The JUICE Media Podcast

Coronavirus - with Dr Norman Swan

Episode Summary

Ep 10: In which I speak with Dr Norman Swan, presenter of ABC's Health Report and co-host of Coronacast, about the latest Covid-19 situation in Australia, our Government's response, school closures, potential treatments, and what we need to do right now to avoid Italy's nightmare.

Episode Notes

This is the podcast companion to the latest Honest Government Ad about the COVID-19 virus. If you haven't seen the video, you can watch it here.

You can follow Doctor Norman Swan on twitter here: @NormanSwan

Make sure to tune in to Norman Swan and Tegan Taylor's podcast: ABC's Coronacast. Or subscribe to it on Apple Podcasts

Please consult your state, regional, and national government advisory pages on COVID-19.

Music featured in this podcast courtesy of Tom Day

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Episode Transcription

Thanks so much for joining us on the juice media podcast. DR NORMAN SWAN You're welcome.

 

Can you please give us an update the situation is changing very fast. Where are things that right now with COVID 19 in Australia. Can you give us a situation report.

 

Well as we speak on the day that we speak which is Saturday the 21st of March there are about 800 cases known which probably means there are 8000 cases in reality maybe even more than that because there are always more than than are reported. We are not doing the intensive testing that we're doing in some other parts of the world so we really don't know about asymptomatic cases or people who are mildly ill and so on. But eight hundred and that's where Italy was on the 7th of March.

 

So we are talking on the 21st of March so that's maybe 14 or 15 days ago was where Italy was and what counts in this is the height, how steep the curve is upwards and our curve is going not quite vertical but almost vertical, vertically I should say.

 

And the doubling time, in other words the number of days it takes to double the number of cases is shortening in Australia. So it was four or five , now getting on to be two according to some analysts. So that means that we are going rapid we are rapidly rising and that means that whatever we did two weeks ago didn't work then because remember this is delayed action the 800 cases we see today and wherever you might be listening to this podcast the number of cases you see today wherever you live is what happened five to 14 days ago maybe even longer ago than that it might have been a virus that was going in the community under the radar with mild symptoms nobody noticed. And it went through two cycles before it started to emerge in the population so it could even be a month ago. But that also means that what's happening today won't be seen in the community for another five to 14 days on average maybe even longer. So it's if you press a button now you don't see the effect for 14 days. That's why there's not a moment to be lost.

 

OK. So basically it's not a good situation we're in. It's not the time to be complacent. Can you give us a sense, y ou say there's no time to lose. How much time do we have?

 

So we are where Italy was. Yeah. So you could argue that we're a couple of weeks behind. Right. Well we're not Italy, we're different and we have low numbers and so on. Yes but if you said to an Italian in Lombardy in Milan or elsewhere in northern Italy two weeks ago when there were 700 cases if you knew then what you know now, would you be saying 100 people indoors 500 outdoors or a four meter radius, and they would say my God no.

 

You've got to shut down now before it goes nuts.

 

With that in mind my hometown of Florence I just shared on our social media footage, it's incredible, it's haunting. Florence is usually bustling with tourists, someone took a drone video of it almost completely deserted. And my dad is in Florence at the moment. Meanwhile in Bondi Beach people are out and about as if nothing, we saw footage yesterday Bondi Beach which just makes my hair rise. Now I don't wanna have a crack at people for going to Bondi or getting off a cruise ship but I'm wondering whether the government deserves to be blamed for not communicating the dangers of these kinds of mass gatherings that we're seeing still today in Australia. Is the Australian Government taking COVID19 seriously enough in your opinion?

 

They're taking it seriously. But I think that they're treading too lightly and they must be looking at the same graphs I am. These graphs are going straight up and there's no magic fairy here with strong muscles that's gonna get to the top of the curve and pull it down by some waving of a Harry Potter wand, that is not going to happen. This is not going to come down of its own accord. You can predict with confidence. This is Year 7 maths, any primary school student can do the maths on this that if it doubles every two or three days where we will be in a week, where we'll be in two weeks, and there's nothing to indicate that that's bending at all. So you can predict with confidence where it's going. And you could have predicted with confidence probably a week ago where it was going and they are just lightly tapping the pedal now and again I'm not saying they're not worried about it. They are worried about it they're taking it seriously but they are not acting decisively.

