For many Melburnians, the turnaround in the weather can be leading.
In recent years, if you’ve felt the fresh winter air on your face, it’s usually been on a short daily outing that didn’t take you more than a few miles from home.
But for the first time since COVID-19 arrived in Australia, Melburnians are entering a winter in which the government has made it clear that there are no lockdowns on the table.
This week, Health Secretary Martin Foley said the rise in COVID-19 in Victorians and flu infections sent the state into a “really challenging winter”, but the government would not put forth any firm demands to respond.
Instead, Foley said the government would “continue to delegate decision-making and responsibility to workplaces, communities and individuals”.
“Because we have this long recovery plateau, it is now another phase of the pandemic and we must now learn to live safely and alongside COVID,” he said.
Many of us have stepped off the COVID rollercoaster
Some data suggests that COVID-19 is not at the forefront of a highly vaccinated Victorian population.
For example, we are no longer so keen on the latest COVID figures.
There are not many fluctuations to follow in the reported cases, which hovered around 10,000 in the past week.
But authorities believe the official count represents only about half of the actual infections in the community.
In hospitals and schoolsThousands of new infections every day cause a progressive shortage of staff.
The education department has called on a pool of retired or apprentice teachers to boost staffing levels in schools, in an effort to prevent a mass return to distance learning.
Acting Chief Health Officer Ben Cowie said the increased transmission of the two viruses had a “significant impact” on the health system, who is already tired from the past two years†
“A lot of people in the hospital and nobody wants to see that,” said Professor Cowie.
But he said there were some promising signs of stability, with hospital admissions falling slightly over the past week.
“Our feeling is that things will probably stay around this level and possibly… go up a little bit until the end of June,” he said.
Contributing to the expected increase is the establishment of the newest Omicron sub-variants, BA.4 and BA.5, in the Victorian community.
Early evidence suggests they are better able to evade immunity from vaccination and previous COVID-19 infection, but not more likely to cause serious illness.
Sharon Lewin, director of the Doherty Institute and an infectious disease expert, said those variants had only caused a “smaller rise” during a recent wave in South Africa, but that was no reason to be complacent.
“There’s a lot of COVID around and even if Omicron is milder in a vaccinated population, which it is, a very high number of cases still means we’re at risk of increasing the stress on our hospital system,” Professor Lewin said.
A high caseload demands more Victorian lives
Vaccination will help reduce the risk of serious illness, but efforts to protect all Victorians with three doses of a vaccine appear to have stalled, with about 68 percent of those over the age of 16.
It’s a figure that hasn’t changed much in recent months, something that Professor Lewin said needed to change.
Professor Cowie agreed, but also believed there could be another explanation for some of the delay.
“I think part of the reason it’s been paused for a bit is that there’s now a recommendation that people wait three months after having a COVID-19 infection before getting their next dose of vaccine,” he said.
Unfortunately, Victoria continues to record a significant number of deaths.
Professor Cowie acknowledged that many Victorians were distraught at the ongoing tragedy of loss of life from the pandemic.
“That person and their loved ones and their family and their entire community around them are clearly affected by that, and that’s… very disturbing,” he said.
Professor Cowie said the actual number of people who contracted COVID and subsequently lost their lives continued to fall.
“It’s now on the order of much less than one person per thousand infections,” he said.
He said unvaccinated Victorians accounted for about a third of those deaths, despite making up just less than 5 percent of the total population aged 12 and older.
Vulnerable Victorians urged to plan ahead on COVID-19 antivirals
Professor Cowie said a crucial “new tool” available this winter to protect those most at risk from the virus is a range of subsidized antiviral treatments.
“They are hugely effective in keeping people away from the hospital and the tragic loss of life,” he said.
But there are two important things to know: the oral antivirals must be taken within five days of the onset of symptoms, and it may take some time to figure out which drug works for you†
Professor Lewin said it is now time for vulnerable people to see a doctor and put together a plan so that they can access antivirals in time if they become infected.
“You could have really mild symptoms and think ‘oh, it’s not worth going to the doctor,'” she said.
“But it’s within those first five days that you have to take the drug for it to work.”
She said some drugs interacted with other drugs, meaning careful assessment was needed to determine which drug would be appropriate if a vulnerable person was infected.
“That’s why it’s very, very important to go through that plan beforehand, with your primary care physician or specialist,” she said.
Masks remain effective barriers, but use is slipping
Throughout most of the pandemic, health authorities have consistently encouraged the use of masks as a simple, inexpensive measure to reduce transmission and help the community survive the pandemic.
It has been mandatory in public transport since July 2020.
Since then, adherence to masks on trains and trams has been highest during outbreaks where the threat of infection was paramount, and lowest during breaks between waves.
But now it appears that the link between heightened vigilance and widespread community transmission has weakened.
Compliance fell to an 18-month low last month, despite things remaining high.
Professor Lewin, who recently visited the United States, Singapore and South Korea, said the cultural differences between communities around mask use were “pretty striking”.
In Asian countries, she said it was rare to see people without masks, even in environments where mandates had been relaxed.
“It’s more about the community’s desire to make sure everyone is protected,” she said.
“It makes life kind of easy, if you don’t have to have that debate in your head, of ‘should I, shouldn’t I’. It’s just been removed from the internal dialogue and I think that kind of helps.
“I have to say that in some parts of the United States I haven’t seen any masks at all.”
Both Professor Lewin and Professor Cowie encouraged Victorians to use common sense for masks when the colder months bite.
“Essentially, it’s quite an easy thing to do that can protect you from potentially not just getting sick yourself, but passing that infection on to your loved ones when you visit them and it’s the last thing anyone wants to do,” Professor Cowie said.
Weighing all the factors, the senior infectious disease physician remains hopeful that the same qualities that have held the Victorian community together so far during the pandemic will sustain her through the difficult winter months ahead.
“Of course we’ll get through this,” he said.
“We should all do our best to get through it as well and healthy as possible.”
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