Coronavirus outbreak: So what is a pandemic, and is Australia prepared?
On Thursday the Australian government made the significant move of treating the global outbreak of coronavirus as a pandemic.
“There is every indication the world will soon enter the pandemic phase of the virus,” Prime Minister Scott Morrison told reporters.
And while the World Health Organisation has repeatedly stated it has avoided using the term to avoid global hysteria, Mr Morrison said such a move was essential to ensure the nation is ready for a spike in cases.
He said while the state ministers are meeting on Friday to discuss how they will enact the country’s emergency response to the virus, its enrolment at this stage won’t significantly affect the daily life of the average Australian.
“People can go about their daily lives. As I said yesterday, go to the footy, a Chinese restaurant, play with your mates. Australians should feel comfortable doing the normal things that they are doing,” he told the ABC on Friday morning.
So far Australia hasn’t had a confirmed case of transmission. There have been 15 confirmed cases while a further eight cases from the Diamond Princess have been put into quarantine.
So far the virus has killed 2,858 people, with a recent spike in deaths occurring in Italy, Iran and South Korea. There have been over 83,000 confirmed cases, with the amount of new cases confirmed outside of China now higher than inside the country.
Following the PM’s announcement on Thursday, state and territory health ministers have been asked to show how they are prepared in terms of shoring up the supply of medical items such as masks and medicines and ensuring there is a "surge capacity" in hospitals.
“Primarily now it moves to a formal engagement with the states, where we are doing all of that work across medical stockpile, personal protective equipment, supply chain, in particular personnel," Health Minister Greg Hunt said.
"One of the things we're most focused on is to make sure we have the personnel capacity if there is a surge within our hospitals and medical system.”
Australian WHO advisor says pandemic discussion too early
Professor Mary Louise McLaws, an infection control expert at UNSW and a WHO advisor, told Yahoo News Australia that while it is essential to plan for such an outbreak, we must be careful with using the term pandemic before it has actually happened.
“The World Health Organisation would agree, and I personally agree, that it’s important to plan but I wouldn’t call it a pandemic yet,” she said.
“But that doesn’t stop us from actively planning. Australia has put in place some excellent first-line defences that include quarantining and travel restrictions. They were hard and sometimes our neighbours overseas found it difficult to accept that it has worked very well.”
WHO chief Tedros Adhanom Ghebreyesus said he “wouldn’t hesitate” using the term pandemic.
The WHO identifies a pandemic as the transmission of a new pathogen easily from person to person in large parts of the world, if it was an “accurate description of the situation”.
A spokesperson said after what was learned from calling swine flu a pandemic meant the word wasn’t used for such outbreaks any longer, but Tedros said if it was required it would be used.
“Do not mistake me. I am not downplaying the seriousness of the situation, or the potential for this to become a pandemic, because it has that potential,” he said.
Prof McLaws said there are “very specific requirements for something to be called a pandemic”.
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WHO says that despite the virus spreading to 47 countries, there hasn’t been "sustained and intensive community transmission" for the virus to be perceived as a pandemic.
Transition from local epidemics to a global pandemic, “may occur quickly or gradually as indicated by the global risk assessment, principally based on virological, epidemiological and clinical data."
“But I appreciate the prime minister wants to perform at the highest level for preparation and initiation,” Prof McLaws said.
“We don’t want anyone to think it’s too late to prevent and to just go into containment.
“Hopefully it will never get to a pandemic given our actions so far and the planning that has gone into all of this from health departments and communicating with the Commonwealth.”
Government’s announcement ‘inevitable’
Phil Russo, the president of the Australasian College for Infection Prevention and Control, told Yahoo News Australia Mr Morrison’s announcement was “inevitable”.
“It was just a matter of time and really it’s about increasing our preparedness,” he said.
“It’s not about people dying in the streets, it’s about us enacting various bits of action to make sure we are prepared in time as it does get bigger.”
Prof McLaws said Australia was well placed in tackling a potential outbreak, but our isolation from the rest of the world was a double-edged sword.
“We are definitely at the prevention level because of our early actions,” she said.
“I believe in going in early and going in hard and we’re very lucky we’re an island on the one hand but on the other hand our supply chain for all sorts of essentials is at risk.
“But for a pandemic we’re very fortunate to have a time where we can plan where other countries have not had that ability.”
Australia’s health system will feel the strain in an outbreak
The government’s emergency response plan admits that "health system already reaches capacity at peak times, such as during severe influenza seasons".
In its plan, there are three levels of potential scenarios – low, moderate and high – with the worst level would see an event on a par with the Spanish flu outbreak which wiped out millions of people globally.
This would lead to the health system “stretched to capacity” and the country would implement some aspects of Hubei’s unprecedented lockdown where the virus first originated.
University of Queensland professor Ian Mackay told The Australian the virus is likely to infect all Australians over the coming months and years.
Large gatherings and events would be cancelled, people would be forced to work from home, mortuary services would be prioritised, aged care homes would be locked down and childcare centres closed.
The biggest threat would be to those with underlying health problems and the elderly, according to Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading.
“While it remains the case that most people who become infected will have light symptoms or none at all, such uncontrollable spread would present a serious risk to vulnerable individuals,” he said.
Lack of trained medical staff serious concern
Prof McLaw questioned whether Australia has enough medical professionals to fight the virus if there was a significant outbreak across the country.
“Do we have enough staff? Do we know which nurses and doctors would come out of retirement?” she asked, saying it was a must that former medical professionals will be forced to assist with the battle.
She said despite having a lot of “exceptionally trained staff” it is essential there is significant training for healthcare workers in infectious diseases if there is a spike in cases.
“We cannot expect staff to work at the normal eight hour or twelve hour shift in personal protective equipment,” she said.
The plight of medical staff in the virus epicentre in Hubei has been widely publicised, many working long shifts and suffering mental and physical anguish due to excessive work hours in the fight against the virus.
Prof McLaw has researched the effect of working long hours during the SARS outbreak and said the mental health of medical staff needs to be considered more.
“They have to work less hours so therefore we have to double the amount of staff,” Prof McLaw said.
She said it was a key decision at the hands of the government as to whether they will fully equip medical facilities now or wait for an outbreak to happen.
“To do very sound planning is expensive so often countries plan for not the worst case scenario. They talk about it but they don’t plan it,” Prof McLaw said.
“Theoretically if we do have a surge then theoretically they know what to do but it’s a catch-up game.”
Associate Professor Russo told Yahoo News Australia there will always be a limit in resources.
“There’s always a limit to how many hospital beds you’ve got, how many ICU beds you’ve got, how many emergency departments there are,” he said.
“I think we’re as well prepared as we can be but we need to expect that if it does get big then things that we’re used to on a daily basis may have to alter.”
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