Lunch with Prof.Raina MacIntyre: cautious coronavirus communicator: By Helen Pitt

Sydney Morning Herald, April 25, 2020

Professor Raina MacIntyre, one of the world’s leading emerging infectious diseases experts has barely budged from the bedroom of her Wahroonga home since the outbreak of COVID-19 in Australia.

The globally-renowned epidemiologist’s clear-yet-cautious tone has made her a familiar face and voice on most things coronavirus related on television and radio: all calmly delivered from her bedroom, where she continues her research almost around the clock. Occasionally, she sleeps there too.

Each day she rises between 4 and 5 am, takes her three dogs – a Doberman, a bull arab and a greyhound shepherd cross – for a quick walk, then is back at her desk with strong coffee and hundreds of emails. She spent this past Tuesday, her 56th birthday, giving an online lecture from home on what she calls the herd immunity “myth” and why she does not see it as an exit strategy from this global health crisis.

She hasn’t been to her office on the Kensington campus of the University of NSW – where she is head of the Biosecurity Program at the Kirby Institute – since early March. Nor has she been to the supermarket.

So when it comes to having lunch via zoom in our respective homes, the food options are limited. She’d prefer to cook than have takeaway brought to the house so it’s either reheating a Coles frozen dinner or leftovers from Easter Sunday. We both opt for leftovers.

Hers, a traditional festive food from her native Sri Lanka: chicken with coconut milk rice served in cubes with condiments, which she cooked on her first day off since the outbreak began. Mine a one-pot Portuguese dish known affectionately in our family as Grandpa Joe’s chicken. Apologies readers, there are no receipts. Her university-aged children, daughter, 20 and son, 18, do the once-a-month supermarket shop and it’s so long ago dockets can’t be found.

Professor MacIntyre’s medical research focuses on respiratory transmissible viral infections. Professionally, she uses tools like epidemiological and mathematical modelling and contact tracing to chart this virus, and has led the world’s largest body of international clinical research on face masks and respirators.

But it’s equally instructive to see the personal precautions Professor MacIntyre, a pandemic preparedness expert takes in daily life. When our photographer arrives to take a shot of her from afar, she’s wearing a surgical face mask (she removes it for the photo – more on face masks later.)

Last year her parents, now both in their mid-80s, moved into her home, which precipitated the move from her study into the bedroom to work. She is extremely prudent when it comes to their care. She washes all fruit and vegetables in soapy water if they are to be eaten raw. Her pantry is stocked with tinned goods. The bathroom has plenty of toilet paper, she assures me.

“When I realised what direction things were going and that staying at home was going to be a likely requirement, I did a big shop early and so now we are trying to make do with what we’ve got. We obviously wouldn’t have fresh fruit and vegetables, but we could survive for a couple of months more, we have everything we need,” she says.

Australian doctors calling for more awareness that a sudden loss of “taste” or “smell” can also be symptoms of coronavirus.

“I think I’ve been a prepper for a number of years now. Through my work in bioterrorism … I suppose I’ve been aware of all the different and serious existential threats to society … And I don’t have an overly optimistic view of humankind and where we’re heading.”

Given her understanding of some of the world’s deadliest new diseases SARS, MERS, avian bird flu and Ebola, her approach is always prepare for the worst, hope for the best.

“In the short to medium to long term – say six to 18 months – it now looks that we’re going to be facing some degree of restriction in lives until we can get a vaccine. It doesn’t need to be highly- effective. I think a vaccine that’s about 60 per cent effective would do the trick, and it may end up being a vaccine where you need boosters. But until then, really we’re in a no-win situation.”

MacIntyre was born in Colombo in 1964, and migrated to Australia with her ethnic Tamil family in 1973 at the age of nine. Her scientist uncle Ron Mather, who migrated here in the 1960s and worked at the University of NSW in earth sciences, sponsored them. Her mother Nalini was a teacher and her father Ernest worked in insurance.

They settled near her uncle in Woollahra, in a two-bedroom apartment where she shared a room and bunk beds with her older brother who is now a lawyer. Their father had been one of the leading English language playwrights in Sri Lanka.

“When we got here my father joined an Aboriginal theatre group. They were the only people who welcomed him in. He couldn’t get into any white theatre group … I wouldn’t say Australia was that multicultural then. I mean, there were very few non-white people at the school I went to. I think there was a lot of racism at that time,” she says.

