Author Archives: Dr Lachlan Soper

Six Essential Criteria the WHO says Need to be Met Before Lifting Restrictions

WHO Director-General Dr Tedros Adhanom Ghebreyesus has reminded the world of six essential criteria that WHO argues need to be met before lifting restrictions:
1. countries must have strong surveillance, declining cases, and controlled transmission;
2. the health system must have the capacity to detect, isolate, test and treat every COVID-19 case and contacts;
3. outbreak risks must be minimised in special settings such as health facilities and aged care;
4. essential venues such as schools must have preventive measures in place.
5. the risks of importing the virus must be managed;
6. communities must be fully educated, engaged and empowered to adjust to “the new norm”.
“The risk of returning to lockdown remains very real if countries do not manage the transition extremely carefully and in a phased approach,”

Dr Lachlan Soper

Tracking COVID-19 hotspots through raw sewage

Researchers from the University of Queensland and CSIRO have successfully been able to identify genetic traces of COVID-19 in raw sewage.

‘The hope is eventually we will be able to not just detect the geographic regions where COVID-19 is present, but the approximate number of people infected, without testing every individual in a location’ – CSIRO Chief Executive Dr Larry Marshall

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Dr Lachlan Soper

Another unanticipated consequence of the COVID-19 lockdown – with a silver lining

Major metropolitan hospitals are reporting a 25-40% drop in road trauma, assaults and sports injuries. Even more pleasing, with pubs closed alcohol-linked violence and injury have plummeted!

Infectious disease presentations have also fallen sharply, with dropping rates of influenza, rotaviruses, and other infections meaning fewer hospital attendances.

A question arises regarding the reduction in presentations for strokes, heart attacks, and chronic obstructive pulmonary disease exacerbations. Has there been a real reduction in the incidence of these things because people were at home (and there were not inflammatory or infective triggers for these)? Or is it a problem, where people didn’t attend hospital when they should have?

The latter theory may be backed up by surveys showing that general practices are overall down 30% in revenue (despite telehealth). Also by data showing that 30% and 40% of private and community pathology testing was currently not being done due to people not visiting their medical practitioner and not having their pathology samples collected.

Will there be a surge of serious medical issues once the lockdown eases, as patients who may have put off treatment return to the healthcare system? Time will tell.

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Dr Lachlan Soper

Unanticipated consequences of COVID-19 lockdowns: people getting seriously injured with home handywork

CareFlight has noticed a “dramatic” upswing in people falling from roofs. As people are restricted to home, they lose their jobs or they cannot get help, more of them are attempting unsafe home renovation work. Work safely!

“As more people are undertaking home projects that put them at risk, CareFlight urges individuals to take appropriate precautions when performing maintenance around the house.”

Dr Lachlan Soper

How does our nation get through COVID-19? Options: Eliminate or adapt.

How do we balance the prolonged damage to the economy, society and medicine (in other medical issues not being treated) by choosing to ease restrictions vs the potential consequences of further spikes in COVID-19 cases and deaths?

Do we keep the strict “lockdown” until all active cases diminish to zero, and then wait a further 14 days until there have been no new cases – eliminating the virus?

Or do we ease things a little, knowing that COVID-19 will not be controlled and more people will die from it?

The Group of Eight, an affiliation of leading Australian research universities, this week published a report inviting the Australian Government to choose between two contrasting but related strategies: ‘elimination’ of COVID-19, and a ‘controlled adaptation strategy’.

Under the elimination scenario, Australia would continue its nationwide please stay-home order for two further weeks after daily cases reach zero. That means lockdown would last until likely June, given the current trajectory of cases. BUT after that, many social distancing measures could be lifted quite quickly, due to minimal risk of societal spread of disease.

However, in the ‘controlled adaptation’ strategy, the Government would still use extensive “test-and-trace” protocols (to test broadly and trace comprehensively anyone who has come into contact with someone with COVID-19) to keep the number of new cases as low as possible. The positive with this strategy is that lockdown restrictions would be lifted sooner, not fully, but gradually, with continued social distancing measures – in parks, work, schools and shopping areas. These measures lasting for perhaps years.

The advantage of elimination is that people can go back to close proximity sooner (eg: gyms and sitting down in cafes).

The advantage of controlled adaptation is that it may allow less strict travel restrictions later this year or next year. Something which is important for the parts of our economy which rely on people flying in from overseas – in particular the education industry.

