Australian (Open) Tennis and COVID-19

[RooFlyer]

Just did a search on shedding in this thread and found no reference to 'unusual' in that context, except two by ... LTO #220 and 236 . Certainly one reason the subject has been raised is to contrast how elite tennis players are treated by the Victorian government compared to its own residents. I still wonder if I, a Victorian resident, rocked up with a positive COVID test, the authorities would investigate further to see if it was 'viral shedding' and if so, they would react to the effect "Relax, its only viral shedding!"

 

[Pushka]

Just did a search on shedding in this thread and found no reference to 'unusual' in that context, except two by ... LTO #220 and 236 . Certainly one reason the subject has been raised is to contrast how elite tennis players are treated by the Victorian government compared to its own residents. I still wonder if I, a Victorian resident, rocked up with a positive COVID test, the authorities would investigate further to see if it was 'viral shedding' and if so, they would react to the effect "Relax, its only viral shedding!"

I think it would depend on whether it messes with their numbers.

Post automatically merged: Jan 24, 2021

But why is it convenenient? And people have often tested negative before returning a week positive test.

The viral shedding cases (apart from Tennys) have to stay in the hot-hotels anyway for the full 14 days before they can rejoin the AO. So is there any real "plot" that is somehow occurring by the AO cases having been determined as viral-shedding cases?

As soon as a AO person returns a postive result they are sent to a med-hotel. They cannot stay in the AO hotel while they await to be determined as a viral shedding case.

Tennys Sandgren remember had his test done 3 days before the flight. So that allowed the time for his case to be reviewed by health officials before he joined the AO bubble.



Also least in Victoria it has been commonplace to investigate week positive cases for some time. Though maybe other jurisdictions do not?


Remember also that the AO contingent are in a sporting bubble and those outside bubbles cannot re-enter them without rigorous testing. You saw this during the AFL bubbles.

Recently in the cricket Warner could not swiftly rejoin the Australian Cricket Team Bubble as well.

It’s convenient to take any ire out of any perception of preferential treatment. Given that even shedders will still be in their lockdown, shedding sounds better than positive but doesn’t actually change anything else.

 

[lovetravellingoz]

I still wonder if I, a Victorian resident, rocked up with a positive COVID test, the authorities would investigate further to see if it was 'viral shedding'

As already referenced earlier in thread yes it is routine in Victoria. Suspected viral shedding cases are reviewed by an expert committee set up for that purpose which then allows them to be classified. If they cannot make a accurate finding they will exercise "abundance of caution"
and classify the case as positive, or an re-infection if they had had CV19 previously.


ie Two non AO cases

Two people who have tested positive for coronavirus in Victoria may just be shedding — so what is that?​

By Leonie Thorne

Posted Wednesday 21 Oct 2020 at 6:11am, updated Wednesday 21 Oct 2020 at 12:08pm

Two people who have tested positive for COVID in Victoria may just be shedding — so what is that?

Two people diagnosed with COVID-19 in July have reappeared in Victoria's case numbers this week. Premier Daniel Andrews says one of the cases is "frustratingly" being treated as a new case. So what is shedding and how do scientists tell if a person doing it is infectious?

www.abc.net.au

 

[dajop]

I would have thought the biggest impact of shedding, if someone is shedding (but in a particular time period not infectious) is the likelihood of infecting contacts (including those on the same plane or same coach to the hotel).

 

[RooFlyer]

As already referenced earlier in thread yes it is routine in Victoria. Suspected viral shedding cases are reviewed by an expert committee set up for that purpose which then allows them to be classified. If they cannot make a accurate finding they will exercise "abundance of caution"
and classify the case as positive, or an re-infection if they had had CV19 previously.


ie Two non AO cases

Two people who have tested positive for coronavirus in Victoria may just be shedding — so what is that?​

No, you have mis-read or misunderstood again. I was addressing the situation where a Victorian presents at the Victorian border with a positive covid test and wondered if they were then given the further investigation to see if its was a real positive, or 'shedding', like the tennis players have been.

You mention reviews of 'suspected viral shedding' cases and two cases (in bold!) where they were cases where the positive infection was months prior and it was a subsequent test. Neither are the same thing.

 

[lovetravellingoz]

I would have thought the biggest impact of shedding, if someone is shedding (but in a particular time period not infectious) is the likelihood of infecting contacts (including those on the same plane or same coach to the hotel).

