Coronavirus: The alternatives to lockdown in NSW may be as effective as a second lockdown
NSW’s surge in coronavirus cases has some pushing for a second lockdown but there are alternatives one expert believes could be just as effective.
Coronavirus cases in NSW continue to increase with 28 cases now linked to the Crossroads Hotel in Casula, sparking fears the state will follow Victoria’s lead and head into a second lockdown.
The Crossroads cluster has highlighted COVID-19’s ability to spread, with only 14 people getting the virus from actually going to the hotel. Another 14 became infected through having contact with those who attended.
NSW is now grappling with a spike in locally acquired cases.
Today, NSW chief health officer Dr Kerry Chant confirmed there had been 13 new coronavirus cases in the 24 hours to 8pm Monday, 10 of these were linked to the hotel and another seven cases had been identified since then.
Authorities have also put several venues on high alert including Sydney’s Star Casino, a shopping centre and restaurants, after positive cases visited many areas around the state after becoming infected.
The surge in cases has prompted NSW to introduce new restrictions on pubs and hotels.
Groups will be limited to 10 people, and venues will be allowed to have a maximum of 300 people. From Friday, every venue will be required to have a coronavirus marshall during peak times, or full-time if the venue can hold more than 250 people.
Every patron will also have to provide their name and contact details, instead of just one person in the group.
Some are wondering whether NSW should go even harder and introduce a lockdown early, including Atlassian co-founder Michael Cannon-Brookes. The Grattan Institute also believes Australia should pursue an elimination strategy, which would involve stricter lockdowns in Victoria and NSW.
If COVID-19 immunity isn’t long lasting (latest research)
— Mike Cannon-Brookes 👨ðŸ¼â€ðŸ’»ðŸ§¢ (@mcannonbrookes) July 13, 2020
... then Aus should aim for bordered elimination (suppression is a slow fail)
... then NSW should lock down now? (40% reduction in cases for every _day_ earlier & lowest overall economic cost)
What’s wrong w my logic? 🤷ðŸ¼â€â™‚ï¸
But infectious diseases physician, Professor Peter Collignon of the Australian National University, said he would first try and control the small clusters in NSW before deciding to go into lockdown.
“To some degree we expected that we would get clusters, particularly in winter,” he told news.com.au. “What we are seeing in NSW is not surprising.”
Prof Collignon said NSW’s move to limit groups to 10 people and restrict patrons in venues to 300 was sensible, especially given it was winter and there was community spread.
“I think what has been done has been very aggressive and reasonable for the data available at the moment,” he said.
ALTERNATIVES TO LOCKDOWN
Prof Collignon said if the current restrictions in NSW didn’t work, the state may have to look at further lowering the number of people allowed to gather in groups.
“If you want restaurants and a lot of places to continue to operate, you’ve got to have something that allows them to continue. Otherwise you are essentially saying that all restaurants and bars will be closed for the next two years,” he said.
“I lot of people want zero risk, so they can do what they like, but I think that’s an unrealistic expectation given what’s happening around the world.”
Prof Collignon said he believed different states, cities and suburbs could have different rules at different times depending on whether there was community transmission.
However, this would require people in the community to understand and agree with those rules so they pull up their friends on risky plans such as agreeing to go to a pub in another area if they are located in a hotspot.
“You can’t use policing and rules to make it work, you’ve got to have the community agree,” he said. “You’ve got to change the attitude, change the culture.”
Prof Collignon said masks could also be considered, although he wasn’t sure they should be mandatory in Sydney yet unless people were working in high-risk professions.
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“A guard at a quarantine hotel would want to wear a mask or face shield,” he said.
“If other people want to wear a mask, I wouldn’t discourage them, especially if they were in a setting where there could be transmission such as public transport.”
People in high-risk professions such as waiters and waitresses could also consider wearing a face shield.
However, Prof Collignon said he didn’t think it was the right time in NSW to enforce mask wearing.
“Are you going to fine people if they are not wearing a mask?” he said.
Prof Collignon said masks should not be seen as a panacea, “physical distancing is more important than a mask”.
Instead of locking down a whole city or state, Prof Collignon believes it is more effective if people continue following advice to keep their physical distance, wash their hands, stay away from work if they are sick, keep away from anyone with a respiratory illness, and limit indoor gatherings to as few people as possible.