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Dr Lachlan Soper

All cause mortality will better evaluate the impact of COVID-19 on deaths

All cause mortality will pick up deaths caused:

  • directly by the virus (eg: respiratory failure),
  • because another disease worsened by the impact of the virus (eg: COVID-19 predisposed to a heart attack), and
  • due to non-presentation or treatment of a disease due to the COVID-19 lockdowns and changes to outpatient and inpatient medical systems

Official statistics are significantly underestimating the true death toll across the world. To calculate excess deaths, the Financial Times compared deaths from all causes in the weeks of a location’s outbreak in March and April 2020 to the average for the same period between 2015 and 2019. The total of 122,000 amounts to a 50 per cent rise in overall mortality relative to the historical average for the locations studied.

The ABC reports that for the UK alone the number of ‘excess deaths’ – deaths above a usual year – have more than doubled in recent weeks, with 22,351 in the week ending 17 April. A normal year would have 10,000 deaths.

While some of these deaths may be due to other causes than COVID-19, the fact the death rate is so much higher than a normal year indicates the pandemic is playing a major role.

The surge in all-cause mortality suggests either an underreporting of COVID-19 deaths, or increases in other causes of mortality because people are avoiding healthcare.

Read more on: Financial Times.

Dr Lachlan Soper

Why do different countries have vastly different death rates from COVID-19?

According to today’s data from John Hopkins University , the United Kingdom has a Case Fatality Rate (CFR) of 15.5%, this means that for every 6 & 1/2 people diagnosed with COVID-19 in the UK, one will die. However, the CFR for Australia is 1.33%. Both of these countries share a similar heritage, wealth and good medical systems. So why the huge difference?

University of Queensland virologist Ian Mackay said that testing is likely to be the key:  ‘My crude presumption has been that in jurisdictions where rates of death are above 1%, there has been too little testing to capture the denominator,’

The Oxford University Centre for Evidence Based Medicine (CEBM) postulates the following reasons that the CFR varies so greatly country by country:

  • The number of cases detected by testing will vary considerably by country
  • Selection bias can mean those with severe disease are preferentially tested
  • There may be delays between symptoms onset and deaths, which can lead to underestimation of the CFR
  • There may be factors that account for increased death rates such as coinfection with another disease, more inadequate healthcare and patient demographics
  • There may be increased rates of smoking in some countries or comorbidities (such as cardiovascular disease) amongst the fatalities
  • Countries with populations that are older get worse hit by COVID-19 (eg: Italy with the 2nd oldest population in the world)
  • Differences in how deaths are attributed to coronavirus – dying with the disease (association) is not the same as dying from the disease (causation)

Another point to note is that COVID-19 may not be as fatal as the “Case Fatality Rate” implies. CFR rates are subject to selection bias as more severe cases are tested – generally those in the hospital settings or those with more severe symptoms. The number of currently infected asymptomatic people is uncertain: estimates put it at least a half are asymptomatic; the proportion not coming forward for testing is also highly doubtful (i.e. you are symptomatic, but you do not present for testing). Therefore we can assume the IFR (infection fatality rate) is significantly lower than the CFR.

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Dr Lachlan Soper

Infectious Diseases Epidemiologists advise that it is too early to open up society

Dr Kathryn Snow and Professor James McCaw, infectious diseases epidemiologists at the University of Melbourne advise that it is too early to lift social restrictions at large risk of a large secondary wave of infections.

“Any epidemic is a random, unpredictable process like a bushfire….At the moment we have spot fires, but they have a habit of surprising you.”

“There’s no surveillance system in the world that picks up every single case. We will still need other risk mitigation in place, and for this virus that means social distancing until we have a vaccine.”

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Dr Lachlan Soper

What happens when countries open up too early after a Pandemic. A look at the 1918 Spanish Flu

During the 1918 Spanish flu pandemic, “social distancing” was also employed. Like is happening in our time businesses were suffering from the lack of revenue, and so there was pressure to ‘re-open’ society.

The below article looks at Denver, a city which loosened social distancing rules too early. They ‘opened up’ before cases were effectively eliminated or there was sufficient heard immunity and had a second wave of infections that killed even more.

“Premature declarations of victory guarantee defeat. Buckling to protests increased the number of dead.”

It shows that towns, cities, states, countries that socially distanced for longer and consistently did better in terms of the number of infections and deaths.

