Sunday, 2 January 2022

This week Omicron and COVID left Australians taking a big cognitive leap, as surge takes us to new ground.

Extract from ABC News

Analysis

Coronavirus

By Leigh Tonkin
Posted 
A nurse tests someone for COVID in a line of cars
Pictures of Bondi rammed with beachgoers have been replaced with its packed testing centre.(AAP: Bianca De Marchi)
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A joke bounced around the country earlier this week. It ricocheted across social media, on front pages and out of the mouths of dads deprived of more days on the couch in front of the cricket.

"Want to get a fast test? Play the Poms."

But for the people who had waited in a testing queue for longer than England's second innings, it was no laughing matter. With queues for kilometres at some PCR test sites that actually opened over the Christmas weekend and rapid antigen tests rarer than the hottest Christmas toy, frustrations ran deep.

We've heard the horror stories — testing centre queues so long they were closed just minutes after opening time, friends who'd visited upwards of five sites trying to get a pre-holiday test, people with long-standing medical appointments missing out on a required PCR test.

Beyond the cancelled plans and missed Christmases, we don't really have a way to judge the real damage done by the poor testing situation.

Some of those with symptoms — or even multiple positive self-administered rapid antigen tests — are skipping the PCR confirmation, turned off by the queues or the risk of passing it on while waiting.

Add to this the rapidly rising positive rate of those who do make it to the front of the line. In NSW over the past seven days, it has skyrocketed,

Despite more than 35,000 cases a day across the nation, experts presume we're seeing the tip of the iceberg.

NSW Chief Health Officer Kerry Chant admitted as much in the state's Friday press conference.

"Obviously we recognised that some people are probably taking a [rapid antigen] test themselves and making their own decision … you should behave as if you've had a confirmed PCR if you're choosing not to [have one] but our recommendation is that you should," she said.

This is living with the virus. And we're only just starting to figure out what that means: long lines, a blowout in waiting times, shelves empty of rapid antigen tests, communication failures and repeated errors.

It's tempting to see the testing crisis as evidence of Australia falling at the first hurdle, but in reality, the hurdles are gone and the track has changed.

We're running a completely different race but we're still trying to follow the old rules.

We're so far beyond COVID-zero that Queensland's Chief Health Officer Dr John Gerrard said it baldly this week: infection with COVID-19 was required for the pandemic to evolve to be endemic — a constant presence in our lives.

"Not only is the spread of this virus inevitable, it is necessary," he said on Thursday.

"In order for us to go from the pandemic phase to an endemic phase, the virus has to be widespread."

That's a big cognitive jump for Australians — and there's no going back.A tiny santa sits on a shop counter next to a QR check in board and a hand sanitizer and a jar of lollies.

A new festive decoration: QR codes and hand sanitiser. (ABC News: Danielle Bonica )

We're in it now

For anyone watching on, it was clear we were facing the perfect storm. Christmas parties. La Niña forcing us back indoors. The festive season. Generations mixing together after months of distancing.

Enter a new variant, faster than any we've seen to date, and a lot can change in a matter of weeks.

NSW was hit by Omicron first, with cases rising from mid-December and escalating sharply just before Christmas. Victoria — which had been sputtering along mainly in the low 1,000s since the end of lockdown — started picking up around then too, albeit at a lower rate than NSW.

Perhaps the escalation was most marked in Queensland, with its newly reopened border no longer protecting it from the surge. Cases moved from double digits on December 21 to well into the 3,000s by year's end. South Australia and Tasmania, too, have an established surge.

Even fortress WA wasn't safe, though it has kept its numbers in single figures for now.

After months of sheltering behind borders and lockdowns, Australia can no longer escape the sort of numbers we used to scoff at overseas despite our nationwide vaccination rate of more than 90 per cent.

At our current pace of 126,224 second doses a week, we can expect 95% of Australia’s adult population to be fully vaccinated by late February 2022.

Total doses include doses given to people aged 12-15 and people who already had two shots of vaccine.
Dates refer to the reporting date (usually the day following vaccination), not the vaccination date.
View the data for your state or territory

Worse than predictions

We'd become used to seeing terrifying predictions at the start of a COVID wave, and then successfully avoiding the worst-case scenario.

