Difficult shift in conversation before coronavirus is managed in community: ACT health minister

Rachel Stephen-Smith said while the zero community transmission strategy would not be abandoned before most people had an opportunity to be vaccinated, because there was no such thing as a "managed outbreak", the virus would eventually need to be managed in the community.

"That transition in narrative is going to be extremely hard in countries that have been highly successful at suppressing the virus, like Australia," Ms Stephen-Smith said.

On the day the ACT marked a year since recording a locally acquired coronavirus case, NSW's outbreak of the virulent Delta strain of COVID-19 grew by another 50 cases, which included 37 who were active in the community for all or part of their infectious period.

NSW Premier Gladys Berejiklian warned the current lockdown in Greater Sydney and surrounding areas would likely be extended and the outbreak would get worse before it got better.

"Cutting corners, flouting the rules is going to prolong the lockdown, and that's the last thing any of us want to see," Ms Berejiklian said on Saturday.

While mask wearing requirements have been wound back in the ACT, tough new restrictions mean anyone travelling from Sydney to Canberra will need to quarantine at home for two weeks.

Authorities have warned exemptions for non-residents to enter the ACT from Covid-affected areas in NSW will only be granted in exceptional circumstances.

Ms Stephen-Smith, speaking to the Sunday Canberra Times, said there was a long way to go in managing the pandemic.

"You can't say, as a government, 'Oh, we'll let it run and we'll only get 20 cases a day or 40 cases a day, and that will be manageable and our health system will be able to cope with that'," she said.

"Even if there was genuinely a trade off between health and economics - and I think what we've seen is there isn't, the best health response is also the best economic response - you just cannot manage this virus that way.

"Every time anyone around the world has tried, they've seen another wave of virus which has meant pressure on their hospital system and ultimately a longer shutdown of their economy in order to suppress the virus again."

Ms Stephen-Smith said she and the ACT's chief health officer, Dr Kerryn Coleman, had sought to strike a balance between asking too much and asking too little of people to manage the risk of COVID-19 in the ACT.

The health minister said there was a trade off between consistency and novelty when applying public health directions, like social distancing requirements and mask rules.

"It has required a lot of patience of people, and I recognise how frustrating it is that people think we're almost back to some kind of normal status quo, something happens and life gets disrupted again. I think, unfortunately, that's just the world of a global pandemic," she said.

"I wish that I was able to provide people with certainty about what was going to happen next, next week, next month, next year. We just can't do that. We learned pretty early on that trying to make those predictions was a fool's errand."

However, Ms Stephen-Smith said she expected some public health directions to remain in place for some years to come and that it was too early to say whether COVID-19 could be managed like influenza in the community.

"I think it is still too far away - management of Covid as just an endemic disease for us - for me to make any predictions about how that will be managed," she said.

Debate about abandoning a zero-transmission strategy has increased in recent weeks, with the NSW Premier, Ms Berejiklian, forced to dispel any suggestion the NSW government could let the virus run through the community if it could not contain the Sydney outbreak.

Senior NSW cabinet ministers had earlier canvassed abandoning the no local transmission strategy, The Sydney Morning Herald reported this week.

Ms Stephen-Smith said she thought the debate over public health response options helped move the community forward.

"While we accept the advice our health experts, it is absolutely clear that there is a range in that advice. At every point on every issue, there are public health experts and epidemiologists that are expressing a range of views, that are taken then into account by our chief health officers and governments as we make decisions," she said.

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Ms Stephen-Smith said the shift would be hard - but Australia had the advantage of watching countries in the northern hemisphere go through the seasons ahead, an experience health officials could learn from.

"Every year people get sick and every year people die and they die of all kinds of things. What we have really had to avoid with Covid is a lot of sickness and death and a lot of pressure on our health system, which means not only people dying of Covid, but people dying from other reasons because the health system is overwhelmed. And that has been really absolutely critical at this point in time. But, you're right, that's not going to be the case for ever," she said.

In the meantime, the Sydney outbreak serves as a stark reminder that the pandemic in Australia is far from over.

"We only need to look a couple of hundred kilometres down the road to Sydney to see what happens when you start to get community transmission, what happens to your health system, what happens to your community, what happens to your economy," Ms Stephen-Smith said.

"So people really need to be mindful that that could happen. We could get a case at anytime. Our chief health officer and her team have done an incredible job. There's been good management, but there has also been an element of good luck in that."

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