Living on Plague Island

I recently watched an excellent lecture given by Dr Nancy Malik, a specialist working in Sydney. It is aimed at her fellow doctors and seeks to impart a few of the most pertinent facts about Covid-19 and reinforces the message that doctors should have a duty of care to learn about Covid-19. Nothing in here will come as a surprise to the Covid cautious / clinically vulnerable communities, but it provides plenty of briefing material that could be used to disseminate the key points to other people. To this end I have produced a few short video clips from the lecture which are re-produced below.

Key Points

The lecture begins by discussing the Semmelweis reflex. This is based on the very sad story of a medic working in Austria in the mid nineteenth century who made a discovery that could have saved countless lives of new mothers. However, much like with Covid-19, the medical establishment ignored him, indeed ostracised him, because what he was saying challenged existing evidence, knowledge and beliefs and was inconvenient. Let’s hope this causes a few twinges of conscience in Malek’s audience.

Covid is a multi system disease that affects multiple organs and blood vessels. It isn’t a simple respiratory disease that is confined to the lungs.

Covid is not like the flu and it’s not ‘ just a cold’. Yet the truth is that Covid is mechanistically different. It is not a simple stable virus, and is far more lethal than flu.

Covid is not mild and self limiting – every infection involves a risk of developing long covid and this is cumulative – the more infections you get the greater the risk. What the lecture does not say, no doubt due to time constraints, is that people with pre-conditions are more at risk of developing long Covid and are also in danger of their pre-existing condition becoming worse due to a covid infection/s.

What are the features of long covid? Over 200 symptoms of LC have been discovered and the vast majority of cases arise after a relatively mild Covid infection. The medical audience that this lecture is addressed to are requested to ask themselves ‘could it be long covid’ when treating sick patients.

Covid is airborne – this will be familiar to regular readers! Despite the views of some Ministers and officials in the UK it is now proven without doubt that Covid-19 is an airborne disease which has fundamental implications for policies and practices on how to mitigate it.

It is important to understand a spot of aerosol physics in order to understand the importance of high quality PPE and ventilation/ air filtration.

Hand washing and cleaning surfaces cannot be used (on their own) to mitigate an airborne virus.

So how should we mitigate – including what type of mask do we need to wear in risky unventilated indoor spaces.

Ventilation is the most important mitigation measure that we should be using. This involves collective rather than individual actions.

And finally a word about HEPA filters.

Concluding Comments

Nancy Malik and her technical team have put together a great 43 minute lecture and I urge everyone to watch it. My purpose here is to write down the key points and create a few video clips for those who want to use them to disseminate key messages and for those who don’t have time to watch the full lecture. Also, just a reminder – tips on how to avoid catching Covid including masks, HEPA filters etc can be found in my blog on the subject.

Gillian Smith 24 June 2025