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| Property management workers deliver goods to a locked down compound in Guangzhou, June 2 |
Pandemicia coronavirus report #59
Epidemic
Global report
Nearly 4 million recognised deaths have occurred worldwide from coronavirus. Europe has had 1.1 million deaths and Latin America is approaching a million deaths. Nineteen countries have had over two million cases, and all of these have had 50,000 deaths or more. India passed 30 million cases on 21 June 2021, and the USA passed 600,000 deaths on 15 June. Recognised deaths in India are approaching 400,000. Global vaccinations are over 3 billion.
The highly infectious Delta variant is now the main cause of concern. It appears that a much lower viral 'load' is necessary to cause infection by the variant. Typically, all the family members of an infected person now become infected. In Europe, new cases have risen 10 percent in a
week after two months of decline, and the WHO has announced that the region is at risk
of a new wave of infections. As a result, Portugal reintroduced night time curfews in several major cities.
Infection rates in Cornwall and and the Scilly Islands rose more than 20-fold during the G7 summit held there. Many of the infected were aged 15-24, and may have been holiday makers.
While new cases are now 'relatively low' in the USA at under 15,000 a day, and Covid wards are almost empty in some places, the proportion of new infections that are Delta variant has risen rapidly from ten per cent to thirty per cent over the last few weeks
The disease is finally moving into the developing world. There are more than 400 cases a day (and rising) in Vietnam, Seychelles, Uganda, Mozambique, Botswana, Zimbabwe and Guatemala. Around the Pacific and South East Asia, a series of outbreaks is occurring, some of which are serious, although death rates are fairly low thanks to younger populations and the availability of vaccines.
The last outbreak in China was in Dec-Feb, with 1150 infections in the NE region, but now the focus is in the south. The Chinese manufacturing hub of Dongguan has been closed following two cases of the Delta variant. There have been 168 cases since 21 May in Guangdong province, mostly in Guangzhou, and Guangdong has sped up its vaccination effort with 101 million doses, 62 million of these in the last month. Guangzhou, a major international travel hub and port, has a congestion of 50 vessels waiting to berth in Guangdong. Some manufacturers have turned to trucks to send cargoes to Europe. Guangdong is planning on building a huge quarantine centre with 5,000 rooms to house travellers and Covid-19 close contacts.
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| 4200 bed Covid encampment built in Hebei province, Jan 2021 |
North Korea, which has claimed to have no cases, is currently in the grip of an unspecified disaster. Its efforts to avoid the virus have led to one of the worst economic crises in its history. There are rumours of secret Covid facilities placed just across the border in China.
Indonesia now has 2 million cases, following a record number of cases on 20 June. Curfews have been announced in 10 locations and gatherings reduced to 25% capacity. Bed occupancy rates exceeded 90% in some locations.
Australia - 12 million in lockdown
We give a rather fuller account of this Australian outbreak than usual for this blog, as it is the first time a Delta variant outbreak has occurred from a zero base with a full contact tracing system in place. The virtual absence of cases in Australia, the presence of vaccines, and the experience that has been gained after 18 months of activity has allowed a fairly experimental approach to non-medical interventions and partial lockdowns to be undertaken.
The latest outbreak began about 17 June, emanating from an unvaccinated airport limousine driver transporting international flight staff in Sydney (it is not recorded what happened to the infected airline staff). As a result, masks were made mandatory on public transport in NSW on 18 June.
Almost all the 40 guests at a 'superspreader' party on 19 June in West Hoxton, outer west Sydney,were infected, with the exception of six vaccinated health workers. One of the infected partygoers returned to Victoria). For possibly the first time, contact tracers viewed a shopper in Bondi Junction catching the virus on CCTV, in a 'scaringly fleeting' encounter merely walking past an infected person at a distance of some metres.*
Sydney was declared to be in a serious situation on 23 June with movement out of Sydney from seven central areas prohibited. Indoor mask wearing was mandated across Greater Sydney along with a swathe of other restrictions on gatherings.
