It's time to start discussions on relaxing Covid-19 restrictions

Every week about 3000 people die in Australia. Last week 16 people died from conditions that included Covid-19, down from 29 the week before. Last week there were 464 new covid-19 infections, down from 1200 the week before. Assuming that there is a death rate of between 1 and 1.5%, as has been the case in Australia so far, that means that about 5 to 7 people per week will die in last weeks cohort. Five to seven deaths is a great improvement from 16 and only about 0.2% of the usual weekly death rate.

There is no sense in pretending that the only reason people die in Australia is Covid-19, regardless of the intense media coverage.

NSW Premier Gladys Berejiklian said, "Every time you relax a restriction, more people will get sick, more people will die." Again the implication is that nobody dies for any other reason than Covid-19. The tricky part for politicians is that no politician is going to be blamed for any one of the 800 deaths per week due to heart disease, stroke or respiratory disease, but they might be blamed for just one increased death from Covid-19. That isn't the way effective governments should be run.

We need to be asking are the covid-19 restrictions making people more likely to die from:

• heart disease (usually 357 per week),
• cerebrovascular disease (strokes) (usually 195 per week),
• chronic obstructive pulmonary disease (usually 144 per week),
• heart failure, cardiac arrythmia, hyper tension (usually 149 per week)
• suicide (usually 55 per week),
• alcohol related disease (usually 80 per week)

Are Australians more likely to die of heart disease, stroke or pulmonary disease due to the Covid-19 restrictions? Medical advice for prevention of all three of these diseases is a better diet and more exercise. The restrictions have probably only made getting a better diet slightly more difficult, but with gyms closed, park benches taped off and many people afraid to go outside due to community pressures, it is likely that the average Australian is doing far less exercise during the restrictions than they normally would. Health professionals have historically assessed the health impacts of one more cup of coffee, one more glass of wine or one more 20 minute walk per week. It would be interesting to know what impacts the Covid-19 restrictions are having on life expectancy and general health. If the restrictions increased the likelihood of death by just 2% from those three diseases that would be 17 deaths per week.

Similarly, what are the impacts on suicide and alcohol related deaths due to the restrictions? What are the impacts of the restrictions on mental illness which impacts 1 in 5 Australians every year.

It is easy to frame relaxing the covid-19 restrictions as a conflict between human health and money / the economy, but that is way too simplistic. The health impacts of losing your job have been well documented. Governments are splashing the cash now and running deficits, but that can't go on forever. The budget impacts will eventually impact health services. New equipment will not be purchased, new hospitals won't be built and there won't be enough nurses and doctors. Gladys Berejiklian may just as well say "When hospitals are underequipped and understaffed, people will die."

It is likely that the current Covid-19 restrictions have saved many lives per week, judging by the huge numbers of deaths in the United States and Europe. That does not mean, though, that each week is the same and a different, though still vigilant, approach would not be better for the overall health of the nation.

Professor Brendan Murphy, the Commonwealth Chief Medical officer, is saying that persons in nursing homes with dementia should have some visitation rights from family because that is important for their overall health. There is no sense letting a person with dementia die to save them from Covid-19. There are compromises that can be made in nursing homes. Allow only two visitors and safe social distancing. They might add that they will test the visitors to ensure they don't have a temperature before they visit.

Similar options are available for other aspects of life. We could have cafes that usually have 20 seats only allow six people to sit and ensure that they observe social distancing. Pubs with a capacity of 100 might only allow 20. The short lived one person to 4 square metres rule might be revived. If two people go to a pub they can still sit 1.5 metres apart and have a talk and a beer. Gyms with space for 50 could accept 10 at a time and require appointments.

The impact on schools is another feature of the Covid-19 restrictions. What is the impact of children missing school on Australia's future economy, democracy and competitiveness in the world? Broadly speaking, countries with a better educated populace are more prosperous. A transition for high schools could be: have year sevens come in by themselves on Monday, year eights on Tuesday, year nines on Wednesday etc.

Professor Brendan Murphy says the biggest concern among medical and health professionals is complacency. If you are sitting in a café that used to seat 20 and now it seats six you are going to be intensely aware that restrictions are still in place. If you take your child to school and there are less than 20% of the usual number children going to the school, you are going to be aware that restrictions are still in place. You are also going to be aware that your government is responsive to the overall needs of the community, not just thinking about Covid-19 in preference to all the other community needs.

The government can try some limited relaxation of the restrictions and watch the new infections very carefully. If they rocket up, the government can say "Look we tried. It didn't work this time. We will try again with some new ideas when the infections drop again, as we believe they will." If there is widespread violation of the social distancing rules in pubs, clubs and cafes the government can close the ones that don't enforce the social distancing rules and then close all pubs, clubs and cafes if people are generally not cooperating. Perhaps the experience at the beach means that the beaches can't be opened up. Based on how Australia has followed the current restrictions, it seems like we would adjust to the relaxed restrictions without too many problems.

This is another chance to show ourselves, and the world, that we are not just the lucky country. We are the clever country.