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The fourth wave: how can Australia avoid another Covid outbreak as it reopens to the world? | Health

Several countries in Europe are in the grips of a fourth Covid wave and have had to reintroduce restrictions to try to control outbreaks. So far Australia’s case numbers have remained low, despite Melbourne and Sydney relaxing most restrictions for fully vaccinated people. But as Australia continues to reopen to the world, could the same thing happen here?

How bad are Covid cases in Europe?

The World Health Organization (WHO) has warned an increasing trend in Covid-19 cases and deaths throughout Europe, with more than 2.1m new cases and more than 28,000 new deaths reported in the week to 17 November. This marks increases of 8% and 5% respectively compared to the previous week, and is the seventh consecutive week of increases.

WHO regional director Dr Hans Kluge told the BBC that 500,000 more deaths could be recorded in Europe by March unless urgent action is taken.

While some of the countries struggling the most have lower vaccination rates, such as Germany (68% fully vaccinated) and Russia (42.2% fully vaccinated), rises in cases and deaths are also being seen in Ireland, where more than three-quarters of the total population and almost 90% of those over 12 are fully vaccinated. There, curfews on venues and work-from-home orders have been reintroduced.

Are our vaccination rates high enough to prevent a fourth wave?

Australia has vaccinated a similar proportion of the total population to Ireland, with Covid-19 restrictions greatly easing in states such as Victoria and New South Wales despite the virus still circulating. In those states more than 90% of the over-16 population is now fully immunised.

But will this be enough to prevent Australia following a similar path to Europe, Canada and the United States, with cases and deaths increasing again even as vaccinations increase?

Head of the University of Melbourne’s school of population and global health, Prof Nancy Baxter, said it is difficult to directly draw parallels between what’s happening in those countries and what may happen in Australia due to differences in vaccination rates, public health measures, and populations.

“But there are still implications for us in terms of what we need to do to not be in their situation,” Baxter said. “A key factor is that they’re going into waning immunity right now as they were vaccinated earlier compared to us. It does make it clear how important it will be to get booster shots into people.”

Though there are still new cases emerging each day in some Australian jurisdictions, reopening in states such as NSW and Victoria still occurred at higher vaccination rates and lower daily case numbers than in many other countries, which putsthem in a better position.

How important is getting a booster shot and increasing overall vaccination?

The federal health minister Greg Hunt has urged everyone eligible to get their booster shot, but at the same time the third shot will not be required to be considered fully vaccinated. Baxter said this advice may change.

“I would say the Australian government are going to move towards requiring a booster,” Baxter said. “It may take them a while to get there, but I don’t think they’ll have a huge impact if they push that in Australia right now, just because so few people are due for it at this point. We need everyone boosted if we want to control this, but we have a bit of time to get there.”

A higher proportion of Australians will also be eligible for vaccination if the Australian Technical Advisory Group on Immunisation [Atagi] recommends vaccination among 5 to 11-year-olds. Atagi is waiting for more data from the United States about the effect of the vaccine on children before making recommendations to government, with that data due in December.

While a combination of cold weather, lower vaccine coverage in some countries and the dominance of the Delta variant have accelerated spread in some countries, by the time Australia enters into winter next year, the hope is much of the population will have been administered booster shots, and children from five years old will also be at least partially immunised. Few countries have started vaccinating those under 11 as they head into winter.

Is vaccination enough?

It will take more than high vaccination rates to prevent hospitalisations and deaths in Australia at levels that hurt the health system in future, Baxter said.

“People in Australia really have done a fantastic job getting vaccinated, and I know we’d all like to think that is all we need to do,” she said. “But if cases do start to rise and we are asked to wear masks indoors again, if we do that early enough, that potentially could stop things from getting worse.

“I know it looks like we’re always going to have 1,000 cases per day and that we’re just going to live with that, but it’s not how these types of infectious diseases work. They’re epidemic diseases. So they spike then come down, and then spike and come down again. There’s always a threat that you’re going to overwhelm the healthcare system if the spike goes high enough when you have an outbreak. You’re just better off pre-empting this as cases first start to rise by telling people to wear masks or have some distance requirements.

“This will stop us from getting to the point of locking down a city or jurisdiction. That’s the hard lesson they’re learning in Europe right now that we need to notice.”

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