Cities in Masks

“There is no more time. We have no more in-patient beds, we are constrained to reuse individual protection equipment, and in many situations the equipment that is available isn’t suitable. We are in constant danger. There is no longer even the time to cry, except at the end of our long, punishing shifts. We are like soldiers at the front. We need hospitals, we need personnel. Immediately. Now. Not tomorrow. “- from the Italian Nurses Federation early April 2020.

“Whatever it is, coronavirus has made the mighty kneel and brought the world to a halt like nothing else could. Our minds are still racing back and forth, longing for a return to “normality”, trying to stitch our future to our past and refusing to acknowledge the rupture. But the rupture exists. And in the midst of this terrible despair, it offers us a chance to rethink the doomsday machine we have built for ourselves. Nothing could be worse than a return to normality. Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different.”

“It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for itArundhati Roy

Methods handed down to doctors dealing with pandemics have not changed much since the Spanish flu. It was Spanish doctors that tried to stop the flu pandemic that killed millions at the end of WWI. In 2020 government implementation of those rules was not followed in Australia so the recent Covid19 virus was allowed cross both state and federal borders infecting many needlessly. Will decision makers in back rooms bear the brunt of this folly that has already led to many painful deaths. I doubt it. Time will tell.

In 1919 doctors did not know about viruses or how they infected healthy human beings. Popular belief is that medical science has come a long way in the 100 years since. But has it? For over 100 years doctors have known to wash your hands; they knew about the importance of physical isolation, of quarantine, about closing borders and so on.

The world our grandparents and great grandparents grew up in was different, especially here in Australia. Those that survived the carnage of the first war were hit hard by Spanish flu. Survivors took a long time to recover after the armistice of 11 November 1918.

The ‘Flu killed around 15 000 Australians that year, including more than 300 in Brisbane by its peak in late June. People were terrified of this disease for which there was no effective treatment. A massive demonstration in Townsville saw over a thousand unionists march to the city wharves to protest against one vessel’s violation of quarantine regulations. But within a few weeks residents were falling ill, and the infection was spreading between workers at the biggest workplaces––including several meatworks and the railway workshops.

When two union leaders were arrested at the end of June there was a violent eruption of political anger in Townsville. One of the arrested men was gravely sick with influenza, and police were blamed for not getting him to hospital quickly enough. Riots broke out in early July 1919, and a group of radicals stormed the police lock-up. Firearms were taken from local shops, and gun battles occurred between police and socialists. A special train took police from Brisbane and other regions to bolster the force at Townsville––but railway comrades were not so keen for this train to run on time. – ‘City in Masks: How Brisbane fought the Spanish Flu’ by Matthew Wengert.

Do we know how COVID-19 is transmitted?

Editor of Cosmos magazine, Elizabeth Finkel, says:

“The official World Health Organization (WHO) line is that COVID-19 is spread through a shower of droplets when an infected person coughs or sneezes. Being heavy they drop to the surface, but like little cannn balls they might trace a trajectory of up to a metre and a half before they do. So if we keep a distance of 1.5 metres and wipe surfaces, we should be OK.”

The WHO is following an hypothesis worked out in the 1950s. RL Riley wrote in The contagiosity of tuberculosis:

In the 1950’s droplet nuclei were shown to be the carriers of infection from tuberculosis patients to guinea pigs breathing air vented from the patients’ ward. Subsequent evidence has indicated that direct contact is unimportant, although close proximity facilitates airborne transmission.

This is the basis for current advice from WHO about Covid19. But is the large droplet theory correct?

The Australian Broadcasting Commission advises:

“COVID-19 is an illness that is mostly spread via respiratory droplets — the little secretions we generate when we sneeze or cough.

It’s mostly passed on by touch — such as via contaminated surfaces — or when someone standing close to an infected person breathes in tiny droplets that have been coughed or sneezed into the air.”

While masks provide some protection at an individual level (if you’re in close contact with someone infected), they’re likely to make little difference if you’re just walking around in public.

Answering her own question “What do we know about how COVID-19 is transmitted?” Elizabeth Finkel is vague, saying:

There are no easy answers. But many of the people I spoke with uttered the same refrain – there are bits missing from the picture. As Wuhan virologist Ke Lan advises, “Considering the serious threat of COVID-19 to human health, it is wise to be careful and take protective measures in advance.”

Meanwhile in North-West Tasmania there has been an outbreak at Burnie Hospitals. The army has been called in to give the two hospitals a ‘deep clean’. There is speculation these cases are associated with the Ruby Princess cruise ship which was allowed to dock in Sydney and allow its passengers to disembark unchecked and spread the virus to all states.

Methinks there are too many unknown unknowns. Many commentators are being careful not to express a point of view based on the uncertainty of the data. However it is hard to look past the data coming from overseas countries. Just look at the United States performance in dealing with the covid-19 pandemic in this graph.

Covid19 in the US

It is important for Australian governments not to follow the example of the United States. Based on the data in this ABC article the US is a failed state, at least for public health.

Ian Curr
14 April 2020


The contagiosity of tuberculosis