A strategy for a phased progression from Australia's COVID-19 lockdown devised by Burnet Institute researchers recommends a 'precautionary approach' focused on optimising existing tools and strategies, with improved pathways for community and multi-sectoral engagement.
The authors, including Burnet's Health Security Program Director, Dr Ben Coghlan and Director and CEO Professor Brendan Crabb AC, acknowledge that while community-wide lockdowns have proven effective and saved many lives, they are economically and socially unsustainable.
The challenge now is to balance the relaxing of control measures while minimising ongoing community transmission of the virus, which is complicated by our incomplete understanding of the disease and risk factors.
Published in the Medical Journal of Australia (MJA), the strategy proposes three additional stages for a transition towards 'recovery' incorporating clear milestones that will need to be achieved for control measures to change.
These stages are:
- Suppress - focused on the effective application and coverage of existing tools and planning to identify and prioritise segments of the community to be 'released';
- Release - in which there is limited restoration of socio-economic activity that would prioritise economic and educational freedoms based on surveillance and empirical data, and
- Restore - a prelude to Stand Down and Full Recovery with broader restoration of normal activities, continued protection of health workers and vulnerable people, and preparation for the introduction of novel tools and strategies.
"Each step down would be preceded by a short transition period of gradual releasing of restrictive actions with intense monitoring for evidence of increased community transmission of COVID-19," the authors write.
The Burnet strategy is premised on making the optimisation of all existing tools and strategies the immediate priority, including detection and monitoring, physical and social distancing, public communication, and rapid response capacity for disease resurgence.
The strategy adopts a whole-of-society approach by harnessing and facilitating the application of expertise and capability across government, non-government and private sectors and the community.
This would involve having the right information to respond and plan effectively; having the right governance and operational mechanisms; and having the right principles and approaches.
"A precautionary approach to stepping down or re-instituting restrictions needs to be adopted where residual uncertainties remain," the authors write.
"People most at-risk of infection and severe outcomes of infection need ongoing shielding.
"A decision on whether a least restrictive approach to maintain disease suppression or a more conservative approach to minimise the chance of disease resurgence must be made either nationally or at sub-national levels."
"As we look to recover from the direct health impacts of COVID-19 and the indirect health, social and economic impacts of the control measures, it is vital to take a strategic, evidence-based and cohesive approach, with full engagement with the community."
Click here to read the strategy in full in the MJA.
