Tegan Taylor: Hello and welcome to Coronacast, a podcast about the coronavirus. I’m health reporter Tegan Taylor.Norman Swan: And I’m a doctor and journalist Dr. Norman Swan. It’s Monday October 12th.Tegan Taylor: So, Norman, we got a question from a listener that sums up what I think a lot of Australians are asking, and that listener is Leigh Sales, so I’m going to ask you their question directly.Norman Swan: Yeah, no preference here Leigh, you just stand in line like everyone else.Tegan Taylor: Exactly. But Leigh wonders; Looking at New South Wales stats in mid-July, there were 15, 18, 14 new cases of coronavirus every day but they never escalated and there was no lockdown and life was pretty normal. Why isn’t this happening now in Victoria with their current numbers?Norman Swan: Several reasons. The bottom line is that it is very difficult for Victoria to retrofit the ideal contact tracing system and it took New South Wales years to build the infrastructure to get there. So they played catch-up.The main reason is that Victoria always fell behind. It’s gotten a lot less, but in the early days of the second wave, there were thousands who didn’t know where the virus was, where people were getting it from, and I believe they had examined 4,000 people at some point.Tegan Taylor: So these are the mysterious cases where you couldn’t figure out where they’re from?Norman Swan: Well I think they held a lot of them but they didn’t know where it came from. And in New South Wales, it’s just a more efficient, faster contact tracing system that they’re on. You may have a case or two at a time that they don’t know where they’re from, maybe five, and they get back to it pretty quickly.Nor do they wait to tell you where everything is happening until the next day, they tell you during the day. So they can post their numbers in the morning, but if there’s a case at a gym or you need to watch out for a specific restaurant or coffee shop, they’ll tell you during the day. So there is this constant update and warning system, and they are just on it.And it’s not that the people in Victoria don’t work hard, they work hard, it’s just that the system works better in New South Wales. And the result is, and it has been the result all along, fewer viruses circulating in New South Wales during the second wave.Tegan Taylor: Is that part of the problem, maybe Victoria was unprepared in the beginning and then there are only so many left before they can figure out the best system?Norman Swan: Yes, that’s right. I’ve talked about how lucky New South Wales was and it was lucky that in some ways they didn’t have that breakdown … I mean, the New South Wales authorities were very angry with me when I said they did Lucky because there’s a lot of hard work here and so on, but in some ways they didn’t have an underground, unknown spread of hotel quarantine that got into big social networks and when they discovered it would have overwhelmed any contact tracing system. But likewise, their contact tracing system and test system and responses were not sufficiently localized for them to access them as quickly as possible. So it took a while.Tegan Taylor: I think Victoria was really keeping the rest of the country on guard too, that people saw what happened there in other states and said, okay, we’re going to start being tested, we’re going do so on your front foot so it doesn’t happen here.Norman Swan: And that’s the other reason New South Wales are lucky because they knew it was coming and that’s why they were on the alert. But they still had a major breakout in southwest Sydney from this hotel, the Crossroads Hotel, and various restaurants and so on, and it looked very worrying at one point in New South Wales and it was about to end, but they managed to bring it back. Incidentally, it is still on the verge of end because New South Wales has had some cases that come with surprises. But again, they seem to have figured it out pretty quickly where the testing rates were incredibly low since they were in Victoria around the same time. They found it in the sewage, they went in and they looked, and they found some additional cases. And as we said at Coronacast, that’s both a concern and good news: the increasing diagnosis rate means they are starting to find cases, and the testing rate has increased dramatically. I think it tripled overnight.Tegan Taylor: Lisa asks questions just so that we don’t just ask our top-class ABC colleagues questions. How will Melbourne Metro be able to hit the 14-day moving average, or five or less, so they can move into the third step on their reopening roadmap?Norman Swan: It’s not magic, it’s just about doing what you do, wearing masks when you are out, keeping your social distance, being really hygienic, wiping surfaces, being as vigilant as possible . not having big family occasions and hoping the contact system actually gets to it because the cases now are at numbers where the contact tracking system comes over. And yes, it’s hovering at nine, ten for a couple of days, but it’s going to start falling, things are going to come back, but it’s only going to be some time. Many viruses circulate in Victoria.Tegan