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While UK COVID-19 cases rose, Australia's slowed to a halt

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Scott Morrison's Australia and Boris Johnson's UK have experienced the coronavirus pandemic in fundamentally different ways (image via YouTube).

Dr Francesco Paolucci and Naomi Moy analyse the UK's and Australia's responses to the COVID-19 pandemic and look to what the future may hold.

The United Kingdom's (UK) response

THE INITIAL RESPONSE to the COVID-19 outbreak in Wuhan, China, by the UK government was to implement screening of passengers on flights from Hubei province.

Until 3 March, the continued response was to monitor and contain the spread of any who picked up the virus overseas. After 596 confirmed cases and the 12th related death, the Government adjusted its strategy to the delay stage. The ultimate goal of this response was to lighten the load of COVID-19 on the National Health System (NHS).

On 31 May, the number of deaths associated with COVID-19 in the UK was 38,489 and the cumulative number of confirmed cases reached 274,762. The number of deaths in the United Kingdom has risen by 4.26% since the preceding week, however, the overall death rate appears to be dropping.

There was an initial emphasis on social distancing, washing hands and self-isolating for seven days if you had COVID-19 symptoms. Focusing solely on suppression by social hygiene measures seemed a stark contrast to the response of the Italian government, whose own health service had been inundated with cases. However, the Government’s response reversed course after receiving a report from the Imperial College of London COVID-19 response team. 

The first move was to improve social distancing measures by closing schools for the school year. In doing so, they would reduce the number of people using public transport at peak times. Yet this trade-off did not come without loss: in order to facilitate the number of children at home, parents would be required to stay home from work.

Next was the closing of non-essential services such as pubs, restaurants, entertainment venues, gyms, leisure centres and nightclubs — affecting thousands of workers. In response, the Government announced a number of financial packages that would help keep staff employed, one of which was paying 80% of staff wages.

Despite these measures, cases in the UK were still increasing. On 23 March, it was announced that all residents in the UK should limit unnecessary travel and work from home, restrict exercise to one hour a day and maintain a social distance of two meters.

Yet, the cumulative peaking of cases occurred almost two months after lockdown.  

Source: Department of Health and Social Care, and Public Health England.

Australia's response 

Australia followed similar interventions to the UK by screening passengers from Wuhan and excluding entry to all who have been in China within the last 14 days. These travel restrictions were extended to additional at-risk countries of Iran, South Korea and Italy by 11 March.

Australia subsequently closed its borders to non-residents and non-Australian citizens on 20 March. On March 13, the National Cabinet was convened to address the nation's response to COVID-19. Part of their recommendations were to ban gatherings of three or more people and close schools.

On June 1, 7,204 cases of COVID-19 had been confirmed in Australia, while 103 deaths have been associated with the virus. The number of cases in Australia has risen by 1.08% since the previous week and there is cautious optimism that Australia has not only suppressed but could eradicate COVID-19.

Australia initially relied on social distancing and contract tracing measures to reduce the spread of COVID-19. Then the Federal Government implemented a number of border restrictions for travellers from at-risk countries and introduced economic stimulus and reprieve packages to help Australians in need. In addition, the individual states and territories within Australia increased their interventions beyond the Federal Government's requirements, closing state borders to residents only.

Source: Department of Health, Australia.

A comparison of COVID-19 cases 

Australia and the UK followed similar testing strategies, testing those who come from at-risk zones and those with severe enough symptoms who are hospitalised. This then extended to medical staff.

The rate of confirmed cases is lower in Australia and appears to have almost stopped, with an average growth rate of 1.07 since May 26. Australia has cautiously announced that restrictions will begin to ease, starting with health and education. Non-essential retail has begun to return; however, some states are still restricting the number of people in groups.

The UK has begun the process of encouraging industries such as manufacturing and construction to reopen with social distancing measures in force. This comes as the average growth rate appears to be lowering with an average rate of 1.09 since May 25.

The lockdowns appear to have had a great effect in Australia, based on the stabilisation of the total number of cases towards the 14th day after restriction of gatherings was implemented.

This delayed lag is not apparent in the UK, potentially indicating the virus was more widespread than originally anticipated. It could also be explained by increasing tests, with the UK aiming to test 100,000 people a day.

Moving forward with COVID-19

The ultimate exit strategy for COVID-19 is a vaccine. Unfortunately, this option is a long way off.

Until then, in order to reboot economies, the process will be to de-regulate interventions as cases drop and ensure that the general public continues to follow social distancing measures. This approach retains its own risks of a second wave of COVID-19 cases, if the number of original cases was not high enough to generate herd immunity.

If the virus has not yet been eradicated from the nation’s shores, a second wave is likely to be the case in Australia rather than the UK, given that Australia has 28 cases per 100,000 people and the UK 411 per 100,000.

Recent spikes in cases in Victoria indicate that this may be the case. Whilst other states and territories such as South Australia, Queensland and Northern Territory have maintained longer periods of no cases.

Despite risks in Australia for a second wave, Australia has followed other nations and begun decreasing the strictness of interventions. At the same time, state and territory governments should be preparing their health systems for potential increases in COVID-19 cases.

The UK has released details for decreasing the strictness of interventions on a national level. However, not all areas have followed the same process, with England being the first to increase the social freedoms and encourage staff back to work, slowly followed by Wales and Scotland. Like the varying strictness across Australia, the differences in approaches has caused confusion in the UK.

Not following a one-size-fits-all approach has enabled governing bodies the freedom to adjust interventions based on the appropriateness for their region. Yet, the most important thing is to continue to prioritise resources and funding for health systems to ensure that areas with initially low cases are not overwhelmed by a second wave.

 Francesco Paolucci is Professor of Health Economics & Policy at the Faculty of Business & Law, University of Newcastle and the School of Economics & Management, University of Bologna.

Naomi Moy is a Research Fellow in health economics at the University of Bologna, Italy. She is currently finalising her PhD in Economics at the Queensland University of Technology.

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