NSW overhaul to restrictions part of state’s plan to ‘co-exist with COVID’

Masks on public transport and at airports are tipped to be the next pandemic restrictions to go in NSW, after the state wound back a raft of coronavirus rules including abolishing compulsory isolation for close contacts.

Seven-day home quarantine for household contacts will be scrapped from this Friday, with asymptomatic people who live with a COVID-19 case instead asked to take daily rapid tests and avoid high-risk locations such as aged care homes.

NSW Chief Health Officer Kerry Chant said the overhaul to the rules were part of the state’s plan to “co-exist with COVID-19”, urging people eligible to receive a booster and flu shot and follow new guidelines.

NSW Premier Dominic Perrottet at Nepean Hospital on Wednesday.Credit: Rhett Wyman

“We want to take a cautious and proportionate approach as we enter the colder months when we know that we might have flu circulating at higher levels,” Chant said. “We have to coexist with COVID-19, but we can’t ignore it.”

The rule overhaul came after the country’s chief health officers and state officials last month recommended home quarantine for household contacts be removed after the peak of the latest Omicron wave driven by the fast-spreading BA.2 variant.

Professor Allen Cheng, a former co-chair of the Australian Technical Advisory Group on Immunisation, said while mask mandates in airports and public transport would likely be the next coronavirus rules to be eased, officials will be closely watching infection rates after taking the “big step” ending close contact measures.

“I would say that that masks [at airports and public transport] would go before compulsory masks in hospitals and aged care,” Cheng said. “If things continue to get better, other changes could be made, but that is unlikely... at least in the next couple of months.”

“COVID-19 isn’t over by any stretch of the imagination,” Cheng said, adding that the potential emergence of newer strains of the virus means “there is no guarantee the next variant will be as nice to us as the last one”.

“We need to keep a close eye on things and be prepared to change things if we need to,” he said.

NSW will also remove capacity limits on public transport on Friday, although masks must still be worn. The state will end its hotel quarantine program for unvaccinated international arrivals on April 30, and vaccine mandates for industries including healthcare, education and aviation will be lifted over the coming weeks.

However, Premier Dominic Perrottet did not rule out reinstating restrictions under certain circumstances, like the emergence of a more severe variant of the virus.

“We will always tailor our restrictions ... to the circumstances that we find ourselves,” he said.

Chant agreed she would “never say never” to reintroducing restrictions, but given the BA.2 wave had passed its peak it was time to “simplify” its virus restrictions.

While close contacts will not be required to isolate, they will need to undertake daily rapid antigen tests, wear masks indoors when not at home and will be unable to visit aged care homes, hospitals and other vulnerable settings unless under end-of-life exemptions.

Mr Perrottet, Minister for Health Brad Hazzard and Minister for Western Sydney Stuart Ayres take a tour of the newly completed 14-storey clinical services building at the Nepean Hospital on Wednesday.Credit: Rhett Wyman

Infectious disease expert Professor Peter Collignon said significant natural immunity generated by huge numbers of Omicron infections over the past four months meant it was “the right time” to remove close contact rules.

Unlike the United Kingdom, where COVID-19 isolation rules even for positive cases have been removed, Collignon believes rules for people who test positive for the virus should remain in place for now.

“If someone test positive to the virus it is appropriate we keep isolation it at somewhere between five to seven days,” he said. “High vaccination coverage means we should have good protection against death and serious disease for at least the next six months.”

With more than 1600 COVID-positive patients in hospital, NSW Nurses and Midwives Association general secretary Brett Holmes said the changes to isolation and resulting increase in cases would likely place further stress on the health system.

“I am concerned there’s going to be greater exposure in workplaces leading to greater numbers of patients in a health system that is already overrun,” he said.

Professor Alexandra Martiniuk, an epidemiologist at the University of Sydney, said the decision to end quarantine for close contacts would see cases increase. The household “secondary attack rate” data for Omicron outbreaks in countries including Denmark, the UK and Korea suggested positive cases infect between a quarter and half of people they live with.

“The reality is people who live with cases are still quite likely to get COVID, so for a few days those people will be free, possibly giving it to others, and then they will need to go into isolation because they are COVID-positive,” she said. “But half of the people in the house will also not get COVID.”

She said it was important to remember children being returned to school or childcare would not be in masks and backed keeping masks in public transport and airports.

“You have to remember COVID is this bizarre disease that has these super-spreader events,” she said.

“We may think that’s okay because we know this is a mild infection, but we still do not know much about long COVID.”

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