New South Wales Opens Up For Fully-vaccinated – Aus SMC Expert Reaction

Sydney has partially eased Covid-19 restrictions for fully-vaccinated individuals after NSW reached its target of 70 per cent of the population double-dosed.

The Australian Science Media Centre has asked experts about the possible risks of the country opening up again.

Professor Tony Blakely, Professorial Fellow In Epidemiology, Melbourne School of Population and Global Health, University of Melbourne, comments:

Note: Prof Blakely is a Melbourne-based New Zealand epidemiologist who still retains links to the University of Otago.

Is this a safe/good idea? What are the chances of another lockdown?

“Not too bad. Please see this piece we published last week. This modelling (probably about as sophisticated as one can get – but ‘just’ modelling nonetheless) finds a 6 per cent probability of case numbers going back up above 2000 in the next six weeks with vaccinated folk going to an equivalent of Stage 2 (whilst the rest of NSW stays in Stage 3.5). Even with all of NSW going to Stage 2 (i.e. imperfect compliance, not recommending this), the risk is ‘only’ 9 per cent.
However, since we undertook this modelling, more freedoms have been granted (which I am not opposing) that means this 6 per cent probability is probably higher now (but still a risk worth taking I think).

“All premiers and CHOs understand, or at least should understand, that when we open up we run the risk of numbers going too high. Thus it is important to keep a close eye on the numbers in about 10 days to three weeks, looking for signs of an increase. If that increase (based on modelling extrapolating it out, and allowing for vaccine coverage continuing to rise) suggests that cases will surge to about 4000 or more (at which point over 2000 or more people would be in hospital on any given day), then NSW will need to tap or hit the brakes to prevent overwhelming the health services.”

How will the opening up of NSW impact the pattern of spread of the virus, and how might we expect new cases to spread through vaccinated communities?

“Spread will still mostly be in unvaccinated communities – including children going back to school. There will be a steadily increasing fraction of cases among the vaccinated, who should only infrequently need hospitalisation.”

Would it make sense for other states to learn from the NSW experience before opening up in the same way?

“Yes – time permitting. VIC will have just enough time before we hit 70 per cent to see if there is a rapid and immediate upsurge.”

No conflict of interest.

Associate Professor Holly Seale, School of Population Health, University of New South Wales, comments:
 

Will putting pressure on businesses and retail workers to check “vaccine passports” mean that people are going to get away with not being vaccinated, or does this open the possibility of fake vaccine cards?

“I have concerns that some local businesses may not be equipped or supported to check vaccine status. Issues came up internationally when vaccine passports were rolled out including situations of verbal and physical abuse towards staff members who asked to see vaccine evidence. Not all businesses have the capacity to hire extra staff members whose sole purpose is to review the evidence. If a customer refuses to show the evidence, what are they going to do? Refuse service? In some situations, we did not see this happening around mask use, even in the big supermarkets.

“On the flip side, many stories are emerging of community members who have not been able to download their vaccine status into the wallet or into their Medicare app, or have not been able to get a hard copy sent to them because the Services NSW hotline has been inundated. Concerns were raised about those community members with low digital literacy being able to navigate the process.

“There is also inappropriate advice being given out to the community members about how to speed up the process. One pub owner suggested that patrons should take a screen shot of the evidence and to have that as the screen saver on their phone. However, if the phone was to be lost, then the persons name and DOB would be known.”

Note: Holly has written a Conversation article about these issues.

No conflict of interest.

Dr Roger Lord, senior lecturer in Medical Sciences, Faculty of Health Sciences, Australian Catholic University; and Visiting Research Fellow, Prince Charles Hospital (Brisbane), comments:

How will the opening up of NSW impact the pattern of spread of the virus, and how might we expect new cases to spread through vaccinated communities?

“Recent preprint data from the UK indicate individuals who are fully vaccinated (two doses of COVID-19 vaccine) and who subsequently contract the Delta variant of COVID-19 are less likely to infect close contacts compared to those who are unvaccinated (Eyre DW et al). This protective effect is however short lived, only lasting three months following the second vaccination.

“Individuals fully vaccinated with AstraZeneca who subsequently contract the Delta variant had a 57 per cent likeliness of transmission to unvaccinated close contacts. Three months following vaccination transmission rose to 67 per cent with similar findings for those who received the Pfizer COVID-19 vaccine (42 per cent versus 58 per cent).

“These findings help to explain levels of breakthrough transmission for Delta despite widespread vaccination in some populations. Currently we do not know what level of antibody response equates to a significant level of protection and if booster vaccination will help overcome the short term problems experienced with vaccination against Delta.

“Certainly individuals who were fully vaccinated more than three months ago are likely to be a source of increased viral transmission as NSW comes out of lockdown. Viral transmission will therefore need to be closely monitored in the vaccinated population.”

No conflict of interest declared.

Dr Karina Powers, Consultant Occupational and Environmental Physician in Western Australia in government departments and in private practice, comments:

“Transmission of the SARS-CoV-2 virus despite full vaccination will still occur. Without adequate controls in place for indoor spaces or in failure of controls, e.g. businesses poorly ventilated without safe air, people with masks off, staff not vaccinated, the disease will impact the unvaccinated, people with low immunity, front-line and first responder workers with waning immunity, those who are impoverished or with limited access due to disability and those in rural and remote Australia as health systems breakdown.

“That is, the main burden of transmission will be sustained by society’s most disenfranchised, the sick and by our critical workers. The rich will notice the impact of any increased transmission mainly with substandard access to health care, e.g. delayed ambulance or one fully qualified paramedic trying to deal with their airway and bleeding at the same time in multi trauma instead of two, delayed health care for their cancer and angina for example, lack of access to overwhelmed paediatric health systems for their children.

“All controls that can be practically kept in place, including movement restriction, are vital in an airborne transmissible disease to protect the vulnerable and maintain societal function, and allow vaccination for susceptible groups and booster vaccinations to safely continue at pace.”

No conflict of interest.

Professor Peter Collignon AM, Infectious Diseases Physician and Microbiologist, Canberra Hospital; and Medical School at Australian National University, comments:

“My views are what NSW is doing is ok. Not a true freedom day (as for UK where there were no restrictions) but now less restrictions for those fully vaccinated. Unvaccinated not till Dec 1st.

“Vaccination works, so get vaccinated and it will have even more freedom but we need to expect some restriction on a more localised scale until maybe this time next year (but not stay at home for fully vaccinated unless they are infected).

“We need to look at hospitalisation and death as a measure now rather than case numbers (just like Germany is doing).

“Zero COVID is not possible. So minimise hospitalisations etc. by vaccines and proportionate restriction e.g. indoor crowd numbers limits.”

No conflict of interest declared.

Note: The University of Sydney has gathered some more responses.

© Scoop Media