Warnings that a second wave of the COVID-19 pandemic could sweep Australia as colder weather sets in indicate the SARS-CoV-2 virus follows a pattern of behaviour which epidemiologists are acutely aware of.
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Epidemiology is the examination of the transmission of disease among a population: where it came from, how long has it existed and in what forms, is it mutable, who does it affect and how; and most importantly, how likely is it to cause widespread death or serious illness.
It translates from the Greek as 'the study of what is upon the people'.
It is also inherently political and economic, as we are learning in the current COVID-19 disease outbreak. Doctors are not economists and they are not usually politicians, but their work in protecting the public in the current crisis has outcomes which reach far beyond the sphere of the hospital ward. What is accepted knowledge in one week - say, 'masks are ineffective' - changes in the next.
The Rapid Research Information Forum is a group of 35 scientists led by Alan Finkel, Australia's Chief Scientist. The states' chief health officers are also members. The group warns that winter may see a second wave of COVID-19, with people's immunity weakened by colder weather. The scientists say the current social distancing prerogatives have been successful in keeping the pandemic limited so far.
The existing lockdown and restrictions have been extremely successful in restraining the infection of COVID-19 among the Australian population. But they are not been popular with many in the commentariat, especially conservative economic writers and libertarian groups such as the IPA, who argue the case for restrictions has been made excessively; that the economic outcomes will be worse than any spreading of disease, and an acceptable death toll is the price we pay for liberty.
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Putting aside opinions from those with no scientific training and, it would appear, no desire to be informed by any, as always history gives salutary warnings, if not lessons, in what happens when a government or a state decides on a course of action in pursuit of a popular outcome over that which may be more responsible, if less palatable.
The Spanish or 'pneumonic' influenza outbreak of 1919 is perhaps most pertinent to our current situation. Prior to the first cases in the country appearing in late 918, the authorities knew what was ahead. The excruciating symptoms and high morbidity rate, already witnessed overseas by no less than the prime minister of the day Billy Hughes (who was in Europe for the post-war deliberations) saw the Commonwealth Government impose strict maritime quarantines late in 1918.
Thousands of lives might be saved by their action; but what is human life compared to the loss of political support? Maybe the Government realised, too, that they were hitting their own friends, the money-making and pleasure-loving class, who were suffering most by the restrictions.
- The Catholic Times, March 1919
The Commonwealth minister for trade and customs, the federal director of quarantine and the respective state health ministers met in Melbourne in November 1918, along with the British Medical Association (BMA, later the AMA) branch presidents. The BMA was present as much to undermine any attempts at the socialisation of medicine as to assist in pandemic planning.
At first strict Commonwealth rules were applied swiftly, with border closures and national quarantine. These soon broke down, with NSW and Victoria falling into dispute over what action should be taken.Sound familiar? Victoria is generally acknowledged to be the source of the first case of Spanish flu; authorities failed to report it to the Commonwealth, and borders stayed open. Another case travelled from Melbourne to Sydney by train, infecting others.
By January 1919 some states began to take lockdown action, as severe if not more than our present conditions. Aside from the closure of public spaces and utilities, travel was restricted and NSW police were given the power to issue travel permits, or to arrest those without one. Masks became mandatory. Meanwhile Victoria issued no travel restrictions at all and was slower to bring in lockdowns.
These oddly inverse actions, NSW vs Victoria, seemed to succeed. There was limited outbreak. In NSW as swiftly as 'Draconian' measures were introduced, they were dropped.
The Catholic Times railed against the easing. It's worth reading some of its editorial in full to understand how near it is in reactive spirit to today's economic editorials and opinions.
'The commercial loss in consequence of the precautions was undoubtedly heavy, and the opponents of the Ministry endeavoured to make political capital out of the restrictions. Then, it would seem, the Government took alarm.
'Thousands of lives might be saved by their action; but what is human life compared to the loss of political support? Maybe the Government realised, too, that they were hitting their own friends, the money-making and pleasure-loving class, who were suffering most by the restrictions.'
The Catholic Times's position was prescient (if also somewhat politically biased: Holman had been expelled from the Labor Party after the 1916 split). Suddenly the pandemic spread with ferocity. From March to May deaths began to spike alarmingly. The true wave of the disease had hit with greater tidal force because of relaxation.
In all states restrictions were introduced, but the hospitals were now overwhelmed. In Melbourne, an emergency hospital was established in the Exhibition Building, but lacked staff. On hearing of the shortage, Catholic archbishop Daniel Mannix offered the services of nuns and brothers voluntarily, which was accepted by the health minister John Bowser.
There was outrage from non-Catholics about the 'garb, ceremonies and customs' of the religious orders, and Bowser withdrew his acceptance, only to find the shortage was too severe to do so.
He appealed to Mannix, who told him he would not put his nuns in the charge of someone who gave in 'to the pressure of a knot of sectarian bigots'. Mannix later relented, seeing the dire situation the government was facing in the rise of the influenza.
It seems the pressure to ease restrictions need to be considered in the light of history as much as current economic desire.
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