‘I never thought we would get there’: Australia’s year of Covid – from the first case to the first doughnut day
When Australia’s first case of Covid-19 was confirmed in Victoria on 25 January, the virus didn’t even have an official name. The case was a man from Wuhan, China, who flew to Melbourne from Guandong on 19 January. On 26 January, Australia Day, the federal health secretary Prof Brendan Murphy held a press conference, his comments revealing how little was known about the virus that was only reported in Wuhan in December 2019.
“We don’t know exactly how long symptoms take to show after a person has been infected, but there is an incubation period and some patients will have very mild symptoms,” Murphy said. At the time, there was no hotel quarantine. International arrivals were just told to alert the airline, or a biosecurity officer, if they had symptoms.
The World Health Organization had given the virus that causes Covid-19 an official name just two weeks earlier, calling it “severe acute respiratory syndrome coronavirus 2”, or Sars-CoV-2, because it is genetically linked to the coronavirus responsible for the Sars outbreak of 2003. While related, the two viruses are different, but how different was not known at the time.
One year on from Australia’s first case, there have been almost 30,000 cases in Australia and just over 900 deaths. Vaccines are being rolled out globally, with vulnerable Australians to receive their first dose in February. Queensland and New South Wales are managing clusters sparked by hotel quarantine leaks, but Australia’s position is enviable when compared with the almost 2 million deaths and more than 90 million cases globally, and the overflowing morgues, exhausted healthcare staff and prolonged and repeated lockdowns being navigated by other countries.
Australia’s relatively strong position comes down to decisions and discussions that happened early in the piece, including focusing on quickly learning as much as possible, says Doherty Institute director Prof Sharon Lewin, who is co-chair of the National Covid Health and Research Advisory Committee, which advises the chief medical officer.
“In early February, we were heavily activated in Australia, and there was a lot happening on testing, on modelling, yet it felt as though the rest of the world wasn’t doing much,” Lewin says.
“It was an extraordinary time, when many other countries didn’t think this would be a big problem. It really wasn’t until March that the gravity of this, I think, hit the rest of the world.
“Of course there were some countries like South Korea, Taiwan, New Zealand and Singapore which were also doing what Australia was early on, but I can’t emphasise enough what a big impact that very early awareness did for Australia. It meant we never got extensive virus seeding in the country,
and that was not just because of the scientists and doctors, but also the politicians taking it seriously back then.”
Lewin is world-renowned for her work on HIV, having worked to fight that virus alongside people such as US infectious diseases expert and White House adviser, Dr Anthony Fauci. Like many physicians, she has pivoted to also focus on Covid in the past year, reviewing evidence, advising government, and helping her institute focus on Covid-19 research.
Lewin had been overseas before Covid hit Australia, and arrived back to Melbourne the day before Australia closed its borders to China, on 1 February. “It’s been ‘go, go, go’ since then,” she said. “It’s been what I call survival mode, and I think all my colleagues have felt like that, they have been working nonstop as have others around the country.”
By 2 March, the first case of community transmission was reported in Australia, in a 53-year-old health worker in NSW. Until that point, the 29 people with coronavirus in Australia had caught the virus by travelling to an infected country or through direct contact with a family member who had travelled. This case and the closure of some international borders, including with China and Iran, sparked panic buying around the country. A pandemic was declared. By 20 March, it was becoming clear daily life would be drastically changed.
Indoor gatherings of more than 100 people were banned. For people meeting in workplaces or other venues in numbers less than 100, a space of 4 sq metres would need to be kept around each person, the prime minister Scott Morrison announced. The national airline, Qantas, said two-thirds of its 30,000-strong workforce would be stood down without pay, and announced a halt to international flights. Australians overseas rushed home and many were left stranded as travel restrictions tightened.
Despite these swift measures, mistakes were made. Communication of restrictions by the federal government, initially, was poor. Travellers aboard the Ruby Princess cruise ship were found to have Covid-19 only once they had disembarked in Sydney on 19 March, and some of those passengers had flown interstate or overseas by the time the virus was detected. In the weeks that followed, more than 600 passengers tested positive, and 28 died. An inquiry found NSW health made multiple “serious”, “inexplicable” and “basic” errors in allowing passengers to disembark.
Infectious diseases physician at St Vincent’s Hospital in Sydney, Prof Gregory Dore, treated patients linked to the Ruby Princess cruise ship outbreak, and patients linked to a backpacker hostel in Bondi. Dore says a moment that stands out for him during the past year of tackling the virus occurred in June.
