Australia initially contained its coronavirus outbreak so well that there were several days in May in which the entire country’s daily number of new cases was in just the single digits, and the country began to reopen. But thanks to a new outbreak, the daily numbers are back in the hundreds — and once again, shutdowns are starting.
To contain the new resurgence, Australia on Wednesday closed the border separating Victoria and New South Wales, restricting nearly all travel between the two states. The border was closed to contain an outbreak in Melbourne, the capital city of Victoria, and the surrounding metropolitan area, where hundreds of new cases have been reported over the past several weeks.
Australia’s management of the pandemic has been a huge success — the country not only flattened its curve but “crushed” it, as University of South Australia biostatistics professor Adrian Esterman told me.
But epidemiologists told me that worldwide, even places with low numbers of new cases will still be susceptible to resurgences until a vaccine is available — so new case numbers, in Australia and elsewhere, will continue to fluctuate.
“You’ll have surges where everyone has to go into lockdown and then cases will go down. Then you can start doing normal things again, then the cases will go up, then you’ll have to go into lockdown again,” Raina MacIntyre, head of the Biosecurity Research Program at the Kirby Institute at the University of New South Wales, told me.
“It’ll be intermittent periods of epidemic and inter-epidemic periods and intermittent lockdowns to manage the situation until we have a vaccine,” MacIntyre said.
How Australia managed to control the pandemic
Australia has done a great job controlling the pandemic, experts told me. But you really don’t need experts to tell you that — just look at the country’s total number of cases.
Only slightly more than 9,300 people in Australia have been diagnosed with Covid-19 to date, and about 100 people have died as of July 10, according to Johns Hopkins University’s Coronavirus Resource Center. To put that in perspective, Peru and Chile have comparable population sizes to Australia’s — but each has reported over 300,000 coronavirus cases, with thousands of deaths as of the same date.
The Australian government took the pandemic seriously from the beginning and, unlike in the United States, government officials listened to the advice of public health experts, Esterman told me. Esterman also said the vast majority of the public complied with social distancing and mask-wearing guidelines — again, unlike in the US, where masks are seen by some as an attack on individual liberty.
Australia first tackled the virus with a ban on travelers from high-risk areas in February. MacIntyre told me that most cases from the first outbreak were travelers returning to Australia. That, and Australia’s lack of land borders with other countries, made it easier to identify who was infected or at risk.
Australia’s borders were closed to non-citizens on March 19, and later that month public gathering places like movie theaters, bars, and schools were closed and social distancing rules were imposed. Testing has also been widely available — more than 2.6 million people of Australia’s population of 25 million have been tested as of last week.
The country’s biggest misstep, Esterman told me, was the docking of a cruise ship in March with infected passengers on board. Hundreds of cases could be traced back to the Ruby Princess cruise ship, where passengers that were clearly sick left the ship without being tested, dispersing around the country.
Reopening began in May, with the intent of safely reopening the economy fully by July.
In the US, the coronavirus is disproportionately impacting Black, Latinx, and Native American communities. But in Australia, although institutional racism against Indigenous populations in health care is pervasive, Esterman said there were not significant racial disparities in Covid-19 infection rates during the initial outbreak because not many people were infected in the first place.
“There were basically too few cases for there to be any differentiation,” Esterman said.
But the new Melbourne-area outbreak is largely affecting immigrant communities. This outbreak began because of failures at quarantine hotels, where people who fly into Australia must stay for two weeks under mandatory quarantine. The BBC reports that improperly trained private security forces are facing the blame, including allegations of rule-breaking — like sharing cigarette lighters and having sex with quarantined travelers.
From the hotels, the virus spread to low-income communities with large immigrant populations in Melbourne, Esterman told me. He said the government also didn’t spend enough time communicating with these non-English-speaking communities about the importance of mask-wearing and social distancing, leaving them vulnerable.
Victoria logged a record-high 288 new cases on Friday. That’s the state’s highest number since the 212 new cases reported on March 28, during the peak of the first outbreak. 3,379 cases have been reported in Victoria to date.
“These are unsustainably high numbers of new cases,” Victoria state premier Daniel Andrews told reporters on Tuesday. “It’s clear we are on the cusp of our second wave — and we cannot let this virus cut through our communities.”
Lockdowns are being reimposed to contain the new outbreaks
Now, metropolitan Melbourne residents are in a six-week lockdown, which began Wednesday, with limited exceptions for leaving home or traveling outside the metropolitan area.
The Victoria-New South Wales border was closed Tuesday for the first time in 101 years — the last closure was an attempt to contain the Spanish flu in 1919, which killed 15,000 Australians.
People who cross the border, which is guarded by New South Wales police and military personnel, will face large fines; 14-day permits are available for a few exceptions, and emergency service and law enforcement workers as well as people seeking medical care are free to cross.
People in the metropolitan Melbourne area aren’t eligible for permits except in extreme circumstances, the Guardian reported.
MacIntyre told me that the decision to close the border was made once daily new cases hit triple digits. Previously, affected suburbs and apartment buildings were locked down, but case numbers continued to rise, MacIntyre said.
The border closure is meant to prevent people from bringing Covid-19 from areas with a high number of cases into unaffected areas, Krutika Kuppalli, an infectious disease physician and emerging leader in biosecurity fellow at Johns Hopkins Center for Health Security, told me. Kuppalli compared the Australian border closure to stay-at-home orders and quarantine mandates in the US, which are also intended to limit travel.
More than 50,000 people crossed the border into New South Wales on Wednesday but were forced to wait for hours due to delays with the online permit system. One person has already been arrested for attempting to cross the border without a valid permit or exemption, the Guardian reported.
Esterman said the fact that people can get a permit and cross the border at all could be dangerous.
“If you live in Victoria and work in South Australia, they will let you through,” he said. “How is that helpful in trying to stop it from spreading from other states?”
Areas that controlled the spread of the virus will continue to see outbreaks
Australia’s new outbreak and the reimplementation of strict prevention measures show that areas that have limited the spread of the virus aren’t immune to spikes in Covid-19 cases once economies reopen and lockdown policies are lifted.
“I think there’s always going to be a risk of resurgence until there is a vaccine, and the decision of when to initially reopen the economy and initially reopen society can be guided by best practices and evidence,” Gregory Tasian, an associate professor of urology and epidemiology at the University of Pennsylvania Perelman School of Medicine, told me.
South Korea also contained its virus outbreak well but then faced spikes in new cases, including one linked to nightclub reopenings. Officials declared in June that the greater Seoul area is facing a second wave.
Tasian said areas that meet criteria for reopening should effectively communicate universal masking and implement social-distancing guidelines in the workplace to decrease the overall transmission.
But the United States is in a completely different situation than countries like Australia and South Korea, which have both managed to flatten their country’s curve of Covid-19 cases, Tasian said. The Northeast, which was once the US’s epicenter, has been able to control the pandemic, but cases in the South and West are on the rise.
“The US never got out of the first wave,” MacIntyre told me. “So opening up is going to be extremely dangerous. It is guaranteed it’s going to result in another big surge of cases.”
Tasian said that to ideally manage the pandemic, the US should implement nationwide policies, like masking and social distancing, and policies targeted to areas seeing spikes in cases — but that widespread testing is necessary to know which areas are facing larger outbreaks.
Even if the US manages to slow the spread of the coronavirus nationwide — which doesn’t seem to be happening any time soon, as cases have just topped 3 million and a record-breaking nearly 60,000 cases were reported Thursday — it’s clear that we’ll be seeing outbreaks until we finally have a vaccine.