Reopening, resistance and long tail of zero COVID

WADA President Omar Khorshid presents the communiqué as an “intermediate†approach between strong opinions. One side “grows too hard” to open up now, he says, while on the other side there were “Chicken Littles” who wanted to wait for the country to reach extreme levels of immunization.

“What we’re saying is if you do the right things, if you follow the Doherty report correctly and don’t just pick the things you like, there is a way out of that,†says Khorshid. “If we follow the science, there is a sure way forward. “

The latest warning voice to enter the debate is OzSAGE, which was formed in August to offer “well-researched and well-debated independent expert advice” amid what it recognizes as a sea of ​​divergent views. on managing the next phase of the pandemic.

The group has significant academic and clinical weight. Its cadre of 11 includes University of Melbourne Professor Nancy Baxter, Burnet Institute Deputy Director, Professor Margaret Hellard, UNSW Economics Professor Richard Holden, Field Epidemiologist Kamalini Lokuge and the Professor of Public Health and Deputy Vice-Chancellor of the University of Sydney Lisa Jackson Pulver.

Another executive member, Professor Lidia Morawska of the Queensland University of Technology, was last week named among Time the magazine’s 100 most influential people in 2021 for his work “recognizing the importance of aerosol transmission [of COVID] and put together the data that would convince the World Health Organization and other authoritative bodies to do the same â€.

Other big names have signed up as OzSAGE members as well, including ANU Vice-Chancellor Brian Schmidt, Burnet Institute Executive Director Brendan Crabb, epidemiologist Tony Blakely, Australian Medical Journal editor Nick Talley, former MP Dr Kerryn Phelps and dozens of others.

One of the group’s seven tenets is that Australia should ‘strive for the elimination’ of COVID-19, similar to measles, where occasional incursions are contained without significant community spread. He argues that this can be achieved through booster shots and other health measures, while still continuing our normal lives.

One of the group’s main arguments is that vaccination is not enough to curb the Delta variant. He also hopes that other measures will be put in place: better ventilation of public spaces, in particular classrooms; improved contact tracing; and the prolonged and widespread use of masks. He calls this series of measures “vaccines-plusâ€.

One of OzSAGE’s executive members, Melbourne-based doctor Benjamin Veness, said the group was not against reopening, but wanted a plan that didn’t lead to overwhelming the healthcare system. “We would really like to avoid this cycle of boom and bust closures and instead have a reopening path that is sustainable from the start,” he said.

This concern is not unfounded. OzSAGE members spent the past week highlighting the growing number of cases in the Canadian province of Alberta, where 71.5% of the population over 12 years of age is fully vaccinated. Prime Minister Jason Kenney declared a public health emergency on Wednesday, warning province could run out of intensive care beds and staff. He also reimposed restrictions, including vaccine passports and a work-from-home order.

[There were 896 people in hospital in Alberta on Friday, and 222 in ICU, from a population of 4.4 million. Paediatrician Greg Kelly, another member of the OzSAGE executive, tweeted that the province was “COLLAPSING BEFORE OUR EYESâ€.]

OzSAGE urges Australia to model its plans more closely on Singapore, where 90% of those over 12 are now vaccinated. Even this country is grappling with an increasing number of cases, although the proportion of people falling seriously ill is low due to the highly effective vaccines.

In the midst of this, NSW announced one of the most cautious reopening plans in the world. Only those who are fully vaccinated will be able to visit the venues and events, and home gatherings will initially be limited to five people vaccinated. The schools will return under a staggered start; masks, QR code recordings and contact search will remain.

OzSAGE quickly warned NSW and National Opening Plans when 70 and 80 percent of the population 16 and over are fully immunized is too quick and too risky, but he has been less willing to quantify exactly when the reopening is expected. happen.

While no one disputes the goal of vaccinating as many people as possible, as long as the country’s two major cities are in long, hard and unsustainable shutdowns, the key question is when and how to end them.

“Ending this type of lockdown will require vaccination and other measures, especially better ventilation,†Veness said. “I think the answer is you can’t just sit back and say, ‘X, Y, and Z are definitely going to happen.’ You have to treat it a bit like a dance; you relax a bit and see what happens.

OzSAGE quickly drew criticism. The telegraph of the day political editor James Morrow called it “the coordinating group of the COVID alarmist wing of the country’s scientific community,” too cautious and puritanical about crushing the virus.

Former deputy chief medical officer Nick Coatsworth said the group was on the extreme extreme of the risk spectrum. “I think there is genuine concern at OzSAGE that the morbidity and mortality from COVID-19 is not over,” he said.

“They are really worried about the potential for new waves in the Australian community. However, their academics’ stance on risk has always overestimated the consequences of the spread of COVID, downplayed the negative effects of COVID restrictions and, frankly, their thinking belongs to 2020. “

Veness says OzSAGE has shared his advice with governments but has yet to brief executives directly. The group, based on the UK’s Independent SAGE, has managed to court some mainstream media coverage, generating 23 mentions in print and online so far this month according to media monitor Streem.

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Many of its members are prominent full-fledged COVID commentators; Streem found that Blakely, Baxter, and Crabb were each mentioned over 200 times this year in major print and online titles (that doesn’t include radio and TV).

University of NSW epidemiologist Mary-Louise McLaws, who has had 740 mentions and is well known for her cautious approach to COVID, has declined an offer to join OzSAGE. “I think it’s a great initiative, but I just don’t have the time,†she says.

McLaws shares many of the group’s concerns about hospital capacity, vaccine coverage and quarantine facilities, although she places more emphasis on the need for Australia to adopt rapid antigen testing as a tool to help reopen Quickly and safely. And although she thinks Australia should aim for a 95% vaccination, she says it’s not possible to keep society locked up until then.

“You have to get people out of lockdown,†McLaws says. “Even from my point of view of where I was – I was fully in favor of eliminating the government [strategy] – but it’s Delta now, and we have rapid antigen testing and we have good masks. “

McLaws is also wary of the modeling barrage of various groups – the Doherty Institute, Burnet Institute, Grattan Institute and OzSAGE among them – which are used to justify various positions or predictions. She says modeling is most useful when multiple models are compared and interpreted by an outbreak manager who understands “granular contextâ€.

“Models should not be used to dictate how we deal with the stages of the pandemic,†says McLaws. “They help catastrophize and determine what happens if we don’t do certain things… how many beds do we need, how many staff do we need, how many deaths will we have if we don’t do something . “

Schmidt, the ANU Vice-Chancellor, said his involvement with OzSAGE was driven by a desire to better connect the country’s leaders with a wide range of COVID-19 experts and quality research.

He said there was a lack of transparency in the evidence supporting decisions by states, territories and federal governments. “My involvement in OzSAGE is not exclusive, nor is it an endorsement of any of the work produced by the group unless I explicitly endorse it.”

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