Don’t let drop in COVID news fool you: more to come

COVERAGE of COVID-19 has taken a back seat, with horrifying images of war in Ukraine and flooding emergencies across the eastern seaboard of Australia leading news outlets, but the pandemic isn’t over and experts warn of “ongoing waves”.

Infectious diseases clinician and OzSAGE executive member Professor Margaret Hellard says it’s how we react to those waves that will determine how impactful they will be.

“That’s really critical for governments, and for the community to understand that there will be waves of infection until we have a broad-acting vaccine that can cover up a whole range of variants,” Professor Hellard told InSight+.

There are many ways those waves could occur, she said. One scenario is when a new variant enters the community, similar to when Omicron arrived.

In front of a budget estimates hearing last Thursday, acting New South Wales Chief Health Officer Marianne Gale said the BA.2 subvariant of Omicron was contributing to a jump in NSW case numbers.

“The dominant sublineage until recently has been BA.1, what we are seeing is an increase (in BA.2) and we are still undertaking further analysis to try to get a better sense and a better handle on it,” she said.

Professor Hellard said: “You have a new variant coming to the community and it might be able to evade the immune responses derived from previous vaccines and previous infections.”

It’s also expected that there will be waves due to waning immunity from vaccination and previous infections.

Although it’s hard to predict, OzSAGE speculates it could be soon.

“We would expect to see the effect of this waning by April,” they warned in February.

However, with the current flood crisis, a spike of infections could occur even sooner. In a press conference on 7 March, OzSAGE member Ms Anna Davidson spoke of how the floods will impact COVID-19 in the area.

She highlighted that a surge in COVID-19 cases was likely, particularly with the low vaccination rate in the Northern Rivers region of NSW, exacerbated by people being crowded together in temporary accommodation or evacuation centres. Northern Rivers also has a large Aboriginal population that has been heavily affected by the floods.

In addition, the increased stresses on hospital capacity because of flood injuries, exacerbation of chronic illnesses due to lack of medicine, and a greater number of gastroenteritis cases will put pressure on the management of COVID-19.

“Access to hospital and [intensive care unit (ICU)] care is an important predictor of mortality from COVID-19. If people with severe COVID-19 cannot access hospital care, the death toll from COVID-19 will be disproportionately higher in flood-affected areas,” Ms Davidson said.

Across the country, vulnerability is a key risk factor in COVID-19 outcomes.

Dr Anita Muñoz, the Victorian Chair of the Royal Australian College of GPs, told InSight+:

“For people who are new to our health system, who aren’t health literate, who have socio-economic disadvantage, who don’t speak English as their first language, or who have difficulty accessing care, COVID-19 remains a major obstacle. And it remains a really valid threat to their health and wellbeing.”

Dr Muñoz said there had been a huge effort in getting information out to vulnerable populations, but it was difficult to know whether everyone had received the message.

“There’s also the burden of misinformation that can confuse people or give them inappropriate information about COVID-19 and how we protect ourselves from that,” she said.

“Misinformation remains an issue for all populations, of course, but also for vulnerable populations who may not have the same access to what are the legitimate and scientific explanations for the situation.”

One of the biggest pieces of misinformation was the belief that COVID-19 is likely to end.

“I suspect that there are people in the population who believe that once the numbers go down, pandemics end. However, we know we will live with COVID-19 in various forms in the future,” Dr Muñoz said.

Making sure people understand the rationale of the booster shot continues to be a challenge.

“There are also some people who, I think, are fatigued with vaccination, with COVID-19 itself, and are reluctant to engage anymore on the topic. Once the immediate threat has passed, the issue of COVID-19 starts to move more into the periphery of people’s lives,” Dr Muñoz explained.

Professor Hellard said we need to reframe that argument.

“Maybe if, as a community, we actually had a conversation to say ‘the August, September lockdown was really difficult, but we actually stopped a lot of people from dying … we did a great job’,” she said.

“In December and January, during the Omicron wave [more than 2000] people died of a much less pathogenic virus. If we think back on Delta, just imagine what would have happened with a more pathogenic virus with not so many people vaccinated?”

“This is the message that we should communicate: ‘We should be extremely proud of ourselves. The sacrifices we made save lives. And yes, it may have been fatiguing and difficult and we would prefer this would go away. But we’re prepared to keep going because we know our actions save lives’.

“If we all keep on being vaccinated … (if we) take some basic steps around control (VaccinePLUS) our workplaces and schools have the right high efficiency particulate air filters, we do our tests and all those things.

“We stop so many people from getting sick and this stops our health system from being overwhelmed. And although we can’t stop all deaths, we can stop many people dying from COVID,” she said.

“This notion that we can’t do anything about stopping COVID-19 and its consequences is a narrative that I think needs to be corrected. There are things we can all do about it and that we can all continue to contribute,” she concluded.