The new normal

Tuggerah Lake this morning

With respect to COVID-19, South Korea and Australia have much in common.  Both have the benefit of being islands (discounting the closed land border between North and South Korea), and both have similar per capita case and death rates.  Both have relatively compliant populations, good testing and tracing capacity, and excellent health systems.

COVID-19 surfaced about 20 days earlier in South Korea so it might be a good short-term predictor of what will happen in Australia.  If that is the case, then we should get used to what is currently happening in Melbourne where virus hotspots are causing such angst.

The Entrance this morning

In South Korea, with double Australia's population, an average of between 40 and 50 new cases of the virus have been identified each day during June, predominantly in Seoul, the capital.  The South Korean authorities are fearful that they may lose control of the virus and are contemplating reimposing regional restrictions if the number of new cases does not decline in the next few days.

All of this sounds very similar to what is happening in Melbourne, where new cases have been averaging between 10 and 20 in June with a recent uptick.

I am skeptical that either Australia or South Korea can eliminate the virus.  The new normal will be an underlying base of community transmission, identified hotspots and temporarily-tightened regional restrictions in both countries.

For my exercise today, I took my touring bike out for an hour and a half to see how the hip flexor coped with real biking, as opposed to the trainer.  There was pain there, but it was low level and easily tolerable.  Not that different from when I took some long bike rides a month or so ago, so I'm feeling a little more optimistic that my body will cope with our looming bike adventure.  Nine days to go, assuming the Queensland government does the right thing and announces this weekend that they will open their borders on 10 July.

Earlier than we thought

Italy's National Institute of Health recently announced that analysis of sewage water sampled on 18 December 2019 showed traces of the COVID-19 virus.  That was two months before the first identified cases of the virus in Italy and about the same time virus cases were first identified in Wuhan in China.

Crowds on the Terrigal beach this wintry afternoon

These findings are consistent with analysis from Spain showing genetic virus traces in their sewage from mid-January, 40 days before their first identified case, and findings in Washington state in the US that two patients who had COVID-19 symptoms in December 2019, but were not identified as virus cases, were later found to have COVID-19 antibodies in their systems.

None of these instances is proof that the current pandemic cases in those countries was sourced from those early cases, but it is fairly conclusive evidence that the virus was around months before the authorities knew of its existence.

It would be interesting to see historic analysis of sewage for Wuhan to determine how long it was before the Chinese first recognised that there was a new virus circulating.  I suspect it was months.  There may have been a subsequent Chinese cover-up, but given the virus was present in other countries months before it was identified as such, I think it is safe to assume that it also took the Chinese some time to realise what they were dealing with, by which time the virus had taken hold.

I did a 30-minute session on the bike trainer this morning without much hip flexor pain.  Later, I limped around the block feeling very sore.  Walking clearly causes more pain than cycling.  During that limp, I filled a prescription for anti-inflammatories that was given to me by my GP prior to our aborted Continental Divide Trail hike.  I'm not going to start taking them yet, because the discomfort is tolerable, but will take them when we start the cycling trip if I really need them.

I used many kinds anti-inflammatories during my running prime with mixed results.  I have come to the view that inflammation is the body's way of repairing injuries and that anti-inflammatories may slow that healing process.  I also know, from bitter experience, the pain-masking attributes of anti-inflammatories can entice you to cause more damage to the injured tissue.  Better to feel the pain and know how you are going, unless it is intolerable and there are things that must be done.

Re-evaluating

Crackneck at dawn this morning

As predicted in yesterday's post, Victoria is re-evaluating its COVID-19 restrictions.  It's possible that this move heralds the end of Australia's exceptionalism with respect to the virus.  Australians (including me) were beginning to think that, with closed international borders, there was a chance we could eliminate the virus in Australia as has been done in New Zealand.  We were looking at the rest of the world's efforts with a mix of scorn and triumphalism, perhaps prematurely.

With Victorian mid-year school vacations starting at the end of next week, many Victorian residents will be seizing the opportunity to travel to warmer climes.  They will not be allowed into Queensland, but they can come to New South Wales.  It's unlikely that those who feel unwell will cancel their trips, and of course, cases may be asymptomatic.  The sources in 21 of the new cases identified in the last week in Victoria have not been identified, making it highly likely that there are other unidentified cases in the community.

