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The Univeristy of Melbourne The Royal Melbourne Hopspital

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11 Aug 2020

Will it ever end? Holding out for the ‘other side’

Written by University of Melbourne Professor Jodie McVernon, Director of Epidemiology at the Doherty Institute.

As Victorians head into another week of restrictions and Melbournians are dealing with the recent escalation to stage 4, ‘lockdown fatigue’ is evident. Many are experiencing economic hardship and mental health impacts are real. Listening to daily reports of hundreds of cases and ever more deaths it’s hard to maintain faith in the effectiveness of what we’re all doing. But we should.

The stage 3 restrictions that were originally imposed at postcode level and then extended to Metropolitan Melbourne and Mitchell Shire over several weeks kept case numbers from rapidly spiralling into the thousands per day. Spurious projections of ongoing epidemic growth hailed as ‘secret government modelling’ have since been outed on Twitter as the work of a mathematical hobbyist. The combination of these social and mobility restrictions with hygiene measures and case isolation has kept the reproduction number at about 1. This means that new infection numbers have been stubbornly steady, with some day on day fluctuations associated with outbreaks, but they’re not growing overall. Once community transmission is down, we know those outbreaks will be less frequent too.

The bottom line is that if you don’t see people, you can’t spread an infection. Stage 4 has taken that to the next level. It’s left us with the services that we absolutely need, and stripped out the ones we want, for the short term. The restrictions on daily outings for exercise and shopping, work and childcare permit requirements and the nocturnal curfew are marked additional constraints that all of us are feeling. They’ll clearly reduce opportunities for transmission between community members and also to essential workers, ensuring service continuity. Additional protections are being implemented in high risk environments like meat works and aged care to reduce outbreak risk. The economic and mental health impacts of these measures are substantial, so they’re not taken lightly, but we need a definitive end to the current situation to work towards a sustainable recovery.

Every country that’s implemented lockdowns of this stringency has seen case numbers plummet. Less severe restrictions worked in Australia during our initial wave. This time around it’s been harder to control the epidemic, because affected communities have been less able to reduce their risks of spreading the infection at home or in the workplace. Additional measures have been needed, including financial enablers to help people access medical care and isolate themselves when unwell. Mask wearing has been an adjunct measure to reduce risk in settings where social distancing isn’t possible. The physical act of putting on a mask before we leave home reminds us that the virus is still out there and we need to work together to reduce the spread.

Stage 4 will make a difference - we just need to give it time. People whose infections are reported on any given day were infected one to two weeks ago, and it usually takes a bit longer again for people to be unwell enough to need hospital care. Deaths are even more delayed, so sadly we will continue to see deaths hold steady or even increase over coming days and weeks. The first indicator we will observe is a downward trend in new infections over the next week or two as the impact of these restrictions really starts to kick in.

Most states and territories around Australia continue to record no community transmission, with the social and economic benefits that entails. That’s where we’re headed. Hold tight just a little bit longer.

This work is licensed and available for republishing under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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