 

OK. Well that's at least partly reassuring. Perhaps slightly awkward question. But if you were the chief medical officer what do you feel the advice should be right now?

 

Well I'm not getting into that game because people are, you know, playing me off against the chief medical officer so, I'm very glad, I am very glad that all I am is a broadcast journalist with a medical degree watching from the side. You know I, I do not envy any of the chief medical officers around Australia or in any other country. Bloody hard job, really difficult decisions. But it is being complicated by the fact that the politicians are too involved in this. And so you have political decisions being made whereas when HIV came along the politicians were smart enough at least in countries like Australia to take it out of their hands.

 

Why would you wake up every morning if you are the Minister for Health feeling responsible for this? Put it in the hands of people who really expert, transparent, communicating with the public all the time and making the tough decisions for you and they have to be tough decisions. Thirty percent of new infections in most parts of the world when it's ticking off like it is know are spread by young people. They have milder disease, they don't recognise they've got it. They're only half as infectious as people with severe disease but there's still a lot of them. So 30 percent of new infections come from young people and that's how it spreads in the community and young people think well I'm steel belted against this I'm not going to get really sick. 38 percent, I think it is at 38 percent in New York state, people in intensive care beds are actually young people and they die. They don't die at the same rate as older people but they do die. And so this is not an exclusive problem of people in aged care homes. This affects the whole community and in particular also in young babies too. So we've got to protect and the other reason we're doing this is to protect doctors and nurses, they're the ones who are dealing with this at the front end and if we are irresponsible about it. I mean the predictions are if we do nothing more now in Australia by April 7th our intensive care units will be overwhelmed.

 

That's the prediction from the modelling.

 

I was just going to ask you that when you said it's very predictable where this is going to go. So April 7th, I think I want to repeat that, I think it's really important for people to understand that our health care services are going to be overwhelmed. That means you don't have to get sick with coronavirus to be in trouble. You could be ill and need hospital treatment of any kind and you might not be able to get that treatment.

 

No question that's what's happening is happening very very quickly in the United States and in the coastal states in the United States.

 

It's happening in Italy, it happened in China, and this is, this is serious stuff.

 

I totally understand your position in terms of not wanting to be played off against the chief medical officer.

 

The reality is that so many people have turned to you because you are providing this daily information, daily updates. It's put you in a really difficult position. I wish our government was providing these kind of daily updates directly. One of the things that's caused a bit of a stir is the question about school. So there's been a lot of debate about what to do about that. The government keeps sort of repeating the angle that's because children are relatively immune to COVID19 it's not a big deal, which has been very infuriating because obviously many teachers are 60 and over, but also people aren't worried necessarily about the children, they're worried about children then infecting grandparents, teachers, health care workers. There was an article yesterday in The Guardian, teachers saying we feel expendable. What is your take on this? There's been a bit of confusion. Has your message been consistent around this and what is your take on the schools situation.

 

There are two aspects to the school situation. So through Coronacast that I do with Tegan Taylor, podcast we get a lot of questions. A thousand questions a day, 5000 last weekend. So a lot of questions coming in and they're changing as time goes on. So it's less about how do you wash your hands. And the questions now are from parents saying "should I keep my child home from school" which a lot of parents are doing anyway. Now my answer to that is you are not necessarily going to save your child from an infection by keeping them home from school at this stage in the epidemic. So you've got to get the school's decision into context. The reason you would shut down schools is not to protect individual children but to protect the community at large because large gatherings of young people are sources of infection for the rest of the community. So it doesn't make sense at the moment to keep your child home from school because the risk to an individual child is low. But in my view we're getting to the point where for the rest of the community, albeit it will be a very difficult decision to make. I understand that. I understand that it's not cost free. Some people will have to stay home from work, if they're going to work, to look after their kids. It's a tough decision. But you do it for the public good. But there's no sense in, before that decision is made, holding your child back from school. You might as well let go. But you do have to keep them away from your 70 and 80 year old granny, your parents, grandparents, because kids could be a source of infection and you don't know it. And so people who are older with more other diseases do need to be relatively isolated at the moment. Even at this stage in the epidemic because while there are this number of cases there are far more people infected in the community than we know about. And we've just got to get things organized.

