Coronavirus Update: Australia


Victoria’s 5-day lockdown may not quash Delta. Here’s what our modelling predicts instead


Lei Zhang, Monash University; Christopher Fairley, Monash University; Guihua Zhuang, Xi’an Jiaotong University, and Zhuoru Zou, Xi’an Jiaotong UniversityVictoria has entered a five-day lockdown to control its growing outbreak of the more infectious Delta variant.

Until midnight on Tuesday restrictions mean residents are only allowed to leave home for essential reasons, can only travel five kilometres away from home, and need to wear masks outside the home, among other measures.

We consider the lockdown essential and we strongly support this rapid action. However our modelling predicts a five-day lockdown may not be enough.

Instead we predict at least 30 days of restrictions will be needed before Victoria reaches three days without community transmission.

That’s if we take into account current and predicted case numbers, the fact we’re dealing with the more infectious Delta variant, and with current levels of vaccination.

The good news is Victoria is more likely to reach these three “donut days” sooner if vaccination rates pick up, even modestly.




Read more:
Why is Delta such a worry? It’s more infectious, probably causes more severe disease, and challenges our vaccines


How did we come up with these figures?

We built a mathematical model based on nine COVID-19 outbreaks across four Australian states (including Victoria) since the start of the pandemic. We posted details online as a pre-print. So our model has yet to be independently verified (peer reviewed).

Our model allows us to predict — given current case numbers, the particular variant in circulation and vaccination rates, among other variables — how long public health restrictions such as lockdowns need to last to achieve particular outcomes. Our model also allows us to predict how many cases an outbreak has at its peak.

Models are mathematical tools to predict the future, something of course no-one can do with 100% certainty.

However, our model differs from others because it considers the difference between mystery cases and cases linked to a known case.

It also comprehensively integrates the effects of various public health measures, such as social distancing, wearing masks, contact tracing and vaccination.




Read more:
Scientific modelling is steering our response to coronavirus. But what is scientific modelling?


What did we find about Victoria?

When we plug data about Victoria’s current outbreak into our model, this is what we find.

Our model predicts the number of daily reported cases of community transmission will continue to climb over the next week or so. Even with the current lockdown we predict a peak of at least 30 cases a day over the next 7-14 days.

We predict the current outbreak will last for at least 30-45 days before Victoria can return to three days of zero community transmission.

Measured easing of restrictions can occur before this time, which Victorian Premier Daniel Andrews flagged might be possible for regional Victoria.

However, given the fact Delta is more transmissible than the original Wuhan version of the virus, controlling Victoria’s outbreak will inevitably be more difficult and take longer than dealing with an earlier outbreak of similar size.

New South Wales knows too well how hard it is to get a Delta outbreak under control, something our model predicted.




Read more:
A tougher 4-week lockdown could save Sydney months of stay-at-home orders, our modelling shows


Back to Victoria, our model supports a hard lockdown that minimises the chance of ongoing transmission.

Strict lockdown (80% reduction in social activities) and mandatory mask use in public spaces and workplaces (90% coverage) — equivalent to what’s expected in Victoria’s current lockdown — have been effective in previous outbreaks in Victoria and other states.

However, we predict the same approaches may only have a 50:50 chance to contain the current Delta outbreak in Victoria.

This means the Delta variant is likely to linger, bouncing at a level of a dozen cases for weeks. This means public health authorities will find it hard to decide how and when to lift restrictions.

Please give me good news

In our favour is at least 25% of Victorians have received at least one dose of a COVID vaccine.

Our model suggests even modest rises in the vaccination coverage in Victoria, by an additional 5% for example, would dramatically increase the chance of controlling the outbreak from 50% to over 80%. If an extra 10% were vaccinated the chance of controlling the outbreak is 94%.

This is because evidence is mounting vaccinated people are less likely to transmit the virus to others. That’s in addition to the vaccines’ well known benefits in reducing your chance of severe disease.

So getting as many Victorians vaccinated as quickly as possible is critical.




Read more:
Should I get my second AstraZeneca dose? Yes, it almost doubles your protection against Delta


What do we make of all this?

Our study conveys a simple message. The battle against the Delta variant in the latest outbreak in Victoria will likely be tough but going early has given us the best chance.

This lockdown will not be as effective as earlier ones in Victoria and coming out of this will need to be carefully managed.

