NSW and Victoria admit they won't get back to COVID-zero. What does this mean for a 'fractured' Australia?

Australia’s two most populous states have now conceded they are unlikely to return to COVID-zero^[1].

The highly infectious Delta variant has spread significantly in both states, making contact tracing and containment more difficult^[2].

This may be welcome news for those in Sydney who have been under stay-at-home orders since June, and those in Melbourne who have lived through more than 220 days of lockdown over the past 18 months. It means these states will leave strict lockdowns eventually without having to wait for case numbers to decrease to zero.

But with other jurisdictions across the country continuing to pursue COVID-zero, what does this mean for Australia?

Read more: Explainer: do the states have to obey the COVID national plan?^[3]

States and territories divided

The future is likely, at least in the short term, to look similar to the current situation with different rules for different states and territories.

Those states pursuing COVID-zero may have greater freedoms, almost resembling pre-COVID life, with generally low levels of restrictions such as mandatory venue check-ins. Though strict lockdowns would be likely when cases do appear.

States like New South Wales and Victoria will require ongoing low level restrictions, such as masks and capacity limits — even with vaccination rates of 70%–80% of over 16s.

Moderate or strict lockdowns would likely still need to occur in response to rising case numbers and local outbreaks.

The importance of ongoing low-level restrictions has been shown consistently by Australian modelling^[4] and is highlighted by the current rise in case numbers in the highly vaccinated population of Israel^[5].

Read more: COVID cases are rising in highly vaccinated Israel. But it doesn't mean Australia should give up and 'live with' the virus^[6]

How will this impact travel?

Likely the biggest impact of divided COVID-zero policies across states and territories will be interstate travel, with different rules between jurisdictions depending on their COVID-zero status.

Restrictions imposed to date would suggest travel between COVID-zero states and territories, who haven’t had any recent COVID cases reported, would be allowed.

There’s also the possibility of interstate travel^[7] occurring between jurisdictions with ongoing community transmission.

Will other states give up on COVID-zero?

As the virus continues to spread, other jurisdictions across Australia may also stop trying to reach COVID-zero.

NSW and Victoria having high levels of ongoing community transmission makes other states and territories more vulnerable to imported COVID infection.

For example, we’ve already seen cases from truck drivers reported in Queensland^[8] and South Australia^[9].

However, tight border control and strict lockdowns when required do appear to be working in some jurisdictions, for example Western Australia^[10].

Read more: What is life going to look like once we hit 70% vaccination?^[11]

How will vaccination impact this?

Modelling by the Doherty Institute^[12] and the Grattan Institute^[13] suggests easing restrictions at 80% vaccination coverage is manageable.

As vaccination rates increase, the need for lockdowns and strict restrictions decreases.

In terms of vaccination, New South Wales is currently leading the way with 76.4% of over 16s vaccinated with at least one dose^[14], and 43.6% fully vaccinated.

Other states’ vaccination rates are also rising, albeit more slowly. Approximately 36%^[15] of over 16s in Western Australia and Queensland are fully vaccinated.

If the current rate of rollout continues, it’s anticipated 70% of over 16s in Australia could be vaccinated by early November^[16], with 80% coverage reached later in the same month.

With vaccination rates increasing rapidly and restrictions easing despite high case numbers, NSW and Victoria may provide test cases for the other Australian states and territories in terms of a roadmap to living with COVID.

While modelling provides a tool to guide decision makers about what to expect, these calculations are based on a number of assumptions^[19]. Predicted outcomes differ depending on key factors such as the ability of the public health workforce to maintain optimal contact tracing.

The real world experience of decreasing restrictions with COVID transmission in the community will provide important information for those that follow.

Read more: Opening with 70% of adults vaccinated, the Doherty report predicts 1.5K deaths in 6 months. We need a revised plan^[20]

It’s important to remember, while the country is slightly fractured in its current response, we are all in this together. As vaccination rates continue to rise in the coming months, states and territories will likely return to a more level playing field.

In good news, it does seem we will have more freedom in the coming months as vaccination rates continue to rise.

But this will be an evolving situation that requires constant monitoring and changes in response to the local spread of disease, with all states and territories likely to require low level restrictions for some time.

With the easing of restrictions, it’s important we all listen to and follow public health directions and get vaccinated as soon as we can to try to maintain manageable case numbers and workload for our public health workforce.

References

1. ^{^} COVID-zero (www.abc.net.au)
2. ^{^} contact tracing and containment more difficult (theconversation.com)
3. ^{^} Explainer: do the states have to obey the COVID national plan? (theconversation.com)
4. ^{^} Australian modelling (www.doherty.edu.au)
5. ^{^} Israel (www.abc.net.au)
6. ^{^} COVID cases are rising in highly vaccinated Israel. But it doesn't mean Australia should give up and 'live with' the virus (theconversation.com)
7. ^{^} interstate travel (www.doherty.edu.au)
8. ^{^} Queensland (www.abc.net.au)
9. ^{^} South Australia (www.abc.net.au)
10. ^{^} Western Australia (www.abc.net.au)
11. ^{^} What is life going to look like once we hit 70% vaccination? (theconversation.com)
12. ^{^} Doherty Institute (www.doherty.edu.au)
13. ^{^} Grattan Institute (grattan.edu.au)
14. ^{^} 76.4% of over 16s vaccinated with at least one dose (www.health.gov.au)
15. ^{^} Approximately 36% (www.health.gov.au)
16. ^{^} November (covidlive.com.au)
17. ^{^} COVID Live (covidlive.com.au)
18. ^{^} CC BY (creativecommons.org)
19. ^{^} assumptions (theconversation.com)
20. ^{^} Opening with 70% of adults vaccinated, the Doherty report predicts 1.5K deaths in 6 months. We need a revised plan (theconversation.com)