WHO has stopped releasing daily Situation Reports and wisely is publishing a dashboard (similar to Johns Hopkins). As at 3:24 pm CEST 8 October, there have been 36,002,827 confirmed cases globally with 1,049,810 deaths.
Even though the WHO data shows over 36,000,000 human beings confirmed as having been infected by the virus, and the WHO suggesting that that number may only be 5% of the actual number suggesting that 10% of the global population has been infected, and over 1 million people have died with COVID-19 (the WHO suggests it is likely double that figure), news is full of the antics of just one infected person – the orange man who lives in the white house.
I am not going to waste my energy to comment other than to say two things: on Friday, including when he took his tour in front of the small gathering of “fans” outside the hospital, further endangering those salaried to obey his whims (not commands), and subsequently, he has reminded me of a 10 year old kid excited about heading out on a big adventure such is the level of his ignorance and narcissism; and I think it worth everybody considering the weight of medical intervention that was thrown at protecting this highly susceptible man to the ravages of this virus – reportedly to this point (less than 1 week post-infection) likely very early detection of infection, monoclonal antibodies, 3 courses of Remdesivir, and dexamethasone. That is an unprecedented level of care that probably nobody has previously received in the pandemic and most of the Americans who have contracted the virus, excepting the one percenters, could only dream of being fortunate enough to receive care that comes even close.
In my Coronavirus Update of 4th March I said the following:
My greatest concern is that all of the deficiencies of the US health system, that President Obama wanted to begin to address, are about to be laid bare. For all of the rhetoric about having the best health care in the world, the truth that that level of care is only accessible to the one percenters, while the average experience across American society is below that experienced in other comparable developed countries, is going to be revealed in a truly terrible manner I fear.
The problem is not the level of care that one man has received – I am very much against “an eye for an eye” philosophy including capital punishment – the problem is the strong contrast with the care received by others in the world including the many Americans who have lost their battle with COVID-19, still worried by who would pay for their treatment, while this man continually down-played its impacts to the point that distinguished medical journals are describing him as “dangerously incompetent“.
What I want most to talk about in this update is further developments on a theme that I have been discussing since late April – the risks around spread of COVID-19 with processed meat, concentrating on developments since my latest post on the subject one month ago.
As I discussed in that latest report I came across a link to some excellent research on the persistence of virus infectivity on meat – which I correctly quoted from the newspaper article as involving pork, salmon and shrimp (prawns), but which the actual research paper in pre-print showed involved pork, salmon and chicken – which reported that infectivity was maintained without loss over 3 weeks. Now I believe that these authors most likely were aware of my work drawing attention to the threat posed via this route and that this likely played a part in them deciding to conduct the study, as I stated in a post which I linked to in a comment below that pre-print, and so I have questioned whether they might consider whether that is worthy of acknowledgment. That does not detract in any way from the quality of research performed and the significance of the data.
It is highly significant that this research shows that the virus does not lose infectivity on meat over a 3 week period at refrigeration temperature or frozen. It highlights the risk that processed meat poses to spread the coronavirus geographically and to potentially cause clusters, even from meat that was stored for some period of time – perhaps after several years as another coronavirus has been shown to maintain infectivity for 2 years when frozen – even if biosecurity had been “perfect” at preventing introductions in the intervening period.
Now Australian and New Zealand’s food safety authority has been updating (as at 22 September) it’s published opinions on COVID-19, but the effect is still very much to downplay the risk of transmission to suggest that it should not be considered by consumers.
So let me expose their biases (possibly forced upon them by political interference) with one very simple statement of logic. Right from the very beginning of the pandemic – and still today, even in the aforementioned updated statement -these “experts” highlighted first that this is a respiratory virus so it is not a “foodborne disease”. However, it has been known for perhaps 100 years or more that respiratory viruses can be spread not only by inhaling droplets containing virus but by touching surfaces where those droplets settle and then transferring the virus to membranes such as in the eyes and nose. That, after all, is why one of the key management strategies stressed by all is to wash hands frequently. So what is so different about meat that it can not be one of those surfaces where the virus settles? (As I pointed out in my first writing it is my view that this is likely how at least some of the significant transmission that occurs in meat processing plants has occurred.)
Note that the published opinion is technical about what constitutes a foodborne disease – infection must be acquired through the digestive tract following consumption. This is known as a straw man strategy – set up a (false) proposition and knock it down, never acknowledging that this proposition was never what was originally claimed.