“In Melbourne, everywhere it spread, it was usually when reasonably large groups got together or when someone had gone to work sick … that’s been a big factor in most of the spread,” he said.
Crowded indoor facilities where alcohol is being consumed can be an issue because it alters people’s behaviour. Places where people sing or shout, such as churches or venues with loud music where people yell to be heard, can also be problematic.
LOCKDOWN MAY NOT BE THE BEST ANSWER
Prof Collignon said lockdown may not be the solution it appears to be.
“Victoria had the hardest lockdown in March and April but hasn’t got the best result and we are seeing the same thing in California,” he said.
“There’s the possibility of overdoing restriction.”
However, he said he didn’t have any problem with restricting the numbers of people meeting indoors and this may be more effective than a lockdown.
“The answer may be not to lock people in their homes but to instead control numbers so there is less interaction in homes and outside,” he said.
“This may achieve the same result as locking down people in their houses for months.”
However, where the line should be drawn, and how many people should be allowed to gather, would depend on how much community transmission there was.
“If you think there will be a lot of transmission, the earlier you do it the better, but predicting that is difficult.”
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Both University of NSW Professor Mary-Louise McLaws, a member of a World Health Organisation (WHO) advisory panel on COVID-19, and Melbourne University epidemiologist Professor Tony Blakely believe NSW should go harder on restrictions.
Prof McLaws has previously told news.com.au the relaxation of restrictions in NSW should be wound back.
“It should go back a step and not allow large public gatherings, and not reintroduce the use of large sporting venues without a limit on the size of the crowd,” she said.
Prof Blakely said it was too early to consider a city or statewide lockdown but authorities should be locking down postcodes in Sydney where positive cases were identified, as well as the postcodes around them.
“I would be very proactive in NSW, they are so close to eliminating the virus – you don’t want to lose that chance.”
SHOULD WE GO FOR ELIMINATION?
A number of experts believe NSW should be tightening restrictions to ensure it doesn’t lose the chance to eliminate the virus.
Prof Blakely said the virus could be said to be eliminated if there were no cases without a known source for 28 days.
“Every state and territory in Australia except for NSW and Victoria have achieved this,” he said. “NSW only had three cases recently, it got so close.”
However, Prof Collignon is sceptical about the use of the word “elimination” as it may also give people a false sense of security. He said elimination was also a “low-probability event”.
“I think a strategy of suppression to low levels is more realistic.”
Meanwhile, Prof McLaws has previously acknowledged it was unlikely the virus would be completely eliminated but getting close to elimination in NSW would make it easier to identify, isolate and do full contact tracing of any cases that did appear.
“If you don’t go for elimination, dealing with an outbreak of the magnitude in Victoria is very difficult,” she said.
“Once cases reach 100 over 14 days, authorities may be too overloaded to do in-depth contact tracing.”
Premier Gladys Berejiklian has dismissed the idea that NSW would get to “zero cases”.
“There is no way that NSW will have zero cases during a pandemic,” she told reporters.
“It’s not going to happen and we shouldn’t expect that we will always going to have cases when we’ve eased restrictions and we have to expect that.”
A ‘NEW PHENOMENON’ FOR AUSTRALIA
Ms Berejiklian said the current situation was a “new phenomenon” for Australia as prior to the Victorian outbreak, the vast number of cases were from returned overseas travellers and their direct contacts.
“We are now at a very different phase in the pandemic, when the vast majority of cases in Australia are from community-to-community transmission and that impacts the way in which we deal with the disease,” Ms Berejiklian said.
She said this was why they had closed the border with Victoria and were introducing extra measures over areas where there was a high risk of contagion.
When asked whether she was admitting that the previous restrictions weren’t tight enough, Ms Berejiklian said it was important to note, as she said last week, that it was highly likely given Victoria’s outbreak, that NSW had been exposed to underlying community transmission from that state.
“The work that (NSW) Health is doing – while it’s yet to get to that conclusion – demonstrates there is no doubt that the impact of what’s happening in Victoria has impacted NSW,” she said.
“That’s why we are in a state of high alert.”
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