July 6, 2020

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Victoria’s coronavirus spike: what’s causing it, and is anyone to blame?

Victoria is experiencing a concerning rise in Covid-19 cases, with 75 new cases announced on Monday which were identified over the preceding 24 hours, one of the largest overnight jumps for the state since the pandemic began. For almost two weeks, the state has seen a double-digit rise in cases every day.

Many are now trying to identify a source of blame for the spread. According to the Australian, overly prohibitive lockdown laws implemented the Victorian government early on in the pandemic were seen the public as excessive given the low number of cases at the time. The report suggested this led some people to relax, and to question government warnings that they needed to keep socially distancing.

On Thursday, Muslim community leaders said they were terrified that unconfirmed news reports claiming one of Melbourne’s coronavirus clusters originated at a family Eid celebration could create a new wave of anti-Islamic sentiment and members of the community blaming Muslims. The government has also been accused of failing to engage culturally and linguistically diverse communities. Despite none of the cases in the past fortnight thought to be spread Black Lives Matter protests, News Corp reports described premier Daniel Andrews urging people not to attend the protests as “weak”, leaving people confused and skeptical of more rigorous government messaging.

trend in cases

Guardian Australia asked health and infectious disease experts about whether the state government is to blame for the latest rise, and if not, what’s driving the spike.

Is this outbreak happening because of something the Victorian government did or didn’t do?

Head of the biosecurity program at the Kir Institute, Prof Raina MacIntyre, said as people resume interactions and contact with other people across Australia, the risk of infection will increase. “This tells us there is silent transmission,” she said, adding this was not unique to Victoria. “The scientific evidence from numerous studies shows an important role of spread of Covid-19 from people who do not have symptoms,” she said. “Many countries have been slow and reluctant to accept the overwhelming evidence of this. Until we do, and act accordingly, there will be more preventable outbreaks.”

Infectious diseases physician Prof Peter Collignon believes the Victorian government was overzealous with increased policing and issuing fines to people breaking restrictions earlier in the pandemic. Because people were so limited in their actions at a time when the virus was not widely spreading, people were growing fatigued the restrictions and may feel less incentive to follow them now, Collignon said. He believes it made no sense to tell people that they could not go fishing or play golf, even though the risk of community transmission is significantly lower outdoors, while at the same time people could go into supermarkets or into cafes to pick up takeaway. However, this mixed messaging was just one factor out of many that may be contributing to new cases, he said. “These numbers could easily still happen in New South Wales.”

Does Victoria need to return to lockdown?

Victoria’s chief health officer, Prof Brett Sutton, said locking down particular suburbs most affected may lead people to travel to other suburbs to wait out the restrictions, potentially spreading the virus even further. “There is a balancing act in terms of making the call on a lockdown,” Sutton said. “We know that it is a real challenge for businesses, it is a real challenge for people in their homes if that is what is required.” However, he has not ruled such a measure out if cases continue to rise.

Professor Gerry Fitzgerald, a public health expert from Queensland University of Technology, said the principal strategy to control the outbreak in Victoria at this stage remains case identification, contact tracing, isolation/quarantine and close monitoring. “However, the effectiveness of these strategies would be enhanced breaking the rate of growth of the outbreak and the spread around other communities,” he said.

Can we call this a second wave yet?

Fitzgerald said it is important to keep the Victorian outbreaks in perspective. He said while the state has detected 75 new cases in the past 24 hours, the United States diagnosed over 44,000 new cases and Brazil almost 47,000 new cases. “Thus, while there is evidence of community transmission occurring in Victoria, it is not as yet widespread,” he said.

A lecturer in nursing at the University of the Sunshine Coast, Dr Matthew Mason, said this is not a second wave of the pandemic. “There are cases in returned overseas travellers and cases related to chains established before the increase in testing that started late last week,” he said. “What we are seeing is this increased testing identifying cases that otherwise may have been missed. Some of these are linked to established chains of infection and others may well be added to these chains as contact tracing progresses.”

Why this is happening in Victoria is likely to be multifaceted, he added.

“We know that respiratory viruses spread well during winter due to people being in close proximity inside with limited natural ventilation,” he said. “This, combined with the expected increase in cases as restrictions were eased is likely the main reason there is a Victorian focus. However, other jurisdictions should not be complacent.”

Professor Hamish McCallum, a disease ecologist with Griffith University, said, “there have probably been lots of other transmission events into the general community from returning travellers that have never been detected and have not led to long chains of transmission”.

Is personal behaviour a factor?

Sutton reinforced that health authorities are seeing young people catching Covid-19, and transmitting it across the community. While young people may have mild symptoms, “they have the potential to infect large numbers of other people, and so this is a call to everyone to do the right thing,” he said.

On the ABC’s 7.30 on Monday night, the health minister Greg Hunt commented on one third of the new cases being found in people in their 20s and 30s. “Particularly in this outbreak, as there was in the Bondi outbreak, young people have been contracting and transmitting the disease,” Hunt said. “The message is not just don’t put other people at risk, we know that young people are still susceptible to a potentially fatal disease.”

Hunt said two elements were driving the increased numbers since the weekend. One was that testing is finding more cases that may have been there, “but there’s clearly a growth in community based cases” too, he said.

map of recent cases

A member of the World Health Organization expert advisory panel for infection prevention and control, Prof Mary-Louise McLaws, said Victoria has had three distinct risk categories fuelling the recent cases: family clusters, quarantine hotel staff, and health providers. “These factors could happen in New South Wales, but what is particularly driving this is the interconnection between these three risk groups,” she said. “Australia is a country of migrants and we embrace our cultural communities, so the authorities need to work proactively with communities with English as an additional language, who may not hear or read the messaging in English about the importance of responding to feeling unwell and keeping visitors to a minimum.”

Director of the University of Queensland Centre for Clinical Research, Prof David Paterson, said experience in other countries such as Singapore or Korea has shown that the novel coronavirus will exploit any weakness in the public health system. “Victoria’s weakness appears to have been ‘leakage’ from quarantine, where quarantine hotel workers were not adequately trained in infection prevention and the quarantined travellers were not ‘cleared’ prior to release,” he said. “This weakness, coupled with community complacency, has led to further spread in the community. For other states, this underscores the importance of quarantine of travellers, with strong training for those involved at the quarantine hotels.”

Associate Prof of microbiology at RMIT University, Taghrid Istivan, agreed the issue with training and Covid-19 awareness among quarantine hotels security guards, and probably the cleaners, was a main factor that led to the spread of cases from quarantined travellers to workers and then to their families. “These community transmitted cases increased between socially connected large families and became an important factor contributing to the surge in positive cases after easing of restrictions, and due to the cold weather in Victoria where people are getting together and staying for a long time in closed space,” she said.

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