It depends on whether the virus is still alive. If the virus is dead then the shedding cannot infect other people.:

ie the referred articles I just posted above.

When might you have a weak positive result?​

In most cases, the genetic material of a virus is only detectable when we’re infected and the virus is still replicating and shedding into our respiratory passages.

But sometimes, even when the virus is no longer alive and replicating, it can hang around and be detectable by PCR. In these cases, it’s unclear whether the virus is infectious.

In the case of the NT man, he had earlier tested positive for COVID-19 in Victoria and recovered. Although he recorded a negative test before travelling to the NT, it’s likely he was still just shedding small amounts of the virus.

This may be more common among people with weaker immune systems, as it takes them longer to clear the virus from their system.


The NT man being a non AO person recorded a negative test before travelling to the NT, before testing positive again. So again another example of in Australia where a local person was investigated and found to have had dead virus shedding.



Such cases are not rare and in Victoria have been regularly reported on.

 

[lovetravellingoz]

No, you have mis-read or misunderstood again. I was addressing the situation where a Victorian presents at the Victorian border with a positive covid test and wondered if they were then given the further investigation to see if its was a real positive, or 'shedding', like the tennis players have been.

I was addressing the situation where a Victorian presents at the Victorian border with a positive covid test

That is not at all what you posted

What you posted was:

Just did a search on shedding in this thread and found no reference to 'unusual' in that context, except two by ... LTO #220 and 236 . Certainly one reason the subject has been raised is to contrast how elite tennis players are treated by the Victorian government compared to its own residents. I still wonder if I, a Victorian resident, rocked up with a positive COVID test, the authorities would investigate further to see if it was 'viral shedding' and if so, they would react to the effect "Relax, its only viral shedding!"​

However now that you have added the border.

The NT man in the recent reference ( see above) crossed a domestic border.

The SA UK Migrant flew in to Adelaide from the UK.

Many Victorian cases, as well as cases in other jurisdictions, have been reviewed to see if they were old cases just shedding. At lease some have been deemed to be reinfections because they could not prove that they were not and so went with the more cautious case.

Victoria has had more total cases than other states, and so most likely has also had many more viral shedding cases to investigated.


Investigating cases to see if they are viral shedding cases is not a special process dreamt up for the AO, and it also not just a process used by Victorian Health officials.

So wither the case is just within Victoria, is detected after crossing the Victorian Border or like the tennis players who entered Melbourne via the International Border all cases that merit investigation are investigated and are referred to the expert committee.

The AO group in particular have rigorous ongoing tests, and no person outside the bubble will be allowed back in with such rigour.



So as one example let us look at what happened over two months ago when a traveller arrives into Victoria, but then tests positive in Victoria:

Monday 9 Nov 2020

Vic virus streak continues despite WA case

Victoria's daily streak of no new coronavirus deaths or cases has hit double digits, despite a traveller from...

www.westernadvocate.com.au

Testing boss Jeroen Weimar, however, revealed a positive test had been reported on Sunday night.

It came from a person who had previously quarantined in WA and has since been ruled a case of "viral shedding", with an expert panel deciding it won't count in Monday's tally.

The traveller arrived in Victoria weeks ago and was declared free of the virus before leaving WA.

"We picked them up again yesterday. It was a very low level of viral load," Mr Weimar told reporters on Monday.

He believes the individual wasn't reporting any symptoms when swabbed in Victoria.


So a positive case in Victoria, and swiftly reviewed to see if it was a viral shedding case on 9 Nov. There have been many such cases and investigations in Victoria.

This protocol is not new, it is not special, and is not just for AO Group. It is just part of what is done.

 

[RooFlyer]

I was addressing the situation where a Victorian presents at the Victorian border with a positive covid test

That is not at all what you posted

What you posted was:

Just did a search on shedding in this thread and found no reference to 'unusual' in that context, except two by ... LTO #220 and 236 . Certainly one reason the subject has been raised is to contrast how elite tennis players are treated by the Victorian government compared to its own residents. I still wonder if I, a Victorian resident, rocked up with a positive COVID test, the authorities would investigate further to see if it was 'viral shedding' and if so, they would react to the effect "Relax, its only viral shedding!"

However now that you have added the border.

