What full lockdown actually means

 

Experts are urging authorities to put Australia in full lockdown but some believe we can avoid this if people start doing the right thing.

Senator Jacqui Lambie is among many in the community calling for Prime Minister Scott Morrison to lock down Australia as the coronavirus continues to spread.

But Mr Morrison on Wednesday dug in his heels against the idea, saying he's not going to shut even more businesses when "there's no medical advice that they should".

The University of Oxford launched a response tracker this week that showed Australia's measures to tackle COVID-19 were not as strict as those in many other countries including China, most of Europe and the United States. However, the data had only been updated to Tuesday, March 24.

The University of Oxford's coronavirus response tracker features a Stringency Index to show the differences in measures between countries.
The University of Oxford's coronavirus response tracker features a Stringency Index to show the differences in measures between countries.

 

With infections now growing to close to 3000, some experts have backed the idea of a full lockdown, including the Grattan Institute, as it would bring infections under control within a few weeks and allow shops to re-open, avoiding the need for a longer period of disruption.

Many other countries have taken this path including China, Italy and India.

However, others say a full lockdown may not be necessary if there was better testing for COVID-19 and people actually complied with the current restrictions.

Here is what a full lockdown involves and what the alternatives are.

WHAT FULL LOCKDOWN LOOKS LIKE

At the moment people are being encouraged to stay home but some businesses and shopping centres are still open, and restaurants can offer takeaway services.

In full lockdown no one would be allowed out of their homes for about three weeks unless it was to access essential services.

Professor Mary-Louise McLaws of the University of NSW told news.com.au supermarkets would have to remain open as some people in the community wouldn't be able to afford to buy enough food for a week, let alone two or three weeks.

Prof McLaws is a member of the World Health Organisation (WHO) Health Emergencies Program Experts Advisory Panel for Infection Prevention and Control Preparedness, Readiness and Response to COVID-19.

She said pharmacies, doctors and hospitals would also continue to operate. Some banks would be needed as not everyone has a credit card.

"In Israel their lockdown is very strict, everyone has to stay home and you are only allowed to be 100 metres from your home - as most people live in apartments - so you can go for a jog around the apartment," Prof McLaws said.

"One person in the family goes shopping and that means that those who can't afford to buy a lot of groceries can go more often."

RELATED: Why 80 per cent of Australians need to stay home

 

Prof McLaws said face masks would also start to play a role for those who have to leave home to access essential services and she believes people could be taught to reuse their masks safely if they were not healthcare workers.

Prof McLaws also suggested the distance between people be increased from 1.5 metres to 2 metres.

"Lockdown would have to be very severe for about three weeks," she said. "During this time cases would recover and people would stop being infectious.

"That's why citizens should be co-operating with the lockdown now because what I'm describing is very severe."

In China, there was a strict lockdown and if people had the virus they were taken to a central area to recover.

"Mild cases were not cared for at home," Prof McLaws said, so people would not infect others.

WHAT HAPPENS AFTER?

After doing the hard work to get the number of coronavirus cases down to zero, or close to zero, the last thing the country needs is for international travellers to bring in more infections.

This means Australia would have to keep its borders closed and for citizens coming back from overseas to be placed in mandated isolation for at least two weeks - away from the rest of the community.

"We would need to have a central area to take them," Prof McLaws said.

Grattan Institute chief executive officer John Daley has previously suggested hotels, which have high vacancies at the moment, could be repurposed as quarantine centres.

IS IT NECESSARY?

This seems to depend on how seriously Australia takes the measures on social distancing.

Prof McLaws said if authorities saw people were complying with current restrictions it may not be necessary to enforce a stricter lockdown.

"If numbers of cases are going up and people are not co-operating then they would have no other decision than total lockdown," she said.

Separate modelling from the University of Sydney found that 80 per cent of Australians needed to stay home in order to have any impact on infections. Even if 70 per cent stayed home, the number of virus cases would continue to rise.

"They are very lucky I am not running the outbreak, I would have been tougher as I am concerned about Australians," Prof McLaws said.