So keeping to the health advice, and vaccinating more Victorians as soon as possible even over the next few weeks, are key to handling this outbreak.




Read more:
Lockdowns don’t get easier the more we have them. Melbourne, here are 6 tips to help you cope


The Conversation


Lei Zhang, Associate Professor of Public Health, Monash University; Christopher Fairley, Professor of Public Health, Monash University; Guihua Zhuang, Professor, Xi’an Jiaotong University, and Zhuoru Zou, Doctor, Xi’an Jiaotong University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A tougher 4-week lockdown could save Sydney months of stay-at-home orders, our modelling shows


Allan Saul, Burnet Institute; Margaret Hellard, Burnet Institute; Michael Toole, Burnet Institute; Nick Scott, Burnet Institute, and Romesh Abeysuriya, Burnet InstituteResidents in Sydney, the NSW Central Coast, Blue Mountains and Wollongong today received confirmation their lockdown would be extended to at least 30 July.

But our modelling suggests it may take until the end of the year to get case numbers close to zero, unless more stringent measures are introduced.

NSW health authorities increased restrictions on Friday. These limit outdoor gatherings to two people, exercise to within 10km from your home, and shopping to one person from a household each day, with no browsing.

These restrictions are similar to Victoria’s Stage 3 and came on top of existing rules, which began on June 23, to only leave your home for four reasons: work/education, care/compassion, shopping for essential supplies, and exercise.

But additional measures – at least as strong as in Melbourne’s Stage 4 – are needed to get the greater Sydney outbreak under control.

For Melbourne’s second wave, this included closing non-essential retail, restricting movements to 5km from home and within the hours of 8pm to 5am, and mask-wearing outdoors.

COVID case numbers will fall if Victorian Stage 4 measures are applied in greater Sydney, for at least a month.

Our predictions

Our modelling shows that without the initial stay-at-home orders, the results would have been catastrophic (red line).

NSW’s updated level of restrictions (orange line, similar to Victoria’s Stage 3 + masks) would prevent daily case numbers from increasing further. But it’s not enough to eliminate community transmission before the end of the year.

But if Stage 4 restrictions were applied now (blue line), the epidemic curve would decline sharply.

It’s difficult to estimate the time to return case numbers from current levels to a seven-day average of less than five per day, but it’s likely to take at least a month.

So how did we reach these conclusions? We use two complementary modelling approaches to generate information about the measures needed to get case numbers under control.

Simulating people’s decisions

The first model, COVASIM, simulates individual people who reflect the diversity of the population. Individuals are allocated different numbers of daily contacts and can participate in various activities (for example going to school, work, bars/cafes, shopping, playing sport), which affect their risk of transmission.

People respond differently to COVID-19: whether they get tested, how long they wait before being tested, and how compliant they are with quarantine. For infected people, their infectiousness and disease prognoses also depend on their age and vaccine status.

COVASIM includes interventions such as testing, contact tracing and quarantine, and public health restrictions that can reduce transmission risk, such as masks and density limits, or the number of contacts.

We calibrated this model using extensive data from Melbourne’s second wave, then simulated a theoretical Delta variant outbreak. We wanted to know whether previous restrictions would be likely to contain the Delta variant, given improved contact tracing and limited vaccine coverage.

To produce a “Sydney-sized” outbreak, we ran the model with light restrictions until it reached a seven-day average of 30 diagnoses a day. We then applied three policy packages: no additional restrictions, restrictions similar to Melbourne’s Stage 3 + masks, and Stage 4 restrictions.

Looking at the whole city

Our second model, MACROMOD, takes the opposite view to COVASIM: it models what happens at the city level, instead of building up from the outcomes of many individual behaviours.

It assumes the epidemic proceeds as a series of periods of exponential growth or decline and is being updated daily as new daily case data becomes available.

MACROMOD was successful in describing Melbourne’s second wave (June to November 2020) and accurately predicted the time to reach zero cases in Melbourne under Stage 4 restrictions.

What does it predict for Sydney?

We modelled Sydney’s current outbreak with MACROMOD for 21 days from June 23, when stay-at-home orders began, to July 13.

The impact of the stay-at-home orders was expected to start by July 1. But we couldn’t detect any decrease in the exponential growth in COVID case numbers.

