Inside Covid-19: Best way to use next 21 days; infections pass 450,000; $2trn cash injection for USA – Ep 4

In this Inside Covid-19 episode, stock markets surge to their best session since 1933 after the US throws trillions of dollars at its economy. The South African Reserve Bank has started to follow suit, and we’ll hear from a respected economist why this is a very good idea. On the other hand, not such a good idea is Donald Trump’s intention to reopen the US economy in three weeks as we hear about conditions on the ground in America’s virus epicentre, New York City. And on the local front, we get to grips with the 21 day lockdown and hear about how to use these three weeks to best effect. – Alec Hogg

Ron Whelan joins us now. He’s the chief commercial officer at Discovery Health to bring us up to date on what’s happening around the world. I look at John Hopkins University every day and I see we’re now looking at 438,000 infections and more deaths. How are you reading it?

Thank you Alec. This has certainly been an unprecedented crisis. Many of us have never gone through this sort of epidemic in our lives and you’re correct around those numbers – 438,000 infections as of this afternoon. We’re now pushing 20,000 deaths. The interesting thing about those deaths is that they are concentrated in the European and high risk countries. 7,000 of the 20,000 deaths in Italy, 3,500 in Spain, 30,00 deaths in China and that epidemic has obviously slowed over the last few weeks or so. In fact China’s recording almost no growth at the moment so they have a handful of infections every day. Iran is now up to 2,000 deaths. If you tabulate those, we’re sitting at around about 15,000 of the 20,000 deaths across 4 countries. And that’s an important calibration point for all of us. There’s a few concentrated outbreaks.

Here in South Africa, Any deaths reported yet?

No deaths yet. So as of this morning we’re at 709 infections, obviously an alarming number, but not surprising given the growth we’ve seen in other countries. Typically you’re seeing growth of around about 30% per day – in many countries in the early phases of infections – and South Africa’s tracking exactly on that trajectory. This is the reason the government has moved so quickly around mitigation strategies because if we’re able to flatten the curve, it gives us the best chance of getting a good outcome with no deaths yet. The other thing that’s interesting about the South African epidemic – at this stage – is it’s affecting many young people so we’re tracking the numbers very closely both in the NICB as well as within Discovery Health. We obviously have a number of Discovery Health members who are now affected by this too. It’s a very young and healthy population at this stage of the game – which is good news by the way – because when you look at the Italy and Spain outbreaks most of the deaths are happening to the elderly. In fact in Italy, the average age of death is 80 years old – 79.5 years old. So that bodes well in terms of mortality in South Africa.

How long are the young people who are being infected in South Africa taking to get over it or is it still too early to tell?

Well over 80% of people are either asymptomatic or don’t have any symptoms, or have very mild symptoms. Generally, if you’re young and healthy, it’s a typical flu-like illness. It starts with a fever and a cough and a general feeling of being unwell, we see that in the first 2 or 3 days, then you go through a bit of an uptick in where you feel a little bit better and then it seems to come back around 8 or 9 days where people tend to feel tired again. You have a little bit of fever again but after days 8 and 9, you’re well on your way to recovery. Most people after 14 days have no issues. In fact we follow up with all of our Discovery Health clients just about every day to check in – how people are doing – and offer any support we can. By and large, people are very comfortable and have no issues whatsoever. We’ve had very few admissions on the Discovery healthier client base, which is very reassuring and positive for us.

Clearly the fact that people are younger is in our favour but on the other hand, is the weather playing a part in it? The fact that we have had some pretty warm days for this time of the year?

