Masks part of the Melbourne look for a long time to come

Melburnians may need to wear masks on public transport and in other busy public spaces until there is a widely available vaccine for coronavirus.

As another person died and Victoria recorded 238 new infections on Wednesday, University of NSW epidemiologist Mary-Louise McLaws said wearing face masks would be a significant cultural shift for Victorians, but a necessary means of protection in the battle against COVID-19.

Mask-wearing on Lygon Street in Carlton.Credit: Eddie Jim

"Wearing face masks is something that should become a part of people's everyday lives until a vaccine is found or this virus stops being a threat," the World Health Organisation adviser said.

Until Victoria drives cases down to single digits for at least a fortnight, those living in Melbourne or the Mitchell Shire should not go out in public without their nose and mouth covered, Professor McLaws said.

Police in Melbourne have been told to wear masks while working in their stations, it emerged late on Wednesday.

"Victoria Police has recommended staff wear face masks within controlled Victoria Police workplaces where physical distancing cannot be maintained, including where no contact with the public occurs," members have been advised.

A woman in her 90s became the third person to die from coronavirus in Victoria in two days. Her death brings the state's toll to 27. There were 105 people with coronavirus in hospital, an increase of 20 from Tuesday. Twenty-six of those in hospital were in intensive care.

UNSW epidemiologist Mary-Louise McLaws.Credit: Dominic Lorrimer

Of the state's new cases, 209 are under investigation and 29 are related to known outbreaks.

As debate mounted on whether the state could achieve elimination of the virus, Victoria's Chief Health Officer, Brett Sutton, said on Wednesday that mandatory mask-wearing "shouldn’t be off the table", but he warned against police punishing people who could not access a mask.

"It’s a risk not to have them, especially with the transmission going on in Melbourne," Professor Sutton said.

People entering Victorian courts and tribunals are now strongly encouraged to wear face masks with security staff handing out disposable versions.

Asked whether Victoria should switch to an elimination approach to the virus, Professor Sutton said: "I'd love elimination, but it's not the right time to be assessing whether that is feasible right now."

When pressed on the likelihood of a harsher stage four lockdown in Victoria, Professor Sutton said any potential hardening of restrictions would be targeted at areas creating the biggest problems.

"If we’re seeing a focus in a particular setting, in a particular cohort of people, related to particular activities, that would be the focus of stage four restrictions," he said.

Former ABC radio host Red Symons wears a mask on Lygon Street in Carlton.Credit: Eddie Jim

Professor Bill Bowtell, of UNSW's Kirby Institue for infection and immunity said, however, that the suppression strategy in Victoria was failing and called for the adoption of an elimination strategy.

He also questioned why Victorians weren't encouraged to wear masks sooner when infections began to climb in March.

“Do we keep on putting people in lockdown or do we go for hard lockdown and aim for eradication, which can be done and has been done?” asked Professor Bowtell, who helped lead Australia's response to the AIDS crisis in the 1980s.

"New Zealand did it and they haven't had community transmission in 70 days. This is a virus, it's not a supernatural zombie. It transmits between people so you need to separate people."

Tony Blakely, a University of Melbourne epidemiologist, is also pushing for Victoria to move into a hard lockdown.

“We know from lots of international experience now, the best one being Wuhan, you can basically knock this virus out of the park if you decide to lock down hard," Professor Blakely said.

"Given that we’ve already gone into a lockdown in Melbourne, we should turn something that depresses us into an an opportunity. In the six weeks of hard lockdown we could actually achieve elimination."

For this to work, the "loose definition" of what essential workers are must be tightened and Victoria would mirror the "New Zealand prototype", Professor Blakely said.

Places such as abattoirs, which have battled multiple outbreaks, should close for at least a month, along with schools, educational facilities and every business except essential services such as supermarkets, pharmacies and medical clinics.

However, Dr Nick Coatsworth, the federal Deputy Chief Medical Officer, has warned that elimination would be a risky strategy.

"The risk elimination creates is a false sense of security that may diminish the community engagement with widespread testing and lead to a downsizing of the enhanced public health response, based on an assumption “we have got rid of the virus once and for all in our part of the world”.

University of Melbourne epidemiologist Professor John Mathews argued that it might be too soon to aim for zero.

"It is impossible to go for elimination without suppressing it first," he said. “At the moment, one couldn’t rule out the possibility that in a week or 10 days' time, we’ve got a disaster on our hands."

Chief Health Officer Brett Sutton.Credit: Jason South

Griffith University infectious diseases expert Professor Nigel McMillan said even if the virus was eliminated, Australia must "still deal with the rest of the world in some manner".

"Elimination won’t be a golden answer to your economic woes, especially in a country like New Zealand or Australia that relies on tourism," he said.

Professor McMillan said for the state to avoid future outbreaks, Victorians would have to change their way of thinking and remain vigilant not only during the lockdown period, but for the months or even years ahead.

"There are probably quite a few people who have said 'it’s just one thing, it’s just a small get-together with my family,’ but of course it does matter. We’ve got to eliminate that sort of attitude," Professor McMillan said. "It only takes one or two people to not do the right thing and it’s away."

There are now 21 cases linked to the JBS Abattoir in Brooklyn, while nine cases have been linked to Embracia Moonee Valley aged care in Avondale Heights and two are linked to St Basil's aged care in Fawkner.

Five cases have been liked to Steel Mains, a steel fabrication business in Somerton, and four cases have been linked to Waste Equipment and Hiab Services in Ardeer.

The outbreak at the public housing towers in North Melbourne and Flemington has grown by five more cases to a total of 247 infections, while 36 cases have been reported at the Carlton towers high-rise up four from 32 on Tuesday.

Wyndham Council in Melbourne’s outer west, which takes in suburbs including Werribee, Wyndham Vale and Truganina, now has 249 cases, the highest number of cases of any local government area in Victoria.

It registered 18 new diagnoses within 24 hours to overtake Hume, which has 235 cases, and the City of Melbourne and Moonee Valley, which each has 209 cases.

Infections outside of lockdown zones are also steadily increasing. Six new cases have been reported in regional Victoria, bringing the total number of active cases outside the lockdown zone to 35. Two cases were reported in Horsham and Macedon Ranges and one each in Geelong and East Gippsland.

With Chloe Booker and Paul Sakkal

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