In the last blog post, I talked about how low English literacy and high rates of no internet connection were found in the 10 COVID-19 hotspots across Melbourne and how this could hamper the government’s efforts to communicate public health measures to migrant and disadvantaged communities. Since then, the Victorian government has announced Stage three lockdowns across all of metropolitan Melbourne and Mitchell Shire in an effort to contain the outbreak. This has emerged as a result of many clusters popping up across all of Melbourne. In this blog post, I look into the origins of the COVID-19 outbreak in Melbourne by looking at the sources of infection in Victoria and NSW. I argue that it is not the sole fault of Victorians for failing to adhere to social distancing measures. Rather, it is failures in the Victorian government’s response to COVID-19 before and during the outbreak combined with the perpetuating local transmission among families that has started the COVID-19 outbreak in Melbourne.
Comparing the number of cases per day between NSW and Victoria
I first investigated the number of new COVID-19 cases that were detected in May and June 2020 and the first few days of July 2020. I did this to compare the growth in new cases between the two states.
Between the two states, the growth in the number of new COVID-19 cases were very different. In NSW, the number of new cases per day did not go above 12 cases, only seeing a slight uptick in late June. In contrast, Victoria still had a relatively high number of new cases at the beginning of May. This gradually decreased throughout the rest of May, eventually reaching the same level as NSW in early June. From there; however, there was an exponential increase in the number of new cases for the rest of June.
What these results show is that strategies implemented by the Victorian government to contain and eliminate the virus were ineffective. In contrast, strategies implemented by the NSW government were effective in keeping COVID-19 case counts low. It is therefore imperative that the Victorian government fully discloses the decisions behind how they implemented the measures to identify failures in their strategy against the virus.
Where are all the NSW cases coming from?
I next counted the source of COVID-19 infections in the two states. COVID-19 cases can be derived from three sources:
- Overseas/interstate cases: these are people that were infected with COVID-19 while interstate or overseas. If these cases are quarantined in an isolated area such as a hotel and if proper measures are taken to contain the virus, the virus has no chance to transmit to other people in the local area.
- Contact with a known source: these are people that were infected by someone who is a confirmed COVID-19 case. These are derived from contact tracing where chains of transmission can be established. By isolating or quarantining cases and their contacts, the chain of transmission can be broken, potentially stopping local transmission.
- Contact with an unknown source: these are COVID-19 cases where the source of infection is unknown. A high number of cases from unknown sources may indicate community transmission where the virus transmits among groups of people with no linear chain of transmission. This makes it difficult to contain the virus due to undetected cases potentially transmitting it to other people, driving the rapid increase in cases.
I first investigated the source of infection among NSW cases. In the first half of May 2020, there was some local transmission as indicated by the small number of COVID-19 cases from known and unknown sources. However, for the rest of the time period nearly all COVID-19 cases in NSW came from interstate or overseas. This shows that hotel quarantine in NSW is working, where infected overseas cases are kept in hotels while they recover from infection. This prevents overseas cases from transmitting the virus to people in the state and causing a statewide COVID-19 outbreak.
Where are all the Victorian cases coming from?
The Victorian government was unable to completely eliminate the virus as it was still present locally for the whole time period. The first half of May was associated with local transmission from known sources, particularly in COVID-19 clusters such as Cedar Meats and McDonald’s Fawkner. An additional cluster of cases from a known source was also identified in a Keilor Downs family in late May. Unusually, local transmission from known and unknown sources was reduced to one case per day in the first week of June as overseas cases predominated. However, while overseas cases stabilized for the rest of June, local transmission slowly grew for the rest of June as indicated by increases in the number of local cases from known and unknown sources. These events indicate low-level local transmission that provided the baseline for COVID-19 clusters to cause an outbreak across all of Melbourne.
The sources of infection in the first half of June may also explain how the COVID-19 outbreak started in Melbourne. The outbreak may have originated from breaches in hotel quarantine that caused security guards to be infected by overseas cases, going on to establish the Coburg and Hallam family clusters. Initially, the high number of new overseas cases in hotels may have infected security guards under lenient hotel quarantine who were not trained on infection prevention and control. The infected security guards; therefore, established a cluster of contact cases from an unknown source on the 9th and 10th June. These infected security guards, not having self-isolated, may have then transmitted the virus to their family members. This established a high number of cases from known sources (in this case, the infected security guards) which established the Coburg and Hallam family clusters. This can be explained by the fact that gathering restrictions in Victoria were relaxed on 1st June 2020, increasing the chances that infected people who were not self-isolating transmitted the virus to other people.
Collectively, these results imply that the Victorian government failed to eliminate or even suppress the virus. This is shown by the COVID-19 clusters that emerged in May and the increase in local transmission in the second half of June. The COVID-19 outbreak in Melbourne is most likely derived from failures in public policy rather than Victorians being solely responsible for their lax attitude against the virus. The breaches in hotel quarantine combined with the relaxation of social gatherings that were not clearly communicated to Victorians established family clusters around infected security guards that perpetuated the COVID-19 outbreak in Melbourne.
Conclusion
The Victorian government’s strategy towards COVID-19 has failed to suppress the virus in Victoria and threatens other states in recapitulating the outbreak across Australia. Despite mishaps in NSW over its handling of the Ruby Princess COVID-19 cluster, the state had for the time period been largely successful in eliminating the virus locally and restricting overseas cases to hotels. In contrast, clusters that continued emerging in Melbourne over May and June 2020 combined with breaches in hotel quarantine and the unclear communication of the COVID-19 risks and restrictions underline a failure of the Victorian government’s overall response towards COVID-19.
The Inquiry into the Victorian Government’s Response to the COVID-19 Pandemic should not just touch on breaches in hotel quarantine that have started the outbreak. It must also investigate the whole Victorian government’s COVID-19 strategy and whether they have followed best practice, including how it has communicated the COVID-19 situation, risk and restrictions to all Victorians, particularly those with low English literacy. The results of this inquiry must be made public not just to Victorians who deserve to know what happened but also to all Australians as a precautionary tale of how to not control COVID-19.