Covid-19 in Australia

Introduction

population of Australia 2020:
- 25.5 million
- NSW: 7.4 million
- Victoria: 6.4 million
- Queensland: 5.1 million
age profile
- 10% are aged 70 yrs or older (Italy is 16%)
- 24% of adults (aged over 15yrs) are aged over 64yrs (Italy has 36%)
- median age 37.4 yrs (Italy is 45.9yrs)
- see https://ourworldindata.org/age-structure
pre-Covid19 healthcare resources
- 3.5 medical doctors per 1,000 population (Italy had 4 doctors)
- 3.9 hospital beds per 1,000 population (Italy had 3.4 beds)
  - seasonal influenza normally adds an extra 5,000 - 30,000 hospital admissions pa which is sufficient to severely strain hospital resources over winter
  - if 25% of Australians become infected with Covid-19, hospital admissions would rise by 1.2 million
- there are 2,229 ICU beds in Australia, 874 in NSW and only 476 in Vic, making it 8.9 ICU beds per 100,000 across Australia (Italy has 12.5, Japan and South Korea have triple the number of ICU beds per capita of Australia, while Germany had 34 but expanding to 49!)
  - there are normally around 160,000 ICU admissions each year in Australia and seasonal influenza adds little to that with only and additional 500-2,600pa recently.
    - if 25% of Australians become infected with Covid-19, ICU admissions would need to double to cope but in addition ICU length of stay averages 10 days for Covid-19 cases compared to a usual average of under 4 days.¹⁾
- during the Delta outbreak in Australia (pre-vaccination):
  - the least-advantaged Australians (the bottom 20 per cent) were about five times likelier to die from the disease than the most-advantaged (top 20 per cent)
  - 84 per cent of deaths from, and related to, the disease were of people aged 80 and older
  - People born in Tonga were 80 times more likely to die from COVID-19 than other Australians during the Delta outbreak - due to cultural factors and higher rates of pre-existing health problems.²⁾
  - more than 70 per cent of deaths were among people born overseas, overall, migrants were almost four times more likely to die from the Delta variant than people born in Australia
  - Age-standardised deaths per 100,000 people death rates by country of origin: Tonga 322, Samoa 198, Iraq 139, Lebanon 116, Turkey 73, Australia 4
    - the migrant disparity “decreased during the Omicron wave and, since July 2022, the death rate of those born in Australia has been higher”
  - of Delta deaths, 40% had chronic heart disease, 21% had dementia (31% during omicron), 24% had diabetes, 19% had chronic lung problems, 16% had hypertension, 7% were obese;

Covid-19 timeline

pre-Australian spread

29th Dec 2019: Chinese authorities identified a cluster of similar cases of pneumonia in the city of Wuhan which was soon to be found to be caused by a new virus SARS-CoV-2, later called Covid-19.
13th Jan: 1st cases confirmed outside of China - Thailand, and on 16th Jan, Japan.
23rd Jan: city of Wuhan, China placed on lockdown

