Maybe some lessons from Sweden

Sweden did not impose many restrictions to prevent the spread of COVID-19, following the advice of it's chief epidemiologist, Andres Tegnell.  It did advise that people should not gather in groups of more than 50, but left most businesses open and relied on encouraging people to practice good hygiene and social-distancing.

Dawn at Terrigal this morning

The result has been a much higher death rate than the adjacent Norway and Denmark (442 per million compared to 44 and 100, respectively), though still lower than the UK (580).  Tegnell has now said that Sweden made some mistakes, referencing in particular the number of elderly people who have died.  Around half of Swedish fatalities have been in nursing homes.

Terrigal lagoon this morning

I find it interesting that the Swedish death rate, though high, has not been as bad as the UK which, admittedly belatedly, imposed much more onerous restrictions.  I did hear one commentator, early in the pandemic, say that Swedes were culturally socially-distanced anyway, and maybe that explains their "better" performance.

High tide and Terrigal lagoon is just open to the ocean

Like Tegnell, I'm inclined to believe that if Sweden had done a much better job of protecting its vulnerable elderly, especially in nursing homes, they might have come through the epidemic with a much lower death rate whilst still managing to keep their economy functioning largely as normal.  There might be some lessons for all countries in the event of a second wave.

I walked and jogged nearly 5km this morning, still feeling very unfit and labouring during the run part.  Even though jogging was unpleasantly hard, it was very tempting to continue much further in the belief that the sooner I can get my mileage up, the faster I will lose weight and regain fitness.  But I have to find that middle ground between doing too little, with its fitness deficits, and too much, with its injury risks.  In the short-term, maybe I should also buy some new jeans, a size larger, so that I am not constantly reminded how out-of-shape I have become.

Is Belgium that bad?

There has been some press recently about the death rate from COVID-19 in Belgium which, at more than 800 per million, is the highest in the world.

A whale breaches way offshore this morning

The Belgians are defensive, and maybe for good reason.  It seems their data may not be a consequence of poor pandemic management or a sub-par health system.  They count every death that  maybe COVID-related, regardless of whether a test has been conducted.  "It's based on the assessment of the medical doctor, usually taking into account whether the coronavirus is present in the same care home," says Prof Van Gucht, a virologist and Belgian government spokesman.  "For example: if you have one or two confirmed cases, then the week after you have 10 deaths in the same home based on similar symptoms."

A lone paddle-boarder encounters the ocean swimmers this morning

This approach seems sensible to me, and I respect the realism of the Belgians.  Many other countries will have under-estimated their death rates, perhaps for political reasons, and this will only be revealed in post-pandemic comparisons with "normal" years.

I walked over to the Terrigal Haven this morning and ran my scheduled 2km.  My hip injury wasn't really an issue, but I couldn't believe how hard it was!  Not fast, and only two kilometres!  I felt unfit and overweight, and am already dreading my next run.  I know it will get easier.  I just have to persist.

Give them a break

Sunrise at Terrigal this morning (courtesy Julie)

Last week, I was going to to blog about my suspicion that the death of a 30-y-o man at Blackwater in remote Queensland had incorrectly been ascribed to COVID-19 (Queensland has had only 7 COVID-19 deaths).  Ultimately, I didn't write the post because I couldn't find anything online to support my suspicions.  The reasons for being suspicious were that it was the only case identified after much testing in the area, that you would expect that a remote location medical facility might not be as familiar with how to conduct the test, and that the tests are not perfect.

Sunrise at Terrigal this morning (courtesy Julie)

A post-mortem has shown the man likely did not have COVID-19, and locals are vociferously criticising the Queensland government and the medical authorities.  I listened to a local politician on the radio this morning berating the authorities for causing such upset and concern in the Blackwater community and to the bereaved family.

I'm sure the authorities have learned some lessons from this case, but like the Ruby Princess affair in New South Wales when thousands of passengers, many of them carrying the COVID-19 virus, were permitted to disembark in Sydney, some patience and common sense needs to be applied.  The people charged with managing these events are being confronted with unprecedented situations and are subject to intense pressure to make big decisions quickly.  Even with the smartest people and the best intentions, mistakes are going to be made, and it is unfair to heap criticism and scorn on those decision-makers.

