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Australia was, until recently, hailed for its effective suppression of Covid-19; Thanks to strict border closures, prolonged closures and its fortune as a remote island-continent, the country was able to avert a large-scale epidemic. The Delta variant, however, upset this success.
Although more than half of Australia’s 25 million people live under very strict restrictions – including overnight curfews, travel limits only about three miles from their homes, and travel restrictions daily outdoor exercise for a few hours – cases have climbed to more than 1,400 a day, the most since the start of the pandemic. As authorities tighten restrictions, hospitals are reaching capacity for Covid-19 patients and Australia’s delayed vaccination program is only just starting to gain momentum.
Australia’s pre-Delta aggressive lockdowns canceled Covid-19 cases and allowed a return to almost normal life from around December 2020 to May 2021. But it cradled the country in a false sense of security, and only 8% of eligible Australians were fully vaccinated by July 2021. Vaccination has progressed in recent weeks, likely thanks to a growing supply of the Pfizer vaccine and increased motivation to break out of restrictions. Today, 39% of eligible Australians are fully vaccinated and 64% have received at least one dose.
The country’s slow start to vaccinations stems from its inability to produce mRNA vaccines locally and its struggle to procure other vaccine options, leaving it dependent on the AstraZeneca vaccine as the backbone of its immunization program. When rare cases of blood clots were linked to the AstraZeneca vaccine, the country was unable to pivot. Although well-meaning, Australia’s Scientific Advisory Group for Vaccinations has urged people under the age of 60 to wait for the Pfizer vaccine. Politicians argued, local media relentlessly attacked the AstraZeneca vaccine, and hesitation about the vaccine spread. With its lowest vaccination rate among high-income countries, Australia was a sitting duck for Delta’s arrival.
The increased virulence of the variant, combined with Australia’s winter climate, has led to multiple and rapid outbreaks across the country, including those spread by an unvaccinated airport limousine driver and a non-Covid-19 hospital receptionist. vaccinated. In its desperation to acquire doses of the Pfizer mRNA vaccine, Australia embarrassingly searched for 500,000 vaccines from Covax stockpile, destined for low-income countries, and received doses from Poland, Britain. and Singapore.
Vaccinations are on the rise, but hopes of a significant easing of restrictions could still take months. It is not known whether the draconian restrictions will continue to be effective against Delta.
Today, the Australian border remains closed; citizens must apply for permission to leave or enter the country, and inbound travel quotas have recently been reduced in an attempt to stem the increase in cases. Although the country has been able to safely bring back more than 200,000 returning Australians through its 14-day hotel quarantine system, more cases are now escaping than before.
Governments increasingly rely on police and military forces for enforcement, and blockades are costing the Australian economy billions. Despite the restrictions, the number of cases continues to increase and “Covid zero” is becoming increasingly out of reach. Australians are tired, frustrated and alone, and the recent protests are turning violent.
And now ?
Australia is at a stalemate: Unable to reverse the Delta variant with previously effective tactics, the country needs a new approach.
A government-commissioned modeling report from Melbourne’s leading Doherty Institute has traced some easing of restrictions after 70 to 80 percent of the adult population is fully vaccinated. Current forecasts, however, may not be possible until November, depending on vaccine supply and community cooperation. Although experts have suggested that the daily number of cases should not hamper Australia’s willingness to open up, it is baffling to consider easing restrictions with thousands of cases per day.
As doctors who have treated many Covid-19 patients in Melbourne and Sydney, we have seen the devastation of the virus firsthand, and many fear for the health system’s ability to cope when restrictions are inevitably relaxed. . There is a backlog of elective procedures to catch up, and many people have avoided medical care for fear of exposure to Covid. We are concerned for Australia’s indigenous population, given the disproportionate impact Covid has on disenfranchised minorities in other countries.
At some point, Australia’s political and health leaders must recognize that the country cannot escape Covid forever and must prepare the community to live with Covid.
To do this, Australia needs to add fuel to its vaccine rollout through incentives; vaccination posts in accessible places such as shopping centers; require vaccination passports at sites, for events and for travel; and a targeted marketing campaign to get more people immunized.
Australia will also need to maintain reasonable public health restrictions in the short to medium term, including indoor masking, avoiding major events and using its system of testing, tracing, isolation and quarantine. . As leaders urge people to abide by the restrictions in the coming weeks, they must simultaneously start preparing Australians for the likelihood that there will be a high number of cases when the restrictions ease. This will be a significant change in expectations, given the relatively low local prevalence of Covid so far.
Less than a year ago, people watched Australians enjoy their happy summer largely Covid-free and unrestricted. Now we are watching friends vaccinated in other countries return to near-normal life amid the harsh reality that Australia may still have months of lockdown ahead. Once the envy of the world, Australia has come to a complete standstill – unable to return to the covid zero panacea it once enjoyed, but far from ready to embrace the normal Covid of tomorrow.
Edward Cliff is a Doctor of Hematology in Melbourne and a Fulbright Fellow. Brian Fernandes is a palliative care physician in Sydney with a Masters in Health Policy from the University of Sydney. Both have worked extensively in Covid-19 services.
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