Experts warning not to relax COVID-19 social distancing measures

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Australians are suffering from flu-like symptoms, including cough and fever, at their highest level since social distancing measures took effect earlier this year, according to monitoring survey FluTracking.

Key points:

  • There have been increases in flu-like symptoms across Australia
  • Lung infections among children are also on the rise
  • Experts are worried it may indicate some Australians are starting to relax social distancing measures

The levels of these symptoms across the whole population are still lower than in previous years, but there has been a sharp rise since mid-October.

At the same time, children are presenting to emergency departments with respiratory conditions in higher numbers than the average peak over the past five years, with very high levels of pneumonia and bronchiolitis.

The situation has researchers concerned the public may be relaxing behaviour around infection control and that could mean any potential COVID-19 outbreak may spread.

Professor Robert Booy, an infectious diseases expert at the Westmead children’s hospital, said the numbers were worrying, especially as the country relaxed its physical distancing measures.

“We’re stepping somewhat into the dangerous unknown,” he told the ABC.

Professor Booy said with these infections on the rise, and state governments easing restrictions on physical distancing, the situation was “going to have to be closely monitored”.

Flu symptoms, not the flu

Flu-like symptoms in the community are monitored by FluTracking, an online survey that asks more than 140,000 people to detail what symptoms they have experienced in the past week.

In recent weeks, the survey has seen as many as 0.7 per cent of respondents – or about one in every 140 – report flu-like symptoms, which is roughly triple the rate seen in October.

The symptoms are not driven by influenza infections or COVID-19.

The rise of flu-like symptoms is mostly among children aged between zero and 17 and aligns with a sharp rise of confirmed cases of respiratory syncytial virus (RSV) since October, reported by NSW Health.

RSV causes respiratory infections, most commonly in young children, and can be severe.

It can lead to bronchiolitis, where the small tubes in the child’s lungs become inflamed, and pneumonia – an infection in the lungs.

The rise in those symptoms and lab-confirmed RSV also corresponds with a sharp increase in people going to emergency departments in NSW with bronchiolitis and pneumonia, especially in children under the age of five.

That rate is now higher than the usual average peak in the past five years, despite being delayed by several months, with the high peak now occurring in warm weather when cases are usually low.

Dr Craig Dalton, a public health physician from the University of Newcastle who runs the FluTracking survey, said the uptick in these viruses meant we were probably at an increased risk of COVID-19 spreading too.

“All other factors held constant – if we’re seeing an increase in other viruses transmitting then there’s possibly an increased risk because the conditions are right for COVID-19 to spread as well,” he said.

Dr Dalton said the sharp increase in these statistics could partly be a result of less immunity to these viruses in the community, following such strong social distancing earlier in the year.

“But it’s probably [also] a relaxation in physical distancing across the population,” he said.

He pointed to data that suggested people were increasingly engaging in activities that carried a risk of spreading viruses, such as using public transport.

Data compiled by Apple shows mobility – including using public transport – was increasing.

While it dropped to just 20 per cent of the usual levels back in April, it was now up to 60 per cent of pre-COVID levels.

‘May be the start of a wider epidemic’

Professor Booy warned despite the infections being almost exclusively among children, it may not stay that way.

“Once it’s entrenched in children it gets passed up to older siblings and parents,” he said.

“It may be the start of a wider epidemic and just harder to pick in an adult who has prior immunity.”

These viruses frequently go undetected in adults, since symptoms are often less severe, and so testing is less common.

Professor Booy said the late peak in paediatric lung infections could explain why the level is unusually high.

“The longer you go between exposures, the less your [immune] memory is to the last exposure,” he said.

“So a lot of children, instead of going six months between exposures, they’ve gone 12 months, their memory – the cell antibody memory – is reduced.”

As a result, there are more children with low immunity to the circulating virus, Professor Booy said.

RSV doesn’t come out of ‘thin air’

Professor Marylouise McLaws is an infection control expert from University of NSW who works on pandemics with the World Health Organization.

She said the data was concerning.

“They don’t get RSV out of thin air and it suggests to me that parents aren’t upholding the advice,” Professor McLaws said.

“They’re probably hearing that children aren’t likely to get COVID-19 and when they do get it they are less likely to get serious disease.

“But if the kids are getting sick, then the parents are also being exposed to other people’s children and also other adults.

“Parents are probably becoming COVID-fatigued and moving back to normal and they’re just very fortunate that there are very low levels of community spread of COVID.”

However, she said the high rates of testing for these illnesses was a positive, and patients were presenting to GPs and emergency departments.

Professor McLaws said childcare operators were very aware of the measures required to minimise the spread of respiratory infections and the viruses were probably spreading in other settings.

“Possibly children are just starting to socialise more without the new social norm of trying to do it outside and trying to keep social distance,” she said.

Professor Booy agreed.

“The more we socially interact, particularly children with each other and with adults, the more the rise is of new infections,” he said.

Influenza ‘virtually eliminated’

Meanwhile, there have not been any deaths from influenza in NSW since April, compared with 320 deaths in the same period last year.

Between January and April, only 12 people died of influenza.

Dr Dalton said few experts would have predicted that.

“I’m not sure any infectious disease experts would have thought this was possible,” he said.

“Influenza is very hard to stop spreading, but we have, as a country, got to the point where it’s almost eliminated – we have almost no transmission of influenza.”

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