The honest experts guide to managing Covid
06 January 2023
NOOSA – OzSAGE is a large group of Australian scientists (infectious disease specialists and immunologists), medical researchers, public health authorities and related professionals.
Its goal is to formulate independent advice on public health, health systems and other policy matters relevant to Covid control.
It is should be a significant network of high level, multi-disciplinary guidance which is listened to and taken seriously by government and business.
The continuing disgrace is that it is not listened to. Worse, it is perceived by those travelling in the wrong direction as their enemy, and it has been traduced by some publicly and by more in private.
The group came together because it understood the Australian and State governments (and doubtless their advisors) were taking the country in the wrong direction in their Covid strategy.
With this as a common position, they have produced a significant body of information that would progress the management and control of the disease in a way that would work.
And which would also significantly reduce the death rate (over 17,00 deaths, 15,000 of in 2022and the alarming incidence (an estimated 500,000 cases so far)of Long Covid.
I do not really have to tell you that the people in our country responsible for good government politics and public health have not listened to the wise counsel of OzSAGE as a result of which Covid is running free throughout Australia.
New variants of the virus now spawn at a rapid rate, the most potent of them rapidly covering the globe delivering wave after wave of public harm and misery.
In recent weeks it has become crystal clear amongst many more people that Australians have been subjected to a campaign of shocking incompetence, deviousness and mismanagement by their leaders.
As eminent scientists Professors Brendan Crabb AC and Mike Toole AM describe it, the Covid debacle is “the worst public health disaster in Australia since World War II”.
Crabb and Toole have also blown apart the flawed, and even criminal, strategy that underpins this disaster.
Without any consent from the public or explanation to the public, Australian federal and state governments have embarked upon what Crabb and Toole called a strategy “that promotes infection”.
And as we know this infection has chalked up a disastrous casualty list of death and chronic illness above and beyond the normal scorecard of human mortality.
“These are people who would have otherwise lived,” they have written. “Put simply, the virus is winning”.
And they’ve taken direct aim at government stupidity. “The gulf between Covid reality and the narrative from our leaders could hardly be wider,” the two professors state
“Our view that the most important change Australia needs to make is a strategic one. One that is explicitly anti-transmission.”
And this is also the strategy that OzSAGE, with growing alarm, has been prescribing.
In an ‘Urgent Call for Action’ published in July last year, in which it recommended that “all governments immediately respond to”, it set out the following prescription to get Australia back on track and not making premature death (particularly of the aged) official government policy.
Here are the core elements of its advice:
PUBLIC HEALTH EDUCATION
Launching a concerted public health campaign to educate the community on what individuals can do to help protect themselves from infection, with a focus on the airborne nature of COVID-19. (Similar to the campaigns for skin cancer, road deaths, and smoking.) • Communicating the need for mask-wearing in all settings where transmission is likely to occur, such as indoor venues with poor ventilation.
Making P2/N95 respirators (high-quality masks) freely available to the community with a public campaign on their use.
IMPROVING VACCINE ACCESS
Renewing efforts to increase third and fourth dose rates, and broadening eligibility for fourth doses.
SAFE INDOOR AIR: VENTILATION/FILTRATION
Championing and legislating standards for safe indoor air through ventilation and filtration.
Educating and providing toolkits for ventilation assessments (e.g. CO2 monitoring).
Offering grants to improve ventilation infrastructure, similar to the Victorian Government’s Small Business Ventilation Program (Ventilation Rebate).
Developing detailed plans to guarantee healthy air quality, especially in high-risk places such as aged and residential care facilities.
TESTING / TRACING / REPORTING
Providing free and easily accessible PCR testing and free rapid antigen test kits to households.
Transparently reporting cases, hospitalisations and deaths from COVID.
IMPROVING ACCESS TO HEALTHCARE
Developing and improving healthcare protocols and pathways, access and provision, and educating the public and doctors about effective treatments such as antivirals and budesonide.
Improving access to primary care for treatment, and advertising clear alternate pathways to treatment, for those living in areas of GP shortage or with limited financial means.
PREVENTING FURTHER OUTBREAKS
Creating teams including an Occupational Physician, Occupational Nurse, and Occupational Hygienist in each state/territory to review residential care facilities’ controls/protections alongside Public Health and advise on practical adjustments to prevent future outbreaks. Similar work should be done for schools and other organisations.
Supporting the efforts of the National Aboriginal Community Controlled Health Organisation (NACCHO) and other community-controlled organisations to mitigate the effects of COVID in all communities.
In a recent ‘Open Letter to National Cabinet’ of 13 December 2022, OzSAGE counselled:
“We urge Australian governments to look again at the evidence of excess disease, disability and death and to opt for a Vaccines-Plus approach that will ultimately lead to better health, economic and social outcomes.
“Public health experts know what to do, but we need our leadership to start the country on the right path rather than just wish this disease was like any other. It is not.”
The letter from OzSAGE recommending a clear focus on measures that reduce transmission appear to be eminently sensible in light of the overwhelming evidence of this pandemic.
15,000 dead in 2022 and 500,000 suffering morbidity is not acceptable. As stated by Prof's Crabb and O'Toole, "It doesn't have to be this way."
They rightly caution that Covid-19 remains a moving target. The recent emergence of XBB.1.5. in USA and the rapid spread in China of what we assume are earlier variants of Omicron are a case in point.
The opening up policy adopted by China may possibly result in the loss of a million people not to mention the potential to unleash potentially more dangerous variants.
What is clear from the science is this virus continues to mutate in ways that enable it to evade acquired and vaccine induced immunity leading to successive waves of infection that threaten to overwhelm health systems over and over again.
The data also suggests that a person’s risk of serious illness, death or ongoing morbidity increases with repeated exposure or infection. The best protection therefore is to avoid getting it in the first place.
Given the outcome in 2022 and track record to date, prudent risk management, as OzSAGE suggest, would include a focus upon ongoing public health awareness, up-to-date messaging, support for P2/N95 mask wearing, widespread testing/surveillance, ready access to updated vaccines and air quality measures backed by enabling legislation for as long as it takes.
While this virus may attenuate into some benign form that remains dominant, its track record also suggests it could send us back to where we started from.
Until the first outcome is confirmed I believe we should adopt the prudent recommendations of OzSAGE.
Posted by: Stephen Charteris | 07 January 2023 at 02:08 PM