[Theme Music Starts]

RUBY:

From Schwartz Media, I’m Ruby Jones. This is 7am.

As our political leaders fight over the proposed national plan to re-open the country, health experts are imploring state and federal governments to learn from the experiences of places like the UK and Israel.

But, there is another country - closer to home - whose prudent and cautious re-opening could prove to be a much better blueprint for Australia.

Today, journalist with the Australian Associated Press and contributor to The Saturday Paper, Hannah Ryan, on what we can learn from the ongoing global experiment.

It’s Tuesday September 7.

[Theme Music Ends]

RUBY:

So Hannah, for most of the pandemic Australia has had a very different approach to the rest of the world. We've had few, if any, cases in the community. And we've been relying heavily on international and domestic border closures to essentially keep covid out. That has changed with the Delta variant. So can you tell me what that means for the future here?

HANNAH:

Yeah. So in the last couple of weeks, we've had this really big turning point in the pandemic in Australia, where two of the biggest states have conceded or acknowledged that what worked before isn't going to work now.

Archival Tape -- Gladys Berejiklian:

“We’re all going through the rollercoaster ride of emotions as case numbers go up and down and I don’t want us to focus so much on the case numbers going up and down.”

HANNAH:

It started with New South Wales, where Premier Gladys Berejiklian, after weeks and weeks of rising case numbers, conceded that the state was never going to get back down to zero.

Archival Tape -- Gladys Berejiklian:

“That's just how the virus works. No amount of government intervention or lockdown is going to get you to zero cases.”

HANNAH:

And she's been shifting the metric to a focus on vaccine numbers, hospitalisations and deaths instead.

Archival Tape -- Gladys Berejiklian:

“We just need to look at what's happened overseas and our path is different. A lot of countries had thousands of cases a day, got their vaccination rates up, and now I've seen a reduction in hospitalisation.”

HANNAH:

And then perhaps more significantly in Victoria, where obviously they've pursued the longest and strictest lockdowns in the country and really borne the burden of trying to get down to Covid zero. Dan Andrews made a similar shift

Archival Tape -- Dan Andrews:

“Has become clear when the chief health officers advice to me and the government has changed, fundamentally changed. We will not see these case numbers go down. They are going to go up.”

HANNAH:

So cases were continuing to rise there despite a really strict lockdown. And the government's now all but said that Covid zero is off the table and restrictions are going to be eased when the state reaches certain levels of vaccination. And the federal government is really backing this approach from Victoria and New South Wales as well.

Archival Tape -- Scott Morrison:

“You can't live with lockdown's forever, and at some point you need to make that gear change.”

HANNAH:

So basically what all of that means is now Australia is at a point where we're accepting reluctantly, I suppose, that covid will continue to circulate in the community. But if we have high levels of vaccination, then we should be able to limit the health impacts of the virus and the impacts on our hospitals.

RUBY:

And so do we know any more about exactly what that could look like? What does it mean to end lockdown and to ease restrictions with the virus still in the community but with higher vaccination rates?

HANNAH:

Yeah, so we do know a lot about what that looks like because that's how much of the world is now dealing with the virus. And one of the most interesting and kind of stark examples is the United Kingdom.

Archival Tape -- Boris Johnson:

“We've come to a stage in the pandemic when there is no easy answer, no obvious date for unlocking”

HANNAH:

They are conducting an experiment in what happens when you just let all restrictions go. You have your high vaccination rates and just let Delta loose in the community.

Archival Tape -- Boris Johnson:

“And it is of course it is only thanks to the vaccine programme that we are able to take these cautious steps now. A jab that could protect you and your family and allow you for instance to go on holiday.”

HANNAH:

So back in mid-July, Boris Johnson had this Freedom Day where they got rid of basically all covid-19 restrictions. And that meant handing over responsibility for avoiding infections from the government to the individual - so the individual can decide what they want to do to protect themselves. But the government isn't going to have these like population wide measures

Archival Tape -- Boris Johnson:

“...because the legal restrictions have come off should not be taken as an invitation by everybody simply to have a great jubilee and freedom from any kind of caution or restraint.”

HANNAH:

But it wasn't about minimising infections for the UK anymore. And their health secretary, Sajid Javid, actually admitted the decision could lead case numbers to go up to 100,000 a day, which sounds really scary to me sitting here in Australia.

Archival Tape -- Sajid Javid:

“So while cases now are ticking up, the number of deaths remains mercifully low. And we'll continue to investigate how our vaccines are breaking that link between cases, hospitalisations and deaths.”

HANNAH:

What he said is that what matters more than anything is actually hospitalisation and death numbers. So they're putting case numbers to one side and despite a lot of public health experts really worrying about what would happen, they haven't seen this spike in case numbers.

Archival Tape -- Sajid Javid:

“And then, look, now you've got cases going up very high indeed. But deaths are very low.”

HANNAH:

Instead, what they've had is case numbers rising steadily and they still have tens of thousands of people getting infected every day and hundreds of people dying every week. But their hospitalisation numbers are actually at about one fifth of what it was at their January peak.