 

So if I've understood correctly yes the right thing would be to shut everything down. Close schools. But until that directive comes from the government and everyone's doing it there's no point, there's no point. So you're saying there's no point. So just to clarify because I think there's been some confusion. Your message has been consistent. Yes we should close the schools but it shouldn't be an individual decision. It should be a collective, government directed policy.

 

Government is gonna make that decision and understand why they haven't.

 

It's a really tough decision. So I do understand that thing is a problem. And I think they were hoping that the curve would bend, the curve hasn't bent, it hasn't bent now for several days and this is a timeframe of days not weeks. And it's not bending and we're at eight hundred cases. We've got 14 days before we turn into Italy. Now's the time to actually do everything we can to get that curve flattened. Keep it down and then work out after that when you might lift your foot off the brake just to see whether it's under control. Yeah, but now's the time to do that.

 

Not when we've got several thousand cases and we've got doctors and nurses picking up this infection and ending up in ICU.

 

I just want to turn from the really disturbing sort of frightening things that we're talking about to some positive angle potentially and solutions that are on the horizon. There's been some talk of what can we do if we take society level action, for example can we have makeshift hospitals that can be quickly set up. Can we have faster testing. South Korea has got a 15 minute test . Now is there an antibody test on the horizon so that at least we know people who have immunity and they can be placed on the frontline. The chloroquine treatment, not a cure but a treatment that's been talked about. Are any of these things giving you cause for hope?

 

Well let's separate them out. I think test technology will change. We have to test more in Australia. Some experts would agree with me, some experts wouldn't. But if you look overseas where they've actually had more success in controlling it, they just test much more than we do, and they contact trace much more aggressively than we do, because they're willing to infringe on human rights, personal rights and so on. So it's not straightforward, but you some places have closed schools, some places haven't, Singapore hasn't. And Singapore is now seeing its number of cases rising quite rapidly. Testing could get faster. Yeah. Everybody's looking for a reliable blood test so that you can actually check whether you've had an infection in the past. Which doesn't tell you whether your infectious but it tells you whether you've actually got one now or you've had one in the past, had infection in the past. So you can find the immune population as well. So that gives you a much more accurate sense of things, so blood tests will be on its way. I'm not sure when there are lots of things being said on the internet about various treatments and what's worked and what hasn't worked in China. The evidence is poor. The evidence is poor for chloroquine the anti malarial. It's not guaranteed that that works. I've got a story on it on Monday night's health report. You just got to do proper randomized trials. This was exactly what happened during the early days of HIV AIDS. New treatments were coming out all over the place without being properly tested and then when the dust settled out of all these hundreds of things with some of which sounded sensible some of which sounded mad. Only one treatment emerged at that point which was AZT and that's likely what's going to happen here is that there'll be just lots of noise and smoke and mirrors and lousy studies that people extrapolate that haven't been properly controlled. And you know some of these drugs are not harmless. They've got side effects and some of them cost a lot of money.

 

You just got to be really careful and just wait until the evidence comes out so obviously there are some things on the horizon but obviously the playing for time game is dangerous.

 

So returning a little bit to the strategy that you are advocating which is a total lockdown. I mean do you feel that that is inevitable.

 

I'm not. A total lock down the way of New York State. I don't think we need that at the moment. But I think it's about people not mixing with other people unless they have to. You know you can be allowed to go to the shops but essentially you're home. Most of the time you try and exercise at home. You don't mix with your neighbors. It's not a total lockdown where people who live in China where people have got to deliver food but much more aggressive and assertive than is now. People don't realize what's going on here. I mean what's going on is a major change to the way we live that we haven't seen for a century and it's because we've got no treatment and no vaccine.

 

And so it's isolate, quarantine isolation, if you've got the infection. That's the way we control it. And spatial distancing is the main thing. To do it properly is major.

 

Okay. Thanks for clarifying that point. So that's actually encouraging in the sense that we're not looking at such severe restrictions as we're seeing in other places yet.

 

Yeah. We're not welding the doors. OK you can get out. In some parts of the world where they've been quite successful, you put on your location identifier on your phone and if you're on quarantine and you move out of your house you'll get pinged right. And they're using CCTV cameras to pick up contacts.

 

Yeah there's all sorts of things happening that we probably would have balked at six weeks ago but maybe we won't balk at it now to protect the common good.

