Three big things to watch as Australia heads towards reopening

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G’day, Liam Mannix here. Welcome to Examine.

Victoria and NSW are racing toward living with the virus, and are just weeks away from lifting their lockdowns. If Prime Minister Scott Morrison has his way, the rest of Australia will soon follow into this new land.

Today, we look at three big things to watch over the coming months: two scientific and the third political, two expected and one entirely unexpected, that will govern what happens from here.

John Shakespeare’s view.Credit:

A ‘safe’ plan for reopening?

The national road map for reopening, the one meant to guide us over the next few months, sits almost entirely on the back of modelling led by the Doherty Institute.

“Our national plan is a safe plan,” Prime Minister Scott Morrison told reporters in August when it was unveiled.

That’s political spin being applied to science. The Doherty’s modelling, and other competing modelling, all tell a fairly consistent story: there is a reasonable chance Australia’s darkest days in this pandemic, at least in terms of hospitalisations and deaths, are still ahead of us.

The Doherty Institute was not asked to model a “safe” plan. The Doherty was asked to model a plan that does two things: a) keeps hospitalisations below the level of overwhelming hospitals and b) cuts the length of time we’re under lockdown.

Reopening with 80 per cent of Australian adults vaccinated and a reasonable level of restrictions – similar to what we’re seeing in the road maps for NSW and Victoria – achieves that, the Doherty’s modelling shows.

Is it “safe”? That depends on your definition of safe. The Doherty is predicting 914,357 cases Australia-wide with 35,322 hospitalisations, 7611 ICU admissions and 6402 deaths over six months (the country has recorded 1256 deaths in this pandemic, total).

Burnet modelling commissioned by the Victorian government is more pessimistic: between 1455 and 3152 deaths in Victoria between July and December. There’s a lot of water to go under that bridge, but the Burnet’s modelling (per some excellent data wrangling from Professor Michael Fuhrer) had the state recording 887 cases on Tuesday – we recorded 867.

These numbers are the outcome of easing restrictions when two out of every 10 adult Australians remain unvaccinated.

These numbers look big mostly because we have been spared the effects of the pandemic that most other countries in the world have already had to encounter; even in a worst-case scenario, Australia will avoid nearly all the harms that have befallen other countries.

There are differences of opinion among scientists, politicians and society about whether that is worth the trade-off of lowering restrictions and rejoining the rest of the world. But we need to be prepared for the outcomes.

The healthcare systems in Victoria and NSW will be stretched. There is a good chance capacity will be exceeded. Hospitals may have to cope with an influx of COVID-19 patients and an influx of patients who have been delaying medical care during lockdown.

“We will get whacked - it’s not a might,” says Peter Cameron, professor of emergency medicine at Monash University.

It’s important to remember: it seems likely premiers will reintroduce controls if we get into real strife. “We can control our own destiny,” says University of Melbourne epidemiologist Professor Tony Blakely.

Now for the good news

The second big thing to watch: Australia’s amazing vaccination rate.

The Doherty Institute projected we’d be doing about 1 million vaccine doses a week in July and August, jumping up to 1.5 million as we came into October.

We’re way in front. We crossed 1.5 million weekly doses in early August, and hit 2 million doses last week – a higher rate than the Doherty had ever projected.

“It’s gone faster than anyone thought, including us,” says Professor Brendan Crabb, director of the Burnet Institute. “It’s amazing what’s happened.”

And with a plummet in the number of people saying they do not intend to get vaccinated – now just 9 per cent – we may actually get to 90 per cent adult vaccination, at least in NSW.

This is really quite exciting, as the various models of reopening are starting to converge on a big point: getting your vaccine rate over 80 per cent really changes the landscape.

“Eighty per cent of adults-only vaccinated will not be good enough – and I think that’s a key message that needs to get out there,” says Professor Blakely.

The Burnet Institute’s director Professor Brendan CrabbCredit:

Is this … a good idea?

There is, I think, a sense of inevitability about “living with COVID-19” being communicated by the NSW, Victorian and federal governments.

“The targets that were set by the Doherty Institute, which made it very clear that once you get to 70 per cent and 80 per cent at that level, and particularly at 80 per cent, then you are managing the virus just like you would the flu,” the Prime Minister said in August.

It makes one imagine a world where we stop worrying about cases and focus only on, say, hospitalisations and deaths. This is in many ways quite nice - we could return a bit to our old lives.

How this shakes out politically over the coming months, whether we choose to live with the virus or remain determined to keep infections as low as possible, will be a determining factor in what the future here looks like.

It is, says the Burnet’s Professor Crabb, a debate that has not really been had yet.

“Do we think it is inevitable, fait accompli, the virus becomes endemic? I object to that.”

Choosing to live with a new virus is “not mainstream virological thinking”, he argues.

We could instead move to a “low-tolerance” approach, tolerating some disease and attacking major outbreaks. Otherwise, we live with risk: no one really knows what this virus will do next.

“It’s a much more radical mindset to assume this changing, epidemic virus – which went from Alpha to Beta, now to Delta – is going to settle into a predictable, stable way.”

“Are you confident Delta will be the last variant?”

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