It's not hard to envisage a situation where these unidentified cases infect people in New South Wales, and that over the course of the next month, the latter travel to other states as borders open.  Within three months, there could be much wider community transmission.  Australia's contact-tracing is very good, and it's unlikely that the virus cases will escalate rapidly, but I wouldn't be surprised if Australia has to be become accustomed to scores of daily cases of community transmission and occasional deaths.  The hospital system will not be overrun, but large gatherings will continue to be prohibited.  States will be tempted to keep their borders closed, but the Federal government has already indicated it will join the legal case to challenge the closed borders on constitutional grounds, so I think they will reopen in July as mooted.

I have been forced to re-evaluate my returning to fitness strategy.  After yesterday's 6.5km walk/jog, my hip flexor injury was quite sore all day.  I decided to modify my planned run/jog of 11km today to just a walk, but after only 500m, I decided that too was unwise.  My hip was sore and it seemed likely to be sorer by the end of my walk.  I returned home and tested the hip with 30 minutes of cycling on my trainer.  It wasn't too bad.  The most important fitness goal now is to be bike-capable by 2 July when we will leave on our big bike adventure, so I will likely abandon my plan to step up my walking/jogging distances by one kilometre every two days.  Very disappointing. 

Instead, I will now focus on getting as much exercise as I can each day compatible with the hip improving and being able to ride the bike.  Running a 50th anniversary marathon on 22 August is now looking even more unlikely.

Second wave?

Terrigal lagoon this morning

The number of cases of community transmission of COVID-19 in Victoria has tripled this week compared to last week.  The number of cases is still low, 21 this week compared to 6 last week, but are still a matter for concern.  The authorities aren't yet willing to reimpose restrictions, or delay the planned easing of restrictions, but have said it will happen if numbers continue to rise.  We returned from a short vacation in Victoria this week and Julie received an SMS from her employer asking her not to come into work if she was exhibiting any virus symptoms!  A demonstration of the concern the surge is creating.

Terrigal sunrise this morning

Although not directly comparable, Beijing has also seen a spike with 183 new cases of the virus in the past week.  In contrast to Victoria, these cases all seem to derive from a single source, a wholesale market, where the Chinese suggest the virus may have been imported with Europe products (however this has not been scientifically proven yet).  The Beijing authorities claim the outbreak has now been contained, but doing that required the suspension of public transport, the closing of schools, the delay of planned restriction easing and the testing of 360,000 people.  Melbourne may yet have to follow suit.

The best example of what a second wave of infections would look like comes from Iran (see chart).  They were one of the earliest countries to be hit by the pandemic, and eventually seemed to get it under control, but since then, with the easing of restrictions, has come a severe second wave that is still growing.

I walked and jogged 6.5km this morning, with the damaged hip flexor causing some pain the whole way.  It's not real bad, but definitely impacting my movement and enjoyment.  Given it is only 12 days until we head off on our bike adventure, and I'm keen to improve my general fitness before then, I'll persevere.  Once on the bike ride, I'm hoping the injury will get a chance to repair.  I followed my walk/jog with 30 minutes on the bike trainer.  It's toughening my butt up, if nothing else.

App or InApp?

The UK government has just announced that it is abandoning the development of its COVID-19 tracking app, after three months development and millions of pounds of expenditure.  During testing on the Isle of Wight, the app, based on Bluetooth handshakes between devices and the centralised collection of data, only connected with Apple devices 4% of the time and with Android devices 75% of the time.

The UK will now switch to an app, based on technology being jointly developed by Apple and Google, which will take several more months to be ready for deployment.  Similar apps developed by Italy and Germany, and based on the Apple-Google model, were released in those countries earlier this week and were rapidly taken up.

The Australian COVID-19 tracking app, which doesn't centrally collect data, but does reply on Bluetooth handshakes between devices, has also had problems.  When released in late April, the app performed poorly in some situations, especially with locked iPhones, but the connectivity has steadily improved (see chart) since that date, with more improvement intended.  Some critics say that Australia should switch to use the Apple-Google model, but the government shows no signs of changing.

The Australian app has now been downloaded by more than 6.3 million people, reaching the government's claimed goal of 40% of the smartphone using population.  In practice, data has only been downloaded from the app about 30 times in Australia as part of contact-tracing efforts, and in all those cases, did not reveal more contacts than had already been uncovered by traditional contact tracing methods.  However, as Australians increasingly travel internally and attend events in greater numbers, the app is likely to prove more useful.

I have the app on my phone and noticed earlier this week, when on a long walk in Lysterfield Park, that twice when I was passed by joggers, my Bluetooth headphone music feed paused momentarily.  Was this the app at work?

