Why the official reluctance in Australia to recognise aerosol transmission?
The UK variant of Covid-19 has changed the game. Oz complacency and the ’relaxed and comfortable’ inaction by the Prime Minister can’t continue. The 40-70% more transmissible UK variant demands strong action.
Yet despite clear evidence about the dangers of aerosol transmission, the government’s expert body, the Infection Control Expert Group, is extremely reluctant to “abandon its outdated views about the transmission of Covid”.
The case for aerosol transmission has been made for months by the now familiar epidemiologists in the media, including Professors Raina MacIntyre and Marylouise McLaws. In July the World Health Organisation recognised airborne transmission aside from cough and sneeze droplets. So did the US Centers for Disease Control.
Back in August Raina MacIntyre spoke strongly against the expert denialists.
“In the midst of the worst pandemic of our lifetimes, we cannot afford to indulge the reasons for this ideology. Continuing to defend or excuse this ideology imperils the lives of healthcare workers, and distracts from the urgent task of keeping them safe at work.”
So why the official reluctance in Australia to recognise aerosol transmission? Despite research published in The Lancet and Nature, former federal deputy health officer Dr Nick Coatsworth asserted on ABC Q and A that aerosol transmission was a ‘live debate’.
This claims was immediately dismissed as ‘wrong’ by Associate Professor Michelle Ananda-Rajah and epidemiologist Professor Tony Blakely. The Burnet Institute’s Professor Mike Toole (ABC Melbourne) also rejected what he saw as the ‘dogma’ of 1912 when aerosol transmission was not accepted.
After the outbreak at the Melbourne Holiday Inn, the president of the Australian Medical Association, Dr Omar Khorshid, said:
‘We need action now. Smart changes need to be made to airflow in facilities, and better personal protective equipment (PPE) including N95 masks and eye protection for workers in hotel quarantine.’
It’s most likely that these cases are the result of airborne spread, yet the experts advising Government, the Infection Control Expert Group, have continually played down airborne transmission in the spread of the virus in hotel and healthcare settings.”
Dr Khorshid noted that the AMA and much of the wider medical profession had been calling for better responses to the risk of airborne spread of Covid-19 for months.
Meanwhile the Australian Society of Anaesthetists has lost confidence in the government’s guiding body, the Infection Control Expert Group. ASA president Dr Suzi Nou declared that ‘it‘s time for expert group to abandon outdated views about the transmission of COVID when the number of experts agreeing about aerosol transmission is increasing as rapidly as the virus’.
Masks matter, along with cleaning surfaces, hand-washing and social distancing. The US chief health expert Dr Anthony Fauci believes that universal mask wearing will save tens of thousands of lives and, facing new variants, the CDC has just recommended double masking.
We should condemn the virus denialists posting on Facebook but the problem goes deeper than that.
Public trust in expert advice is a problem when the ‘experts’ disagree. The ICEG, an almost invisible committee, and the AHPCC, don’t like masks. Their ‘Don’t mention the ‘M’’’ word policy marginalises mask wearing and goes against all the evidence.
Why do they do this? The hospital infection/infectious disease experts who comprise the mysterious Infection Control Group are not epidemiologists. Are they less confident about understanding transmission in the community, in different cultures and in the success of the mask-wearing countries of North East Asia? Are hospital clinicians uncomfortable with non-laboratory observation and demographic research? Or can committees just become too comfortable, even smug?
The Federal Health minister Greg Hunt’s suggested in September an ICEG report on airborne spread but that has come to naught. No report has appeared.
The battalions of professional epidemiologists in the universities and the AMA and fluid transmission researchers have long recognised aerosol transmission and therefore the importance of wearing masks; they are frustrated at governments slow to recommend and mandate masks, particularly the NSW government.
In a December letter to the journal Antimicrobial Resistance and Infection Control Raina MacIntyre and Michelle Ananda-Rajah argued that “scientific evidence supports aerosol transmission of SARS-COV-2”.
Australia would be in for ‘more groundhog days’ if advice did not change, says the Burnet Institute’s Mike Toole.
“Why does this keep happening? The answer is that there is no national standard and a stubborn resistance to taking aerosol transmission seriously. This is going to keep happening again and again until the aerosol transmission is taken seriously.”
The week-long media cycle is fascinated by dramas: by lockdowns, by who is to blame for quarantine infections and the arrival of the magic bullet, the vax. Talkback callers rightly and wrongly blame the Andrews government: there have been serious PPE failings in quarantine hotels.
Public debate needs to look beyond tabloid tales and dramas. The failure of the Infection Control Expert Group to recognise airborne transmission is the problem, not the epidemiologists. The epidemiologists and the AMA tear their hair out in frustration as they seek, to no avail, to follow the primary goal of medicine – to do less harm.
The uncertain ‘vaccine wall’ won’t be fully functional until April. The quarantine frontline urgently needs improved PPE and “mitigating airborne transmission ventilation and other building engineering measures”.
If not, we will have a third – and fourth – wave and more deaths, more “long Covid” illness and everyday restrictions.
