13 July coronavirus report #33

Army mobilised on South Australian border

13 July Pandemicia coronavirus report #33

Epidemic

Mexico has passed the United Kingdom in cases, and South Africa will do so perhaps tomorrow. They both now have extremely virulent epidemics. South Africa has 14,000 cases per day, fourth highest in the world.  Its low death rate is probably due to the younger population. Japan's second wave is looking serious.

Cases continue to rocket in US states that have not had a full epidemic. Overall, the US is moving ahead in new cases faster than it was it was before lockdowns. There are now over 60,000 infections per day or 400,000 per week.

The re-opening of all these states was dictated by business interests rather than health authorities. In the South, there are so many cases that contact tracing has become infeasible. 

Florida, one of the first states to push aggressively for re-opening, has had a record number of daily cases for any US jurisdiction, 20% higher than New York at its peak. Most ICU units in Florida have reached capacity, with over 15,000 hospitalised. They have also run out of PPE - again. Deaths however, while showing minor signs of turning upwards, are not doing what might be expected at this stage and following new cases.

This is partly because of the lag and partly because the average age of those tested in the USA has fallen by 15 years. It has been found in Australia and elsewhere that the highest level of infection is among young women aged 20-29, a particularly sociable group, but this has been a surprise to Americans who have not tested young people till now. Nevertheless, with positivity rates on tests of over 10% in most of these states (compared with 0.3% in Australia) either these states are still chronically short of testing facilities or a huge proportion are infected.

In other states hospitalisations continue to rise, with more than 10,000 hospitalised in Texas on 12 July.

It has been suspected that high population density contributes to the spread of coronavirus. A study of US counties has not found density to be significant, just settlement size. Many have been pressuring for denser cities for decades and the question has arisen as to whether it is actually too dangerous to have very many people crowded together. This also is of relevance in social class issues.

Victoria

Only Victoria and NSW have new cases in Australia, but now they are almost all community transmission whereas in the past they were from abroad. As expected, the epidemic in Melbourne has continued to surge from the lockdown on 9 July. The size of the epidemic is still considerably below the original Ruby Princess outbreak in NSW, but is much larger than the previous Victorian outbreak.

Victoria has done the most tests in Australia, over 1 million, and the positive test rate is reassuringly low at 0.34%. There have been six new deaths so far. 

Permits are needed for travel from Victoria  into NSW and South Australia. The army has been mobilised to help enforce the border closures. Hundreds of people made a last-minute dash into South Australia, many saying they did not feel safe in Victoria. On the other hand, the opening of the Queensland border at last has led thousands to head north, with long delays at the border.

The official data site now includes a useful visualisation of the larger Victorian clusters, showing how coronavirus was almost eradicated by 8 June then emerged from quarantine hotels. The Rydges outbreak continued into the Coburg family, totalling 32 cases. The larger Stamford Plaza outbreak with 43 cases passed out of control into four family outbreaks totalling 79 cases, including one in North Melbourne; then into St Monicas's College by 21 June, and finally into the Al-Taqwa College outbreak, largest cluster in Australia up till then, with 144 cases, and to several more family gatherings. Then it passed into the public housing towers in Flemington before 4 July, with cases now 242, and another tower in Carlton with 32 cases - now both under complete lockdown. It was into three age care facilities by 10 July, now totalling 50 cases and another meat processing plant. With all these high risk locations involved, it will continue for awhile and may not even be controllable.

Al Taqwa College, Melbourne, closed down

An outbreak has also occurred in a site in southern Sydney, all associated with a staff member who served on July 3 and probably associated with the Victorian outbreak. 
  

The speed with which this virus moves once it starts superspreading, even in a very well prepared jurisdiction, is breathtaking and has never been so vividly demonstrated. We can only wish the Victorian government and all the frontline workers the very best of luck and safety.

 Response

It has taken six months, but CDC has finally issued some parameters that make general modelling possible. They are assuming an infection fatality rate of only 0.5% - a fiftieth of the case fatality rates of 25% found in New York. If correct it would imply there have been 8.8 million cases in the United Kingdom, 7 million cases in Italy and 5.6 million cases in Spain, only a small fraction of which were picked up by testing in March and April. It is a tacit admission that the CDC thinks there have been 8.7 million cases in the USA so far, similar to the UK. It also suggests that cv deaths in the USA will ultimately be not far short of a million.

People returning to New South Wales from abroad will now be required to pay $3000 for their hotel quarantine. "They have been given every chance.," said the Premier Gladys Berejiklian. NSW has already spent $65 million on quarantine accommodation. 

After telling Australians that they would not be released from lockdown unless they downloaded the CovidSafe bluetooth tracking app, and paying two firms $1.6 million to collect the data, governments  have only used the app once to try to trace the contacts of an individual and it did not reveal anyone new. The British have already discontinued their app. This is just one of very many failures in the hasty introduction of IT apps.

Economy and society

President Bolsonaro of Brazil, the ultimate COVID denier, has been forced into isolation and mask-wearing. He is taking chloroquinine to assist his condition.

At a time when one might expect Australia to seek closer relations with China - given that good relations are now absolutely essential to its economic future - the government continues to head in the opposite direction, apparently rattled by its new role as the champion of democracy in the COVID-suppressed region. "Prime Minister Scott Morrison has made contentious and confrontational announcements and commentary in respect of China every week since late June, from warnings of cyber attacks, a massive realignment of defence strategy clearly aimed at the Middle Kingdom and, just days ago, tough-talking pushback against new security laws in Hong Kong".

Although the Trump administration has announced its formal withdrawal from WHO, it must pay arrears of $58 million to WHO and $110 million to the Pan-American Health Organisation before it can do so. The USA has been in breach for several years. 

Many cruise ships more than 20 years old are to be scrapped. 

Unsurprisingly, the proportion of Australians feeling concerned about COVID issues fell from 43% to 28% in June. The fears will doubtless be rekindled in July.

US airlines are packing planes to capacity again, in the middle of an active pandemic, and the same is true in Australia. United Airlines received billions in Federal aid, but is announcing it is shelving 36,000 workers.

 Darwin Award

Eleven people in Hobart have been hospitalised with carbon monoxide poisoning after trying to use a charcoal grill indoors. Seven are in a serious condition, including five children. It is not clear if their actions had anything to do with quarantine

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