covid-19 pandemic healthcare briefing...examine the life course of a typical pandemic and what to...
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C o n t e n t s 3
Topic Page
Introduction and purpose 4
Review background and current status of COVID-19 situation in Australia and globally 7
Examine the life course of a typical pandemic and what to expect at different stages 19
Consider learnings from international COVID-19 responses and assess the public health response in Australia
24
Review practical considerations for ourselves, friends, families, communities and organisations 27
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I n t r o d u c t i o n 4
• This document summarises the facts and science about COVID-19 in a digestible format
• These materials are based on the most recent science available using trusted international and national news sources, scientific publications, scientific data aggregation sites and the views of Rebbeck Consulting
• In the early stages of any pandemic, the science is constantly being tested, improved, and refined and some of the estimates provided today will inevitably be revised over time – the accurate science will only ever be known in hindsight
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P u r p o s e 5
• To provide a shared and consistent level of understanding about the facts and science about COVID-19
• To provide a daily update on the current crisis as at 23 Mar 2020
• To consider how the current situation may evolve in the coming months
• To consider how we can we look after ourselves, our family, friends, colleagues & community
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W h e r e a r e y o u s i t t i n g o n t h e c h a n g e c u r v e ? 6
Time
Mo
rale
an
d c
om
pet
ence
Create Alignment
Maximise Communication
Spark Motivation
Develop Capacity
Share Knowledge
ShockSurprise or shock at the event
DenialDisbelief; looking for evidence that it isn’t true
FrustrationRecognition that things are different; sometimes angry
DepressionLow mood; lacking in energy
ExperimentInitial engagement with the new situation
DecisionLearning how to work in the new situation; feeling more positive
IntegrationChanges integrated; a renewed individual
Source: The Kubler-Ross Change Curve
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BACKGROUND AND CURRENT STATUS OF COVID-19 SITUATION IN AUSTRALIA AND GLOBALLY
7
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I n h i s t o r i c a l t e r m s , p a n d e m i c s a r e a r e g u l a r o c c u r r e n c e
8
Source: Visual Capitalist
9K and counting
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A c o c k t a i l o f f a c t o r s h a v e c o m b i n e d t o m a k e C O V I D - 1 9 e x t r a o r d i n a r i l y p r o b l e m a t i c
9
1. How contagious is the virus?
It spreads very easily, making containment efforts difficult (the Reproductive Number is between 2 and 3).
2. How deadly is the virus?
Our best current estimate is a Case Fatality Rate of between 0.25% and 3.0%
3. How long does it take to show symptoms?
The Incubation Period is between 2 and 14 days, allowing the illness to go undetected.
Because the symptoms are easily confused with the flu, many cases go untested
4. How many people will have immunity?
Because this is a novel coronavirus that humans have not been exposed to before late 2019, only people who have recovered from an episode of COVID-19 illness will have immunity.
5. How will Australia fare?
Most of Australia will be affected worse than the northern hemisphere as we move into the winter (with COVID-19 combining with flu season).
Sources 1: The Lancet, Source 2: “Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality”
Wilson, Kvalsvig, Telfar Barnard, Baker Emerging Infectious Diseases, Centers for Disease Control & Prevention Materials adapted from the New Yorker
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C O V I D - 1 9 a p p e a r s w o r s e t h a n S e a s o n a l F l u b u t n o t a s b a d a s t h e S p a n i s h F l u
10
Source: The New York Times
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C O V I D - 1 9 h a s a h i g h e r C a s e F a t a l i t y R a t e ( 0 . 2 5 % - 3 . 0 % ) t h a n S e a s o n a l F l u ( 0 . 1 % )
11
Source: Our World in Data
Source: “Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality” Wilson, Kvalsvig, Telfar Barnard, Baker Emerging Infectious Diseases, Centers for Disease Control & Prevention
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C O V I D - 1 9 a l s o h a s a m u c h h i g h e r C a s e F a t a l i t y R a t e t h a n t h e 2 0 0 9 S w i n e F l u
12
Source: The Washington Post
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T h e m a i n s y m p t o m s o f C O V I D - 1 9 a r e f e v e r , d r y c o u g h a n d f a t i g u e
13
Source: Our World in Data
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C O V I D - 1 9 d i s p r o p o r t i o n a t e l y a f f e c t s o l d e r p e o p l e w i t h u n d e r l y i n g h e a l t h c o n d i t i o n s
14
Source: Our World in Data
C O N F I D E N T I A L
15
Confirmed cases is likely to be significant under-estimate of actual cases given the low levels of testing globally
As of 23 Mar 2020, Johns Hopkins is reporting 335,957 confirmed cases globally with 14,632 deaths and 97,882 people recovering
Source: Johns Hopkins Coronavirus Resource Centre
C O N F I D E N T I A L
