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‘No longer possible’ to stop imported coronavirus cases


Matt Woodley


2/03/2020 4:04:25 PM

A doctor in NSW has contracted the virus after treating a patient who had recently arrived from Iran, marking the first human-to-human transmission within Australia.

Adelaide airport.
Health authorities have conceded Australia will have more imported cases of coronavirus. (Image: AAP)

Up until now all confirmed coronavirus cases within Australia had been contracted by people who arrived in the country after travelling overseas.
 
The doctor, a man in his 50s, is being treated at Sydney’s Westmead Hospital.
 
There have now been 29 confirmed cases domestically and as the virus continues its spread across the globe, at least one Australian state has vowed to introduce compulsory quarantine laws.

People in South Australia who are at risk of spreading coronavirus could be arrested and detained by police, under new laws set to be introduced by the State Government later this week.
 
The proposed changes will make it possible for authorities to order patients to remain at a hospital or quarantine facility, or require them to undergo testing or counselling.
 
South Australian Premier Steven Marshall said the new amendments will give health authorities the powers they need to protect people from the virus.
 
‘We know people are anxious, and I assure the people of South Australia that you are unquestionably our priority,’ he said.
 
South Australia currently has only three confirmed cases, but Health Minister Stephen Wade said while the health system was prepared for any scenario, authorities needed to plan for the worst.
 
‘Key to being prepared is to ensure that our public health experts have the tools they need to be nimble and proactive in control ling any possible outbreak scenario,’ he said.
 
‘The limited amendments ... will provide greater capacity to rapidly respond and contain public health risks.’
 
No other state or territory has indicated that it will follow South Australia’s lead, but Federal Chief Medical Officer Professor Brendan Murphy did earlier concede that it is ‘no longer possible’ to prevent new cases of coronavirus from entering Australia.
 
‘It is no longer possible to absolutely prevent new cases coming in, given the increasing changes in epidemiology around the country,’ he said.
 
Professor Murphy also recommended that Australian healthcare workers and residential aged care workers returning from Italy or South Korea should not go to work for 14 days as a precaution.
 
‘We do believe that there are some people whose symptoms are so mild that they may be almost unaware that they are infected, particularly just as they become infectious,’ he said.
 
‘That is one of the reasons why quarantine is still being practised for very, very high-risk situations.
 
‘But, all of the evidence suggests people are most infectious when they are symptomatic. That is still the most important piece of advice, to isolate when you are symptomatic.’
 
The number of cases in Italy increased by 50% in 24 hours on Sunday, while South Korea has recorded the largest outbreak outside of mainland China, with more than 3735 confirmed cases and at least 21 deaths.
 
Australians are currently being warned to ‘exercise a high degree of caution’ in Italy and South Korea, while a travel ban on foreign nationals travelling from China to Australia has been expanded to also include Iran.
 
Iran has recorded the highest number of deaths outside of China, and the four new cases confirmed in Australia over the weekend all had a recent travel history that included the south Asian nation.
 
‘We had a very high suspicion that the caseload in Iran was much greater than being reported because of the death rate,’ Federal Health Minister Greg Hunt said.
 
‘So even though we have a relatively low travel volume from Iran we have had these four cases, so that’s why Iran has been a particularly special case.’
 
Professor Murphy said the travel bans are in place as ‘a way of slowing things down’ and that while the outbreaks in Italy and South Korea are large, they appear to be confined and localised.
 
‘In Italy and South Korea … the risk, the proportionality of putting in a travel ban was not justified in terms of its benefits to the health protection of the Australian community,’ he said
 
‘They are working hard to control their outbreaks but we are still concerned that people look about those countries and any other high risk countries and may present with an infection.’
 
Professor Murphy said the most important thing for anyone coming from an area of risk is to monitor their health, and isolate if they become unwell with any flu-like symptoms and contact their doctor or the hospital.
 
Coronavirus is now present in at least 67 countries and territories, leading some countries to impose drastic measures to try and reduce its spread – Japan has closed schools for a month, football matches in Italy were postponed, and Saudi Arabia has banned foreign pilgrims from visiting Islamic holy sites.
 
Over the weekend, the US, Thailand and Australia all confirmed their first coronavirus-related deaths.
 
At the time of publication on Monday 2 March, there had been more than 89,000 cases worldwide, of which nearly 41,000 were still active with around 7400 in a ‘serious or critical’ condition. There have been more than 3050 deaths, while 45,000 people are said to have recovered.
 
The RACGP has more information on coronavirus available on its website.
 
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Dr Ian Mark Light   3/03/2020 7:14:18 AM

Front line health professionals need revision training by podcast or video cast on personel protection gear and the general protection from droplet spread .
There is a lot available because of past experience re SARS and measles containement example having health professionals with at least basic PPE -n95 mask eye protection gloves disposable gown doing out of clinic triage .


Dr Nicholas John Brodie Page   3/03/2020 7:57:07 AM

Professor Murphy should emphasise that people with flu-like symptoms should self isolate and not just walk into the GP’s because their employer wants a medical certificate and has told them to get a check up.


Dr Helena Andrea Smetana   3/03/2020 8:01:20 AM

I don't think there's enough being done by our authorities - there should be a complete travel ban to anyone who has been in the highest case countries including Italy. All the new cases being diagnosed in countries that have not had any cases are from travellers who have been to northern Italy recently. The short term economic hit will be far less than the long term hit if this becomes a community endemic illness in Australia. The RACGP posters are completely off the mark asking people to put on masks and sterile hands with supply that you can only assume would be placed outside the clinic doors (and thus would be stolen within 5min due to shortages) and then asking people to go to reception (step 3) is mind boggling. I have been tracking the numbers closely and it's pretty clear that lock down/containing this virus works (there have been almost no cases outside Hubei Province in China) and it's mind boggling what the so-called experts are not advising to contain this.


Dr Ratnakar Bhattacharyya   5/03/2020 2:56:21 PM

How can you prevent droplet infection in air conditioned closed environment with people who may be infected coughing and sneezing without covering their face be that in a Medical centre, hospital , supermarket, plane, train , other transports conference premises ? Providing mask to every one is not parctical. High quality face masks should be made available to all front line health workers. Cover mouth and nose with tissue when coughing and sneezing can prevent droplet infection should the message to the public .


SD   7/03/2020 10:05:53 AM

Self isolation and dedicated fever clinics is the key apart from hygiene measures. There is no urgent need at present to expose every health professional and decrease medical workforce by exposure. Not only this, an infected health professional can spread it to far more patients than a patient itself.