NSW is setting a national agenda on living with COVID-19

A strange dynamic has emerged as power is transferred away from Canberra and to state and territory leaders amid the pandemic. The idea of a national approach to COVID-19 rules has largely been shattered as leaders, emboldened with new emergency powers and popularity among their constituents, implement rules and restrictions even if it goes against national advice. 

NSW has started setting its own goalposts, with NSW Premier Gladys Berejiklian openly discussing a strategy of living with the virus, flagging potential freedoms for fully vaccinated residents, such as being allowed to visit pubs and bars, in regions with high vaccination rates and low case numbers.

This is the first clear pathway to freedom Australians have had. While the federal government’s vague four-stage plan flags eased restrictions when 70% of the adult population is vaccinated, it doesn’t provide further details. 

But NSW’s plans have caused a rift with WA which wants to keep case numbers at zero even when Australia reaches 80% vaccination, further muddying a national approach. 

From elimination to suppression

The federal government has long called Australia’s approach to COVID-19 one of suppression instead of elimination. The National Cabinet’s goal is “no community transmission” under its suppression strategy while less than 70% of the adult population is vaccinated. This strategy was agreed to by all state and territory leaders, despite McGowan’s comments.

Associate Professor in Epidemiology at La Trobe University Hassan Vally told Crikey with low vaccination numbers combined with the Delta variant, aggressive suppression was the only option. 

“The flaw in the thinking is there’s a choice between having zero cases or a little bit and it’s not,” he said. 

“It’s like a bushfire. Either you suppress really aggressively to get to zero or have NSW’s situation where they are locked down anyway and still not bringing it under control.”

But as more and more of the population get vaccinated, Australians will have to shift their focus from COVID-19 case numbers to cases of hospitalization, severe disease and death as markers for success. Iceland is a successful case study of this: While infections are reaching the second-highest levels since the pandemic began, the country hasn’t recorded a single death since late May. 

The appetite to do this depends largely on how exposed a region has been to the virus. WA and New Zealand haven’t faced the same outbreaks Victoria and NSW have. 

But suppression among a population with low vaccination rates is a dangerous game with the Delta variant, Chair of epidemiology at Deakin University Catherine Bennett told Crikey.

“You only have to miss one person and that can be the chain [that creates a cluster],” she said. 

“As is the case in Victoria, chances are the virus has been in the community for a while. If you miss the first case or one missed contact, the virus bubbles along under the surface and by the time it appears, you can’t quite link every person together.” 

But, she stressed, the Delta variant wasn’t spreading at its usual reproduction rate of each infected person transmitting the disease to five or six others but had a reproductive rate of less than two in Sydney — meaning social restrictions were working. 

“Especially with a vaccinated population, you should be able to manage the disease in the community and keep cases down,” Bennett said.

NSW is setting goalposts

NSW Premier Gladys Berejiklian said eliminating COVID-19 in the state was “almost impossible” with ­restrictions and lockdowns likely to ­remain in place until November, even when the state achieves 80% vaccination rates. 

Last month, NSW Health Minister Brad Hazzard conceded “at some point, we’re going to a stage where we’re going to have to accept that the virus has a life that will continue in the community”. 

WA Premier Mark McGowan has baulked at the idea of living with COVID-19, arguing that WA’s border will stay shut to NSW until there’s zero transmission — even after the state achieves 80% vaccination rates. 

This is a similar approach to New Zealand, which will keep pursuing an elimination strategy even after its borders reopen.

Will other states have to follow suit? 

Greater Darwin and the Katherine region, all of NSW, Canberra and Greater Melbourne are currently in lockdown, each stemming from Sydney’s outbreak (with the NT in lockdown after an international traveller exited quarantine in Sydney, though it’s not known if he picked up the virus during transit or was still infectious when he left quarantine). 

If other states like WA continue to pursue an elimination strategy, they’re likely to have to pursue more aggressive restrictions than other states, Vally said. 

“It’s possible states operate like a separate country in terms of the control they have over their policies and who crosses the border,” he said. 

“It’s not ideal to have different states following different strategies. It would hold us back and it would make life more complicated and difficult.”