In the weeks before Australia’s most populous state of New South Wales emerged from a 106-day lockdown in October, a surge of Covid cases seemed certain to coincide with the easing of restrictions. Experts predicted infections would rise and hospitals braced for a spate of new admissions.
But instead, the opposite happened. Daily Covid cases have dropped and – more than a month after exiting lockdown – the numbers continue to fall.
On 11 October, thousands of Sydneysiders flocked back to newly reopened cafes, bars and gyms. A total of 446 new cases were reported across the state and 769 people were being treated for Covid in hospital.
Modelling predicted daily cases in the state of 8 million people would swell to 1,900 each day in the weeks following restrictions easing, as schools and offices reopened, with a second, larger peak around Christmas. Australia’s leading medical research centre, the Burnet Institute, forecast hospitalisations would reach between 2,286 and 4,016 in Sydney by the end of September.
Instead, new daily Covid cases in NSW fell from a peak of 1,603 on 10 September, and now hover at about 200 to 250 new cases a day. The past week saw a seven-day average of 226 new infections each day. Hospitalisations have also dropped by more than two-thirds.
Australia’s second most populous state of Victoria has similarly seen a steady decline with new daily Covid cases dropping from a peak of 2,293 on 13 October to fewer than 1,000 over the past week.
It is unexpected but welcome news as other parts of the world eye their own rising Covid case numbers with trepidation, reinstate lockdowns and race to roll out booster programmes.
Fourth and fifth waves of the virus are sweeping across Europe. This month alone, Germany, Greece, France, Italy, the Netherlands, Russia and many countries in the eastern bloc have seen infection rates surge to record highs as hospitals face increasing strain.
Health experts say there are lessons that can be learned from the success of NSW in keeping case numbers low while reopening its economy. The combination of an impressive and rapid vaccine uptake, together with mask mandates, contact tracing and isolation requirements as well as vaccination entry permits, has largely been credited for containing the outbreak and keeping case numbers low.
On the first day of Sydney’s lockdown, fewer than 9% of adults in NSW had received both jabs, according to government health data. By the time lockdown ended several months later, this figure had risen to 73.5%, with 90.3% of the eligible population receiving their first dose.
Dore said the turnaround in vaccine rates was “in one word: phenomenal”. NSW now boasts one of the highest vaccination rates in the world with 91.4% of adults double-dosed as of 18 November. The speed at which the state ramped up the rollout is counter to countries like the US and the UK, which began to stall as they approached the 50% mark.
Still, experts believed even high levels of vaccination would not be enough to contain Covid.
“Models underestimated the impact of the vaccination on transmission, and the rate of the vaccine take-up in those first few months, particularly targeted vaccination spreading to broader geographical areas,” Dore said.
Timing was also crucial. A short interval period between Pfizer doses allowed NSW Health to vaccinate huge swaths of the population quickly and “optimised the impact in preventing infection”, Dore said. So when lockdowns lifted, immunity levels were high. Unlike other parts of the world, NSW maintained key public health measures even after restrictions eased.
The University of NSW epidemiologist Dr Abrar Chughtai said health authorities continued to mandate masks in public places while maintaining contact tracing and isolation requirements in order to curb the spread.
The Doherty Institute’s final report, released this month, credited continuing public health measures such as testing, tracing, isolating and quarantine as “critical interventions” in achieving low case numbers.
Prof Alexandra Martiniuk from the University of Sydney school of public health also cited the importance of the state government’s “gradual reopening”, with vaccination requirements for entry in most indoor venues and social distancing measures.
She said NSW had also maintained “excellent” testing rates, with low test positivity compared with other countries that have similar vaccination levels. About 0.3% of tests were coming back positive in NSW, while tests had continued to exceed 50,000 a day.
Martiniuk explained the reopening of NSW was done gradually compared with countries such as England, which reopened much sooner and with more restrictions taken away all at once.