Over the past few days, a barely perceptible trend has emerged in Victoria’s daily tally of COVID-19 infections.
The seven-day average for new infections has begun a slight decline.
It could mark the turning point in the state’s latest wave of infections, which have largely been of the Omicron BA.2 subvariant.
But as University of Melbourne epidemiologist Tony Blakely notes, it’s come after a “very flat climb up”.
“So it’s hard to read the turn,” he says.
“But if we look at New South Wales, that has clearly turned and we would expect to be following that.
Monash University infectious diseases modeller Michael Lydeamore is judging it as more of a “plateau”.
“I wouldn’t expect to see it go down dramatically over the next few weeks,” Dr Lydeamore says.
Deakin University’s epidemiology chair Catherine Bennett calculates the state’s effective reproduction number for the virus has remained steady at around one over the past week.
“Hopefully we only ever replace one case with less than one now and we’ll keep that reproductive number below one and see the numbers come down,” Professor Bennett says.
“But it will take a while to do it because it’s not a focused outbreak, it’s a very dispersed community-wide one.”
The Premier, Daniel Andrews, says there are “promising signs” the state is close to the peak, but it’s not there just yet.
Either way, for many Victorians the latest wave has perhaps been the least remarkable — decent vaccination coverage has kept a relative lid on hospitalisations, although they have continued to rise over the past month.
In good news, the proportion of hospitalised patients requiring ventilation is much lower than in previous outbreaks.
So if we’re moving past the crest of this latest wave … what comes next?
Close contact rules should ease
Australia’s peak COVID-19 public health advice body has recommended that the mandated quarantine period for close contacts be phased out as states and territories emerge from this latest wave.
Professor Blakely says that shift means it’ll be up to all of us to make sensible decisions.
“It would still mean that if you were sharing a bedroom with somebody who was really sick and symptomatic, it would not be smart to go to work,” he says.
“But for those people who are sort of peripheral close contacts, I think it’s time to let them circulate in the community and encourage them to have RAT [rapid antigen] tests each day.
Such a change would bring welcome relief to businesses across the state who have battled through rolling worker shortages for much of this year.
And it’s very likely more of us will catch COVID-19 again in the months ahead.
Health authorities recently revealed around 10,000 Victorians have been reinfected with COVID-19 since late last year.
The state opposition and business groups have called for eased quarantine rules for weeks, but on Thursday the Premier argued the time to loosen rules hadn’t arrived just yet.
“Things like the vaccinated economy, masks, all sorts of different things will be looked at closely by the public health team, by the health minister and we’ll make announcements in due course,” he said.
“But I think people know that it’s probably not a great idea to take rules off while case numbers are going up.
Dr Lydeamore agrees that allowing a “little bit more time to pass” will help ensure we’re definitely past the peak.
“But of course, if you have a plateau, and we’re comfortable with things like the level of hospitalisation and other severe outcomes, then we can start to think about removing some restrictions, absolutely,” he says.
Vaccine mandates are under the microscope
The rationale for the state’s controversial vaccination mandates is among the measures under scrutiny.
The policy is credited with driving up immunisation rates, but has forced unvaccinated Victorians out of jobs, and barred them from dining out and other parts of life.
Professor Blakely says the justification for the mandate has now passed.
“It is no longer in my view proportionate to not let unvaccinated people go to the restaurant, to keep unvaccinated people out of … jobs like teachers,” he says.
“I would still be keeping mandates on people working in aged care having to be up to date with vaccines.”
Professor Blakely says that’s because while vaccines stop people getting seriously ill, “they don’t necessarily reduce infection hugely”.
“So the risk of somebody out there who is circulating in the community, who’s unvaccinated, there’s not a huge difference from somebody who’s vaccinated,” he says.
That view is shared by Professor Bennett, who says the mandate “served its purpose” during earlier outbreaks, but the risks have “changed dramatically” with the Omicron variant.
“[With Omicron], if you only look at people based on their first and second doses, it doesn’t actually change their infection risk now,” Professor Bennett says.
“It will change their risk of serious illness, but not infection risk.”
Dr Lydeamore agrees that “we’re very close” to the point where the downside of mandates to unvaccinated people outweighs the benefit to the rest of society.
“And I think it definitely should be on the table to look at either removing it in some contexts, or perhaps even getting rid of it entirely, perhaps a bit later on,” he says.
But keeping up with vaccine boosters is still important
As the pandemic has moved to the back of most Victorians’ minds, it appears the urgency to be protected from the virus by a third dose has waned as well.
While the state has achieved a two-dose vaccination rate of 94.5 per cent among Victorians aged 12 and older, the third-dose rate for adults is still sitting at 66.9 per cent.
Dr Lydeamore says that is a concern, but notes that with so much COVID-19 circulating in the community, many Victorians will also have received a natural immunity boost from being exposed to the virus.
“But I think it is important that people keep getting their boosters … the younger people need to be getting their primary courses in as well, especially in places like schools, where we know there’s been a lot of transmission now,” he says.
Professor Blakely notes that even if you’ve been infected, keeping up to date with vaccines helps protect you from reinfection in the future, and makes the community more resilient “to whatever COVID throws at us next”.
We need to be prepared if another variant emerges
With Melbourne Airport passengers numbers hitting pre-pandemic levels once again and the CBD buzzing back to life, there’s a sense that Victoria has arrived at a point of stability in this pandemic.
Professor Blakely is hopeful this will last, but says it’s important the state is prepared for the possibility of a new variant that is both more infectious and more severe.
“And if there’s one extra thing I think we should be doing at the moment as a country that’s stockpiling 10 to 20 N95, KN95 masks per Australian,” he says.
“So that if a bad variant comes our way we can quickly get mass masking happening with higher-quality masks, so we don’t need to go into a lockdown, if a bad variant arrives.”
Professor Bennett says it’s critical that all members of the community receive the information and resources they need in the months ahead to make informed choices about protecting themselves and their families from the “rolling waves” that lie ahead.
“And if we get that right, that will protect the whole community,” she says.
“So it’s really moving to modern public health messaging, not about fear of the virus, or having to put lockdown rules in place or rules around masks, it’s more about really empowering the community to fundamentally keep this in control.”