COVID-19 PANDEMICHEALTHCARE BRIEFING

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INTRODUCTION AND PURPOSE

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C o n t e n t s 3

Topic Page

Introduction and purpose 4

Review background and current status of COVID-19 situation in Australia and globally 7

Examine the life course of a typical pandemic and what to expect at different stages 19

Consider learnings from international COVID-19 responses and assess the public health response in Australia

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Review practical considerations for ourselves, friends, families, communities and organisations 27

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I n t r o d u c t i o n 4

• This document summarises the facts and science about COVID-19 in a digestible format

• These materials are based on the most recent science available using trusted international and national news sources, scientific publications, scientific data aggregation sites and the views of Rebbeck Consulting

• In the early stages of any pandemic, the science is constantly being tested, improved, and refined and some of the estimates provided today will inevitably be revised over time – the accurate science will only ever be known in hindsight

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P u r p o s e 5

• To provide a shared and consistent level of understanding about the facts and science about COVID-19

• To provide a daily update on the current crisis as at 23 Mar 2020

• To consider how the current situation may evolve in the coming months

• To consider how we can we look after ourselves, our family, friends, colleagues & community

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W h e r e a r e y o u s i t t i n g o n t h e c h a n g e c u r v e ? 6

Time

Mo

rale

an

d c

om

pet

ence

Create Alignment

Maximise Communication

Spark Motivation

Develop Capacity

Share Knowledge

ShockSurprise or shock at the event

DenialDisbelief; looking for evidence that it isn’t true

FrustrationRecognition that things are different; sometimes angry

DepressionLow mood; lacking in energy

ExperimentInitial engagement with the new situation

DecisionLearning how to work in the new situation; feeling more positive

IntegrationChanges integrated; a renewed individual

Source: The Kubler-Ross Change Curve

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BACKGROUND AND CURRENT STATUS OF COVID-19 SITUATION IN AUSTRALIA AND GLOBALLY

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I n h i s t o r i c a l t e r m s , p a n d e m i c s a r e a r e g u l a r o c c u r r e n c e

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Source: Visual Capitalist

9K and counting

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A c o c k t a i l o f f a c t o r s h a v e c o m b i n e d t o m a k e C O V I D - 1 9 e x t r a o r d i n a r i l y p r o b l e m a t i c

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1. How contagious is the virus?

It spreads very easily, making containment efforts difficult (the Reproductive Number is between 2 and 3).

2. How deadly is the virus?

Our best current estimate is a Case Fatality Rate of between 0.25% and 3.0%

3. How long does it take to show symptoms?

The Incubation Period is between 2 and 14 days, allowing the illness to go undetected.

Because the symptoms are easily confused with the flu, many cases go untested

4. How many people will have immunity?

Because this is a novel coronavirus that humans have not been exposed to before late 2019, only people who have recovered from an episode of COVID-19 illness will have immunity.

5. How will Australia fare?

Most of Australia will be affected worse than the northern hemisphere as we move into the winter (with COVID-19 combining with flu season).

Sources 1: The Lancet, Source 2: “Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality”

Wilson, Kvalsvig, Telfar Barnard, Baker Emerging Infectious Diseases, Centers for Disease Control & Prevention Materials adapted from the New Yorker

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C O V I D - 1 9 a p p e a r s w o r s e t h a n S e a s o n a l F l u b u t n o t a s b a d a s t h e S p a n i s h F l u

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Source: The New York Times

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C O V I D - 1 9 h a s a h i g h e r C a s e F a t a l i t y R a t e ( 0 . 2 5 % - 3 . 0 % ) t h a n S e a s o n a l F l u ( 0 . 1 % )

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Source: Our World in Data

Source: “Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality” Wilson, Kvalsvig, Telfar Barnard, Baker Emerging Infectious Diseases, Centers for Disease Control & Prevention

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C O V I D - 1 9 a l s o h a s a m u c h h i g h e r C a s e F a t a l i t y R a t e t h a n t h e 2 0 0 9 S w i n e F l u

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Source: The Washington Post

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T h e m a i n s y m p t o m s o f C O V I D - 1 9 a r e f e v e r , d r y c o u g h a n d f a t i g u e

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Source: Our World in Data

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C O V I D - 1 9 d i s p r o p o r t i o n a t e l y a f f e c t s o l d e r p e o p l e w i t h u n d e r l y i n g h e a l t h c o n d i t i o n s

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Source: Our World in Data

C O N F I D E N T I A L

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Confirmed cases is likely to be significant under-estimate of actual cases given the low levels of testing globally

As of 23 Mar 2020, Johns Hopkins is reporting 335,957 confirmed cases globally with 14,632 deaths and 97,882 people recovering

Source: Johns Hopkins Coronavirus Resource Centre

C O N F I D E N T I A L

16In Australia, Johns Hopkins is reporting 1,314 confirmed cases and 6 deaths and the Department of Health is reporting 1,098 confirmed cases and 7 deaths

Source 1 : Johns Hopkins Coronavirus Resource CentreSource 2: Australian Department of Health

These figures are a significant under-estimate given the low levels of testing globally