Well, yes (although the border situation has been stated more than once), but the reply you gave was to the "non border" one. So that reply and my response to it (now with added bolding AND bolded red!! ) stands.

Many Victorian cases, as well as cases in other jurisdictions, have been reviewed to see if they were old cases just shedding. At lease some have been deemed to be reinfections because they could not prove that they were not and so went with the more cautious case.

Victoria has had more total cases than other states, and so most likely has also had many more viral shedding cases to investigated.


Investigating cases to see if they are viral shedding cases is not a special process dreamt up for the AO, and it also not just a process used by Victorian Health officials.

So wither the case is just within Victoria, is detected after crossing the Victorian Border or like the tennis players who entered Melbourne via the International Border all cases that merit investigation are investigated and are referred to the expert committee.

The AO group in particular have rigorous ongoing tests, and no person outside the bubble will be allowed back in with such rigour.

OK, when have those 'reviews' occurred? The situation, still in question, is whether an ordinary citizen (sorry, I mean 'Victorian'), presenting with a positive test result (at the border, or not ), is offered the opportunity to have 'viral shedding' investigated there and then and referred. The Australian open cases apparently all 'had merit' and were investigated immediately. Do the cases of ordinary Joe Blow 'have merit' (oh, "Joe Blow" means Victorian here )? That's all I'm trying to determine. If you don't know, that's OK; we aren't experts.

Is the criteria of 'having merit' in this context published anywhere?

 

[lovetravellingoz]

Cases all get investigated immediately if required.....unless like in the second wave in Victoria the workload overwhelms the workforce.


With positive cases they will look at amongst other things the viral load and CT number to assess if the lab believes it is a true positive or may be a false positive.

Extra testing will then be done. The AO cohort are already tested daily. But other lab tests can be done on the swab and also blood tests may be done.

Results on investigating may be found to be false positives and not just because they are viral shedding cases. Sometimes the test is just faulty.

Swabs are also then sequenced to match the strain either for immediate contact tracing, or to provide data to match to for later contact tracing. ie the Vic second wave being mainly matched to the one family of 4.

Just because the media or health authorities do not report on every case does not mean that protocols are not followed.

It just means that there is a huge appetite by the media to know about the details of every AO case.

 

[Lynda2475]

Cases all get investigated immediately if required.....unless like in the second wave in Victoria the workload overwhelms the workforce.

All shedding cases reported (in any state) have either been arrivals in HQ or local cases where the person has travelled from another state (and often overseas before that), having already been allowed in and then presented for testing where a weak positive has been detected.

The sceario Roo Flyer presented, a question I asked ages ago, has not been tested as Vic do not give people in red zones the opportunity to do a test outside the state (or at road borders), in order to be given an exemption to enter Victoria.

Also, the testing done for orange zones is done after the person has been let in, and that person is already in ISO. As there have not been any positive cases from Orange zone returnees, we can see no evidence of what would happen if they were positive - would they find them selves in a new 14 day iso or would someone actively try to prove shedding?

It's unknown, but given they dont even offer a way for Victorians who have been in a red zone to get home, so call be sceptical of them going out of their way to help joe average.

 

[lovetravellingoz]

All shedding cases reported (in any state) have either been arrivals in HQ or local cases where the person has travelled from another state (and often overseas before that), having already been allowed in and then presented for testing where a weak positive has been detected.

That is not accurate.

For example in Victorian patients who have ongoing treatment (ie cancer patients) have presented for that treatment and returned positive results, after having been positive in the past.

These were referred to the expert committee who consider such results. Most were deemed to be viral shedding. At least one such case investigated by the expert committee was considered to be not conclusively viral shedding and so was instead deemed to be a possible re-infection and so was handled as a new positive case.


Vic DHHS Media Release
15 November 2020


Yesterday afternoon, the Department received notification of a positive test result in a previously diagnosed case of COVID-19. The case originally tested positive in July and was cleared in August.

This result is thought to be persistent shedding and not a new infection. Precautionary public health actions are being taken while further testing is underway. There are no known public exposure sites linked to this case.

The Expert Review Panel will meet today to further examine this case.


Vic DHHS Media release
18 November 2020

Yesterday the Department received notification of a repeat positive swab in a previously diagnosed case of COVID-19.
This test result is considered a case of persistent shedding and not a new infection.