On 25 June, 22 new cases were confirmed in NSW and the 'Bondi cluster' had spiralled to 65 cases. People who lived or worked in four affected areas were subjected to a level four lockdown as a 'circuit breaker'. The following day, this was extended to the whole metropolitan area. An infected student nurse who worked in several major Sydney hospitals for five days caused the closure of a number of wards.
Finally on 26 June, the Premier announced a two-week L4 hard lockdown for the whole of the greater Sydney region, with epidemiologists saying it was a week too late. More than 15 $1000 fines were issued by police after breaches of rules on the first night, and about 50 per day have been issued since.
The coronavirus now began jumping long distances, carried by air-plane and interstate road travellers. The first real outbreak in the Northern Territory occurred, spread by a mine worker at the Tanami Desert gold mine, who became infected in an incident in a Covid quarantine hotel in Brisbane. Fly-in fly-out workers from the mine then spread to a dozen cases, including five in South Australia. Seven hundred workers are now in isolation at the mine, under very poor conditions. A Darwin lockdown on 28 Junewas followed by an Alice Springs lockdown on 31 June, as unprepared contact tracers raced to move ahead of a Delta variant outbreak. At Alice Springs airport, 60 employees were identified as close contacts.
Queensland declared mask and other restrictions on 28 June after several cases appeared, including a female miner. The following day, a three-day 'snap lockdown' was declared for all of SE Queensland, Townsville and Magnetic Island by 'furious' Premier Anna Palaczuc, who has emerged as the strongwoman of the pandemic period. The cause was a hospital receptionist who despite directives was unvaccinated, and who had travelled widely for ten days while infectious. The whole population of the holiday resort Magnetic Island was tested as a result.
By 30 June NSW, Queensland, Western Australia and the Northern Territory were locked down in metropolitan and surrounding areas. With 12 million Australians now under short-term lockdown arrangements, three State premiers issued very strong statements calling for purpose-built facilities and for a drastic slowdown in arrivals until the population could be fully vaccinated. The Queensland Deputy Premier pointed to a traveller who had been allowed to travel between Indonesia and Australia multiple times as having infected the receptionist. He accused the Federal government of allowing 46,000 citizens and permanent residents to depart each month, and allowing large numbers of non-Australians to arrive each month on temporary visas, while 34,000 Australian citizens were left stranded overseas - some since the start of the pandemic.
By 30 June NSW, Queensland, Western Australia and the Northern Territory were locked down in metropolitan and surrounding areas. With 12 million Australians now under short-term lockdown arrangements, three State premiers issued very strong statements calling for purpose-built facilities and for a drastic slowdown in arrivals until the population could be fully vaccinated. The Queensland Deputy Premier pointed to a traveller who had been allowed to travel between Indonesia and Australia multiple times as having infected the receptionist. He accused the Federal government of allowing 46,000 citizens and permanent residents to depart each month, and allowing large numbers of non-Australians to arrive each month on temporary visas, while 34,000 Australian citizens were left stranded overseas - some since the start of the pandemic.
Although Queensland currently has five outbreaks, on 3 July it decided to drop its lockdown back to L2 (general social distancing and small gatherings) because they are reasonably confident an ongoing transmission chain is not present. New South Wales by contrast looks like it is set for weeks of lockdown.
In NSW 188 of 226 cases are linked to the Bondi cluster. About half of new cases are found in people who have not been isolating. Numbers have continued to increase despite the lockdown, with 31 new case on 2 July and 40 cases on 3 July.
A temporary financial support package was put together for affected businesses across NSW.
Further opinion by Pandemicia of problems with quarantine and vaccination in Australia is provided in the next section.
Further opinion by Pandemicia of problems with quarantine and vaccination in Australia is provided in the next section.
*At the start of the pandemic, health authorities thought it took about 15 minutes of close contact for someone to become infected with COVID-19.This was tied to the belief that coronavirus was largely spread by large droplets or by touch. This is now known to be incorrect, and infection can take place in fleeting circumstances.
