With the Coronavirus (COVID-19), officially being declared a pandemic by WHO, people are naturally fearful and uncertain what it means.
While a lot is still unknown, what is known is that it will impact every small business in Australia in the coming months: whether that be through economic uncertainty, staff absence, supplier interruptions, or forced closures due to quarantine.
This post is designed to help summarise the key facts about what we may be facing, and what we as individuals and business owners need to do about it.
I need to state upfront that I am not a doctor or scientist. However, my parents were both research virologists and many of my relatives are frontline medical staff. While I am not a psychologist, I studied Psychology at the UNSW, and have a special interest in mental health issues.
I also need to state that this post was written on the 12th March 2020. The information about COVID-19 and its impacts are chaing rapidly, and some of this information may be out of date in coming weeks or months as more is learned by scientists.
My skill is turning a mountain of information/research in actionable information. However, this is a VERY long post, so jump to the sections that interest you.
Medical Briefing: Isn’t Coronavirus Just Like The Flu?
A common thing that I hear is that Coronavirus is just another flu and the media are all over-reacting. Unfortunately, Coronavirus is not just like the flu for many reasons (Much of this data comes from the main WHO website, including their Q&A page, as well as Our World in Data):
The flu has a vaccine. There is no vaccine against Coronavirus, and current estimates are 12-18 months before a viable vaccine will be available to the community.
People have immunity to the flu. People currently have no natural immunity to Coronavirus.
The transmission rate for Coronavirus is higher than the flu. While there is still a lot we don’t know about Coronavirus, scientists are telling us that the transmission rate is currently estimated between 3-4 people (meaning each person who gets it passes it on to between 3-4 others). The flu transmission rate is 1.3. This means more people will get sick.
Current confirmed cases are doubling every 5 days (according to WHO data and reported at Our World in Data). What that means is if you had 50 cases 5 days ago and 100 today, the doubling rate is 5 days.
This rate has been changing and getting shorter as the virus has progressed. In early days the doubling rate was 7 days.
People mentally struggle with exponential growth. Our brains think in a linear fashion 1,2,3 etc. With exponential growth, 100 cases grow to 102,400 cases after doubling 10 times – so in 50 days, 100 cases can become 102,400 known cases.
So when you hear someone say, “It’s only a handful of people, why should we worry?” think of exponential growth.
A good example is Italy. In less than a month they went from just 3 cases to now having the highest number of cases and deaths outside Wuhan.
The other challenge is that COVID-19 testing is not widespread in many countries (including Australia), which means there may be many unknown cases that are spreading the virus. You can’t count and control what you don’t test for.
A well-presented graph of available data by country showing epidemic growth transmission patterns has been put together by Andrew Lilley.
The incubation period varies. Incubation before someone shows symptoms is between 1-14 days, with the average being 5-6 days. However, in China, there were cases with a more extended incubation period.
While the data is not all that clear as yet, it appears some people may be infectious with Coronavirus days before they show symptoms whereas with the flu you are only infectious one day before symptoms show.
The rate needing hospital intervention is higher than the flu. With COVID-19 up to 20% of people (1 in 5) need to be hospitalised for pneumonia, and 5-10% end up in intensive care.
This is different in Italy, where it is being reported that 50% of people are being hospitalised. Doctors think this may be because of the ageing Italian population combined with higher smoking rates, but they are not sure as yet.
The recovery period is longer. Most minor cases of the Coronavirus only take 2 weeks to recover from. Recovery if you are hospitalised takes between 6-8 weeks.
The fatality rate appears higher. You will see the media and different sources quoting fatality rates. At the moment, these figures are not sufficiently accurate as there is so much uncertainty about the exact rate of infection, combined with the fact that many people may be intensely ill for 6-8 weeks before dying and the pandemic is still relatively new.
The rate varies depending on the country and the progress of the virus, but currently sits somewhere between 2% and 3.48%, while the flu death rate is approximately 0.1% but this varies depending on the intensity of the flu season.
This rate is not uniform though. Babies and children currently are unlikely to die from Coronavirus, but the fatality rate increases as you age.