This tells us that despite the fine work done by contact tracers and the NSW public, the high transmissibility of the Delta variant requires a much more vigorous response.

We then projected the model forward to predict the impact of the extended controls on July 9, and a further hypothetical increase similar to Melbourne’s Stage 4 restrictions.

The model suggests that the extended controls may be enough to “flatten the curve”, but are unlikely to contain the outbreak.

Thankfully NSW still has public health levers it could use to get the outbreak under control. We found if Stage 4 restrictions were applied now, the epidemic curve would decline sharply.




Read more:
80% vaccination won’t get us herd immunity, but it could mean safely opening international borders


The Conversation


Allan Saul, Senior Principal Research Fellow (Honorary), Burnet Institute; Margaret Hellard, Deputy Director (Programs), Burnet Institute; Michael Toole, Professor of International Health, Burnet Institute; Nick Scott, Econometrician, Burnet Institute, and Romesh Abeysuriya, Senior Research Officer – Computational Epidemic Modelling, Burnet Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Sydney is locked down for another 7 days. So what will it take to lift restrictions?


AAP/Dan Himbrechts

Hassan Vally, La Trobe University and Catherine Bennett, Deakin UniversityNew South Wales Premier Gladys Berejiklian today confirmed what Sydney was fearing: the city’s lockdown will be extended for another week.

With 27 locally acquired cases identified in the past 24 hours, this decision isn’t surprising.

Of some concern, seven of these people had been moving around in the community during part of their infectious period. Another seven appear to have been in the community for the whole of their infectious period.

These aren’t the numbers you want to be seeing when considering emerging out of a lockdown.

So what are health authorities looking for when when making decisions about relaxing restrictions?

The first key factor is whether the public health team is identifying the epidemiological links between cases.

The second is whether contact tracers are able to identify all potential cases and quarantine them before they’re infectious. This is clearly not yet the case in NSW.

Remind me, why did Sydney go into lockdown?

After health authorities identified the initial cluster, it looked like it could be brought under control. But then they discovered a new, significant chain of transmission.

While it could be traced back to the Bondi Junction cluster, there had been more than one generation of spread in the community. This included a seafood wholesaler in Marrickville, with transmissions going back a week before they caught it, and a flight crew member who travelled interstate while likely to be infectious.

It would take some days to identify, trace, isolate and test all contacts.

The second and equally important reason for lockdown was contact tracers weren’t able to keep up with all the cases, despite identifying this outbreak within the first generation of spread.




Read more:
Did Sydney’s lockdown come too late? Here’s why it’s not that simple


Contact tracers were finding the interval between exposure and becoming infectious could, in some cases, be as short as 24 to 48 hours.

They were concerned that known chains were still active and other significant chains of transmission were yet to be discovered. So they needed the extra level of transmission suppression that lockdown brings.

What’s happened since?

Fortunately, no other chains have been unearthed linked to large workplaces or complex setting. But the outbreak isn’t yet contained, so restrictions are still needed.

However, this could turn around quickly, as the number of new exposure sites diminishes.

An important element of the public health response has been the decision to ask the households of those who have been to key exposure sites to also isolate while the infection status of the person exposed is worked out.

This, along with people rapidly self-identifying when new exposure sites are listed or older sites are reclassified to “close cotact” status, will allow the contact tracers to get ahead of the virus. Then, new cases will only be found in quarantine.

At that point, new cases may continue to be reported, but lockdown will no longer be necessary.

So what needs to happen for Sydney to end lockdown?

When it comes to relaxing restrictions in Sydney next week, there is a lot to consider.

First, we have to take into account we’re dealing with the more infectious Delta variant. It’s around twice as infectious as the original strain that emerged from Wuhan. This has considerably changed the risk assessment, given the ease and speed at which it seems to spread from one person to another.




Read more:
Why is Delta such a worry? It’s more infectious, probably causes more severe disease, and challenges our vaccines


It’s also important to consider we’ve seen casual exposures in shared public indoor places contribute more to the spread in this outbreak. Indeed, this outbreak was seeded with a number of casual exposures resulting in new cases and widespread transmission within the first generation of spread.

Schools have become key transmission sites in this outbreak, and also in the smaller Delta outbreak in Melbourne in May. So, while schools were once seen as less worrisome locations, they’re now a more important consideration.

