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A new University of Melbourne study finds that measures taken by the Australian public and government have effectively contained the spread of COVID-19 in Australia for the time being. The document is published on the prepress server medRxiv * in May 2020.
The study analyzes the development of the epidemic and the subsequent public health response, including the “intensity and timing of public health interventions.”
Melbourne, Australia – April 13, 2020: Beach closed due to COVID-19. Coronavirus sign on St Kilda beach. Image Credit: Alex Cimbal / Shutterstock
Early travel restriction reduces infection import
On January 31, 2020, China reported 9,720 cases of COVID-19. However, Australia only had 9 cases that had a travel history or a direct link to Wuhan.
Australia has taken precautions since February 1, when China was the only country where community transmission was reported. All travel from mainland China was restricted, except in the cases of Australian citizens and residents, who were recommended to self-guarantee after arrival.
In addition to this, testing and awareness campaigns became part of border precautionary measures for arrivals from other countries. These measures were based on a tool developed to assess the risk of spread through these means, in early February.
Approximately 200,000 air passengers were expected to land in the country from mainland China. However, due to established restrictions, travel numbers were significantly reduced.
“These restrictions were not (and very unlikely) intended to prevent the final importation of COVID-19 into Australia. Their purpose was to delay the establishment of an epidemic, which bought valuable time for health authorities to plan and prepare, “the researchers explain.
In February, the country only saw 12 cases. However, travel restrictions were extended in March 2020 to cover other countries with uncontained outbreaks such as Italy and Iran.
Prevention of community spread
However, the number of cases began to increase in the first two weeks of March, most of them linked to returnees abroad. Localized community broadcasting was reported in Sydney and Melbourne. The infection rate charts began to resemble those of China, Europe, and the United States.
The second half of March saw the Australian government introduce a series of stricter step-by-step restrictions, all aimed at reducing the spread of the existing community and preventing it where it was not yet operating. These measures included social distancing measures, mandatory self-quarantine for all international arrivals (which included Australian returnees within the next two weeks) and closed international borders to all countries (except citizens and residents).
In late March, the government recommended strict social distancing measures, where people were discouraged from leaving their homes for any reason that was not essential. It also banned public meetings with more than two people. It worked, the cases started to drop again.
Australia stands firm
Australia reported more than 6,500 confirmed cases of COVID-19 prior to April 18, 2020, with 67 case deaths. However, the disease curve has been flattening since the end of March 2020, with fewer infections reported each day.
The researchers say: “Our analysis suggests that Australia’s combined strategy of early and targeted import risk management, case-directed interventions, and large-scale social distancing measures applied before the onset of detected widespread community transmission has substantially mitigated the first wave of COVID-19 “.
Descending playback number
The researchers used a breeding number: the number of people infected by a COVID-19 infected patient, in the presence of public health measures and normal susceptibility to the virus. If the breeding number were less than 1 in a given area, the researchers could safely assume that there would be a drop in the infection rate. This also meant that hospitals and intensive care units would not be overwhelmed by a large number of simultaneous infections.
“We estimate that the effective number of reproduction was probably less than 1 (the threshold value for control) in each Australian state since mid-March and we forecast that the occupancy of the intensive care unit and the hospital ward will remain below capacity thresholds in the next two weeks, “the researchers noted. said.
The worst-case scenario was avoided, the researchers add, where the daily demand for ICU beds would have been 35,000 ICU beds in May 2020, the same as other countries that could not contain the outbreak. This would have overwhelmed Australia’s healthcare system capacity of approximately 2,200 ICU beds.
Cautious relaxations to keep the curve flat
The team warned against premature relaxation of containment measures, especially in places where localized transmission has already been reported, as well as in high-risk areas such as nursing homes for elderly patients, which have reported a high mortality rate. global.
While the case detection rate among symptomatic patients is over 77% in Australia, the number of mild, undiagnosed, asymptomatic infections remains largely unknown, the researchers added. The presence of large numbers of asymptomatic cases has been a thorn in the flesh for many countries dealing with the epidemic.
Even if there were a large number of such cases, the Australian population would be extremely vulnerable to infection due to the low prevalence of COVID-19 so far. However, the time Australia has bought with its early action may allow it to be more prepared when the wave hits, the researchers conclude.
As of today, May 4, 2020, Australia has reported 6,801 cases and 95 deaths. 5,817 cases are reported as recovered. To date, more than 633,000 tests have been conducted for COVID-19.
“For now, Australia is one of the few countries that is fortunate enough to be able to plan next steps from a position of relative calm rather than crisis,” the report concludes.
*Important news
medRxiv publishes preliminary scientific reports that are not peer reviewed and are therefore not considered conclusive, guide clinical practice / health-related behavior, or are treated as established information.
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