As the game of Whac-A-Mole continues, time will tell if we need stronger countermeasures

Okay, so it’s been exactly one month since my call to #lockdownNSWnow. Let’s go over what’s changed, what risks remain and the missed opportunity.

First, a big shout out to all the staff at NSW Health who are doing a great job testing and contact tracing. Testing is one of the best weapons in the arsenal and let me make it quite clear it should continue on even after any strategic lockdowns.

Let’s look at the achievements of the past month:

  • We’ve so far avoided large scale community transmission
  • Masks are now well accepted in the community
  • The Victoria border closure has been upheld, stopping any further outbreaks
  • Moderate to high rates of testing have, on some days, uncovered only a few cases

NSW has “held the line” and kept transmissions under control without a lockdown, but we’re not out of the woods yet.

Risks remain

On the flip side, since we didn’t lock down at the first sniff of community transmission, NSW continues to carry a risk of a spike in community transmissions, which can then snowball in the current environment.

To illustrate how quickly the situation can deteriorate, see the number of community transmissions in Victoria before the curve shot up.

Victoria had days with zero community transmissions immediately before it’s rapid spike.

Within two weeks of recording some days with zero community transmissions Victoria was in the midst of an uncontrolled outbreak.

Notice how Victoria did not have a sustained period WITHOUT many days of zero community transmissions during a time when restrictions where being eased. Perhaps the authorities need to pay closer attention to this type of trend?

This is what NSW’s pattern looks like:

NSW had a pause in community transmission before this outbreak.

Granted, we’re more aware of the dangers than Victoria appeared to be at the time of its large scale outbreak, but that doesn’t mean we’re not carrying a number of risks:

  • The virus has been seeded over a lot of different parts of the Sydney region. The geographic dispersion is wide.
  • Quite a few cases have been found in schools and this farce of random school closures doesn’t appear to be curtailing it.
  • It only takes one spreading event to lift case numbers drastically
  • While the testing rates are okay, they often don’t tell the full story. People are much more inclined (and being directed to) to get tested only if they have symptoms. This is another game of catch-up and misses the asymptomatic carriers. Some estimates put the true number of cases to be anywhere between 5-10 times the positive infection counts.
  • Without a lockdown there will be many more cases circulating in the community waiting to flare up.

Opportunity knocks (and locks)

As we saw over the past month, most of the outbreaks were linked to gatherings that wouldn’t have happened during a lockdown.

If NSW had a four week lockdown today would be the final day of it. We would have:

  • Eliminated community transmission
  • Allowed contact tracers to catch up
  • Restored business confidence
  • Booked in a hell of a lot of domestic NSW tourism for the summer
  • Re-opened the border with Queensland
  • Possibly opened the borders with other states as well (they are not too keen)

But we didn’t so we’ll just have to wait and see what September holds. Again, I hope that I’m wrong and we can bring it under control.

Time will tell if it’s possible to win at Whac-A-Mole.

About the author

IANAE! (I am not an epidemiologist)

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