We can’t wait for infections to vanish before reopening

The grim outlook for lockdowns in Victoria (“Stage four set to be extended: Andrews”, 4/9) is not merely disastrous for business; it ignores history. We are fortunate that this latest wave of COVID-19 infections in Victoria arrived three months after similar events in Europe, but our leaders seem incapable of learning from experience overseas.

The curve for Victoria closely replicates that for France, and that recognition allowed predictions to be made from late in July as to the timing and shape of our peak around August 2. Such recognition was sorely absent from epidemiological models published at the time.

Case curves for France, Italy, Germany, Spain and the UK all show that daily case numbers decline to a background but non-zero level about six to eight weeks after the peak. Those backgrounds, when adjusted for population numbers, all point to an equivalent expected range of between 22 and 65 for Victoria from about September 13. The suggestion in the leaked document that Victoria should wait for daily cases to be below five for a period of two weeks before relaxing from stage four to stage two restrictions is quite unrealistic; no country (or US state) that has experienced a wave of infection such as ours has seen such a low result, but all have reopened businesses and schools.

European cases also raise an important cautionary note; the two countries experiencing a subsequent major wave of infections (France and Spain) are the Mediterranean holiday destinations of the recent northern summer. Australia will need to be acutely aware of risks this summer at our beaches, or more probably the associated after-sunset social mingling. Is it beyond the wit of our leaders to design controls targeted at actual risk, rather than blanket shutdowns that devastate the social, educational and economic life of an entire city?

Michael Asten, Monash University, Melbourne, Vic

The seven-day average rate of new infections in Victoria is continuing to trend lower — as it must under such harsh quarantine — and will continue to do so with more sensible settings such as we see in NSW. It is already very low by international standards in developed countries.

Two-thirds of these new infections are from health and aged-care workers dealing with infected patients; well, where the hell else would you expect them to be? This is a highly contagious virus that can so very easily be transmitted that only the strictest application of PPE can prevent it. Human processes will always have occasional flaws; this is why we see infections in the healthcare setting and our frontline workers know this risk. Outside this setting, the risk (of transmission) is now at an extraordinarily low level of 30-odd per day in a population of 6.5 million. Most of this arises in known hotspots or from the irresponsible activities of a few individuals.

We have to learn to live with this virus, Premier Andrews. Hear the voice of the hitherto silent majority. We have had enough. Ease the restrictions.

Dr Hugh Pearce, Elwood, Vic

On August 10, you published my letter describing how postmortem studies of patients dying from COVID-19 demonstrated extensive clotting or thrombosis in the microvascular circulation of the lungs, heart and other vital organs, including the brain. This sludging within the tiny blood vessels reduces the blood supply to these organs, provoking an intense inflammatory reaction causing catastrophic organ damage. I commented there had been no studies of the use of anticoagulant therapy, even simple aspirin, to prevent this sludging.

Since then there has been an article in the Journal of the American College of Cardiology (26/8) from Mount Sinai Hospital in the US detailing a preliminary observational study of the use of anticoagulants. Anticoagulants in this study reduced the death rate of hospitalised patients with COVID-19 by 50 per cent. Clinicians in Australia would be aware of these findings in the management of hospitalised COVID-19 patients.

Ian Bernadt, retired surgeon, Swanbourne, WA