What living with COVID-19
Today, Victoria exits its final lockdown. In two short weeks, the barrier between metropolitan Melbourne and regional Victoria will come down for the final time. State borders are soon to reopen, and international borders will follow. Coronavirus is unlikely to leave Shepparton and the Goulburn Valley — not for years or decades. It’s living with us now, and we need to learn to live with it. Max Stainkamph runs through what we know and don’t know about the Goulburn Valley’s brave new world.
When it first swept across the globe, coronavirus changed the world. Now, as an endemic virus as common and ingrained in the population as the flu or the common cold, it will change us yet again as we open up.
It is set to cause a strain on the health system in the Goulburn Valley, and containing the virus is no longer possible as it ingrains itself.
The hyper-vigilant contact tracing, which for 20 months has tracked the virus’s every move, will take a backward step, as being tested and isolating becomes a personal responsibility.
Over the next six months, we’ll all be exposed to COVID-19 at some point. At a supermarket, at a hairdresser, through your children’s school or preschool or returning from a visit to Melbourne.
It’s confronting. I’m double vaccinated, young and — I’m not going to say I’m fit, but let’s go with healthy. And I’m kind of scared by the knowledge I’ll be exposed to it — I might catch it and could spread it.
We’ve been treating this thing like the bogeyman for so long, tracking its every exposure site — desperately hunting COVID-zero — that accepting it is in the community is a big change.
There are a million questions about what this new world looks like. Will we all catch it? Can the health system cope? How will isolation, contact tracing and exposure sites work in the future? How do businesses cope? How do I protect myself? My grandparents? Younger kids? What does day-to-day life look like over the next month? Over the next three, six and 12 months?
I’ve spoken to a broad range of people about it, and over the past two months have watched more press conferences from health officials than I hope to ever have to watch again. We still don’t have a lot of concrete answers to these questions, and the further we look into the future, the murkier it gets. But let’s do what we can.
Will everyone contract COVID19 at some point?
COVID-19 is here to stay, and as Professor Paul Johnson told the Shepparton online community forum during the most recent outbreak, the entirety of Melbourne is “effectively one big Tier 2 exposure site”. That will happen to Shepparton and Echuca; to Seymour, Benalla, Kyabram, Cobram and beyond.
Victoria’s Chief Health Officer, Brett Sutton, said especially as the state opened up, more people who had coronavirus would be active in the community.
“A lot of those illnesses are asymptomatic and you won’t know the person you’re standing next to will have COVID-19,” he said last week.
“It sounds confronting but it’s what’s going to happen.”
It’s a sentiment echoed by GV Health chief executive Matt Sharp, who told me while not everyone might catch it in the next six months or so, Shepparton’s days of COVID-zero were over.
“I’m not sure, necessarily, everyone will catch COVID, but if they’re not contracting COVID someone in their friends and family group will at some point probably contract COVID,” he said.
It’s sobering, especially after hearing for so long how terrifying the virus can be and chasing COVID-zero, to be confronting something we’ve been avoiding for so long.
However, 95 per cent of people in the Goulburn Valley have had at least one dose of a coronavirus vaccine. More than 70 per cent have had their second.
In and of itself, this is a huge boost. You’re less likely to catch the virus when you’re double vaccinated, and less likely to spread it.
“The way to reduce how unwell people will get from that is just to be vaccinated because we know that reduces people needing hospitalisation, but it also, of course, reduces how unwell people are going to get,” Mr Sharp said.
According to the numbers cited by Prof Sutton or Victoria’s COVID-19 response commander Jeroen Weimar or Premier Daniel Andrews nearly every day, vaccination is the best thing you can do.
Nearly 90 per cent of people admitted to hospital with COVID-19 are unvaccinated, and more than 95 per cent of people who end up on a ventilator haven’t had two doses.
It’s because of this Prof Sutton is desperate to push the vaccination rate as high as possible — because anyone who isn’t vaccinated is probably going to catch COVID-19 in the next three or six months, and they’re way more likely to end up in hospital.
