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Victoria must establish which of its coronavirus lockdown measures were most effective so that another onerous shutdown can be avoided if a third wave emerges next year, a former World Health Organization adviser has said.
The infectious diseases doctor Prof Peter Collignon said there was no doubt Covid-19 control measures – including testing, contact tracing, social distancing, the closure of venues such as restaurants and retailers, and mask wearing in crowded places – had been essential in bringing the state’s second wave of the virus under control. But questions had to be asked about whether workplace spread – in abattoirs, and health and aged care facilities – had been identified early enough, and whether harsher measures such as curfews and fines could have been avoided had public health laws targeted those sectors sooner.
“A lot of transmission was in essential workplaces and in low-paid jobs where workers were moving from working place to workplace, and targeting those issues in future will be more effective than broad-brush, blunt approaches,” Collignon said.
“The curfew doesn’t do much to stop transmission; it just makes it easier to police other measures. If you take away people’s normal lives, like the ability to go outside, you need the reasons for it.
“Now, we know people are in fact safer outside exercising than inside in a crowded home. Some of the suite of things introduced in Victoria have a harsher effect than others and we must try to justify those harsher measures especially. That means asking: ‘How much difference did this measure make?’
“I fully accept that can be difficult to do but we need to do it, as we may have to resort to these measures at different points for a year or two until we get an effective vaccine.”
The premier, Daniel Andrews, said restrictions on leaving home would be lifted on 26 October if the daily average number of cases in the 14 days leading up to that date were fewer than five statewide, and if there were also fewer than five cases statewide with an unknown source – known as “mystery” cases.
On Monday the federal health department secretary, Prof Brendan Murphy, said this was “a very conservative approach” and, if the state’s public health response were stronger, “you could take some slightly more generous triggers” for each step of reopening. But Victoria’s chief health officer, Prof Brett Sutton, said the state could emerge from lockdown earlier if case numbers dropped sooner.
Collignon said it was unlikely this would occur.
“To get to an average of five cases that soon you need really good contact tracing and so far Victoria’s contact tracing has not been on the same par as the system in New South Wales,” he said.
An adjunct professor and epidemiologist at the University of Sydney’s school of public health, Alexandra Martiniuk, disagreed. Aiming for the five-case target was reasonable, she said, since this would only capture tested and detected cases.
“We know Covid-19 can transmit before symptoms and in those who never feel symptoms,” she said. “We need to assume there are multiple other cases in the community. We can expect that given the large number of cases recently in Victoria’s second wave, there will be cases ‘lurking in the shadows’ – either in people who sadly chose not to get tested, or in people who don’t have symptoms and don’t think they need testing.”
But she said the timeframe for reaching the target was harder to predict.
Martiniuk said there was also evidence of the benefits of tougher measures such as curfews. “Activity in the night time may be more likely to be non-essential, and can assist with reducing gatherings in informal locations,” she said. “As a potential side benefit, research prior to Covid-19 has shown curfews to be effective in reducing youth violence and car crashes.”
But like Collignon, she said: “More should have been done sooner for workplace spread, especially hospitals and aged care.
“Individuals and workplaces all need to do their part. We really need to make sure our healthcare workers are safe – they are going into battle for all of us – and in doing so they put their own and their families’ lives at risk.”
Source: The Guardian
Keyword: Victoria warned it must zero in on best measures to avoid another coronavirus shutdown | Health