from Anne in Adelaide, South Australia: Herding Cats … or … It’s Coming your Way.

Rottnest Island off Fremantle, Perth, West Australia. Wouldn’t you come here just to stay in this Quarantine Village?

February 8, 2021

This week our Prime Minister, Scott Morrison, hosted a ‘National Cabinet’ meeting. This is his extra-political Covid-19 group, an ‘intergovernmental decision-making forum’ including the State and Territory Premiers and Chief Ministers. It is apparent that this is a challenging business for the Prime Minister and one where decisions in a time of pandemic are important to get right – for our country and for his political future. Eleven months have passed since this group was formed and the various state leaders are getting more and more techy and determined in their self-opiniated ways of dealing with Covid-19. (5 Labor, 3 Liberal politicians) . For the PM it must be like herding eight feral cats through a narrow door.

Obviously, Prime Minister Scott Morrison would like the gathering of premiers and ministers to discuss the issues relating to the pandemic in a reasonable, if not rational way. Everyone, of course, says they are following the science of medical advice. The trouble is there are various medical advisors and interpretations.

The issue of quarantining returning Australians from overseas (and various other travellers) is one that divides and stresses our states’ leaders. The press calls these differences, ‘deep rifts’. The Labour Premier of Queensland, Annastacia Palaszczuk, and the ultra-cautious West Australian Premier, Mark McGowan, would like the federal government to be more proactive in the face of the new more contagious strains of Covid 19. Everyone loves to have someone to blame.

The numbers of travellers are small. Over 210,000 international travellers have gone into hotel quarantine in Australia. 1.4% have returned a positive Covid test. 82 hotel staff involved in the quarantine process became infected. At the moment, just over 6,000 Australians (and tennis players!) are arriving per week directly into the various major cities. The states are responsible for their own quarantine systems and have thus reacted in different ways. Recently, Western Australia had a severe five-day lockdown after a single worker in the Sheraton Hotel contracted the virus – perhaps through airflow. He had a second job as an Uber or rideshare driver. Victoria and NSW recently each had single quarantine workers infected and those states used ‘hotspot’ strategy, finding out where the individual had travelled while infected.

The sporadic infections in quarantine continue. There is the story of how one quarantined family opened the door of their hotel room to gather in their meal, deposited in the corridor, and managed to infect the family across the hallway. So now we are becoming aware that the virus is far more airborne than previously thought. It is likely to travel through air conditioning systems in large establishments like quarantine hotels.

So the question is: should quarantining decisions be delegated to states? Are hotels suitable quarantine facilities? It appears that hotels have multiple gaps in their infection prevention systems. For example, corridors need separate ventilations systems; quarantine workers should not have second jobs and should wear masks even in corridors (perhaps double masks as they are recommending overseas).

So now our federal government is in process of investigating whether to organise remote quarantine stations outside of our major cities – more like refugee villages. Perhaps in Toowoomba outside of Brisbane or remote islands. Thus, our cities would be protected and we can lessen the impact on our lives in 2021-2022-2023. The support staff and health staff would be isolated in these camps as well. The Prime Minister compares this idea to fly-in fly-out remote mining camps where you stay for two weeks at a time. Rottnest Island has aleady been used for Vasco da Gama cruise passengers in March last year. Remember that Australia is a country of a few major cities and lots of space. (16 out of 25 million live in the 6 major cities).

Hardly a mining camp! Rottnest Island off Fremantle, WA

I think that all countries should take note. This is probably the way of the future. Can you imagine the situation when most people are vaccinated, but, with international travel, people arrive from across the world and require quarantine? We will have sporadic outbreaks for years to come. Maybe new strains will be arriving having bred in the countries that could not get access to enough vaccine. Maybe the virus will become less deadly, maybe our vaccines can be adapted fast enough and given out fast enough to dampen down the world threat. Reading about how wealthy countries are hoarding vaccine supplies and how third world countries are struggling to get access, I am not optimistic.

