It is reasonably certain that Australian governments will take measures for “social distancing” fairly soon.
It is difficult to determine the optimum time as such measures are extremely disruptive and cannot be maintained for very long. The aim is not to contain the outbreak but to spread out the peak to reduce the number of people who die because intensive care such as mechanical ventilators are unavailable during the peak case load.
Italy moved too late according to this article for GPs from their main professional organization, dated 11 March:
6.2% case fatality rate
Italy is now one of the worst-affected nations, with a high elderly population where the virus spread undetected for several weeks.
The entire nation has now been placed into quarantine in an effort to get on top of the virus. All public gatherings are banned, restaurants and bars have restricted hours, and cinemas, theatres, libraries and museums have been ordered to close. Schools, daycare and universities have also been closed.
The national quarantine may be effective, as it was in China, but it will take time to have an effect.
In the interim, large numbers of serious or critical cases have swamped hospitals, leading to top Italian health official Professor Giacomo Grasselli to dub the virus ‘worse than a bomb’.
Dr Daniele Macchini, an intensivist in Lombardy, has described the impact of the virus as an ‘epidemiological disaster’ and a ‘tsunami’ that is threatening the ability of the hospital to offer care.
‘Suddenly the E.R. is collapsing … Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before,’ he wrote on a Facebook post that has been translated.
The concerning account is echoed by another anonymous Lombardy intensivist, whose comments were posted by UK doctor Jason Van Schoor on Twitter.
The intensivist said that despite Lombardy’s wealth and excellent healthcare system, the virus has overwhelmed hospitals.
‘The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by COVID-19, they are running 200% capacity,’ the intensivist wrote.
‘There are hundreds of [patients] with severe [respiratory] failure and many of them do not have access to anything above a reservoir mask.’
Due to the shortage of ventilators – which are essential to keeping critical patients alive through the severe pneumonia – China has now offered to send Italy 1000 ventilators, as well as large supplies of personal protective equipment and testing kits.
The RACGP has more information on coronavirus available on its website.
Going too early might perhaps be as bad as going too late if it merely delays the peak rather than widening it. But the idea of Australian governments moving too rapidly seems implausible.
Here’s a simple journalistic explanation about “flattening the curve”, same date:
China sending ventilators to Italy confirms that social distancing in China has been successful. This is confirmed in a detailed statistical analysis published in British medical journal, The Lancet on the same date:
Other medical information can easily be accessed via the links at that site’s resource center, including links to many other resource centers:
The absurd delay resulting in the Grand Prix being cancelled only at the last minute suggests that Australian governments will not act too early.
That means the public needs to be mobilized to shut down social contacts and self isolate before official announcements and publicity campaigns.
In particular the more older people self isolate now the more that will surive the shortage of intensive care for severe cases at the peak.
Inevitably triage for access to Intensive Care Units must allocate them to severe cases among younger people more likely to survive than among older people less likely to survive a severe case.
Pretty well everybody will eventually get the flu when it becomes endemic. There is no chance of vaccines being developed quickly enough to prevent this and little likelihood of effective anti-viral drugs being available to help soon. What matters is whether the small minority of mainly older people who get a severe case needing intensive treatment such as mechanical ventilators, need such treatment during the peak or more slowly after the main peak has subsided.
Detailed advice on hygiene, social distancing, self isolation etc has been available from US and EU Centers for Disease Control for some time, although that availability of advice has not been matched by implementation. The Australian equivalent has not yet fully caught up even on advice: