Figure 1. Border control during the Cholera epidemic of 1865-1866. (Photograph in the author’s possession). 

The world is going through the pandemic of Covid-19 at the moment. What is the best strategy to contain the spread of this virus?

Quaratine and isolation

Plague, epidemic occurs every a few decades in the past three centuries. An epidemic of SARS in 2003 resulted in more than 8000 cases. The pandemic of Covid-19 started in late 2019 has now affected about 200 countries resulted in almost 550,000 cases and over 24,000 deaths. We will continue to see these numbers to rise in the foreseeable future. 

The centuries-old strategy – quarantine and isolation has proven effective as a public response to epidemics. Centuries ago, there were not advanced technologies to detect and treat the infectious diseases. Quarantine and isolation was almost the only way to contain the spread of epidemic diseases. However, this strategy raises political and socieconomic issues. It slows down the economy. People lose jobs. It may cause riots. etc.

Screening

In the 21st century, the advance of technology has made proactive screening possible to identify the infected individuals for further treatment. What does this imply? In the perfect scenario, it means that the newly infected individuals could be separated from the healthy group once they become contagious, so that the healthy group could continue with work and life. It also means that the disease will be put under control quickly and the dealth toll will be significantly reduced due to early treatment. 

In real life, either the technology is not advanced enough, or the community does not have sufficient resource, or the community is not coordinated well enough, the perfect screening scenario does not exist. However, this does point out the direction for the government to design a response strategy that saves both lives and livelihoods during the epidemic outbreak.

Australia is in a better position than most countries

Australia has a few advantages relating to containing the spread of Covid-19:    

1. Australia’s population density is low.

2. Australia has a well educated population.

3. The medical system in Australia is advanced.

4. Australia is geographically isolated from the rest of the world.

We have seen that the numbers in Australia rise in a slower rate than other countries before strong public intervention was taken. Up to date, the situation in Australia is still better than most countries. This allows a time window for the Australian people to get organised and equipped. 

Does Australia need to shut down the whole economy

There are big consequences shutting down the whole economy to contain the spread of the virus. The government is trying to flatten the curve without causing too much damage to the economy, which is challenging. Up to date, Australian government has implemented staged shutdowns to carefully cushion the blow to the economy.

Given the advantages that Australia has in its community and technology, there is a chance that Australia could contain the spread of the virus without shutting down the whole economy.

The solution is to quickly ramp up the screening capacity before the situation goes beyond control.

The better Australia can screen out the infected individuals quickly, the less shutdown is needed. Good examples that Australia can learn from are South Korea, Singapore and Hong Kong.      

How is the Australian government doing

It will never be perfect a government acting against an epidemic. 

The government should have closed border to USA and Europe earlier. The government should have implemented strict social distancing rules earlier with better specifications. The government should have prepared the screening program before the outbreak. Stage II shutdown may not be necessary should the government be proactive enough.  

Overall, the government is a few days behind the spread of the virus. However, Australia is still doing better comparing with countries like Spain or USA. 

What needs to be done for effective screening

1. Reduce the movement of people and ban non-essential gathering of any kind. Provide bridging support for those business/individuals affected.  

2. Educate Australian people about Coronavirus and the importance of social distancing; Strictly enforce social distancing.

3. Build a workforce to conduct screening. The workforce should includes doctors, nurses, medical students, a large number of volunteers, public servants, representatives of each business, etc. The workforce needs to be quickly trained up for the task.

4. Establish a network of screening service covering the whole community. The network is to include test centres, mobile test facilities, test stations for each suburb/area and for each business.

5. Quickly organise other necessary resources for the nation’s screening program.

6. Prepare medical resource to treat infected individuals.  

7. Australia is not able to do this well alone. Australia needs to collaborate with other countries to access their knowledge, experience, resource and technology.

Facing a pandemic, the world needs to act collaboratively. Politics and ideology should be discarded.    

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