I have seen nobody, and certainly not myself, suggest that the main risk with meat was in consuming it (although I will say that this virus has a knack of surprising scientists -i.e. revealing that assumptions were made that proved incorrect – and infection in the process of ingesting uncooked foods of any form may yet be proven to present a risk). The main issue with potential infection by SARS-CoV-2 from contaminated (or infected) meat that I have been discussing is with handling it when uncooked including during food preparation.
Now this updated opinion does include some other relatively current information, much of it about how China has been responding to this threat, mostly to disparage them, and it is also draws on an opinion given by the International Commission on Microbiological Specifications for Food. With a title like that, one could be forgiven for thinking that it is a specialist group set up under the auspices of the United Nations/Food and Agriculture Organisation/World Health Organisation. No, on it’s site it says that:
Currently the Commission includes 18 members from 13 different countries: 8 members are from academia, 4 from governmental organisations and 6 from industry
The description does go on to attempt to further suggest close alignment with these supranational organisations by stating that some members have participated in their working groups, meetings and consultations, but that is a far, far cry from this being an outfit under the auspices of these important organisations. (After all, many of us can make the same point.)
For those who have experienced first-hand the many conflicts that scientists and researchers face, like these people, or if you have read my post “Politics and Biosecurity“, “On The Likelihood Of Transmission Of SARS-CoV-2 From Contaminated Meat” and even my R U OK Day post, you will note that the membership of this grouping does little to provide confidence that published opinions would be free from conflict.
Note this one piece of critical logic: the report by this grouping was published 3 September, but it failed to mention, let alone detail, the key findings that SARS-CoV-2 remains without appreciable loss of infectivity on a variety of processed meat for at least 3 weeks which was published in pre-print over 2 weeks earlier (and for which there was also articles in the mainstream media and discussion on Twitter). Even if the article was found following last minute searches prior to publication very late in the drafting process, such critical information should have been inserted in the “opinion” prior to it being published. Alternatively, if the finding was considered so significant as to require a significant redrafting process, then what is the point in publishing an “opinion” that is already out of date? That a paper was yet to be peer-reviewed, when dealing with a pathogen known to mankind for 9 months, is hardly a viable reason to exclude it entirely, after all the most powerful man in the world has just undergone multiple still experimental treatments for the disease it causes.
To say, or to use a quote from an opinion by a grouping of potentially industry-conflicted individuals, to say that “there is no documented evidence that food is a significant source or vehicle for transmission” is weak, misleading and utterly disappointing.
Again, it is another straw man argument – nobody has ever said that it is likely to be a route for a significant proportion of cases.
However, it does not need to be that for it to be a major concern in regions that have eliminated or stamped out the virus. That is why China’s approach is entirely valid, and why other nations – that have fought hard to protect their people from the extreme human costs of this pandemic – and where food security is not an even greater issue and\or can be managed satisfactorily – should consider doing likewise.
In fact, very much of Australia’s animal and plant biosecurity policy is based on that very premise! Australia has a global reputation for setting a very conservative “appropriate level of protection” for animal and plant biosecurity supported by very stringent measures for the importation of animals and plants, and their products, to prevent disease and pest introductions.
So I will say again, it is a great pity when Australian politicians appear to care more for the health of our prawns and bananas (and businesses) than they do about the health of our people.
Now, having said all of that I do want to say that it appears that the state Governments have heard my calls for extra measures in meat processing facilities and have instituted a number of risk management measures which should significantly reduce the likelihood of serious outbreaks which threaten their workers and the potential for spread of outbreaks. These measures include reducing the workforce in these facilities and weekly testing for the virus in 25% of the workforce. That is excellent and should be a comfort to everybody residing in and\or consuming Australian meat products, but I do note that an epidemiologist for whom I have a high regard, Prof. McLaws, is recommending that testing in high-risk workplaces should be increased.
For as long as we can have trust in the competence of our Government authorities tasked with managing the quality and safety of our meats – a standard assessment criterion in biosecurity – we can be confident that the risks associated with COVID-19 are being managed better than for many other countries. However, the paradox is that when officials understate and downplay the risks, to uphold confidence and thus minimise economic impacts on the industry and more broadly, the more they erode that trust and suggest that their actions will be less than transparent should there be important developments.
I have always also been quite concerned with butchers, for the same reasons (i.e. they are in regular contact with a product that may be contaminated with virus in the similar conditions as in meat processors), and the cluster involving the Chadstone shopping centre, and specifically a butchery, came as little surprise to me. I would note while authorities seem to suggest that the infection was brought into the premise on people, specifically a family who were contracted as their cleaners, without definitive evidence to the contrary, it is also possible that they became infected in the process of cleaning the facilities due to contaminated meat.