The federal committees have left Australia with one hand tied behind its back, although under pressure the ICEG has made noises about reviewing its airborne transmission advice. The federal government needs to act after listening to the epidemiologists.
In the words of the AMA, and the Society of Anaesthetists, ‘we need action’. It is a matter of life and death.
Adjunct Professor Stephen Alomes (RMIT University) is a social researcher investigating power and powerlessness and contemporary populism. A member of medical advisory committees, in 2020 he presented on patient empowerment at the University of Tasmania clinical reform conference. His poetry collection recording everyday experience during the pandemic, Our Pandemic Zeitgeist (Ginninderra Press, Port Adelaide) appeared in late 2020. He is also the author of Australian Football The People’s Game 1958-2058, Walla Walla Press, Sydney, 2012 and The AFL and the Movement Against Racial Vilification in Gus Worby and Lester Irabinna Rigney, eds., Sharing Spaces: Indigenous and Non-Indigenous Responses to Story, Country and Policy, API Network, Perth, 2006.
‘Defining New Populisms: Causes, Characteristics and Trajectories (Australia and Beyond)’ in Ludwig Deringer and Liane Stroebel, eds., International Discourses of Populism since 2015, Routledge, 2022
Comments
7 responses to “Expert denialism: federal Covid advisory committee slow to accept airborne evidence”
The risks of aerosols have been well documented and presented; El Pais in Spain did an article in English explaining, and visually, how aerosols operate, with or without masks in closed spaces.
Conclusion was that all measures need to be taken to lower risk of transmission through aerosols in various ‘spaces’ including masks, fresh air, avoidance of large gatherings, prolonged periods of exposure etc.
In article titled ‘A room, a bar and a classroom: how the coronavirus is spread through the air’ (28 Oct 2020)…
…..understanding the dynamics of indoor transmission was a choir rehearsal in Washington State, in the United States, in March. Only 61 of the 120 members of the choir attended the rehearsal, and efforts were made to maintain a safe distance and hygiene measures. But unknown to them, they were in a maximum risk scenario: no masks, no ventilation, singing and sharing space over a prolonged period. Just one infected person passed the virus on to 53 people in the space of two-and-a-half hours. Some of those infected were 14 meters away, so only aerosols would explain the transmission. Two of those who caught the virus died.
After studying this outbreak carefully, scientists were able to calculate the extent to which the risk could have been mitigated if they had taken measures against airborne transmission. For example, if masks had been worn, the risk would have been halved and only around 44% of those present would have been affected as opposed to 87%. If the rehearsal had been held over a shorter period of time in a space with more ventilation, only two singers would have become infected. These super-spreading scenarios increasingly appear to be critical to the development and spread of the pandemic, meaning that having tools to prevent mass transmission at such events is key to controlling it.‘
Anybody who has stopped working in a large, air-conditioned office building soon notices the absence of flu and colds. My understanding is that people outdoors are under no risk of catching Covid 19 and walking around parks wearing a mask is ridiculous. My main source on these Covid matters is The Dark Horse Podcast that comes out of America’s North-West Pacific coast from husband and wife biologists, Bret Weinstein and Heather Heying. The answer seems simple enough. Don’t pen up people in hotels where they are breathing the recycled farts from last year’s night-shift.
The experts that deny aerosol transmission are straw men. They don’t exist. The proportions of transmission via contact and via aerosol are difficult to measure.
I think the political reluctance is incredibly simple.
Ordinary people feel. They also vote. Ordinary people do not like their breathing being compromised nor their identities and facial expressions compromised. Those Governments which have manifestly maintained some of the World’s lowest infection rates (all States except Victoria) would compromise their re-electability if they compelled mask wearing.
Let the experts profess their expertise. And also let the politicians make their judgements according to the total context.
In what other area of public policy is the Federal government attuned to the voices of engineers and physical science practitioners? Look at the debacle that is electric vehicle, energy, climate change, ocean, reef and land environmental protection, and water policy.
Mr Westerman: good point.
And there may be another (relevant to some other comments on this post).
The committees mentioned in this article are said to advise decision makers which in most cases are State officials.
The committees include people representing or employed by the States.
In what other public policy field do such expert committees actually make sufficient progress?
Not in mine – transport and infrastructure – where decisions are also largely made by the States.
In my field there are some ‘mechanics’ around protect State bureaucratic interests- maybe for later.
The Federal officials, presiding, don’t force issues – to avoid responsibility.
The result is Ministers – who should be the decision makers – are given nothing real to decide.
So they hardly need to meet – leave it to the experts.
The upshot is that it doesnt particularly matter what the Commonwealth Minister is attuned to when decisions are left to/made by the States.
I am not saying it is happening in this case, or for energy etc.
Merely relaying many years of observation.
Best wishes
If aerosols (mists) can be used for disinfecting complex and compound areas, why do these contrarian ‘experts’ consider that infection cannot be dispersed in a similar manner?
I suspect a simple matter of arrogance and stubbornness lies at their reluctance to accept the empirical evidence which is presented every moist and misty autumn morning.