COVID-19 STATE OF PLAY AUSTRALIA 2024: "the mortality experience" in an epoch of obfuscation

 

ACTUARIES INSTITUTE, Mortality Working Group, 12 September 2024:

Mortality in First Five Months of 2024 Was Slightly Higher than Prediction

In summary:

• Total mortality was 1% higher than the new baseline for the first five months of 2024.

• The mortality experience of 2024 includes higher COVID-19 mortality than predicted from March to May.

• Mortality from the COVID-19 wave that started in April 2024 rose more sharply than predicted and by May had reached a higher level than anticipated.

• For 2024, the Working Group measures mortality relative to 2023, allowing for some mortality improvement and an estimate of COVID-19 mortality (see April 2024 and June 2024 blogs).

Table 1 – Excess deaths in Australia (versus 2023-based expectation) – by cause of death for January to May 2024

COVID-19 was a much more significant cause of mortality in the first five months of 2024 than influenza (1,610 doctor-certified deaths for COVID-19 versus 144 for influenza).

The last Australian Respiratory Surveillance Report indicated that between 1 January and 22 September 2024 there were a total of 237,001 confirmed COVID-19 infections officially recorded in Australia, with 44 per cent of all cases being with New South Wales.

According to NSW Health from 1 January to 5 October 2024 there were 108,777 confirmed cases of COVID-19 in the state, with by far the highest concentration found in Western Sydney at 20,305 confirmed infections (or 19% of all officially recorded cases across NSW).

In relation to COVID-19 deaths, all state and federal departments and agencies have perfected the art of fudging the data by making it difficult to compare across agencies/sources.

However, Australia-wide from 1 January to 31 August 2024 there were 2,943 doctor certified deaths due to COVID-19 respiratory infection [ABS 30.09.24]

The cohort group with the highest mortality numbers appears to be aged care residents, with recorded deaths due to COVID-19 reaching 7,019 individuals between 1 January to 10 October 2024 [Australian Govt. DoH, 11.10.24]

In New South Wales according to ABC News (14.10.24) NSW Ministry of Health data released under freedom of information laws showed 1,729 hospital inpatients catching COVID-19 and 86 dying between January and April this year.

COVID-19 2024: I suspect there has long been a debate in government & public health sectors from which the Australian public in large measure appears to have been excluded

How the road to widespread abandonment of effective communicable disease control began.

In January 2020 the SARS-CoV-2 virus, commonly known as COVID-19, entered Australia and by 7 April 2020 there were 5,844 confirmed COVID-19 cases across the country, with 44 deaths [North Coast Voices, COVID-19 confirmed cases count for Australia, states and territories from 29 March 2020]. 

Infection numbers continued to rise and as of 29 July 2021 the national total confirmed infection number stood at 33,732 - with 2,857 mostly locally acquired active cases - and the death toll from COVID-19 was listed as 920 people with the highest number of deaths occurring in the 80-89 year age group.

Eight days later on 6 August 2021 the Sydney Morning Herald reported:

NSW Premier Gladys Berejiklian said the state must learn to live with COVID-19 as the number of people in hospital with the virus doubled within a week and the nation’s chief medical officer called for a circuit-breaker to halt the spread across Sydney.

As NSW reported a record 291 new cases on Friday, Chief Medical Officer Paul Kelly said low vaccination rates, non-compliance and the speed of diagnosis highlighted the need to reconsider the state’s strategy.

On 23 August 2021 then Australian Prime Minister Scott Morrison announced the 'national plan to live with COVID'

Prime minister Scott Morrison has said Australia must 'learn to live with' Covid-19. 'Once you get to 70% of your eligible population being vaccinated, and 80% ... the plan sets out we have to move forward'. Morrison said once those vaccine targets are hit, it is not about case numbers any more and people need to change their mindsets. 'Because if not at 70% and 80% then when? Then when?,' he said. 'This can not go on forever, this is not a sustainable way to live in this country,' Morrison said.

Needless to say by 31 December 2021 'living with COVID' à la Gladys and Scott saw the national confirmed COVID-19 infection numbers grow to 395,504 men, women and children with 137,752 mostly locally acquired active infections and, 2,239 deaths.

For it seemed that 'living with COVID' might have been Morrison's coded phrase for forced herd immunity and, like many of Morrison's schemes this one doesn't really appear to be working that well - unless the intention was to abandon the old, sick or vulnerable to this disease.

So this is where we are at today.....