This virus impacts the health of people over 60, people with low immunity, high blood pressure, diabetes, heart disease, respiratory issues and other underlying health conditions more strongly than other groups, so their hospitalisation and fatality rates are higher.
COVID-19 remains on surfaces. Studies have shown Coronavirus can stay on hard surfaces like plastic, glass and metal for up to 9 days, but regular cleaning and sanitation measures kill the virus. https://www.ncbi.nlm.nih.gov/pubmed/32035997
It impacts the vulnerable and poor. People with pre-existing health conditions and the elderly are at higher risk of more severe impacts.
People who are poor or who have wage instability, can’t afford to disaster prep, take time off in quarantine or to care for children or other ill people. This forces them to remain in the workforce or be in public areas to survive, increasing their exposure to the virus.
Why Are Entire Countries Being Closed, Schools Closed And Events Cancelled?
Another thing I hear is, “Well, there must be something that “they” aren’t telling us if entire countries are being closed down,”
While the estimates vary widely because it is still such a new virus, virologists and epidemiologists estimate that somewhere between 25% and 70% of the world’s population will get Coronavirus this year.
It is very likely that you and I (and our families) will get the Coronavirus this year, and it is also expected that for most of us that all we will get is a minor dose that will only inconvenience us for a few days.
However, the impacts on other people may not be as minor which is why there are widespread actions being taken at a national level.
As we talked about before, approximately 1 in 5 people who get it end up in hospital, and 5% overall end up in an intensive care unit.
Running some back of the envelope numbers, Australia has 25.4million people. Assuming the lowest case of 25% getting Coronavirus this year, that means 6.35million Australians could get it.
If the 1 in 5 hospitalisation ratio remains throughout the pandemic, that means 1.27million Australians will need to be hospitalised, and 317,687 will need an intensive care unit.
If this number is spread out over a few months, the health system may be able to cope. If they all land in a few short weeks, then the health system will not be able to manage.
With any pandemic, a country needs to:
- Protect the vulnerable
- Stop the spread
- Support healthcare workers by “flattening the demand curve.”
- Keep the economy ticking over
Countries try to stop large numbers of people being sick at one time. The goal of all the interventions we are seeing at national levels is to “flatten the curve”. To reduce the rapid spread of the disease to allow our medical facilities and society to cope.
With any pandemic, countries have to balance economics with inconveniencing people.
If they close down the country, then the spread of the virus slows or is stopped, but businesses and the economy suffer, and people have severe limitations on their civil liberties.
If they don’t take action or take action too late, with exponential growth, the pandemic can overwhelm the health system meaning not enough beds for people who need it, front line medical staff getting ill and not enough critical supplies such as ventilators to cope with demand.
It also means larger numbers of people die (and not just from the pandemic – cancer patients pregnant women, etc.) as they can’t get the care that they need when they need it.
Australia has approximately four hospital beds (public and private) per 1000 people, on par with China and Italy. That’s why our medical specialists have been closely monitoring developments in those countries to see the potential impacts.
For more context, Lombardy in Italy (one of the first regions closed down) is has similar hospital ratio to us, and is rated in the top 5% of WHO medical care, and right now they are overwhelmed with cases. They are in the yellow curve in the graph above.
If you want to know what that looks like on the ground from frontline medical staff, this Twitter thread reporting from a doctor in Lombardy is very confronting. So if you worry that you are not getting the full story – this is what governments are trying to avoid.
Psychological Responses – Let’s Talk Toilet Paper
What happens when a new severe and unexpected threat arises is that people go into an over-reaction mode. They look for information – they may constantly watch the news or scan Twitter (guilty), and they look to others for clues in how to respond.
They may take extreme and unnecessary precautions such as not eating at Chinese restaurants or standing near people who look generically “Asian”. These are racist and inappropriate responses and not grounded in any valid data.
This response is known by psychologists as an adjustment reaction and is extremely common in times of crisis.
Right now, people are frightened and feel like things are out of control. They are not getting enough useful information about what the Coronavirus is and how their community is responding, so they are following the herd in trying to make sense of things.
This has led to panic buying of toilet paper (probably one of the few things that is actually NOT needed during a Coronavirus pandemic), which then went on to create more fear as their personal supplies dwindle.
