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So The Curve Is Flat, Now What?

When Will Lock Down End?

Firstly, I want to give a big shout out to Australia, we did it! The curve is flat. We are one of a handful of countries on the planet that’s in this very privileged position, and it was only possible because we ALL did our part. Go us!

So we have bent the curve, we are suppressing transmission, we’ve bought precious time to boost healthcare capacity, now what?

The big question on everyone’s mind is: When will lockdown end? I saw lots of comments yesterday where people discussed how they’re going to celebrate the end of lockdown, what they planned to do… etc. I hate to be the one to break this to you but we will not be celebrating like at the end of World War II where people ran onto the streets and danced and hugged and kissed strangers. That ain’t gonna happen. Whilst the world has seemingly snap frozen in the blink of an eye, the exit is likely going to be a long and gradual thaw out. Here’re my musings.

Before I share my thoughts, let me first say that I’m not a pandemic expert. These are the reflections of a physio who has combined publicly available scientific data, information released by the Federal Government, various trusted national and international news sources, applied logic, and a generous helping of common sense. I am sharing my thought process in the hope that me “thinking out loud” will help some of you organise your thoughts and join a few dots.

2 Key Elements

Planning the exit of the lockdown brought on by a pandemic is no doubt an extraordinarily difficult task. I believe there’re 2 key elements in consideration here – (1) what are our strongest and most effective restrictions that must stay for our protection? And (2) what are the risks associated with lifting each restriction?

As it stands, our best and most effective defence against the spread of the coronavirus are closing our borders (both international and state) and social distancing. 

Why are these so powerful? Because of the nature of the virus and how it spreads. This coronavirus originated overseas so closing our international borders was always going to have a big impact, we have essentially turned the main tap off, it is still dripping, yes, but it’s at a not-crushing-our-hospitals level and we are managing. Closing our state borders is simply turning off very specific smaller taps to stop the virus from flooding our nation, and it has been very effective.

This virus is highly contagious and is spread via droplets, so when you minimise contact with people and also keep a safe distance when near people, it is much harder for us to infect each other – if you don’t come within spittle range, I can’t really infect you. In fact, social distancing is our single most powerful defence against this virus! This is both good and bad because you can never predict human behaviour nor can you trust everyone will do the right thing. That said, the ball is in your court and you have in your well-washed hands the power to protect yourself, your loved ones, and to help determine our collective fate. Personally, I’m empowered by that and am proud to do my bit for my country.

Because border control and social distancing are so powerful, it is logical that we keep these “big guns” in place until it is truly safe, i.e. until we have a vaccine.

A Slippery Slope

But we are a long way off a vaccine, if we ever get one!

Yes, that is true. It is also true that we can’t stay in lockdown forever, our economy will truly die! Our Liberal Government, who has been obsessed with bringing the budget back in surplus in recent years has just racked up a monumental credit card bill, they have just done the same thing they bagged the Labor Government for doing during the Global Financial Crisis and they have done that on a galactic scale! This I dare say, is hurting their pride and ego, and I reckon they are desperate to get some economic activity going as soon as it is safe to do so. They are not going to be stupid about it because if we lift the restrictions too soon or lift the wrong ones, it will undo ALL the good we’ve done in the last 4 weeks and set us back to square one. I don’t think anyone would want to go back to January and redo the last three months, do we?

This is one seriously slippery slope!

The Safety Net

This virus has a very long incubation period of around 14 days. If I get it today (17 April, 2020), I might not show any symptoms until May! That is if I show any symptoms at all! 80% of people who contract CoVID-19 show very mild or no symptoms at all. Think of it as having mobile landmines in our community that can go off at anytime and wreak havoc. To help detect these silent cases they must ramp up testing and literally go hunting for them. I’m really glad to see that some states have already expanded their testing regime and according to the Government’s address yesterday, they are set to do this nationwide. Having nationwide sentinel testing capability and the ability to quickly snuff out outbreaks are pre-requisites to lifting restrictions, it is a safety net so to speak. The Government announced yesterday that lockdown is in place for another 4 weeks, 4 weeks to prepare this safety net is reasonable.

When and only when this safety net is in place are we then in the position to try lifting some restrictions.

One Logical Possibility

So how do we decide what restrictions to lift first? It is logical to lift those with the smaller risks to trigger an outbreak first and go from there. This would likely be a reversal of how we got here. This is how I see it may go.

Modify one restriction
Wait 3-4 weeks to assess the impact (2 weeks incubation period + margin for error)
Meanwhile, do a tonne of sentinel testing to quickly identify and snuff out any outbreak/s
If things go bad, lockdown comes back until the number of new infection drops back to the level before lifting restrictions. If it goes ok, consider modifying other restrictions
Rinse and repeat until we have a vaccine or an effective treatment

This is going to take many, many months even if we get everything right the first time.

What could it look like in practice?

Seeing as Scomo has already posted a little video on social media about going back to school and announced 7 principles in relation to that, it’s safe to say reopening schools is on top of their list, though I’d imagine schools will run quite differently in term 2.

As mentioned before, this is a Liberal Government mad keen on resuming some economic activity, it is safe to reason that some non-essential businesses going back to work under strict social distancing measures is next on the list.

When we first started getting more cases in Australia, there were 2 criteria for someone to be considered a close contact during contact tracing and quarantining – (1) close proximity with a confirmed or suspected case for 15 minutes and (2) being in the same room with a confirmed or suspected case for 2+ hours. When you take this into consideration and factor in the need to maintain strict social distancing, businesses operating in condition similar to criteria (1), such as some retail, could be next-next on the list. And those that are similar to criteria (2), such as restaurants, cinemas, live venues, sporting events… etc are mostly likely going to be at the bottom of the re-opening list.

Remember, social distancing is our most powerful defence and it’s here to stay until we are in the clear so the way businesses operate will also be very different to how it was before the plague. One thing for certain is that we won’t see a packed venue or stadium for any reason anytime soon.

Once things are pretty stable across the states and territories, our national borders may reopen. My husband and I are looking forward to the day where we can freely travel around our beautiful country again so we can support our domestic tourism industry. I do imagine holidaying with social distancing would be a new and interesting experience but I’m sure we’ll have the routine down pat by then.

And very lastly, our international borders will gradually reopen and according to if a country has got their ship together; travel restrictions will be in place to make sure no one brings the plague back here. It will also be wise to put new biosecurity measures in place globally to help prevent the spread of diseases by the movement of people across the globe.

So you see, things can’t and won’t come back all at once, it’s simply too risky and dangerous. It’s a long road ahead and sadly, mass gathering will almost certainly be at the end of the road, so there really ain’t gonna be no wild dancing on the streets for quite some time.

That day will come though, and when it does, it will be glorious.

’Til next time, Be Free In Your Movement™.

x
Selina
B. Phty
This information is not medical advice. Got health concerns? Consult a real-life health professional.
Views are my own.

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Selina Tannenberg

Selina Tannenberg

Selina is a health content creator-musician-physiotherapist based in Brisbane, Australia. She is the director of MoveMedics and its subsidiaries, Voice Physio and Pole Physio. She is passionate about dispelling misinformation, simplifying healthcare, and empowering people with evidence-based knowledge for healthy and pain-free living. She enjoys running, attempting handstands, Formula 1 Racing, and publishes music under her nom de plume, Asirus.

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