So in the U.K., Covid-19 is becoming what experts now say is the end goal instead of what they used to be talking about herd immunity, now they're talking about endemicity. So if the virus is endemic, what that means is there's plenty of cases circulating around, but we simply don't care that much. So we'll have widespread immunity and that will mean that severe illness, hospitalisation and death will become much rarer. So something much more like the flu.

RUBY:

Essentially, what you're saying then is that despite all the fear that surrounded the kind of freedom day in the UK leading to hospitals being overwhelmed, that actually hasn't happened. And that's largely thanks to the vaccine. So does that bode well for us here then? If we reopen at the point where we have 80 percent of people in Australia vaccinated, which is the current proposal.

HANNAH:

So that could be what happens. But there is another example that should kind of give us pause, and that's Israel. Israel, people were talking about a few months ago as the real shining star, the example that you can vaccinate your way out of the pandemic.

Archival Tape -- Unidentified Reporter:

“Almost half of all Israelis have now received Covid-19 vaccines thanks to a world leading inoculation programme.”

HANNAH:

And then by April, they pretty much declared that covid-19 was over, declared victory over it.

Archival Tape -- Unidentified Reporter:

“The country is one of the first developed countries to now be rolling back its latest round of restrictions.”

HANNAH:

They eased back restrictions. They had international travel back, compliance fell away and they had a vaccine passport scheme and they even got rid of that.

Archival Tape -- Unidentified Reporter:

“Most Israelis living in one of the most vaccinated countries on the planet thought the worst of covid-19 was behind them.”

But that actually wasn't enough to defeat the virus.

Archival Tape -- Unidentified Reporter:

“But now the fourth wave has come.”

HANNAH:

By July, they had the Delta variant circulating in the community and then by the next month, they had thousands of cases every day.

Archival Tape -- Unidentified Reporter:

“Forcing covid wards back into action…”

HANNAH:

What had happened was they had relatively high vaccination rates. That was right. But that covered up the reality that there were pockets of the population that were under vaccinated. So you had actually low vaccination rates in young people. So people aged between 12 and 20, in the ultra-Orthodox community was another one and low vaccination rates also in the Bedouin and other Arab communities. I guess the real lesson here is that vaccination alone is not enough. If you're going to have a good Covid-19 defence, yes, you need vaccination. But the Israel experience shows that you need other weapons.

But then there is another country that's probably more interesting to Australia that has had a similar trajectory to Australia's. It’s taking this kind of approach - a more prudent approach. And it's one that experts think that we should be looking to. And that's Singapore...

RUBY:

We’ll be back after this.

[Advertisement]

RUBY:

Hannah, can you tell me a bit more about Singapore's experience with Covid-19 and how that has changed, shifted over time?

HANNAH:

Singapore's experience has so far been a lot like Australia's in that we've both been trying to get to covid zero. And for a lot of the pandemic, Singapore has been able to do that. They've had under 100 deaths during the whole pandemic. But now, their leadership has explicitly acknowledged that that Covid zero approach isn't sustainable. A small island country like Singapore can't keep its borders closed forever. And also, the Delta variant is just so transmissible that it's not possible.

Archival Tape -- Lee Hsien Loong:

“My fellow Singaporeans. Good evening again. In Singapore, each time it looks like we've beaten the virus, it breaks through in different places.”

HANNAH:

And a couple of weeks ago, their prime minister made a speech.

Archival Tape -- Lee Hsien Loong:

“It's no longer possible to bring covid-19 cases down to zero, even if we are locked down for a long time. Therefore, we must prepare for covid-19 to become endemic.”

HANNAH:

Saying they want covid-19 to become something like the chicken pox or the flu, something endemic.

Archival Tape -- Lee Hsien Loong:

“Fortunately, with vaccination and added precautions, we can live with a virus and become covid resilient.”

HANNAH:

So what they're saying now is like 100 to 200 cases a day, bubbling away really. They're increasing, but only slightly. So it's a real world experiment in how to reopen and throw everything they've learnt about public health at it. To keep the community safe and then reduce the load on the healthcare system is the critical thing.

RUBY:

Ok, can you tell me more about that - what has Singapore learnt from the pandemic and how are they putting that into practice as they reopen?

HANNAH:

Firstly, in Singapore Vaccinations are absolutely essential and they didn't open up anything until they had vaccinations to a really good rate. And I was really taken aback when I heard Singapore's vaccination rate. Around 80 percent of the population is fully vaccinated and that includes children. So it's not like Australia where we're measuring at 16 and above.

Archival Tape -- Peter Collignon:

“Now, Singapore is actually a good example to follow because they've already reached very high levels of vaccination.”

HANNAH:

So I spoke with Peter Collignon. He's an infectious diseases doctor and a microbiologist from ANU, and he's been saying that Australia should adopt the Singaporean model.

Archival Tape -- Peter Collignon:

“Overall they've had a lot less lockdowns, but they've had a lot of restrictions in place, indoor dining numbers and good contact and tracing, quarantine, isolation, et cetera. All of that has been very successful.”

