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Victoria and NSW are facing coronavirus outbreaks, but that doesn't mean the rest of Australia is immune - ABC News

The biggest threat to the Northern Territory is clear, Chief Minister Michael Gunner forewarned in April: "It's not us, it's them."

With Australia's southern states continuing to grapple with a resurgence of the coronavirus as the rest of the country seeks to forge a path towards normality, this sense of enmity is understandable.

After all, a chain is only as strong as its weakest link: If the coronavirus outbreaks gripping Victoria and New South Wales can't be contained, Australia could find itself back at square one.

"We reported only two cases on June 9, less than six weeks ago, and this shows how quickly outbreaks can occur and spread," Deputy Chief Medical Officer Michael Kidd warned on Wednesday, as Australia recorded its highest number of new cases in a single day.

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Professor Michael Kidd says it is the largest daily increase of cases in Australia.

"This virus is highly contagious and, as we have seen from the continuing rise in infections and the rising number of people being hospitalised and dying, we must all remain vigilant, we must not let our guard down."

But while many states and territories may see themselves as immune to the quandary facing their southern neighbours, the message from authorities is clear: a single misstep could see them reckoning with their own resurgence.

Complacency, it would seem, poses just as big a threat.

How much testing should we be doing?

Underpinning the nation's response to the global pandemic is testing.

With evidence supporting a true asymptomatic rate of around 40 per cent (plus an additional fraction of patients who are pre-symptomatic), the need to continuously canvas the community is clear.

But as restrictions begin to ease and case numbers decline, the approach taken by individual states and territories has changed — a corollary of the different challenges they face.

In Victoria, for example, daily testing more than doubled from June 22 (10,321 tests) to July 22 (26,938), in response to a surge in active cases — more than 1,000 of which have been linked to community transmission.

In contrast, in jurisdictions with few active cases, and where there is no or limited evidence of community transmission, testing blitzes have been understandably more modest, with an increased focus on the risks posed by interstate and international arrivals.

But this doesn't mean they can rest on their laurels or assume the threat is confined to borders or airports.

In fact, the Australian Medical Association this week warned that recent interstate travellers may have already spread the virus in WA.

Bruce Armstrong, an emeritus professor at the University of Sydney, says that while the immediate focus of testing should be "where there is any suspicion", such as those presenting with symptoms or travellers from known hotspots, there is also a strong case for ongoing testing within the community "essentially on a random basis".

"But you can only get a sense of to what extent you've achieved that by continuing to test."

A man stands in a queue outside a COVID-19 fever clinic at Royal Perth Hospital with a face mask on.
Bruce Armstrong says there is a strong case for "random" testing.(ABC News: Benjamin Gubana)

Professor Peter Collignon agrees. An infectious diseases physician and microbiologist at ANU Medical School, Professor Collignon says that while "we are still doing a lot of community testing", analysing sewage could be another tool in the national arsenal.

"The reason that's an advantage is because you can test the whole community and not just people who have respiratory symptoms," he says.

"How much movement you allow people and what is safe to allow is very dependant on how much community transmission there is, and the only way you know that is to have testing and ongoing testing."

Keep your distance

Of course, there's also the ongoing challenge of ensuring the public maintains good hygiene and social distancing measures, even as restrictions ease outside of Victoria and New South Wales.

A report from the Doherty Institute, examining the uptake of social distancing measures, found that by early July, those in the Northern Territory were interacting with 11.5 non-household contacts per day — the highest rate in Australia, up from 5.7 people in mid-April.

During the same timeframe, their estimates of self-reported adherence to the 1.5m rule dropped from 60.2 per cent to just 27.9 per cent.

In Western Australia, the findings were similar: adherence peaked at 61.5 per cent in April, and almost halved to 31.2 per cent by July.

But coronavirus "can come back so quickly", Professor Collignon warns, even in states and territories where it would appear it has been eliminated or remains at low levels.

"And so the basic premise of decreased transmission is to keep physical distancing as much as practical," he says.

"The advantage is, if it comes back and you don't realise it for two or three weeks, there'll be a lot less spread. I don't think we can go back to normal until we have a safe and effective vaccine."

Tight knit crowd in shopping centre
Maintaining social distancing is key to stopping the spread of coronavirus.(Twitter: @hoogsview)

As evidence around the efficacy of face masks evolves, Professor Armstrong believes there are opportunities for "safer" states to take heed.

"Certainly here in WA, I would urge people getting into situations like mass gatherings or travelling on mass transport, where they're going to be much closer to people than 1.5 metres, to wear masks," he says.

"They do work and there's a lot more information around now about what are good masks and how to prevent infection."

To control the spread, you have to change behaviours

But how do you motivate people to maintain these sorts of behaviours when parts of Australia are beginning to emerge from the COVID bubble?

The University of Queensland's Professor Jolanda Jetten, who co-authored Together Apart: The Psychology of COVID-19, says addressing the social-psychological dimensions of the pandemic will be imperative in stopping further spread.

"Up until the moment that there is a vaccine, the only way you can control the spread of the virus is by changing behaviour," she says.

"As a leader, how can you actually ensure compliance? It's often by messages that we're in this together, focusing on the importance of solidarity in this."

It is a sentiment reflected in research by the University of New South Wales, which surveyed 1,420 Australians between March 18 and 24 about their willingness and capacity to adopt coronavirus mitigation strategies.

It found that 94 per cent of respondents modified their behaviour out of a sense of social responsibility.

"But if you did that survey in Sydney and Melbourne right now, you'd probably find very different levels of behaviour than what we would find in maybe Western Australia and Queensland," says lead author Dr Holly Seale, a social scientist at UNSW Medicine's School of Public Health and Community Medicine.

"And I'm theorising here ... but we can't draw generalisations across Australia anymore, because things are vastly different."

Posters about COVID-19 pasted on a wall in Perth
One study found that 94 per cent of respondents modified their behaviour out of a sense of social responsibility.(Supplied: Philip Gostelow)

Professor Jetten believes the message of national solidarity that defined the early stages of the pandemic has been slowly eroded by a tendency to assign blame.

"Now, it's where you live that's dependent on how strict the restrictions are," she says. "There's a bit more blaming of people who brought the virus back, which has undermined the solidarity that we saw at the very beginning."

'We'll get caught out really badly'

While it would seem swathes of Australia have so far avoided the problems NSW and Victoria are now grappling with, the experts aren't mincing words.

Coronavirus isn't going anywhere anytime soon, they say, and until a vaccine is found, we must all do our part to stop the spread.

Letting our guard down, says Professor Armstrong, "is the best way" to trigger a surge in infections: "This is a very infectious virus and it is very hard to successfully control it without everyone doing their very best to make sure they're not contributing to the spread."

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2020-07-24 19:00:00Z
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