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Why our COVID ambition must remain close to zero cases, even as we climb to high vaccination

Australia’s third wave is showing no sign of peaking. All of NSW, ACT and Melbourne are in lockdown; all outbreaks have originated from the international border breach in NSW. It’s hard not to conclude that NSW has lost control of its COVID-19 outbreak with the seven-day average at 502 and a current doubling time of 11 days. If the trend continues, that translates to 1000 cases a day by the first week of September and jettisons the nation’s roadmap out of the pandemic.

Tradies lining up to be vaccinated at the Sydney Olympic Park hub.

Tradies lining up to be vaccinated at the Sydney Olympic Park hub. Credit:Dean Sewell.

The federal government’s roadmap defines the vaccination levels required for restrictions to be eased – but it relies on a starting point of zero cases. This is what is required at the end of Phase A for any restrictions to be lifted. It also depends on Phase B dealing with an outbreak of just 30 cases across Australia.

Until now, every state and territory has pursued a policy of zero COVID (no community transmission) but recent signals from Premier Gladys Berejiklian suggest NSW has deviated from this goal. This makes the Doherty Institute modelling of scenarios based on 70 to 80 per cent vaccination redundant. Even if vaccination rates get to 80 per cent, the state cannot afford to lift restrictions at current case levels or the health system will be overwhelmed.

It is clear the state needs to reset its response to this outbreak if it is to grant its citizens more freedoms, in the long term, in line with the national roadmap.

Greater Sydney and the rest of NSW urgently need a strategy that is marked by uniformity, clarity and strong financial and social support. The current approach has the NSW government always behind the virus – gradually expanding local government areas of concern on the basis of infections that occurred a week earlier while the virus continues to spread elsewhere.

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All of Greater Sydney at least should be under the same level of restrictions to simplify the message and stop transmission across the city. The government needs to work with community groups to ensure everyone is getting the support they need and that the message gets across to everyone. And it should share more information about how and where transmission is occurring, especially the role of workplaces when it comes to transmission, to help both the health authorities and the public understand how the virus is spreading and what they can do to prevent infection.

There is evidence to inform the measures in a reset. The impact of various stages of restrictions imposed during Victoria’s second wave has been clearly documented. Stage 4 restrictions were introduced in Melbourne on August 3 last year when the daily number of new cases reached 671. This led to a steady decline in cases that reached fewer than 10 a day 10 weeks later. And that was without the addition of vaccination.

While it is impossible to disaggregate the relative impact of each component of Stage 4 restrictions, the package worked. It included mandatory masks indoors and outdoors, a five-kilometre limit on travel, the closing of all non-essential retail, containment of workplace transmission, a night-time curfew, and a strict definition of essential workers. It’s worth trying at least in Greater Sydney and western NSW, to get the state back in sync with the rest of the nation.

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