I walked and jogged 4km this morning, with less discomfort in the right hip flexor than yesterday, so am feeling a little more optimistic.

Queensland still closed

Cloudy dawn at Terrigal today

Julie and I were hanging out for the Queensland premier's promised end-month announcement about the easing of COVID-19 restrictions yesterday, but were disappointed to hear their border will remain closed for at least another month.  That pretty much guarantees we will not embark on our planned bike trip around Australia this year, and maybe that colours my views on the border closure.

Looking across The Haven to Terrigal this morning

Queensland claims this is a decision based on health advice, and I can understand that they are keen to keep their new COVID-19 cases at zero, but I fear the decision-making process is also being influenced by political considerations.  A state election is due later this year, and a recent poll showed that 78% of Queenslanders support the border closure.  Queenslanders have traditionally been suspicious of southerners ("Mexicans") and possess an independent streak, so the advice of their Chief Medical Officer does tend to support their underlying predispositions.

However, there are two good reasons why the border should be opened now.  Firstly, the national medical advice is that there has never been sufficient reason to close domestic borders.  Although Queensland may have a chance to eradicate COVID-19 in its comparatively dispersed population of 5 million, the chances of eradicating it in New South Wales (NSW) and Victoria with a more concentrated total population of 15 million are considerably less.  If that is the case, continuing with their current policy means Queensland's borders will remain closed for a very long time.

You could see past Crackneck all the way to the Norah Head lighthouse this morning

Secondly, Queensland's capacity to close their border is partly funded by NSW and Victorian taxpayers.  Queensland gets allocated more of the Australian Goods and Services Tax (GST) than is raised from their state economy, primarily sourced from the two southern states who receive less.  Also, the tourist sector in Queensland, which would hugely benefit from the resumption of tourism from the south, is being supported in the absence of those tourists by the Federal JobSeeker and JobKeeper payments.  This money comes from Federal consolidated revenue and borrowing, primarily sourced from, or repaid by, the taxpayers of the two southern states.  They are not quite as independent as they would like to think.

Apparently diving is back in business at the nearby sunken HMAS Adelaide

Today, I started my personal challenge of building up to run the marathon distance, by running at least every second day and incrementing the distance by one kilometre each time (I still may exercise on the intervening days).  I walked over to the Terrigal Haven and ran two laps of the park, totalling one kilometre.  Sadly, my right hip flexor was sore, more so on the walk over, so not really an encouraging start.  I have had some soreness in that hip flexor for years, and still managed to run, so maybe it's not a big deal.

Unrest in the US

Ocean swimmers going in from the Terrigal Haven rocks this morning

I have friends in the US despairing at the state of their nation.  The riots spreading across the country are yet another symptom of a fissured and polarised society made worse by poor leadership.

Trump has rightly publicly condemned the recent shooting death of a black jogger in Georgia and the asphyxiation of a black suspect by police in Minnesota, but has said and done little to repair the underlying problems that have led to the subsequent riots.

The latest black death was a catalyst for the riots, but Trump's long-standing subliminal (to him) racism -- treating white supremacists with equivalence at Charlotte, questioning Obama's place of birth, denigrating Mexican immigrants as "rapists", and so on -- sets the tone for the nation and gives racists succour.

This undercurrent of racism has been greatly exacerbated by the pandemic.  The COVID-19 restrictions have created economic and emotional stress generally in the US, but the impact on the poor has been much greater.  Statistics from 2018 show that 20.8% of blacks in the US live below the poverty line as against just 8.1% of whites.  With inadequate safety nets, the economic effects of the pandemic must be hitting the black population particularly hard.