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Dr Lachlan Soper

Testing for COVID-19 available for all people with respiratory symptoms in NSW

New South Wales is increasing testing for COVID-19 by expanding the testing criteria to include all individuals – particularly healthcare, aged care or other high-risk workers – with symptoms of acute respiratory illness including fever, cough, shortness of breath tiredness or sore throat.
This is due to NSW doubling its laboratory testing capacity from 4000 tests per day to 8000 per day.
Even people with mild symptoms are being encouraged to come forward for testing to help identify as many COVID-19 cases in the community as possible.

Dr Lachlan Soper

Ingredients to great conversation. Be prepared to be amazed – Celeste Headlee

In this talk by Celeste Headlee, she outlines the ingredients of a great conversation: Honesty, brevity, clarity and a healthy amount of listening. And most importantly, “be prepared to be amazed.”

Most of us need to be challenged to apply our minds to what we hear, before we engage our mouths to add our opinion.

10 Rules for better conversations:

  1. Don’t multitask. Be present. Be in that moment. Don’t be half in the conversation
  2. Enter every conversation assuming you have something to learn. Everybody is an expert in something
  3. Use open ended questions. Who, what, where, when, why or how? What was that like? How did that feel? It gives a more interesting response.
  4. Go with the flow. If thoughts come into your mind, let them go.
  5. If you don’t know, say that you don’t know.
  6. Don’t equate your experience with theirs. Their loss of a family member, job loss vs your family loss or job loss. Their and your experiences are different.
  7. Try not to repeat yourself. It’s condescending and boring.
  8. Stay out of the weeds. People don’t care about the years, names, dates… They care about you, what you are like, what you have in common.
  9. Listen. Keep your mouth shut as often as you possibly can. Keep your mind open. Always be prepared to be amazed.
  10. Be brief.


“Conversational competence might be the single most overlooked skill we fail to teach.

Kids spend hours each day engaging with ideas and each other through screens. But rarely do they have the opportunity to hone their interpersonal communication skills. Is there any 21st Century skill more important than being able to sustain competent confident conversation. Paul Barnwell, High School Teacher

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Dr Lachlan Soper

How near could Australia be to opening the economy and society post our COVID-19 pandemic?

With the number of “active cases” in Australia at 1473 (see 2nd graph in link below) , & the number of new cases in the nation hovering between 8 and 23 daily for the last 6 days (see 3rd graph), could Australia wait for those 1473 to recover and 14 days of no new cases to resume our society & economy with closed international borders?

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Dr Lachlan Soper

“Controlled Contagion” for getting through COVID-19

Prof Ian Fraser (who developed the cervical cancer vaccine) and others such as Dr Guy Campbell have proposed that IF a vaccine for COVID-19 is developed it is likely 12-18 months away. Therefore we need to think about “controlled contagion” whereby younger (less vulnerable) people are gradually allowed back into society.

The reason for this is the questions that have been rightly asked by many about the negative effects of the social isolation policies (or lockdown as colloquially phrased), including:

  • Deterioration in mental health – increasing anxiety, depression, domestic violence and suicide.
  • Missed cancers in people not presenting to their usual doctor or hospitals as they usually would.
  • Deterioration of chronic diseases such as diabetes and cardiovascular disease
  • Delayed surgery
  • Not to mention the broad and likely long-lasting economic and employment effects of the social isolation policies to combat the COVID-19 pandemic.

The idea with “Controlled Contagion” is to slowly develop a community “heard immunity” in a sustainable way. This could be done by bit by bit allowing those at lowest risk of severe disease and death from COVID-19 back into society. Noting that statistics from Imperial College London, UK, show only 0.06% of those younger than 40 who are diagnosed with COVID-19 require intensive care. The risk of mortality in those under 40 years is less than 0.03%, and so is less than the current consequences of influenza.

However, 23% of those infected with COVID-19 who are over 60 year old will require hospital admission, of which 47% will require ICU. As a result, those over 60 will account for 90% of ICU demand, even though they make up only about 20% of the population.

Nobel Prize winner Professor Peter Doherty is strongly convinced re-infection is unlikely, and “even if it was … your prior infection would give you very rapid immunity and you would recover very quickly.”

By allowing all healthy individuals under the age of 60 to return to work under the present restrictions of social distancing, the virus would be allowed to spread in a sustainable and more controlled manner.