Moreover, I also noted these comments by Prof. Sutton, CHO for Victoria, with regards to this cluster (my emphasis):
The interactions probably would have been less than what we would call a close contact for customers. But again, you can get individuals who are very infectious. And you can be unlucky with that interaction and that’s why the callout has been to everyone who was there at that time.
I have a high regard for Prof. Sutton, and I am willing to look past known errors made by Victorian politicians at this point because I do believe that their motivation has very much been to protect human life, but these comments do reveal how lesser likely routes of transmission – such as with food contaminated by infected workers – can remain underappreciated.
On a related issue, to demonstrate just how serious can be the animal reservoir and spread issue when dealing with susceptible species, a further 1 Million mink will be culled in Denmark as SARS-CoV-2, the novel coronavirus that causes COVID-19, was found to infect animals in 41 farms and is suspected in another 20 farms!
That this issue is not more widely discussed should be proof enough for just how much desire there is for the general public to not be alerted to the nature of these risks.
In “COVID-19 Elephants In The Room” which I released 10 March – think about how early in the pandemic that was – I said the following:
Something has been in the back of my mind – a nagging concern – that I did not really want to acknowledge even to myself.
This is a new viral disease to humanity. The very basics are barely understood such as what type of disease does it cause and how severe is it, how does it transfer, and how do people become unwell and how many will become so unwell that they will die. There is still very much unknown. My friend Dr Shi Zhengli only discovered the viral cause of the new pneumonia-related disease, now referred to as COVID-19, just over 2 months ago.
Now think about HIV and how long it took for scientists to get a reasonable understanding on how it caused disease in humans. Sure, our tools have improved since early in the HIV pandemic but that virus was tricky compared with other viruses then known to science.
So what has been in my mind is that the superficially apparent aspect of disease visible as the pandemic ramps up may not be the only aspect of how this virus causes disease in humans. If we were unlucky, there could be some more chronic element – perhaps more chronic disease leading to mortalities or disability, or foetal defects – who knows, almost anything is possible.
The main point of my article then was to discuss how foolhardy it would be of decision-makers to assume at that very early stage that they fully understood the risks that would be involved with not doing everything within their power to halt the progress of the pandemic, or worse, if a strategy like herd immunity from natural infection were adopted.
Since writing this there have been many surprises in the areas to which I was pointing. There have been a plethora of stories of chronic impacts from even mild infection and support groups have sprung up throughout social media. One of the most recent stories to emerge is detailed in this story on ABC.net.au entitled “Experts warn coronavirus may cause ‘wave’ of neurological conditions including Parkinson’s disease“.
Unbelievably that herd immunity debate continues as some will not give up on the concept even though many scientists are openly pointing to the catastrophic consequences of such a strategy. Even in the UK where the pandemic has raged with inconsistent and typically delayed responses, it is believed that only 8% of people are immune due to prior infection. Obviously the mathematics do not add up – at this rate it would take 3-4 more years for 60-70% of the population to have developed immunity (required for herd immunity) from having been infected – and that assumes that immunity is not lost over time, when in reality early research is suggesting that is in fact what occurs. Thus herd immunity is unlikely to ever be achieved by natural infection. To this point, with the pandemic raging in the UK for 6 months, over 40,000 Britons have died from COVID-19. At an annual rate of around 80,000 lives lost that is a very high cost indeed for a likely ineffective strategy.
For my next update I will recap the first year of the COVID-19 pandemic and outline my views on what lies ahead for next year…
Addendum: A highly significant piece of research from CSIRO has shown that the novel coronavirus can persist and remain infective on a variety of surfaces for much longer than most would have predicted (i.e. assumed) including for 28 days on glass, stainless steel and paper and polymer bank notes at 20C. (Infectivity was rapidly lost when subjected to 40C). That is hugely significant for risk management and even needs to be considered when goods travel across borders from regions with high prevalence of COVID-19 to regions that have worked hard to minimise the spread of COVID-19 and\or eliminate it. Ironically, when I first mentioned that risk, in my landmark coronavirus update of 11 February, I wondered whether people might fear receiving goods shipped from China. Now one must wonder whether electronics and other products containing glass or other hard materials shipped from the US and other regions severely impacted by the pandemic may be treated with suspicion. Perhaps an idea to decline expedited shipping and\or ensure packaged goods are subjected to 40C for a period prior to opening…
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© Copyright Brett Edgerton 2020