 

In February 2024, as part of its fragmented public reporting of COVID-19 infection in the state, NSW Health announced that from 1 January 2024 to 3 February 2024 a total of 17,140 people ranging from 0-4 years up to 90+ years tested positive to COVID-19 via a PCR test, a total of 523 of the people were local residents in the Northern NSW Local Health District. With an est. 28% of the 17,170 requiring hospitalisation in the first week of January rising to 35% by 3 February. [NSW COVID-19 WEEKLY DATA OVERVIEW Epidemiological weeks 4 & 5, ending 03 February 2024]

Confirmed COVID-19 Infection by Age Groupings, 1 July 2023 to 3 February 2024

[ibid] Right click on image to enlarge

Note: The highest age group infection rate per 100,000 for the entire 6 months is a Bright Pink line representing those aged 90+ years and the second highest is Bright Blue representing those aged 65-89 years. While for the last four months and four days the third highest infection rate is represented by Red which indicates small children 0-4 years of age.

At state and national level total COVID-19 deaths have been increasingly hidden from the view of the general public in undifferentiated or hard to quantify mortality graphs and, on 20 October 2023 Australia’s Chief Medical Officer declared that COVID-19 is no longer a Communicable Disease Incident of National Significance (CDINS) following the end of winter in Australia.

On 8 February 2024 La Trobe University sent out a media release discussing a study led by Dr Joel Miller, Associate Professor of Mathematics and Statistics at La Trobe University, found that locking down the most at-risk group of people for a significant period, while simultaneously promoting infection in other groups in order to reach herd immunity, could be the best way to protect the high-risk groups. [my yellow highlighting]

However, increasing the exposure of one group to a disease would create an ethical dilemma and potentially result in the most disadvantaged groups in the community – usually with the least political power – becoming the highly-infected group.....

ABC News, 11 February 2024:

Steve Irons' older brother Jim was only supposed to be in hospital for a short while. A retired stockman from Maryborough, Queensland, Jim was diagnosed with leukaemia just before Christmas in 2022. He was flown to Brisbane for testing, then back to Maryborough Hospital, where doctors were putting together a plan for him to be treated at home.

But a patient in the room next door to Jim's had COVID, Steve says, and on January 14 last year, Jim tested positive too. "After four days, when the hospital told me he was no longer infectious, I took the risk and decided to visit him," says Steve, who'd flown up from Tasmania. "I sat with him for three days, playing country music, reading to him."

And then, on Saturday January 21, Jim Irons died of COVID-19 pneumonia and acute myeloid leukaemia, aged 79. It still distresses Steve to know his brother would have lived longer had he not caught a dangerous virus in a place he should have been safe. Once Jim had COVID, he says, hospital staff kept his door closed and donned masks and gowns when they came into his room. But hindsight is 20/20. "For me, to put him next door to a COVID patient caused his death," Steve says. "It didn't have to happen that way. If they'd had a separate COVID ward … with formal routes of entry, cleaning, controlled ventilation, Jim could still be with us now."

Twelve months later Australian hospitals have become a strange new battleground in the fight against COVID, with doctors and public health experts concerned that too many patients are catching the virus — and an alarming number are dying — as a result of inadequate infection control. Until recently, tools like contact tracing, testing, N95 respirators and good ventilation were mainstays of COVID management in healthcare settings. But in many hospitals they've been wound back or ditched in tandem with other community protections, putting patients and healthcare workers at risk and deterring others from seeking treatment.

Health departments insist the risk of catching COVID cannot be eliminated completely, and that hospitals maintain stringent measures to prevent infections and manage outbreaks. But senior healthcare workers in several states say vulnerable people — including transplant and oncology patients and others with compromised immune systems — are contracting COVID because even basic precautions are not being taken: a consequence, they say, of hospitals' failure to address airborne transmission, and the pervasive myth that COVID is "just a cold".

The 'Robodebt' of medicine

Of course, evidence clearly shows COVID is nothing like a cold, particularly for hospital patients who are at higher risk of severe illness and death. Shocking data released under Freedom of Information laws last year revealed 5,614 people were suspected to have caught COVID in Victorian public hospitals between 2020 and April 2023, with more than one in 10 confirmed or suspected to have died as a result of their infection. In Queensland, similar data shows an average of 13 people caught COVID in hospital every day in the 18 months to June last year, with one patient dying every two days.

