Making the tough decisions: what it will mean to live with COVID

Patchy uptake of COVID-19 vaccines across cities and regions means Australia’s public health measures are likely to continue well into next year, with a leading epidemiologist predicting the country will achieve tolerable disease control by early 2022.

Professor Catherine Bennett, Chair in Epidemiology at Deakin University.

Writing in Public Health Research & Practice, a peer-reviewed journal of the Sax Institute, Professor Catherine Bennett, Chair in Epidemiology at Deakin University, warns against any expectations of an immediate return to normal life once vaccination targets of 70% and 80% are met. She says the concern will be inconsistent vaccine uptake across states and communities, which will need to be considered when assessing local public health responses.

With the arrival of the highly infectious Delta variant of the virus, “we are now drawn into the more compelling global experiment to find a workable, ethical and economically sustainable approach to controlling disease incidence and hospitalisations,” Professor Bennett writes.

Easing is likely to be gradual and public health measures of some kind will continue to be needed wherever community transmission persists, until we finesse what it takes to contain outbreaks. But if we can keep hospitalisations in check, we can look forward to a measured, staged opening that allows for multiple disease control mechanisms to be adjusted as required, Professor Bennett says.

Masks indoors will be the last precaution to go, and large gatherings the last to return, although large events could happen sooner if we go the way of other countries and implement vaccine passports.

Professor Bennett says test, trace and isolate needs to adapt in response to larger infection numbers and when we no longer need to identify every case once we are in suppression mode. In this regard, NSW is paving the way for all states as they shift emphases under the burden of higher case numbers.

“The virus is in the community, the COVID-19 transition has begun, and we are on track to live with the virus, but control the disease, from the first quarter of 2022,” she concludes.

The latest issue of Public Health Research & Practice also features a paper on suicide risk during pandemics. While the Australian Institute of Health and Welfare does not report any increase in suicides during the current COVID-19 pandemic, Connor Brenna of the University of Toronto and others warn in this paper that we may be in a ‘honeymoon’ period and there may be heightened risks ahead. The study authors urge use of virtual suicide risk assessment tools, including telemedicine and phone apps.

And in an editorial for the issue, Professor Don Nutbeam, Editor-in-Chief of the journal and Professor of Public Health at the University of Sydney, likens the impact of the Delta variant to a ‘punch in the mouth’, demonstrating how a state like NSW – widely acknowledged to have managed the pandemic successfully – can be thrown completely off-balance by the variant’s speed of transmission.

Papers is in the current issue of the journal “show how our public health response has to be one of continuous adaptation to a ferocious and unpredictable foe,” Professor Nutbeam writes.

Click here to view the full contents of the latest issue of Public Health Research & Practice.

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Public Health Research & Practice is an open-access, peer-reviewed, Medline-listed quarterly online journal published by the Sax Institute. Click here to subscribe for free