Another COVID summer for Victoria and Australia looms. Here's what it might look like

Another COVID summer for Victoria and Australia looms. Here's what it might look like

For the third summer in a row, Australia is facing a wave of COVID-19 which is seeing more people contracting the virus in the lead-up to Christmas. After years of lockdowns and medical advancements, most people are now living the "COVID-normal" life afforded by high vaccination coverage and an endemic virus. But over recent months, the amount of virus in the community has risen, alongside hospitalisations and deaths. The numbers suggest Victoria started entering the eighth wave a few weeks ahead of the rest of the nation — and one expert thinks it could provide encouraging signs for the months ahead.

Here's what we know.

How much COVID-19 is in the community?

The number of people in Victorian hospitals after getting COVID-19 has been steadily rising in recent weeks, with a daily average of 326, an increase on recent weeks but still below a peak in early June. The rate of deaths has remained fairly constant, with a 28-day total to Friday of 144 — compared to 145 last Friday. Now it's no longer mandatory to report cases, health authorities across the country now largely rely on wastewater testing to get a sense of just how many people have COVID-19. "Quantitative wastewater levels indicate there are currently high COVID-19 viral loads in Victorian wastewater," the department said today.  Deakin University epidemiologist Catherine Bennett said the numbers started rising in Victoria in September, which was "a little bit earlier" than other states and territories began their eighth wave.

So far, the number of people in hospital has not reached the levels seen in post-Omicron waves. For example the most recent one in winter. "With each wave, we are seeing fewer infections," she said. Professor Bennett said the situation in Victoria appeared to be starting to level out, which could be a good sign for the rest of the country. "It's still too early to say whether this means we're reaching a peak, or at least a shoulder, in the current curve. But it certainly looks to have slowed a little bit over the last couple of weeks," she said. One reason it's harder to tell whether the numbers would stop rising, Professor Bennett said, was due to the new variants circulating in the community.

What are the dominant COVID variants?

According to that wastewater testing mentioned earlier, the EG.5 variant has been the most prevalent across the state. EG.5 is also known as Eris and has been growing in prominence across the globe for the latter half of the year and is now the most prevalent strain of interest worldwide. With EG.5, Professor Bennett said, "the pattern of illness seems to be similar to other variants". "Everything else about it, it was the devil you know. It can spread easily, it looked a bit different from the variants responsible for our winter wave," she said. "Our immunity was waning anyway, so that gave this particular variant a good foothold. And that's why it's been leading infections, not just in Victoria, but across Australia and around the world."

Now, the HK.3 sublineage of Eris is on the rise in Victoria, with recent wastewater testing showing it overtook EG.5 towards the middle of November. While it might be hard to keep track of the different combinations of letters and numbers, the World Health Organization says there is no reported change in disease severity with these variants. 

"The concern is that we might have other variants that that are also in the mix, that keep this current wave of infections travelling on as we have more people being exposed to slightly different sub-variants," Professor Bennett said. "And perhaps a greater risk of this wave not being as quickly resolved as previous waves."

It's worth noting a University of Melbourne, Royal Melbourne Hospital and Victorian Department of Health study released earlier in the week found people infected with the Omicron strain last year were less likely to develop long COVID than those who caught the original strain in 2020. But multiple exposures to the virus do still increase the risk of long-term illness.

With changing variants, do old RATs still work?

Good news —  Burnet Institute head Brendan Crabb said despite changes to the virus, "RAT tests are still very effective". Speaking from personal experience, Professor Crabb said when he recently had COVID-19, he tested on a range of different brands of the tests and they all delivered a positive result. "So yes, they work well. And it's a very important part of your arsenal," he told ABC Radio Melbourne. But as many of us stocked up on RATs some time ago, it is important to make sure your tests are still in date.

The effectiveness of the tests can be reduced if they're not stored correctly, so make sure they've been sitting at the recommended temperature (usually 2 to 30 degrees Celsius). And remember each test is different — even if you've tested countless times before, make sure you read the instructions before the swab goes up your nose. Professor Bennett said the rapid tests remained an important tool, especially as people described "very mild infections, or not typical infections".

"So that's where RATs can be really important to try and sort out whether you might have COVID, or to reassure yourself that you've got less risk of having COVID," she said. "Even if you're without symptoms, if you're going to visit elderly relatives, or people with other comorbidities, or on medication that might make them more of a risk of serious disease." So the tests could still be useful before large gatherings, especially during the festive season.

What's next for Australia?

There is no crystal ball for what will happen with the virus next.  But a look at overseas waves and the slightly ahead Victoria can provide a few ideas. "The bigger picture is now more reassuring," Professor Bennett said. That was due in a large part to the smaller waves of infection and the growing time in between peaks, she said. "That's telling us that our immunity is building to a level where we are better able to fight off the infection more often than we were in the past, we're less likely to have more severe disease on average," she said. Despite the possibility of a smaller wave this summer, a look overseas suggests it could take longer for the level of virus to return to lower levels.

In the United States and United Kingdom, which saw different sub-variants take hold over their recent waves, infection has passed its peak but rates are still higher than before the spike began. "So that's a risk for us," Professor Bennett said. "We might see the infections start to come down, but they might also level out because we've got this mix of variants in the community.

"And while we're not in winter, we are going into our most social time of year in the lead up to Christmas. So there is a concern that that might mean, in fact, background infection rate remains higher than it was back in September before we started to hit this wave."

What about vaccinations?

Vaccination is one of the key ways to prevent against developing serious illness after contracting COVID-19. "I think we need to take some reassurance out of that trend that we're seeing consistently wave-to-wave," Professor Bennett said. "But at the same time, take note when our own infection risk is higher, such as times like this, so that we can do what we can to minimise that impact even further."

Recent federal health data showed about 66 per cent of eligible aged care residents had received a booster in the past six months, with just over half of people aged 65 years of older up-to-date with their boosters. For the first time, monovalent vaccines will be available to Australians from December 11. They are designed to specifically target the XBB.1.5 COVID-19 variant. Whilst it's not the dominant strain currently, it is closely related to Eris, so it is expected to offer greater immunity than the bivalent boosters currently available.

As a new wave of COVID-19 hits Australia, why are so few aged care residents up-to-date with their COVID-19 vaccinations?

Most vulnerable Australians least vaccinated for COVID
 

Eligibility varies based on age, other health conditions, how many vaccines you've already had and when, and whether you've recently had a COVID infection. The vaccine advisory group ATAGI explains in more detail on its websProfessor Crabb said Australia was currently living with a "terribly unfair, actually a dangerous strategy", where people who were vulnerable were left to protect themselves but were not always able to get a booster.

"There's multiple reasons for that. One is sort of complicated eligibility requirements," he said. "The other is a general attitude that, COVID is behind us in the rear view mirror, to quote our former prime minister, I think that has pervaded." Professor Crabb said the health advice was the same as it always had been: "You do need a booster if you can get it."

Source: ABC News/Health