"The data we are aware of indicates that there is a large problem here," says Associate Professor Suman Majumdar, chief health officer for COVID and health emergencies at the Burnet Institute. "The key policy aim in Australia is to protect the medically vulnerable and there is no more vulnerable group than people in our hospitals and aged care."

Whilst patients who catch COVID in hospital might be older and sicker, Dr Majumdar says, "this is a patient safety issue". "These are preventable infections and therefore preventable deaths and we need to take action to reduce them by setting targets, tracking progress and reporting transparently like we do for other hospital acquired infections."....

Quotes of the Week

 

"The sort of ballsy Rutherglen Shiraz that comes out of the bottle dragging its knuckles."

[Alex Csar on Twitter/X, 30 December 2023]

“It [SARS-CoV-2 subvariant JN.1] is very competitive if you look at the numbers compared to the other variants, its growth advantage is very, very high.”

[UNSW Associate Professor& virologist at The Kirby Institute Stuart Turville writing in The Sydney Morning Herald, 21 December 2023]

COVID-19 NSW STATE OF PLAY 2023: Counting Dead People - Part 2

 

An update on the NSW COVID-19 death toll…...

Deaths due to COVID-19 reported in Northern NSW in 2023

1-7 January — 0 deaths

8-14 January — 4 deaths

15-21 January — 8 deaths

22-28 January — 2 deaths

29 January-4 February — 4 deaths

That is a total of 18 Northern Rivers residents who were officially reported as dying from COVID-19 over the space of 35 days.

Total deaths due to COVID-19 across NSW

1-7 January — 92 deaths (91 of these deaths were people 50 years of age & older, with 36 being aged care residents)

8-14 January — 123 deaths (123 of these deaths were people 50 years of age & older, with 60 being aged care residents)

15-21 January — 124 deaths (123 of these deaths were people 50 years of age & older, with 64 being aged care residents)

22-28 January — 86 deaths (86 of these deaths were people 50 years of age & older, with 47 being aged care residents)

29 January-4 February — 90 deaths (88 of these deaths were people 50 years of age & older, with 40 being aged care residents)

A total of 515 NSW residents were officially reported as dying from COVID-19 over a 35 day time period.

Next COVID-19 update containing information on local health district deaths not due until 16 February 2023.

All surveillance reports can be found at:

https://www.health.nsw.gov.au/Infectious/covid-19/Pages/weekly-reports.aspx

BACKGROUND 

2023 COVID-19 NSW STATE OF PLAY 2023: Counting Dead People - Part 1, 22 January 2023

Review of COVID-19 Vaccine and Treatment Purchasing and Procurement aka the Halton Report is very clear about the fact that the world & Australia are not yet 'COVID-stable'. That federal and state governments need to revisit public heath and vaccine procurement policy & planning.

 

Transcript of letter accompanying Review of COVID-19 Vaccine and Treatment Purchasing and Procurement report:

The Hon Mark Butler

Minister for Health and Aged Care

Parliament House

CANBERRA ACT 2600

Dear Minister

On 30 June 2022 you commissioned an independent review of the purchasing and procurement of COVID-19 vaccine and treatments to inform the next 12-24 months. This report provides the conclusions and recommendations of the review.

The review team engaged with a number of key stakeholders involved in Australia’s response to the

COVID-19 pandemic and rollout of vaccines and treatments. This included epidemiological experts

both nationally and internationally, Commonwealth, state and territory Health departments and bodies, health sector organisations, as well as manufacturers of the vaccines and treatments procured within Australia.

As principal reviewer I was assisted by Professor Peter Collignon AM who provided expert medical advice. I would also like to acknowledge the work of the review project team led by Georgie Fairhall, Department of Health and Aged Care.

Early procurement of vaccines and treatments occurred in a highly competitive global market. In this context Australia secured a portfolio of effective COVID-19 vaccines and treatments enabling high rates of primary course vaccination preventing serious illness and death relative to global peers.

However, Australia and the world are not yet ‘COVID-stable’, and we are unable to confidently predict the timing or impact of new waves and variants. This uncertainty presents particular challenges. The availability of efficacious vaccines and treatments will continue to play a key role in ensuring ongoing protection for lives and livelihoods.

The next two years are critical to supporting our economy, health and education systems to recover. Australia's approach to the procurement of vaccines and treatments needs to be responsive to the changing environment and should be guided by clear policy and understanding of risk appetite.