“I do not want people to go through the rest of this year and into 2022 remaining vulnerable,” he said.
On top of that, doing the little things we’ve been doing for nearly 20 months will become far more important now the virus is everywhere.
Mask-wearing, washing hands, signing in and — most importantly now, according to Mr Sharp — getting tested when you have symptoms.
“Vaccination and people continuing to get tested when they’ve got symptoms is the best way to find cases and reduce demand on the hospital and health system,” he said.
Expect news on booster shots to become more clear in coming days and weeks too.
Can the health system cope as we open up?
That’s the million-dollar question. I’m still haunted by the harrowing stories from New York and Milan in April 2020, of the UK over their past two winters, of American and Canadian hospital wards overf lowing, of hospitals in India running out of oxygen when they were swamped in February.
That won’t happen here, largely because of our vaccine coverage, but there’s an element of the unknown as we approach the grand reopening.
Rob Phair is the president of Rural Doctors of Victoria. He told me he hopes we don’t emulate the “terrifying” scenes in regional Canada, where patients couldn’t be transferred to major centres and some regional cities ran out of beds.
“I hope we’ve got the vaccination rates high and I hope we don’t get to that point. It would be terrifying,” Dr Phair said.
“It’ll be very challenging for us. People will be moving all over the state and COVID will be free to spread.
“It depends so much on the numbers, and it’s hard to know if we’ll be overrun. We’re shortstaffed for GPs in Shepparton, Traralgon; a lot of places.”
Dr Phair predicted a mass exodus from Melbourne when the wall between metro and regional areas disappeared for the final time. “When it becomes endemic, you have to keep testing to avoid increasing loads on health services,” he said.
He said “tailored restrictions” might need to be put in place if case numbers rose in some areas, especially those with low vaccination rates or areas that had sections of the community that were more at-risk.
Traditional Owners — on Yorta Yorta country and across the nation — generally have lower vaccination rates than the rest of the community.
Shepparton’s Traditional Owners’ first-dose vaccination rate is 71 per cent, while the percentage of fully dosed Sheppartonian Traditional Owners is less than 50 per cent.
There have been efforts to boost those vaccination numbers, through the incredible work of Rumbalara and other Aboriginal co-operatives across the region, through the VACCHO mobile vaccination van and through initiatives such as GV Health’s mobile vaccination hub Jabba the Bus.
But Dr Phair is still concerned by vaccination rates among Traditional Owners in Victoria and across the country.
How many cases can Shepparton cope with?
This was a question I’ve had for a while. Seeing lines of ambulances lined up out the front of Melbourne hospitals six weeks ago left me fearful we could see the same on Graham St, Shepparton outside GV Health.
Thanks to Shepparton’s vaccination rate jumping from 45 per cent first dose to more than 95 per cent in those six weeks, we won’t be faced with that, according to Mr Sharp.
He said it was difficult to predict to what degree cases could spike in Shepparton, or even if they would spike. NSW’s numbers have been dropping steadily for a while now. We simply don’t know how it will all pan out.
“With the way the outbreaks are at the moment, it’s been about five per cent of the total number of cases requiring hospital admission, so that gives us a good indication of what we can expect,” Mr Sharp said.
He said the number of active cases where officials started to get concerned — where GV Health needed to drastically shift health staff and beds and resources around to cope — was about 400 or 500 active cases in Shepparton.
At the moment, GV Health is able to have five or six people ventilated at one time, but plans made at the start of the pandemic in 2020 would allow the health service to have 30 people on a ventilator if needed.
But COVID-19 doesn’t just impact the people who get sick from the virus, eating up resources and taking beds, nurses, time and more away from people who have heart attacks, strokes and car accidents and everything else hospitals treated before the pandemic (and still treat now).
“The challenge is some of those areas where we do have fixed capacity, like for example our emergency department — we can’t increase capacity as readily in some of the areas,” Mr Sharp said.
