AMEN Australia 2020 Conference: Centres of Influence

<p>Free sharing permitted under the Creative Commons <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">BY-NC-ND 3.0 (US)</a> license.</p>

Adventist Medical Evangelism Network Australia

Justin Jackson

Final Charge: Pandemic in Paradise

I'm an infectious diseases physician and internal medicine specialist working in regional Australia on the border between New South Wales and Victoria.

So thank you very much to the AMEN organizers for offering me this opportunity.

And the talk that I'm going to present this morning is entitled, Pandemic in Paradise.

And there are quite a number of different interweaving threads that you'll find in this talk.

So I hope you gain a real blessing from it.

I don't think it's a stretch to say that this year, which is now fast drawing to a close, has really been unprecedented in living memory.

2020 will, I guess, forever be etched on our memories as the year that the pandemic interrupted paradise.

As I pause to reflect back over the last 12 months, so many questions come to mind.

And I guess the first is that paradise that we all thought we had, was it reality or was it an illusion?

Is the pandemic in fact reality and the paradise the illusion?

1 of the articles that really caught my attention this year from Insight partnering with the Medical Journal of Australia, was entitled COVID-19 as an evolutionary event.

And the author writes, it's important to remember that our evolution and that of all organisms is not a journey with a destination or a goal.

The random chances of evolution in a dynamic environment mean that we continue to face new micro parasitic threats.

When we do, and leaving aside the obvious social and health risk factors, it is simply chance, whether our individual prize in the genetic lottery, shaped by the selection of the genes of our parents, has provided us with an immune system that can block or overcome the particular parasite, or leave us vulnerable to serious illness and the possibility of dying.

This is an incredibly bleak perspective and as you follow this perspective through to its logical conclusions, the implications are huge.

And as I read this article on the fact that life is random, without a destination, without a goal, I asked myself, why bother locking down?

If this is a means whereby the random forces of nature are purging those from our planet who are less fit for survival.

I want you to contrast this very bleak analysis with the clear, emphatic and unambiguous declaration that the Bible opens with.

It says, in the beginning God created the heavens and the earth.

God saw everything that he had made and indeed it was very good.

The creation story found in the first few chapters of Genesis is a hidden gem, often undervalued.

In these brief few chapters are contained the high-level map outlining the secrets for physical, mental and spiritual health.

Medical truth, and here's a new term for you, Bible-based medicine, shines brightly out of these passages, undimmed by the ages, providing illumination for our day and for the crises we face.

This is an image of Melbourne CBD, where a few months ago, in the middle of winter, a stringent lockdown was enforced and cases reached a peak of 700 per day.

This is not too dissimilar a view and not too dissimilar a situation of many of the great cities around the world in Europe and America.

As an infectious diseases physician, I'm always curious about the epidemiology, that is the story behind the infection.

Where is the crime scene for the coronavirus?

What sort of a paradise will it flourish in?

We don't have to look too hard to find the clues.

Here in our second outbreak, 1 of the major clusters heralding the wave of infection was a large outbreak in meatworks.

This is certainly not a pattern that's unique to Australia.

And again, it asks yourself, why this spot?

If you look closely, you'll notice the poor ventilation, the surfaces made of stainless steel, the crowded quarters, the lack of sunlight, and the shared meal breaks.

As the outbreak progressed, high rise towers were next in the spotlight.

Again, the same environmental factors are present.

Lack of sunlight, crowded living spaces, steel elevators.

And finally, The outbreak went on to dominate nursing homes.

Similar to other countries, this has been where the predominant number of deaths have occurred.

I guess there have been outliers in all age brackets, but certainly a predominance in residential care facilities.

Why do bars and restaurants, cruise ships, nursing homes, meatworks and high-rise buildings all spread this contagion?

Why are these the sites where we're seeing outbreaks?

And why are these the sites where we're seeing fatalities?

What can we learn about infectiousness and disease severity?

Are there some clues that this is perhaps a pandemic's paradise?

