Covid zero risks being Covid limbo amid slow vaccine uptake

A protective bubble that's kept Australia's Covid-19 fatalities to less than 1,000 is unsustainable, Greg Dore, an infectious disease physician and epidemiologist with the University of New South Wales' Kirby Institute in Sydney, told a Bloomberg panel. The country needs to overcome complacency and ramp up immunizations to reach "disease immunity," where SARS-CoV-2 no longer poses a major threat, he said during a discussion broadcast live on Twitter Thursday.

"Once we get a higher proportion of the adult population vaccinated, we will provide that disease immunity and then we'll be able to open up," Dore said. "The virus will come in. There'll be some cases. There may be some people who get reasonably sort of sick, but the numbers of cases with severe illness and the numbers of deaths will be very small."

Such tolerance is in stark contrast with the situation now, where the Australian state of Victoria is in the middle of two-week lockdown to eliminate transmission of the virus in Melbourne for a fourth time. There were 69 active Covid-19 cases as of Wednesday, according to the state's health department.

The nation of 26 million people has recorded just over 30,000 cases since January 2020, but administered only 4.5 million Covid shots, according to the Bloomberg Vaccine Tracker.

"The elimination success has come with some complacency," Dore said, adding that he's hopeful the current Melbourne outbreak will act as a wake-up call and spur higher immunization rates in the coming months.

Hong Kong, Singapore and other cities that have used social and public health measures effectively to curb Covid's spread must also improve vaccine uptake as a buffer against localized epidemics, said Jody Lanard, a risk communications consultant in New York.

"I'm worried that the 'Covid zero' countries are kind of like sitting ducks for Covid to come in," she said during the discussion. "I'm very worried that 'Covid zero' is really 'Covid limbo.' You're just waiting for something terrible to happen."

Governments need to prepare their societies for some level of transmission, she said. "They have to help the people have their 'oh my God' moments ahead of time if possible."

When speaking to his citizens, Singapore Prime Minister Lee Hsien Loong frequently slips in reminders of the threat of super-spreading events, Lanard said.

"And then he makes that a little bit vivid so people aren't totally surprised when things go wrong," she said. "Helping people have an adjustment reaction to what is likely to happen is going to help things move along faster."

People living in Singapore should expect routine, large-scale, fast and simple testing to be part of a "new normal" in which residents "learn to carry on with our lives even with the virus in our midst," Lee told the nation in an address on Monday. "In the new normal, Covid-19 will not dominate our lives. Our people will be mostly vaccinated, and possibly taking booster shots every year."

Betting on "Covid zero" was a gamble that paid off for many countries whose policies were based on an intolerance of the coronavirus, said Peter Sandman, a risk communications adviser who works with Lanard.

"Having won the gamble, you have to convince people to collect their winnings," he said during the discussion. "The only way they get to collect the winnings is to be willing to get vaccinated and open up."

How tolerant of Covid cases societies are willing to be in exchange for greater freedoms, including the ability to travel abroad, should be debated and not decided exclusively by government officials and scientists, Sandman said.

"No country wants to be the hermit kingdom of the 21st century," he said.