Consideration should be given to the decision-making structures and advice required, and whether new and existing pathways for procurement and distribution of vaccines and treatments should be retained or adapted. Finally, it is critical that Australia maintains surge capacity in the event of a serious new variant or another infectious disease.

Yours sincerely

Hon. Professor Jane Halton AO PSM

19 September 2022

[my yellow highlighting]

Review of COVID-19 Vaccine and Treatment Purchasing and Procurement aka the Halton Report by clarencegirl on Scribd

https://www.scribd.com/document/618758421/Review-of-COVID-19-Vaccine-and-Treatment-Purchasing-and-Procurement-aka-the-Halton-Report

Note: This letter, executive summary & recommendations are the full extent of what the federal government was prepared to release for public consumption. The remainder of the Halton Report allegedly covers contractual arrangements with vaccine manufacturers and as such is commercial-in-confidence.

The Saturday Paper, 7 January 2023, excerpts:

A summary of the review by former senior health bureaucrat Professor Jane Halton was released in September last year. The full version of the report, obtained by The Saturday Paper under freedom of information laws, paints a disturbing picture of what could lie ahead as the virus mutates further and existing vaccines become less effective.....

Speaking to The Saturday Paper this week, Halton emphasised that the virus remains a serious threat that could worsen. 

“The world is currently seeing the emergence of yet more new variants, including XBB1.5, which underscores that the pandemic and particularly the effects of SARS-CoV-2 are not yet completely behind us,” said Halton, who heads the global Centre for Epidemic Preparedness Innovations, or CEPI. 

“It’s really important to take a step back and say, ‘What are we trying to achieve here?’ I’d love to see a narrative from the federal Health minister – the goals we want to achieve. I’m just not seeing that. It just seems to be a lot of Whac-A-Mole going on.” 

“The entire world is looking forward to a day where we don’t have to worry about SARS-CoV-2. However, we continue to need to be prepared for all circumstances, including new and more dangerous variants.” 

In her report, Halton writes that Australia signed advanced purchasing agreements (APAs) with vaccine manufacturers “later than other comparative countries which delayed the supply of vaccines and the speed of the rollout”. 

Australia later overtook other countries, once a distribution plan was in place. However, Halton warns that those foundational APAs are now expiring. “As a consequence, new APAs giving effect to purchasing decisions will be needed.” 

A spokesperson for Butler declined to comment specifically on new purchasing agreements but said the government “has ensured there is a portfolio of vaccines and supply available to Australians in 2023 and 2024”. 

The report says the new government should rethink eligibility for both vaccines and the antiviral treatments that lessen the virus’s impact on individuals. It says optimising their uptake and investing in new versions will be “critical” in what will continue to be a highly competitive global market. 

“In the short-term, wider eligibility for some treatments should be considered where there are stocks available, there is evidence of efficacy, safety and broader economic and societal benefits (such as workforce availability). This is particularly the case where there is no significant private market to help limit the burden of the disease.” 

The absence of a “private market” highlights that the government’s approach to Covid-19 vaccines is different than for other vaccines. 

For example, anyone in Australia can access the annual influenza vaccine. The government lists the vaccine on the Pharmaceutical Benefits Scheme (PBS) and identifies priority groups who can receive it free. Others who want to be vaccinated protectively can pay to obtain it through vaccination clinics or their local general practice. Some employers offer staff vaccinations to limit workdays lost to illness. 

That is not the case for Covid-19 vaccines and was also not the case for Covid treatments when they first became available. The government is the only purchaser and distributor of these vaccines and it alone controls who can access them. 

Unlike its American counterpart, the Australian government has only authorised a fifth vaccine dose for the most vulnerable. In the United States, a protective fifth shot is widely available. 

Butler’s spokesperson did not respond directly to a question about the different approaches to eligibility. “New booster dose recommendations are anticipated in early 2023 in preparation for winter,” they said. “Future recommendations will aim to provide ongoing clear guidance across all groups including time since last dose and definitions of eligibility.” 

The current, restrictive approach was adopted in the pandemic’s emergency phase to ensure access was not dictated by who could pay; but Halton notes circumstances have now changed, with most of the population protected by at least basic vaccination. 

She suggests that widening access to vaccines – and treatments – could slow the spread of variants and lessen risk as immunity wanes. In other words, the cost-benefit equation around restricting access has shifted. 

Halton writes that variants influence the effectiveness of both vaccines and treatments. “These changes are significant for decision-making,” she writes, “and the relative benefit of individual vaccines and treatments will continue to need to be assessed.” 