So far, the NSW government has delayed the return of students, with those in greater Sydney moving to home learning next week. The premier said this wasn’t because they were risky places, but to “stop literally hundreds of thousands of adults moving around and interacting with each other” at pick up and drop off times.

Hopefully the extra week of lockdown and home learning is enough to stamp out transmission, so NSW can start to get back to where it was a few weeks ago.

As Berejiklian said today, there is only one thing worse than a lockdown and that is cycling in and out of lockdowns, given the huge economic and social costs.

All the evidence shows that going hard to suppress transmission pays dividends many times over for both health and economic outcomes.

And of course, as soon as we reach a high enough level of vaccine coverage, lockdowns will be a thing of the past. This should be a big motivation for all of us to get vaccinated.




Read more:
Australia has a new four-phase plan for a return to normality. Here’s what we know so far


The Conversation


Hassan Vally, Associate Professor, La Trobe University and Catherine Bennett, Chair in Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Vital Signs: Australia’s anti-lockdown tribe battles on against the evidence


Richard Holden, UNSWYou might have thought the “lockdown wars” in Australia were over.

After all, Australia navigated the pandemic better than essentially any other country in 2020.

We closed our international border in March, used an early and relative light lockdown in NSW to get contact testing and tracing up and running, squelched costly hotel quarantine leaks in Victoria with more dramatic measures, and generally kept Australia as COVID-free as possible.

We adopted the wise principle, borne out by so much tragic international experience, that we could not have a functioning economy with a pandemic raging.

The overwhelming focus of public policy has now shifted to getting people vaccinated. But some of the anti-lockdown tribe are battling on, suggesting our border controls and lockdown didn’t save lives.

Are they right? No.

Their latest argument uses a US National Bureau of Economic Research working paper by academics from the University of Southern California and the RAND Corporation that looks at “excess deaths”. That is, it compares total deaths from all causes in a particular jurisdiction with an estimate of “expected” deaths in that jurisdiction based on historical data.




Read more:
Yes, lockdowns are costly. But the alternatives are worse


Their data covers all 50 US states and 43 nations, including Australia. Their conclusion is that “shelter-in-place” policies were associated with an increase in excess mortality, with the exception of three countries: Australia, Malta and New Zealand.

So this isn’t a good argument against our approach. Nor did the authors find any statistical significant result covering more than the immediate weeks following shelter-in-place implementation in the more internally comparable US data.

Nonetheless it’s worth examining this paper, and also looking at what Australian data on excess deaths is showing.

A brave empirical method

The National Bureau of Economic Research is a distinguished organisation. It has published nine of my working papers. But this does not bestow some kind of magical status on them. It doesn’t mean they are peer-reviewed. Rather, it is an automatic privilege accompanying bureau affiliation.

Thus every paper comes with the disclaimer that “working papers are circulated for discussion and comment purposes” and “have not been peer-reviewed”.

The paper latched on to by the anti-lockdown tribe uses an empirical method known as an “event study”. Such studies were popularised in financial economics thanks to an influential 1969 paper on stock prices by American economist Gene Fama and colleagues.

Eugene Fama 1969 paper 'The Adjustment of Stock Prices to New Information'.
Eugene Fama 1969 paper ‘The Adjustment of Stock Prices to New Information’.
CC BY-SA

Fama has been called the “father of modern finance” for his work on the “efficient markets hypothesis” – the idea that asset prices reflect all available information, so it is impossible in the long run to “beat” the market.

The efficient markets hypothesis is a big and important idea in financial economics. It rightly led to the 2013 Nobel prize for economics, which Fama shared with University of Chicago colleague Lars Peter Hansen
and Yale University’s Robert Shiller, who built on Fama’s work and concluded that markets are often very far from efficient.

Whatever one’s view about the rationality of asset prices, it is important to understand the “event study” method relies crucially on rationality in financial markets and the efficiency of securities prices. As one survey article of event studies notes:

The usefulness of such a study comes from the fact that, given rationality in the marketplace, the effects of an event will be reflected immediately in security prices. Thus a measure of the event’s economic impact can be constructed using security prices observed over a relatively short time period.

Using an event study to assess a noisy measure of mortality in decidedly inefficient political markets (if one can even call them that in this case) is a million miles away from the purpose and internal logic of event studies in securities markets.

The nice way to describe using an event study to assess pandemic policy is that it’s “brave”.

