High risk of coronavirus second wave as Australian shops and workplaces reopen, report says – The Guardian

Workplaces pose a high risk of triggering a resurgence of Covid-19 cases in Australia, which means people should continue to work from home as long as they can, a report from public policy thinktank the Grattan Institute says.

Published on Sunday evening, the report, Coming out of Covid-19 Lockdown: the Next Steps for Australian Health Care, says schools can safely remain open as long as policies are in place to reduce the risk of outbreaks.

It comes as Victoria announced it would extend its state of emergency for at least four more weeks and ramp up its police enforcement of lockdown rules after a spike in Covid-19 cases in recent days.

The rise also prompted neighbouring South Australia to reconsider its decision to reopen its border, while Queensland declared all of greater Melbourne a Covid-19 hotspot.

The report uses new modelling to suggest that reopening shops and workplaces heightens the risk of new infections, especially if people perceive the threat is over and ignore social distancing rules.

Workplaces should be reopened slowly, with as many people as possible continuing to work from home, the report says. Social distancing in workplaces is crucial and must continue to be incorporated into workplace reopening plans. Schools must be closed, and rigorous contact tracing implemented when a case is detected.

For millions of working parents, having their children at home from school is a significant burden, the report says.

It also disrupts the education of children, particularly already disadvantaged children and those preparing for exams, it says. It is a potential restriction to the spread of Covid-19 with substantial costs to society. The literature finds school closures has minimal effect on the transmission of coronavirus diseases, including Covid-19.

Once there are no longer any active cases, testing must remain a routine part of life, the report says, and current mandatory quarantining of international arrivals must also remain in place. However, it suggests quarantine exemptions could be made with other countries that also have no active Covid-19 cases.

While the prime minister, Scott Morrison, has said Australia is pursuing a strategy of suppression and not elimination of the virus, the lead author of the Grattan report, health economist Stephen Duckett, said: Its really the states driving the public health response and theyre going for zero.

The report said states could only be confident of zero active cases once no new domestic transmissions had been recorded for several weeks.

If there are no local transmissions, governments can afford to allow all activity that would otherwise lead to new infections growing, the report said.

This may not amount to complete elimination, because travellers may enter with the disease, provided that they are quarantined, and care is taken to ensure that while in quarantine they do not infect anyone in the wider community. The elimination scenario is much less restrictive than the others. It would permit normal activity. A government can only afford to permit this much activity if it is confident that there really are no cases out in the community.

The report suggests people should only be permitted to move freely between states once this near elimination had been achieved.

It says the pandemic demonstrated a more effective, efficient and equitable health system is needed.

It would be a tragedy if lessons werent learned from the pandemic, the report says. We argue that Australia should not snap back to the old order, but rather that the changes that occurred during the pandemic should inform what happens during the recovery period and beyond.

Telehealth should become a central part of healthcare, and the government should address poor internet connectivity in rural and remote Australia as a priority, the report says.

In the new normal, health professionals and their patients need to assess when telehealth should be the preferred medium because of the nature of the problem, distance to be travelled, and other factors.

The pandemic had also exposed weaknesses in Australias disease-reporting system. Through the first few months of the crisis, there was no nationally coordinated approach to publicly releasing real-time data on confirmed Covid-19 cases and deaths. This needed to be addressed to better respond to future crises, the Grattan Institute suggests.

The chair of the Australian Healthcare Reform Alliance, Jennifer Doggett, said many of the problems with the heath system that obstructed the response to Covid-19, including a lack of real-time disease reporting, poor oversight of the private hospital system and a lack of coordination between governments, were well known before the pandemic. Once Covid-19 subsides, Doggett said, governments must continue to listen to the experts.

One reason for the success of our Covid-19 response is that policies were informed by expert medical and scientific advice, she said. It would be great if governments paid the same attention to expert advice outside of a crisis situation.

While Australia appeared to have emerged from the initial stages of the pandemic relatively well compared with other countries, Doggett said the government must also reflect on the near misses.

Had Covid-19 arrived only a few weeks earlier in Australia, the peak risk period for community transmission would have coincided with the mass evacuations due to the bushfires, she said. This would have dramatically changed our capacity to contain the spread of the disease at this crucial early stage with potentially catastrophic consequences. Next time we might not be so fortunate.

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High risk of coronavirus second wave as Australian shops and workplaces reopen, report says - The Guardian