Learning to live with COVID? Read the fine print first

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It pays to read the fine print. That was, essentially, what the Doherty Institute was saying last Monday when it released a statement clarifying the modelling it produced for the national cabinet’s COVID strategy.

If you had been skimming news reports in recent days, it would have been easy to come to the conclusion that, based on the Doherty modelling, we will – mostly – be living a normal life, enjoying our previous “freedoms”, when 70, then 80, per cent of Australians have been vaccinated.

Doherty Institute director Sharon Lewin says her modelling supports reopening at high levels of vaccination regardless of the number of COVID-19 cases in the community.

That has certainly been suggested in Prime Minister Scott Morrison’s messaging. The goal, he told a press conference last week, was to “help people overcome” their fears about a rise in cases and to treat COVID much as we treat influenza as we transition out of the pandemic into a post-vaccinated world.

“If not at 70 per cent and 80 per cent [vaccinated], then when?” he asked. “We should not delay it. We should prepare for it. We should not fear it. We should embrace it.” Or, as he memorably told the Today program. “We can’t stay in the cave.”

Indeed. Victorians, who have now clocked up more than 200 days in actual hard lockdown, with no end in sight, know this more than anybody. We want out.

But we also want to know, after all our hard work, after our celebrated doughnut days, what “living with COVID” will actually look like. And this is where the Doherty fine print comes in.

First, they make clear, we cannot expect a general lifting of restrictions. There will be no “freedom day”.

That lesson has been learnt from other countries, such as the UK, which now has almost 40,000 cases a day as a result of lifting restrictions, albeit with a much lower death rate than pre-vaccine.

In Israel, one of the most successful nations in fighting COVID, an easing of restrictions in June that included lifting a mandate on masks in public saw a spike from zero to nearly 10,000 cases a day now.

Some “light” health measures will remain indefinitely as will testing, tracing, isolating and quarantine measures.

The institute does not guarantee an end to lockdowns, only that they will be “unlikely” once the vaccination thresholds are reached. Nor does it put a timeline on reopening the borders for overseas travel.

The emergence of the Delta variant in particular means “it won’t be possible to maintain a situation where there are no cases at all”. The focus, instead, “will shift to keeping the number of people going to hospital and dying at a minimum”.

And what does that look like, exactly? With 70 per cent vaccine coverage of the adult population and “partial” public health measures, the Doherty predicts 385,983 symptomatic cases and 1457 deaths in six months. With “optimal” public health measures but still no lockdowns, they believe the numbers can be reduced to 2737 cases and 13 deaths in the same period.

Bottom line: opening up at 70-80 per cent means enduring some ongoing restrictions in return for a death rate that ranges from probably acceptable to possibly not. Polling this week suggests we’re still squeamish about what that number looks like: most Australians support relaxing lockdowns at 70 per cent vaccinated, but only 27 per cent of those polled agreed with the premise that “we should open up and live with the infections and deaths”.

How, then, to open up in an acceptable way, to convince the likes of WA and SA to lift their border closures in the knowledge that some of their citizens will inevitably be infected, but that it will be worth it?

As Melissa Cunningham and Aisha Dow wrote on Saturday, it likely means a life where checking in with QR codes is routine, and permanent, and where outbreaks at places like hairdressers and restaurants are swiftly quashed. We can expect rapid testing for, possibly, schoolchildren and certainly for festival-goers. Employers may be able to require employees to be vaccinated. Masks will probably remain mandatory indoors.

Living with COVID in the future will look a lot like life today, (hopefully) just minus the lockdowns. That is what the Doherty modelling actually tells us.

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