Our current COVID-19 situation

30 March, 2020

~9 minutes read time

In short

To our friends and family. We would like to update you about our situation in regards to COVID-19. The whole world is having to adapt and brace for the time that (maybe, hopefully not) is coming. This is not a time to panic, complain or be sad, it's a time to help each other and look for solutions rather than problems.

We will try to attach as many sources as we can, some of them will be Swedish resources. However much of the information we have learned is from talking with Caitlin's father Alistair who is a heart and lung surgeon here in Melbourne.

We have decided to not return to Sweden and plan to monitor the situation in Sweden over the next few months. This has been a hard decision for us and we would like to elaborate on why we made it.

Background

Caitlin has severe asthma. She is on the highest possible dose of asthma medication and still have issues with her breathing on a weekly basis. This means that in the unlikely chance that she will have a bad reaction to the COVID-19 virus, she will most likely need medical assistance for her body to cope with the infection.

There are many different factors we have taken into account but it all comes down to the question "do we think Caitlin is safer in Australia than in Sweden?". The short answer is Yes. Many different factors are contributing to making this decision, We will try to describe them below. Hopefully, they are of use to someone.

The virus for people at risk

A few things we learnt from Caitlin's dad:

Any virus can result in inflammation of the lung which is referred to as "pneumonitis". This is merely inflammation and this causes fluid to leak between the airways and later into the airways which is what causes the problem with lung functions.

The majority of people are expected not to have a major illness of any kind. Up to 20% may have significant issues with this virus, but a smaller percentage of those the virus may be fatal.

Someone with asthma is not more or less likely to contract a viral infection than the average person. However, if they did get inflammation of the lungs from the virus, coughing the fluid, mucus and pass out of the lungs is impaired because the outflow to the lung is restricted. Therefore they will have more difficulty to combat the virus than a person with normal lungs.

A lot of the problems that develop are related to the immune response to the virus rather than the virus itself.

This is also why the heart may have problems potentially following a viral infection. It is not that the heart is infected with the virus, but rather the immune system that is attacking the heart after it makes antibodies to the virus that is most dangerous.

What is now being discussed in Australian hospitals; is that most COVID-19 related deaths seem to occur because the patient is admitted to critical care far too late. That by the time they are intervened for ventilation there is no way to save them.

What is important here is if high-risk people (also includes the; elderly, immunosuppressed, critically ill and smokers) can test for the virus earlier, an active intervention gives alternative treatments a chance to be effective while we wait for a vaccination or cure.

The trip home

People are panicking and the probability of contracting the virus while flying or in the airport is very high. We considered flying home despite this as most airlines have stopped flying. Our flights home with Thai Airways were cancelled without any information and the phone lines were disconnected. The exception to this is Qatar Airlines, who instead is offering all their customers a free cancellation and date change on any ticket and are increasing their number of flights. The Swedish embassy published a recommendation that Swedes should attempt to return home with Qatar Airlines as soon as they can.

The side-effect of Qatar Airlines continuing to fly people across the world is that they are contributing to the spreading of COVID-19. There is a high risk that Qatar will be forced to stop their flights by authorities to reduce the spread, as the situation deteriorates globally.

This made us determined to go home as soon as we can until yesterday. We believed we had a small window of opportunity to go home.

However, after reassessing the preparations and precautions are being made in Sweden comparative to Australia we have decided to stay in Australia instead.

The situation in Australia

Most of Australia is currently in lockdown and have been for about a week now. All non-essential institutions have all been forced to shut down including; schools, bars and gyms. People are also being officially instructed to stay at home unless necessary. Indoor and outdoor gatherings are now restricted to two people. Australia is responding but not a severely as we had hoped, as a slower response will cost everybody far more.

Since this lockdown, the government has reported that the rate of increase had dropped from 25 to 30 per cent a day, to 13 to 15 per cent a day. The numbers aren't accurate as the number of people infected and not tested is unknown.

Unfortunately, as much of Australia's medical supplies are manufactured in China there are a limited number of tests available. However, as part of their testing and contact tracing scheme- if you have COVID-19 symptoms, at this time you can be tested.

The situation in Sweden

The first thing that made us reconsider going back to Sweden was; the speech Stefan Löfven held to the nation. There was nothing in his speech that called to serious action, advising only to stay home if you feel any symptoms which we know is not enough to slow the spread. We know that COVID-19 is infectious before symptoms occur and that some people might never have any symptoms at all.

The Public Health Agency of Sweden has chosen to go another way than most other countries. The strategy is based on individual responsibility rather than restrictions and regulations. People are free to do what they want. Free to be out in springtime and have a beer with friends. Go to bars and restaurants.

What we know so far is that; many countries that have responded by restricting social contact too late and are now overwhelmed. We have the data from many countries now. Because the disease is so highly infectious the only effective measure is a legal strict restriction of social interaction by the government. Hoping that each individual will take this same level of responsibility is a naive ineffective way of "preparing" for what's to come as we have seen in Italy to a devastating degree.

Conclusion

No healthcare system is built to support the estimated number of critically ill people infected with COVID-19. We were concerned that if Caitlin did become ill, that an overwhelmed system and combination with government advice not to be tested unless you are severely unwell would mean that she might not have access to the care she would need until it was too late.

We hope that this will change but until then, the unfortunate reality is that we are safer down under than up north.

We know that we are very far on the side of caution and hopefully the predictions about Sweden are wrong. But we would rather be on the side of caution this time.

Take care of yourselves 🖤

Caitlin & Gustav

Resources

These are resources we collect data from daily:

Worldometers

Johns Hopkins University

Tidings (App Store, Google Play)