"We love our liberty but people don't understand they are impacting other Australians' liberty."

Prof McLaws believes more widespread testing and mapping of infection hot spots is needed to give authorities a better understanding of whether measures are working, or whether a stricter lockdown should be introduced.

She said the current restrictions would probably need to be in place for a very long time until Australia's infections started going down.

They could only be lifted once new cases started going down, there was widespread community testing showing negative results in people with mild symptoms, and the likelihood of cases became more rare.

RELATED: Australia has to decide on its endgame

RELATED: Coronavirus clusters identified in NSW

The new normal: Sydney’s usually busy Darling Harbour is empty. Picture: Dan Himbrechts/AAP
The new normal: Sydney’s usually busy Darling Harbour is empty. Picture: Dan Himbrechts/AAP

 

"For now, restrictions will continue for many weeks, this is the new reality, and you don't want the next reality.

"Please take this phase very, very seriously and do what the Chief Medical Officer and the Prime Minister are asking of you.

"It's all about caring for each other."

IS THERE AN ALTERNATIVE?

Professor Louisa Jorm, Foundation Director of the Centre for Big Data Research in Health at UNSW Sydney, has done modelling that shows vigorous testing, identification of cases and isolation could also work to suppress the virus, bringing down the number of cases and deaths.

She said countries like South Korea and Japan seem to have almost completely suppressed infections by using these methods.

Australia's approach so far has focused on social distancing and while this may bring down cases in the short-term, modelling shows a jump in infections after a few months when restrictions are lifted.

"It will come back once you stop, for example, intensive social distancing," Prof Jorm said.

However, she said delaying the peak in infections could be valuable in allowing health services to prepare themselves and allow them to think of different approaches to tackling the virus.

It could also give time for authorities to mobilise more resources, such as testing, case finding, isolation and quarantine, in anticipation of a jump in cases.

Prof Jorm believes that better testing, such as the new finger-prick antibody test that will reportedly be made available in the UK soon, is crucial in identifying more people who have the virus but are only experiencing mild symptoms.

These people can then be isolated, slowing the spread of the virus and allowing restrictions to be focused on targeted individuals rather than forcing the whole population to suspend their daily lives.

A focus on tracking cases and isolation, would also mean that Australia may not have to rely on things like herd immunity, which involves around 60 per cent of the community being infected with the disease, to slow the spread.

"You don't need herd immunity if you had larger scale testing, involving asymptomatic individuals as well as those who are symptomatic," Prof Jorm said.

IT COMES BACK DOWN TO TESTING

Prof McLaws is also a supporter of more widespread testing and believes the criteria for testing should be changed.

At the moment people can be tested if they have symptoms and have either returned from overseas recently, or have had contact with a known confirmed case. They can also be tested if they are among certain groups, including health care workers, aged care worker, living in an identified hotspot or a detention centre.

However, this means that most of Australia's coronavirus cases are linked to overseas travellers, such as the outbreaks on cruise ships, and this doesn't give authorities a true picture of how widespread community infections are.

"Now is the time to test more of the community to tell us how many mild cases there are," Prof McLaws said. "That way we get a good handle on the spread."

She said the new finger-prick antibody test should also be introduced in Australia as quickly as possible, as nasal swabs currently being used to diagnose COVID-19 didn't always pick up the infection if people were in the early stages of the disease.

Because of this, Prof McLaws also believes those who had tested negative previously when they had mild symptoms should also be allowed to take the test again.

She said the lack of follow-up testing for those with mild symptoms was a "real cause of alarm" because it could be placing the community at risk.

Better testing would also allow analysis to be done on hot spots of infections to inform decision-making.

IS AUSTRALIA DOING ENOUGH NOW?

Prof Jorm believes a stricter lockdown will probably be necessary to get infections down and stricter enforcement may also be necessary.

"In Singapore they track people's locations on their mobile phones of people diagnosed, to make sure they stay at home," she said.

But she also believes some of the messages to the public are confusing.

"They say you can have 10 people at a funeral but only five at a wedding," she said. "There is no logic to that."

 

Originally published as What full lockdown actually means


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