The run on toilet paper merely is an indicator of how deep and profound the fear is.
That’s why I will not mock or share memes about loo roll hoarders. It makes the people who hoarded feel shame (and less likely to be open about the illness if they get it) and makes those who didn’t hoard feel guilt and confusion that they did not “get the memo” earlier and failed to provide for their families. Responding from guilt or shame is not a great place of resourcefulness to respond to what is coming.
Disaster prepping is simply a psychological and logistical rehearsal for what may come. On a huge plus, studies have shown that people who have successfully gone through an early adjustment reaction are better placed emotionally to cope when the real disaster hits.
If the over-reaction (e.g. toilet paper buying) is explained so people understand why they did it, what it means and what they need to do instead, then we can help our community positively get through what is coming.
What Communication Is Needed Now
Right now, we need to crank up public information campaigns so that people know genuinely what they need to do and not do.
One of the best resources on what you SHOULD be doing to prepare is from Dr Ian Mackay (Virologist) https://virologydownunder.com/so-you-think-youve-about-to-be-in-a-pandemic/
He has a very practical list of what supplies you genuinely do need to be collecting and prepping now.
We also need to know more about likely impacts of the Coronavirus on our community, and what that may mean for us and our lives.
The Victorian Premier gave a frank press conference that went some way to helping people understand what may be coming. It is worth watching both for the information shared, and the honesty in explaining what the impacts are likely to be. He did not sugar-coat things or fan unnecessary fear but attempted to be factual and informative (we need more of this!)
What we are likely to see the Australian government do is keep an eye on transmission.
If the numbers of known cases show that the person caught it locally rather than recently coming in from another country, then it is probable we will see similar measures to Italy: Stopping public events/conferences/meetings, limiting travel, closing schools, reducing public transport, closing restaurants and coffee shops, limiting store trading hours, closing non-essential businesses.
This means it’s time to start thinking through what that could mean to you, your family and your business.
NSW Health briefed their staff to expect the first wave of Coronavirus to last for between 12 – 22 weeks, with 1.6 million people in NSW potentially infected.
What Happens Next – Protecting the Vulnerable
If anyone you visit or provide services to falls into the vulnerable category (over 60 with a pre-existing health condition), then you have a higher responsibility of care during the outbreak.
- Increase your hand hygiene. Wash your hands or use hand sanitiser before entering their home or coming in contact with them.
- Increase social distancing (staying 1.5m-2m away from them at all times).
- Reduce their need to be in public places where the risk of transmission may be higher. Do their shopping for them. Home deliver their medications (and life’s niceties like good coffee.)
- If they are part of networking groups, explore live streaming via Facebook/Zoom so they can remain engaged and involved.
- Ensure anyone who comes in contact with them is not ill.
- Don’t visit aged care facilities if there is the slightest hint you could be ill.
- Work out care and support plans for elderly or vulnerable friends and family members.
As a business owner, consider how you can add a home-delivery or drive-by service for your products, and offer online or over the phone orders.
When you do this, explore no-contact delivery options (where you can leave at the door without a signature provided a photo clearly showing where the item has been delivered is sent to the person).
If you fall into the vulnerable category, keep an eye on official communication channels, and if you see community outbreaks near you, then minimise your non-essential travel and self-isolate for your safety.
Stopping The Spread
Each of us has a responsibility to help stop the spread of the virus through our community.
Wash your hands with soap and water for at least 20 seconds. Do this before/after eating, first thing when you enter your home, after using the toilet and after touching public surfaces (e.g. handrails, elevator buttons, public transport).
If you can’t get to soap and water, use hand sanitiser. (Be aware that products like Purell currently have a 3-month backorder.)
In Rwanda, portable hand washing stations have been installed that must be used before anyone can get on a bus https://twitter.com/NewTimesRwanda/status/1237048775526547456 (they currently have zero known cases).
In other countries, we are seeing businesses use point of sale alerts, and email alerts to remind staff to wash their hands throughout the day.
