Is the new COVID wave worth worrying about?

Sam Hawley: Hi, I'm Sam Hawley, coming to you from Gadigal Land. This is ABC News Daily. For many of us, COVID has drifted from our thoughts, but infections are surging again. So what should we be doing as this next wave takes hold? Today, infectious disease expert and director of the Burnet Institute, Brendan Crabb, on the new variants, the latest vaccine and why COVID is still a force to be reckoned with.

Sam Hawley: Brendan, COVID, we don't talk anywhere near as much about this as we used to, and I think a lot of us would prefer not to talk about it. But you have it right now, don't you?

Brendan Crabb: I do indeed have it right now. For the first time, knowingly. Most definitely, it's an issue for me personally. But of course, that's not the reason it's important.

Sam Hawley: I have noticed more people around me have been getting COVID recently, but it does feel like we're in a different era of COVID now. It just feels different than it did, you know, two years ago, 18 months ago, even a year ago. Is that right?

Brendan Crabb: Yes, I think it's right. But it's also a blindfolded era, you know. We are entering a wave now off a pretty high base. It is a black box. We don't test any more much. Of course, when we do test, we don't report the tests. Those tests that are reported don't get on to any sort of daily release. You know, it might be monthly or whatever. So but by analogy with this wave of last year, it's likely a few hundred thousand people in Australia have the infection now. If we don't do anything by the time this wave is over, there'll be three, four or five million Australians who will get COVID in the next few months. There'll be thousands of Australians who die early in the next few months. As a result, there'll be 50,000 to 100,000 cases of long COVID. There'll be businesses disrupted. There'll be aged care facilities shut down. So, yeah, there's no doubt it's it's different. It's not an emergency anymore, but we're just too casual with this. Treating it like a cold or even like the flu, which is a really important disease, mind you, doesn't get anywhere near the scale of of of what this is. And it means that even the interventions the government puts up, which are good interventions and, you know, the latest release from our peak health body, the AHPPC, is really good. You know, it talks about preventing transmission. The first time I think they've done that for a while. Importance of ventilation, importance of vaccination, importance of testing and treatment. But of course, no one's doing that or very few people are doing any of those things because the attitude is too casual. And that's the main message.

Sam Hawley: And as you say, we don't even track it anymore, right? So we don't know for sure, do we, how many cases there are?

Brendan Crabb: We don't know for sure in real time. In hindsight, we will. We'll know through this thing called excess deaths. This time last year, the general advice was a bit similar to how we started this conversation. Things are a bit different. You know, this will be a short, sharp wave. Well, in February, Minister Butler got up and said we were wrong. This was a long and protracted wave.

Mark Butler, Health Minister: This wave has endured for longer than was expected at its beginning. It was not short or sharp. It lingered for longer and it had a very significant impact on the community, our health system...

Brendan Crabb: At that stage, two and a half thousand people had lost their lives. Four to five million or so people had got COVID. And so we're in that position again. It's a real deja vu situation. If nothing changes, Minister Butler will be up in February going, gosh, that was a big deal.

Sam Hawley: I think we've all lost track by now of which variant we're actually up to, and I'm not sure if it really even matters, but where are we up to at the moment?

Brendan Crabb: We have variants of two flavours. One is these incremental mutants, you know, that that week by week, month by month, mutate and and get selected by our immune systems to cause a problem. And that's the major problem we're facing. We have a variant of the virus that's a problem in Australia at the moment, a variant called EG5 and its relatives. And then occasionally, and up until recently, we were wondering if this would still happen, you get a radically new variant like Omicron. When Omicron came along back in November 2021, it just looked completely different to Delta strain that was there before. Well, that has happened again. We have a virus called Pirola... and it's now starting to circulate. Now, whether it takes off or not is another question, but it's a radically different looking virus, one that doesn't look anything like the existing ones. So we have these two forms of variants out there. It isn't about are they more virulent or not. You know, we've got so much vaccine induced immunity, a lot of immunity to the virus itself through through infection. So what we can't really talk about the inherent virulence of the virus, but the effect they cause is still quite significant. And the basic message is relying on our immune systems alone is not doing the job, is not getting the job done. And if we don't have a deliberate effort as a world, not just as Australia, to reduce the amount of transmission, it's hard to see an end to this continual evolution, this continual problem of, you know, 10,000 or more Australians dying before their time and all the associated problems underneath it.

Sam Hawley: All right, well, let's then, Brendan, talk about vaccination. Tell me more about this vaccine around the corner, because many Australians wouldn't have had a vaccine for a while now, right? I mean, a lot of people would have had a shot or their last shot a pretty long time ago.

