Six Big Covid Ideas


The science is very clear that Covid in all its variants is not “just like the flu” and therefore evidence-based strategies such as vaccination, testing, physical distancing and mask wearing are essential

By Dr Shawn, a Perth based GP frustrated by COVID as much as anyone

At risk of adding another token “a doctor’s opinion” on the topic, I would like to start by warning that the issue requires a significant medical background to interpret the COVID-19 situation. Without looking into the details, we risk over-simplifying the nuances around the pandemic. We are best to look towards experts (i.e. professors of epidemiology, virologists, and infectious diseases) for their opinions (which are up-to-date, evidence-based knowledge).

I am, however, a medical doctor with a bit of scientific background: Bachelor in Biomedical Science, Masters in the same field, medical school, and further Masters in Surgical Sciences. I am a little more equipped than the average person in understanding medical information, but I am immeasurably under-qualified in terms of epidemiology and public policy. That’s why I look to some of the incredibly well-trained professionals for my knowledge and opinion.

With that preamble, this is what I have gathered:

1. COVID-19 is NOT just like the flu

2. Omicron is NOT a mild disease

3. Vaccination DOES work

4. You still need to keep distances & wash your hands

5. There will be new variants, the virus will keep evolving, as will we

6. Vaccine mandate is not new

The COVID-19 infection is difficult to diagnose, people do not walk around with a label on their heads “COVID infected, Day 1". That is why we need to assume any viral-like symptoms are COVID-19 infection (particularly in the beginning of the pandemic), and take the necessary precautions. We now have a very high vaccination rate in WA and most of us who contract the infection will be OK, but bear in mind, that we need to protect those with a weaker immune system with our actions.

1. COVID-19 is NOT just like the flu: COVID-19 has been compared to influenza because they are both highly infectious respiratory viral illnesses capable of causing widespread infections. In March 2009, the world saw cases of a novel influenza virus beginning to emerge in Mexico and USA. In mid-April 2009, there were reports of atypical severe pneumonia occurring mainly in healthy young people. The pathogen responsible was later identified as the H1N1 influenza virus: the first influenza pandemic in more than 40 years. By the end of 2009, there were 37,755 laboratory confirmed cases, including 5,085 hospitalisations and 188 deaths notified.

In comparison to the last influenza pandemic, since the emergence of SARS-COV-2 entering into Australia in early 2020, we have had 2.5 million total cases of COVID-19, 4,500 total deaths, and over half of those from the turn of 2022 (due to Omicron)! COVID-19 is much more infectious than influenza, it causes more severe disease, it lands more people in hospital and ICU, and it has killed more Australians in the past two years than influenza has in the past 5+ years.

There are four other viruses in the Coronavirus family that commonly infect humans, i.e. the common cold. Pre-2020, when you came down with “something”, and your GP said, “it’s probably viral,” there was a good chance that it was one of the coronaviruses, or a host of other common respiratory viruses. The hope ‘fingers crossed’ is that SARS-COV-2, the virus causing COVID-19, will become a milder viral infection tolerable by most of the human population.

2. Omicron is NOT a mild disease: Omicron variant of the SARS-COV-2 causes a MILDER disease than the Delta variant (which caused significantly more morbidity than the original strain). There’s a cognitive fallacy of anchoring effect here. We recognise that Omicron is milder than Delta, so we feel that Omicron is mild. The appropriate analogy is saying that tiger sharks are less bitey than great-whites, so tiger sharks are no more bitey than a goldfish. The Omicron strain has made so many updates to its genome that we are really worried about its ability to escape our vaccine-induced immunity, as well as the immunity that people got from previous COVID-19 infections. In other words, you can have COVID-19 infection last year (predominately Delta), and contract COVID-19 infection again this year from Omicron.

3. Vaccination DOES work:  Immunisation is recognised as one of the world's most successful and cost-effective health interventions. I explain to my patients about the mRNA COVID-19 vaccines (Pfizer & Moderna) as follows:

The vaccine contains no virus. Period. It’s like buying furniture from Ikea except you don’t receive a flatpack. The vaccine delivers an instructional manual, your body acts in DIY mode to make the spike proteins (bits on the outside of the virus that break-in and enter your cells) using your own material. Your immune patrol sees the spike proteins, recognises that it’s foreign and learns to fight it. This process generates an immune reaction (like a military exercise), so you WILL feel a bit run down, tired, achy, sometimes feverish, and even unwell, but almost everyone recovers after 24 hours. When your immune system encounters the real virus, it reacts harder, better, faster, stronger (cue Daft Punk).

What about the fact that there are more vaccinated patients in ICU than un-vaccinated? That is a poorly thought-out argument without taking account of proportions. Drunk drivers cause traffic accidents, but there are far more traffic accidents caused by sober drivers ‒ why? Because there are far more sober drivers around.

In NSW, of the 61,800 locally acquired COVID-19 cases with disease onset from 16th June to 7th October 2021: The majority of cases (63.1%) had received no vaccine, 9.2% had received one dose, and 6.1% had received two doses of vaccine. About one in five people (21.7%) had no vaccination recorded on the Australian Immunisation Register. Of the 8,660 cases hospitalised, only 5.7% (493) had received two doses of a vaccine and just 3.0% (30) of the 1,015 cases who were admitted to ICU were fully vaccinated. Twenty-six of these 30 people had significant underlying health conditions (meaning that 23 out of those 30 would have ended up in ICU regardless) ‒ vaccination protects the young and healthy from landing in ICU. You are up to 15 times as likely to end up in ICU (that's 1500%) if you were un-vaccinated, when compared to someone fully vaccinated.

