NSW has achieved rapid and high vaccination rates in 2021.We updated our model for NSW using data from the milestones of adults 16+ being 70% and 80% fully vaccinated, using actual case data and vaccination rates for 12+ beyond the targets from these dates, and public health orders stipulated in the roadmap. The next policy question is about vaccination of children 5-11, as well as the use of other public health measures such as masks, testing and tracing. There has been some talk of ceasing QR codes (and thereby reducing contact tracing capacity when case numbers rise). In Victoria, it has been announced that infected people will have to notify their own contacts. We looked at six scenarios based on the NSW Roadmap:
1) No vaccination for 5-11 age group, 80% contact tracing
2) 5-11 age group vaccinated, 80% contact tracing
3) 5-11 age group vaccinated, 0% contact tracing
4) No vaccination for 5-11 age group, 0% contact tracing
5) No vaccination for 5-11 age group, 50% contact tracing
6) 5-11 age group vaccinated, 50% contact tracing
We assumed testing capacity always remains high, but modelled the impact of ceasing or reducing contact tracing and vaccinating children 5-11 years. If testing capacity remains high, children 5-11 are vaccinated by early 2022 at high rates, and contact tracing capacity remains high at 80%, NSW can achieve good control of COVID-19. In all scenarios, a rise in cases occurs after the December 15th milestone, with a peak between January 31 and February 21 2022. In scenarios with high rates of contact tracing and vaccination of children 5-11 years, ICU and hospital capacity will be sustainable. In scenarios where contact tracing is ceased, NSW may face code black conditions in February 2022. We did not model waning of vaccine induced immunity, which will begin to show effects by February 2022 and coincide with the epidemic peak. The best outcomes can be achieved by vaccinating younger children as early as possible, maintain high test and trace capacity and ensuring high and timely uptake of the 3rd dose booster in NSW.
It shows that the outlook for NSW is good if children 5-11 years are fully vaccinated soon, and if testing and contact tracing capacity is maintained at high levels. A rise in cases will occur following lifting of restrictions on December 15th 2021, peaking in February 2022. If we do not vaccinate children 5-11 or relax contact tracing, the ICU bed capacity may be exceeded. The population impact of waning vaccine immunity will be seen by February, so high, timely uptake of the 3rd dose booster is important. In order to preserve our healthcare system function and protect the community, we need:
- High levels of vaccination in children 5-11 years before schools re-open in 2022
- High levels of 3rd dose boosters for people 18 and over.
- Scale up of digital tracing capacity including supporting QR code use so that high epidemic activity can be suppressed. Contact tracing as a public health capability needs to be maintained
- Maintain high testing rates in the community, improve access to home testing, lower the cost of rapid testing for community and business.
“Living with Covid” is possible if we actively plan, prepare and maintain all levels of mitigations we practically can in our community, schools, businesses and health system, to suppress disease and death. Vaccination is critical but we mustn’t forget safe indoor air, respirators, masks, testing, tracing and administrative controls to prevent further outbreaks disrupting our lives and critical workforce.