By way of contrast, this is the view from my kitchen window and I can report that coronavirus cases currently are 0.

Certainly you'll say the population density is vastly different, but are there other factors in play?

Contemplating this view has led me to ask the question, could a pandemic have existed in the original paradise, the 1 that God described as very good.

So firstly, I want to move your thinking away from infectiousness for a particular pathogen from being a fixed value to something that is dependent on the circumstances.

The ability of a virus to transmit from 1 person to another depends on a whole range of variables.

Likewise, the severity of a disease caused by a virus depends on a large range of variables.

This is an extremely important concept to understand because if we can understand what the variables are behind infectiousness and behind disease severity, this will remove the fatalistic approach that many have adopted in this pandemic.

This is where I believe a Seventh-day Adventist understanding of health comes to the fore.

God saw everything that he'd made, and indeed it was very good.

So coming back to the question, could a pandemic have survived in this paradise?

Or was disease designed out, the design features of creation, making it impossible for disease to find a foothold?

What are the secrets that we can learn from creation story?

I read in Ministry of Healing page 127, pure air, sunlight, abstemiousness, rest, exercise, proper diet, the use of water, trust in divine power, these are the true remedies.

Often I think as Adventists we view this as an Alan White concept, but I want to tell you that these 8 laws are based solidly on the Creation Week and it is actually the Creation Week that provides us with our health secrets.

Genesis 1.6 says, let there be an expanse in the midst of the waters and let it divide the waters from the waters.

So I want to begin unpacking these secrets by looking at something that's taken for granted, that is, until it's missing, air.

We read that the atmosphere was created by God himself.

Modern science is only just beginning to appreciate the complexity of air, something we often take for granted.

In fact, air is an incredibly powerful disinfectant.

This paper, entitled The Open Air Factor and Infection Control, details how fresh air has a germicidal constituent that reduces the survival and infectivity of pathogens.

This factor disappears rapidly when air is enclosed.

In infectious disease circles as well as more broadly there's been a lot of discussion about whether coronavirus is transmitted via a droplet route or via airborne spread.

This dichotomy has important implications for the choice of infection control measures, as well as understanding the degree of infectiousness of the virus.

Droplets on the 1 hand stay in the air for only a very short period of time, travel only a short distance and can be thought of more like rain.

Airborne particles on the other float in the air for prolonged periods, they travel long distances and can be thought of more like fog.

This method of spread, that is airborne spread, will be much more infectious and infect many more people than droplets.

Are there situations and circumstances where droplet spread will predominate and other locations where factors will lead to airborne spread?

Is it a spectrum from droplets on the 1 hand all the way through to airborne on the other hand?

And is the point on the spectrum dictated by something to do with air.

While only a preprint, this paper entitled Evidence for Probable Aerosol Transmission in a Poorly Ventilated Restaurant, supports this hypothesis and the types of locations also support this, where we're seeing outbreaks occur.

So you can see in this diagram that members of family A dined out while infected with coronavirus.

Subsequently 3 members of family B and 2 members of family C became infected, whereas none of the waiters or the patrons.

So you can see that the airflow and the ventilation resulted in transmission from 1 table to the next in this restaurant.

And what it needed, not so much as disinfectant, was a good squirt of fresh, pure air.

It's fascinating to note that largely because of tuberculosis, our hospitals designed and built more than 50 years ago were superior in terms of airflow and air exchanges compared to modern hospitals.

The older buildings were characterized by large windows and high ceilings and had 40 air changes per hour.

You'd be safer treating someone with coronavirus in 1 of these hospital buildings than in a modern negative pressure room.

Moving outdoors into the forests, we discover that this also will boost our immune system.

This paper describes how visiting a forest but not a city will increase human natural killer cell activity and expression of anti-cancer proteins by up to 80% compared to baseline.

As you think about that you may well recollect some advice given about where the best location to care for the sick is.

So what is it about a forest that's different to a city?

Back to Menu

Final Charge: Pandemic in Paradise

Transcript

Parent Conference

Sponsor

Recorded

Sound Doctrine