Additional investigations and the re-testing of samples are underway. The case is asymptomatic and is in hospital with an unrelated condition. The case is in isolation out of an abundance of caution.

The Expert Review Panel will meet today to further examine this case who was originally diagnosed with COVID-19 in early October and was cleared of the virus in late October.

From the ABC



Even Wastewater testing results can cause investigations which get linked to a viral shedding case.

Former COVID patient likely cause of virus fragments in Colac, says DHHS

"This person was an old COVID case"

www.standard.net.au

I could go on, but viral shedding cases are not a recent AO related matter. They have occurred amongst travellers and also amongst people who do not travel. They have often been reported on.


I suspect that some people may only be noticing the viral shedding reports on the AO cohort, because they are in the AO cohort.

 

[Lynda2475]

For example in Victoria patients who have ongoing treatment (ie cancer patients) have presented for that treatment and returned positive results, after having been positive in the past.

Ive not read that, then again outside Victroia so few people have actually had covid the chances of them also being a cancer patient is super low.

Beause my Mum has cancer we are super careful where she goes and who she interacts with, and when she has gone to hospital for scans etc immuno compromised patients use a special entrance, dont wander through the areas that are publically acessible i.e where Covid may be.

Thats said, your anecdote is another one where the person already was in the state and has previously been known to be positive, so not the sceanrio being questioned. There is no eveidence that a shedding investigation would be inistigated where there is no history of a past case for domestic traveller trying to enter a state from a restricted zone, because Vic simply doesnt let them in.

With the new requirment to test negative before flying in form overseas, we may finally see some evidence of what actually happens - are those people told to apply again when they test negative or will our govenrments help get them extra testing to see if shedding or not? With so many waiting to come home, my guess is poistive test is automatic bump from the flight for someone else, then a difficult road to prove shedding not actually positive.

 

[Pushka]

I suspect that some people may only be noticing the viral shedding reports on the AO cohort, because they are in the AO cohort.

Not really. With SA numbers being relatively low we are always told of a positive case later turning out to be a case of old infection and shedding. Mainly because we wont get so quickly shut down, which happens if there are more than a couple of positives. Hair trigger here.

 

[lovetravellingoz]

Not really. With SA numbers being relatively low we are always told of a positive case later turning out to be a case of old infection and shedding. Mainly because we wont get so quickly shut down, which happens if there are more than a couple of positives. Hair trigger here.

Yes it is one reason to identify them.

Another reason is that local cases are contact traced. If the case actually is a viral shedding case then the contact tracing team will be wasting a lot of effort looking for links that simply are not there.

There are good reasons to determine if a positive case is actually non-infectious and also nota recent case.

Another reason can be to allow a person who keeps testing positive to be released from isolation if they are considered to not be infectious. There are some long-haulers who would have to spend long periods of times in unnecessary isolation if a positive result was the only measure of whether someone should stay in isolation or not.

 

[HappyFlyerFamily]

There is so much cross discussion

A key point of this special AO shedding treatment/process is as Lynda2475 puts :

The sceario Roo Flyer presented, a question I asked ages ago, has not been tested as Vic do not give people in red zones the opportunity to do a test outside the state (or at road borders), in order to be given an exemption to enter Victoria.

Or a similar scenario with pre-test but being allowed to board / enter Australia because they quickly determined that it was shedding.

 

[lovetravellingoz]

There is so much cross discussion

A key point of this special AO shedding treatment/process is as Lynda2475 puts :

The sceario Roo Flyer presented, a question I asked ages ago, has not been tested as Vic do not give people in red zones the opportunity to do a test outside the state (or at road borders), in order to be given an exemption to enter Victoria.

Personally I do not see this as a situation where things should be shut done when risks are acceptable.

Note that with the AO that after a negative test that the cohort could enter a 14 day quarantine and bubble paid for by the AO. However who would pay for a 14 day quarantine for all such returning return red zone people? Now personally apart from high risk locations I would have allowed people from NSW and Qld to return home and quarantine till a negative test result was obtained.

I personally was and am still of the view that the border restrictions as enacted were too tight. But as even NSW restricted travel of the northern beaches it is not really surprising that other states also chose to have travel restrictions. Remember too that the Black Rock Cluster was caused by someone travelling from NSW. The teenage girl was also linked to the Avalon Cluster, though luckily no local transmission.