Russia
Cases are rising in Russia in what looks like a third wave. Moscow has hit all time daily records in cases, and the country overall has reached a record in daily deaths. Russia and other eastern European countries have consistently produced low death figures by not attributing deaths with comorbidity involved - but excess mortality figures suggest that true COVID total death figures were more like 475,000 by the end of April rather than the official 132,300 deaths.
Many venues in Russia are closed. Mandatory vaccination for service workers has been ordered in several regions. The Mayor of the southern city of Krasnodar has said he will withhold bonuses and allowances from unvaccinated city administration employees if they fall ill with the coronavirus.
Many venues in Russia are closed. Mandatory vaccination for service workers has been ordered in several regions. The Mayor of the southern city of Krasnodar has said he will withhold bonuses and allowances from unvaccinated city administration employees if they fall ill with the coronavirus.
Bangladesh
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| People in Dhaka struggle to board a ferry in anticipation of lockdown |
Bangladesh has recorded its highest ever number of daily cases and deaths, and has prepared for a major one-week staggered lockdown. Public transport was stopped early in the process, so thousands of people walked to work along the major roads. Rickshaw prices soared to unaffordable levels. Migrant workers scrambled to return to the provinces, packing onto ferries to cross major rivers.
Thailand and Burma
Thailand was the first country outside of China to record infections, but through early action was able to contain the virus very successfully. The economy shrank by 6.7% in 2020, and 90% of all businesses reported a fall in revenue of 50% or more.
However from early April 2021 a major outbreak of the Alpha variant occurred, originating in upscale clubs frequented by the elite. The government was reluctant to reintroduce restrictive measures as it had in earlier outbreaks, and as anyone testing positive was required to hospitalise, beds were soon filled. Cases rose from zero to above 5000 per day in only 5 weeks. Many of the new cases came from the country's notoriously overcrowded jails. In one poultry company, 245 cases were recorded. Not till 27 June did Thailand finally introduce Level 2-style curbs. This has been found elsewhere insufficient to stop a significant outbreak and the trend continues upward. From June, Thailand has been manufacturing Astrazenica vaccine locally from June, and about 10% of the country has received shots of this or the Sinopharm vaccine.
However from early April 2021 a major outbreak of the Alpha variant occurred, originating in upscale clubs frequented by the elite. The government was reluctant to reintroduce restrictive measures as it had in earlier outbreaks, and as anyone testing positive was required to hospitalise, beds were soon filled. Cases rose from zero to above 5000 per day in only 5 weeks. Many of the new cases came from the country's notoriously overcrowded jails. In one poultry company, 245 cases were recorded. Not till 27 June did Thailand finally introduce Level 2-style curbs. This has been found elsewhere insufficient to stop a significant outbreak and the trend continues upward. From June, Thailand has been manufacturing Astrazenica vaccine locally from June, and about 10% of the country has received shots of this or the Sinopharm vaccine.
In what is known as the 'Phuket sandbox', vaccinated tourist arrivals since 1 July have been allowed to roam free on the holiday island of Phuket, after waiting 24 hours for a Covid test. Government and the tourist industry hope the re-opening will save the battered tourist industry.
Hundreds of migrant workers from Myanmar working in garment factories or as fishermen, and living in their own villages in Thailand, have been infected. These residents in lockdown 'have to take responsibility for themselves'. Volunteers have been buying them food and medicine. Myanmar ialso has a record number of cases in a runaway second wave.
Paradise in lockdown
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| Suva outbreak |
Ancient coronavirus
For a while there has been some consideration that East Asian populations might have extra resistance to coronaviruses, as it has taken a long while for Covid-19 to spread in the region and death rates have been low. A study has suggested that one such epidemic swept across the area 25,000 years ago, leaving adapted genes that might help with resistance.
Response
Vaccine
A study in Israel in January showed that the infection rate among unvaccinated persons is 20 times greater than that of people given the Pfizer vaccine - around the 95% efficacy claimed by Pfizer.