HANNAH:

Life in Singapore is not exactly what I would call normal or free. They've only recently returned to the office. They have 50 percent of the workforce in office at any given time, and they kind of swap. They have dining in groups of five, but only if everyone is fully vaccinated. Otherwise, it's capped at two people and it has to be in an open air setting.

Archival Tape -- Peter Collignon:

“You know, we know this transmits more indoors than outdoors so you can have a variety of things you let off that is proportionate to the risk of the population.”

HANNAH:

So that's a risk based measure. It's a kind of thing that Peter Collignon thinks that Australia should embrace.

Archival Tape -- Peter Collignon:

“You know, we need a better risk based approach, which will look for higher risk. However we define that and check it, you'll have much more things done than if you're from a much lower risk or low risk situation.”

HANNAH:

And then, like Australia, they have a quarantine system, but it's slightly different from ours. They have four categories of countries depending on what the risk is. And Peter Collignon reckons that that's the kind of thing that Australia will embrace in the end as well.

Archival Tape -- Peter Collignon:

“Well, I actually think we'll get to the situation where we'll have countries designated as red, orange and green, probably, you know, on risk. And that'll be how much transmission is there and what variants they have.”

HANNAH:

The country’s also being smarter about how it monitors vaccine rates. So it's not just looking at the top line national figure, which is the thing that Australia is quite fixated on.

I spoke to a public health expert in Singapore and he told me that if they get to an overall figure of 80 percent, they could hit eighty. But that could leave vulnerable groups behind, where rates might only be like 50 and 60 percent, which would make it very dangerous for them if they open the society at that point. So they would still see a lot of hospitalisations and deaths if they fully reopened at that point. And that's a bit of a rebuttal of the Israeli experience where the overall vaccination rate was high. But in some communities it was low.

And we have parallels to Australia as well, where Aboriginal people outside Victoria are currently vaccinated at a much lower rate than the rest of the population.

RUBY:

Hmm, and so Hannah what does all of this mean for Australia? Because we do seem to be inching towards this acceptance that we are not going to be able to keep covid-19 out of the country forever. And at the moment here, the focus is on vaccination rates. But it does sound like from these international examples that the conversation needs to change and we need to be talking about other measures as well.

HANNAH:

I think the international experience shows that vaccination is absolutely necessary and at the highest levels possible, but on its own, it's not enough. So. You need a range of other public health measures, you need things like masks, contact tracing, surveillance, testing, vaccine passports, all of these are going to need to be used depending on what the virus is up to at any given point.

And then we've got these really clear warnings from overseas not to be deceived by top line vaccination numbers. The national level, 70 percent, 80 percent figures. We have to have equitable vaccine distribution to avoid difficult outbreaks in unvaccinated groups. Peter Collignon, in fact, thinks that vulnerable groups should be at 95 percent vaccination.

Archival Tape -- Peter Collignon:

“I would think, you know, if you're over the age of 70, I'd like to see 90, 95 percent plus vaccination. That doesn't mean you don't take off any restrictions to achieve that, but that should be what we're aiming for.”

HANNAH:

As we move away from Covid zero life, we won't be monitoring Covid-19 infection numbers every day. So we won't have that kind of melodramatic press conference every day where we're waiting for the number at 11 a.m. instead will be looking at how many people are hospitalised, which is how we monitor the flu at the moment.

Archival Tape -- Peter Collignon:

“...at the moment. And you've got to remember, every year or in a bad year of influenza 2017, for instance, there are over 1200 deaths. So we're going to have to, if you like, change the way we look at it.”

HANNAH:

There are plenty of warning signs from overseas. And, like, as usual, with covid, there's plenty to worry about if you're looking for it.

Archival Tape -- Peter Collignon:

“The real issue for us, I think, will be, again, winter next year in 2022. And that's where we need to learn from what happens in the UK, Europe, America, Israel, where they've got lots of virus, lots of vaccination. And we need to see, well, what happens in that situation, particularly with hospitalisations and death. What can we learn from there?”

HANNAH:

But I think that looking overseas, there's also some real hope and reassurance. And if we avoid those pitfalls and we can learn from those experiences, then hopefully Australia can reach a really good point.

RUBY:

And hopefully that also means that at that point we can open up and people can come home and others can travel overseas.

HANNAH:

Yeah, which would be really nice.

[Advertisement]

[Theme Music Starts]

RUBY:

Also in the news today…

Victoria has recorded its highest number of daily Covid-19 cases in over a year, with 246 new cases on Monday. 92 people in the state are currently hospitalised with the virus, but only one of those has been fully vaccinated. Meanwhile the state Opposition is in turmoil after frontbenchers Matthew Guy and Tim Smith quit their positions ahead of a planned leadership challenge later this week.

And in NSW health officials are expecting cases of between 1,100 to 2,000 a day until mid-September. The state recorded 1,281 cases and five deaths on Monday.

I’m Ruby Jones, and a reminder - you can listen to Schwartz Media’s new investigative series Everybody Knows, hosted by me, right now. Search for Everybody Knows in your podcast app. Episode three is out tomorrow.

See ya then.

[Theme Music Ends]