The CODE Update: 27 May

Priscilla Robinson

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This has been a mostly much slower week in COVID-19 land, and many places have seen a reduction in new cases this week from last week. The fatality numbers are mostly also reduced although not by as much – presumably a legacy of cases who have been ill over time. The stand-out WHO region is Europe, which has seen a huge drop – presumably because of the vaccination programmes being well under way now. I have not noticed any countries reporting massive increases, although this could be my inattention …

Speaking of vaccines, in general there has been good progress with roll-outs, except for resource-poor settings. Please support the COVAX programme, and the initiatives to provide good access to vaccines and patent waivers. The countries which have few or no cases need it the most, all those small island nation states with not much in the way of infrastructure, who, should COVID-19 arrive on their doorsteps, will be in deep trouble.

Speaking of island nation states, I have a question. Why, in heaven’s name, when travel from India to Australia was banned, was the travelling Australian cricket team allowed to return by quarantining en route via … the MALDIVES??? India’s population overall attack rate is around 2% (i.e. ~200/100,000), and the Maldives at 10.6% which is more than five times higher per head. I know that India’s rate is probably undercounted, although there is no guarantee that the Maldives does it so much better, and the rate in the Maldives has been steadily rising for many weeks now. The only plus is that the hotels will have benefitted from the revenue, and presumably the team could open the windows and doors … I gather from a good friend that a similar arrangement is happening in the Seychelles (rate also 10.6%) with other travellers (so my comments are similar about that). I know that these holiday islands depend on travellers for income, and I have no wish to prevent the $$ from arriving, but this policy for the Australian cricket team does not make sense to me.

Now to ventilation and the 5 micron question, which I missed before but is important when thinking about workplace safety etc., especially for those of you when communicating with staff who are in face to face contact with the public. WHO has updated advice about respiratory transmission based on the differences between airborne transmission and droplet transmission.

The 5-micron thing is somewhat arbitrary – particles smaller are airborne, larger are considered to be transmitted in droplets, and the recommendations for dealing with these are a bit different. Droplet infections are prevented through using masks, handwashing etc., but infections transmitted via an airborne route also need the air to be cleaned (as in operating theatres and so on, where the risk is quite high). Attention is now being paid – one might say ‘at last’ – to the possibility that bad ventilation is also responsible for transmission, which seems to explain the possible transmission in hotel quarantine. (Maybe the Maldives was not such a bad idea after all.) The image below is one of a few I have seen, basically showing the same thing.

Floor plan of the 11th floor of “building X,” site of a coronavirus disease outbreak in Seoul, South Korea. Blue colouring indicates the seating places of persons with confirmed cases.

Park SY, Kim YM, Yi S, Lee S, Na BJ, Kim CB, et al. Coronavirus disease outbreak in call center, South Korea. Emerg Infect Dis. 2020 Aug

 

So, advice about all of this might change. In the meantime, masks work (as long as they cover your mouth AND nose!), and in places such as travelling on public transport which pose a risk, remain a primary preventive measure, whether you are vaccinated or not. This is of course in addition to other measures such as handwashing, etc.

Stay safe and see you next week.

 

About Dr Priscilla Robinson and The CODE Update

Dr Robinson is a public health epidemiologist with particular interests in international health and communicable diseases, and public health competencies. She has worked in health departments in England and Australia, has managed public health teaching programmes, and taught and researched many aspects of public health epidemiology and policy in many countries. She is an adjunct Associate Professor at LaTrobe University, and to stop herself being bored is an editor of PHAA’s journal ANZJPH, and holds board positions (almost all unpaid) on various NGOs, journals, and at her local hospital. Otherwise, 10 acres of untamed bushland on a hill in South Gippsland makes weight-bearing gym exercise and strength training a bit redundant.

The CODE Update is a new regular feature on the Intouch blog to keep readers informed of COVID-19 developments around the world.

The CODE update originally began at the start of the SARS CoV-2 pandemic as a way of explaining it to Priscilla’s friends and family who happen to live all over the world, and who were being bombarded with information and misinformation in their own countries. The CODE Update provides links to practical materials and papers written for people who are not versed in the language of outbreaks and epidemic curves. It is sent out every week, and includes a short commentary to provide context to the numbers included in the spreadsheets.

Note: Whilst every attempt is made to transcribe all data faithfully, every now and again mistakes are made and not noticed until the next update. Also, on occasion numbers are revised after posting at the source databases.

We hope you will find these updates to be a helpful tool, and the links to current information useful.

 

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