Don’t touch your face. Transmission often comes from you touching a surface and then rubbing your eye, nose or mouth. Try to stop touching your face (this is remarkably hard to do). Some businesses are making a game of this within their team to try and reduce this behaviour.
Do the vampire cough/sneeze. If you do have to sneeze/cough, cough into your elbow or a tissue (that you then put in a bin) and not into your hand. Remind your employees of correct cough/sneeze etiquette.
Don’t go out if you have a fever or cough. If you have a cough or fever, stay home. If you are diagnosed with COVID-19, then stay at home for 14 days.
If you have a cough, then wear a facemask to help protect other people. The only time you need a facemask is if you are ill or if you are caring for someone that is ill. Otherwise, the facemasks are needed to help protect our frontline health workers and you buying them may could put their supply at risk.
In some countries, we have seen every employee’s temperature taken every time they enter the building to stop employees with fever coming to work.
Don’t shake hands or hug. This is the time to practice jazz hands, smiling and nodding, foot taps or Namaste greetings instead of shaking hands or hugging.
Minimise touching common surfaces. Try to reduce touching handrails (unless needed for stability – in which case use your forearm instead of hands if possible).
This is the time where touchless EFTPOS comes into its own rather than handing over cash or keying in your pin and touching the machine.
Use your knuckle to touch elevator buttons rather than using your finger.
You also may want to consider bringing your own cutlery/straw to eateries rather than relying on open utensil drawers.
Remember to regularly wipe down your smartphone/tablet with a disinfectant wipe if you rest it on a surface others touch.
In other countries we are seeing stores that are able to trade putting reminders out over store PA systems each hour to remind people to use hand sanitiser and for staff to wipe down surfaces.
Clean common surfaces. Help stop the virus spread by wiping surfaces commonly touched with household disinfectant wipes.
This includes EFTPOS keypads, public transport rails, the table you sit at in a food court/restaurant, shopping trolley handles, light switches and doorknobs.
Every time you clean a surface, you help others.
Stay 1.5-2m from people. Social distancing works to reduce transmission and takes a bit of creativity to make work in the real world.
- Stagger your shopping trips/commute to avoid peak times.
- If you own a café/restaurant – increase the spaces between tables (remove tables if you have to).
- In schools, increase the spacing between students and hold more classes outside.
- At social events reduce the numbers of people seated at tables and increase the space between each person.
- Limit the numbers of people in elevators. In China, signs on elevators limit each elevator to no more than four people, with tape on the floor in each corner suggesting where people should stand.
- If you have to wait in a queue, try to space yourself 1.5m-2m away from the next person.
- If you are on public transport and someone coughs or sneezes next to you, then move!
- Increase the use of meal delivery services rather than eating out. If you do eat in a public space, try to sit next to rather than facing other people.
Keep fresh air moving. Turn off the recirculating function on air-conditioners (including car air-conditioners). Add a fan or open windows to let fresh air through to spread out the droplets to reduce the viral load you may breathe in.
Reconsider gatherings/meetings. This is something we will see more of as the virus spreads through community transmission, but we are already seeing many conferences, conventions, exhibitions, sporting events and other public events being cancelled across the world.
In Italy, restaurants may only open between 6am-6pm, and all pubs, gyms, schools, cinemas, public landmarks have been closed. Church services, weddings and funerals, sporting and cultural events have also been banned.
In China and Hong Kong, schools have been closed for over six weeks, and parents have had to home school their children, while teachers either live-stream lessons or email lesson plans to the parents.
Chambers of Commerce, BNI and other community meetings have been cancelled in most countries under quarantine.
Work from home. If you can work from home, then work from home as much as possible, especially if community spread is occurring in your area.
Get a flu shot. This won’t stop you getting Coronavirus, but it will mean you don’t get the double whammy of flu + Coronavirus which increases your hospitalisation risk factor.
Protecting Our Healthcare Workers
While ensuring adequate PPE and staffing is beyond our individual control, we all have a role to play in supporting and protecting our healthcare workers.
Call first. Always call your doctor/emergency department before presenting with suspected Coronavirus symptoms, and follow their instructions to the letter.
