According to new research, future variants and outbreaks of COVID-19 would be best managed by ongoing vaccination and a faster increase in restrictions.
Key points:
- The research is the first of its kind to rank policies based on economic and health outcomes
- The report’s lead author says the models show the importance of increasing health measures if more dangerous variants take hold
- Modeling suggests thousands of additional COVID-related deaths will be recorded this year
Researchers at the University of Melbourne modeled the health and economic effects of more than 100 different policy responses to a range of possible new outbreaks.
“In general, we found that slightly stricter public health and social measures or lower thresholds for slightly increasing restrictions achieve better results on average across these scenarios,” said lead author Joshua Szanyi.
The researchers assessed 104 types of government response, looking at the severity of health measures, the level of mask-wearing, whether governments provided respirators or not, and the type of vaccination coverage.
All policies have been modeled based on nine different future COVID-19 scenarios – one without the new major variant of concern and eight other options with the new variant – since October last year.
It builds on earlier research by the university that helped shape the government’s responses, including the way out of Melbourne’s 2020 lockdown.
Where the modeling differs from previous research from around the world, said Dr. Szanyi, is that the economic effects of the policies were compared to health outcomes such as deaths and hospital capacity. The effects of long-term COVID were also taken into account in the model.
The findings were published today in the journal Lancet Regional Health — Western Pacific.
“The results also reinforced the importance of vaccination in response to COVID-19,” Dr Szanyi said.
The research found that increasing the number of people over 30 would reduce hospital admissions by 12 per cent and deaths by 27 per cent.
Vaccination was also found to be a cost-saving measure in all scenarios.
The report was released at a time when revaccination rates in Australia have stagnated, with about 72 per cent of the eligible population receiving the third dose and about 44 per cent receiving the fourth dose.
The research also found that the increasing prevalence of respirator masks during outbreaks, such as the N95, had little effect on the number of hospitalizations and deaths.
Dr Szanyi said that while there is strong evidence masks help reduce the transmission of the virus and increasing their use, “once things get out of hand, they can leave things too late”.
A high number of COVID-related deaths is expected in most scenarios
The research focuses on Victoria and looks at the 12 months from October 2022.
It found that regardless of policy or context, high numbers of infections and deaths were likely, with 4.2 million infections and 8,100 deaths in Victoria predicted to average over a 12-month period.
The researchers sorted the responses into four equally weighted categories – cost-effectiveness for the health system, cost-effectiveness with a GDP perspective, number of deaths and days exceeding hospital occupancy limits.
Overall, the highest rated combination was stricter health measures, two additional doses of the vaccine for those over 30 and support for increased mask wearing, but not government provision of respirators.
UNSW infectious diseases professor James Wood, who was not involved in the research but reviewed the paper for the journal, said the researchers had “done a really solid job with the health burden and cost-effectiveness” of the policies.
“[They] they’ve done some nice work for a long time that COVID could contribute to those burdens as well,” he said.
As a mathematician, Dr Wood said he would like to see more detail in the paper about the agent model used.
But he said the “tremendous amount of work” that went into the paper played an important role in starting a conversation about how to balance competing interests in the pandemic.
Health precautions are most important for the more “dangerous” variants, the author says
The lifting of lockdown rules in October marked the end of nearly all of the country’s COVID restrictions, and leaders have indicated they are unlikely to return unless there is a dramatic need to roll them back.
UNSW’s Dr Wood said that when the work was initially done, “it was more of an open question as to how much further we would intervene in the COVID epidemics with non-vaccine and non-viral interventions”.
“I think the population has shifted a lot in the time frame from the middle of last year to the end of last year in terms of their willingness to accept something like that,” he said.
“But if a bad option comes up again, something worse, then you want to know what the trade-offs are in terms of cost and so on.”
The author of the report Dr. Szanyi said public health and social care inputs into the model weren’t necessarily locked in, but things like working from home were at some levels.
But he said the models showed the importance of increasing health measures “should we be unfortunate enough to get a virus or a variant that emerges that is more virulent than Omicron”.
“While we considered the economic implications of these decisions, we really saw the value of increasing public health and social measures in these particular contexts,” he said.
Last year was the first time that the dominant strain at the start of the year — Omicron — remained the most common 12 months later.
For example, in Victoria, Department of Health data published today show that “the XBF recombinant strain accounted for the highest proportion of detections, followed by BQ.1/BQ.1.1 and BR.2”.
The ministry said that “a group of variants that cannot be classified due to new mutations” accounted for 17 percent of the wastewater detections.
“While we are dealing with sub-variants of Omicron at the moment, there is no guarantee that the virus will not evolve to be more virulent and dangerous and to have a greater ability to cause serious disease,” Dr Szanyi said.
“So I think it’s important for people to be aware of that, to have realistic expectations about what might be around the corner.
“We hope that’s not the case. But there’s no guarantee that it won’t be.”
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