In the US by 23 April, 80% of over 65s had been fully vaccinated, but only 35% of those aged 18-29. Nearly all Covid deaths in the USA in May were among the unvaccinated. Only 1% of the 107.000 hospitalisations were 'breakthrough' infections of the vaccinated. Deaths are rising in Arkansas, where vaccination is low.
In the US by 23 April, 80% of over 65s had been fully vaccinated, but only 35% of those aged 18-29. Nearly all Covid deaths in the USA in May were among the unvaccinated. Only 1% of the 107.000 hospitalisations were 'breakthrough' infections of the vaccinated. Deaths are rising in Arkansas, where vaccination is low.
Slovakia is the second EU country to use Sputnik V vaccine for large scale vaccination. Sixty-four countries have approved the vaccine, most notably Argentina and Iran, and in India, where it is to be manufactured in quantity. The vaccine uses an adenovirus carrier, like Astrazenica and several other vaccines. Each of the two doses uses a different type of adenovirus: first dose with type-26 (Ad26), then a booster dose with type-5 (Ad5). The purpose of using two different types is to lower the possibility of the body developing antibodies against the adenovirus after the first dose, which could make the second dose ineffective. Johnson and Johnson uses only Ad36. While a Lancet trial has reported a high level of efficacy (92%) and safety for Sputnik V, the development of the vaccine has previously been criticised for unseemly haste and lack of transparency.
Attempts to mandate vaccination by colleges and healthcare establishments in the USA are proving contentious. A group of students at Indiana University filed a lawsuit against the college. An unvaccinated nurse at Houston Methodist Healthcare sued the hospital but the case was dismissed.
Attempts to mandate vaccination by colleges and healthcare establishments in the USA are proving contentious. A group of students at Indiana University filed a lawsuit against the college. An unvaccinated nurse at Houston Methodist Healthcare sued the hospital but the case was dismissed.
Other
Many countries are relaxing movement rules for the vaccinated. Vaccinated Americans can avoid most restrictions and travel freely abroad, and vaccinated British who travel to the USA do not have to isolate on return. Hong Kong has shortened quarantine for arrivals with two vaccine doses to 7 days (quarantine has been 21 days until now). The city has a surplus of unused vaccines. Since April, China has allowed entry to international visitors who have been vaccinated. Many European countries have done likewise.
Flight attendants in the USA have reported record levels of unruly behaviour from passengers refusing to wear masks.
Apparently during the Trump administration, nearly 900 members of the Secret Service were infected.
Apparently during the Trump administration, nearly 900 members of the Secret Service were infected.
Australia - Quarantine and rollout
Australia has been a poster child as the largest Western country to eliminate the disease, Despite this fortunate situation, there has been a great deal of stumbling, with the Federal government presiding over an unimpressive vaccine rollout while bypassing its constitutional responsibilities for quarantine. The States have had to bear the impact. With lockdowns in four States over the past few days, the State governments have lost patience - accompanying federal parliamentarians in the delivery of blistering criotical speeches.
The fundamental problem has been that while Australia has gone to extraordinary lengths to keep introduced animal diseases out of the country for more than a century and to provide full biocontainment of pathogens, and while it has has spent many billions of dollars to eliminate coronavirus while keeping morale and employment high, it has apparently been unwilling to take fairly low-cost steps to avoid the reintroduction of Covid-19.
In a country free of the virus, the two obvious sources of new infections are returning travellers and airline staff. Returning travellers have been placed in quarantine in ordinary hotels where infected people lack even rudimentary separation of ventilation from each other or from staff, let alone the elaborate pressure gradient separation used to quarantine virulent animal diseases. Security and hotel staff have been low paid, poorly trained, and work in multiple jobs as do their families.
Airline staff have been ferried backward and forward to similar poorly protected premises, often by local drivers who are not separated in a closed environment. The situation has been an accident waiting to happen - and it has finally occurred in Sydney.