We could start with those under 40, and then under 50, and then under 60, while maintaining self-isolation for those over 60-years of age.

This is a proposal worth reasoned consideration – to minimise the medical, economic and societal consequences of the COVID-19 pandemic (in their totality over the next number of years as all of the consequences play out).

Dr Lachlan Soper

COVID-19 isolation is suppressing the spread of influenza as well.

According to the latest weekly FluTracking report, rates of flu-like symptoms in the community have dropped from a peak of 1.6% in early March to a historic low of 0.3% in mid-April.

This is significantly lower than the 1.8% incidence of flu-like symptoms reported at the same time last year.

Influenza vaccination has also skyrocketed thus far this year. Since 1 March over 2.1 million flu vaccines have been administered and recorded in the Australian Immunisation Register compared to 634,000 at the same time in 2019, and 235,000 in 2018.

For more information see

Dr Lachlan Soper

Walkers, runners and cyclists need greater distances apart to prevent transmission of viruses incl. COVID-19

Keep exercising, but stay outside slipstreams.

A research paper by Prof. Blocken et. al. looking at wind and fluid dynamics, shows that greater distances of “social distancing” are required for exercise for no droplet exposure to the person behind. While 1.5 to 2metres apart may be sufficient for people exercising side-by-side, the distance to the person behind varies for different exercises (as studied in wind tunnels) and for different speeds of that exercise.
“If someone exhales, coughs or sneezes while walking, running or cycling, most of hte micro-droplets are entrained in the wake or slipstream behind the runner or cyclist. The other person who runs or cycles just behind this leading person in the slipstream then moves through that cloud of droplets” Prof Blocken.
The distance to the athlete / exerciser in front should be no less than:
5 metres when walking at 4km/h
10 metres when running at 14.4km/h
20 metres cycling (the cycling data

As the paper has not been peer reviewed yet, a link to a journal is not yet available, but he has released his data considering the need for good data in short time with the current pandemic.

Dr Lachlan Soper

COVID-19 template for telehealth consultations

The attachment below is the infographic flow chart that primary health care workers use for telehealth. Although it’s intended for doctors, it gives a good idea what they are looking for. The little circles down the right hand side indicate the frequency of symptoms.

The most common symptoms of COVID-19 in order are:

Cough, temperature, fatigue, sputum with the cough, shortness of breath, muscle aches, sore throat, headache, chills.

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Dr Lachlan Soper

COVID-19 detected on shoes

COVID-19 is spread by our shoes. Consider taking off shoes & putting them in a bag after you leave potentially infectious areas.

Also COVID-19 has been detected in air about 4 metres away from patients, as well as on computer mouses, bins and sickbed handrails.

Is 1.5m enough for social distancing?

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Dr Lachlan Soper

More than 2-000-000 cases of COVID-19 worldwide

Worldwide COVID-19 cases now top 2million with 128-000 deaths.
That’s 6.5% of people detected with COVID-19 dying. The death rate is greater than 10% in the UK, Spain, France and Italy!
On the positive side, worldwide, the number of new cases daily is increasing at a slower rate.
Australia has nearly 6500 cases confirmed, with a 1% death rate.

Dr Lachlan Soper

Should Australia aim for complete COVID-19 elimination?

“The least-bad endgame is to eliminate the virus from Australia, continue to control our borders until there is a vaccine or a cure, and restore domestic economic and social activity to “normal”, albeit keeping a close watch for new cases” Grattan Institute.

I think this makes the best sense as a strategy. Australia is lucky to be an island, and a long way away from other countries. We can keep our borders locked down. And, if possible, complete elimination enables people to go back to work, school, local holidays etc… (albeit somewhat disengaged from world trade).

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Dr Lachlan Soper

Could Australia ease stage 3 COVID-19 isolation restrictions in June?

A paper from the Grattan Institute, looking at the reduction in new cases of COVID-19 in Australia, using modelling from the Universities of Sydney and Melbourne give hope that Australia could possibly get to 0 cases of coronavirus around June.

As they say “Getting from ‘nearly 0 cases’ to 0 cases is the toughest part of the elimination strategy.”

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Dr Lachlan Soper

Simple educational video on COVID-19, worthwhile for discussions with family.

The attached link is an educational piece from Wolters Kluwer who do medical education. It’s a good, simple yet reasonably comprehensive piece on COVID-19. It’s particularly good for those who have not been following the disease closely – like children, teenagers or to give to patients as a starting point for discussions. It discusses things like:

What is coronavirus?