Taylor: So one of the things that is happening in Victoria today, a lot of viruses are still circulating in Victoria, but the kids are back to school and Mark emailed us this and said he was a little disappointed with it. Kids, they are said to be less contagious, but the best evidence doesn’t seem conclusive. What do we know about how safe it is to send children back to school now?Norman Swan: It’s remarkable how uncertain some of the evidence is here. If you take the balance of evidence, the balance of evidence is that children under the age of 10 are less prone to and seem less likely to transmit SARS-CoV-2. It’s not like they won’t transmit it at all, but that risk increases significantly after the age of 10.Just recently, a review of the available evidence was conducted on tens of thousands of children, and they were able to say, quite conclusively, that young children, especially elementary school children, are less prone to SARS-CoV-2. Interestingly, what they couldn’t say after all this time was a look at the studies that were carried out, which conclusively showed that they were not serious spreaders. It is likely that this is the case from other studies, but not conclusively.And the CDC in the US has reported a 13-year-old who was a super-spreader in an environment where he was on vacation with his family for several days and spread in that environment. So this is a case, it means that children are not free from the risk of spread.Tegan Taylor: And Dan Andrews in Victoria was pretty sure that kids who have symptoms shouldn’t go to school. Although many children are asymptomatic with Covid, it is even more of a reason that when children experience symptoms they need to stay home and be tested.Norman Swan: Yes, that’s right, and unfortunately the confusion this time of year (and we had some questions about it) is that kids get hay fever, they get rhinitis, they get a bit of asthma this time of year. It’s spring, and the question actually comes down to whether it’s an unusual symptom for this child. However, if you really want these numbers to go down, then in Victoria ignore the fact that your child may have rhinitis, hay fever, asthma and get them tested.Tegan Taylor: Let’s talk to Donald Trump, the most famous Covid patient in the world. So we know Covid can … when someone gets a bad case of it it usually gets bad around eight or ten days, which is roughly where they are in the course of their illness. How does he look like he’s going, and when will we know for sure if he’s not in the forest?Norman Swan: Well, if he were to fall off the cliff, he’d probably do it around now or would have done it by now. So I suspect that it is good news for the President, I would suspect, and that he won’t get a serious illness.Tegan Taylor: We actually got a question about Trump’s case from our audience about how safe are outdoor environments because we keep saying that there is less risk of transmission outdoors than indoors, but it looks like this as if that cluster in the White House actually came from an event out there in the rose garden.Norman Swan: Yes, I think it’s still uncertain. I think the White House was a super common setting, and maybe the Rose Garden event, I don’t know enough because they don’t do contact tracing at the White House so we’re actually never going to know the contribution this rose made to the garden event done, but there was certainly coronavirus, as it stands now, that was spreading in the White House. And it could be that the rose garden event was a little furry, a distraction. So it’s uncertain. And because they’re not doing proper contact tracing, we’ll likely never find out.So outdoors it’s a lower risk environment, it’s unusual, but in this situation people were packed together so they weren’t socially distant. And I don’t know if it was a quiet day or a windy day, it looks like a pretty quiet day so you’ve had a lot of people breathing over each other for long periods of time so it could have been an event where Things spread. Most of the time outdoors you have social distance, wind, and ventilation and the virus is unlikely to hang around that long.Tegan Taylor: Well, that leads us this morning to some research by the CSIRO on how long the virus can survive.Norman Swan: Yes, they tried to correct this and look into it much more closely and there was great interest in how long this virus survived at the beginning of the pandemic. In short, they found it varied based on temperature, and they tried things like glass, steel, and even Australian polymer banknotes. And they found that it can take up to 28 days at 20 degrees Celsius, but the warmer it gets, up to 40 degrees, the shorter it takes, up to a few hours. So this virus lingers on surfaces.Tegan Taylor: Do we know if it is enough to actually infect you?Norman Swan: You always have to ask the awkward question, Tegan. And the answer is, no, we don’t actually know the answer to that question, but it looks like it is an infectious virus.Tegan Taylor: Well, that’s all we have time for today on Coronacast. Stay tuned, we’ll be back tomorrow.Norman Swan: See you then.
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