This isn't the way we thought it would be after such a promising start: the epidemic is still not contained in Melbourne and it is expanding in Sydney.
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So is it time for a new approach?
The Prime Minister has suggested that trying to eliminate COVID-19 would have too high a cost: "You don't just shut the country down because that is not sustainable."
"You would be doubling unemployment, potentially, and even worse. The cure would be worse than what arguably wouldn't be delivered anyway."
The debate has shifted from whether we should eliminate COVID-19 or just try to control and limit outbreaks.
But first, some terms
Eradication: Getting rid of the virus completely.
Elimination: Getting rid of it to such an extent that there are virtually no new cases - like New Zealand has done.
Suppression: This means keeping the number of new cases down to manageable levels so they don't overwhelm the health service, for example.
Ring-fencing: When there's an outbreak like the one in Melbourne, the authorities close off the community containing the outbreak. People within the fence can't leave and take the virus with them.
Let's eradicate, then
Not so fast, says epidemiologist Professor Adrian Esterman of the University of South Australia.
He told ACM that only two diseases have ever been eradicated: smallpox and rinderpest which affected cattle.
"We can't eradicate the virus. That's not possible," Professor Esterman said.
Elimination?
Disease experts have different definitions of elimination but they all have similar meanings: getting new infections down to very low numbers and being able to trace who each infected person caught the illness from.
Professor Esterman says that has already happened in most areas apart from in Victoria (though we wait to see what happens in Sydney).
Professor Mary-Louise McLaws who advises the World Health Organisation told this paper that she still favoured elimination in this looser sense - numbers down so low that new cases can be dealt with and contacts traced.
The incubation period - the period when someone has the virus but the illness hasn't taken hold - is between five and seven days. Professor McLaws of the University of New South Wales reckons that when we get to fewer than a hundred cases in two successive two week periods, that adds up to elimination.
Is that possible?
Professor McLaws is optimistic. She thinks the authorities in Victoria are getting a grip on the situation in Melbourne.
Sydney is a bit more difficult in that the virus has been spread from a pub, a hotel and a few other places like a gym. Because the clients came and went, they may have spread the virus far and wide, particularly as the hotel is one used by truck drivers.
"I'm a little bit concerned about the enormous challenge of Sydney," she said, "but I think they will be able to get it under control and get the number of new cases back down into single digits."
One reason for her optimism is that people are now genuinely aware of the dangers. The bravado of the past has gone.
The government decided that suppression - flattening the curve, reducing the peak but having a longer epidemic - was the way. But to everybody's surprise, we did brilliantly. We didn't just flatten the curve, we squashed it.
- Professor Adrian Esterman
"There's been a wake-up call because people realise that individual behaviour matters."
But if the outbreaks spread
We will be looking at tougher measures like a stage four lockdown.
This would be much tougher than the lockdown we all went through in April.
In contrast, on the other side of the Tasman, the lockdown was much more severe. Everything closed apart from supermarkets, pharmacies, clinics and what were called "lifeline utilities".
A stage four lockdown would mean staying at home for all but the most essential reasons.
"If you instituted that in Sydney or Melbourne, can you imagine the economic consequences," Dr Sanjaya Senanayake of the Australian National University said.
READ MORE:
Why has it gone wrong after such a good start?
Professor Esterman blames "stupidity".
The Victorian outbreak stemmed from the quarantine hotels for returning travellers.
Privately contracted guards weren't trained, he said. Some lived in the flats which have since been locked down. The flats were ideal for spreading the virus and that wasn't recognised until it was too late.
But he remains optimistic. He doesn't think the situation in either Melbourne or Sydney is totally out of control. with new cases stemming from untraceable contacts in the community.
In the rest of Australia, the illness has been eliminated - and that's in huge contrast to the way it seemed at the start when the fear was that the epidemic would be so fierce that hospitals would be unable to cope.
"The government decided that suppression - flattening the curve, reducing the peak but having a longer epidemic - was the way," Professor Esterman said.
"But to everybody's surprise, we did brilliantly. We didn't just flatten the curve, we squashed it."
If we can bring the outbreaks in Victoria and Sydney under control, we will be back to our previous controlled situation - but the virus won't have gone away completely. It could come back if we get it wrong again.
"It's a very fragile situation," Professor Esterman said. "We cannot put our guard down. It just takes one person doing the wrong thing."
- For information on COVID-19, please go to the ACT Health website or the federal Health Department's website.
- You can also call the Coronavirus Health Information Line on 1800 020 080
- If you have serious symptoms, such as difficulty breathing, call Triple Zero (000)
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