Reopening Western Australia's borders is all risk and no reward

14 Sep 2021 | 3 mins

Q and A with epidemiologist Dr Zoë Hyde, from The University of Western Australia’s Medical School.

What are the risks and rewards for Western Australia opening its borders to the eastern states?

Reopening Western Australia’s borders in the near future is all risk and no reward. There’s currently no known community transmission in the state, so opening the borders would trigger an epidemic.

What would need to be considered before Western Australia opens its borders?

Western Australia, and in fact anywhere that wants to try “living with the virus” needs very high levels of vaccination. Both modelling and overseas experience shows we need to get 90 per cent of the total population vaccinated, including children, before we can think about relaxing public health measures. We need to learn to walk before we try to run. It’s the same story worldwide. Places that open up prematurely end up having setbacks and have to bring back restrictions.

Is it too big a leap for Western Australia to open domestic borders, when it has no COVID and very few borders with other states?

Prematurely opening up Western Australia to the eastern states would be an incredible act of social and economic vandalism. You don’t need a crystal ball to know the result. Hospitals would be overrun with COVID-19 patients, regular healthcare for cancer, heart disease, and accidents would suffer, and our economic prosperity would decline. People alter their behaviour and stay home even in the absence of lockdowns. Consumer spending would collapse.

Is there an acceptable level of COVID in the community from an epidemiological perspective?

Inevitably we’ll have to expect some outbreaks of COVID-19, but we should be aiming for a measles-like situation, where we have small, occasional outbreaks that are quickly contained. If we aim for a 90 per cent vaccination target, we can achieve something like that. If we settle for a lower target, we’ll see the kind of sustained transmission and ongoing deaths that’s dragging the UK down.

Is there an acceptable level of COVID in the community with respect to the health system?

People need to understand that healthcare is finite. You can add more beds and ventilators, but you can’t add more staff. The surge capacity that people talk about has to come from somewhere else in the system, and it means that doctors and nurses who would be treating cancer and the like are now treating COVID-19 patients. Unless we have very high levels of vaccination, there will be enough transmission to bring healthcare as we know it to an end.

What would be an ideal vaccination rate?

We need to aim for 90 per cent of the entire population, including children. Although most children don’t get seriously ill, enough do to overwhelm children’s hospitals as we’re seeing in the US. Fortunately, it looks like we’ll have safe and effective vaccines available for children in the next couple of months. We also need to think about vulnerable populations within the community, and aim for very high levels of vaccination in these groups. Our country towns and remote Aboriginal populations are very high risk. If people get sick with COVID-19 out there, there’s just not the level of healthcare needed to keep people safe.

Where NSW is on the path to "living with COVID", what could this look like for Western Australia?

New South Wales is on the path to disaster. It’s crazy to be thinking of relaxing restrictions right now. I think the state is just setting themselves up for a future harsh lockdown. I think Singapore could be a good model to follow. They’ve managed to vaccinate 80 per cent of their entire population. That’s quite different to Australia’s target of 80 per cent of eligible people, which is actually only 64 per cent of the total population. Singapore has also kept a range of public health measures in place, including highly efficient digital contact tracing. I imagine Singapore will move to vaccinate the remaining 20 per cent of their population, a large part of which are children, as soon as they can.

How does the Doherty Report and the Federal Government's National Plan relate to Western Australia?

I think a one-size-fits-all approach doesn’t work with a country the size of Australia. Leaving aside the government’s targets being too low generally, states like Western Australia have additional problems because of their size. There’s a lot of people living in rural and remote communities who are very vulnerable because of the limited healthcare available to them. If COVID-19 got into these communities, we’d see people dying before they had a chance to get to hospital. That’s why we need a 90 per cent vaccination target across all age groups to keep these communities safe.

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