The report also indicates a shift in the importance of antiviral treatments, which have not been a focus in Australia’s Covid policy. Halton notes that if vaccination or previous infection no longer offer significant protection against new variants, treatments may now be considered proportionally more beneficial than when protection from vaccines was higher.

Halton warns that the current broad distribution framework for vaccines “does not include a strategy for the distribution of treatments as they were not widely available in 2020”...... 

Halton’s report says strategies and frameworks drafted early in the pandemic are now out of date and don’t adequately consider developments in vaccines and especially treatments for the virus. She says government should rethink those restrictions put in place because of supply constraints.....

She also notes that because the previous government elected to adopt all advice from the Australian Technical Advisory Group on Immunisation (ATAGI), it effectively became the decision-maker. Its advice was not always interrogated and was portrayed as entirely clinical when it was sometimes based on judgement.

“The ATAGI advice, which is released publicly, is often treated as prescriptive and rules-based. The timeliness of this advice has also been questioned.”

Halton describes a “mismatch” between vaccine supply and demand, the latter having been restricted by the eligibility criteria ATAGI had applied, which were often narrower than those contained in the Therapeutic Goods Administration approvals. Halton says this has created confusion about their respective roles.

She writes that ATAGI’s advice “has changed over time and does not provide a firm foundation for procurement decisions”.

Halton’s report says there have also been delays in the booster stage.

“While Australia has had early success with managing the pandemic, further emergence of new variants and management of the vaccination rollout has seen waning performance in comparison to other countries,” the report says. “Australia currently has the second lowest rate of booster uptake among comparator countries.”

Halton says “inconsistent messaging from health authorities” has contributed to the slow booster uptake and urges the government to significantly improve public communications.

The government has accepted all of Halton’s recommendations “in principle”, Butler’s spokesperson said. A formal government response is expected soon.

So what is currently in the SARS-Cov-2 viral soup swirling around us as we go about our daily lives?

 

 

The NSW Perrottet Government decided in late 2021 that it would ignore the SARS-CoV-2 pandemic. It no longer publicly report instances of COVID-19 infection in a meaningful way. As well as removing in stages all mandatory health measures, including an obligation to get tested or to isolate if unwell. 

Therefore the general public knows little about the viral soup that now swirls arounds Australia's public spaces, transit systems, workplaces and even our homes.

So as a new cluster of Omicron subvariants make themselves felt this month in New South Wales: the population is generally under-vaccinated; the viral transmission rate is rising; the number of people testing positive is growing by approx. six to eight thousand confirmed cases every 7 days; hospital admissions due to COVD-19 are climbing; and somewhere between 22 to 39 deaths are occurring over 7 day periods.

With all statistics belatedly supplied by NSW Health indicating an increase in the already massive under reporting, once all pretence of a public health approach to this pandemic was abandoned.

So how many SARS-CoV-2 subvariants are there now?

Well since the original subvariants Apha, Beta, Gamma and Delta gave way to Omicron, there have been so many more subvariants of concern spawned in Australia and around the world.

Here is an outline of what is currently in the viral soup......

Doherty Institute, News, 3 November 2022:

From Centaurus to XBB: your handy guide to the latest COVID subvariants (and why some are more worrying than others)

The Omicron variant of concern has splintered into multiple subvariants. So we’ve had to get our heads around these mutated forms of SARS-CoV-2, the virus that causes COVID-19, including BA.1 and the more recent BA.5.

We’ve also seen recombinant forms of the virus, such as XE, arising by genetic material swapping between subvariants.

More recently, XBB and BQ.1 have been in the news.

No wonder it’s hard to keep up.

The World Health Organization (WHO) has had to rethink how it describes all these subvariants, now labelling ones we need to be monitoring more closely.

What’s the big deal with all these subvariants?

Omicron and its subvariants are still causing the vast majority of COVID cases globally, including in Australia.

Omicron subvariants have their own specific mutations that might make them more transmissible, cause more severe disease, or evade our immune response.

Omicron and its subvariants have pushed aside previous variants of concern, the ones that led to waves of Alpha and Delta earlier in the pandemic.

Now, in Australia, the main Omicron subvariants circulating are BA.2.75, and certain versions of BA.5. More on these later.

 

Viral genomes from Australia: once we had Alpha and Delta waves. Now we have waves of Omicron subvariants. Author provided

We still don’t fully understand the driving forces behind the emergence and spread of certain SARS-CoV-2 subvariants.

