Until early June this year, we have been very successful Australia wide in eliminating all strains of COVID-19 that have caused numerous outbreaks. This has sometimes been very painful and slow, such as last winter in Melbourne. But the Delta strain seems to have changed this likelihood of ongoing success. Delta has twice the infectivity of the original Wuhan strain. People are infectious earlier and often when they have minimal symptoms.
New Zealand, Victoria and Canberra all have now implemented very early and strict lockdowns but are still seeing ongoing and increasing transmission. Ongoing community transmission is also occurring in Singapore (but at relatively low levels), despite high vaccination levels. High vaccination rates have not stopped high levels of Delta transmission in Iceland, Israel, and Britain.
Vaccinations are very effective in saving lives. Data from the NSW outbreak, US, Britain and Israel show that once you are fully vaccinated, you get very high levels of protection against death and serious disease (hospitalisation). Vaccination also decreases viral transmission, but less so.
The problem we have in Australia, is currently we still don’t have enough people vaccinated. We do have high uptake (over 80 per cent with at least first doses) in those most at risk of serious disease e.g., those older than 70 years. But still the majority of those over 12 years of age are not fully vaccinated. So, the consequences of uncontrolled spread of COVID-19 will still be substantial. But this will change as more people get vaccinated. There should be no reason that all adults before the end of this year, cannot be vaccinated with one of the two vaccines (AstraZeneca and Pfizer) we have available now – and potentially others (Moderna).
But we will also need to change our mindset as vaccination rates increase. We need to change from looking at case numbers and maintaining zero COVID. Instead, we need to look at how many people are filling our hospitals and associated fatalities. This doesn’t mean that at a certain level of vaccination (e.g. 70 per cent) you drop all restrictions, as Britain appears to have done. I think some restrictions will need to be with us until at least until the middle of next year. But it means that the restrictions can be substantially loosened.
Singapore has flagged their strategy will be to look more closely look at deaths and hospitalisation numbers rather than cases – although not yet implemented despite their high vaccination rates.
Even with high levels of vaccination, we will likely need some ongoing restrictions at times so that we “flatten the curve” with any unexpected and large upward rise in hospital admissions, so we can cope, and don’t allow our hospitals and health systems to be overwhelmed. The success of high levels of vaccination will become more evident after Europe and North America go through their next winter, and we see how their health systems and populations cope.
We need to keep in perspective that it’s likely that the COVID-19 virus will become endemic, not only globally but also in Australia. This will mean that every winter we will have a marked increase in transmission of the virus – but the consequences will be lessened by having high vaccination levels. As others have stated previously, by the end of this year it’s the unvaccinated that will need to lock down, rather than the vaccinated. While there will be deaths and serious disease, with high vaccination rates, COVID-19 should be no worse than a bad influenza season (in 2017 with over 1200 influenza related deaths).