Australian data on deaths

The Australian Bureau of Statistic collates definitive statistics about deaths after reports from state coroners are finalised. It usually publishes these annually, in September.

Due to the interest in deaths due to the pandemic, however, the bureau has been publishing monthly “provisional mortality statistics” based on doctor-certified deaths. (About 80-85% of all deaths are certified by doctors, without a coroner determining the cause.)




Read more:
You can’t fix the economy if you can’t see it: how the ABS became our secret weapon


The provisional statistics show Australia had slightly fewer non-COVID-related deaths in 2020 than normally the case (an average of 385.6 deaths per day, compared to the baseline average of 385.8.)


Doctor certified deaths, COVID-19 infections, Australia, 23 Feb 2020 - 28 Mar 2021 vs 2015-2019 benchmarks.

ABS, CC BY-SA

In 2020 and so far in 2021 Australians have been less likely than normal to die of heart disease and strokes, and dramatically less likely to die from flu.

What about suicides?

A common claim by the anti-lockdown tribe is that suicides have risen due to people being socially isolated and losing work.

But early evidence from insurance companies on suicides shows the opposite.

There’s a good reason for this. As Simon Swanson, the chief executive of ClearView Life Assurance, told the House Standing Committee on Economics on June 25:

If you read our annual report last year you would have seen we increased assumptions for suicide. That did not actually happen — suicide actually went down —and in our research part of that was because people were participating in a global pandemic and everyone was in this together. The second impact was there was an incredible increase in telehealth, which was an interesting part of technology actually delivering to consumers.

Everyone was in this together.

There may, of course, be other mental health impacts from lockdowns. But there are no perfect options. We will have a greater array of policy options when at least 80% of the population are vaccinated.

With apologies to John Keating (played by Robin Williams) in Dead Poets Society: “‘Twas always thus, and always thus will be.”The Conversation

Richard Holden, Professor of Economics, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Did Sydney’s lockdown come too late? Here’s why it’s not that simple


Mick Tsikas/AAP

Catherine Bennett, Deakin UniversityLast Saturday, the New South Wales government announced a two-week lockdown for Greater Sydney, the Blue Mountains, Central Coast and Wollongong after a spike in new COVID cases.

It’s spawned a lot of commentary about whether NSW delayed going into lockdown, and therefore has caused itself a longer lockdown. Indeed, one modelling study by University of Sydney researchers, published last November, estimated delaying lockdown by three days would extend the lockdown by three weeks.

But it’s not that simple.

This kind of modelling is about using lockdown as a primary intervention where you’re relying on the lockdown itself to snuff out transmission. Even if the cases aren’t tested and recognised, the virus eventually runs out of new susceptible people to infect. This isn’t the case in NSW, which is still relying on a strategy of test, trace and isolate.

If this lockdown is about buying time to allow contact tracers to get in front of the virus by getting all at-risk contacts of cases in quarantine before they’re infectious, then a day’s “delay” is probably not going to add weeks to it. The modelling doesn’t apply in this scenario.

Whenever we’re evaluating a lockdown, there’s always an element of “hindsight being 20/20”. Some of the circuit-breaker lockdowns we’ve had over the past year didn’t change the management of cases and contacts because all community transmission that did occur after lockdown was among known contacts already in quarantine. But we didn’t know that until after the lockdown was called. Circuit-breakers are essentially insurance policies or safety nets (though we should still evaluate them to know when they are justified).

During this pandemic we’re often making decisions in situations of considerable uncertainty.

Things have clearly shifted in our latest outbreaks in Victoria and NSW. Contact tracers have been very effective at finding, linking and documenting the spread of cases. And in NSW’s latest outbreak, health authorities have had the added advantage of discovering the cluster within the first generations of spread. This means they’ve been able to collect data on where the virus was, and how transmission was occurring, in almost real time.

It’s easy to sit here and say locking down earlier would have made a difference. But when should it have been called? When we knew of only ten cases the Saturday before last? While infections among casual contacts were concerning, nobody knew 24 future cases would soon be exposed to a case at private party of 30 held later that same night.

So what works best in situations like this — go early just in case? I would argue go with the data when you are this close to the leading edge of the outbreak. Assess the data in real time and be prepared for a rapid change in response.

