Dr John Langford-Smith, West Ballina
With an Australian case fatality rate of 1.1 per cent for COVID-19, it is tempting to suggest that SARS-CoV-2 is not that serious, and that the actions of politicians are disproportionate to the threat the virus poses.
However, in a survey of 1600 non-hospitalised COVID-19 patients, the Dutch respiratory group LongFonds, found that 9 of 10 reported difficulties with basic daily activities three months after initial symptoms.
One prospective study found 55 per cent of patients with COVID-19 had cardiac damage on the basis of echocardiography (Dwek et al). Using cardiac magnetic resonance, another study found evidence of cardiac involvement in 78 per cent and new-onset, persisting myocardial inflammation in 60 per cent (Puntmann et al). A study examining asymptomatic passengers from the Diamond Princess found that over 50 per cent had CT changes in their lungs (Inui et al). While it has received little attention, SARS-CoV-2 can damage Leydig cells in the testes, potentially causing permanent testicular atrophy (Yang et al).
A significant proportion of those with mild disease exhibit persisting long-term malaise, respiratory impairment, cardiac damage, neurological damage, and new-onset psychiatric disorders. While knowledge of long-term effects is evolving, the literature increasingly suggests a large percentage, perhaps even a majority, are left with permanent disability – the appearance of which is not necessarily linked to the severity of initial symptoms or age. This is not widely reported, but should be.
There is growing evidence that repeat and recurrent infections occur, and suggestions that herd immunity may not evolve spontaneously.
Studies suggest 50–80 per cent of spread is from minimally symptomatic or pre-symptomatic disease, which is why mask-wearing by all is advisable, and that masks are able to reduce spread by around 10 fold. Consistent mask-wearing, in conjunction with other measures, has the potential to eliminate the virus or avoid serial lockdowns and outbreaks as has occurred in Victoria. Public wearing of masks should be pre-emptively mandated and permanently established in other states before numbers accelerate. A reactive approach is inadequate and a proactive approach required.
If disposable masks are in short supply, they should be recycled after allowing the virus to inactivate for a few days in the heat on the car dashboard. As a previous science-based microbiologist and immunochemist, I suggest that a mask that is moist from day-long use is still better than no mask at all. There are also lots of patterns available for home-made masks on the internet, which can be washed in hot water and detergent, see the Community Mask Coalition. A local part-time Byron resident has also designed and is now manufacturing Australian-made, high-grade reusable ‘injected’ masks .
There has been strong emphasis on the need to maintain the economy, with which I agree. However, the countries with the least economic damage are those with low rates of infection. I advocate elimination of the virus which could have been achieved after the last lockdown if masks had been widely adopted.
Few complain that prohibiting drink-driving or mandatory car seatbelts threaten liberty. We all should accept masks as the new norm and aim to eliminate this virus. COVID-19 could be this generation’s polio if not taken seriously.