Is Australia ready for the COVID Delta variant?

In May, the WHO first declared Delta a ‘variant of concern’. Just over a month later, it has spread to 92 countries and is quickly becoming the dominant strain worldwide.
 
In the UK, where close to 60% of the adult population is fully vaccinated, Delta accounts for 95% of newly confirmed cases, with almost 15,000 new infections and 11 deaths reported on 27 June.
 
Similarly in Israel, where about 80% of those aged 16 and over are fully vaccinated, preliminary findings suggest about 90% of new infections are the Delta variant, with daily case numbers up to 200 from just 10 earlier in the month.
 
The variant is fast moving, with the prevalence doubling in just two weeks in the US, accounting for about one in every five cases, and is predicted to account for 90% of cases in the EU by the end of August.
 
‘This particular Delta variant is faster. It is fitter. It will pick off the more vulnerable more efficiently than previous variants, and therefore if there are people left without vaccination, they remain even at further risk,’ Dr Mike Ryan, Executive Director of the WHO’s Health Emergencies Program, said.
 
And now, despite closed borders, a mandatory 14-day quarantine requirement, and a previously demonstrated ability to contain the spread of COVID, the highly infectious Delta variant has gained a foothold in New South Wales and is threatening much of the rest of the country.
 
Professor Adrian Esterman, Chair of Biostatistics and Epidemiology at the University of South Australia, says Australia hasn’t been strategic enough in using the months of almost no community transmission to its advantage, and is concerned the country is not prepared to deal with the variant.
 
‘Australia did a brilliant response, and in fact, is still in a good position compared to most other countries. But for some reason, both our federal and state governments simply aren’t learning – learning from what’s happening in other states and learning from what’s happening in other countries,’ he told newsGP.
 
‘It’s all reactive.
 
‘Our population is incredibly vulnerable because of the lack of vaccination. We know that two doses of any one of the vaccines is very protective against the Delta variant and yet only up to 4% of the population have been fully vaccinated.’
 
As of 27 June, 7.3 million doses had been administered in Australia, equating to 28.7 per 100 people. At the same stage of the UK’s rollout, 63 doses per 100 had been administered.
 
Meanwhile, the former World Health Organization (WHO) epidemiologist says the continual breaches in the hotel quarantine system are a significant cause for concern given the Delta variant is at least 40% more contagious than the Alpha variant.
 
‘We’ve been talking about this now for months and months,’ Professor Esterman said.
 
‘The fact is that the current system of hotel quarantine and the … transport arrangements are just not good enough. For example, the recent outbreak in New South Wales was caused by a driver who wasn’t wearing a mask and wasn’t vaccinated. I mean, how could that happen?
 
‘So in terms of are we ripe to have a major outbreak? Yes.’
 
But immunologist Associate Professor Stuart Turville from the Kirby Institute at UNSW Medicine and Health, says while vaccination rates are not in Australia’s favour, it is reassuring is that Australia has so far proved able to supress outbreaks.
 
‘Anecdotally, from what I’ve seen, a lot of people, even before lockdown orders are put in place, they kind of get into a mode where they’re more cautious,’ he told newsGP.
 
‘For instance in the first wave lockdown, my wife and I, we pulled our kids out of school early and a lot of other people did … and then they gave orders.
 
‘In our culture, we’re inherently cautious and I think that that type of attribute will serve us well, hopefully, with this particular variant.’


Hotel quarantine leaks have led to a number of different COVID-19 outbreaks. (Image: AAP)
 
Australia’s prior success notwithstanding, Professor Esterman says timing is of the essence, in particular with the Delta variant.
 
‘What we do know is that the standard ways we handle outbreaks, whether that be social distancing, lockdowns, hygiene, and of course, good contact tracing, all those things work against any variant,’ he said.
 
‘But the big trouble is that this current variant … is so transmissible that the suppression approach taken by New South Wales simply isn’t working.
 
‘They’re doing the right thing now, but they’ve left it way too late, and on top of that, they’ve now seeded other cases in other states and territories.’
 
Infectious disease epidemiologist Dr Abrar Chughtai is concerned about the bigger picture, when it comes to the Delta variant. Though he is confident that lockdowns and mask-wearing will be helpful to contain the spread, he says the endgame is vaccination for all, and that no country can say it is truly prepared with vaccine inequality.
 
‘Even if Australians are vaccinated, people will be travelling and people will be coming from outside … Australia is a multicultural country,’ he told newsGP. ‘So Australia should support overseas vaccination as well, as long as they can.’
 
Professor Esterman says there are a number of steps Australia can take to be prepared for the next stage of its pandemic response, starting with addressing vaccine hesitancy.
 
‘In several European countries and in Canada, they are allowing mix and match. So if you’ve had AstraZeneca, you can then have Pfizer,’ he said. ‘The Canadian equivalent of the TGA have approved it, and it’s something that should seriously be considered here, and it’ll get around all the vaccine hesitancy.’
 
Meanwhile, looking to the UK’s current situation, where the Delta strain has swept through a number of schools, Professor Esterman says Australia needs to seriously start looking into approving the vaccines for children.
 
‘That’s why they’re seeing the virus going through schools and kindergartens because they’ve got this huge pool of unvaccinated people in the UK,’ he said. ‘So the lesson there is let’s get everyone vaccinated, including children, as soon as possible.’
 
The other step is setting up purpose-built quarantine stations. So far, the Federal Government has agreed to fund three facilities, which Dr Chughtai says is a step in the right direction that should be accompanied with updated policy on who can travel to Australia.
 
‘Will you allow unvaccinated people to travel?’ he said. ‘And if they travel, then what are our quarantine options?
 
‘It will still probably take at least one more year to vaccinate most of the population in Australia, so we need some backup, and that backup is quarantine.’
 
Associate Professor Turville says Australia still has a lot to learn globally, and that robust data being released by the UK will help to provide statistical confidence in what is happening in real time.
 
‘What’s going to be really key is to be looking at the disease severity and also, unfortunately, the deaths that are accumulated in those cases. The thing about it is, those things … take a while to accumulate in the data,’ he said.
 
‘I think in terms of the variants, this isn’t going to be the last … and we don’t know what they have in store for us. We don’t know whether they’re going to increase in their levels of transmissibility or whether they’re going to plateau.
 
‘So I think we need to be mindful that there might be a few more gears that this has in its gear box to go up.’
 
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