Patchy uptake of COVID-19 vaccines across cities and regions means Australia's public health measures are likely to continue well into next year according to a leading epidemiologist.
Professor Catherine Bennett, chair of epidemiology at Deakin University writes in the Sax Institute journal Public Health Research & Practice that the country will achieve tolerable disease control by early 2022, but COVID-zero is no longer an option available to Australia's leaders.
There's no going back to comfortable planning of when or how Australia lets the virus in while cases in Australia's two biggest cities and national capital are still growing, she writes, which could be a reassurance for both those impatient to reopen and those anxious about a sudden reopening.
"We no longer need to find out the hard way if our public health response and vaccination rates under the plan will cope when the levee gates open and the virus arrives.
"Instead, we are testing our seaworthiness as we go."
Meanwhile, Australia's governments must find a workable, ethical and economically sustainable approach to controlling hospitalisations and deaths, she argues. Particularly, the test, trace, isolate model used to date in Australia needs to change.
Tracing large numbers of cases is no longer a priority once Australia transitions from elimination to suppression mode.
"NSW Health may be paving the way ahead for all states as they shift emphasis under the sheer burden of case numbers."
Professor Bennett warns against any expectations of an immediate return to normal life once vaccination targets of 70 per cent and 80 per cent are met due to the challenge of the inconsistent vaccine uptake across states and communities.
Easing of restrictions is likely to be gradual she notes, as authorities finesse what it takes to keep hospitalisations in check allowing a staged reopening of communities in 2022, she wrote.
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The acceptance that uncertainty will remain was echoed by one of the UK's top epidemiologists. Professor Neil Ferguson who heads the modelling group at Imperial College London said the data was firming up that vaccine effectiveness was waning over time.
"That doesn't mean vaccinations hasn't dramatically reset the relationship between infections, hospitalisation and deaths, but it does lead to that additional uncertainty."
Masks indoors will be the last precaution to go, and large gatherings the last to return, although large events could happen sooner if Australia goes the way of other countries and implements vaccine passports.
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