by Richard McCure
Historically, respiratory infections have been spread by exhaled droplets, and facemasks have been used for at least a century as a proven prophylactic. However I wonder if public health officers are ignoring some unique characteristics of Covid-19?
Three things about Covid-19: It is extraordinarily contagious, it can remain viable on surfaces for hours or even days, and commonly a catastrophic immune response of the lungs renders them unable to transfer oxygen to the blood and is the most likely cause of patients headed for ICUs.
First reports indicated that only the frail were likely to succumb to Covid 19. The first young healthy fatality that we heard about was the Chinese doctor in Wuhan (the whistle blower). This has continued to be the trend with health workers commonly contracting the illness. At first I concluded that it must be dose related, despite the use of ever more elaborate protective clothing. On the other hand I have seen little evidence that failure to wear masks at crowded events or on public transport has been a cause of major outbreaks. But Cruise Ships, Tower Blocks, and Nursing Homes have all suffered despite enormous efforts to stop the spread, using masks, distancing, filtered air, plus elaborate decontamination measures.
Steps to avoid inhaling the virus are very straightforward and even intuitive. To me it seems likely that the outbreaks have come from more esoteric sources like, say, a contaminated lift button.
My concern is this: What if the immune response of the lungs is our best line of defence, and by avoiding inhaling small doses of contaminated droplets and aerosols from a passer-by we are nullifying the mild infection that could provide a form of inoculation. Eliminating all transmission leaves the whole population ripe for an outbreak, What if all non-airborne transmissions eg, by ingestion, avoid the lung’s initial immune response allowing the disease to become well established elsewhere in the body. Serious outbreaks in restaurants under this scenario originate not from droplets inhaled but by droplets settling on food and tableware. By the time the infection reaches the lungs it has become very serious. Unfortunately leaders realise that at this stage draconian social distancing has popular support largely due to the tradition of direct spread by droplets or aerosols, and that relaxing lockdowns at this stage would not have much popular support in Australia We are all well programmed to keep clear of people who cough and sneeze.. But to have some friends ‘round for dinner and to manage all potential surface contamination is difficult to say the least. Likewise an item purchased on eBay and air freighted from Tullamarine could equally carry the infection.
I should point out that I have absolutely no medical qualifications, but I did run training courses in the safe handling of chemicals. There is no doubt that well trained medical professionals have great difficulty isolating infectious substances. All the evidence I have seen suggests that outdoor transmission hardly ever happens because there isn’t as much handling of surfaces. But the virus is too contagious to contain. It is impossible to eliminate it.
Under this scenario:
- Holding out for a vaccine is counter productive.
- The whole world will have to be exposed to the virus eventually because it is so very contagious.
- New “cases” are a good thing because 99.9% of them are mild and we need to get it over with ASAP.
- Masks should be abandoned. They are lazy policy.
- Restrictions on public eateries should stay in place for the time being.
- Instructive videos on hand hygiene should be produced and circulated widely. These should include strong messaging that all surfaces are continually contaminated.