Can Australia avoid Europe’s COVID-19 surge next winter?

Jolyon Attwooll

10/12/2021 4:47:11 PM

With COVID now present in many parts of the country, newsGP looks at how well placed Australia is to avoid a similar increase in cases next year.

Masked woman in front of the Colosseum.
The death rate in Europe has risen sharply since September.

This week, the World Health Organization (WHO) drew attention to the rapidly climbing case numbers across Europe.
Dr Hans Henri P. Kluge, WHO Regional Director for Europe, spoke on Tuesday (7 December) about the situation in 53 countries across the region.
While noting the death rate is ‘significantly below’ previous peaks, he warned it has risen steeply from 2100 daily mortalities on average in September to 4100 now.
He said the cumulative death toll from COVID-19 has now passed 1.5 million for the 53 countries in the region and drew attention to some the rapidly rising case numbers.
‘By the end of this week, one in 10 people across Europe and central Asia will have had a COVID-19 infection confirmed by laboratory testing,’ he said.
Dr Kluge also noted that children aged 5–14 had the highest infection rates of any age group.
It comes with countries in the region weighing up imposing tighter restrictions, including further limitations on the unvaccinated.
So how well placed will Australia be in six months’ time when the southern hemisphere season mirrors Europe now? And what difference might the newly confirmed vaccination program for younger children make?
For Professor Peter Collignon, an infectious diseases physician who also works at the Australian National University Medical School, the country should be at an advantage compared to many other nations. He believes that transmission in Australia is likely to remain relatively low over summer and views the coming winter as the next ‘big risk period’.
But even then, Professor Collignon sees several factors in Australia’s favour.  
‘I think for lots of reasons we’ll be in a much better position than Europe,’ he told newsGP.
‘Most of our teenagers will have been vaccinated, and also a large proportion of our children aged 5–12, which means we’ll have less disruption, but also less transmission.
‘We’ll start from a lower base of cases, plus we’ll have better protection … than a lot of North America and Europe.’
The role of vaccinating children
Associate Professor Asha Bowen is a paediatric infectious disease specialist at Perth Children’s Hospital as well as the Telethon Kids Institute’s head of vaccines and infectious diseases. She believes the detailed data emerging from the United States on children’s vaccination should put the rollout in Australia in good stead for its take-up.
‘It’s very reassuring that with these large numbers who have received the vaccine, and with very good safety surveillance programs in place in the US, we haven’t seen a new signal emerge that should cause us to be concerned,’ she told newsGP.
‘I think that from Australian families’ perspective, this is the best possible scenario to be rolling out a vaccine.’

Associate Professor Asha Bowen says vaccination among young children should be combined with other mitigation measures.
Associate Professor Bowen also notes the proportion of children among the overall cases in Australia has risen substantially in 2021 compared to 2020, a trend she associates with high vaccination rates.
‘[Infection among children aged under 20] is now sitting in that 25–30% range of our total case numbers. I think that speaks to the successful vaccination program in older adults, and then younger adults and adolescents.
‘I expect that if we start to vaccinate young children, it will once again reduce the number of cases that are found in that particular age group because there [will be] fewer infections being transmitted.’
Professor Fiona Russell, a paediatrician, infectious diseases epidemiologist and vaccinologist at the University of Melbourne, also believes COVID-19 inoculation among the younger age group has a part to play, both for their own protection and that of the wider community.
‘The number one priority is to prevent [children] from getting severe outcomes in the same sort of [way] as adults, to prevent [them] getting infections and ending up in hospital and having multisystem, inflammatory disease, those sorts of things,’ she told newsGP.
‘That’s the critical thing.
‘We have known all along children transmit the virus, there’s no doubt about that, as all age groups do. There is a contribution from children and teenagers as well to this overall burden.
‘The more people that get vaccinated, the better, because that will also reduce infections, as well as obviously the severe illness.’
However, Professor Russell is clear that the most important step is for the most vulnerable to protect themselves.
‘One of the critical things for Europe or for anywhere is to get people vaccinated that haven’t been vaccinated, and then to have a booster,’ she said.
‘The biggest way to prevent severe illness and death in the elderly is for them to be vaccinated themselves.’
A timely boost
All of the experts newsGP spoke to believe that Australia, relatively, is in a good position compared to many northern hemisphere countries due to the timing of its vaccination program – both for boosters and for children.
‘Perversely, because we’ve had relatively late vaccination, for the big percentage of the population the six-month [booster] will come up [in] February, March, April, which is the best time to have people vaccinated before the next big risk, which is winter,’ Professor Collignon said.
Professor Russell makes a similar point, saying the timing is likely to give ‘maximum protection’ at the most difficult time – but did note the uncertainty caused by the rise of the Omicron variant of concern, and the potential for the situation to change.
She is also keen to stress that vaccination among young children should be combined with other measures.
‘In addition to a vaccination program, we also need to make sure that schools have a test to stay strategy and other mitigation measures such as improved ventilation set up as well,’ Professor Russell said.
‘The whole country needs to have that and needs to have rapid antigen testing in place for primary close contacts for schools so that only the children that test positive stay home, [and] they are not all staying home for two weeks.’
It is a position also supported by Dr Kluge, who called on countries to do as much as they can to ‘create COVID-safe learning for young children so that we can avoid school closures and home learning’.
Associate Professor Bowen in the meantime is hopeful that the country can continue to learn from experiences abroad.
‘Preparing for the potential next winter surge, the next wave, and having as many children vaccinated in advance as possible I think will be a contributor to protection against the [spread],’ she said.
‘Our experience today of COVID is that it seems to come in waves during the winter periods. We really do want to be prepared for that in Australia.’
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