In most cases, minor symptoms can be managed at home with over the counter medications (that you previously stocked up on). Only go to the GP or emergency (after you have called them first) if you have a fever and are having difficulty breathing.
If You Get Sick Or Need To Care For Someone Who Is Sick With Coronavirus
Everyone needs to know how to care for themselves or their loved ones if they get Coronavirus.
Two Australian GPs, Dr Wendy Burton and Dr Kat McLean, have put together an extremely useful guide covering everything from what quarantine means, through to how to clean your home if someone is sick with Coronavirus.
I recommend everyone dowload and print a copy of their Guide to Self Isolation and Quarantine with COVID-19 for future reference.
If You Are An Employer
You have a duty of care to protect your employees. Measures that we are seeing implemented in other countries:
- Re-routing staff entrances to the building through the kitchen/toilets to ensure staff wash their hands before entering/leaving the building.
- Having hand sanitiser available in all common areas and encouraging staff to use it.
- Having cleaning wipes available for staff to wipe down common surfaces near them throughout the day regularly.
- Ensuring all staff who are sick, do not come to work.
- Many businesses are exploring additional paid leave to all employees (permanent and casual) to cover for quarantine or illness so they can stay home and not have to be forced to work to be paid. Walmart in the US has an excellent emergency leave policy that may provide some ideas https://www.cnbc.com/2020/03/10/walmart-deploys-new-emergency-leave-policy-kentucky-associate-has-coronavirus.html
- Eliminating all non-essential travel and face-to-face meetings.
- Introduce staggered work hours so people can travel outside peak hours on public transport.
- Ensuring all staff who can work from home do so as often as possible.
- Separating desks that are closer than 2m from another person.
- Stop hot-desking during the outbreak.
Read more about what you need to know if you employ staff.
Longer-Term Community Effects
While the initial focus of this piece is on getting through the next couple of months, there will be longer-term effects that will continue to rumble after the pandemic wave has passed through.
Economic instability and uncertainty. Major health events shake consumer confidence, so people reduce their spending.
When this is combined with income instability through quarantine and illness, and business closures or sales due to fewer customers or forced closures, there is less money to trickle through the economy which can trigger a recession. This will lead to more job losses and businesses closing their doors.
The OECD has already warned that the global economy faces the greatest danger since the GFC. McKinsey & Co have developed a useful briefing on possible scenarios and what that may mean for businesses.
Whatever the scenario that plays out, Australia is in for bumpy economic waters as we are still recovering from the major bushfires early this year.
Like all challenging economic times, some businesses will sail through and grow, and others will struggle. Look for opportunities, and seek help if you need it.
This will increase in the coming months as other supply chains are disrupted across the world.
What I predict may happen is that many businesses will start to explore supply chain diversification as a way to reduce future risk. This creates a “buy local” opportunity for local suppliers savvy enough to capitalise on it.
Discounted travel. The travel industry has been one of the hardest hit, and many in the industry will likely fold. However, as the pandemic wave moves through, the more prominent players and travel locations will be competing to get people travelling again, so expect to see once in a lifetime travel bargains being offered.
Predicted Societal changes. The Coronavirus will force many events/groups/workplaces to explore virtual meetings/telework. I predict that this will mean a higher expectation that this should be offered as a “norm” after the pandemic and not as an afterthought. As a society, this will increase inclusiveness for people with disabilities which will have positive flow-on effects for society.
Will handshaking go out of fashion? I think it is too early to tell, but I predict it will be much less prevalent than it is now.
Coronavirus is rapidly moving, and there is still so much unknown about it. Scientists around the world have been working together in unparalleled cooperation to share knowledge and try to get in front of this pandemic.
Right now, we need to do our part to deal with the situation, and yes, that will mean we will all face disruption in our everyday lives. We need to think bigger than toilet rolls and start thinking of our community.
Right now, we can’t afford to be complacent and think it won’t happen to us (or whinge about the measures that are needed). The experience in other countries tells us that this is serious and will impact everyone.
Right now, we ALL need to do our bit to:
- Protect the vulnerable.
- Stop the spread.
- Support frontline healthcare workers.
- Keep the economy ticking over.
Right now, we all need to go and wash our hands!