4. You still need to keep distances & wash your hands: Immunisation is not like wearing a bulletproof vest. When exposed to the real virus, depending on how long it has been since your immunisation, you can still catch COVID-19. Why? The vaccine-induced immunity allows a more adapted response to the virus. When exposed, the virus is much less likely to establish a beachhead in your body, and it is less likely to cause a full blown severe disease. But you can still catch the infection, nothing in life is 100%.

Just because someone wears a seatbelt, doesn’t mean they can drive like a maniac. The seatbelt can save life in a fatal crash, but it does not prevent the crash, if you choose to drive like a maniac.

So when we are asked to keep the social distance, we are lowering our exposure risk. Please do the right things: keep a social distance (for now), wear masks (surgical masks please - cloth masks are as useless as wool-knitted condoms), wash your hands (with soap, for 20 seconds, AND dry your hands), cough into your elbows, stay home when sick, get a PCR or RAT when symptomatic, and seek medical help.

5. There will be new variants, the virus will keep evolving, as will we:

Just like haters are gonna hate, the virus will keep mutating. Each time the DNA or RNA replicate, there's a chance that some mistakes will be introduced. It's like asking someone to hand-copy the entire Wikipedia, there are bound to be spelling mistakes each time they do it. These mistakes might accumulate and change the meaning of the Wiki article.

We cannot predict how the virus will evolve (contrary to common believe, evolution is not directional, variations happen by random chance, then the best fit variation survives and becomes more dominant). So, there will be new variants of SARS-COV-2, just like there will be new variants of influenza. Similarly, just like we need annual flu-shots (different each year), we will likely need to updates to our COVID-shots.

Can the virus evolve itself to become obsolete to our immune system? Absolutely! It has happened to SARS-COV-1 in 2004. But for now, expect this coronavirus to stay.

6. Vaccine mandates are not new: I was born in Taiwan in the 80’s. Taiwan had a very high rate of hepatitis B infection for decades before I was born, which led to a high rate of liver cirrhosis (hardening), liver failure leading to death, and liver cancer. Hepatitis B vaccination was made mandatory for the island nation in the 80’s and the rates of hepatitis B dropped dramatically. When my family moved to NZ in the late 90’s, we had to provide evidence that we had a vaccination record for a whole host of diseases: measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, etc. No jab, no entry. When I entered medical school, I had to provide my full vaccination record. Again when I went into hospital placement. Again when I finished med school and into hospital to work. Again when I changed hospital. Again when I left the hospital to start training at a GP clinic...etc. You get the idea.

By the way, this applies to ALL HEALTH PROFESSIONALS, including nurses, dentists, pharmacists, physiotherapists, occupational therapists, social workers, etc.

This is for your safety, and ours. It does not make sense to protest this one particular vaccine mandate now, apart from this being made a right-winged political rhetoric.

Apart from the vaccination mandate, we live a life of restrictions, everywhere. You cannot drink and drive, you cannot drive without seatbelts, or use your phone at the same time. You cannot smoke on the plane. You cannot bring water, or a lighter, or a snake on the plane. You have to wear clothes in public ‒ surely that’s more restricting to wrap your whole body in clothes than wearing a mask. By the way, a mask does not suffocate you, your oxygen saturation does not drop even wearing N95 (which I wear all day every day, and LOADS of tradies do too, prior to COVID). Not only does it not impede your breathing, people win Olympic Games events wearing masks.

Cognitive fallacies

There will be those around us who disagree everything that I've listed above. There will be debates with people giving arguments backed by "alternative science". In an age of misinformation, in a time of anti-science sentiment, and in this world of social media, "facts" have become a rare commodity. It is increasingly essential to arm yourself with the skills of recognising cognitive fallacies, and train yourself to think logically (i.e. logic as the first lesson you learn in philosophy).

Recently, we’ve seen the Rogan vs Young debacle played out over Spotify platform. There are some parts of life where objective, measurable facts exist, and medical knowledge falls in this field. Sometimes, it is actually not ideal to “take in all opinions and perspectives” for consideration, in the view of “balancing the discussion.” This is a cognitive fallacy called the Middle Ground Fallacy. You cannot interview an astrophysicist and a flat-Earther and take the conclusion that maybe earth is anything but an oblate spheroid.

Finally, some links for those interested:

1. Scientists warn of "endemic delusion":

2. The rarity of myocarditis (as a side effects of mRNA vaccines):

"The Australian Technical Advisory Group on Immunisation (ATAGI) notes that COVID-19 is estimated to cause myocarditis at a rate of 11.0 events per 100 000 persons, whereas the Comirnaty (Pfizer) vaccine has been estimated to cause myocarditis at an overall rate of 2.7 events per 100 000 persons.
By 23 January 2022, 431 likely myocarditis cases and 774 likely pericarditis cases related to the Comirnaty vaccine had been reported to the Therapeutic Goods Administration, out of 31.6 million doses given. A further 46 likely myocarditis and 57 likely pericarditis cases linked to Spikevax (Moderna) were also reported, out of 2.7 million doses. For both vaccines, the data include several cases among adolescents."

3. Proper RAT usage:

Take-home message: Don't test yourself the minute you get exposure. You actually need about 2-3 days for the virus to replicate, before the antigen level is high enough to be detected. After 5-7 days of infection, it's not accurate again.

Header photo: Ultrastructural morphology of SARS-CoV-2, Centers for Disease Control and Prevention (USA)/ Alissa Eckert, MS; Dan Higgins, MAM Wikimedia Commons

[Opinions expressed are those of the author and not official policy of Greens WA]