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In late December, the phrases #GladysCluster, #GladysTheCovidiot and #GladysOutbreak began to trend periodically on Twitter, as some users of the social media platform began calling on the New South Wales premier to #LockNSWdown.
It was a response to a slowly growing but concerning number of cases and clusters of Covid-19 in the New South Wales community. After weeks of no reported community cases of the virus, a man from south-west Sydney tested positive on 16 December. He had been working as a van driver shuttling airline crew between Sydney airport and their accommodation.
By the end of that day, two further cases were announced, affecting Sydney’s northern beaches. Over the ensuing weeks, the outbreak grew in the northern beaches and another cluster broke out centred around the Berala BWS bottle shop in western Sydney, with other cases appearing as far away as the Blue Mountains, Wollongong and Orange. By mid-January, the summer outbreaks had reached a total of 217 cases.
But not long after, on 26 January, NSW marked eight days in a row without any new cases of the virus in the community.
NSW’s containment was achieved without the premier, Gladys Berejikian, resorting to the drastic statewide lockdowns or business closures that many called for. Instead, the NSW approach was to focus lockdowns on the most affected suburbs and to reintroduce limits on indoor and outdoor gatherings without banning them altogether.
It is not the first time NSW has contained an outbreak with potential to spiral beyond control. The Ruby Princess, a cruise ship that was authorised by federal and state authorities to dock in Sydney in March, led to hundreds of cases of the virus in NSW and 28 deaths. But by 28 May, the state reported no new cases of community transmission of the virus, averting a lasting disaster. Victoria did not reach the same milestone until 6 June and would later go on to experience a second wave.
In July, NSW experienced another scare after two cases of Covid-19 announced on 10 July were found to have attended the Crossroads Hotel in Casula. The Crossroads Hotel cluster grew, and by 1 August, 14 new community cases were announced and one death was linked to the venue. Another cluster linked to the Thai Rock restaurant was announced on 17 July and grew to more than 150 cases by 19 August.
Yet by 27 September, NSW was back to reporting no new cases of community transmission. While further cases were reported during October, the spread was largely contained. It took four months to stamp out completely, but NSW Health managed the outbreak by regularly updating venues of concern and relying on contact tracing and testing to manage persisting cases of community transmission.
NSW tolerated low levels of community transmission, many of them linked to known cases, until 16 December when the northern beaches cases emerged. The NSW response to the outbreak came down to enormous confidence in its contact tracing system and ability to track cases. The prime minister, Scott Morrison, told reporters on 17 December: “NSW is the gold standard [of contact tracing]. I don’t spend too much time worrying about NSW.”
Berejiklian even allowed modest increases in visitors to people’s homes for Christmas Day as Covid clusters grew, saying mental health needed to be considered.
The feared large outbreak of cases over Christmas and New Year never eventuated.NSW appears once again to have contained the virus, although Berejiklian has repeatedly said many times that testing rates need to be much higher before the state can rest easy. However, she has been confident enough to reduce the already minimal restrictions.So can the success of NSW still be put down to luck?
The chair of epidemiology at Deakin University, Prof Catherine Bennett, said: “I think what NSW has done really well is taken a nuanced approach, and tailor their approach to wherever the outbreak is, whatever the challenges are, whatever the opportunities are, and to put the restrictions in place as needed. And it’s proven to be enough.”
Bennett said most of the outbreaks in NSW had been contained within three to five generations of spread, which she described as a “good hallmark of strong containment”. But Bennett said where NSW failed was in its approach to masks.
Despite calls from peak medical bodies and infectious diseases physicians, Berejiklian did not mandate masks until 4 January. Even as the number of cases has dwindled in NSW, masks now remain mandatory for many indoor settings, in airports and on flights, raising questions as to why they were not mandatory when case numbers first began increasing.
“NSW weren’t gold standard on masks,” Bennett said. “Mandatory masks might have meant the person who went to the BWS store while infectious had a mask on and the person serving them had a mask on, and that might have been enough to stop the Berala cluster. We’ll never know what might have happened but I would argue, at least, the number of people infected through the BWS cluster could have been smaller or prevented in the first place.”
Bennett said it was difficult to compare the responses of Victoria and NSW given the differences in the outbreaks. In Victoria, for example, the virus got into high-risk and essential workplaces such as healthcare, aged care and abattoirs, which meant even lockdowns could only do so much to contain the spread.
“I think we have to we see every outbreak as a learning exercise even when we ‘win’ at containing it. The situations in Victoria and NSW proves there’s multiple ways to get to the same outcome, and we need to learn from both.”
Epidemiologist and associate professor in public health with La Trobe University, Hassan Vally, said “time and time again” NSW had shown it could keep the virus under control.
But he said he believes luck is still playing a role.
“Yes, the state brought things under control without a wide-scale, lengthy lockdown so all credit to them,” Vally said.
“But if you are successful you can’t assume you can take that approach every single time and it will turn out well. If NSW had that situation 10 times over, 10 out of 10 would it have worked? The way randomness works, maybe it could have got away with them. We just don’t know.
“But you’ve got to give credit where credit’s due. At the end of the day, they got transmission under control, and that’s a really positive thing for NSW and also for Australia.”
Source: The Guardian
Keyword: Lucky break or gold standard? How NSW got Covid under control | Australia news