Worried you might test positive and put a spanner in Victoria’s COVID roadmap? Here’s why you should get tested anyway

Breanna Wright, Monash University

Victoria’s much-anticipated roadmap out of lockdown was released on Sunday, bringing with it a clear outline of how (and provisionally when) Victoria will see an easing of restrictions.

The plan is transparent about the case numbers, or lack of them, required for the state to move to each progressive stage. For example, moving to the second step, provisionally scheduled for September 28, will require an average of 30-50 new cases per day over a 14-day period.

Victorians are suffering from lockdown fatigue. They’re exhausted and drained. The reopening of playgrounds, the singles bubble, shortening the curfew, and an extra hour of daily exercise are all gestures to keep them going during this difficult time. But many people are still desperate for the lockdown to end.

Lockdown won’t be over until the number of positive cases falls. And there’s a risk that a desire to end restrictions might discourage Victorians from getting tested, for fear of adding to the numbers and prolonging the lockdown.

Not getting tested?

The way society views an illness affects how people who have it or might have it feel and behave. Since the beginning of the pandemic, terms such as “COVID suspect” or “superspreader” have risked creating a sense of shame for those who contract the virus.

Those feeling unwell may not want to be seen as “part of the problem”. We know from other diseases, when there is stigma attached to being sick, people with symptoms are less likely to seek care. No Victorian will want to be blamed for restrictions lasting any longer than they have to.

Read more:
Why children and teens with symptoms should get a COVID-19 test, even if you think it’s ‘just a cough’

Testing is still vital

Nevertheless, it is crucial people continue to get tested. Without this information, it will be impossible for the government to negotiate a safe path out of restrictions. Gaps in our knowledge could mean the decision-makers don’t have enough confidence to progress to the next step.

Analysts already know when there are gaps in our understanding. Earlier this week, evidence of the coronavirus was found in sewage from Apollo Bay, about 200 kilometres southwest of Melbourne, despite no one in the area having tested positive.

Test results are just one piece of data — albeit a crucial one — that informs our understanding of the situation. Testing actually helps us move forward faster, not slower.

How to encourage testing

There are several ways to ensure the number of COVID-19 tests remains high. More than 2,403,388 tests have now been done in Victoria, 12,938 on Sunday.

1. Create a sense of pride in getting tested

Obviously, low numbers of positive tests are good. But high numbers of negative tests are much more informative than no test results at all. Telling your friends you’ve been tested, or posting it on social media, should be a source of pride that you’re doing your bit for Team Victoria.

2. Remove the stigma and shame

We should also work to remove the stigma of contracting COVID-19 — no one is catching it on purpose, after all. Campaigns such as Melbourne Strong aim to help people who are struggling in lockdown, and we should extend this kind of support to those going through COVID-19 itself.

3. Promote positive messaging

It’s important to remember how far we’ve come since the peak of Victoria’s second wave. On July 30 there were 723 new cases; on Monday we had 41. We also now know the targets we need to hit to end the restrictions, and Premier Daniel Andrews has raised the possibility they could even be lifted early. Influential community messengers can help reinforce this message of hope.

4. Make testing easier

The Victorian government has tried to make testing as easy as possible, through measures such as mobile testing, incentive payments and research into faster tests. They should also consider keeping information on wait times for different testing sites up to date, as for many places it is not currently available.

Read more:
Goodbye, brain scrapers. COVID-19 tests now use gentler nose swabs

There’s no easy road out of this pandemic, but now we have the roadmap and we know where we need to get to. So if you have COVID-19 symptoms, don’t hesitate to get tested. You’ll be doing yourself and the whole state a favour.The Conversation

Breanna Wright, Research fellow, BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University

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

How long will I have to wear a mask? Can single people visit a sharehouse? Common questions answered about Victoria’s new roadmap

Liam Petterson, The Conversation and Sunanda Creagh, The Conversation

The Victorian government’s roadmap out of pandemic lockdowns includes new provisions for single people living alone and single parents: the “single social bubble” system, which comes into effect on September 14.

Under the new system, if you’re a single person living alone or a single parent with children under 18, you can nominate one other person to be a part of your bubble.

The nominated person can visit your home and you can visit theirs — but only under certain circumstances. Both the single person and the nominated person must wear masks during the visit.

The system will replace the old rule, under which people could leave the house to visit an intimate or romantic partner but not a friend.

We collected answers to some common questions and asked three experts — an epidemiologist, an academic who researches sharehouses, and a philosophy researcher who examines how governments make rules around different types of relationships — to reflect on the new rules.

How long will I have to wear a mask?

Potentially for a good while yet.

Victoria’s Department of Health and Human Services told The Conversation:

Masks will remain a tool in our fight against coronavirus for the foreseeable future. We have seen that there is more and more evidence to support the use of masks in slowing the spread of coronavirus. They are relatively inexpensive, accessible, and not too much of an imposition.

