Shepparton's Dr Peter Eastaugh is a renowned paediatrician with more than 40 years experience in medicine — including epidemiology. We asked the veteran physician and public commentator for his views on responses to the current COVID-19 pandemic.
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Have the Australian government responses — both state and federal — been appropriate?
The Federal Government was slow to respond at first, but when they did it was appropriate.
I was disappointed and concerned when the Prime Minister felt the economic and health outcomes were of equal importance. To me that meant we might possibly sacrifice some Australians for the sake of the economy!
The federal chief medical officer (Professor Brendan Murphy) has been known since the outset to be the Secretary of the Department of Health-in-waiting, making his advice weighted towards his masters and I have been concerned by this when considering his advice. Although he is trained as a physician, his career has most recently been as an administrator.
The Victorian chief medical officer (Professor Brett Sutton) on the other hand, is a widely experienced clinician and public health physician whose advice is clear, succinct and very balanced. I have been most impressed by him on all fronts also knowing the epidemiological quality of his team.
Is it too early to lift restrictions on movement and gatherings? What needs to be considered?
The challenge is that this virus is not going to go away in the short term. The likelihood of a vaccine is remote. Remember SARS, MERS, ebola and even HIV have no vaccines.
Therefore, virologists and epidemiologists need to continue to develop models and, more importantly. recommendations. The reason for the current mass screening is to determine our community's viral load. Once this is done we can lift restrictions, but there will continue to be cases.
Should schools re-open? What are the risks?
The unanswered question is — are children vectors? In other words, are they the carriers and spreaders of the virus? Overseas experience has demonstrated that children deal with this virus totally differently to adults and even to teenagers. The current Swiss study will demonstrate a further understanding of this, but at this stage I do not think schools should open fully.
I am confused about federal advice that schools should open and that social distancing is unnecessary, but children should avoid contact with their grandparents. What about our teachers — does the same apply?
Australia and New Zealand appear to have flattened, if not completely squashed, the infection rate curve. Can we get back to normal now?
Absolutely NOT. The virus is unique and highly infectious and still out there. Recent international experience tells us to be conservative. Then there's history — during the 1918 Spanish flu, restrictions in Australia were lifted for armistice celebrations. There followed thousands more infections and deaths. On the other hand, the deadly bubonic plague in 1347 was eventually stopped by social isolation.
Why have some countries done better than others in controlling the spread of COVID-19?
Simple — early intervention, social isolation, lack of urban congestion, a functional public health system and governments not influenced by politics. Certain Australian political parties recently have not demonstrated ethical behaviour in my opinion.
Is COVID-19 worse than flu? If so — why?
This is a novel virus whose structure is unique, and which invades cells via a unique pathway, hence it behaves differently — and is far more lethal — than the flu virus. It invades blood vessels and every organ in the body and it probably even creates its own pathways into cells.
Do we know yet if you can be re-infected with COVID-19?
This is uncertain. We know you can contract some viruses a second time (for example, chicken pox) but not other viruses. Children in China were found to retain the virus for weeks after they had recovered. Only time and epidemiological studies will answer this question.
Why does it take so long to produce a vaccine?
This comes down to the very structure of the virus. The most effective vaccines have to enable the immune system to attack the internal structures of the virus. The surface of this virus is very different which make it difficult to deal with.
Is the Federal Government’s COVIDSafe mobile phone app a good idea?
From a theoretical epidemiological point of view — yes!
But it is not proven, and with radical politicians potentially having even more access to one’s data, without legislation there are concerns. There are already anecdotes of messaging from outside sources.
The World Health Organisation has come under attack for not doing enough at the start to prevent the spread of COVID-19 and for being under Chinese influence. What are your thoughts?
WHO is a massive organisation which is essential for world health.
Any such organisation will be politically vulnerable and should be questioned on their performance so they need to be accountable and reviewed, but not punished.
Similarly, Australian political parties who behave inappropriately or unethically should be called to account.
What about hydroxychloroquine?
It is not a proven effective treatment for COVID-19. It is a very toxic drug with significant potential side effects such as blindness, liver and kidney damage. A bad choice!
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