The population has been generally compliant with government directives, but many remain lackadaisical about the risk. A College of Pathologists survey showed only about 45% of those suffering cold and flu symptoms in the past six months bothered to get a Covid test. The rapid spread in the present outbreak shows a lack of due care in many of the unwitting infected. Nevertheless, a majority of those testing positive had been isolating as required, and did not pose a danger to the community.
Vaccine
By the end of June, 23% of the Australian population had received one jab, around half the proportion across Europe. Only 6.9% had been fully vaccinated, comparing poorly with around 50% in the USA and the UK. This was partly due to Australia being on the end of the supply chain, but also to slow and conflicting government directives, and a general lack of urgency.
By the end of June, 23% of the Australian population had received one jab, around half the proportion across Europe. Only 6.9% had been fully vaccinated, comparing poorly with around 50% in the USA and the UK. This was partly due to Australia being on the end of the supply chain, but also to slow and conflicting government directives, and a general lack of urgency.
- In the recent Victorian outbreak, a number of aged care residents were found to be unvaccinated. Two thirds of health care workers in private establishments remain unvaccinated.
- Under 50s were supposed to receive only Pfizer shots not Astrazenica, but very few are available.* Although the Prime Minister announced that under 40s can take Astrazenica, the advisory body ATAGI and several States have advised under 40s to wait for Pfizer - on the grounds that the risk from the disease to this age group is lower than the risk from thrombosis complications. Nevertheless, the risk to vulnerable populations remains substantial while this age group remains unvaccinated.
- The decentralised distribution through GPs has left many doses unused - possibly as many as one in five - when local doctors cannot find sufficient patients.
- In Britain and the USA, pharmacies have been dispensing shots since January. In February Australian pharmacies were told to apply, and 4000 were approved by 1 May. This was only implemented in Queensland, with other States due to receive the go-ahead in mid-July.
- CSL was contracted to provide 50 million doses of Astrazenica through local manufacture. So far only 1.3 million doses have been received.
Former PM Malcolm Turnbull has described the rollout as a 'phenomenal failure' in public administration.
On 2 July, a day of many significant announcements a number of new hubs were opened in NSW, assisted by "speech pathologists, student dentists and podiatrists - in what was said to be a doubling of capacity to administer doses. The Western Australian three-day lockdown also ended, and also the outer Brisbane lockdown. The Queensland lockdown ended on 3 July.
Pfizer delay
On 15 February while other countries had their mass vaccination programs well under way, 142,000 Pfizer doses arrived in Australia, the first of 20 million that had been 'secured' by the government. "Approximately 50,000 vaccines will be made available for the states and territories for hotel quarantine and border workers and frontline healthcare workers. Approximately 30,000 vaccines will be made available for the Commonwealth vaccine in-reach workforce to aged care and disability care residents." More than a million doses arrived by April in limited quantities of 30,000 a week. An order of a further 20 million was put in in at that time, following the decision to limit Astrazenica to older people. Australia was however put "at the back of the queue" for Pfizer, with significant quantities of teh vaccine arriving only after July when the US rollout of 300 million doses was complete. The plan
There has been concern that the current PM Scott Morrison has been lukewarm on vaccination, However on 2 July, after the 45th meeting of the National Cabinet, he announced his solidarity with the 'Covid-normal' Singapore Plan in a shift from suppression to management of the virus. A four-stage plan was proposed, being
- the current pre-vaccination phase, which he called 'vaccinate, prepare and pilot' in which quarantine and lockdowns are applied, and overseas arrivals are cut by half (with facilitation of Commonwealth-sponsored repatriation flights). Home quarantining will be trialled. Seven days of quarantine would probably be sufficient for incoming vaccinated passengers.
- a second stage would be triggered when a pre-determined level of vaccination was attained. Then the vaccinated would be excluded from lockdown and arrivals would return to present levels, with a higher cap for vaccinated arrivals.
