On 16 December 2020, NSW health authorities warned the public about two new coronavirus cases on Sydney’s northern beaches.
Within a week, the local government area was closed and the rest of the city returned to restrictions that it had been free of for several months. Families were separated during the summer holidays, and the CBD closed to the public for the New Year.
This year, December 16 will look very different: the second day of further easing restrictions in the state, with capacity limits for hospitality sites scrapped, the withdrawal of the Service NSW vaccination certificate and QR check-ins no longer needed in shopping malls .
Bondi Beach in the last week of Sydney’s lockdown, in October.Credit:Brook Mitchell
Sydney has been promised the summer it missed in 2020. While nothing is certain in a global pandemic – this weekend a new Omicron tribe has been identified as a variant of concern – that’s what public health experts expect will follow.
Unvaccinated people re-enter high-risk places
NSW will lift restrictions that prevent people who have not received two doses of a COVID-19 vaccine from entering places such as restaurants, gyms and other people’s homes on December 15th.
Since its reopening, these sites have been sites of virus transmission. However, with participants all protected by vaccination, the number of cases in NSW has remained relatively stable and hospitalizations and intensive care units have declined.
The government and health authorities say they expect the number of cases in the state to increase over the summer, but the main concern now is hospitalizations.
When NSW reopens, more than 93 percent of the population aged 16 and over will be fully vaccinated. But what about the 7 percent who are not?
“It’s not ideal. Because we ‘shoot for the stars’ here in Australia,” said University of Sydney epidemiologist Professor Alexandra Martiniuk.
Schools are now a major driver of case numbers since the end of the lockdown. The summer holidays may prove to be a respite from community transfer. Credit:Louise Kennerley
»It can cost lives. It can put the health care system under more stress than otherwise. However, the high vaccination rate means that there is a reduced risk. “
The difference of a few percentage points is probably insignificant, says James Cook University’s infectious disease doctor and mathematician Professor Emma McBryde, when herd immunity – 95 percent of the total population vaccinated – is impossible due to the lack of an approved shot for children.
School holidays can help limit the number of cases
Last year, health authorities raised concerns about school holidays driving virus clusters through extended family gatherings and regional travel. But with high vaccination rates for adults, schools are now a major driver of community transfer in NSW, meaning the holiday can be a welcome respite.
Since the beginning of November, data from NSW Health’s weekly COVID-19 monitoring reports show that about a third of the cases have been in children aged 11 and under who are not yet eligible for vaccination. NSW Health has repeatedly asked parents to keep children with symptoms at home from school due to the number of school clusters that have developed since the return of personal learning in October.
Professor Catherine Bennett, president of epidemiology at Deakin University, says it’s not as simple as saying that children only catch the virus at school – research published earlier in the outbreak showed that most COVID-positive children caught it at home – but it’s a good sign for australia that the northern hemisphere summer holidays resulted in lowercase letters.
“The virus has a few things that counteract it over the summer; the weather is better, people are outside where they are less likely to get COVID. But schools during recess are also an important part of it,” she says.
Delta is likely to remain the dominant variant
Reopening of fully vaccinated arrivals from abroad and from Victoria, where the majority of Australia’s infections are recorded, has had a minimal impact on NSW figures. But could a new, more transmissible variant of the virus, such as Omicron, hit our shores, just as Delta did in 2021?
Associate Professor Stuart Turville, who heads the Kirby Institute’s research into COVID-19 mutations, says – although researchers are keeping a close eye on new variants evolving in Africa – more than 98 percent of coronavirus infections globally are the Delta strain that already exists in Australia and it is likely to remain the same over the summer.
While higher vaccination coverage in the population may result in a higher number of “breakthrough infections” – cases in vaccinated people – should the transmission of society increase, says Dr. Turville that the available vaccines are still extremely effective.
“What we see in the lab and in the real world is that efficiency keeps up,” he says. “Yes, there will be breakthrough infections, but the good news with these cases is that they are rarely hospitalized.”
Vaccination for children aged five to 11 years
Earlier this month, the United States became the first country in the world to approve Pfizer’s pediatric COVID-19 vaccine for use in children aged five to 11 years.
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The Therapeutic Goods Administration and Australia’s vaccine advisory group, ATAGI, are currently considering whether younger children will be shot. They are waiting for real-world evidence from the United States to ensure that the very rare incidence of vaccine side effects (such as heart complications) does not outweigh the benefits of age-group vaccination coverage, which largely only experiences mild illness if infected. with COVID-19. Federal authorities have said there is no plan for a rollout before January.
“The dream would be that children can be vaccinated in January, February before school returns,” says Professor Martiniuk.
Israeli child Liam Lev Tov, 6, in the arms of his mother, receives a Pfizer vaccine. Credit:AP Photo / Oded Balilty
Modeling conducted by the Kirby Institute’s Biosecurity Program, led by Professor Raina MacIntyre and published this week, suggested that although vaccination of children aged five to 11 years would have a greater impact on how many cases were registered by June 2022, retention it a strong contact tracking practice – ideally reaching 80 percent of cases within 24 to 48 hours of notification – that would help state hospital admissions and ICU admissions remain at manageable levels.
Professor Bennett says that case modeling may be deficient because it does not take into account changes in public behavior in an outbreak – or localized public health reactions. However, she agrees that admissions are generally driven by adult infections, especially those in older adults.
Contact tracking, QR codes reduced
On Thursday, Prime Minister Dominic Perrottet confirmed that from December 15, QR checks in low-risk environments, such as retail stores, will be scrapped, although they will still be needed elsewhere, such as restaurants, gyms and hair salons.
“Contact tracking is important because contacts are the most likely people to become infected after an infected case,” says Professor MacIntyre.
Following initial proposals that NSW may want to completely abolish QR codes for venues, Professor Martiniuk says it is a good idea to keep some protocols in place.
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“It’s a principle that is maintained in the management of all infectious diseases – when we have measles, we contact clues, we issue warnings.”
Instead of the long lists of exposure sites seen earlier in the Delta wave, Professor Bennett says local public health units are likely to respond to high-risk outbreaks in a more tailored way.
For example, when an unvaccinated employee at a Byron backpackers tested positive this week, NSW Health locked the hostel for a week and provided on-site vaccinations due to the risk of spreading in a population with a vaccination rate below the state average.
February ‘crunch time’
With children returning to school, a possible epidemic peak of infections, as well as a slight decline in vaccine immunity for the hunt of people who received the Pfizer vaccines, which arrived en masse in the state in September, Professor MacIntyre says February is likely to be “crunch” time “for COVID-19 in NSW.
But if practices like social distancing do not get in the way, vaccine uptake remains strong for boosters and the possible pediatric course, and La Nina does not hold everyone back, Professor Martiniuk says, Australia could be a “miracle case” in the world scene.
Then there is what happens after the summer is gone. Professor Bennett is optimistic and notes that the autumn – when cases began to rise again in the US and Europe – will coincide with the majority of NSW’s booster doses being administered.
“It will be perfect timing. If we can get safely into the fall, we are in an excellent position to keep the virus under control.”
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