We expect that they will continue to be a part of our daily lives for some time to come.

FAQs for the roadmap to recovery in Victoria can be found on the Vic gov website here.

I’m single but live in a sharehouse or with family. Can I form a single social bubble with my friend?

No. The government factsheet says:

You can only nominate a person to be a part of your ‘single social bubble’ if you live alone, or are a single parent.

If you’re single and live alone, does the person you nominate also have to live alone?

No. Your nominated person can live in a sharehouse or with family. The factsheet says “you are also able to visit them in their home, but only when they are alone.”

So their housemates or family must be out of the house when you (the single person) wants to visit.

I live alone but am not single. Can I nominate a social bubble person to visit – my best friend or my sister, for example?

You’re faced with a tough choice. According to the Victorian government’s FAQ sheet:

people must choose whether they wish to see their intimate partner or form a ‘single social bubble’ with another nominated person.

If you designate someone to be in your bubble, is there some formal procedure? Do you have to register the person or get a permit?

No. If you’re a single person living alone or a single parent, your “nominated person” doesn’t need a permit – the Victorian government says it’s relying on people to “do the right thing”.

Read more:
‘Slow and steady’ exit from lockdown as Victorian government sets sights on ‘COVID-normal’ Christmas

The epidemiologist’s view: analysis from Mary-Louise McLaws

I am glad the rule on masks is remaining in place for a while yet. It’s a cost effective way to reduce transmission.

I am pleased the government has responded to calls from the community for compassion. I have argued before in favour of the bubble concept.

Yes, there are a lot of rules about how the single social bubble system will work in practice and some single people will miss out but I can understand why the authorities have done that.

On the rule that a single person can only visit their nominated person’s home if all other adult household members are out, I understand the logic and I think it’s reasonable and likely based on reducing the risk of spread to the household.

Yes, it might be tricky but you will be allowed to sit outside for two hours with one other person, so you and your bestie could be in the park.

Nothing is going to be perfect. Everything will have some logistical challenges but the fact authorities are willing to insert a compassionate component into this roadmap at the first step is commendable. For the sake of those who need support, we need to work around it.

I understand why they have asked people to wear masks when a single person and a nominated person get together in a shared home. There’s still a risk of transmission to others living in the shared accommodation even when they aren’t at home during the visit because the visitor can exhale virus several days before they start to show symptoms. Exhaled virus particles can contaminate surfaces or remain in the air when air flow at home is not high.

I hope people do the right thing. People are desperate to see the person they love or the person that makes them happy to help them get through this pandemic.

I am so delighted authorities are understanding they need to keep people safe and safety includes compassion. This is a step forward. Yes, some people will miss out and yes there are issues around the rules that need to be made safe. But Australia hasn’t had a pandemic quite like this before.

Two people sitting in the park
Socialising outside has a lower infection risk than indoors.

The sharehouse researcher’s view: analysis from Katrina Raynor

My research involved surveying more than a thousand people who have lived in a share house in Victoria at any time in 2020. We found many of them are already under intense pressure.

I think the single social bubbles concept in the new roadmap is an excellent step, but will be experienced differently by people who live in sharehouses.

Throughout the pandemic, I think there has been a presumption towards nuclear families or couples in the way policies have been written.

Particularly in relation to the idea of single social bubbles idea, the idea that a single person living alone can only visit their nominated person if the nominated person is alone in their house — this could be incredibly tricky in practice. And it differs from how intimate partners are treated in the rules.

These rules could present an extra area of conflict for sharehouses, many of which are already in conflict. One person we interviewed described COVID-19 as being like Married at First Sight for housemates, and I think that is very true.

Read more:
Victoria now has a good roadmap out of COVID-19 restrictions. New South Wales should emulate it

Rules that stipulate only one person per household can shop are also confusing for sharehouses — housemates tend to shop for their own needs rather than the “household’s”. I suspect there are many who are not or can not follow that particular rule.

While I understand why members of share households won’t be able to take advantage of the single social bubble from a public health perspective, I think many will continue to feel lonely.

We may presume these single people have a fulfilling relationship with their housemates and that’s not always the case.

The philosopher’s view: analysis from Stephanie Collins

I think the single social bubble concept is an improvement on the rules we had before, where people could only visit their intimate partners. That clearly was an instance of society privileging one type of relationship over another, which is a question I look at in my research.

I am not too worried about “coupled up” people who live with an intimate partner and can’t take advantage of the social bubble.

But I am a bit worried about people who are single and living in a sharehouse not being able to form a single social bubble.

People don’t always know their housemates particularly well and might not turn to their housemates for the kind of intimate psychological connections we know are so important for human flourishing.

But we have to acknowledge the law is a blunt instrument. It’s difficult for the government to say “if you are not friends with your housemates then you can visit a nominated person”.

