So, Victoria, what do we do now?

It’s now mathematically impossible that Melbourne will reach its COVID-19 case target to release to Step 3 of the Roadmap soon - but how might we open up a little and beat the disease modelling?

By Professor Tony Blakely, University of Melbourne

Professor Tony Blakely

Published 13 October 2020

It has been a disconcerting two weeks here in Victoria.

Five-day COVID-19 daily numbers have stubbornly refused to go below 10 cases per day and have even started increasing again.

Updated on 12 October. This graph is for all of Victoria – which closely resembles Metro Melbourne given cases at the moment.The red line is a five-day smoothed average, allowing for trends in the data.The orange line projects out this red line using the average percentage change in the last 10 days. I hope our average is less than 22 per day by 19 October – and we beat this simple projection. The yellow line is the projected 14-day average to each date. Again, I hope we can be lower than 16 by 19 October, but we also need to accept the reality that we will not be as low as five on average. Graphic: Supplied

It is now mathematically impossible that we are going to achieve the target set out in the Roadmap of an average of five new cases per day to release to Step 3 (or what we used to call Stage 2) on 19 October.

The second target, less than five mystery cases in the last 14 days, looks unlikely.

I can run arguments both ways – to release to Step 3 on 19 October, and to not release to Step 3.

The argument to release is as follows.

First, the modelling myself and colleagues provided to the Victorian Department of Health and Human Services that underpinned the Roadmap suggested a 10 per cent chance of a third wave by Christmas if we released at an average of 10 cases per day – compared to three per cent for releasing at five per day.

A 10 per cent risk is not that much more than three per cent – a risk worth taking.

Second, we have learnt form New South Wales (NSW) that the virus can be controlled at low levels without lock downs – with a good dose of luck.

Third, the last two steps of the Roadmap (a distant mirage at the moment) are actually elimination steps.

Melbourne won’t reach the Roadmap target of an average of five new cases per day by 19 October. Picture: Getty Images

Given both the stubborn tail we are now in, and the fact that NSW has had a modest resurgence and has made it utterly clear they think long-run elimination is impossible, it is near pointless for Victoria to overtly pursue elimination.

Fourth, we are completely over lockdown.

Socially and economically. Our young people in particular are having their lives seriously impacted. Life is dull, and the economy is hurting.

On the other hand, the argument to not release has merit too.

First, myself and colleagues have been engaging in more modelling (as we do). We are trying to design clever strategies that (if elimination is not possible) will keep the daily case numbers at a reasonably constant level over the next months and year.

No matter how clever I think these strategies are (carefully designed triggers when case numbers go up to quickly tighten restrictions, cautious triggers to release social restrictions when numbers are low again) – the future daily numbers still yo-yo.

In and out of Stage 3, and even Stage 4 lock downs, to prevent an explosion of case numbers. With a cycle of about 100 days. If we release on 19 October, the next lock down may not occur by Christmas but perhaps soon after.

Living with the virus requires all our smarts to get back some liberties and the ‘good things’ we love about Melbourne. Picture: Getty Images

Second, and related, most of Europe is heading back into lockdown after relaxing for a while.

Third, simple logic tells us that if the case numbers now have plateaued following our last modest opening up on 28 September, they will go up again if we open up further on 19 October.

Bugger.

So, how might we open up a bit more and beat the model? Nothing is guaranteed. But here are my thoughts.

We need to prioritise what we open up. Children back to school is essential – with as many measures as possible to prevent schools becoming a transmission setting.

But people like me going back to work is not a priority – those of us who can keep working at home, keep working at home.

Perhaps with the occasional one day a week or a fortnight to go into a 10 to 20 per cent capacity office to catch up (carefully) with my immediate work colleagues to oil the necessary interpersonal aspects of teamwork.

Children back to school is essential – with measures to prevent schools becoming a transmission setting. Picture: Getty Images

As citizens we cannot drop our guard. We have to keep social distance, try to keep social contact as much as possible to our family and immediate ‘bubble’, and wear masks when unable to maintain social distance.

And, importantly, get tested with any symptoms or if a contact of a (suspected) case.

Quid pro quo, the citizenry of Victoria – especially Metro Melbourne – need some sanity restoring, but minor, reinstitution of liberties.

The 5 kilometre radius has to go. My life expectancy is shortening by the day as my girth grows while my bicycle is chained up. Surely I could ride up the Dandenongs again – so long as not in a big bunch ride.

We need to cautiously capitalise on summer.

While mosh-pit and pumping pub band venues are not going to happen again till we have a vaccine, we can close down Lygon Street and enjoy al fresco dining and socialising – in your immediate bubble at tables well spread out.

2020 has and continues to be the worst of years, and we need to front up to 2021 probably not being much better.

We have to keep social distance – try to keep social contact as much as possible to our family and ‘bubbles’. Picture: Getty Images

Living with the virus requires all our smarts and nous to claw back some liberties and the ‘good things’ we love about Melbourne and Victoria, but we will not get to anything like pre-COVID normal.

Unless we either eliminate (no longer an option) or go nuclear with a massive wave of infection and thousands of deaths (which is not on the table as an option and should not be on the table given a vaccine looks closer).

My prediction, and indeed my prescription, is that we have to open up a bit more on the 19 October. But it should not be as much opening up as the Roadmap laid out in going from Step 2 to 3.

We need to prioritise those loosenings we value the most. We also need to lift our understanding and discussion.

I hate to be the bringer of bad news, but if we do open up more on the 19 October it is very likely that at some point in the future – hopefully after Christmas – we will have to tighten up again.

I hope I am wrong, but I fear yo-yoing between Step 2 and Step 3 is our most likely – even most optimistic – trajectory till we get a vaccine.

To maximise how much we can open up, and for how long, we need to all behave COVID safe. And, critically, our contact tracing and testing has to be top notch.

A version of this article was first published in The Age.

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