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W i t h C O V I D - 1 9 d o u b l i n g e v e r y 3 - 4 d a y s , A u s t r a l i a i s i n t h e ‘ m i d d l e o f t h e p a c k ’

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Source: Our World in Data

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A t c u r r e n t e s t i m a t e s , C O V I D - 1 9 c o u l d e a s i l y b e c o m e t h e l e a d i n g c a u s e o f d e a t h

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Source: ‘Could Coronavirus Cause as Many Deaths as Cancer in the U.S.? Putting Estimates in Context’ Katz, Sanger-Katz, Quealy, The New York Times

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LIFE COURSE OF A TYPICAL PANDEMIC AND WHAT TO EXPECT AT DIFFERENT STAGES

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W e n e e d t o ‘ f l a t t e n t h e c u r v e ’ t o b u y t i m e g i v e n o u r l i m i t e d h e a l t h s e r v i c e c a p a c i t y

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Source: “Pre-emptive low-cost social distancing and enhancedhygiene implemented before local COVID-19 transmission

could decrease the number and severity of cases.” Dalton, Corbett, Katelaris

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H e a l t h s y s t e m s l a c k s u f f i c i e n t c r i t i c a l c a r e b e d s t o c o p e w i t h t h e s u r g e i n d e m a n d

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Source: Imperial College COVID-19 Modelling of UK health system

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T h e m e a s u r e s t a k e n b y e a c h c o u n t r y w i l l s h a p e t h e C O V I D - 1 9 p a n d e m i c p r o g r e s s i o n

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RecoveredSickHealthy

Recovered

Sick

Healthy

Recovered

Healthy

Recovered

Healthy

Source: Washington Post

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T h e s t a g e s o f a n a t i o n a l p a n d e m i c r e s p o n s e 23

Before Pandemic During Pandemic After Pandemic

Monitor Health

Environment

Prepare System

Minimise Impact & Spread of Outbreaks

Co-ordinate Government

Pandemic Response

Minimise Pandemic Impact & Spread

Manage COVID-19 Patients

Manage Excess Deaths

Uphold Vital Infra-

structure

Restore Vital Services

Post Pandemic

Inquiry

1 2 3 4 5 6 7 8 9 10

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LEARNINGS FROM INTERNATIONAL COVID-19 RESPONSES AND APPLICABILITY TO AUSTRALIA

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W e m u s t a p p l y t h e l e a r n i n g s f r o m i n t e r n a t i o n a l C O V I D - 1 9 r e s p o n s e s

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Iran

Italy

USA

Australia

UK

China

Singapore

Relative Trajectory

Catastrophic Moderate-Good

ResponseDenial & Cover Up

Rigorous & Transparent

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R a p i d m o b i l i s a t i o n o f h e a l t h p r o m o t i o n a n d p r i m a r y p r e v e n t i o n w i l l r e d u c e h o s p i t a l a d m i s s i o n s a n d d e a t h

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~1%

cases

~4%

cases

~14%

cases

~81%

cases

Well population

Deaths

Critical Cases

Severe Cases

Mild Cases

Healthy

Acute Care

Respectful & Safe

Management

Intensive Care

Primary Prevention

Health Promotion

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PRACTICAL CONSIDERATIONS

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H o w c a n w e l o o k a f t e r o u r s e l v e s , o u r f a m i l y , f r i e n d s , c o l l e a g u e s & c o m m u n i t y ?

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Stay at home if you have flu like symptoms (i.e. self isolate)

Get tested if you meet the criteria - in any case stay at home until your symptoms resolve

Wash hands and cough into elbows

Eat and drink well

Do things you enjoy and exercise

Sensible social distancing (risk based)

Pace yourself at work (this is a marathon not a sprint)

Take time to switch off every day

Check in on vulnerable family, friends, colleagues and community

Look after the mental health of yourself and others

Support employees who are not eligible for sick leave

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W h a t w i l l t h e ‘ n e w n o r m a l ’ l o o k l i k e a f t e r t h e p a n d e m i c ?

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Political

Economic

Social

Technological

Environmental

Legal

Epidemiological

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C o n t a c t d e t a i l s 30

As always, feel free to get in touch.

Jay Rebbeck

jay@rebbeckconsulting.com

+61 (0) 41 400 524

www.rebbeckconsulting.com

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D i s c l a i m e r 31

• This document has been issued by Rebbeck Consulting PTY LTD (ACN 609 606 073) (“Rebbeck Consulting”) and is provided for informational purposes only

• While every effort has been made to ensure that the information in this update is accurate, its accuracy, reliability or completeness is not guaranteed. This information does not take into account your particular needs or circumstances and is for informational purposes only. It is not intended to be a substitute for professional advice, and should not be relied on as health, personal or financial advice

• Rebbeck Consulting do not accept any responsibility for loss or damage suffered by any person or body relying directly or indirectly on any information provided in this presentation and do not accept any liability for any decisions made on the basis of the information provided

Rebbeck Consulting

Unit 222 Lifestyle Working

117 Old Pittwater Road

Brookvale

NSW 2100

Australia

+61 414 400 524

jay@rebbeckconsulting.com

www.rebbeckconsulting.com