 

And I think that takes us into how I want to kind of shift into the bigger picture. I always like to try and end all these podcasts on a bigger picture. You mentioned in one of your podcasts that this will be remembered as the year of the plague. We will never forget this year, it is going to leave a permanent mark on our collective conscience and change the way that we live essentially. Can you reflect a little bit more on that perhaps you know feel free to get philosophical if you want but in terms of how will this change the cultural mood of Australia, potentially even our society.

 

Well I think that, we will find, I think some wonderful things will happen and they already are. So choirs rehearsing on Zoom for example, we had drinks here afternoon drinks here at the ABC on zoom with everybody in the unit coming in on Zoom and talking to each other. So it's spatial distancing not social distancing. So we will find ways of socially coming together perhaps even more closely and we'll think about social contacts and social support in a much more sophisticated and nuanced way than we have in the past. We'll find new ways of doing that. And I think that we'll value each other and our friends and our families more after this than we did before. Those are wonderful things that will happen. Hopefully the government loosens up on innovation and releases some funds. And you might get some entrepreneurs in Australia and other places developing new businesses new ways of communicating new apps new ways of controlling the epidemic minimizing the effect on lifestyle maybe even new pharmaceutical industries and so on. So you'll see a blossoming of things, maybe we'll see some breakdown of barriers to better healthcare that we haven't seen but all of those are good things that will happen as a result of this. I think it's going to be a growing experience for us all. But it's gonna be tough too. I mean very tough, you know nice weather outside and you really can't go out or you shouldn't go out and mix with other people. If you're a grandparent you're not going to be seeing your grandchildren directly. It's as if you're living overseas and you're going to be doing face time with your grandchildren as if you're living in London but they're just around the corner. Those sorts of things, and that's going to be so upsetting and so difficult for many grandparents and for young people. There's an even greater sense of responsibility on young people because I think they all just go off and some some will go off and have COVID19 parties where they infect each other because they want to just get it over with not realising that the effect of that will be to spread to their parents and grandparents and maybe people that they went to school with who are now doctors and nurses who were actually gonna have to deal with this and get infected and maybe end up in an intensive care bed simply because you wanted to get it over with. But you're spreading it through the community. We've all got to play our role here and it is going to be tough.

 

I think the other thing that I completely agree with and I think the other thing that we also are realising very quickly is how dependent we are on each other and specifically we're recognising that nurses and teachers are essential workers. You know we we kind of like get told that you know it's the big bankers and financiers that hold the whole society together and the whole idea that wealth trickles down. But once you take away these essential parts of society everything comes to a standstill and hopefully next time there's another pay negotiation for nurses and teachers this will be treated differently. And also I think important to remember how essential the ABC is, your podcast has played such a vital role and yet only a year ago we were talking about the government was talking about cutting funding to the ABC. Not just talking about, they did cut funding right. So hopefully this will not be allowed to happen again. We now know, we can see how essential services are.

 

So the point I'd make here is people are kind of overblowing what I've done. Just over blowing and I know I feel I've accidentally filled a vacuum, it's been an accidental thing but sort of vacuum. But what's not accidental about this is that there would be no me were it not for the ABC. So the commercial television stations would never have developed somebody like me who was, you know, a trainee paediatrician who joined the media. I've been on the ABC ever since and I've developed skills and knowledge about how to communicate and combine my medical training with communication so now I'm not a doctor anymore, I'm a doctor in front of my name, I'm medically qualified but I'm a broadcast journalist and be able to synthesize those two.

 

People say well if you look at David Attenborough, he's a naturalist. Well David was not a Naturalist, never has been. He's a broadcaster his entire career has been in broadcasting people just identify him in that way. And it's the BBC that's nurtured David Attenborough, commercial television in Britain would not have done that and commercial television and radio would not have done developed somebody like me over a period of decades and invested in specialists.

 

The thing, the reason I can do what I do and it would be anybody who was recruited to the ABC into the role I've got would have been able to do what I do and it's only because the ABC exists. So if we want bushfire emergencies you know reliable trustworthy sources you want trustworthy sources of information.

 

Only the ABC in Australia will develop that and nurture that for you because the market doesn't provide for it. I'm not blaming commercial television but they're on a commercial imperative and if I worked on commercial television they'd have me selling margarine, cholesterol lowering margarine because that's how they make their money and you wouldn't have the freedom to do what you need to do in broadcast journalism.