We can, however, assume the virus will keep evolving, and new variants (and subvariants) will continue to emerge and spread in this wave-like pattern.

How do we keep track of this all?

To monitor these subvariants, the WHO has defined a new category, known as “Omicron subvariants under monitoring”.

These are ones that have specific combinations of mutations known to confer some type of advantage, such as being more transmissible than others currently circulating.

Researchers and health authorities keep track of circulating subvariants by sequencing the genetic material from viral samples (for instance, from PCR testing or from wastewater sampling). They then upload the results to global databases (such as GISAID) or national ones (such as AusTrakka).

These are the Omicron subvariants authorities are keeping a closer eye on for any increased risk to public health.

Newer versions of BA.5

The BA.5 subvariant that arose in early February 2022 is still accumulating more mutations.

The WHO is monitoring BA.5 versions that carry at least one of five additional mutations (known as S:R346X, S:K444X, S:V445X, S:N450D and S:N460X) in the spike gene.

The spike gene codes for the part of the virus that recognises and fuses with human cells. We are particularly concerned about mutations in this gene as they might increase the virus’ ability to bind with human cells.

Throughout recent months, BA.5 has been the dominant subvariant in Australia. However, BA.2.75 has now established a foothold.

BA.2.75 or Centaurus

The BA.2.75 subvariant, sometimes called Centaurus, was first documented in December 2021. It possibly emerged in India, but has been detected around the globe.

This includes in Australia, where more than 400 sequences have been uploaded to the GISAID database since June 2022.

This subvariant has up to 12 mutations in its spike gene. It seems to spread more effectively than BA.5. This is probably due to being better able to infect our cells, and avoiding the immune response driven by previous infection with other variants.

 

BJ.1

This was first detected in early September 2022 and has a set of 14 spike gene mutations.

It has mostly been detected in India or in infections coming from this area.

We know very little about the impact of its mutations and at the time of writing, there was only one Australian sequence reported.

BA.4.6 or Aeterna

BA.4.6, sometimes called Aeterna, was detected in January 2022 and has been spreading rapidly in the United States and the United Kingdom.

There have been more than 800 sequences uploaded to the GISAID database in Australia since May 2022.

It may be more easily transmitted from one person to the next due to its spike gene mutations.

Early data suggests it is better able to resist cocktails of therapeutic antibodies compared with BA.5. This makes antibody therapies, such as Evusheld, less effective against it.

BA.2.3.20

This was first detected in the US in August 2022. It has a set of nine mutations in the spike gene, including a rare double mutation (A484R).

Like BA.2.75, this subvariant is probably better able to infect our cells and avoid the immune response driven by previous infection.

There are more than 100 Australian genomic sequences reported in the GISAID database, all from August 2022.

XBB

This recombinant version of the virus was detected in August 2022. It is a result of the swapping of genetic material between BA.2.10.1 and BA.2.75. It has 14 extra mutations in its spike gene compared with BA.2.

Although there have only been 50 Australian genomic sequences reported in GISAID since September, we anticipate cases will rise. Lab studies indicate therapeutic antibodies don’t work so well against it, with XBB showing strong resistance.

Although XBB appears to be able to spread faster than BA.5, there’s no evidence so far it causes more severe disease.

 

How about BQ.1?

Although it is not on the WHO list of subvariants under monitoring, cases of the BQ.1 subvariant are rising in Australia. BQ.1 contains mutations that help the virus evade existing immunity. This means infection with other subvariants, including BA.5, may not protect you against BQ.1.

In the meantime, your best protection against severe COVID, whichever subvariant is circulating, is to make sure your booster shots are up-to-date. Other ways to prevent SARS-CoV-2 infection include wearing a fitted mask, avoiding crowded spaces with poor ventilation, and washing your hands regularly.

Written by

Dr Ash Porter, Research officer and Dr Sebastian Duchene, Australian Research Council Future Fellow.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID-19 Pandemic 2020-2022: State of Play in New South Wales and Northern NSW

According to Professor Raina McIntyre (Global Biosecurity, Head of Biosecurity Program, Kirby Institute UNSW New South Wales) on 2 April 2022, COVID-19 case numbers are bouncing around. Case numbers in New South Wales have increased since a low of 4,916 daily cases on 21 February 2022. “In the past week, they have ranged from 17,000 to more than 25,000 a day”.