My daughter in Seattle was told by a friend working in childcare that they were advised that this situation may continue for years to come. Up to 2025. We could be living in a world of social distancing, sporadic outbreaks, new strains with strange numbering systems, reduced local and international travel and concern about all sorts of flu-like symptoms.

Our PM is now talking about vaccination rollout starting at the end of this month. Bearing in mind that the AstraZeneca vaccine is now in question.

‘On Monday morning South African authorities said they would suspend use of the AstraZeneca shot after clinical data showed it gave minimal protection against B.1.351, a variant of SARS-CoV-2 which contains several mutations that cut the ability of antibodies to neutralise the virus. (Sydney Morning Herald – Monday 8 Feb, 2021).

‘Know your virus variants

Three mutant varieties of COVID-19, first spotted in the UK, South Africa and Brazil, are more resistant to vaccines than the original strain.

The British B.1.1.7 variant was first seen in September.

  • There is some evidence, although not concrete, that the new variant may be slightly more deadly.
  • At this stage, evidence suggests the variant slightly reduces the effect of vaccine-generated antibodies but not enough to pose major problems.
  • The variant has several mutations that seem to make it significantly more transmissible. It has rapidly spread through the United Kingdom and is now emerging across the world.

South Africa’s B.1.351 is also known as N501Y.V2.
It was first spotted in South Africa in October last year.  

  • It concerns scientists because it has picked up a large number of different mutations. 
  • These mutations may make it more transmissible. It is not known if they make it more deadly. 
  • Human data suggests, but does not prove, these mutations allow the virus to reinfect people who have natural immunity to COVID-19. 
  • Early data suggests the variant’s mutations cut the efficacy of COVID-19 vaccines, by varying amounts depending on the vaccine.

Less is known about the  P.1 variant first spotted in Brazil.

  • It bears similar mutations to the South African variant, which scientists suspect may give it the ability to evade antibodies.’

(Sydney Morning Herald – Monday 8 Feb, 2021).

from Anne in Adelaide, South Australia: Justinian’s Flea and the Spanish Flu…

December 27. UPDATE. So Christmas is over and we are still (holiday-less) in Adelaide while the virus bubbles away in Sydney, NSW. The numbers testing positive are low – yesterday 7, today 5 more positive cases have been diagnosed in the ‘Avalon’ Cluster that now stands at 130. NSW Health have conducted over 4 million tests. The Northern Beaches area of Sydney has gone back into lockdown. Our famous New Year’s Eve Sydney fireworks will go ahead in a shortened 7-minute form, but no public will be allowed on the foreshore lining the harbour. (Often a million people gather). Chief Health Officer, Kerry Chant, said that people are testing positive 11-12 days after infection so she justified the requirement stipulating 14 days of isolation after contact with an infected person. Serological testing is showing that the majority of cases are connected to the Avalon outbreak.

Obviously, we remain vulnerable to infection outbreaks with any international arrivals. All arrivals into Australia are significantly down but still enough people are arriving for it to be a challenge for quarantine management at ports of entry. In November 2020, just under 30,000 people arrived from overseas, divided almost equally between Australian citizens and others. (Compare with a year ago: November 2019, 746,080 Australian citizens arrived and 978,440 non-Australians arrived).

One year of Australian citizen arrivals
One year of non-citizen arrivals

Tonight, it was announced that the new strain of the virus, B117, from the UK, which is shutting international borders has been detected in six travellers arriving into Australia from the UK: two are in South Australia. These individuals are all in hotel quarantine. Chief Medical Officer, Paul Kelly, says Australia will not be banning flights from the UK.

I note that our neighbour, Indonesia, is requiring all international arrivals to have a negative Covid-19 (PCR) test done within two days before arrival. Hotel quarantine is also required. But no international tourists are allowed into Indonesia. Australian immigration do not require arrivals to show recent test results but there is media discussion asking, why not?

All the recent news and discussions about the virus shows how we are all learning more and more: how it is highly infectious; how better to treat people; how poorer countries are suffering and their death rates are under-reported, how we need to worry about the rise of mutations. We are all learning the language of epidemiologists and vaccine research. Experts abound!