 

So this is why you've got the ABC to be able to nurture skills that are reflected in what I do but they're not unique in me is what I'm saying. But they are unique to the Australian Broadcasting Corporation.

 

So remember that people next time the government talks about cutting funding hands off the ABC needs to be really firm in our minds because we need more Norman Swan's and bushfire information services because if one thing is clear from all this and the bushfires is that we can't rely on government to play that role. I just want to ask you one final question and then I'm gonna let you go because you have a nation to help keep informed. The climate emergency. Here at the juice media, really it's the story, it's the narrative for us that really glues everything together. All roads lead back to the climate emergency. And so does this one and I was hoping to end by reflecting a little bit on the parallels between this crisis that we're seeing with COVID19and the broader crisis that we face with the climate emergency. The parallels in how we respond to these two crises is very revealing and in some ways very similar. Their response to COVID19 is like a fast forward high speed version of our response to the climate emergency. The first similarity is that it's a threat. We've been warned about it for ages but we haven't prepared for it. In both cases scientists and experts are not heard. The second is that when the symptoms finally manifest themselves our leaders respond with dumb fuckery and nowhere has this been clearer than the US where there's been massive denial and dismissal which has wasted precious time and a third parallel is that once our governments finally admit that there is a serious problem by then it's too late to craft gradual incremental and manageable changes and the measures that we have to take have to be vastly more difficult costly and hurtful to our society than they would have been if we had acted earlier. The solutions are also very similar. The thing that need to be done to solve the climate crisis is the world coming together. If if everyone on the planet could theoretically self isolate for three to six weeks COVID19 would be gone from the planet. But that requires a level of coordination global coordination which just seems impossible. Which brings me to my very vague rambling open ended question about can the COVID19 situation be a teachable moment for humanity so that we can learn to come together as a species so that we can really tackle some of the greatest problems that we face such as the climate emergency.

 

The way I think about this is that in Australia if you go back a year, you had climate change scientists and bushfire experts saying to the government and others there's going to be a bad bushfire season in the Australian summer of 2019 2020. Predicted it with confidence. They then tried to convince people of it, they wouldn't be convinced of it.

 

They didn't take action and it happened and I find myself in a very similar situation to them. If you'd asked any of them they would have said please let me be wrong.

 

The best thing that can happen to me is that in six weeks time the shock jocks that have been saying this is not a problem say what an idiot. That guy at the ABC Norman Swan. He predicted this. He's a Jeremiah. Nothing's happened. That will be the best result of all because it would mean that prevention has worked because when prevention works you don't see a crisis.

 

And so it's the absence of a crisis. And so it is like climate change where we've seen that in the last twelve months you don't have to project forward with climate change you just go back a year confidently predicted from the mathematical models that we were going to have a bad bushfire season. Sure enough it happened and where we're sitting now. It's not magic, it's Year Seven maths, it's just going to keep on going. And you just set that as an exercise for a primary school child in maths and they'll work it out for you and in two weeks time how many cases will be in Australia unless that curve gets bent down, and we know what to do and we're not doing enough of it yet.

 

Thank you for leaving us with that. I'm not going to take up more of your time because I know you have a lot to do. Thank you so much for coming on the juice media podcast. DR NORMAN SWAN Thanks for having me.

 

And for those of you who are not aware of the Coronacast which is the podcast that Dr Norman Swan And Teagan Taylor do providing a daily update on the situation with the corona virus in Australia and not just Australia, most of the information is relevant to everyone. I'm going to put the link to that podcast in the show notes please check it out please tune in daily to keep informed and stay up to date. I'm going to wrap this up now so we can get this podcast out as soon as possible because the information is really time sensitive. You've been listening to Giordano on the juice media podcast if you appreciated the podcast, if you enjoy what we do please spread the word share the podcast with your friends and families and pets so that more people know about it. Spread the podcast not the virus. I'll catch you soon for our next honest government ad which will be out soon. Until then please take care. And if you're like us and in self isolation indoors. Thank you for doing your part to flatten the curve and protect our health carers and hospitals our elderly and the most vulnerable in our society. Take care. Good luck and please keep in touch. Remember physical spatial distancing not social distancing.

 

We can get through this. Thank you.