Brendan Crabb: Really worryingly, in that respect, we are we're very under vaccinated. Everybody wants Australians to be vaccinated. The government and all the governments, all their principal committees and so on. And yet we have this situation where even those in the most vulnerable circumstance in our aged care facilities, for example, are over 75, woefully under vaccinated, a third to a half in most circumstances. So we do have vaccines that are good and that people should get. What's available now in the US, UK and many countries in the world is what we call a monovalent vaccine against this sort of latest strain that's around and in fact, that's circulating in Australia now. So we're very keen to get this monovalent vaccine in Australia. I suspect it will be available quite soon, although I have no great insight into that. And there's two reasons for it. One is, of course, you're getting a vaccine that is made against the current variant. You know, so it's the specific immunity is better. The second is the word monovalent is important because it means it takes out that original Wuhan strain of the virus that was in the original vaccine. And what happens if you include that is you get this sort of immunological immunity to this kind of irrelevant virus now. It's irrelevant. We don't see that virus. So you get a lot of focus on building immunity to a virus that isn't around anymore. So it's a double whammy positive effect to get this monovalent vaccine. But with the current vaccines will still work. And I'd encourage people if they're booked in to get those or thinking about it, please go and get them.

Sam Hawley: And this new vaccine, when do you take it? How often should you take it? You know, who should take it? Do we all need it? What are the boundaries around this?

Brendan Crabb: Yeah, well, there'll be different advices in different countries. From the US, for example, everyone over the age of six months of age. So babies six months and up are encouraged to get the new vaccine. We'll see what Australian advice is. We don't know yet. But we tend to emphasise vaccination in older people or those with, you know, some extra at risk condition. From my perspective, you know, talk to your doctor and read the guidelines. But getting vaccinated every six months, if you haven't been infected, kind of no matter what your age, if you're eligible, is a smart choice.

Sam Hawley: A new vaccine coming, we don't know exactly when, but as you mentioned, it's already available in America, in the UK. So what is the hold up here? Or is there just no rush for this?

Brendan Crabb: Well, that's a question for authorities rather than me. We're close enough to the richest country per capita in the world. It's not obvious as to why we wouldn't have that vaccine here now. And the reason we're having this conversation, Sam, is, of course, we've got a significant uptick. Hundreds of thousands of people are currently COVID positive, would be my estimate. It'd be fantastic if this vaccine was in people's arms before they encountered that virus. You know, the situation that I've outlined, the, you know, two, three, four or five million people getting infected in the next four months, five months is a choice. It does not have to be that way. And the vaccine's a big part of that choice.

Sam Hawley: Brendan, I'm going to have to ask you the dreaded mask question because nobody, I mean, let's face it, I hardly ever see anyone wearing a mask. I must admit, I don't even carry one around anymore. So will there be a point where we do actually need to start thinking about masks again? Or is that just in the past now?

Brendan Crabb: Oh, no, it's definitely not in the past. But it's context dependent. The things you can do about COVID are pretty simple, right? You can get vaccinated. You can breathe clean air. And of course, getting tested and doing something about that result is going to help you. That's all you can do. So the breathe clean air thing is obviously you want to be in well-ventilated spaces. You want to preferably know you're in a well-ventilated space because you can see the windows open or even carry a CO2 monitor or something like I do as a surrogate. But if you're worried about whether you're in a crowded environment, people are coughing around you and so on, all you've got is a mask between you and infection. A well-fitted mask, not just a surgical mask, but a well-fitted N95 or P2 equivalent type mask. If you're not including that in your small armoury, then you're missing out on one key layer of protection.

Sam Hawley: Alright. Well, aside from that, Brendan, as we hurtle towards Christmas, yet another one, tell me what's your advice for people then? Because, you know, we don't want our festive season ruined, I suppose, by COVID, do we?

Brendan Crabb: No, we don't want any time ruined by COVID. But of course, a festive season, we're A, wanting to enjoy ourselves, but B, often mixing, of course, with travelling and mixing. And so remember the only three things at a general level you can do, get vaccinated, breathe clean air and get tested. And so my advice for sort of garden variety advice is that for any function, firstly, get vaccinated. Secondly, for any function, ask people to get tested before they come. It's not offensive to do this. It's amazingly powerful because those who are positive will take steps to make sure they don't infect others. Mostly they won't come, of course. And then secondly, do things in a ventilated space. Talk about it. Make sure that you're doing it outside or really well ventilated. Those two actions will be, you know, incredibly protective on top of the fact that people are up to date with their vaccines. It's not about cancelling events or, you know, radical restrictions or keeping density limits down. Nothing else you can do than those three things, get vaccinated, breathe clean air and get tested and act on that result.

Sam Hawley: Brendan Crabb is an infectious disease expert and director of the Burnet Institute. He is recovering well from COVID. This episode was produced by Bridget Fitzgerald, Sam Dunn and Anna John, who also did the mix. Our supervising producer is David Coady. I'm Sam Hawley. To get in touch with the team, please email us on ABCNewsDaily@abc.net.au Thanks for listening.