‘Strategic mistake’: Australia’s virus fail

 

Australia's brutal border wars have dominated headlines as the coronavirus crises raged on, with the NSW and Queensland Premiers repeatedly locking horns over the controversial issue.

Queensland's Annastacia Palaszczuk and NSW's Gladys Berejiklian have clashed again and again after the northern state barred NSW residents from entering for months on end, with similar divisive border closures also in place in other states during the COVID-19 pandemic.

While restrictions have slowly started to ease in recent days as the nation's virus case numbers continue to drop, there are still many limits on movement in place, with Ms Berejiklian arguing there was no medical reason for them to remain at all.

"Apart from the Victorian situation, which I'm pleased to say is looking better and better every day, the rest of Australia has absolutely no reason to have any borders between us," Ms Berejiklian said recently.

Scott Morrison previously weighed in to the border issue between the pair, telling reporters that if Ms Berejiklian did not open her borders to people from NSW, she could not have access to international students crossing the mainland border.

And it seems the nation's leading virus experts agree.

Six academics and medical experts from the country's top universities and health institutions told the Australian Financial Review this week there was no public health benefit to state border closures, with some labelling the policy "politically driven".

Peter Collignon, a professor of infectious diseases at Australian National University's Medical School, was one of them, and he told news.com.au the unofficial elimination strategy adopted by some states - and the border closures which arose as a result - were a "strategic mistake".

He explained the border lockdowns weren't "sustainable" in the medium to longer term as a safe and effective coronavirus vaccine was still at least a year away.

"I think we are going to have to live with this virus for the next couple of years - it's not going to go away any time soon," he said.

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Queensland’s Annastacia Palaszczuk and NSW’s Gladys Berejiklian have repeatedly clashed over the thorny border closure issue.
Queensland’s Annastacia Palaszczuk and NSW’s Gladys Berejiklian have repeatedly clashed over the thorny border closure issue.

"This elimination strategy that seems to have taken hold in different states is not sustainable - we can achieve it, but it's not sustainable.

"This is a respiratory virus and the only respiratory infection that has ever been eliminated and had that elimination maintained … is measles and German measles, and we only did that when there was a vaccine that was 90 per cent effective."

Prof Collignon pointed out that influenza had not been wiped out despite the availability of a vaccine which was 30 to 50 per cent effective, and that swine flu continued to circulate.

He said Australia had initially adopted a "flatten the curve" strategy which was so successful we recorded "very low levels" of infections in most parts of the country.

"New Zealand is the only country that expressed an elimination strategy and in my view, it didn't work, because they had an outbreak there," he said.

"The problem with an elimination strategy is that people want to get their lives back to how it was a year ago, but I don't think that's going to happen for quite a while.

"We're going to have to live with restrictions like lower numbers of crowds indoors until we have a vaccine … The worry is that elimination strategies mean harder and longer lockdowns."

He said Victoria's road map out of virus lockdown indicated an elimination strategy had been adopted, even though it was not explicitly stated - and that it would likely take even longer to hit the low case number targets than predicted under the state's plan.

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Professor Peter Collignon says an elimination strategy is not sustainable.
Professor Peter Collignon says an elimination strategy is not sustainable.

And even if those ambitious targets were met, he warned it was "so easy for (the virus) to come back again".

"The problem with an elimination strategy is that people think it will get things back to normal, but I think it's a strategic mistake and that we will have to live with restrictions for the next two or three years," Prof Collignon said.

"However, we have restrictions in NSW at the moment - things like restaurant tables having to be two metres apart - so they can be quite liveable and you can get on with an almost normal life."

He said Australia needed to be flexible enough to change its restrictions based on the fluctuating levels of community transmission - and that the most crucial figure was not daily case numbers, but mystery cases with no known source of infection.

"It's the smallest number, but the most important one - the ones we find in the community with no obvious contact," he explained.

 

"With every one of those, there's at least one other we haven't found already, so how many people are walking around with COVID that we don't know about?

"In NSW it's much less than one in 100,000 which means there are some restrictions but not a lockdown, because we can live with those sorts of low numbers."

Prof Collignon said Australians needed to remain vigilant about the COVID-19 risk but that at the same time, we "don't have to live like hermits and be locked down … which comes with huge costs socially, economically and healthwise".

"Even if we have a vaccine that is 50 per cent effective, if (the virus) is reintroduced it can spread again, not as markedly as with no vaccine, but it won't be eliminated," he cautioned,

Prof Collignon said we needed to "pick some number we think is low risk" and once it is achieved, start allowing movement and reopening borders.

"The decision shouldn't be made by one state, it needs to be a combined decision between the Commonwealth and the states together, based on risk level," he said.

"At the moment, everybody probably wants zero risk, which is what border shutdowns are all about, but then why not take it to the extreme - why not lock down towns or cities? A zero risk strategy is not a sustainable policy.

"We need national consensus."

 

Prof Collignon said Australia should consider adopting a national coronavirus risk system similar to the current Fire Danger Ratings, which describes the risk level on a given day and area.

"Fires are never zero risk and we need some sort of quantification that tells us what level we stop people moving around at," he said.

"Many people think we'll have a magic vaccine next year and it will probably go away, but I think we will have a vaccine - but it will be a while before it is 90 per cent effective and safe."

Prof Collignon said it was likely Australia could experience "third, fourth and fifth waves" of the virus until a vaccine was rolled out, which means we would need to introduce and scale back different levels of restrictions in the meantime, according to case numbers.

"We've got to keep restrictions on, but they need to be proportionate to how much community transmission we've got," he said.

"My message is there's good news and bad news - good in that we should allow people to do more for now on the basis the elimination strategy is not sustainable in the medium to long term, and bad in that we will be wrestling with this for some time, and restrictions need to be proportionate to the risk.

"We will have to learn to be adjustable with what restrictions we put on."

Originally published as 'Strategic mistake': Australia's virus fail


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