Around that time, much of Australia was reopening, including NSW, which had managed to get on top of the cruise ship outbreak. The national restrictions in March had worked more swiftly and effectively than expected, and led to Morrison to announce: “We’ve gotta get out from under the doona at some time.” But Dore says as that was happening, “several patients were referred to me for assessment of ongoing post-Covid symptoms”.
“The story they told, of debilitating fatigue, problems breathing, and chest heaviness, despite having ‘mild’ acute Covid-19 and being previously healthy, made it very clear that long Covid was real,” he says. “The focus had been on deaths and those admitted to hospital, but is was evident that a large epidemic would lead to enormous and ongoing burden of illness.”
Meanwhile his health colleagues in the neighbouring state of Victoria were about to face a devastating lockdown and second wave of the virus that would seriously strain their stamina and overwhelm the aged care system. For most of May, the state was recording new cases in the single digits. By 13 June there were 10 new cases in 24 hours, and this jumped to 20 new cases in 24 hours by 16 June.
As other jurisdictions continued to report new cases in the single digits, or none at all, it became clear by the end of the month that something concerning was occurring in Victoria, with 76 new cases announced on 30 June and 10 Melbourne postcodes ordered back into lockdown. Public housing towers were swarmed by police and ordered into a harsh lockdown on 2 July, and the way it was carried out would later be investigated and condemned by human rights organisations. Metropolitan Melbourne, then the rest of the state, followed into a lockdown which would not be significantly lifted until November.
Victoria’s chief health officer, Prof Brett Sutton, said even he doubted Victoria could get back down to zero cases of community transmission. But on 26 October, the state recorded its first “zero day” since 9 June.
“I don’t think at the time we were really convinced that we could achieve the incredible outcome of no community cases, no transmission,” Sutton told Guardian Australia.
“But we did. I also don’t think any of us really understood just how precious the outcome has been and what it means for everyone.”
Lewin, who worked closely with the government, agrees: “I never thought we would get there.”
“It was very tense at times, everyone had a view on this outbreak both within the field and outside the field, there were tense times between the business community and the politicians, there were tense times between the Victorian government and the federal government. So what was achieved, I still think was absolutely extraordinary and a real highlight for me was the first day of zero, and then seeing that for 60 odd days in a row.
“People shouldn’t underestimate what a difference it is to be at zero, compared to having a dribbling amount of Covid.”
The state would record more than 20,000 cases and 800 deaths before reaching zero, with many of those in aged care. Health and aged care workers who were exposed to Covid-19 were stood down or furloughed, with no one to fill the gaps. Aged care residents were evacuated from their homes and sent to hospitals instead. Families were left devastated. The federal aged care minister, Richard Colbeck, repeatedly refused to reveal where deaths were occurring.
“There’s been absolutely tragic loss of life in the last year, without question,” Sutton says. But the emergence of new, highly transmissible variants was “appearing to be absolutely disastrous for Europe, the Americas and really any country with ongoing transmission,” he says, making the suppressing of the virus in Victoria an especially meaningful feat.
“I reflect on a year with immense pride that Victorians looked over a cliff edge of the kind of catastrophic outcomes that are playing out in the northern hemisphere and achieved the incredible situation we have today,” Sutton says. “That took unbelievable perseverance, compassion and trust. I shouldn’t be surprised that Victorians worked so hard together to get to this point, but I’m so thankful they did.”
Scientists now know more about how the virus spreads and the measures needed to contain it, and the second year of living with Covid in Australia will mark the rollout of vaccine programs.
It is a rapid and remarkable scientific achievement which has triggered new challenges and debate, with some calling for the vaccine to be rolled out sooner, for more vaccine candidates to be secured, and more doses of those already locked-in.
Health authorities are also fighting to ensure the new more transmissible B117 variant identified in the UK does not get into the community. Domestic and international border restrictions remain in place, and many Australians are still struggling to return home and wondering when they may be reunited with loved ones.
And even once the vaccine is rolled out, the prime minister warned in January, it would not be a “silver bullet” that would see travel and other aspects of life return to normal.
“Once the vaccination starts, Covidsafe practices do not end,” Morrison said. “The vaccine both here in Australia and around the world will continue to be rolled out, but it will still be a fight over the course of 2021. There is still a lot still to be learned about these vaccines and how they impact transmissibility.”
A real highlight for me was the first day of zero, and then seeing that for 60 odd days in a row Prof Sharon Lewin