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Three months on, top doctor tells of the day 'patient zero' landed on Qld's doorstep

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Gold Coast infectious diseases specialist Dr John Gerrard has worked in hotspots around the world, including a deadly ebola outbreak in west Africa. But in January, the latest emerging virus landed on his doorstep.

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Gerrard had been paying close attention to the international clinical reports when an unusual respiratory disease started spreading through Wuhan, China. But he still felt it was a long way from Queensland’s Gold Coast.

“I suspected we’d never have a traveller from Wuhan here,” Gerrard recalls.

He was wrong. Within weeks, a Chinese tour group would fly into the Gold Coast, via Melbourne, with two families from Wuhan. On January 28, the day after the nine tourists arrived, a 44-year-old man began to display symptoms and was taken by ambulance to the Gold Coast University Hospital, where Gerrard is director of infectious diseases.

With staff taking even precautions, for their own safety and the welfare of the patient, the man was placed into a state-of-the-art isolation unit, despite yet to test positive to COVID-19, the disease caused by SARS-CoV-2.

Gerrard knew the potential for there to be untold dangers.

“We did everything by the book,” he says.

The following night, public health officials made the decision to also isolate the other members of the tour group, which had consisted of three families, each with a mother, father and son.

“I think one of them spoke English, the majority didn’t,” Gerrard says.

Renal nurse Catherine Li became a key member of Gerrard’s team, not only due to her training but also her proficiency speaking Mandarin. The tour group had come to the hospital with knowledge of others who had fallen gravely ill with the disease in China.

“They were very scared, very frightened,” Gerrard says.

“But they were also conscientious, educated, and didn’t want to infect anyone else.”

Complicating matters, two of the children were not old enough to look after themselves, so each had to stay in isolation with an adult. Hospital staff swabbed all nine every day, ever alert to the possibility of COVID-19, as Queensland declared a state of emergency and the world grappled with a looming pandemic.

“One of the things that was very strange about it was it had this long incubation period, five or six days from the first symptoms,” Gerrard says, adding that some cases have been even longer.

Ultimately, five of the nine would be diagnosed with COVID-19, including one of the children staying with an adult and, separately, an adult staying with another child. All were thought to have been infected in transit through China, but their level of sickness varied.

The worst affected was Queensland’s patient zero, the 44-year-old man, who endured a lengthy, severe fever, before he, like the others, recovered.

“He caused us quite a bit of concern,” Gerrard said.

Gerrard was in constant contact with colleagues in Sydney and Melbourne, who had seen patients with lesser symptoms and needed to be told of the potential severity of COVID-19 cases.

“The frustrating thing as a clinician is that this illness varies from quite a trivial illness to death and you can’t pick it,” he says.

“Obviously we now know young children get quite mild symptoms and for older people it can be quite severe, but the variation is still quite considerable.”

Indeed, when one of the children from the tour group tested positive, Gerrard says staff were “stunned” as he had presented as a perfectly healthy kid. With the tour group since returning home, Gerrard believes staff felt a sense of accomplishment at not only successfully treating those with COVID-19 but stepping up when required.

The 200 or so cases on the Gold Coast have also included Hollywood actor Tom Hanks and his entertainer wife Rita Wilson. Gerrard insists the hospital treats patients the same regardless of background or circumstances.

“We’ve become very aware of the overseas travellers that we have on the Gold Coast,” Gerrard says.

Three months into the state’s outbreak, and having been there since day one, Gerrard believes all Queenslanders should feel a sense of pride in the early progress fighting the disease. His wife was born overseas and has noted, perhaps with the benefit of an outsider, the community spirit and strong sense of unity in the face of adversity.

“No one has attempted to do what we’re doing now and this is not in any pandemic plan,” Gerrard tells InQueensland.

Bans, restrictions and social-distancing measures had sought to flatten the curve of infection but had “inadvertently now practically eliminated it”.

Yet there is an element of caution in Gerrard’s comments. Asked if the health system had risen to the challenge, Gerrard says it has – “so far”. He urged Queenslanders to continue following the expert health advice on how to prevent infection and respond to any early symptoms of COVID-19, lest a future surge in cases overwhelm even the best-prepared hospitals.

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