The emerging story over last week was of many cases, but almost all linked to the known cluster. By week’s end, it was clear at least one branch of the outbreak was missed with multiple cases infectious in the community over five days or more.

What led to this lockdown?

Rather than relying on high-level modelling of transmission risk and projections, we can also build a detailed picture of the epidemiology of an outbreak as it is playing out.

NSW has had very detailed transmission data on almost all cases, bar a handful, which puts them in a strong position.

A potential risk in relying on contact tracing is how quickly things can escalate if you miss a major chain of infection. This was the case for the cluster involving a seafood wholesaler in Marrickville, which was spreading invisibly and had transmissions going back a week before they caught it. On Sunday, ten of the 30 new cases announced were linked to this cluster.

Another factor was casual transmission. This Delta variant is much more infectious than previous strains, and some of the early cases in this outbreak occurred from merely “fleeting” exposure. Some of these early transmissions happened in places where health authorities couldn’t be confident they could track down all casual contacts, and those who were exposed may have underestimated their risk of having been infected.




Read more:
We’re seeing more casual COVID transmission. But is that because of the variant or better case tracking?


Yes it’s true almost all the cases are “linked” to previously known cases, but some of these were linked via a convoluted, longer path as a contact of earlier missed cases. This meant more people circulating while infectious over a larger number of days.

The distribution of cases also played a role. Even though it seems to still be largely focused around Bondi, cases and potential exposures were now spread beyond.

Should NSW have locked down a few days earlier? It’s hard to say, but will be important to evaluate when things settle

A lot of people forget there were only ten cases in total in this outbreak just over a week ago. There were two new cases per day between June 16 and 20 inclusive, which are numbers we all know are manageable for NSW contact tracers.

Should they have gone into a full lockdown on Sunday, June 20, when they had a total of ten cases? I don’t think you could defend that epidemiologically.

Cumulative cases then went from ten to 25 two days later, to 54 another two days later on June 24, to 112 on Saturday June 26 when lockdown was announced.

It looked like they were right on top of it, and were very close to getting to all contacts before their infectious periods. But they were still probably a day or so behind the virus. Even one infectious day each in the community by a few contacts simultaneously is very risky and adds to exposure sites.

This Delta variant also seems to have reduced the time between cases being exposed to the virus and becoming infectious themselves, according to NSW Chief Health Officer Kerry Chant.

All this painted a very different picture to the week before, and would have contributed to the decision to lock down.

We need to analyse the data

Now we need to evaluate this outbreak response, along with all others in Australia, and learn more about how the virus moves through our communities, our weak points, our most effective containment measures, and the optimal timing of these.

The lockdown won’t yet have played a significant role for new cases. But we also know from the timing of cases that locking down a few days earlier wouldn’t have stopped the seafood wholesaler outbreak, nor would it stop spread in high-risk essential workplaces.

Analysing the outbreak aims to understand any additional cases that might have been prevented with earlier lockdown, or how many cases will be prevented with lockdown in place now. It will allow us to, under various alternate scenarios, use these rich detailed case data to remove some of the uncertainty next time.The Conversation

Catherine Bennett, Chair in Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We need to prioritise teachers and staff for COVID vaccination — and stop closing schools with every lockdown


Shutterstock

Asha Bowen, Telethon Kids Institute; Archana Koirala, University of Sydney, and Margie Danchin, Murdoch Children’s Research InstituteYesterday Victoria announced a snap lockdown to last at least seven days starting from 11:59pm last night.

As part of the lockdown, schools will close and move to remote learning, and today is a pupil-free day while schools prepare to teach online. Only the children of authorised workers and vulnerable kids will continue to be able to learn in person.

It’s another episode of schools being closed seemingly as par for the course in any COVID-19 outbreak. While communities are concerned about the outbreak, the inclusion of schools in the lockdown should be as an extension of controls if transmission is more widespread, rather than the immediate response.

Despite good evidence, the previously developed traffic light system isn’t being used for schools during outbreaks in Australia. There’s currently no national plan to guide states and territories on how to manage schools during COVID outbreaks, and to advise them on the evidence and best-practice. This needs to change.

We argue schools should be prioritised to remain open, with transmission mitigation strategies in place, during low levels of community transmission.

What’s more, if schools are a priority, then vaccinating all school staff is something we should be urgently doing as part of these strategies.