I do think the government is in a difficult position. What they have come up with is not a terrible compromise but it certainly won’t solve every social connection problem.

In general, I am very much in favour of the single social bubble. I think the previous rule really unjustly favoured people in intimate relationships over other kinds of relationships.

I hope this rule sticks around if Victoria or other states need to lockdown again in future. This concept could be integrated and improved in an ongoing way and I hope it’s not a reactionary decision.The Conversation

Liam Petterson, Assistant Editor, Health + Medicine, The Conversation and Sunanda Creagh, Head of Digital Storytelling, The Conversation

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

Victoria now has a good roadmap out of COVID-19 restrictions. New South Wales should emulate it

Stephen Duckett, Grattan Institute

The COVID-19 roadmap for Victoria announced by Premier Daniel Andrews sets the state on the right path. Something like it should be emulated by New South Wales, which has not yet achieved zero new cases.

Victoria’s roadmap towards what Andrews calls “COVID-normal” makes a clear distinction between metropolitan Melbourne and regional Victoria. Restrictions are marginally less severe in regional Victoria, where the incidence of infections is lower.

Read more:
Victoria’s path out of COVID-19 lockdown – quick reference guides

For metropolitan Melbourne there are five steps; regional Victoria has four. For each step, the roadmap outlines which restrictions will be lifted on our road towards the cherished status of COVID-normal – or zero active cases of COVID-19. The roadmap also provisionally outlines when restrictions will be lifted, although this depends on case numbers.

For metropolitan Melbourne, the curfew will be eased from next week to start at 9pm instead of 8pm. It will remain in place until new cases average fewer than five per day over the course of a fortnight – the criterion to move to the third step of the roadmap.

The first two steps will still entail significant restrictions on public gatherings and visitors, plus the creation of a “single social bubble” allowance, under which people living alone can designate a person who can visit their home. Staged school returns will begin once there are fewer than 50 cases a day on a fortnightly average.

Step three sees the partial resumption of Melbourne’s café culture, as well as hairdressing.

A new traffic light system will also be introduced to allow a phased reopening for businesses and workplaces.

Is the roadmap heading in the right direction?

Grattan Institute’s four-point plan, detailed in our report last week titled Go for zero, argues that states should reaffirm the National Cabinet’s target of zero transmissions and set clear criteria for easing restrictions.

The Victorian roadmap keeps appropriate restrictions until zero active cases – the Grattan criterion for defining zero – before the final step on the roadmap, COVID-normal.

Grattan’s second criterion – clear and explicit staging of the easing of restrictions – is also met in the Victorian roadmap, but in a confusing way. The thresholds adopted in the Victorian plan are a mishmash of epidemiological criteria, case numbers and dates.

It is entirely appropriate that the roadmap’s dates are purely provisional, and subject to epidemiological criteria such as average case numbers. But this raises the question of why the roadmap has dates at all.

Read more:
‘Slow and steady’ exit from lockdown as Victorian government sets sights on ‘COVID-normal’ Christmas

Victorians may read the epidemiological criteria as reasons to bring forward the provisional dates for easing restrictions, when in reality they are more likely to put the provisional dates back. The public might end up frustrated if the promised date passes with no reward for good behaviour.

The epidemiological criteria are expressed in an extremely complex way: a 14-day threshold average, plus further criteria based on the source of infection. Until now, the public’s attention has been focused simply on the number of new cases each day.

Introducing this more complex measure is a step backward. Expressing the criterion as an average also runs the risk of the threshold being met but the final few days of the 14-day averaging period revealing an upward trend. A simple and clear criterion, based on number of new cases, would have been better.

Politics as well as science?

The Victorian government has trumpeted the use of epidemiological modelling to support its decisions. However the first two steps seem to be driven by a mix of politics and science.

Step one will occur on September 13, regardless of the number of new cases detected between now and then. The new case threshold for step two is expressed as an average of 30-50 cases a day over the previous 14 days. It is unclear why there is a lower bound; why not just say “fewer than 50 cases”? If it is designed to give political flexibility, it defeats the purpose of clear criteria.

Knowledge of the coronavirus and how it works – both in terms of clinical treatment and public health science – is advancing rapidly. We now know more about which restrictions work best than we did when Melbourne first entered its Stage 4 lockdown.

Some restrictions included in the roadmap – such as night curfews – now have a weak evidence base. The evidence is also stronger now in allowing primary schools to return before secondary schools, but the roadmap takes no account of this distinction. It is a pity the roadmap doesn’t align more closely with the latest science.

Read more:
Children might play a bigger role in COVID transmission than first thought. Schools must prepare

Lockdowns are necessary, but they have big downsides which need to be weighed against the undoubted benefits. One main downside is that they hit the most disadvantaged people hardest. The cost of social isolation has been somewhat ameliorated in the roadmap, with its provision for “social bubbles”, but this could perhaps have been more generous.

