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COVID-19 crossing the Rubicon

By Arthur Dent - posted Thursday, 21 May 2020


That could result in a substantial overshoot with the numbers of cases picking up again until it becomes necessary to slam on the brakes again.

The public health officials taking these decisions are not in the same position as politicians mouthing off. They have serious powers, responsibilities and duties, with corresponding legal liabilities for negligence, misconduct or refusal to perform those duties.

I don't see how it would be possible to avoid a second wave from pre-clinical transmission given that the reproduction rate for pre-clinical transmission without physical distancing is itself nearly enough to cause an epidemic. The peak transmission rate for each case tends to occur just before they start to show symptoms so they are only tested after having already had the opportunity to infect others. We are starting from a position with the effective rate already above 1 even before the actual removal of restrictions.

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If the decision makers have got it right, that second wave will be smaller than the first wave. They will be able to avoid overwhelming the health system while still substantially raising the numbers of cases and deaths, for some significant increase in the numbers back at work.

If they got it wrong there might be a more sudden increase in infection rates that discredits the "Adapt and Control" policy and forces a serious attempt at "Eradication".

But I don't see much likelihood of that reversal unless they get it so wrong that there is again a serious danger of the health system being overwhelmed. Nor do I see that as likely in Australia. The danger arose from failure to prepare in advance and was averted by the few weeks warning from the collapse in Italy. The next demonstration of spectacular incompetence seems more likely to be about something else rather than acting even slower for a second wave than for the first. It would require criminal misconduct rather than mere negligence and failure to perform duties for the brakes not to be slammed on before a second wave overwhelmed the hospitals. In Australia the consequences are likely to be a longer economic shutdown rather than an overwhelmed hospital system. The same may not be true in many parts of the USA and Europe and it certainly won't be true in most of the countries ruled by kleptocrats.

I don't know whether "Eradication" was likely to succeed. But we did have the option to try and no attempt has been made to find out. Australia still doesn't have any seriouis modelling capability. Other developed countries did not have that option.

If an attempt had been made and had been successful, it could only have resulted in "Zero Tolerance" for outbreaks rather than zero outbreaks. There would have inevitably been occasional outbreaks, but only sporadically with each outbreak or set of outbreaks stamped out rather than becoming a continuous background rate of infection that would continue to grow, again at first gradually and then suddenly. Eradication means preventing that initial gradual growth, not preventing all outbreaks. The resources available for testing and quarantaining contacts and their contacts ("even unto the fourth generation") are sufficient for sporadic outbreaks, but would be quickly overwhelmed when outbreaks become continuous rather than sporadic. Contact tracing is much easier when people have few contacts because they only go out for "essentials". What was achieved by contact tracing under recent restrictions won't still be possible without those restrictions. The last announced numbers for downloads of the "CovidSafe" tracing app would only cover less than 5% of contacts.

"Occasional outbreaks" seems to be what is being sold to people now. The story is that we can have less physical distancing and more people going to work or school together in confined spaces at the cost of some occasional outbreaks that will be kept under control.

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That could have been true if we had Eradication first – i.e. zero community transmission for a few weeks before starting to ease up. It might even still be true for Western Australia etc. But it seems pretty implausble for Victoria and NSW now.

It remains to be seen how many people they will be able to get back to work but it seems reasonably certain that any economic recovery will be much slower than if there had been a successful Eradication first.

There doesn't seem much hope of those responsible for this policy doing much to help other countries in a far worse situation, eg our neighbours in Papua New Guinea and Indonesia. They will be far too busy trying to drive people back to work.

For those in the vulnerable categories the danger of infection will now become significantly greater than it was with tighter restrictions and will remain present until a vaccine is developed.

What remains to be seen is how much longer people will remain tolerant of a ruling class whose unfitness to rule is now a matter of life and death.

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This article was first published on C21st Left.



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About the Author

Arthur Dent (formerly Albert Langer) is a left-wing political activist and an occasional contributor to the C21st Left blog.

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All articles by Arthur Dent

Creative Commons LicenseThis work is licensed under a Creative Commons License.

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