So risk was there, but as I have stated many times I thought the restrictions were too tight.

And again I do not see this as an either or argument. What should be ok to do with reasonable risk (and of course there are different opinions on what reasonable risk is) should be allowed to occur. And yes things have not been done which should have been.


ie

• Why was Howard Springs not continued with once it was set up?
• What has it it taken so long after Howard Springs was re-activated to increase its capacity?
• Just the above two points would have seen the backlog of Australians wanting to return home to be substantially less than it is now.
• As Border Controls really is a Federal issue why after 12 months has not the Federal Government in particular been more pro-active in setting up similar facilities to Howard Springs and a more robust and expanded quarantine process?
• Why have some of the recent charter flights by the Federal Government been sold on a "lucky dip" first in, best dressed basis rather than on a needs basis, or at least a significant proportion been sold on a needs basis?
• Why has the Federal Gov not set up Quarantine in separate self-serviced demountable cabins where for 14 days the occupants would not have to mix with staff, unless for medical reasons? ie Those in quarantine cook for themselves and clean them own accommodation (except for a tiny % who cannot). By reducing mixing you reduce risk.
• With more Federal Gov Charter flights more Qantas Flight Crews could have been kept flight ready and qualified.

If non-government organisations are willing to provide the funding to reactivate things in a Covidsafe manner, which while benefiting themselves also benefits the Australian economy, then to me this is a good thing in my opinion. ie AO, WA Mining, Film Industry etc...

Or a similar scenario with pre-test but being allowed to board / enter Australia because they quickly determined that it was shedding.

Was tested 72 hours prior and so duration would be in line with other viral shedding review timelines in Victoria. It was also part of the protocols set up for the AO Charter flights.

All the players and coaches who tested positive and who were not to be old viral shedding cases have not been allowed to enter Australia.

ie The Portuguese player Joao Pedro Sousa being the latest player to report like Murray that he was not allowed to fly in. In this case he has evidently recovered, but not in time to meet the AO quarantine arrangements.

 

[RooFlyer]

Cases all get investigated immediately if required..

There's that qualification again, "if required".

OK, I think its obvious that ordinary Victorians presenting with a positive covid test are NOT afforded the opportunity to have it investigated as 'shedding', unlike the tennis players recently. For the life of me, I don't see why that would have been so difficult to say; its not as if anyone here is dictating the policy. All the states seem to have inconsistent and at time, unfair covid policies - Victoria is no different, but that seems so difficult to recognise.

 

[lovetravellingoz]

There's that qualification again, "if required".

LOL

Yes they test for viral shedding if required.

Do you believe that every positive test should have a serology test as as well, or does it make more sense to just do serology tests if required due to low viral loads and due other clues like the CT number?

Do you really believe the expert committee should review every case rather than those that require a review?



Doing things if required is a pretty normal state of affairs.

I wear a mask if required

I do my annual tax return annual if required.

I complete a change of registration if required.

 

[RooFlyer]

Do you believe that every positive test should have a serology test as as well, or does it make more sense to just do serology tests if required due to low viral loads and due other clues like the CT number?

Do you really believe the expert committee should review every case rather than those that require a review?

Oh dear, you’ve misread or misunderstood again. I wasn’t questioning the policy of doing things as or “if required” ( bolded not). Just asking whether ordinary people could get the ‘shedding’ clarification. The answer seems to be no.

i don’t think I could have made that any clearer. Where exactly did you perceive that I thought the “if required” qualification was unreasonable?

Again, if you take a bit more care to read carefully the points of view being put forward, you might find less cause to get wound up.

Oh, just to be crystal - no and no

 

[dajop]

Oh dear, you’ve misread or misunderstood again. I wasn’t questioning the policy of doing things as or “if required” ( bolded not). Just asking whether ordinary people could get the ‘shedding’ clarification. The answer seems to be no.

The question is has anyone tried?

I guess primarily relevant for those who are denied boarding in foreign country due to pre-departure positive test (let's not get into state border closures) - and then I guess the question is does the lab itself identify "weak positives" to the passenger being tested (and thus could be shedding) or just that given a result that they tested positive. In the case of the AO, AO itself had an interest in working with labs and understanding what was going on, but is anyone going to step in and perform that role for "ordinary" people?