Welcome to Coronavirus Government Global Briefing, Mandarin Premium’s morning update on everything in local and global government responses to the COVID-19 outbreak.
WHO urges caution for dexamethasone, as world reacts to breakthrough
While the World Health Organization has welcomed the preliminary release of trial results for dexamethasone — the cheap, widely-available inflammatory steroid found by Oxford researchers to reduce mortality for critically ill patients by up to a third — officials have also urged some caution considering:
- Dexamethasone is not as a preventative measure, or a treatment for the virus itself.
- Use of the drug must be reserved for severely ill patients; further, the drug has not been shown to have an effect on patients with mild cases.
- Clinical advice for the drug should not be rushed — i.e. appropriate doses, how people are assessed, training — and final data from the study needs to be assessed.
- Even then, the drug must only be used under medical supervision — as The Conversation notes in its explainer on dexamethasone, it a) suppresses the immune system, so doctors will require caution if patients have other infections, and b) the drug has rare but significant side-effects i.e. severe stomach or intestinal pain, sudden changes with vision, fits, significant psychiatric or personality changes, severe dizziness, etc.
- Additionally, countries must be supported to both access and utilise the drug in the most effective and appropriate way possible.
"We need more therapeutics that can be used to tackle #COVID19, including those with milder symptoms.
— World Health Organization (WHO) (@WHO) June 17, 2020
How has the world responded?
Since the release of Oxford’s preliminary results, a number of government have already approved the use of dexamethasone as part of standard clinical care including the UK, Australia, Saudi Arabia, and Kuwait, while South Africa’s Department of Health and the Ministerial Advisory Committee has since recommended the drug for consideration.
As ABC News reports, the steroid has previously been approved by America’s FDA for other treatments, meaning doctors can prescribe the medication “off label” for treatment of COVID-19.
In fact, New York City emergency physician Dr. Robert Glatter had already used the drug to help treat a younger colleague, Dr. Scott Krakower, that was struck with severe upper airway symptoms during a period without any as-yet approved treatments:
“Scott came in the ER with multiple complaints, difficulty swallowing, difficulty breathing, and I noticed that he was breathing relatively rapidly,” Glatter told ABC News. “So because of that, I wanted to select a medication that had rapid onset that was quite potent.”
“These steroids belong to a class of medications that have effects on cells — and really it’s the inflammation that the steroid affects and helps to reduce. So the effects of the virus are usually inflammation, and it causes swelling of cells and produces byproducts that are adverse in terms of recovery.”
Elsewhere, The Jakarta Post reports that Indonesian pandemic monitoring community KawalCOVID-19 — “Guard against COVID-19 — has warned of possible misconceptions by the public, specifically if results are misreported by the media and/or public officials ala hydrochloroquine:
“The articles [reporting on the drug] provide correct information, such as that dexamethasone was given to hospitalized patients with severe symptoms,” KawalCOVID-19 cofounder Elina Ciptadi told the Post. “However, we have a problem with the public’s literacy rate. We’re concerned that the public might mistakenly believe the drug is a cure for COVID-19.”
“We fear a possible disconnect between media reports and the public’s reaction,” she added, citing concerns over a rush to purchasing the drug leading to scarcities.
However, as Quartz reports, shortages are less of a concern for dexamethasone than other treatments, due not only to a widespread, global supply chain but the ease to both produce and creates substitutes for the drug.
New Zealand wrap: Stranded Vanuatu nationals, a third case, and responding to a border failure with the military
In a noticeably big day for New Zealand, the government yesterday announced:
- Joint efforts between the NZ and Vanuatu governments to repatriate over 1000 stranded Vanuatu nationals via New Zealand Defence Force flights over the coming week.
- Plans to extend and increase Rent Arrears Assistance from 6 July to 31 December 2020, ahead of restrictions on tenancy terminations ending under Alert Level 1 on 25 June.
- That GDP fell 1.6% in the March quarter from December due to the country’s relatively early and hard lockdown.
Additionally, the ABC reports that New Zealand recorded a third case — a man in his 60s who flew from Lahore in Pakistan, via Doha and Melbourne on June 11 — and Jacinda Ardern has called in the military to oversee quarantine facilities and manage border defences.
