithy humour. On Twitter, follow @k_eagar

Bookmark this link to follow the series.


See our archive of stories on COVID-19.

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Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery