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analysis

COVID-19: Experts say the worst is over, maybe, but infections will continue for decades

When experts say ‘‘the worst is over’’, it pays to read the fine print.

On Wednesday, The Australian ran a bold piece, citing infectious disease modellers who claimed the worst of the COVID-19 pandemic was over.

After a tough winter, with deaths spiking to almost 2000 for the month of July, the modellers say that subsequent waves will ‘‘most likely’’ see fewer people getting sick, and there will be less serious illness and death.

Certainly case numbers have tamped down dramatically in the past couple of weeks – in parallel with a short, sharp and harsh flu season that was tough on kids, but has appeared to run out of steam.

And, as we reported last week, health experts were confident that Australia will ‘‘move past the worst of its winter COVID-19 wave in coming weeks, even as deaths from the virus spike to a monthly record’’.

There were 41 virus-related deaths across Australia on July 31, bringing the month’s total death toll to 1949.

That was 11 days ago. Is the worst of COVID-19 really over?

Some promising numbers

On Wednesday, for example, there were 37,085 active cases reported in Victoria – a steep decline from the 71,428 cases recorded on July 23.

New cases nationally have also taken a steep drop.

On July 21, there were 55,590 new cases, while on Wednesday, August 9, there were 26,740 new cases reported.

When you look at the figures from the Department of Health for the year, in a graph, you can see the peaks and troughs of waves getting fractionally smaller (after the monstrous breakout at the beginning of the year).

Hospital cases have declined but not so steeply.

On July 26, there were 5571 Australians in hospital with COVID-19. On Wednesday, there were 4415 cases in hospital.

Overall though, strictly by case numbers, the winter wave wasn’t so bad compared with those from summer and autumn.

Except for the inconvenience, as reported in late July by The Guardian, that a winter Omicron wave ‘‘has left Australia with one of the highest recent COVID death rates in the OECD’’.

So what about the ongoing death rate?

So, does this mean that future waves will be smaller but deadlier?

Who knows? Vaccines and boosters are doing a good job, even against tricky variants.

The big question is: What are future variants going to be like? Nobody knows.

The Australian’s experts

James Wood, a NSW government modeller, told The Australian on Tuesday it was unlikely Australia would see another epidemic wave this year.

‘‘If we don’t see an ­Omicron-like jump, this is as bad as it’s going to get,” he said.

Victorian infectious diseases modeller Romain Ragonnet was likewise ‘‘optimistic’’ about future waves ‘‘if no major variants emerge in the  future’’.

He told The Australian that there ‘‘should be less hospitalisations’’ and that COVID-19 will ‘‘end up being seasonal like flu”.

But there was a caveat: “The only thing we need to consider is that the main driver of resurgence is the emergence of new variants, and this we can’t predict.”

Australian National University’s Professor Peter Collignon believed the pandemic would take a route similar to that of the Spanish flu, which was ‘‘very severe for two to three years’’ and then dribble on with less virulence for decades.

‘‘My guess is we’ve seen it as bad as it’s going to get with COVID this winter,” he said, noting that people were still strongly advised to get boosters.

University of Melbourne epidemiologist Tony Blakely, while ‘‘cautiously optimistic’’, noted: “There remains the possibility, a chance that is impossible to predict, that a new variant comes along that is non-Omicron like and has both higher infectivity and virulence.”

Where is this optimism from?

This optimism is predicated on the idea that a combination of vaccines and natural immunity gained through illness was ‘‘likely to lessen the impact of future waves, as cases and hospitalisations from the Omicron BA.5 outbreak drop across the nation’’.

Meanwhile, Queensland’s chief health officer John Gerrard told the ABC that the next wave would probably hit in December, potentially making for another compromised Christmas.

But Dr Gerrard noted that the severity of that next wave couldn’t be predicted.

Low booster uptake leaves us vulnerable

Adrian Esterman, professor of Biostatistics at the University of South Australia, told The New Daily: “As much as governments and the general public, including myself, want it all to be over, unfortunately it is not – yet.’’

‘‘Yes, case numbers and hospitalisations have peaked in this BA.4/5 wave, but we are getting these waves every three to four months, so will likely have another one in November.

“BA.4.6 is now accounting for an increasing percentage of cases in the USA, and potentially could be the next one.’’

He said that a ‘‘major issue that is little talked about is what is happening during the trough between waves’’.

He said that cases are still remaining at a ‘‘comparatively high level, leading to constant pressure on our hospital system and increasing numbers of people ending up with long COVID’’.

Professor Esterman said this was because vaccination alone ‘‘isn’t sufficient to reduce case numbers to a low level, especially with these new subvariants that are good at evading our immune system, and only 70 per cent of the eligible population having their booster shots’’.

He said face masks needed to be better promoted if not mandated.

He said the Victorian government ‘‘should be applauded for giving out free high-quality face masks – it’s a great pity that other governments don’t follow suit’’.

The good news on the horizon was that both Moderna and Pfizer will soon be selling their bivalent vaccines.

‘‘These contain the original Wuhan strain plus one of the Omicron subvariants, and should be much more effective than existing vaccines,’’ Professor Esterman said.

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