16In Australia, Johns Hopkins is reporting 1,314 confirmed cases and 6 deaths and the Department of Health is reporting 1,098 confirmed cases and 7 deaths
Source 1 : Johns Hopkins Coronavirus Resource CentreSource 2: Australian Department of Health
These figures are a significant under-estimate given the low levels of testing globally
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W i t h C O V I D - 1 9 d o u b l i n g e v e r y 3 - 4 d a y s , A u s t r a l i a i s i n t h e ‘ m i d d l e o f t h e p a c k ’
17
Source: Our World in Data
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A t c u r r e n t e s t i m a t e s , C O V I D - 1 9 c o u l d e a s i l y b e c o m e t h e l e a d i n g c a u s e o f d e a t h
18
Source: ‘Could Coronavirus Cause as Many Deaths as Cancer in the U.S.? Putting Estimates in Context’ Katz, Sanger-Katz, Quealy, The New York Times
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LIFE COURSE OF A TYPICAL PANDEMIC AND WHAT TO EXPECT AT DIFFERENT STAGES
19
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W e n e e d t o ‘ f l a t t e n t h e c u r v e ’ t o b u y t i m e g i v e n o u r l i m i t e d h e a l t h s e r v i c e c a p a c i t y
20
Source: “Pre-emptive low-cost social distancing and enhancedhygiene implemented before local COVID-19 transmission
could decrease the number and severity of cases.” Dalton, Corbett, Katelaris
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H e a l t h s y s t e m s l a c k s u f f i c i e n t c r i t i c a l c a r e b e d s t o c o p e w i t h t h e s u r g e i n d e m a n d
21
Source: Imperial College COVID-19 Modelling of UK health system
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T h e m e a s u r e s t a k e n b y e a c h c o u n t r y w i l l s h a p e t h e C O V I D - 1 9 p a n d e m i c p r o g r e s s i o n
22
RecoveredSickHealthy
Recovered
Sick
Healthy
Recovered
Healthy
Recovered
Healthy
Source: Washington Post
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T h e s t a g e s o f a n a t i o n a l p a n d e m i c r e s p o n s e 23
Before Pandemic During Pandemic After Pandemic
Monitor Health
Environment
Prepare System
Minimise Impact & Spread of Outbreaks
Co-ordinate Government
Pandemic Response
Minimise Pandemic Impact & Spread
Manage COVID-19 Patients
Manage Excess Deaths
Uphold Vital Infra-
structure
Restore Vital Services
Post Pandemic
Inquiry
1 2 3 4 5 6 7 8 9 10
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LEARNINGS FROM INTERNATIONAL COVID-19 RESPONSES AND APPLICABILITY TO AUSTRALIA
24
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W e m u s t a p p l y t h e l e a r n i n g s f r o m i n t e r n a t i o n a l C O V I D - 1 9 r e s p o n s e s
25
Iran
Italy
USA
Australia
UK
China
Singapore
Relative Trajectory
Catastrophic Moderate-Good
ResponseDenial & Cover Up
Rigorous & Transparent
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R a p i d m o b i l i s a t i o n o f h e a l t h p r o m o t i o n a n d p r i m a r y p r e v e n t i o n w i l l r e d u c e h o s p i t a l a d m i s s i o n s a n d d e a t h
26
~1%
cases
~4%
cases
~14%
cases
~81%
cases
Well population
Deaths
Critical Cases
Severe Cases
Mild Cases
Healthy
Acute Care
Respectful & Safe
Management
Intensive Care
Primary Prevention
Health Promotion
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H o w c a n w e l o o k a f t e r o u r s e l v e s , o u r f a m i l y , f r i e n d s , c o l l e a g u e s & c o m m u n i t y ?
28
Stay at home if you have flu like symptoms (i.e. self isolate)
Get tested if you meet the criteria - in any case stay at home until your symptoms resolve
Wash hands and cough into elbows
Eat and drink well
Do things you enjoy and exercise
Sensible social distancing (risk based)
Pace yourself at work (this is a marathon not a sprint)
Take time to switch off every day
Check in on vulnerable family, friends, colleagues and community
Look after the mental health of yourself and others
Support employees who are not eligible for sick leave
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W h a t w i l l t h e ‘ n e w n o r m a l ’ l o o k l i k e a f t e r t h e p a n d e m i c ?
29
Political
Economic
Social
Technological
Environmental
Legal
Epidemiological
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C o n t a c t d e t a i l s 30
As always, feel free to get in touch.
Jay Rebbeck
+61 (0) 41 400 524
www.rebbeckconsulting.com
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D i s c l a i m e r 31
• This document has been issued by Rebbeck Consulting PTY LTD (ACN 609 606 073) (“Rebbeck Consulting”) and is provided for informational purposes only
• While every effort has been made to ensure that the information in this update is accurate, its accuracy, reliability or completeness is not guaranteed. This information does not take into account your particular needs or circumstances and is for informational purposes only. It is not intended to be a substitute for professional advice, and should not be relied on as health, personal or financial advice
• Rebbeck Consulting do not accept any responsibility for loss or damage suffered by any person or body relying directly or indirectly on any information provided in this presentation and do not accept any liability for any decisions made on the basis of the information provided
Rebbeck Consulting
Unit 222 Lifestyle Working
117 Old Pittwater Road
Brookvale
NSW 2100
Australia
+61 414 400 524
www.rebbeckconsulting.com