Schools should be a priority

As paediatricians and vaccine experts, we believe kids’ well-being and learning should be among the top priorities in any outbreak.

We advocate for strategies to reduce the risk of COVID transmission in schools during outbreaks, including measures like:

  • minimising parents and other adults on the school grounds, including dropping kids off at the school gate rather than entering the school
  • parents, teachers, other school staff, and high-school students wearing masks
  • focusing on hand hygiene
  • enhanced physical distancing
  • good ventilation in classrooms and school buildings.

On top of this, we believe if schools, teachers and kids are viewed as a priority by decision makers, then vaccinating all school staff should urgently be considered.

Vaccinating all school staff would reassure those who have concerns about being at work in a school environment during a lockdown, and potentially lower the risk of spread in schools even further. This would increase the confidence in schools remaining open.

Kids are not major drivers of transmission

Kids can and do get sick with the SARS-CoV-2 coronavirus, though they tend to get less severe disease.

The best available evidence suggests kids and schools are not major drivers of transmission, even though children can transmit the virus.




Read more:
Why do kids tend to have milder COVID? This new study gives us a clue


Snap lockdowns have become the new norm in Australia for managing COVID transmission emerging from hotel quarantine. We strongly argue snap lockdowns shouldn’t automatically include schools. Data from overseas, where widespread community transmission is occurring, suggests schools remaining open with public health measures in place hasn’t changed transmission rates very much.

We advocate for schools to remain open, and if a student or teacher attends a school while infectious, the measures in place to test, trace, and isolate the primary and secondary contacts are activated. We have done it before. NSW was able to continue with face-to-face learning and had 88% attendance in term three 2020 even with low levels of community transmission.

When there’s rampant community spread like some countries overseas, this changes the risk-benefit equation and school closures may be needed. The traffic light system has been developed for exactly this scenario.




Read more:
We can’t close schools every time there’s a COVID outbreak. Our traffic light system shows what to do instead


But with an outbreak of 30 cases so far, we don’t think Victoria is near the flexion point where school closures are necessary. If there were many more, the risk equation would change, and the traffic light system could be applied.

Also, there’s a different risk equation for primary and secondary school students. Primary school kids are much less likely to transmit the virus than secondary school students. Daycare and early childhood centres remain open in Victoria. The evidence supports at least primary schools remaining open too.

We need a national plan on schools

Our concern is that jurisdictions are reaching for school closures as an almost predictable part of lockdown, without relying on a national plan to guide these decisions. The only current guidelines are the Australian Health Protection Principal Committee’s (AHPPC) statement from February on reducing the risk of COVID spread in schools.

Only about 13% of Australians have received at least one COVID vaccine dose, and ongoing community COVID outbreaks are expected for at least the next year or more. So, we need a proper national plan on COVID and schools. States and territories would benefit from a national plan, as they could lean on it to make informed decisions on schools during outbreaks.

School closures cause enormous strain

Whenever school closures are announced, we hear many parents sigh and say things like “I won’t be able to get any work done!”. Indeed, school closures put enormous strain on families, especially working parents with pre-school or primary school aged children. Younger children require some supervision and are less likely to have the skills necessary to get value out of online learning, compared to older kids in the latter stages of high school who may be more independent.

Challenges might also include poor or no internet, not being able to have relevant supervision, or not having the right devices.

Home learning has a substantial impact on children’s well-being and mental health. Over 50% of Victorian parents who participated in a Royal Children’s Hospital poll in August 2020 reported homeschooling had a negative impact on their kids’ emotional well-being during the second wave in 2020. This was compared to 26.7% in other states. Jurisdictions keep playing into this risk if they keep closing schools.

It’s an absolute priority we find and use ways to support kids to continue face-to-face learning in times of low community transmission, especially primary schools. One important way to do this is to prioritise teachers and other school staff for COVID vaccines.




Read more:
Children, teens and COVID vaccines: where is the evidence at, and when will kids in Australia be eligible?


The Conversation


Asha Bowen, Program Head of Vaccines and Infectious Diseases, and Head of Skin Health, Telethon Kids Institute; Archana Koirala, Paediatrician and Infectious Diseases Specialist, University of Sydney, and Margie Danchin, Paediatrician at the Royal Childrens Hospital and Associate Professor and Clinician Scientist, University of Melbourne and MCRI, Murdoch Children’s Research Institute

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