Experts call for Australia to replace coronavirus suppression strategy with elimination plan
Australia should change its COVID-19 strategy to a more ambitious “elimination” plan to stop the “endless game of groundhog day” of fighting ongoing outbreaks, some top public health experts say.
- Some experts say aiming to eliminate COVID-19 would limit disruptions to society down the track
- Most states and territories effectively eliminated community transmission before latest outbreak in Victoria
- However others argue a long-term suppression strategy would achieve similar results
The current national suppression strategy is aimed at “flattening the curve” to keep case numbers within the capacity of the health system, rather than eliminating the virus completely.
An elimination strategy would likely involve tougher lockdowns, and has proved successful in New Zealand.
Prominent public health experts who now believe Australia should adopt the strategy include Bill Bowtell and Gregory Dore, from UNSW’s Kirby Institute, and Melbourne University epidemiologist Tony Blakely.
Dr Bowtell, an adjunct professor at the University of NSW and one of the architects of Australia’s response to HIV, said Australia was on the verge of eliminating the disease.
“We’ve got the evidence in front of our eyes,” he told ABC Radio Melbourne.
“I don’t think people want to go through six weeks of lockdown in the middle of a Melbourne winter and come out the other end wondering whether there’ll be another one if cases surge again.
“Let’s go for it, I think.”
New Zealand’s lockdown was among the toughest in the world, and involved closing all schools and non-essential businesses, including butchers and large retailers.
States and territories outside of NSW and Victoria have effectively achieved elimination without meaning to, Dr Bowtell said.
Tasmania has gone more than 50 days without a new case while other states have recorded little to no community transmission in recent weeks.
“If we could get rid of it now, why wouldn’t we do that knowing that we would not have to go back into a third lockdown or fourth lockdown and play this endless game of groundhog day?” Dr Bowtell said.
The institute’s Dr Dore, an infectious diseases doctor at Sydney’s St Vincent’s Hospital, has written an opinion piece for Nine Newspapers arguing for Australia to switch strategies.
He said he once believed eliminating COVID-19 was not possible — but he had changed his mind after data from states outside of Victoria proved it was.
“Having watched the COVID-19 elimination bus do its rounds with a few rowdy passengers, I have decided to flag it down and climb aboard,” he wrote.
‘On the road to elimination’ with six-week lockdown?
Professor Blakely said Victoria was already taking steps towards elimination by closing schools and encouraging people to wear masks during Melbourne’s six-week lockdown.
But he said Victorian authorities should demonstrate leadership and explicitly set a goal of eliminating COVID-19.
“We have six out of eight states and territories in Australia that have eliminated community transmission,” Professor Blakely told 7.30.
“We’re also seeing in Victoria at the moment the consequences of suppression gone wrong — that is a big outbreak happening.
“That will keep happening in the future if the virus keeps circulating, which is incredibly disruptive for society and the economy.”
Professor Blakely has argued Victoria could increase its chances of eliminating COVID-19 with harder lockdown measures, including:
- Tightening the definition of essential workers
- Requiring Melburnians and essential workers to wear masks
- Closing more stores, including department and hardware stores
Victorian Chief Health Officer Brett Sutton has frequently been asked about the prospect of shifting strategies. He has not ruled it out, but points to the National Cabinet’s firm position on pursuing suppression.
“I think we’re on the wrong side of the curve now to really be talking about the nitty-gritty of elimination,” he told reporters today.
“But if we can drive numbers down to single figures, then we should have that further consideration about whether it’s feasible and what it would look like.”
Experts are divided — many say elimination is too hard
Some experts, like ANU infectious diseases professor Peter Collignon, believe elimination would be “very difficult to achieve and even more difficult to sustain”.
“We need to go for long-term low-level suppression, which is what we have been very successful in doing,” Professor Collignon told ABC News Breakfast.
He said most parts of Australia had very little community transmission over the past six weeks, and that using the term “elimination” could cause people to become complacent.
“I think that is a very dangerous position to have because if we’re in pubs and in clubs and not doing any physical distancing, when it comes back —which I think is inevitable because it is so widespread around the world — it will take hold and spread more widely than if we keep up the practices that are necessary to basically suppress it,” he said.
And others say Victoria should focus on getting its current wave of infections under control before assessing whether tougher restrictions were needed.
Catherine Bennett, chair in epidemiology at Deakin University, said following the current strategy of suppression in Victoria could very well lead to elimination.
“I think, at this stage, to ramp it up immediately to a stage four [lockdown] is premature, but you would have to stay on it,” she said, adding that more mask-wearing and widespread community testing would help.
There was good evidence the previous stage three lockdown could have achieved elimination before the latest outbreak in Victoria, she said.
“If we get everything right and we’re aiming for suppression and we’re aiming to achieve that as quickly as we can, then we’re on the road to elimination,” Professor Bennett said.