Yeah there’s lots of questions being asked about the weather at the moment and whether temperature and humidity is a factor, whether the virus is sensitive to heat and ultraviolet light. Lots of studies happening globally. The evidence thus far is inconclusive. We can’t say whether it has anything to do with increased infection rates, you can’t say whether heat or humidity has any impact on the virus particle – hesitant to hazard a guess on that at this stage of the game – what does make it complicated for South Africa over the next 2 or 3 months, is that unfortunately Covid-19 is hitting us at exactly the same time as flu typically hits us. So our flu season typically starts towards the end of March and we’re heading into a flu season plus a Covid-19 season. The symptoms are very similar – flu and Covid-19 – so at Discovery we’re on a very big drive to please get your flu shot this season. If there’s one season you need a flu vaccine, it’s this season and the reason you need a flu vaccine is you don’t want a double whammy of Covid-19 and the flu. If we can take one of those diseases out of the community, it would be massively valuable to our healthcare system and to the health and lives of people across the country.

Are those vaccines available? I know my GP has been complaining, she’s sends us WhatApp’s all the time to say that she still hasn’t managed to get any flu vaccines.

Flu vaccines are in very short supply this year – perhaps not so short supply given the relative demand for flu vaccines – we’re getting around about the same amount of flu vaccine doses as we would in any given year but given the demand for flu vaccines it’s going to be tough to get a flu shot so I’d urge people to get to their local pharmacy or get to their doctors, get in front of the queue. We’ve actually – as Discovery – been in contact with the big pharmaceutical companies who make the flu vaccine and tried to secure more supply so we do have some more supplies coming into the country this year, but it’s certainly not going to meet the demand. So it’s important that you move on the flu vaccine as quickly as possible.

From Discovery’s point of view, when the emergence of this novel coronavirus started, you would have been paying attention – I guess you go back 2.5, 3 months now – what exactly do you do in an organisation like yours to prepare for this?

That’s a great question Alec and it’s been almost 2.5 months. We started early in January. Coming back from December vacations for all of us, in the first week of January we spotted a trend in China. Discovery partners with a group called Ping An Health in China and they alerted us to the developments in Wuhan in China. So we knew that there was something on the boil. We had started watching the situation closely. We started learning more about the virus and about the spread of that. We exchanged learnings from our colleagues in China at the time and we started preparing some of the awareness and communication material The second thing we’ve done is we’ve assembled a very senior leadership team to drive and coordinate the response.

And you mentioned Ping An, no doubt you’re getting a lot of support there, but what about your colleagues at Vitality in the UK? Neville Koopowitz and his team.

We speak to them on a regular basis. Neville is the CEO, we’re on the phone I would say – if not every day, every second day – in regular contact sharing learnings around how the epidemic is unfolding in the UK. They’re learning a lot from us. We’re learning a lot from them. They’ve got some very innovative responses. We’ve got some innovative responses. In addition to that we’ve obviously got colleagues in the US as well – in Chicago – and yeah, we’re learning a lot from them as well. So we really have coordinated our response across the different marketplaces to share best practices and learnings.

So the UK has now – belatedly perhaps – decided to go into lockdown. We are going into lockdown on Thursday night. 

We’ve been preparing for this for a while. We ran our first lockdown dry run 3 weeks ago. Admittedly, not to the extent we thought we were going to have to run a lockdown, we thought at that stage, a provincial or a Metropole lockdown was likely. But we were starting to dry run scenarios 3 weeks ago. What we are also doing – 3 weeks ago already – a work from home strategy where we could. This has been a process for us over the last 3 weeks.

For those of us who are home – who are going to be at home – you presumably need to be employing something to stay healthy and to not get this virus?

