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Scanning the second waves: how Victoria's COVID-19 response compares
By Craig Butt
In recent months Victoria has sometimes felt out of sync with much of the world in battling the coronavirus. As the second wave took hold and the state's daily case numbers climbed through July, many countries were loosening restrictions after weathering their first waves.
Now it’s the opposite. Victoria is posting single-digit daily case increases as other parts of the world are grappling with surging infections. On Thursday, there were 26,676 new cases in France, 26,687 in the United Kingdom, 15,199 in Italy and 20,986 in Spain.
These countries are all obviously much bigger than the state of Victoria, so this graph compares the 14-day case average of each jurisdiction while adjusting for population size. The data shows how the infection rate in all of these countries is now tracking higher than Victoria’s during the peak of the state’s second wave in early August.
It also shows that at various stages since early August Victoria had an identical infection rate to each of these countries. Epidemiologists say there are many reasons why these contrasting paths have been taken including differences in climate, geography and cultural norms.
Latrobe University epidemiologist Hassan Vally said it was reasonable to compare the infection curves of different countries, but that it was important to understand the limitations of those comparisons.
"Australia is very different to those countries - we are in a different hemisphere and there are lots of cultural differences," Associate Professor Vally said.
Deakin University epidemiology chair Catherine Bennett said the northern hemisphere’s autumn and winter provided conditions favourable for COVID-19. More people would cluster indoors, encouraging transmission. A lack of sunlight means the virus can survive on surfaces longer and people experiencing symptoms may delay getting tested if they thought they merely had a cold.
She added Europe’s more porous borders meant these countries did not have the same lockdown options as Victoria, removing an ability to similarly drive down numbers following their first waves.
The different approaches national governments around the world have taken to the pandemic over time has been tracked by Oxford University researchers. They have created an index that takes into account 17 variables such as whether movement restrictions are in place, whether schools or workplaces have closed and the extent to which contact tracing is being carried out to compare the level of lockdown restrictions in different countries.
This animated graphic above shows how Australia stacks up against France, the UK, Spain and Italy when it comes to the stringency of government response to the virus. The index gives each place a score out of 100, with 100 being the strictest. During Melbourne’s second wave, restrictions varied throughout Australia, but the index takes into account the area of a country with the tightest lockdown.
It shows that Australia - strongly influenced by Victoria's regime - ranks amongst the toughest lockdowns in these jurisdictions as it has brought cases down. In recent weeks it has dropped closer to the pack as rules have eased and as some countries - such as the United Kingdom and France have tightened their rules.
Professor Blakely warned it was likely too soon to be making direct comparisons between certain countries.
"To compare directly with Britain and say ‘they’re doing appallingly, look at where we are’ misses the fact they are using a different strategy," he said. "It will take three to four years to know which strategy was right, and we have the advantage of geography."
Professor Blakely estimated that a high proportion of those infected during the UK’s first wave were essential workers who were active in the community. He said this level of partial immunity in people most likely to contract and spread the virus could act as a handbrake on infection numbers during a second wave.
But Professor Bennett said the pattern emerging was that the bigger the first wave, the bigger the second wave. "It looks like herd immunity has little to do with it," she said.
As for the country that has chosen the best economic approach to the pandemic, Professor Blakely said that too would take a few years to determine, and even then the answer would depend on whether you talk to "an epidemiologist or an economist".
"We may well end up with several best options because of the different pathways countries took. We are in such uncertain times at the moment and who is successful will depend on how long it takes to put out a vaccine," he said.
Recent analysis from the International Monetary Fund forecasts the economic impact of the virus - based on falls in gross domestic product, rising unemployment and increased debt. It predicts the impact will be less severe in Australia compared with western Europe’s largest economies despite this country's lockdowns.
Grattan Institute health program director Stephen Duckett said out of all the places that had dealt with a second wave, Victoria deserved the gold medal for bringing down case numbers. "We’ve done remarkably well," he said.
Dr Duckett said Singapore (to whom he would award the silver medal), China, New Zealand, Thailand, Vietnam and Yemen were the countries that had best dealt with second waves of the virus. He said these countries had succeeded in suppressing transmission thanks to good contact tracing, population monitoring and better records of movements across borders.
To this list of countries, Associate Professor Vally added South Korea. "Very few countries have been able to do what we have been able to as quickly and effectively," he said.
The graph above shows the 14-day case average for Victoria against South Korea and Singapore (again it has been adjusted for population size). Victoria is the red line.
As of October 25, Victoria’s 14-day case average had fallen below five for the first time in almost six months, and there were 98 people currently known to be infected with COVID-19 statewide.
Professor Blakely said Victoria was in a good position, and had about a good chance of eliminating the virus based on the current trend in infection numbers.
Professor Bennett said the state’s contact tracing system had evolved during the second wave, so health authorities were better placed to deal with any localised outbreaks down the line.
She said it would take an extraordinary set of circumstances and some bad luck akin to the hotel quarantine breaches that sparked the state’s second wave for Victoria's case numbers to increase to such heights again.
"A third wave is incredibly unlikely if we all do our bit, particularly in regards to getting tested and doing it as early as possible," she said.
Associate Professor Vally added that he expected Victorians would be responsible coming out of the second wave and would not take unnecessary risks.
"People in Victoria have been changed by our experience over the past few months and I think we are all pretty sensitive to the risk of ever having to go back into lockdown again after coming out of this second wave," he said.