of Australia’s population was in lockdown last week, as parts of New South Wales, Western Australia, the Northern
Territory and Queensland enacted strict coronavirus restrictions.
But this angst-driven reaction of locking down with low community transmission of COVID is not a viable long-term
strategy. This is because the coronavirus is increasingly likely to become endemic
, meaning it will settle into the human population.
Vaccination markedly reduces your chance of getting severely ill and dying from COVID. Vaccination also reduces transmission to some extent
. As vaccination rates start to climb, we need to start moving to a calmer, more planned and balanced strategy to help
us all learn to live with the virus.
That needs a simultaneous focus on achieving high vaccination rates as fast as possible, while continuing with a
consistent strategy of test, trace and isolate. Instead of daily announcements of new cases at press conferences, we
should start reporting on vaccination rates and on severe outcomes like hospitalisations and deaths.
Last month Singapore announced its long-term strategy
to prepare the country for life with COVID as a recurring, controllable disease. And last week, Prime Minister Scott
Morrison announced a similar four-phase plan
for Australia.COVID is likely to become a regular part of life
There’s a theory that viruses often become more transmissible over time
. SARS-CoV-2 might be heading that way
One of the newer variants of the virus, Delta
, is estimated to be significantly more transmissible than the Alpha variant, which is more infectious
than the original strain of the virus discovered in Wuhan.
Research in Nature found the majority of the 119 scientists it surveyed believed the coronavirus would become endemic
, meaning it settles into the population, becoming a part of our environment like the flu.We can’t continue an elimination strategy forever
When the pandemic was first taking hold, Australian health authorities aimed to “flatten the curve
” by reducing new cases to a manageable level. In July 2020, the federal government’s own Deputy Chief Medical Officer declared
eliminating COVID-19 a “false hope”.
But then Australia (and New Zealand) achieved success in not only suppressing the virus but reducing community spread to
zero using lockdowns, social distancing measures and severe restrictions on incoming travellers. Elimination then became
the new goal for many chief health officers
around Australia, and many public health experts declared it the optimal strategy
However, the high costs of the repeated elimination attempts over time are evident in the economy
, in people’s livelihoods and businesses, and people’s broader health and well-being
While we continue to debate whether the huge costs of lockdown are worth it
, the costs of not having lockdowns in an unvaccinated population would be far higher. However, it’s likely the benefits
of lockdowns will greatly diminish once we have rising vaccination rates and treatments for COVID continue to become
Elimination also requires really tight control of our borders. Very limited numbers of travellers (mostly returning
Australians) are allowed through our quarantine system. This creation of “fortress Australia
” ignores thousands of Australian citizens stranded overseas and prohibits overseas travel for almost all residents.
Despite this, our system continues to leak the virus into the community and to spark snap lockdowns. Australia currently
experiences about one to two outbreaks per month
from hotel quarantine.Australia needs a more mature COVID approach for the long-term
Three Singaporean ministers, writing in The Straits Times
, sum it up perfectly:
The bad news is that COVID-19 may never go away. The good news is that it is possible to live normally with it in our
Moving away from an elimination approach to a long-term management strategy requires us to rapidly vaccinate most, if
not all, of the population, as vaccination significantly reduces severe outcomes from COVID.
We need vaccine development to keep pace with the emergence of variants of the virus, as these seem to reduce the
efficacy of vaccines to some extent. This will require booster vaccinations and continued research and development of
Developing effective treatments for COVID is also crucial. As we find effective treatments, these will make COVID a
“milder” disease, lowering the risk of hospitals and intensive care units becoming overwhelmed.
Although we don’t yet have a gold-standard treatment, methods to treat the disease are rapidly improving
. Steroid treatment dexamethasone
is one example, which cuts the risk of death by one third for patients on ventilators
. Antibody therapy
The federal government’s four-phase plan doesn’t mention treatment at all. But we should accelerate support for ongoing
research into COVID treatments.
Given COVID is likely to become endemic
, the national cabinet decision to commit to a four-phase plan
is a welcome recognition that Australia needs to begin treating COVID-19 “like the flu” in a long term approach.
This transition of Australia’s approach
should be based less on anxiety-inducing reports of daily new cases and where they might have strolled near you.
Instead it should focus more on how many people are partially and fully vaccinated, as well as how many people become very ill from the coronavirus
and other health outcome measures.
This will give a consistent set of messages aimed at encouraging much stronger vaccination take-up. This looks to be
included in “phase 3” of the federal government’s transition timeline
and therefore we estimate this isn’t likely to occur until well into next year.
We’d argue this phase should begin much earlier, in tandem with the move from phase 1 to 2 and paired with sustainable
public health measures to reduce exposure to infection. Public health measures should focus on community awareness,
knowledge and engagement and on restoring community calm, economic livelihoods, health and well-being
Masks, rapid and routine COVID testing, and tracing and isolation of contacts will be important when cluster infections
What’s more, there should be particular engagement and protective measures for highly vulnerable people
, such as the elderly, those who are disadvantaged, minority groups and people living with mental ill-health and with a
We need to learn to live with yet another viral disease among us. Our health system should move rapidly to reduce fear,
improve vaccination rates, improve treatments and reduce complications as it does with other diseases we cannot
eliminate or fully protect against.