Zero-case status is the best Covid-19 option for Australia – and that means stronger controls over international arrivals (Part 1 of 2)

Australia is the victim of its own success – the jurisdictions that have succeeded will not give up their gains. Thus, Victoria and New South Wales – and Queensland – have to achieve zero-case status too, otherwise we will have a fractured nation and lives that are too far away from normal.

Five of our states and territories have eliminated Covid-19 from their communities. Their lifestyles and health systems, if not their economies, have returned to close to normal. It is they, along with Queensland and New Zealand, who are likely to drive what happens in Australia.

To achieve and continue with zero-case status, we need to minimise the risk of a major breach in our current systems for quarantining international arrivals.

The Grattan Institute has recently written about the disorder of a “yo-yo” economy, one that is open one day, closed the next. Their view is that “… the right thing to do is to pursue a goal of zero cases before restrictions are completely eased” and that to “… maintain zero cases there must be effective quarantining of all international arrivals”.

In Part I we consider the “zero-case” concept; in Part II we look at international arrivals.

The current situation among our states and territories

The following table summarises the active case status of our eight states and territories and New Zealand on September 6, when the Premier of Victoria announced the road forward for his state.

Covid-19 active cases by jurisdiction on September 6, 2020

Source: https://www.covid19data.com.au/​ ​ ​ ​ ​

Active cases Days with no active cases Days with no new cases Days with no locally acquired cases Estimated 7-day average of latest locally acquired cases
NSW 168 0 0 0 Less than 10
VIC 1872 0 0 0 Less than 100
QLD 25 0 0 0 Less than 3
SA 1 0 1 31 0
WA 2 0 9 119 0
TAS 0 5 26 114 0
NT 0 23 36 155 0
ACT 0 37 58 59 0
NZ 116 0 0 0 Less than 5

What is meant by zero-case status? The Queensland government seems to have defined it as “no community transmissions for 28 days, equivalent to two incubation periods”. They say that if NSW can achieve that status, Queensland would open the border.

Using this definition, the table shows that five Australian states have achieved zero-case status – SA, WA, NT, Tasmania and ACT. They can be deemed to have “eliminated” the virus from the community, even though some active cases may occasionally occur in managed quarantine from international or interstate arrivals. They all accept that community breakouts might occur, but hope that they can be controlled quickly.

Queensland and New Zealand have a small number of local transmissions persisting. Those two jurisdictions are determined to conquer the virus and should soon join the “eliminated” group.

NSW is struggling after incursions from Victoria and is just managing to keep the virus “suppressed”. But with cases popping up unpredictably, and with lack of strong action, one fears a serious outbreak will occur in NSW any moment.

In Victoria, my home state, though infections are trending downwards, the Covid-19 situation is “uncontrolled”. Victoria is the pariah. None of the other jurisdictions welcomes us.

Some state borders are likely to remain closed until all states reach elimination

Victoria’s current outbreak, resulting from a breakdown of the hotel quarantine system, has been rampant for about three months, exceeding 700 daily infections at the end of July. Level 4 restrictions are in force and likely to last until mid-October.

Lifestyle for Victorian residents, and Melburnians in particular, is far from normal with virtual home confinement, face masks outside the home, 9pm curfew, a five-kilometre travel limit, no restaurants, gyms, cinemas, and so on. Work conditions are far from normal with significant impacts on education, retail, construction, all forms of tourism and for private and public transport. And the health system is severely compromised with significant numbers of health workers Covid-19 positive or isolated, and virus clusters in hospitals and aged care.

Other states don’t have anything like this. They are almost back to normal life, with dinner parties, restaurants, intrastate travel, and so on – except perhaps for NSW. Our interstate friends and families confirm all this.

At the moment the five zero-case states along with Queensland and New Zealand all seem to be coping with their borders closed or restricted (education and tourism industries the main exceptions).

The Premier of Western Australia has refused to commit to a date when he will open borders – he noted that all Australian states, in the middle of the year, made a commitment to open the borders but then“Victoria happened”. He emphasised that releasing and reimposing lockdown and opening and closing borders, again and again, is not how he wants to run his state. Tasmania’s Premier has more or less said the same. The Queensland Premier has been very vocal about keeping borders secure.

The evidence is that Australia’s approach to the virus means it has not done as badly as nearly all other Western economies. And GDP data show that those states with strict border controls have not done as badly economically as Victoria and NSW.

Thus the successful jurisdictions will fight to retain the results they have attained and the hard work put in to get there. Victoria seems determined to reach zero-case status. NSW might have to take the political and economic risk and implement a Victorian-style lockdown, rather than continuing to pressure the other jurisdictions to adopt NSW’s weaker “suppression” model. Their penalty is rejection by the rest of the country if there is suspicion that there are undetected infections that could be imported.

We need better quarantine management of international arrivals

To reach zero-case status or any kind of normality, Australia (and New Zealand), in addition to eradicating local transmissions, have to ensure no new infections enter their communities from overseas.

Hotel quarantining is like a rusty bucket – a leakage waiting, and certain, to happen. The risk from quarantining international arrivals in city-based hotels is way too high in terms of the devastation it could wreak on the economy, on our health systems and on our lifestyles.

If possible, quarantining needs to be moved away from Australian population centres into remote or secure locations such as those used as immigration detentions centres. This policy was used in the early stages of the virus. International arrivals should be flown there directly and not to any major airport or centre.

If remote quarantining is not possible, international arrivals should be severely curtailed.

As we listen to evidence given at Victoria’s hotel quarantine inquiry, we hear example after example of systemic breakdown in practically every aspect of the hotel quarantine system since the end of March. But the problem is nationwide, and we still hear of people “escaping” from quarantine, security guards becoming infected or anecdotes of pandering to the “quarantined”, such as allowing them to make regular visits to the nearest bottle shop.

The chance of the virus escaping from quarantine somewhere in the country is way too high for the consequences that would flow.

In Part 2 we consider overseas arrivals in more detail to examine the risks of infections leaking from the hotel quarantine system.

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Robin Boyle lectured in statistics at Deakin University and preceding institutes for three decades until 2009. His academic background in mathematics, economics and finance, as well as statistics, led him to developing teaching software in those areas and to be widely sought after as a textbook author.

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