Watching a whale from Terrigal Haven this morning
(too far offshore to make a picture worthwhile)

The health impact of the pandemic on the black population is even more startling.  Research published earlier in May estimated the death rate for blacks was 2.4 times higher than for whites.  A lot of this can be explained by economic factors -- low incomes leading to poor nutrition and health, a concentration of cases in poorer inner-city areas -- but whatever the reason, there's legitimate cause for aggrievement.

Having said all of that, although he has helped perpetuate it, Trump cannot be blamed for long-standing racial bias and inequality in the US.  However, he can be blamed for the very poor response of the US to the pandemic.  Back in January, when the pandemic first hit the global radar, Australia and the US had the same information from their intelligence sources (Five Eyes) and from the World Health Organisation (WHO), yet the US has a death rate 77 times higher than Australia's.  No amount of China- or WHO-bashing should be allowed to obscure these facts.

I walked (mostly) and jogged 6km again this morning.  The hip flexor was bothersome, but not enough to cause limping or stop the running comeback plans.

Children

Boot camps are back in operation ...

Earlier than expected, children have all returned to school in New South Wales (NSW).  There have been a couple of brief closures because of identified student COVID-19 cases, but overall there have been no dramas, and so far it looks like a good policy call.

 .... rock fisherman were making the most of the day ...

The soundness of the decision seems to have been supported by some interesting statistics about COVID-19 in children published in the Sydney Morning Herald yesterday.  For NSW, there have only been 59 children diagnosed with COVID-19 who have acquired it locally.

..... the boat ramp was busy ...

On a per capita basis, adults have recorded positive tests at roughly ten times the rate of children.  If you assume they are exposed to the virus at the same rate, children are clearly less vulnerable.  Even if there are other factors that help explain the difference, they are unlikely to explain it all.

... and the beach was popular.

Apart from two cases where tests were inconclusive, no children were found to have been infected by other children, although it is true that in a quarter of child infections, the source has never been identified.  There was only one case where a child infected an adult in the same household, and that child was 17 years old.

If there is a silver lining in all of this, it is that children have suffered far less from the virus than the rest of the population.  I doubt anyone would begrudge that.

I walked and jogged (mostly walked) 6km this morning.  I'm conscious of my right hip flexor all of the time, but there was less discomfort when running and also after I had covered a few kilometres.  It was another beautiful morning, in the last days of our southern autumn, and everybody was making the most of it.  Not too much social-distancing was apparent.

It's not over 'til it's over

South Korea has reimposed COVID-19 restrictions after an uptick in new cases.  It had 40 on Wednesday, the highest daily number in seven weeks, and 79 on Thursday.  Museums, parks and art galleries in Seoul have been told to shut for the next two weeks in response, and the gradually reopening of schools is being reassessed.

This matters for us here in Australia, because there are many similarities between our two countries in terms of their relatively effective management of the COVID-19 pandemic.  Both have made use of advantages they enjoy -- geographic isolation (South Korea's only land border is with North Korea, though they still accept some international arrivals), first world medicine and technology, and a relatively compliant population.

I have little doubt that South Korea will manage this latest uptick in cases, but the fact that it has happened just reinforces the advice that we are unlikely to eliminate the virus completely.  Too many people can be asymptomatic while infectious and many of those will never show symptoms.  Therefore, it's quite feasible that the virus can fly under the radar for weeks, and even months, before surfacing as an identified case.

It seems very likely that the South Korean experience will be repeated in Australia and we need to be prepared for the re-imposition of restrictions, though maybe only on a regional basis.  It will be troublesome, but manageable, and we will get used to it.  Under this scenario, it makes sense that borders between countries (and states) with similar infection levels and testing, tracing and isolation capabilities should be opened.

My exercise for today was a game of golf with mate, Dave, on a beautiful morning.  It was my first game for more than three weeks, so I was a bit anxious, though not about my form which was rubbish as usual.  My golf swing imposes stresses on my troublesome hip that are different to running and walking, so I was worried about incurring damage, but I can't wrap myself in cotton wool for ever.  As it happened, I was conscious of some hip discomfort but won't know until tomorrow whether that was just lack of use, or a setback.  I'm hoping the former.