covid-19 Teetering at the Rubicon

Perhaps Australia is teetering on the edge of the Rubicon rather than having crossed it.

The pause in rollback of restrictions in Victoria suggest at least a certain hesitation about actually crossing.

My view was and is that a flat rate of daily infections implies that the rate is likely to start rising.

That is because the declining numbers from incoming travellers are presumably being roughly balanced by the increasing numbers of “community transmission” from untrackable local sources.

I wrongly thought that the week or so of roughly flat numbers at around 50 marked the bottom of the trough, but in fact that was a temporary blip and the numbers continued to decline.

But restrictions were lifted while there was still community transmission so I assumed the relevant authorities were aware of the consequences and fully committed to a much higher rate of infection (while also committed to not risking the hospitals becoming overwhelmed).

Now I’m not sure what’s going on. Victoria’s Chief Health Officer mentioned that the virus is doubling every week. I haven’t attempted to analyse the statistics and last time I looked some of the necessary information was not available (proportions “under investigation” that end up classified as “community” or “known source”). The raw numbers more than doubled over the past week but I assume he was referring to a more relevant estimate of the underlying effective rate at which each infected case generates another one before becoming non-infectious or dying (taking into account that many are isolated and unable to infect others while others transmit before ever being isolated or while ineffectively isolated).

If it is doubling every week under the present level of restrictions it would obviously be necessary to impose much tighter restrictions to prevent the hospitals eventually being overwhelmed.

Perhaps the local restrictions are intended to prepare the way for that and help neutralize the massive campaign that has been waged from “business” to reopen regardless.

But perhaps not.

Perhaps there is still some lingering belief that a “sweet spot” exists in which the level of restrictions and behavioural adjustments just keeps the virus “under control” with a relatively small number of sporadic outbreaks. each of which can be contained. It might be hoped that local lockdowns and the “pause” would tip the balance of behavioural changes sufficiently.

That doesn’t make sense to me. “Eradication” is the only such “sweet spot” – when the numbers are so low that new cases are merely “sporadic” outbreaks. That was not attempted in Victoria or New South Wales. I am not competent to say whether it was feasible but if they were going to attempt it they would need to maintain a much longer period of tight restrictions and I cannot estimate how long that would have needed to be or how feasible it would be to maintain restrictions for so long. Also far more would need to be done to ensure that subsequent sporadic outbreaks could not get out of control (eg the contact tracing app would have had to be mandatory).

The alternative to Eradication was and is successive “waves” of infection. Each time the restrictions are lifted the virus comes back at first gradually and then quickly so that another shutdown has to be introduced. That alternation continues until a vaccine.

But the current “pause” seems to indicate some sort of “teetering” between fully accepting a policy of successive waves and actively seeking to replace it with a policy of Eradication.

I don’t see how local lockdowns could prevent ongoing community transmission within a city like Melbourne. Such measures could only work against “sporadic” outbreaks. It will be interesting to see whether it can work in Beijing.

But perhaps others who know more about it than I do think it is at least worth trying. If so, perhaps they could still go in either direction – continue crossing the Rubicon or attempting Eradication.

3 thoughts on “covid-19 Teetering at the Rubicon

  1. Tomas Pueyo frames it as the Hammer (lockdown) and the Dance (other). A few countries have succeeded with only the Dance, eg. South Korea. He argues that the hammer was essential early for those countries who were not prepared and because we didn’t know enough about how to stop the virus early on. Some countries had experienced earlier pandemics and were better prepared. He makes many more points which I thought were significant, not attempting a full summary here, due to lack of time.

    I’ve read a couple of his longer articles, one about Sweden and an old one one about the USA

    His twitter feed has a recent 11 point twitter essay about why the virus is winning in the USA

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  2. You do wonder about the mistakes made by Victoria with our model of quarantining returned travellers. Multi story hotels, lifts, in the heart of the CBD. Are there no broad acre facilities where people could be placed in huts, spaced well apart? I’m thinking of settings like the old migrant hostel Bonegilla,up on the Murray River. Is there nothing similar that could be used?

    Also having poorly trained private security guards overseeing the facility does not inspire. The State trains,resources those armed bodies, the police and the ADF. Surely these trained groupings whose career is about upholding the law,maybe also ‘serving the people’ would have done a far better job in overseeing quarantine.

    So Viele Fragen, So Viele Berichte.

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