Their early life was spent at barbecues and picnics with Indigenous actors like Bob Maza (father to actress Rachael) and Justine Saunders. Their Anglo last name dates back four generations, when she believes her great-great-grandfather converted to Christianity, and took the name of the missionary who converted him: MacIntyre.

From Woollahra Public, where she spent her two final years of primary school, she went onto the selective Sydney Girls’ High where she toyed with becoming a policewoman. Then, in her final year, she decided to become an artist.

“At the last minute I changed my mind because I didn’t think I could make a living from it. I was interested in science in general and medicine just seemed like it had more potential to be actually doing people-centred things,” she says.

She went to the University of Sydney to study medicine with a focus on public health, then undertook a masters in applied epidemiology at the Australian National University, based on the US Epidemic Intelligence Service teaching. This training she says was life changing.

“It equips you to be able to go out in the field and investigate an outbreak and figure out what’s causing it, how to control it. It’s a very specific science … It’s a bit like detective work. We don’t have the answers when you go out into the field and you collect evidence and information, put it together, analyse it and get the answers that you need to be able to control the epidemic. Shoe-leather epidemiology.”

The director of that program, Australian epidemiologist Aileen Plant, who had been involved in the original severe acute respiratory syndrome outbreak in Hanoi, became her mentor. Plant went to Vietnam to take over from Carlo Urbani, the Italian epidemiologist who was the first to identify SARS and then died of it in 2003.

Before Plant’s sudden death in 2007, MacIntyre did a PhD under her supervision. This led to her gaining a Harkness Fellowship to study at Johns Hopkins University, the gold standard globally for public health research. Here she studied the transmission of tuberculosis in the Maryland prison system. Her findings: the more crowded the environment, the higher the risk of infection, remain in the major infectious disease textbooks..

During the course of our lunch – MacIntyre’s computer pings constantly – typically with questions from healthcare workers from around the world about personal protection equipment – PPE. On this she is adamant – if a healthcare worker does not have PPE they should not be working with COVID-19 affected patients.

“With emerging infections there is no drug or vaccine – all you’ve got is non-pharmaceutical methods to control them– so the first people at the healthcare frontline are the ones most at risk of getting infected, they are the people we need to protect the most,” she says.

Raina MacIntyre as a medical student in 1984.

On the issue of masks, while they’re recommending wearing them in the United States in public, she’s not recommending it in Australia yet.

“We don’t want to use up all the limited stocks of surgical or respirator masks. Because the healthcare workers need them. But in public you could wear a cloth mask if you’re living in a heavily-affected suburb. In the hotspots you could certainly consider it even if you’re well,” she says.

“It’s important to remember most transmissions actually happen in the household. A study in China showed that 70 per cent of all the inflections came in the household, so it is the household context where we are most are at risk.”

While she eats her delicious-looking meal, licking her well-washed fingers, mine has gone cold.

In a sense, her life’s work has been about preparing. Last year she was preparing for a bushfire (the whole family-of-five had to be evacuated in November when a bushfire at nearby Turramurra came close to their home). She installed a fire-proof safe, then went back to her studies on pandemic preparedness. It’s not a good feeling what she’s been prepping for has actually come to pass.

“I have been one of the many saying look, these are the preparations we need for a pandemic. Hopefully some of what I say has influenced the direction we’ve gone in. I’ve certainly sent unsolicited advice and my thoughts to government officials, and it’s been well received. There’s a feeling you’re putting your neck on the line sometimes with politicians and like you’re not feeling listened to. But I’m feeling listened to now,” she says.

Michael Kirby, the patron of the Kirby Institute which was founded in 1986 to study infectious diseases related to AIDS/HIV, believes MacIntyre is listened to because she has the skill to explain complex virology in everyday language. “Her high intelligence shines through … but so does her human empathy,” he told me before our lunch.

Some of this is to do with her faith. Although she was raised an Anglican, she is a practising Catholic. So as well as “zooming” with absent family members, including her ex-husband –with whom she and her children are still close – she also watched the Easter Sunday service streamed from her local Catholic church.

Raina MacIntyre as an extra in Midsummer Night’s Dream with Opera Australia.

The ritual comforts her. She loves the drama of opera too, and was once an extra in Opera Australia’s Midsummer Night’s Dream, as hand maid to Titania, played by Dame Joan Sutherland.

Although she says she’s quite self-contained, she does miss taking the dogs for longer walks, and the citizen science project she was involved with, documenting bush turkeys in her neighbourhood.

She’s noticed lots more bird life during this period of enforced rest for the Earth. But until there’s a vaccine, she won’t be resting anytime soon.