Some experts disagree, however, with the Grattan Institute’s health policy expert Stephen Duckett saying the government should pursue a target of zero daily infections, which could not be achieved without another eight weeks of hard lockdown.
Of Victoria’s 2060 active cases on Friday, 993 were related to aged care and 297 were among healthcare workers – between them about 63 per cent of the total. In response, the state government announced that, from late on Friday it had started asymptomatic testing in the COVID-19 wards of hospitals. All staff would be tested weekly for six weeks even if they displayed no symptoms, a spokeswoman said.
Friday’s 81 new cases included eight with an unknown source, while the death tally rose by 59, of which 53 were previously unreported deaths in aged care.
Premier Daniel Andrews will on Sunday announce a road map for loosening restrictions in Victoria from as early as September 13. A draft version suggested stage four restrictions could continue for two more weeks until September 27, although Mr Andrews on Thursday dismissed that draft as outdated and of “no status’.
On Friday, he again refused to rule out the possibility of stage four continuing beyond September 13 and said Victoria had come too far to hastily wind back restrictions now.
“The only thing that works here is to see this thing off properly, defeat it and then lock in a COVID normal not for a few weeks but for many, many months,” he said.
Professor Bennett and Professor McCaw both estimated Victoria would still be recording up to 50 or 60 cases per day as the original stage four period expired on September 13 – a number Chief Health Officer Professor Brett Sutton described on Friday as the “stubborn tail of the epidemic curve”, and has said was too high to loosen restrictions. But with two-thirds of the state’s active cases in healthcare and aged care, Professor Bennett said Victorians should probably not be left in hard lockdown beyond next Sunday.
“There may be an argument to keep stage four going for a week or two, but I don’t think blanket stage four restrictions will drive down the cases we’re seeing,” she said.
Professor McCaw, one of Australia’s top epidemiologists, said the strict stage four lockdown had achieved its goal of limiting community transmission. Now, however, there was “very little circulation within the general community”.
He said he had been in favour of a move to stage four last month, which included an 8pm curfew and five-kilometre limit on movement, because Victorians were not adhering to stage three restrictions as they did in the first wave in March and April.
On the possibility of reopening, he said: “There is no obvious answer to this question. You have to be very careful because loosening those restrictions could still pose a risk when outbreaks occur … but it is a very reasonable question to ask: is it appropriate to lock down five million people when the virus is circulating in a definable pattern [in healthcare and aged care], where those stage four restrictions aren’t the key way of changing those infections?”
Professor Blakely said a “nitty gritty” approach to infection control was needed in healthcare settings.
“A really big thing here is mask-fitting for health workers. Aerosols are a major way COVID-19 spreads, where it can sneak around the side of masks,” he said. “The system design is also important, so ensuring workers aren’t coming into unnecessary contact with each other. It seems we’ve fixed that up in places like distribution centres, where visitors like truck drivers arrive at certain times and leave quickly. We need to refine that kind of approach in hospital settings.”
A Grattan Institute report released this week argues that Victoria’s daily infection rate could drop to zero if the city sticks out another eight weeks of lockdown, calling on state and federal governments to set a target of zero daily infections.
Dr Duckett, a health economist, said this would be achievable only if authorities were able to get on top of the virus in hospitals, aged care, abattoirs and public housing. Without improving infection control measures in these environments, he said the numbers will never drop below 20.
Up to 80 per cent of healthcare workers who have contracted COVID-19 picked it up at work and at the end of August the Victorian government said it would begin trialling the fit-testing of masks, introduce “PPE spotters” at hospitals and study hot spots of transmission.
Professor Bennett said ongoing health worker infections showed that “we’ve got to be missing something in the way people are interacting in those settings”.
Daily case numbers fluctuated this week: tallies of 70 on Monday and 73 on Tuesday were followed by 90 on Wednesday, 113 on Thursday and 81 on Friday.
With Anna Prytz
Michael is a state political reporter for The Age.