Justinian’s Flea by William Rosen

I am reading Justinian’s Flea by William Rosen, (Plague, Empire and the Birth of Europe) a history more about the rise and fall of the Roman Empire under Emperor Justinian (527-565CE) than the pandemic. While only part of the book is about this bubonic plague there are many parallels to reflect on.

‘During these times, there was a pestilence, by which the whole human race came near to being annihilated.’ (Quoted by William Rosen in Justinian’s Flea by historian, Procopius of Caesarea.)

The medical treatment of the 6th Century was ‘weighted towards spells, folk remedies and charms’ including saint’s relics and magic amulets‘ (page 212). Application of cold and hot water was suggested. The only possible respite seemed to have been in the use of the opium poppy juice!  Procopius of Caesarea blamed the plague on Emperor Justinian. Other Christian leaders blamed the plague on peoples’ wickedness. Millions died: between 20 and 50% of the population over the 200 years as the waves of infection criss-crossed Europe and Middle-eastern empires.

Nowadays, we too have magic treatments and strange advice: Trump’s internal UV light treatment, alternative medications (Chloroquine), garlic, drinking water every 15 minutes to wash the virus into the stomach; saline nasal washes and avoiding 5G networks.

The Plague of Justinian arrived in 542 CE with the ubiquitious rats on the grain shipments from Egypt and thence through the Mediterranean shipping lanes to ports and onward along the Roman roads (in carts bearing grain with the hidden black rats carrying the fleas) into the interior. The main plague was zoonotic so depended on the movement of Rattus rattus.

At first, our Covid-19 pandemic spread through air travellers – so much faster than Justinian’s plague.

William Rosen argues that Justinian’s plague changed history: it weakened the waring empires of the Romans and the Persians (the Sassanid Empire). Justinian was unable to extend his initial reconquest successes in Italy. The way was open for the rise of the Islamic people led at first by the righteous caliphs.

And so with us. It is arguable that both the USA, UK and hence the EU have been weakened by recent events coupled with popularist leaders in the UK and USA. It has hastened the rise of China to world economic significance and power. But on the other hand, without Covid-19, Trump might have been re-elected. His and his administration’s mishandling of the pandemic was enough in the forefront of citizens’ concerns to persuade those vacillating voters to cast a vote for Biden.

The Spanish flu of 1918-1920 was an H1N1 virus originating in birds, probably in North America. My father, Mervyn Smithyman, (1911-2008) loved to tell stories of his childhood in Nyasaland (Malawi) where the family moved after the First World War. But before that, my grandfather was with the South African Army in German East Africa fighting General von Lettow-Vorbeck’s forces and he did not return until late 2019. My grandmother stayed in Wepener in the Orange Free State with her 7 young children.

My father was 8 years old when the Spanish Flu swept through Southern Africa. He and Harold, his elder brother, had vivid memories of those days.

Harold. ‘At the end of the war, before Dad got back, the Spanish Influenza arrived. I was a Wolf Cub and we had to go round to the Market Square where they had clothes boiling in a huge cauldron. These charity workers had a big billycan to take from door from door and people went in and cleaned out and I waited outside. I wore a little packet of garlic round my neck and then Mum said, ‘No! I had to stop!’ I was then sent away to get away from the infection.’

My Father. ‘One by one the rest of the family got sick except Mum and me. Then she got sick and I can remember she was telling me how to go the kitchen to get soup. People came to the door to help but she said that she would not accept charity. Mum told me from her sick bed how to get to the kitchen to get the soup.’

‘That was all fine for a little while and then I said, “Mum I have a headache!”’

‘Now she had to get up, otherwise there was no way we were going to survive. But she got up. She could not stand so she crawled to the kitchen. I remember she gave us some soup to bring back. Every one of us survived the influenza. The carts were passing the door with the corpses of hundreds of people.’

We are not at the end of the Covid-19 story. 2021 will be a long year as we wait for vaccination and desperately hope that a nastier strain of the virus does not develop and catch us before it is dampened down into the furthest little corners of the world. But I fear that we will all harbour a new anxiety about our world.