Disclaimer: The content of this website does not constitute medical advice. If you are sick, contact your general practitioner. The information provided above has been collected from a variety of internet resources including from WHO, credible medical professionals and anecdotal evidence reported in the media. It is provided for information and discussion use only and is not intended to diagnose or treat any illness. There is no guarantee or scientific evidence that following the mentioned guidelines will lead to a reduction in new infections or even stop the COVID-19 epidemic. There is also no guarantee that following these guidelines will reduce the risk of getting infected with SARS-CoV-2 or any other viral or bacterial contagion. All information provided on this website is given with the best intent and will to provide factual information. In no event shall the website operators be held liable for any claim, damages or other liabilities. If you have concerns or comments about the information provided on this website, please write to [email protected]
General Coronavirus Resources
Australian Department of Health
General Information – https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov
Information for Employers – https://www.health.gov.au/resources/publications/coronavirus-covid-19-information-for-employers
State Health Departments
Victoria – https://www.dhhs.vic.gov.au/coronavirus
Fair Work Australia
For information on international travel
Centres for Disease Control and Prevention
This is one of the peak health bodies in the world and has some of the most comprehensive lists of publicly available resources on Coronavirus.
World Health Organisation
For whole of world information and guidance
ABC Coronavirus site: https://www.abc.net.au/news/story-streams/coronavirus/
Our World In Data: https://ourworldindata.org/coronavirus
New England Complex Systems Institute: https://necsi.edu/guidelines-for-coronavirus-in-business-settings
WHO – How to Manage COVID-19 in Workplaces, Meetings and Events https://www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19.pdf?sfvrsn=359a81e7_6
Dr Peter Sandman – Has extensive resources on crisis communications during pandemics. This one is useful in explaining the toilet paper run https://www.psandman.com/col/teachable.htm
Paper on social distancing strategies by Dalton CB, Corbett SJ, Katelaris AL– loads of helpful information.
Useful Twitter Threads
Twitter is designed perfectly for dealing with a crisis. You can follow scientists directly and get current information rather than information filtered through mainstream media.
Where possible, I have used a thread reader rather than linking to Twitter so you can read the posts without having a Twitter account if you prefer.
What China did to stop the spread – By Nicholas A Christakis (Professor of Social and Natural Science at Yale. Physician) (@NAChristakis) https://twitter.com/NAChristakis/status/1237020518781460480
Why he is worried (and the numbers are not why) – Max Roser (Uni of Oxford Researcher) (@MaxCRoser) https://threadreaderapp.com/thread/1236932313642143745.html
Direct observations in China during the quarantine. Tony Lin @tony_zy (Producer & Academic) https://threadreaderapp.com/thread/1236139704627728385.html
Useful People to Follow on Twitter
This my carefully curated list of people to follow on Twitter to get accurate, evidence-based, scientific information about what is happening. There are many Australian scientists and academics on this list.
Dr Norman Swan (Health broadcaster) @normanswan
Dr Siouxsie Wiles (NZ Assoc. Professior Microbiology) @SiouxsieW
Juliette O’Brien (Writer – produces the best collation of Australian Covid-19 stats currently available) @juliette_io
Dr Ian M Mackay (Australian Virologist) @MackayIM
Nicholas A Christakis (Professor of Social and Natural Science at Yale. Physician) @NAChristakis
Dr Anthea Katelaris (Australian Public health Registrar and Epidemiologist) @AntheaKatelaris
Marcel Salathé (Professor EPFL) @marcelsalathe
Liz Specht (Associate Director of Science and Technology) @LizSpecht
Dr Sarah McGuinness (Australian Physician) @drsarahmac
Dr Emma Hodcroft (Uses programming & phylogenetics to study & track diseases (mostly viruses). @firefoxx66
Allen Cheng (Australian Physician, epidemiologist/statistician) @peripatetical
Marc Lipsitch (Infectious disease epidemiologist and microbiologist) @mlipsitch
Dr Kat McLean (Australian GP) @drkatmclean
Dr Wendy Burton (Australian GP) @Lady_Gwendoline
Victorian Chief Health Officer @VictorianCHO