PM’s ‘game-changing’ virus goal

 

 

Prime Minister Scott Morrison has confirmed Australia is aiming for "no community transmission" of coronavirus, a goal which experts say is aligned with an elimination strategy.

After a National Cabinet meeting today Mr Morrison said there had been an "affirmation of the suppression strategy" among federal, state and territory leaders.

But it was the next line that caught the ear of experts.

"The goal of that is, obviously, and has always been no community transmission," Mr Morrison said.

When asked how the goal for "no community transmission" would impact the staged lockdowns, the PM said this had always been the goal of a suppression strategy and there had been "no change".

"There's no change in the strategy. This has always been our goal. There's no change," Mr Morrison told reporters.

However, Melbourne University epidemiologist Professor Tony Blakely said aiming for "no community transmission" was actually the goal of an elimination strategy and would be a "game-changer" for Victoria.

"That is what is defined as elimination - no cases of community transmission where the source for the case is unknown, for 28 days," Prof Blakely told news.com.au.

"It is great to receive this clarity from the PM that indeed our national goal is elimination."

The definition of elimination and suppression have been contested among experts.

Back in April, Australia's former chief medical officer Brendan Murphy told reporters it was "quite possible" Australia could eliminate COVID-19 in parts of the country despite its suppression policy. However, his comments seemed to indicate "no community transmission" was not a firm goal.

"We are on the same trajectory as New Zealand, which is heading for elimination, and if we achieve complete lack of transmission and no cases, that would be great," Prof Murphy said.

Prof Murphy said there was not a lot of difference between an aggressive suppression strategy and an eradication strategy, with the exception that "we don't feel the need to hold the country very seriously in lockdown until we have no cases".

Comments from Victorian Premier Daniel Andrews earlier this month also suggest "no community transmission" was not previously a goal.

Mr Andrews told reporters the state was pursing a strategy that suppresses the virus in line with the National Cabinet decision.

"If you were to go for the … strategy where you have eliminated the virus, then that is a very different set of arrangements," he said.

"That is not potentially a lockdown for six weeks, it could be much more than that.

"If, however, as a result of the suppression strategy you can achieve zero cases for a long period of time and have a degree of confidence that you have beaten the thing, then that is a fantastic outcome."

Interestingly, in a National Press Club address today, Treasurer Josh Frydenberg said Australia's "aggressive suppression strategy" that targeted "low or no community transmission" could be effective when implemented well.

"We have already seen this occur in seven out of our eight states and territories," he said.

A delivery rider wearing a face mask in Melbourne. The PM says Australia is aiming for “no community transmission”. Picture: Daniel Pockett
A delivery rider wearing a face mask in Melbourne. The PM says Australia is aiming for “no community transmission”. Picture: Daniel Pockett

Other states and territories, except for NSW and Victoria, have successfully managed to eliminate community transmission of the coronavirus in their jurisdictions, as a by-product of the suppression approach.

Earlier this month, deputy chief medical officer Dr Nick Coatsworth suggested authorities had dubbed the success achieved in other parts of Australia as "aggressive suppression" not elimination.

"If we take the accepted public health terminology, that we reduce to zero the number of infections in Australia and target deliberate public health interventions to prevent re-establishing community transmission, that sounds very similar to what we have achieved in most parts of Australia," he wrote in the Sydney Morning Herald.

"We have termed this "aggressive suppression", where we take whatever measures are necessary, including the difficult decisions to reintroduce restrictions and close borders, to shut down community transmission where it occurs."

He said that "true elimination" was only a realistic strategy if there was a vaccine available, which was not the case for COVID-19.

But while suggesting calls for an "elimination" strategy were surprising and dangerous, he pointed to community transmission.

"The inference is that if Victoria had eliminated community transmission, this second outbreak would not have occurred - something which is patently false," he wrote.

Prof Blakely said he believes the PM's comments appear to be an explicit statement of an elimination goal, although comments that Australia was sticking to a suppression strategy may indicate the government is choosing to take a softer approach to the process.

Regardless of the strategy, Prof Blakely has welcomed the move and said it would ensure Australia would not get split into two parts, between those states that had achieved elimination and those that hadn't.

It comes after suggestions Victoria could be isolated for two years if it was not able to get its coronavirus cases under control, as all other states and territories except for NSW, have done.

However, if the goal is for no community transmission, Prof Blakely believes extra restrictions should be considered in Victoria.

Police and army made their presence enforcing mandatory face mask laws around the Royal Botanical Gardens in Melbourne. Picture: Matrix Media Group
Police and army made their presence enforcing mandatory face mask laws around the Royal Botanical Gardens in Melbourne. Picture: Matrix Media Group

"From the Victorian standpoint, our best strategy is to maximise the use of a lockdown, and go hard," he said.

"This would mean reducing the scope of who is an essential worker, in addition to the many good enhancements of stage 3 already put in place."

Prof Blakely believes restrictions should be kept in place until there was no, or nearly zero, community transmission, before locked down areas were allowed to open up cautiously.

This may involve a longer lockdown but Prof Blakely said mandatory masks may be a game changer, although it will take 10 days to see how they effective they are in driving the number of cases down.

"The vexing issue of who is an essential worker remains - we need to reduce the virus transmitting through these people, by either limiting their number or doing 'essential work' much smarter," Prof Blakely said.

"Finally, we have clearly learnt in Victoria that our planned strategy of contact tracing and community testing did not work - it did not stamp out the current outbreak.

"We need better systems, and a phone app that actually enhances the work of contact tracers. Everything helps."

 

charis.chang@news.com.au | @charischang2

 

 

 

Originally published as PM's 'game-changing' virus goal


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