“The challenge for us then is to try and treat and manage both patients with and without COVID as quickly as possible so that they get the treatment they need and then can go home, or we admit them as quickly as possible just to maintain the f low and access to those services in our emergency department.”
GV Health has already cut back elective surgery, but will be able to resume some of that as it regains staff from vaccination hubs when they are scaled back.
He told me there would be “a lot of catch-up work” on those surgeries and outreach programs, but some COVID19-related services, such as testing sites and treating patients who were positive, would remain.
There are plans to manage the looming surge. Or surges, as it will likely be — the Burnet Institute modelling that guides much of the health advice predicts a surge following restrictions being loosened at 70 and 80 per cent, and again around Christmas.
How does isolation work these days?
During the August outbreak, that was one of the biggest things we focused on at The News. The rolling coverage focused heavily on where positive cases had been and when they were there, who had to isolate and for how long.
I was one of the 20,000-odd people who had to isolate for 14 days then. We’ll never have a third of Shepparton isolating again — those days are gone.
The new protocols are less clear and, honestly, more confusing.
Close contacts now only have to isolate for seven days if they’re fully vaccinated, but fewer Tier 1 sites are being listed online.
Tier 1 exposure sites where everyone is easily and quickly accounted for won’t be listed. This will likely include ticketed events, schools, and places such as doctors’ clinics and dental surgeries and hairdressers where people are monitored. Tier 2 sites won’t be listed at all.
The places that will be listed are busy spots such as bars, restaurants and places where there’s a lot of movement and not a lot of control over who’s going where and — especially — where people aren’t wearing masks. We’ve already seen that this week: Shepparton bars The Deck, Shingo’s and Wild Life Brewing Co have all been labelled Tier 1 sites.
These will be listed online, by the state Department of Health and — increasingly — by the venues themselves on social media, and staff from the Department of Health will reach out to people who were there and signed in.
When they do, you need to isolate and get tested, and after you’ve been tested you need to stay in isolation. Otherwise, according to Mr Sharp, Prof Sutton and other authorities, the virus runs unchecked. People have already started breaking isolation rules to attend supermarkets, venues and more.
It puts people at risk and also hurts businesses.
The management of The Deck phrased it well when posting on Facebook after a patron allegedly broke quarantine, attended the venue and then tested positive.
“We know it’s tough (we’ve known this, as we have had to shut our business regularly over the past 19 months) but acting in this way can put anyone’s business out of pocket, which is truly heartbreaking for all of us,” they said.
“All industries but especially the hospitality industry doesn’t need this right now, please think about what your actions may lead to if you’re thinking about breaking the rules.
“Not only for yourself but the town. Shepparton doesn’t need this right now, especially after everything the town has been through already.”
John Anderson, from the Shepparton Chamber of Commerce and Industry, said for these reasons social distancing and maskwearing would still need to be factors in running businesses.
“Before as an employee there was an expectation that even if you were unwell, you came in — now, you stay home. It was brave and stoic once,” he said.
That applies to patrons as well. He said closures were “very cruel” on businesses, and venues knew that people would need to isolate on an ongoing basis.
Mr Anderson hoped deep cleans would become a thing of the past, and said businesses shouldn’t have the sole burden of tracking down patrons following positive cases at their venue.
He called for more long-term clarity on how often staff would have to isolate. Schools are in a similar boat, too, but that’s another thing that will need more clarification from the health and education departments, and hopefully soon.
What don’ twe know?
A lot. There’s plenty we don’t know, and we won’t know until we get to it.
We don’t know how many cases we’ll get and how the pandemic will peak, and just how we shift into this new normal. How will sport work when a positive case unknowingly lines up — especially contact sports such as footy and netball?
How do businesses adapt to frequent exposure? How long does the Department of Health track every single positive case? Do guidelines change down the road? How long until we live without any restrictions at all? We simply don’t know.
It’s a lot to process, and there’s a lot we’ll find out over the next three to six months as we enter a new world of living with coronavirus.