The most important thing – and this is the strategy Discovery has been driving, the government is driving very hard at the moment – the most effective response globally, has been social distancing and spatial separation. There’s a very simple physics around this, the virus is spread by droplets – small little liquid droplets that come out of your mouth and nose when you cough, sneeze or talk – and the reality around the physics of the saliva droplets is, that they don’t typically spread further than 1.5 to 3 metres and that’s why social distancing and spatial separation is so effective. So as long as you’re further than 2 metres away from someone who’s got Covid-19 as an infection, you are generally safe. The second way Covid-19 spreads is these droplets land on different surfaces, the surfaces can be tables, desks, elevator rails or railings and they can survive on those surfaces for a period of time. There’s lots of research around how long they survive and if you’re touching those surfaces and you bring your hand to your mouth, you get infected. If you play that back into a home environment, if you’re at home you’re separated from any potential Covid-19 contact. What’s useful being at home is you’re not going into the public spaces and coming into contact with someone who is infected. The second thing is that your home environment – so long as no one in your home is being infected – is a relatively sterile environment from a Covid-19 perspective. You’re not picking up Covid-19 on your hands. What that does is, if we’re all staying at home and we’re all socially separated for a little while – and by the way we’re not socially separated because we have this thing called social media where we’re still very much more socially connected, we’re physically separated for a while – what that does is it gives us a gap and it gives us time where we’re able to reduce the infection rate. So that’s why being at home is so important. That’s the one aspect of being at home and being healthy at home, it prevents you from getting Covid-19 and more importantly prevents Covid-19 from propagating. I think the second aspect of being at home – and we’re pushing hard on this at the moment, not only across the employees and also across our members – now is an opportunity to be physically active. The weather is still pretty good, you’ve got time on your hands, you don’t need to spend time in traffic, so we’re working at the moment on stretch classes and pilates classes and yoga classes and healthy eating, runs around the garden if you’ve got some space, so there’s an opportunity to get physically healthy over the next 21 days. I think a third aspect that is really important is to maintain good mental wellbeing. It’s really important to maintain your social connectedness, to maintain a positive outlook. This is not jail time. We would encourage people to certainly remain connected, to talk to people who are virtual obviously, but watch your mental health over the next 21 days.

Brilliant. What are the chances of this being extended?

That’s a very tough question to answer.

Maybe, when will we know whether it’s working or not. How deep into the 21 days will we get an idea?

What we’ve got to do over the next week or so is watch the infection numbers closely and I think we can expect the infection numbers to grow quite a bit over the next 7 days or so, we then – if our strategy is successful – as they’ve been by the way in countries like the Republic of Korea, Korea has been very successful in stemming the tide on the infection rate. So Korea went up to 1,000 odd infections and they’ve stayed at 1,000 infections for the last 5 or 6 weeks. That’s the trajectory we would like to follow. That’s the essence of flattening this curve. All of the stuff we’re doing right now and all of this stuff our president introduced last week – in terms of our travel bans and this week in terms of our lockdowns – is designed to help us flatten that curve so that we are able to keep this epidemic under control. We will obviously watch these things closely over the next week or two. The more we work together on this, the more chance we have of flattening the curve, the more chance we have of getting through this as quickly as possible.

But I guess for the uninitiated if we finish the 21 days and the curve has flattened, the number of infections hasn’t been growing, what risk is there – if we all go back to work again – of just starting up again?

That’s a great question. So I think the first principle is that it will be a gradual return to normality. So it’s very unlikely that all restrictions will be removed immediately after the 21 days. It will likely return to some level of normality gradually and start to open up businesses and open up schools and universities and so on. This will more than likely be a process over a few months. And depending on how successful we are on flattening the curve, that would dictate the timelines. The best measure we have is the Wuhan response so we’re on it in China. Wuhan over the course of two months – had a very aggressive social distancing campaign and spatial separation campaign, was very effective in getting people separated, getting the curve flattened and is now starting to come back online. In fact, as of this week they’re loosening restrictions. Around about the middle of January they started to spike and then started to put these restrictions in place. So that’s about our most reliable case study. We’re starting to see the Republic of Korea come out of the snarls – also somewhere around a 6 to 8 week time frame – but those are two countries that did a remarkable job. They kept it under control and I think everything South Africa has done so far has been very solid and robust. We have moved quickly on this. The response by the government has been extraordinary and we’ll all work together, we’ll hopefully get through this much quicker.

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