“Part of the problem is the lack of testing and the lack of reporting. The message of “live with it” runs counter to the importance of reporting a positive test, if you can afford one. PCR testing remains restricted, so daily case numbers are a substantial underestimate and even the trends may not be accurate.” [my yellow highlighting]

As of 4pm 1 April 2022 there were 20,389 new confirmed cases of COVID-19 in New South Wales and a total of 268,761 active COVID-19 cases across the state the majority of which are being self-managed at home.

There were 1,302 COVID-19 cases admitted to hospital as at 4pm 1 April, including 47 people in intensive care, 16 of whom require ventilation.

NSW Health reported the deaths of 13 people with COVID-19 – seven women and six men. Of these, 7 people were aged in their 70s, 5 people were aged in their 80s and 1 person was aged in their 90s.

Included in the day’s total of newly confirmed COVID-19 cases were 520 people in Northern NSW.

There were 14 COVID-19 cases admitted to hospital with 2 in intensive care.

These 520 cases were all 7 local government areas within Northern NSW:

Tweed Shire – 149 cases across postcodes 2483, 2484, 2485,

Lismore City – 82 cases across postcodes 2472, 2480;

Clarence Valley – 79 cases across postcodes 2460, 2462, 2453, 2464, 2466;

Ballina Shire – 75 cases across postcodes

Byron Shire – 73 cases across postcodes 2479, 2481, 2482, 2483,

Richmond Valley – 51 cases across postcodes 2469, 2470, 2471, 2473;

Kyogle Shire – 11 cases across postcode 2474;

TOTAL 520

According to the federal Dept. of Health as of 31 March 2022 there were 229 COVID-19 outbreaks in residential aged care facilities involving 976 residents. 

A full list of these NSW facilities can be found at

https://www.health.gov.au/sites/default/files/documents/2022/04/covid-19-outbreaks-in-australian-residential-aged-care-facilities-1-april-2022_0.pdf

On 10 February 2022, the Australian Government announced changes to the definition of fully vaccinated against COVID-19 so as to include vaccine booster doses required for those 16 years and over. The new term in use is “up to date” vaccination.

Therefore as of 1 April 2022 only 60.2% of people aged 16 years to 90 years and older, 79.5% of children aged 12 to 15 years and 26.9% of children aged 5 to 11 years are considered to be “up to date” (fully vaccinated).

The fact that New South Wales is falling behind recommended vaccination rates is a concern given this statement. 

ATAGI Statement, 26 March 2022:

ATAGI recommends an additional booster dose of COVID-19 vaccine to increase vaccine protection before winter for selected population groups (see Table 1) who are at greatest risk of severe illness from COVID-19 and who have received their primary vaccination and first booster dose. These groups are:

• Adults aged 65 years and older
• Residents of aged care or disability care facilities
• People aged 16 years and older with severe immunocompromise (as defined in the ATAGI statement on the use of a 3rd primary dose of COVID-19 vaccine in individuals who are severely immunocompromised)
• Aboriginal and Torres Strait Islander people aged 50 years and older.

The additional winter booster dose can be given from 4 months or longer after the person has received their first booster dose, or from 4 months after a confirmed SARS-CoV-2 infection, if infection occurred since the person’s first COVID-19 booster dose.

ATAGI recommends that the rollout of the additional booster dose for these groups starts from April 2022, coinciding with the rollout of the 2022 influenza vaccination program.

As of 4pm 2 April 2022 there were 16,807 new confirmed cases of COVID-19 in New South Wales and a total of ? active COVID-19 cases across the state the majority of which are being self-managed at home.

There were 1,355 COVID-19 cases admitted to hospital as at 4pm 2 April, including 50 people in intensive care, 19 of whom require ventilation.

NSW Health reported the deaths of 11 people with COVID-19 – seven women and four men. Of these, 1 person was aged in their 30s, 1 person was in their 50s, 1 person was in their 70s, 6 people were in their 80s and 2 people were in their 90s.

Included in the day’s total of newly confirmed COVID-19 cases were 471 people in Northern NSW.

There were 14 COVID-19 cases admitted to hospital with 1 in intensive care.

These 471 cases were all 7 local government areas within Northern NSW:

Tweed Shire – 144 cases across postcodes 2484, 2484, 2486, 2487, 2488, 2489;

Clarence Valley – 75 cases across postcodes 2460, 2462, 2462, 2464, 2465;

Byron Shire – 71 cases across postcodes 2479, 2481, 2482, 2483;

Lismore City – 67 cases across postcodes

Ballina Shire – 66 cases across postcodes 2478, 2479;

Richmond Valley – 41 cases across postcodes 2469, 2470, 2471, 2472, 2473;

Kyogle Shire – 5 cases across postcode 2474;

Tenterfield Shire – 2 cases across postcode 2476; Tenterfield is not in the NNSWLHD but shares a postcode so some cases are included here.

