‘Superspreader’ sparks second wave fears
South Korea was celebrating. COVID-19 was down for the count. Businesses were back. Bars were open. But it took just one unwitting party animal to wreck it all.
The virus behind the global pandemic is highly contagious.
A dramatic "superspreader" event in Seoul has reminded us of that.
And it's a warning of what lies ahead as Australia begins to relax its lockdown.
Just days after reopening its 2100 nightclubs and bars, the capital of South Korea has ordered them to close once again. Almost 6000 venues in the surrounding province also are shuttered.
At the weekend, the country's health system reported the sudden appearance of more than 40 new coronavirus cases. It was the first time in a month the figure had spiked so high.
Contact tracers immediately went to work. What had caused this disturbing turnaround?
Turns out, it was mostly due to just one 29-year-old man.
He was desperate to let his hair down after long weeks confined to his home.
He went on an epic pub crawl to make up for the lost time.
In the process, he infected at least a dozen fellow partygoers. Some 30 infections are linked to the five nightclubs he visited. A further 7200 people may have been exposed.
Now South Korea is bracing for a dreaded "second wave" of pandemic cases.
"A drop of ink in clear water spreads swiftly," Vice Health Minister Kim Gang-lip told a media briefing. "Anyone can become that drop of ink that spreads COVID-19."
In the space of a weekend, South Korea's government has lost confidence in its COVID-19 rebound.
"At this moment, it's too early to say whether we need to postpone the opening of schools, but we will monitor the spread of the virus and review information" director of the Korea Centers for Disease Control and Prevention Jeong Eun-kyeong told media.
Things had been looking good. For more than five days, the country had been recording no more than ten new cases daily. Well-targeted physical distancing measures combined with extensive contact tracing had put South Korea in this healthy position.
Keen to get the economy rolling again, the national government began relaxing its physical distancing guidelines. It initiated a phased reopening of the community.
Stadiums. Clubs. Schools. Restaurants. Museums. Libraries. All were scheduled to reopen in stages over the coming weeks.
But this 'superspreader' event has put all plans on hold.
It's been a stark reminder of the power of the COVID-19 virus, and how it's capable of seizing any opportunity to restart its exponential spread.
South Korea is well aware of the knife-edge its pandemic response rests upon.
"The (partygoer) infection cluster has raised awareness that even during the stabilisation phase, similar situations can arise again, anytime, anywhere in an enclosed, crowded space," South Korean Prime Minister Moon Jae-in told media. "We must never lower our guard regarding epidemic prevention … It's not over until it's over."
UNCAGING THE BEAST
COVID-19 hasn't been beaten. Anywhere.
It's like a caged animal, pacing its enclosure looking for the first opportunity to escape.
And a Harvard epidemiologist has warned even the rampant US outbreak will likely see a second-wave explosion soon.
Professor of epidemiology Marc Lipsitch says the rush to get the wheels of industry rolling again will take a terrible toll on lives.
"Almost every government is talking about lifting control measures. Not every government, but many, because of the economic burdens," he told the Conversations with Dr Bauchner podcast. "Given the fairly high caseloads that we have in the United States, that's a really risky thing to do right now."
He says the northern hemisphere summer has produced a 20 per cent decrease in the virus' transmission rate. "That's only enough to slow it down, but not enough to stop it."
Which means COVID-19 is waiting in the wings for a fresh outbreak opportunity.
"We will have a harder time controlling coronavirus in the fall … and we will all be very tired of social distancing and other tactics. The hard thing will be to keep enough of it to protect our ICUs and keep the number of cases from flaring up," he says.
Making matters worse is an unfounded sense of optimism among all levels of government.
"Many jurisdictions will have a plan to open up but not a plan to reclose, leading to more situations like New York, New Orleans and Detroit," he warns.
It's a problem confronting governments around the world.
Professor Lipsitch's fears are already panning out in Germany.
Its physical distancing policies averted the murderous chaos of Italy and Spain. It recorded some 170,000 sick and about 7400 deaths.
But that success has produced a price.
Germany's public is increasingly unconvinced of the need to maintain strict limits on social and economic activities.
It's based on broken logic being trumpeted by lobbyists, columnists and conspiracy theorists: There is no terrible outbreak. Therefore, the measures needed to prevent one aren't required.
Last week, German Chancellor Angela Merkel announced the gradual reopening of shops, restaurants, bars and schools.
People surged back into the streets. Thousands protested at the weekend for a total lifting of the lockdown. Social distancing and hygiene rules were largely ignored.
Now, the medical research group Robert Koch Institute has found Germany's COVID-19 infection rate is back on the rise.
A week ago, the virus was diminishing. The basic reproduction number was 0.65. This means every three sufferers were only infecting another two.
That number has since increased to 1.13, meaning the virus may already be resurging.
German authorities are anxiously watching the numbers unfold, knowing that they may have to reimpose "emergency brake" lockdown measures on an unwilling public. The trigger point is when cases rise to 50 new infections per 100,000 in the space of one week.
'SECOND WAVE' SACRIFICE
The world is sick of social distancing.
But those who fall sick with COVID-19 are still dying at an alarming rate.
Ultimately, communities are being asked to weigh the value of their economies against that of the aged and immunocompromised.
But it's not a simple equation.
Lockdown itself comes with a blood-price through suicide and loneliness related deaths. Not to mention economics.
And incomes dramatically affect lifestyles and access to healthcare.
In the absence of any isolation measures, the Australian government projects some 68 per cent of the population will rapidly contract the virus.
"Our estimates suggest this would result in more than 287,000 deaths from COVID-19 as the health system could not cope with the volume," writes Monash University mental health researcher Neil Bailey.
"We assume this would produce a recession lasting five years instead of ten, with 10 per cent initial unemployment and an associated 753 extra deaths from suicide."
He has analysed the economic and human costs of fighting or capitulating to COVID-19.
Under a controlled 'herd immunity' plan - where the infection rate is reduced to levels hospitals can cope with - he says modelling predicts a fall to 141,000 deaths from COVID-19. "We assume this would result in a deep recession of ten years with 15 per cent initial unemployment and an associated 4015 deaths from loneliness and 2,761 deaths from suicide."
Going in hard and early with a full eradication program, Bailey argues, will slash COVID19's toll to just 27,000 lives. The inevitable deep recession will still take a steep toll in suicides and related deaths.
"People are understandably concerned about what the lockdown will do to their jobs, businesses and investments. That damage extends beyond lives lost," he says.
"Yet our calculations clearly suggest that, when it comes to human lives, far fewer will be lost by continuing restrictions than would be lost by ending them now."
Jamie Seidel is a freelance writer | @JamieSeidel