Coronavirus disease 2019 (COVID-19) was first identified in Australia in January 2020, and between then and February 2021, there had been only 28,905 confirmed cases of COVID-19, with 909 deaths. Compared with other similarly wealthy and populated countries such as the UK, Italy, and the USA, Australia had a much lower rate of community transmission and case fatality. In a paper recently published in the International Journal of Health Planning and Management, Australia's response to the COVID-19 pandemic is described, identifying the factors that contributed most to the countries success.
Study: The COVID-19 pandemic in Australia: Public health responses, opportunities and challenges. Image Credit: Dave Hewison Photography/ Shutterstock
Following the introduction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cases remained low until February 2020, at which point the "first-wave" began in Australia, peaking on March 18th with 460 cases being reported. The number of daily reported cases around the country then declined steadily to minimal levels by late April before the second larger wave began in late June, this time lasting around four months before reported cases reduced to more manageable levels.
The authors state that the Australian government set clear goals in the early stages of the pandemic, providing guidelines to the general population and healthcare systems to minimize infections and deaths. A committee was set up to allow better communication between state and federal authorities, ensuring that data was shared and evidence-based policies could be developed on both a local and national level.
Travel bans and restrictions played a large role in Australian policy against COVID-19, with international travel from China, Iran, South Korea, and Italy being blocked consecutively between February-March. International travelers from other countries were also required to self-quarantine for two weeks from this time onwards. By March 13th, the decision was made to block all incoming travel from non-residents of the country. This policy was based on studies indicating that such restrictions could reduce COVID-19 cases and deaths by 85%. In combination with the strictly enforced quarantine procedure for any remaining incoming travelers, this seems to have been effective at limiting the entry of SARS-CoV-2. Travel restrictions between states were also put in place on an as-needed basis, and widespread COVID-19 contact testing was undertaken to track the source of any local cases.
The strategies utilized for dealing with the COVID-19 pandemic were largely adapted from Australia's existing influenza outbreak action plans. The Australian government put out an emergency response plan before the World Health Organization declared the pandemic. Information relating to the pandemic was distributed to the public and relevant organizations on a daily and weekly basis to differing levels of detail, allowing policies to be enacted or adjusted promptly.
Going forward, the Australian government has set out a framework for removing COVID-related restrictions that aim to limit the spread of SARS-CoV-2 by implementing remote-working and education policies, funding local clinics that can identify COVID-19 early, and applying extensive protections for the most vulnerable. However, unlike many other diseases, SARS-CoV-2 has been seen to be transmissible in the pre-symptomatic stages and when presenting as asymptomatic, making containment based on self-reporting difficult to achieve. While regular testing will remain for those in healthcare positions or similar, the application of wide-scale testing in addition to other non-pharmaceutical interventions for the remainder of the population must be balanced against social and economic pressures. Like many other island nations, Australia has been better able to control entry across its borders and thus bore fewer early outbreaks from incoming travelers. However, this policy is becoming an increasing economic threat to the country, given the many migrant construction workers usually employed there.
The authors highlight the situation in Singapore, where COVID-19 cases and deaths were previously dramatically lower than other similar nations since the beginning of the pandemic but recently gained a sudden massive spike in infections, and warn of the dangers of overenthusiastic relaxation of social distancing measures and SARS-CoV-2 surveillance. While published in early September, this paper was submitted in August, shortly after the beginning of a third COVID-19 wave in Australia that is set to outdo those seen previously, with 1,727 cases reported on September 9th, according to Our World in Data. It remains to be seen how Australia's policies will change in light of the currently intensifying third wave. Still, the past success of Australia in containing SARS-CoV-2 may aid in limiting this outbreak if conditions can be emulated.
- Ritchie, H. et al. (2020) "Coronavirus Pandemic (COVID-19)", Our World in Data, p. Available at: https://ourworldindata.org/coronavirus-data (Accessed: 13 September 2021).
- Nguyen, H. et al. (2021) "The COVID‐19 pandemic in Australia: Public health responses, opportunities and challenges", The International Journal of Health Planning and Management. doi: 10.1002/hpm.3326.