TOTAL 471

On deaths in Australia…..

At the tail end of the Delta wave in December 2021, where we could reasonably point to the start of the Omicron wave, we had 2006 deaths. The Omicron wave saw close to a 200 per cent increase in deaths compared with all previous waves combined, with 5928 deaths by March 29. This includes six deaths in children under 10, two in people aged 10-19 years, 16 in the group 20-29 and 52 deaths in people 30-39 years old. The largest single age group for deaths was in people 80-89 years, with 2025 deaths. Another 2100 or so deaths were recorded in people aged 40-79 years and the remainder – about 1400 deaths – in people aged 90 years and over. [Professor Raina McIntyre writing in The Saturday Paper, 2 April 2022]

As of 4pm 3 April 2022 there were 15,572 new confirmed cases of COVID-19 in New South Wales and a total of 266,110 active COVID-19 cases across the state the majority of which are being self-managed at home.

There were 1,418 COVID-19 cases admitted to hospital as at 4pm 3 April, including 56 people in intensive care, 18 of whom require ventilation.

NSW Health reported the deaths of 6 people with COVID-19 – four women and two men. Of these, 1 person was aged in their 70s, 3 people were in their 80s and 2 people were in their 90s.

Included in the day’s total of newly confirmed COVID-19 cases were 437 people in Northern NSW.

There were 19 COVID-19 cases admitted to hospital with 1 in intensive care.

These 437 cases were all 7 local government areas within Northern NSW:

Tweed Shire – 113 cases across postcodes 2483, 2484, 2486, 2486, 2487, 2488, 2489;

Ballina Shire – 83 cases across postcodes 2477, 2478;

Byron Shire – 69 cases across postcodes 2479, 2481, 2482, 2483;

Clarence Valley – 62 cases across postcodes 2460, 2463, 2464;

Lismore City – 55 cases across postcode 2479;

Richmond Valley – 43 cases across postcodes 2469, 2479, 2471, 2472, 2473;

Kyogle Shire – 12 cases across postcode 2474.

TOTAL 437

A reminder......

NSW Health states: 

Everyone is urged to take simple precautions to protect each other from COVID-19, such as:

• use a mask in indoor settings where you cannot maintain a safe physical distance from others

• get your booster vaccine

• get a test and isolate immediately if you have any COVID symptoms

• clean your hands regularly.

SOURCES:

• 2022 media releases from NSW Health

https://www.health.nsw.gov.au/news/Pages/2022-nsw-health.aspx

• COVID-19 in NSW - up to 4pm

https://www.health.nsw.gov.au/Infectious/covid-19/Pages/stats-nsw.aspx#today

• Australian Dept. of Health, Coronavirus (COVID-19) pandemic

https://www.health.gov.au/health-alerts/covid-19

BACKGROUND

Current SARS-C0V-2 Variants of Concern in Australia

B.1.617.2 (Delta) and sub-lineages AY.*

B.1.1.529 (Omicron) and sub-lineages BA.*

SARS-CoV-2 Variants Which Decided To Call Australia Home

SARS-CoV-2 Variant A.2.2, Identified 2020-03-17, Australian lineage.

Australia 92.0%, New_Zealand 2.0%, Canada 2.0%, United States of America 2.0%, United Kingdom 1.0%.

SARS-CoV-2 Variant D.2, Identified 2020-03-19, Alias of B.1.1.25.2, Australia.

Australia 100.0%, United States of America 0.0%, Chile 0.0%, Mexico 0.0%, United Kingdom 0.0%.

SARS-CoV-2 Variant D.3, Identified 2020-06-14, Alias of B.1.1.25.3, Australia.

Australia 100.0%.

SARS-CoV-2 Variant B.1.1.136, Identified 2020-06-03, Australian lineage.

Australia 86.0%, Turkey 7.0%, Russia 5.0%, United Kingdom 2.0%.

SARS-CoV-2 Variant B.1.1.142, Identified 2020-03-03, Australian lineage.

Australia 39.0%, United Kingdom 12.0%, Iceland 12.0%, Switzerland 6.0%, United States of America 6.0%.

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