new cases in Australia and counter-measures

25th Jan 2020: 4 confirmed cases in Australia
29th Jan: 9 confirmed cases
6th Feb: 15 confirmed cases
21st Feb: 4 new cases taking it to 19 confirmed
27th Feb: 23 cases
29th Feb: 25 cases
2nd Mar: 32 cases
3rd Mar: 40 cases
4th Mar: 51 cases
5th Mar: 59 cases
7th Mar: 73 cases
10th March 2020: Australia has 100th confirmed case.
11th March 2020: WHO declares pandemic
13th Mar: 198 cases
15th Mar: 297 cases
16th Mar: 1st confirmed cases acquired in Australia without known contacts to overseas travel (NSW cases)
17th Mar: 454 cases
19th Mar: 709 cases
19th March: mass gatherings of more than 100 people indoors and 500 outdoors banned in Australia, resulting in sports being played without crowds, tourist destinations closed.
20th March: Australia bans entry of all non-residents and residents arriving will have to self-isolate for 14 days
21st Mar: 1072 cases
24th Mar: 2050 cases
24th March: WA, SA and NT close borders to eastern states
27th March: peak of daily new confirmed cases acquired overseas
29th March: all residents arriving in Australia enforced quarantine in hotels on arrival for 14 days
29th March: rate of daily increase in new confirmed cases starts to decline - but this is probably due to the massive reduction in international travel as 86% of confirmed cases are overseas acquired or their close contacts, as well as a significant decline in the number where transmission source is under investigation, and thus may NOT be a reflection of control of the community spread which currently falls outside of testing unless they end up in hospital
30th March: Stage 3 social distancing restrictions put in place - no more than 2 people together outside; beaches, outside gyms and playgrounds generally closed;
30th March: Australian acquired confirmed cases without travel contacts rises to 281
1st April: 4763 confirmed cases (2182 in NSW, 968 in Vic, 743 in Qld), 20 deaths;
13th April: local new cases substantially fallen in most states except Tas; only 5 per day in Vic. and around 12 per day in NSW.
20th April: minimal new cases (20 on 20th Apr) in Australia apart from repatriation and cruise ship cases; Fed Govt lifts ban on elective surgery. Virgin Australia airline goes into voluntary administration as Fed Govt refuses to offer $1.2b hand out to keep it running. Qld and NSW plan to open beaches for limited use.
23rd April: Ruby Princess cruise ship departs Port Kembla after repatriating over 500 crew members by air flight from Sydney. It is thought 10% of Australian confirmed cases could be linked to this ship including 23 deaths. It is thought to account for 20% of Sth Aust and ACT cases, 13% of NSW cases, at least 10% of Tas and WA cases, 8% of Qld cases, 7% of NT cases and 2% of Victorian cases. 1st docked in Sydney on 19th March when 2,700 passengers were allegedly approved by NSW Health to disembark despite more than a dozen on the ship being tested for Covid.³⁾ ⁴⁾
24th April: 6650 confirmed cases; daily average new cases around 15/day for past 5 days.
1st May: 4 million Australians have downloaded the COVIDSafe tracing app in the 1st week after its launch as some states start to lift social distancing restrictions
9th May: most of new cases in May are in Victoria related to an outbreak at the Cedar meat processing plant
10th May: Fed Govt announces stages for easing of restrictions and most States announce their easing of restrictions
26th May: new 2nd wave commences in Victoria
June: 5400 overseas visitors arrived for the month of June;
July: NSW clusters begins at:
- a funeral service in a Western Sydney church when a +ve lady attended without realising she was infected
- Thai Rock restaurant
Aug: Victoria's 2nd wave peaks after Stage 4 restrictions introduced in Melbourne. NZ commmences 2nd wave after having “eliminated” the virus for 100 days.
15th Aug: total of 23,035 confirmed coronavirus cases and 379 deaths = 14.9 deaths per million people.
Nov 2020: Victorian outbreak eliminated.
Dec 2020: NSW northern beaches outbreak spreads to Victoria via a Black Rock Thai restaurant but seems to be well contained with extensive contact tracing and asymptomatic testing.
Jan 2021: outbreak of UK strain in Brisbane;
21st Aug 2021: NSW records 825 new cases easily beating Victoria's 2020 peak of 725 new daily cases; Victoria hits a 2021 daily high of 67 new cases with 17 in Shepparton;
2nd Sept 2021: NSW 1288 new cases, 957 in hospital, 160 in ICU, 64 on ventilators; 2.5m fully vaccinated; Vic outbreak now seems out of control due to compliance fatigue with new cases hitting 176 despite prolonged lockdown, 61 in hospital, 20 in ICU 13 on ventilators, 2 deaths at home. 1.9m fully vaccinated;
4th Sept: NSW 1533 new cases, 1041 in hospital, 173 in ICU, 62 on ventilators;
1st Oct: Aust PM's international travel re-opening plans
16th Oct: NSW reaches 80% double vax target as daily cases fall to around 400 while Vic's daily cases are around 2000
25th Nov: omicron variant start to enter Australia from Sth Africa
1st Dec: 1st mRNA vaccine developed in Australia is announced - phase one trials to start Jan - developed in Victoria by Monash University researchers, pharmaceutical manufacturer IDT Australia and the Doherty Institute.
31st Dec: omicron wave hits most Australian states as 11% have had 3rd vaccine dose:
- NSW at over 22000 per day, hospitalisations hit 1000, PCR test positivity hits 20% as PCR tests are restricted
- Vic at over 7000 per day, at least 75% are omicron
- Qld at over 3500 per day and 112 in hospital
- SA at over 2000 per day
- ACT at over 500 per day
- Tas at over 400 per day
- NT at nearly 300 active cases
- WA still below 20 active cases as border remains closed
6th Jan: exponential spread of Omicron continues throughout most states with effective R of 3 in Victoria; NSW reports unsettling alleged case of a death of a previously well man in his 20's who had been double vaxxed.
10th Jan 2022: Australia now has higher per capita rates of 7 day average daily new infections than UK, USA, Canada, Germany, India but not as high as France or Ireland and is struggling with supply chain failures and hospital crises due to staff furloughs
Mar 2022, BA.2 Omicron becomes dominant strain with very high infectivity
April 2022: NSW took 731 days to officially reach 1 million COVID-19 cases but only a further 75 days to get to 2 million cases, although actual numbers are probably much higher with at least 50% under-reporting. 2500 have died in NSW since the start of the pandemic - 1% of cases with Delta and 0.1% of cases with Omicron thanks to high levels of vaccination.
June 2022: BA.4 and BA.5 variants set to become the dominant Omicron variants in NSW
Oct 2022: rise in XBB, BQ 1.1 and the B2 sub-lineages with increasing hospital admissions
June 2023: main variant in Australia has been XBB with a small peak in June 2023 causing 7 day average hospitalisations of 488 in Vic
Oct 2023: 8th wave of Covid-19 commences in Australia. To date 23,300 are recorded as having died from Covid-19 in Australia (7 million worldwide)
Jan 2024: wave is increasing with about 400 admitted each week in each of NSW and Vic, in Victoria, the JN. 1 variant is now the most prevalent strain. In NSW, the EG.5 variant is responsible for about 40% of recent Covid cases and JN. 1 for 35%