The emergence of the outbreak in Melbourne with the Indian variant of SARS-CoV-2 that is spreading fast requires a new lockdown. This variant is leading to a faster spread, so we have to stop the transmission chain as quickly as possible, and lockdown and vaccination are achieving this goal.

New studies show that even if the Indian variant can spread faster, the current vaccines that we have in Australia (Pfizer and Astra Zeneca) have strong efficacy against the variant and so people who are vaccinated are protected. The data show that even if the antibody levels are decreased due to the variation in the virus, the vaccine still provide a strong level of protection.

It is also important to note that other immune cells such as the killer T cells are very good at recognising different variants and protecting us.  

To avoid future lockdowns we need to roll out the vaccine on a large scale. Vaccines protect us against the COVID-19 disease, and also decrease the virus transmission between individuals by 60-70%. To help break the transmission chain of the virus we need more than lockdown and quarantine, as neither of those are protecting, or are perfect, despite much efforts put towards them.  

We need the population to be protected, which means to be vaccinated.

Lockdown in Melbourne is a very timely decision, as apart from vaccination, there is no other way to stop transmission quickly. Throughout the pandemic, there's been a discussion around slow vaccination in Australia and breaches in hotel quarantine. We need to strengthen both. So far we are lucky that we did not have large epidemics here in Australia (except one in Melbourne last winter), but that may happen anytime.  

Due to slow vaccination, most of the Australian population is still vulnerable. We need to increase the vaccination rate rapidly, otherwise we will see these stringent measures in future as well. Australia is really behind in vaccine rollout, even compared to many low-income countries.  

Genomic data links this outbreak to a case who contracted the virus in South Australian quarantine earlier this month. Overall hotel quarantine system is working well in Australia and has prevented major outbreaks here. However, we need to plan for the long term. These hotel-based facilities are not designed for managing infectious disease cases. Now there is enough evidence in support of airborne transmission of COVID-19. Due to slow vaccination in Australia and overseas, we may have to rely on hotel quarantine for a longer period. So we should acknowledge the risk of airborne transmission of SARS-CoV2 and consider designated quarantine facilities for returning travellers.  

It’s good that so far all cases in the current Melbourne outbreak have known contacts and there are no mystery cases, however we know that the B.1.617 strain is highly transmissible and has led to a very large epidemic in India and a few other countries. Moreover viruses spread more quickly during winters. So we should use all available non-pharmaceutical strategies (lock down, avoiding mass gathering, mask use etc) to control this outbreak. If this is out of control, this may be more devastating than the previous outbreaks.

The lockdown in Melbourne is a necessary step to control this concerning COVID-19 outbreak. It is clear now that we are dealing with a highly contagious variant of the virus, which must be dealt with before it is too late. I feel that more measures should have been put in place earlier in May, since the first case from the Wollert man who got infected in the quarantine hotel in South Australia was detected. Given that we are heading into winter, in addition to the hesitancy in getting the AstraZeneca vaccine by older eligible recipients, and that many aged care residents haven’t yet got their first COVID-19 shot yet, and with the fast growing number of positive cases detected in the past 2 days, I hope it is not too late.

Furthermore, this highlights the problems in the leaks from hotel quarantine system, and the need to improve the current system and establish better run facilities similar to the Howard Springs facility in the Northern Territory.

Acknowledging the negative effects on people’s wellbeing, Victorian have dealt with harsher lockdowns in the past, hopefully we will get through this one quickly and effectively.

The recent outbreak in Melbourne, and the way the virus is replicating with its very short transmission time, is a clear indication for everyone to get vaccinated. As we are now in lockdown there is no better time. It is the only way out of future cyclical lockdowns.

The current outbreak (as with most others) appears to be due to aerosol transmission. As we move into winter, the combination of cooler weather, less sunlight (UV) and more humid conditions in southern states, all combine to increase the risk of more frequent outbreaks. Some newer COVID-19 strains appear to remain viable for longer periods as an aerosol. All of this further highlights the inadequate ventilation systems in current quarantine facilities and the need to move to a national/centralised approach, ideally located outside major population centres.

Unless we change the model of hotel quarantine, we will continue to have virus escape into the general population that result in lockdown periods. Those who understand the history of infectious diseases understand this. Quarantine areas need to be distant from large urban centres, where workers in the quarantine system do not interact with people from large urban settings on a frequent basis. This will substantially reduce the chances of virus escape into the general population. It is surprising that after almost 18 months we have not established better systems for hotel quarantine, and ones that enable a return of Australian citizenry to their home country.

Currently, we are conducting the worlds largest virus evolution experiment; we are selecting for viruses that are easier to transmit and unfortunately for viruses that may escape our current vaccines. It is essential that we move to vaccinate the population as quickly as possible to offer the greatest chance of eradicating this virus and to drive a return to normalcy.