In April 2020, we were told 30,000 Queenslanders would die, that demand for intensive care could peak at 35,000 beds a day, that Victoria could have reached 58,000 cases a day.

But with strong community response to prevention measures, hard work from the health sector and a stroke of good luck, we dodged the worst-case scenarios.

Not this time. 

NSW Health Minister Brad Hazzard suggested on December 15 — just 18 days ago, when the state recorded 1,360 cases a day — that NSW should brace for 25,000 cases a day by the end of January.Play Video. Duration: 1 minute 26 seconds

NSW 'could' have 25,000 COVID-19 cases per day.

On the last day of December, that was starting to look optimistic, with the 20,000 mark already broken, well ahead of that pace.

NSW Chief Health Officer Kerry Chant said on Friday it was a challenging time, but not unexpected.

"It reflects the international experience with Omicron, where we're seeing a rapid doubling rate," she said.

Omicron is a game changer, Prime Minister Scott Morrison said on Thursday.

"We need to reset how we think about the pandemic, and how we manage ourselves and the things we need to do as governments," he said, announcing new definitions of "close contacts" and loosening the parameters for who needs to get tested.

But here lies the cognitive gap for Australians.

Mindsets don't change overnight

It's one thing to know that the way we see COVID is changing, that this is potentially a milder variant for most people and mass vaccinations should prevent the huge rate of hospitalisation and death seen overseas last year.

But Australians have had the need to get tested drilled into them from the start of the pandemic. Every press conference, every QR code, every public health poster. Every exposure, every sniffle.

A new set of rules won't change that demand overnight — especially at a time when we're reconnecting with loved ones, taking holidays and mixing like we haven't in months. Many are worried — if not for themselves then for their more vulnerable loved ones.

Lockdowns aren't yet a distant memory: Australians are still used to shutting down when cases go up. And before Christmas, many businesses did just that.

Of course, we're not alone — the whole world is being buffeted. The US has topped 500,000 daily cases and reduced its isolation period, records are being smashed in Europe as many countries increase restrictions, Israel is attempting an uncharted fourth vaccination shot. In South Africa, where authorities say the Omicron wave has now peaked, restrictions are being loosened.

Play Video. Duration: 2 minutes 5 seconds

Israel approves a fourth dose of the pfizer vaccine for people with weak immune systems.

But Australia is approaching the wave from a different starting point to other countries and that's affecting how our infrastructure is handling the surge and our attitudes towards it.

Our competing priorities were shown in the need for PCR tests to travel to states with fewer cases — which helped fuel the testing crisis in NSW and Victoria. It took longer than ideal for NSW to put its foot down, and for Queensland and South Australia to back down.

Again, when a new "national" set of rules for close contacts and testing were announced on Thursday — with four different timelines, and exceptions in South Australia, an "in principle" yes but no changes in WA and an announcement to come from the NT. And the rules changed again less than 24 hours later.

The decision to make rapid antigen tests free in only limited cases — apparently to allow the "private market" certainty to order more stock, according to Morrison — won't see supplies increased in the short-term to fill the gap.

The good news is that hospitalisations haven't risen at the same rate as positive cases, nor have ICU admissions or deaths.

The changes to the close contact rules should limit the number of healthcare workers taken off the roster and strengthen the system, along with a new directive from NSW to allow asymptomatic staff deemed as close contacts to leave self-isolation.

It's unclear at what price these changes come, in terms of increased risk to essential workers and their families.

"It seems national cabinet is prepared to bet that a massive Omicron outbreak won't cause large numbers of hospitalisations," Australian Medical Association president Omar Khorshid said on Thursday.

"We expect hospitalisations to rise in coming weeks, simply due to the very large number of cases, which will be far larger than the positive tests indicate, due to today's decision."

But for now, fewer of us need to get tested and, according to Morrison, that's cause to relax.

"If you don't fulfil this definition of a close contact then there is no need for you to be in that line," Mr Morrison said.

"You should go home. Go to the beach, go and do what you want to do. Read a book in the park."

We've come a long way from chained-off beaches and scare photos of heaving crowds at Bondi, though we're not all quite ready to live with that reality yet.Play Video. Duration: 1 minute 54 seconds

How accurate are rapid antigen tests?

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