What it affects.

How does it spread?

How long it takes to get sick after exposure.

What are it’s symptoms?

How to get help – call first.

How to prevent it: Good use of hand sanitiser and handwashing technique; social distancing; cleaning surfaces; masks

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Dr Lachlan Soper

Health economic impacts of COVID-19 – a very tough moral and ethical discussion

This ‘health-economics’ blog by Scottish GP Dr Malcolm Kendrick is worth considering in any rational discussion on the whole-of-society impacts of COVID-19. The fact that money to treat patients is finite is a harsh reality worth consideration.

Every person comes at such a discussion with a different bias and perspective, in what is a very emotive topic. Lives will be lost, in large numbers, whatever choices or paths are taken.

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Dr Lachlan Soper

How to prepare for your entire day to be virus (COVID-19) free

For those who work on the “frontline” this article is a great piece on how to reduce your risk of infection as you: prepare for work, transport there, arrive, during the day, how to leave, getting in the car and arriving home.
There is A LOT to think about. There are so many things that we do during the day, that we take for granted, that need to be thought about in ways that we have not done so before, and be meticulous in preparation.

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Dr Lachlan Soper

World-first “living guidelines” for treatment of COVID-19

By “living guidelines”, it means that they are updated as new information comes in, rather than multiple versions over time. This will have up-to-the-minute recommendations.

There are 4 key tabs:

  • Living Guidelines
  • Decision Flowcharts
  • Evidence Under Review
  • What Further Guidance is Needed.

While these guidelines are intended to assist overwhelmed medicos, they are also a good source of information to the discerning reader in the public.

As time goes on the guidelines will endeavour to answer questions that people ask of their GP when consulting them.

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Dr Lachlan Soper

Covid-19. Winter is Coming (a very unfortunate pun on Game of Thrones). Thoughts from Prof. Peter Collignon

“This problem is going to continue until a lot of us are either immune, which means we’ve caught the infection, which is not a good idea, or we get a vaccine that is safe and effective,”

“I don’t think life is going to be normal in three months. It would be nice if life was reasonably normal in six months, but that’s the earliest horizon,”

“My honest view is this will go on for 18 months to some degree.”

“Every winter you have ten times more transmission of respiratory viruses than summer or autumn. The real worry for Australia is June to early September. That’s when we might have to be more restrictive on what we do.”

Professor Peter Collignon, an infectious diseases expert at the Australian National University.

Dr Lachlan Soper

Clinical Course of COVID-19: presenting symptoms, how the illness progresses clinically, and why patients deteriorate

According to the Department of Health, the recognised symptoms of COVID-19 (coronavirus) currently include fever, shortness of breath, and flu-like symptoms such as coughing, sore throat and fatigue.

Others may include reduced sense of smell or taste, altered taste, gastrointestinal symptoms and cardiac presentations, including new onset myocarditis, pericarditis or atrial fibrillation.
Gastrointestinal symptoms comprised the chief complaint in 48.5% of patients, a paper published in The American Journal of Gastroenterology on 20 March found.

Patients with COVID-19 may appear to improve but can then experience a rapid deterioration later in the illness. Some patients spontaneously improve, and other patients deteriorate. The deterioration can be a few days, even a week later, rather than a stepwise deterioration from the time of presentation. That can make it tricky, just as patients appear to be improving clinically, they can deteriorate rapidly.

The below progression of symptoms, written by an Emergency Physician in New Orleans is likely to be an accurate representation of the clinical course of COVID-19 (it is consistent with data from Wuhan China):

  • Day 2–11 post-exposure (on average, day 5) – the patient develops onset of flu-like symptoms. These commonly include fever, headache, dry cough and muscle aches (mainly back pain), nausea without vomiting, abdominal discomfort with some diarrhoea, anorexia, reduction in smell and fatigue.
  • Day 5 – The patient is likely to develop increasing shortness of breath due to bilateral viral pneumonia.
  • Day 10 – A cytokine storm may occur in those with severe manifestations of SARS-CoV-2, leading to acute lung injury (previously known as acute respiratory disease syndrome [ARDS]) and multi-organ failure.
    • What that means is the capillary bed (where the oxygen gets into the blood) and the alveolar spaces (the tiny little sacks through which oxygen is exchanged) are damaged and inflamed. Their lungs become stiff and don’t exchange gas and they die a hypoxic (not enough oxygen) death

According to the above source, 81% of patients experience mild symptoms, 14% have a severe disease requiring hospitalisation, and 5% of patients become ‘critical’.

