2021: Living in a COVID World

Blog post by Professor Tracy Smart AO, our Public Health Lead in the ANU COVID Response Office
27 October 2020

By now it should be less about following rules and regulations and more about doing some basic things to stay safe, things we should all be doing anyway.

Lately, I have been doing a lot of pandemic futurecasting - sitting back and analysing where we are and where we're heading. The reason for this is that I am involved in some intensive planning for next year. From an ANU perspective we've been mapping out our approach to things such as class sizes and on campus activities as we try to go back to something approaching "normal" university life in 2021. And of course we are continuing to look at ways to bring our international students home to Canberra. I have also been providing advice to those planning the upcoming AFLW season, as well as briefing some RAAF officers. From these ruminations I would like to share my predictions of what the next 12 or so months might look like.

First of all, let me say that my crystal ball is still not clear enough to make a prediction about when a safe and effective COVID vaccine might become available and in widespread use. We may see one emerging in the next few months and be in a position to vaccinate everyone before the end of next year. But for most of us, it is kind of irrelevant and we definitely should not be planning our lives based on whether or not we have a vaccine as there is just too much uncertainty out there. As I have said many times before, we need to change our lives to live with this virus. That way, getting a vaccine will be a bonus and we will have learned healthy habits to stand us in good stead going forward and prepare us for future pandemics.

Even without a vaccine, for those of us in Australia I think next year is going to look pretty good and that our lives will return to near normal. Even though Victorian restrictions have not yet been lifted, we are incredibly close to achieving no community transmission across the country (aka "zero spread") and I think we can get there. At the very worst, we might have the occasional small flare up that will be quickly and effectively controlled through targeted testing and vigorous follow up. This is what is happening in NSW at present. With good luck and good adherence to COVID-safe behaviours we will avoid another major outbreak.

We will, however, continue to have cases of COVID-19 in Australia. As long as we continue to allow people to come in from overseas, which we need to do to sustain our economy and connections, we will also still have cases in quarantine. This is what happened last week in Canberra, when our magic 100+ day COVID dry spell was finally broken. This is expected and shouldn't pose a risk to the health of the public. Our quarantine system has been reviewed and is now much more mature, therefore the risk of disease spreading outside of quarantine is very low.

Speaking of quarantine, we will pretty soon be able to travel around most of the country without having to do it. Most of the borders are now open, and as of today we here in the ACT can now travel to every state except Victoria and WA without quarantining either way. Victoria should be open by Christmas but WA continues to be an unknown at present. And overseas travel is not completely out of the question next year. I think once we get to our steady state we are going to see lots more "travel bubbles" opening up. The New Zealand bubble is already open one way and hopefully will open both ways early next year. Bubbles with Pacific Island nations and parts of Asia may also follow. I also think we could start to see more flexible quarantine arrangements based on the associated risk of the country you have visited, perhaps even at home with wearable devices of some kind.

Unfortunately I don't think we will be routinely travelling to Europe or the Americas for some time. Europe is deeply entrenched in a second wave with a higher peak that the first in countries like UK, France, Germany, Italy and Spain. And for those of you who think the southern lockdown was an over-reaction, the Victorian daily new case numbers were quite similar to those of some of the European countries in July but are now only a handful, while the latter are well over ten thousand. The USA is at the start of a third peak (not sure it's a wave because it never really went away) as the cooler weather hits, again bigger than the previous two. The good news is that death rates everywhere are much lower than the first wave due to evolving enhancements in how to treat those with COVID-19. But death rate lags behind the new case rate by a few weeks, so we may not have seen the full effect of these new peaks yet.

So 2021 is looking very promising for us Down Under. This is because we have done a great job as a nation in focussing both on the high-tech end (developing new, less invasive testing, gearing up our tertiary care capabilities, and vaccine development) as well as good old fashioned public health. We've applied public health principles and bought ourselves time to get our systems in place - yes even, eventually in Victoria. We can all feel proud and take the credit for this but we can't just relax and rest on our laurels. Each individual still has a role to play but fortunately the requirements are far less onerous than they appeared back in March. By now it should be less about following rules and regulations and more about doing some basic things to stay safe, things we should all be doing anyway. I call these COVID's greatest 'HITS':

Hygiene 101. It's not ok to sneeze and cough over everyone and it never has been. You also should be washing or sanitising your hands on a regular basis as any surface could be covered with bugs. We don't do it but we know we should! I think ubiquitous hand sanitiser is here to stay, handshakes with strangers are a thing of the past, and standing 1.5 metres from people will start to feel normal (if it doesn't already).

Isolate if unwell. Don't come to work or classes if you are unwell, especially if you are coughing or sneezing - you're probably infectious. We all think we need to "soldier on" like the ads say. I know - I have been as guilty of this as anyone. But it's not cool to spread your sickness to others and again, never has been. And if 2020 has taught us nothing else it is that we can work effectively at home. Soldier on in the privacy of your own home - you can't spread disease via Zoom.

Testing Testing Testing. Cold and flu symptoms are now COVID-19 until proven otherwise. If you get any symptoms that feel like an upper or lower respiratory tract infection or something similar, immediately get tested. Also get tested when you are told to get tested. If people don't do this we won't be able to control flare ups so have a high index of suspicion and if in doubt do it. The good news is that the new types of tests are being developed are less invasive.

Stay informed. You don't have to obsessively follow the pandemic like I do but you do need to remain alert. Keep an eye on the news and on the ANU COVID-safe campus alert system and respond when required. Things can change quickly and when they do, we need to act immediately to ensure we get on top of things. And if we are told to up our precautions, such as wearing masks or going back into lockdown, accept it and do it. Modelling has shown that for every day you delay lockdown it could add a week to the end of the lockdown.

None of this is hard - its mostly common sense, by now we are used to it, and for most of us it doesn't preclude our living pretty normal lives. And it's a sustainable solution for whatever might lie ahead.

Here's to 2021!