- in the third stage, levels of hospitalisation would be similar to influenza. Outbound travel would be permitted to other countries. Vaccinated people would have no restrictions. Lockdowns would be a thing of the past.
- the fourth consolidation stage would be essentially normal, except for pre- and post-testing for international flights.
He saw no reason, all going well, why the second stage could not be reached by 2022 The message was, if you want all this to go away, get vaccinated. The details are to be worked out over the next few weeks.
Premier Gladys Berejiklian of NSW repeated an earlier statement that 80% vaccination would be necessary before 'Covid-normal' could be achieved.
The Federal Opposition Leader Anthony Albanese said it was rather breathtaking that it has taken eighteen months to come up with any kind of a plan, but that Australia now has one can only be applauded.
Singapore and Covid-normal
A comparable plan was put forward in Singapore on 24 June by three senior government figures, Rather than ongoing stringent lockdowns, the necessary conditions for 'living with Covid' will be met. These will be similar to living with influenza, where the chances of hospitalisation are tolerably low and anyone who wishes can get an annual jab against new variants. At least two-thirds of the population must be vaccinated. Infected people will gradually be allowed to recover at home. Tests will only be administered in specific scenarios such as citizens returning from abroad or in preparation for large events, and numbers of infections will no longer be counted, only outcomes like hospitalisations and deaths.
Similar early low-intervention strategies conducted by Sweden, Belarus and Brazil led to well-documented disasters, but they were without the benefit of 'herd immunity' levels of vaccination.
Singapore has been averaging about 18 cases a day, and has recorded only 36 Covid deaths all told. On 24 June, a plan to give every household an oximeter was announced.
Singapore has been averaging about 18 cases a day, and has recorded only 36 Covid deaths all told. On 24 June, a plan to give every household an oximeter was announced.
Return of the cold
A benefit of lockdown has been the dramatic reduction in influenza and pneumonia cases. As lockdowns diminish in the Northern Hemisphere, colds and other respiratory illnesses are making a resurgence. There has been some concern that lack of exposure to ordinary colds has led to an increase above normal in the number of ill children.
Environment
A survey from the Ocean Conservancy, an environmental nonprofit, found that 94 percent of respondents who had been at trash pick-up events in the last year saw PPE pollution. Researchers have observed birds weaving latex gloves into their nests and other animals getting tangled in masks.
Economy
Some smaller apartments in downtown Melbourne sitting empty for a year have been offloaded at a massive loss, while a price boom has been under way for larger suburban or out-of-town properties. Nationally, house prices have risen by about 8% during the pandemic. Demand continues to race ahead of supply in a red-hot property market. Any price falls have mostly been recorded in areas popular with immigrants.
A similar boom has happened in Britain, with excess savings of 100 billion pounds amassed and a stamp duty holiday. Since 2008 interest rates close to zero. With up to 50% of the population now working from home there has been massive demand for country properties - prices rose 10% during 2020, and properties were being bought without even viewing them.
As women are more often casually employed, many more women than men in the USA left the workforce in the pandemic, and many are struggling to find work, particularly among minorities.
Brazil
President Jair Bolsonaro of Brazil justified his disastrous hands-off policy of allowing Covid to rage largely unchecked on the grounds that the poor would suffer most from any attempts to slow the pandemic. Unfortunately Brazil has ended up with the worst of both worlds. The economy collapsed under the weight of the coronavirus, while half a million people died. One quarter of the people in major favela settlements contracted the virus, and half of those going to public ICUs died. For a while a temporary payment of $120 a month was made to millions, but this was eventually discontinued and 19 million people are going hungry each day. Around 13% of the population fell into extreme poverty with an income of less than $2 a day. The government did not stop evictions as elsewhere, and shanty settlements of the newly homeless have proliferated on public and private land.
A collection of shacks built on the trash-strewn remains of a bankrupted factory, cut off from public transportation, with neither running water nor a market — one more new settlement in a profusion of sprawling communities now being settled by Brazilians left homeless.
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