Covid suppression is the only long-term strategy

Covid-19 is reminding leaders that sometimes there are no good options. As NSW Premier Gladys Berejiklian decides where to go with the state lockdown on Wednesday, she effectively must choose a lesser evil. Does she follow her philosophical instincts to limit restrictions and promote free choice? Or does she clamp down further and hope to mirror the success of other jurisdictions in keeping Covid-19 in check? Victorian Premier Daniel Andrews has been able to end the lockdown but maintain some restrictions after acting quickly on the most recent outbreak in his state. Western Australia is claiming justification for its self- imposed isolation. South Australia has followed Victoria’s lead, and Queensland has shut its borders and, so far, escaped a widescale outbreak of the Delta strain.

Given the global experience, all premiers know the stakes have changed dramatically with the emergence of the more easily transmissible Delta variant of the virus. Nonetheless, there is no shortage of advice for Ms Berejiklian from other state leaders who had to put up with claims that NSW had been the gold standard with its pandemic response. This is understandable. But on the numbers to date this remains true. NSW has taken the biggest share of international arrivals for quarantine. It has led the economic bounce back nationally from the pandemic. Unlike other jurisdictions, it has avoided widescale lockdowns when minor outbreaks have occurred. Despite all this, there have been fewer cases and far fewer deaths in NSW than in Victoria.

State leaders who have criticised the nature of the Sydney lockdown have misrepresented, by and large, the harshness of restrictions and the high level of compliance by citizens. But despite the impositions, the number of Covid-19 cases stubbornly refuses to fall. Another 172 new Covid cases were disclosed on Tuesday, with at least 60 of those diagnosed having circulated in the community while infectious. There were 171 people in hospital with 46 in intensive care units and 19 on ventilation. This is a big number for Australia but is still low considering what has happened in many parts of the world. On some of the worst days in Britain over the past 18 months, case numbers have soared by more than 50,000 and the death toll has topped 1800, equivalent to about 16,000 new cases and 600 deaths in Australia.This is what makes Ms Berejiklian’s decision on what to do next doubly difficult. To use a 17th-century nautical expression, she finds herself between the devil and the deep blue sea. Does she face immediate social, economic and political peril by attempting to plug a leaky hull in rough seas or potentially risk the entire ship and crew by refusing to act?

Her instincts to keep restrictions to the minimum possible disruption are correct. Her decision to close down construction activity across the nation’s biggest city was against this instinct and has been a mistake. It is difficult to see why construction poses a bigger threat than other retail and commercial activities that have been allowed to continue. There would have been better, site-specific ways to address threats posed by construction than a blanket ban.

Debate within the NSW crisis cabinet has been to what extent it is possible to ease restrictions in some outer areas of the city where there are no cases and increase them in areas where case numbers are high. These decisions go to the heart of the issue of suppression versus elimination. If suppression is the goal, given the relatively low numbers of infections and hospitalisations, existing measures appear to be working. Pursuing elimination risks a perpetual cycle of lockdowns and restrictions whenever new cases present.

The big unknown is whether an effective suppression strategy can hold until there is a high level of community protection through vaccination. Overseas experience shows a tough approach is needed to combat the Delta variant. It also shows that elimination – across Europe, North America, Asia and Africa – is a false hope. In countries with high vaccination levels, infections of the Delta variant remain high but the health impacts are much reduced. Emotionally and financially, the nation cannot afford a never-ending cycle of restrictions that unduly limit freedoms and curtail productive activity. But until the vaccine rollout has done its job, leaders cannot afford to let the Delta variant breach containment measures that so far have kept the outbreak under control.