According to research in The Lancet, patients with COVID-19 who tend to fare worse include those who are older, and those who have underlying comorbidities such as hypertension and cardiovascular disease.

It is currently unclear whether patients who undergo that rapid deterioration are those who had a more severe illness to begin with, or whether people with mild illness are as likely to go downhill.

The minority of people who develop an acute lung injury and survive, or those who develop secondary bacterial pneumonia, may end up with permanent pulmonary fibrosis.

Remember though, the vast majority of patients with COVID-19 recover from the illness

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Dr Lachlan Soper

Australia “flattening the COVID-19 curve” means the time to running out of ventilators will be later

If our infection rate continues to slow,as it appears to have been doing over the past few days, there’s a chance our hospital system may cope better with the pandemic than original modelling was showing.
The number of new cases coming in from overseas, and the local spread of infections are both slowing.
This may mean that the Australian capacity for ventilated beds may not hit the wall in mid April as many people had been modelling.
A small ray of sunshine in dark times.

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Dr Lachlan Soper

Likely ICU bed use for COVID 19 in comparision with influenza

This article looks at the impact on ICU beds due to seasonal flu and the comparative effect of COVID-19’s impact on this if we don’t act.

A bad flu season can result in 2500 ICU admisisons. Depending on how many Australians are infected, Australia is predicted to have between 250-000 and 750-000 ICU admissions (and for double the usual ICU time) from COVID 19.

Normally there are around 161-000 ICU admissions in Australia. These people will still get sick, as well as the COVID 19 patients.

There is a desperate need to “flatten the curve” and source more ICU beds, this is why elective surgery in Australia is about to shut down.

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Dr Lachlan Soper

Impact of influenza compared with COVID 19 – COVID 19 is far far more deadly!

The International Journal of Infectious Diseases looked at how many people in Italy got and died from influenza over 4 winter flu seasons from 2013/14 to 2016/17.

In each of those Winter flu seasons, it is estimated there were 5-290-000 cases of influenza-like-illness in Italy. In a population of 60million. That means that influenza infects about 9% of the Italian population each season.

During this study period, on average about 12 to 41 people / 100-000 died from influenza. So in a population of 60 million, that is about 17-000 deaths per year from influenza in Italy. That is 0.028% of the population

Thus far with COVID 19 Italy has had 84-000 cases with 9100 deaths (half the annual influenza deaths already), and this is only 33 days after they reached their 100th case, this is 10.5% of people dying. That equates to COVID 19 having a 370-fold increased death rate compared with influenza for those infected in Italy! And considering they have reached peak capacity of all their ventilators, that death rate may sadly rise!

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Dr Lachlan Soper

Loneliness – important to consider for those you know in these times of self-isolation

Loneliness can be a killer.
It increases early mortality risk by 26%.
For comparison, that’s similar to obesity or 15-cigarette daily smoking habit.
Loneliness, research shows, raises systolic blood pressure, BMI (body mass index), and puts people at increased risk for depression and suicide.

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Dr Lachlan Soper

All Intensive Care Units in Australia (ICU’s) are predicted to be at peak capacity in 10 days time! Medical Journal of Australia

COVID-19 modelling predicts that Australian ICUs will be at capacity in just 10 days if case numbers continue to climb at the current rate.

“ICU capacity will be exceeded at around 22,000 COVID-19 cases sometime around 5 April if public health measures fail to curb the rate of growth”

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Dr Lachlan Soper

The benefits of decluttering

This season in life was one I never sought after. BUT there have been so many opportunities to grasp a hold of. One of the small opportunities is decluttering.

“Minimalism is the intentional promotion of the things we most value, and the removal of the things that distract us from it”
Benefits include more time with family & generosity.

Dr Lachlan Soper

COVID 19 Symptom checker

Below is the link to the HealthDirect Coronavirus Symptom Checker:

Click on the yellow box.

It then asks questions about your basic details, emergency symptoms, your state you live, if you work in health, what your symptoms are and if any are severe.

It then advises what to do.

This is what the nurses on the Health Direct helpline will likely work through.

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Dr Lachlan Soper