On Coronavirus Australia is split into two parties

1) The “Anxious Group” which consists of those watching Coronavirus, seeing the stats, seeing other governments actions and in turn being mystified by a lack of action here at home.

This group is probably in the majority which is a surprise to me.

I am in this group and I am still sending my kids to school but around a third of kids at both primary school and day care in my area are being kept at home already in response to the virus.

2) The “Larkin Group” consisting of those who are still in its “just a bad flu” viewpoint or “it will be alright maty” mindset

The government needs to communicate better to bring these groups in alignment around a sensible center.

At this point Australia is pretty much committed to an Italy style lockdown sometime in the next two weeks. Why you might ask? Well to help set the stage ask yourself these questions

Is it better to Overreact?

or

Is it better to Underreact?

At a simple level a lock down will be required because we know it is works, at a more subtle level the progression of the disease in Australia matches what happened across the world from China to Italy to California we are just lucky enough to be delayed in seeing the impact. If you combine local and international data then a lockdown will be required in Australia

The delay between Australia and the World gives us a wonderful opportunity to learn from others, but it almost means if we do not learn then the failure is on Australia

Reviewing both local and international data informs us that a lockdown will be required so the Government needs to communicate this openly to the public. This will calm everyone in “Anxious Group” group because the government is on top of the situation and it will spur everyone in “Larkin Group” into undertaking appropriate planning around work continuance activities before they are forced to stay at home.

Come out and say what is going to happen with a simple statement like.

“Australia will have to have a lock-down. For the lock-down period schools and non-essential workplaces will be closed down. Food Stores, Food Delivery, Pharmacies, Medical will continue operating as normal and everyone will have access to these services. The chief medical office will announce when the lock-down is required to start based off latest modelling and the duration of the lock down will be tailored regarding its effectiveness. We expect the lock-down to commence in one to two weeks”

A government statement in this regard will help the Australian public understand the governments thinking and prepare mentally for what is coming.

Why we need a lock-down?

When you bring together disparate facts into a single whole it shows why a lockdown will be required

1) Coronavirus is growing exponentially in Australia

2) Measurement of the effectiveness of the current round of social isolation will not be available till Late March. (Incubation delay (5 days) and Diagnosis delays (2-8 days) means there is probably 10 days delay between actions and observable impact on case numbers)

3) Available ICU capacity (NSW) is likely to be committed to being overwhelmed if no action taken before late March

4) China on the day they locked down recorded 7 deaths at which point hospitals were already committed to being overwhelmed (Australia cannot ship in 30k health workers from elsewhere and build new hospitals). Italy locked down later and will likely have deaths peak at thousands of deaths per day

5) CFR rate will spike if ICU is overwhelmed as 50% of ICU cases survive and if there is no bed they will die.

1. Coronavirus is growing exponentially in Australia

A simple graph of Cases over time shows the exponential growth occurring. Growth in cases for Australia is 1.2 per day or cases doubling every 4 days.





2. Delay due to Incubation and Testing

If Australia locks down perfectly today, then everyone who caught the virus yesterday will still be infected and will not show symptoms for 5 to 14 days. Also, we are only testing Symptomatic patients, we need to wait 2+ days for symptoms to progressive enough to clinical diagnosed as a suspected case and then a couple of days for tests results to return.

If all infections stopped today it will therefore be nine plus days before we could see this in our case data. The other way to look at this is that the 75 cases recorded on the 18th of March actually reflects infections from the 8th of March and cases have doubled twice since then.





Australia is already committed to 2000 plus cases as we have only introduced limited social distancing measures to date.

3. ICU Capacity likely to be overwhelmed

Australia has limited ICU capacity. Once ICU beds start being filled things rapidly get out of control. You can go from having no capacity issues to then being full and then to having twice as many patients as beds in as little as little as 8 days (using the doubling every 4 day rate currently calculated from Australian data)

If there are 1000 ICU beds available for Coronavirus in Australia (Best Estimate) then based off global hospitalization rates we can support only 2,500 infections per day. If we are to stop below this tipping point we need to lock down when we are reporting just 1500 cases per day. NSW is more advanced than Victoria and will pass this threshold on the 30th March. ICU is then expected to get overloaded in mid-April once these cases caught in late March flow through into critical care.

Detailed Analysis around ICU Capacity can be found in my previous article https://www.linkedin.com/pulse/you-live-major-city-when-do-want-start-panicking-allan-greenwood

4. Locking down too late costs lives

China locked down on the day they recorded 7 deaths. Over 3000 people died.

Italy locked down on the day they recorded ~100 deaths. 475 people died yesterday, and this will keep growing for another 11 days.

Detailed analysis including underlying data can be found in my previous article https://www.linkedin.com/pulse/psa-deaths-expected-keep-growing-21-days-after-italy-peak-greenwood/





To avoid this calamity occurring in Australia we need to act early

Summary

· Existing Government Social Isolation Policies may or may not be effective in stopping exponential growth

· Data to prove effectiveness may not be available at the point you need to lock down to stop hospital overloading in the case that existing policies are ineffective. In this case it is better to overreact in order to save lives

· Given this data delay at the very least a precautionary lockdown will be required

· The government at all levels should be communicating this to help those anxious about a lack of public action and to help those who are dismissing the threat the virus and allow them to prepare