People in face masks while shopping at the Queen Victoria Market in Melbourne during the second Covid lockdown. Photo / Darrian Traynor, Getty Images
Authorities have never been supportive of Australia adopting an elimination strategy against the coronavirus, but experts believe Victoria may regret it if the state doesn't have a crack at doing this during its second lockdown.
Some have described the elimination option as an impossible task but somehow the majority of Australia's states and territories have managed to essentially eliminate the coronavirus.
Only two jurisdictions are still struggling: Victoria and NSW.
NSW got close to achieving elimination before Victoria's latest outbreak forced it to close its borders amid fears the virus could migrate north.
Victoria, on the other hand, has seen its cases spiral dramatically and suburbs in Melbourne and the Mitchell Shire have gone back into lockdown.
From the modelling I've seen and the experience we're seeing around the world in places like New Zealand, I don't think what we're doing now will maximise our chances
There are now 1007 active cases in the state and the number of cases with an unknown source has spiked to 562 cases, another 843 are under investigation. There have been several days of triple-digit growth and on Sunday there were 273 new cases.
Contact tracers, who ensure any potentially infected people are identified and told to isolate, are having trouble keeping up with the numbers.
With parts of Victoria going back into lockdown, experts including those at think-tank the Grattan Institute, are now calling on the Federal Government to switch from its official suppression strategy and adopt elimination instead.
"Despite the fact that Australia had a suppression strategy, six and maybe even seven [NSW], states and territories have succeeded in elimination so it is achievable," Melbourne University epidemiologist Professor Tony Blakely told news.com.au.
While this would involve tougher measures in NSW and Victoria in the short-term, it would have benefits for the long-term.
"It's becoming clear based on the Victorian experience and also around the rest of the world, that if there are still infections, you go in and out of lockdown, there's so much uncertainty, you can't book holidays, it's a pain, socially destructive as well as economically damaging," he said.
Blakely believes tougher measures should be brought in as the state only has a 50/50 chance of achieving elimination based on current restrictions.
"If we don't do it, we will regret it in a few months time if Victoria has ongoing transmission and the rest of Australia doesn't," he said.
"I don't think Victorians would be willing to have another crack [if there was a third lockdown] so this time will be the last time we can try it."
He said he would not be suggesting this course of action if the other states and territories hadn't broadly achieved elimination.
"If everyone was in a travel bubble and Victorians were left out, I don't think they would enjoy that space," he said.
"This is the time and place that Australia would have a strong crack at elimination.
"Given where we are now, we should be going hard."
Experts believe both NSW and Victoria should introduce tougher measures so that elimination is a possibility.
While it's not likely that the virus will be completely eradicated, states can get numbers down low enough so that when there are flare-ups they are small and easily dealt with.
Blakely said the virus could be said to be eliminated if there were no cases without a known source for 28 days.
"Every state and territory in Australia except for NSW and Victoria have achieved this," he said.
"NSW only had three cases recently, it got so close."
Victoria has the toughest job ahead of it and Blakely said it was still not certain that the state could get to elimination even after six weeks of lockdown.
But he said "we have a good chance at achieving it by going a lot harder than we have".
He believes a number of new measures should be introduced including changing the definition of "essential worker" to only those who were truly essential, this would not include building workers for example.
Essential workers would be forced to wear masks and Blakely believes masks should also should be worn by anyone on public transport and visiting busy indoor places such as supermarkets.
"Masks will reduce transmission from people before they know they are infected," he said.
"It will lower the chance of the virus spreading by about 80 per cent or so."
So far authorities have suggested people wear a mask in public when they are unlikely to be able to stay 1.5 metres away from others but it is not compulsory.
Blakely said there should also be a stricter lockdown on businesses.
"There are still a lot of people out there, it's fairly half-baked, we still have department stores open and Bunnings," he said.
He believes schools should be closed and if senior students needed to continue their studies, the government should consider boarding arrangements with those in the private sector.
"It's harsh but if it works you get short-term pain for long-term gain," he said.
"From the modelling I've seen and the experience we're seeing around the world in places like New Zealand, I don't think what we're doing now will maximise our chances.
"With Covid you need to stack everything up that you possibly can to get on top of it."
So far Victorian authorities appear to be sticking to a suppression strategy.
Premier Daniel Andrews was asked about the issue on Friday and said the state was pursuing a strategy that suppresses the virus in line with the National Cabinet decision.
"If you were to go for the … strategy where you have eliminated the virus, then that is a very different set of arrangements," he told reporters.
"That is not potentially a lockdown for six weeks, it could be much more than that.
"If, however, as a result of the suppression strategy you can achieve zero cases for a long period of time and have a degree of confidence that you have beaten the thing, then that is a fantastic outcome.
"There are some states that have been able to achieve that [but] they never had community transmission to start with and that is part of why they have been able to get to that point.
"We are about delivering the strategy and that is bringing this back under a sense of control. That is what suppression is about."
Australia's Health Minister Greg Hunt also dismissed the idea of elimination saying "we've been very realistic".
"We've achieved extraordinary things but we've been honest with the Australian people there would be outbreaks," Hunt told 7.30 on Thursday night.
"We saw other countries that have made predictions and then had to walk back because there had been cases after there have been claims of elimination."
Prime Minister Scott Morrison has previously ruled out pursuing an elimination strategy as it would be too costly to the economy.
"The eradication pathway involves an approach which will see even more economic restrictions than are currently in place," Morrison said.
"That is not seen to be, in our view, a wise trade-off."
Morrison said Australia's suppression strategy also "sat well" with Australia's ethos and how people lived.
"We like our freedoms, we like to be able to do what we want to do."
At the moment NSW is the only other state not to have achieved elimination but it is close. Experts believe it should also put in tougher measures to ensure any cases it imports from Victoria don't spread.
On Thursday it announced a 14-day quarantine period for any travellers from Victoria.
If NSW is successful at keeping new infections down and is then able to eliminate the virus, Victoria will be the only state that hasn't achieved this. It may be left isolated if other states and territories keep their borders closed to Victorians.
Blakely said this could create border issues and issues with the economy.
If Victoria was successful then it could have open borders with the rest of Australia as well as countries like New Zealand, Taiwan and possibly Singapore, which is also close to elimination.
"Then you can open up those countries and live reasonably normally," Blakely said.
"If a vaccine arrives in two years, you have won.
"If it takes three to four years then you are in a limbo and isolated from the rest of the world but at this point in time, elimination is probably the best and safest bet.
"We have an opportunity at the moment, we've gone into lockdown, let's do it really well and maximise elimination."
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