Writing at The Conversation on the lack of legal uncertainty over the country’s capacity to have detained the two early cases for the full two weeks, University of Waikato professor of law Alexander Gillespie has issued called for a royal commission into the entire country’s handling of the crisis.
A warning for museums
In joint reports announced in May, UNESCO and the International Council of Museums found around 90% of the world’s 95,000 museums were forced to close due to COVID-19 and that, more worryingly, nearly 13 percent may not reopen at all.
Now, a new article at the World Economic Forum, Curator of Biological Anthropology at the Smithsonian National Museum of Natural History Sabrina Sholts explores both the inequalities in terms of permanent museum closures — specifically in African, Arab and Pacific countries “where museums are relatively young and scarce” — and how even a brief look at ongoing responses from museums to the world’s top three challenges — racism, health, and climate change — demonstrates their unique and vital role in society.
On the home front: Queensland’s even bigger day
In another packed day for the state, the Queensland government yesterday announced:
- $2.6 million in infrastructure funding for 32 racing clubs across the state.
- The passage of two deregulatory laws:
- The Co-operatives National Law Bill 2020, meaning state co-operatives will have simplified financial reporting and auditing requirements, be exempt from lodging publicly available accounts, and no longer register in other state or territories to do business outside Queensland; and
- The Associations Incorporation and Other Legislation Amendment Bill 2020, which includes amendments particular classes of not-for-profits will be exempt from the financial reporting requirements under the Associations Incorporation Act 1981 — a move that benefits approximately 5,000 organisations.
- That aged care residents can have two visitors at a time, including children, for as often and as long as they like.
- The government will not increase the state’s WorkCover premium rate, with the average premium to be maintained at $1.20 per $100 of wages paid for 2020-2021.
- That boarding school students will be able to return to school next term.
See you in the NT on Friday, 17 July
As the ABC reports, Northern Territory Chief Minister Michael Gunner yesterday announced plans to end mandatory quarantine for interstate visitors from Friday 17 July.
Gunner’s announcement, which comes after the territory’s last recorded case recovered on May 21, is based on recommendations from Chief Health Officer Dr Hugh Heggie — who Mandarin Premium yesterday profiled as part of our Team COVID-19 series — for a 28-day assessment period before opening our borders i.e. or two COVID-19 replication cycles.
“This gives the rest of Australia four weeks’ notice, and it gives the Territory four weeks to get ready. It gives us time to market the Territory to visitors,” Gunner said.
“Twenty-eight days’ notice makes sure we that we don’t stuff this up. The safety of Territorians will always be my priority.”
According to the national broadcaster, the decision goes against advice from the Australian Medical Association, which — per the vulnerability of remote Indigenous communities to the virus — called for the NT’s borders to remain “closed” (i.e. at least enforcing quarantine) until all other states and territories had eradicated the virus.
South Australia to unwind restrictions on school activities
Yesterday, the South Australian government unveiled a plan to lift restrictions on the following school activities from 29 June, per existing government health advice:
- School assemblies
- Class photos
- All intrastate camps and excursions
- All school sport competitions, sports days and carnivals, including inter-school competitions
- Inter-school choirs, bands and other performing arts activities
- School formals, socials and discos
- Playgroups and occasional care
- Larger face-to-face professional learning activities
The government noted that parents, volunteers, departmental support and other service providers will also be able to re-enter school and preschool grounds, providing health advice is followed. There will be no cap on the number of people in one room, however the one person per 4-square metre requirement will need to be followed by adults.
Ahead of South Australia re-opening borders on 20 July, the government notes that the the Education Department will consult with SA Health on interstate school camps and provide further advice to schools.
- Yesterday, the NSW government announced updates to their Planning System Acceleration Program, including a $500 million plan to rejuvenate Western Sydney housing and town centres and three new primary schools in Blacktown, Wagga Wagga and Camden.
- The Tasmanian government announced that aged care residents can have up to two visitors per day from Monday, 22 June, and that works to upgrade the King Island Hospital have restarted following the lifting of travel restrictions to the island.