Overall, Victoria’s roadmap is good. It identifies the right goal (zero active cases), it provides explicit criteria for when restrictions might be lifted (but unfortunately not as clear and simple as they could be), and each of the steps involves mostly appropriate restrictions.

Victorians have every reason to share in Andrews’ hopefulness for a COVID-normal Christmas to cap off a very difficult year.The Conversation

Stephen Duckett, Director, Health Program, Grattan Institute

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

New roadmap gives Australia two paths out of COVID-19 lockdown: elimination or adaptation

Peter Sivey, RMIT University

Australia is in an enviable position when compared with major world cities like New York, London and Madrid, each of which continues to deal with COVID-19 deaths in the thousands.

Although Australia has suffered 91 deaths, its daily rates of new cases are now in the low double figures or even single figures – evidence of very little community transmission in the country.

This means that unlike places that are still facing lockdown for weeks or months to come, Australia has some crucial imminent policy choices: how to balance the economic and social benefits of easing restrictions with the risks of a future spike in cases.

Read more:
What might trigger a return to ‘normal’? Why our coronavirus exit strategy is … TBC

Roadmap to recovery

The Group of Eight, an affiliation of leading Australian research universities, this week published a major independent report describing a Roadmap to Recovery for the nation. It sets out some key policy choices, as well as a suite of recommendations to state and federal governments for the months ahead – specifically, beyond May 15, the extent of the federal government’s current restrictions.

The report invites the Australian government to choose between two contrasting but related strategies: “elimination” of COVID-19, and a “controlled adaptation strategy”.

Under the elimination scenario, Australia would continue its nationwide stay-home order (although restrictions currently vary between states) for two further weeks after daily cases reach zero. That means lockdown would last until the end of May or mid-June, given the current trends in cases. But beyond that many social distancing measures could be lifted relatively rapidly, due to minimal risk of community transmission. Travel restrictions would have to remain tight indefinitely, to prevent the possibility of reintroduction of the virus.

In the alternative, “controlled adaptation” strategy, the government would still use aggressive test-and-trace protocols to keep the number of new cases as low as possible. But lockdown restrictions would be lifted earlier – perhaps in the next couple of weeks – although the lifting would necessarily be gradual, with continued social distancing measures applied to shops, schools and workplaces.

Pros and cons

The advantages of elimination is that it prioritises Australians’ health while also affording a more rapid lifting of restrictions once it is deemed safe. For example, restaurants and cafes might perhaps return to serving sit-down customers once elimination has been achieved.

Controlled adaptation will involve more ongoing social distancing. Conceivably, even six months from now, shops and public transport might operate at restricted capacity so people aren’t crowded together. But the advantage of this approach may be in the long term: it prepares Australians for the fact that this virus will probably be circulating around the world for years, and we should adapt our behaviour accordingly.

Furthermore, with improved speed and availability of testing, an adaptation strategy would perhaps allow less stringent international travel restrictions later this year and into 2021. That would be a boon for Australia’s higher education industry, its immigration-dependent construction sector, and its (currently shrinking) overall population.

A ‘continuum’ of choice

Why does the report advocate two strategies, rather than backing just one? The report argues they are not distinct choices, but rather they lie “along a continuum” of strategic options.

So if the government opts to pursue elimination, it would still need to maintain testing and tracing capability in the longer term, as well as continuing to enforce some forms of social distancing even as other restrictions are lifted (for instance, it’s hard to imagine moshing at rock concerts being allowed anytime soon).

Conversely, pursuing a controlled adaptation strategy doesn’t mean Australia can’t also aim to bring cases to zero if possible, as many states are already recording zero cases for several days in a row.

The final exit from either strategy will involve a safe and effective vaccine. Neither allows for the growth of cases contemplated by other countries relying on immunity conferred by people infected with the virus.

Read more:
6 countries, 6 curves: how nations that moved fast against COVID-19 avoided disaster

Personally, I favour the end of the continuum that aims at controlled adaptation, rather than aiming for complete elimination of the virus in Australia. Elimination may prove elusive due to the long incubation period and high rate of asymptomatic cases of COVID-19.

But either way, it’s clearly important that cases are kept very low. While the disease disproportionately affects the old, people are still dying early and health economists have shown that an average of between 3 and 11 healthy life-years are still being lost per COVID-19 death.

The rapidly advancing scale and quality of testing and tracing capability should allow for the near-elimination of COVID-19 to continue with mild social distancing measures. Travel restrictions could be eased in the longer term as the pandemic (hopefully) wanes across the world.

Arguably most important of all is for the government to be agile in its approach to the crisis – to keep an eye on the situation both here and abroad, and react accordingly.The Conversation

Peter Sivey, Associate Professor, School of Economics, Finance and Marketing, RMIT University

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