I walked 3km and jogged 7km this morning to reach my scheduled 10km target.  The jog was very hard work, primarily due to unfitness and weight, though my right hip was also a little painful.  I was very pleased to reach the end.  Shortly after, I spent 30 minutes on the cycle trainer, trying to build up some bike fitness in preparation for our adventure starting in thirteen days time.

Foreign infections

Timing of UK Sources of COVID-19

A preliminary report was published last week that analysed the source of COVID-19 infections in the UK.  It examined the genetic sequence of the virus in 20,000 infected people to build a sort of family tree that could be used to trace back the original source of each line of infection.

Sources of UK COVID-19 infections

The research showed that the 20,000 cases analysed originated with 1,356 people who entered the UK primarily in March and primarily from European countries. They estimate that 34% of lineages arrived from Spain, 29% from France and 14% from Italy.  Very few of the lineages originated in China.

UK Inbound Travellers and Infection Rates

The study, which hasn't yet been peer-reviewed, clearly shows how important closing international borders was in the early stages of the pandemic.  Even now, in Australia, I find it interesting how many new cases are reported each day in returning travellers held in compulsory quarantine.  It is clear, that without compulsory quarantine, it would be very hard to control the spread of the virus in Australia.

Australia's tourism minister said yesterday that it was unlikely foreign tourists would be allowed into Australia until at least 2021, and I suspect it will be longer.  Julie and I are still hoping to travel to the US in late March next year to begin our postponed hike along the Continental Divide Trail, but I'm not counting my chickens yet.

I walked and jogged 6.5km this morning, feeling very stiff and sore after yesterday's first jog in a while.  I was a bit looser by the end and followed up with 30 minutes on the bike trainer.

Racism and nationalism

Worshiping the sunrise at Terrigal this morning

The pandemic, because of its disproportionate impact on minorities, probably exacerbated the Black Lives Matter (BLM) protests around the world.  And those protests have caused me to ponder my own racial biases.  I would claim not to be a racist, but suspect I would also have failed the Implicit Association Test recently conducted in Australia to test implicit biases against Indigenous Australians.  Three out of four Australians tested were found to have a bias.  The test, developed by Harvard, is based on the speed of association of positive or negative words with images of Caucasians and Indigenous Australians.  For the sake of clarity, the test identifies bias, which is not necessarily racism.

Crackneck this morning

I know from my travels in Australia by bike, that I have been particularly careful with my belongings when in remote towns with many indigenous inhabitants.  I have also been extra careful in black neighbourhoods in my times living in the UK and US.  I'm not comfortable with my wariness and would like to think that my caution was unjustified, especially since I have never had a bad experience in these places.

My (self-serving and amateur) explanation for my bias, implicit and explicit, is that humans are primarily tribal.  That is, we are implicitly suspicious of outsiders and people who look different, and implicitly comfortable with those who look like us and have a shared culture.  Fear of the "other" is in our DNA and probably evolved as critical to survival in ancient times.

Wamberal lagoon this morning

I think the cure for this implicit bias is to recognise it for what it is, to continually examine our own response to racial cues, to embrace opportunities to interact with other races and cultures, and to try and see things from their point of view.  I believe all humans have the same motivations and ambitions, good and bad, and the world will be a better place when we see that and treat them the same as we would wish to be treated.

Terrigal Beach this morning

Nationalism, in my mind, is akin to racism, and seems to have grown with the pandemic.  The politicians and commentators who argue for putting their countries first, who denigrate other countries, and who fight to prevent jobs "going overseas" are really de-humanising the people in those other countries.  They present those countries as amorphous blobs, rather than workers and families trying to get ahead and live happy lives.  This is not a zero sum game.  The Australian job that goes to a Chinese factory worker or Indian call centre worker comes back to Australia as a Chinese tourist or Indian student.  The more Chinese and Indians who visit Australia, the more comfortable we will be with those cultures and the more likely we are to treat them fairly.  Each country has comparative advantages in some goods and services that it produces.  It should play to those strengths and we will all be better off, economically and socially.

I stepped up the exercise this morning, though it's all relative.  I covered my scheduled 9km, walking the first 4km and jogging the last 5km, my first running in 10 days.  It was slow and hard work, with the hip injury no worse at the end than at the start, which I'm hoping is a good sign.  Back home, I cycled for 30 minutes on the trainer to see how the hip would handle cycling.  Pretty much the same story as when jogging this morning ..... no sorer at the end than at the start.