NSW pushes for fourth doses with new wave set to rival January

NSW is pushing for national medical advisory groups to expand fourth dose eligibility and facilitate more people to receive antiviral treatments, as the state faces a COVID-19 wave tipped to rival that seen at the start of the year.

Chief Health Officer Kerry Chant said the state’s latest wave was expected to peak in late July or early August, with hospitalisations similar to January. The surge in cases is being driven by the newer BA.4 and BA.5 Omicron variants, which better evade immunity from previous infection and vaccination.

NSW Chief Health Officer Kerry Chant and Health Minister Brad Hazzard on Tuesday.Credit: Louise Kennerley

While 68 per cent of people who received two doses have had at least one booster, many people aged under 65 have now gone six months without a shot.

The state’s top doctor said she would support vaccine advisory group ATAGI extending eligibility for second booster shots of the vaccine, currently only available to people aged over 65 or with certain health conditions, when it meets on Wednesday.

“I’ve always said I defer to the expert advice of ATAGI ... [but] there are many people, me included, who are about six months since [their] third dose,” she said, adding she “wouldn’t mind a bit of a top-up” in immune protection as Australia’s cases rise.

Health Minister Brad Hazzard said he had advocated for “quickly” expanding fourth dose eligibility at meetings of state and federal health ministers last week.

However, the minister also called on the third of the population yet to have a booster to book in. Since the start of the year, 56 per cent of the 2186 COVID-related deaths in NSW have been in people who had two or fewer doses.

“If you haven’t had your three, to put it bluntly, you’re crazy. You should go and get them because that is what is going to make a difference,” he said.

Throughout June, about 30 per cent of the dead – about three-quarters of whom were in their 80s and 90s – were not up-to-date with their shots.

Chant and Hazzard told reporters they wanted to increase uptake of antiviral treatments for COVID-19, such as Paxlovid and Lagevrio. They advocated both for the Pharmaceutical Benefits Advisory Committee to review its conditions for subsidised access and asked those eligible to plan with a GP to receive the drugs and have a PCR to diagnose respiratory symptoms, as rapid antigen tests may take days of repeat testing and the antivirals should be taken within five days of symptom onset.

Antivirals are currently available for people aged 65 and over with two high-risk factors, those aged 75 and over with one high-risk factor, or moderately to severely immunocompromised people. People in these age groups may be recommended one antiviral and not the other, due to interactions with other medications.

Dr Charlotte Hespe, NSW and ACT chair of the Royal Australian College of GPs, said it was very important people at higher risk of severe COVID-19 see a doctor to plan for antivirals so they can receive them as soon as possible if they test positive. COVID-positive people can leave the house for healthcare.

“Five days is not just the cut-off, it’s also not nearly as good as if they get it on day one,” she said.

There were 1782 COVID-positive people in hospital in NSW on Thursday, the highest figure in recent weeks.

Despite expecting hospitalisations to be similar to the state’s original Omicron wave, Chant said she had not recommended further public health restrictions. Instead, she encouraged the public to wear masks and take steps to reduce their risk of catching winter viruses, including flu.

Hazzard said rules like additional mask mandates in shopping centres were not necessary in a world with vaccinations and antivirals, noting the latest global coronavirus wave had been met with updated advice rather than mandates.

“Let’s live in the times that we’re in and that requires people, all of us as members of the community to be responsible,” he said.

Australian Medical Association NSW president Michael Bonning asked the public to consider healthcare workers and wear masks indoors.

“The hospital system is experiencing high levels on both unplanned and planned catch-up activities, as well as staff shortages across all disciplines with the remaining staff in public hospitals almost universally burnt out,” he said.

“If we want to preserve the business as usual this time around, we need to continue following orders and respecting the health and wellbeing of others.”

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