explainer

The question no one wants to ask: What happens if lockdown just doesn't work?

With a four-week lockdown extension confirmed for Greater Sydney, affected NSW residents will now endure 63 days of being confined to their homes. 

For the past nearly five weeks in lockdown, the numbers have plateaued a little but they haven't reduced, and there's growing concern they simply won't. The Delta variant is, as NSW Premier Gladys Berejiklian keeps reminding us, a "game-changer."

The NSW government, in announcing an extra month in lockdown and 177 new cases, has opted against enforcing stricter rules like Victoria's stage five. They're instead hoping that a localised and targeted approach against eight of the most affected Local Government Areas will have the desired effect.

But as Dr Norman Swan warns, "another month of lockdown won’t make much of a difference unless they strengthen the settings very significantly. Hard to find an epidemiologist who disagrees with that."

As Dr Swan explains on ABC's Coronacast, the government needs to enforce tougher rules more broadly right now, citing Sydney University research that warns that 'for everyday you delay, it could be a week at the other end.'

"You can still travel 10km in Sydney, bring that down to 2.5 or 5km, even if that's just a signal to people that you can't drive halfway across Sydney. Maybe insist on masks outside. Again, we tend not to catch this outside, but it does give people a signal about social distancing and being careful," said Dr Swan. 

Even though NSW is leaving restrictions as is, the government has started to shift its language. There's less talk about 'getting back to COVID zero' and more talk of 'getting everyone vaccinated,' suggesting they're moving more towards a plan to try to live with the virus, which is the reality already in place in France and various other countries. 

Read: "I left Australia for a country that's 'learned to live' with the virus. This is what it's like."

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So, what if the NSW lockdown doesn't work? Let's look at the options. 

Mass vaccination. 

The NSW government is already redirecting vaccine supply to the LGAs most at risk, and we're getting a taste of the freedoms vaccination could grant us. 

It was announced on Thursday Year 12 students in Greater Sydney would be able to return to face-to-face learning in two weeks' time on August 16, with those students in the eight high-risk local government areas given priority to the Pfizer vaccination program. 

As Professor Greg Dore of the University of NSW’s Kirby Institute told the Sydney Morning Herald he supports the stratification of freedoms for vaccinated people, such as exemptions from isolation requirements, being allowed to see other vaccinated family members and being able to travel within NSW.

“That benefits the whole of society in a way, because that incentivises vaccination,” he said. “It gets some movement happening, and it provides some hope for the future.”

Similarly former deputy chief medical officer Nick Coatsworth and the Australian National University’s Sanjaya Senanayake told The Weekend Australian the way to reopen was not all at once but to start giving fully vaccinated people more freedoms.

To reach herd immunity, the estimate for COVID-19 is that roughly 70 per cent to 85 per cent of the population will need to be vaccinated. (In contrast, the flu only needs around 44 per cent to reach the herd immunity threshold.)

Right now 14 per cent of the Australian population is fully vaccinated, and in NSW 30.4 per cent of the population has now received their first dose of either Pfizer or AstraZeneca. But as the ABC reports, more than 150 days into our vaccination rollout, no age group is yet to reach a first dose vaccination rate of 80 per cent.

As NSW Chief Health Officer Dr Kerry Chant said on Monday, "it is actually quite distressing, when I review the numbers, to see how few over even 60-year-olds and over 70-year-olds we have managed to reach."

So for this to be our answer out of lockdown those numbers need to start climbing, fast. 

The NSW government is doing everything in their power to make this happen. Wednesday marks the first day adults aged 18-39 can book an AstraZeneca jab at participating pharmacies, supermarket workers in south-west Sydney are being given priority access to Pfizer, more vaccination hubs have been set up and additional Pfizer doses are being redirected to the state.

It's all systems go, so if you can, get vaccinated. 

Rapid antigen testing.  

Rapid antigen testing is already being used widely across the US and Europe, with some experts in Australia confident they could help get us out of constant lockdowns, open borders and protect frontline health workers.

They are on-the-spot screening tests that detect proteins in the virus and, as the name suggests, deliver results within minutes.

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There has been a resistance to use them more widely, as they are considered less reliable than the PCR tests and can lead to false negative and positive results. 

Professor Mary-Louise McLaws, an epidemiologist at UNSW Sydney and advisor to the World Health Organization has told Cosmos Magazine the tests could be valuable tool to prevent lockdowns when a higher percentage of the population are vaccinated, for things like sporting and music events.  

So in conclusion?

The two other weapons in our arsenal, vaccinations and rapid antigen tests, are going to be great long-term solutions for preventing future lockdowns. But when it comes to Greater Sydney's current predicament, stopping the spread remains our only ticket out.

As Dr Swan told Coronacast, "science says you have to separate people and stop them spreading the virus."

"The modelling from overseas is, you have to go hard and you have to go early. Social distancing is the one thing that will control this pandemic when you don't have other means at hand. Yes, contact tracing can help control small numbers of cases, but as soon as it gets to a bigger number it gets out of control.  NSW was several days late in determining that number...they're paying the price of it now."

Right now, those in the Greater Sydney region have one choice: stay at home, follow the rules and ride this out. 

Ms Berejiklian did confirm on Thursday, that if the virus stayed out of the fringe areas like Wollongong and Central Coast for long enough, they would consider lifting lockdowns in those areas. That means an 'exit' from lockdown for NSW will look different to the ones we're used to seeing in Victoria. Instead of coming out together, we might edge our way out LGA by LGA. 

Feature image: Getty.