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Flattening the curve

As cases of novel coronavirus (COVID-19) rise around the globe, you’ve likely heard public health officials use the term ‘flattening the curve’.

This ‘curve’ is based on modelling and shows the likely number of people who will get COVID-19 over a period of time. Currently, many countries affected by COVID-19 are seeing continued large increases in the number of cases each day.

The average person with COVID-19 can infect up to 2-3 people. Without any control measures, these people then go on to infect another 2-3 people each. It can spread fast, and this is how we see large rises in cases.

#FlattenTheCurve: social distancing

#FlattenTheCurve: social distancing

Posted by Queensland Health

Flattening the curve means we are trying to slow down the spread of the virus to ensure the health system will cope. Right now, it’s just as important as stopping the spread of the virus.

What we want to see is the curve remaining steady – or flat – rather than rapid rises.

Every country in the world that has seen COVID-19 enter their borders is trying to flatten the curve while work is underway on developing a vaccine – and that’s why social distancing and travel measures were introduced.

As the virus spreads through droplets from an infected person’s nose or mouth, or from droplets landing on a surface that another person touches then touches their eyes, nose or mouth, we needed to limit the amount of physical contact we have with other people in our day to day lives.

We also needed to reduce the number of people travelling that could unknowingly be bringing the virus with them everywhere they go, coming into contact with potentially hundreds of people at airports, on public transport, and in public places. This is why border and travel restrictions were introduced.

If we didn’t do anything and let the virus run without controls in place, the number of cases would inundate every health system around the world. Many more lives would be at risk than there is currently, as there wouldn’t be enough beds or equipment for everyone that suffered serious illness.

Flatten the curve: coronavirus (COVID-19)

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The good news is that in Queensland, and across Australia, we are seeing that curve flatten. Queensland is currently seeing only a handful or less of new cases each day.

But that doesn’t mean we can lift restrictions just yet. We need to continue the current measures and see sustained flattening of the curve.

How do we continue flattening the curve? 

Flattening the curve is not an easy fix – and we cannot risk complacency during the process.

We need sustained low numbers of cases over many weeks to know we’re on the right track to containing COVID-19.

We all play an important role in continuing to flatten the curve through social distancing.

Social distancing keeps people further apart physically, reducing the risk of the virus spreading between people.

Right now, your role is to continue staying at home as much as possible, limit contact with people outside your household, and keep a distance of 1.5 meters – that’s two big steps - between yourself and others.

The measures are working. In Queensland, we’ve seen very little community transmission to date, with less than 4% of cases where we don’t know the source of infection. More than 92% of our confirmed cases are in people that have recently returned from overseas, or people who were close contacts of people that have travelled overseas.

But now is not the time to relax these social distancing measures. They continue to be necessary to save lives as COVID-19 is still here – and there’s still Australians returning from overseas or interstate.

We have all worked really hard to slow the spread, and that progress could be completely undone if we relax these measures now. We’ve seen this overseas, where festivals or public celebrations were the start of an outbreak that got out of control very quickly.

We can’t have that happen here.

Flattening the curve could take at least six months – while this means that many social distancing measures will be in place for a while, it also means our hospitals can cope with the number of cases we’ll see.

As this situation continues, restrictions will constantly be reviewed to consider if any can be relaxed – or if some need to be strengthened. It all depends on how the situation develops over the coming weeks and months – and if we continue to see more cases each day, and if we continue to see community transmission.

We want to thank Queenslanders for adjusting to these changes, and for your patience and kindness during these tough times. We will get through this together.

It is up to everyone to play their part, sustain the control measures, protect those most vulnerable in our community, and continue to flatten – and lower – the curve.

What scenarios are we prepared for?

Queensland Health has been working hard since the first cases of COVID-19 were identified in Australia to ensure our hospitals are well prepared for all scenarios that could happen.

The good news is that Australia has not seen the high number of cases that many other countries are now experiencing. We have also had time to look at what other countries have been doing to slow down the spread and put effective plans and restrictions in place.

We are prepared for an increase in COVID-19 cases, and we are prepared for a prolonged pandemic. It doesn’t mean it’ll happen, it just means we’re ready if it does.

Part of our planning work is to make sure we have capacity for more people needing urgent medical care, and more space to cater for isolation areas in hospitals.

We are prepared to triple our Emergency Department capacity and double our Intensive Care Unit capacity if and when required.

We have planned to do this through a variety of measures including:

  • Installing new demountable buildings to increase clinical space.
  • Ordering additional ventilators.
  • Establishing a talent pool of clinical and operational staff to boost the health system workforce as required.
  • Postponing non-urgent elective surgery and appointments.

Queensland Health’s plans are scalable, which means we can ramp up our response gradually or rapidly or in a phased approach, as we need to.

For example, this may mean if cases start rising rapidly, we can quickly increase space in our hospitals, and employ more staff who are in our talent pool.

This is a rapidly evolving situation, and Queensland Health is ready to adapt as we need to, to support the health of Queenslanders.

The good news is that most Queenslanders that have contracted COVID-19 so far experienced mild symptoms, and the majority recovered at home and did not spend time in hospital.

What does a full lockdown look like?

As the COVID-19 pandemic develops, social distancing measures are being revised regularly across Australia.

There are four stages of lockdown, and all states and territories across Australia have entered the third stage.

Each state and territory are responsible for applying the stage three lockdown measures, so there may be some differences between jurisdictions.

Most measures are aligned, however social distancing measures can vary, such as the number of people allowed in a public gathering or whether people can visit your home.

Some states, including Queensland, have put in place tighter border restrictions than others.

Restrictions are enforced by directions under relevant Public Safety Health Acts in each state and territory. You can read Queensland’s directions here.

All measures are subject to change at short notice and can mean tightening or loosening restrictions.

For example, Queensland’s border restrictions got stricter over time. First borders closed to all international travellers, and only Australian travellers were permitted entry. Then interstate land borders closed.

Many countries have tougher restrictions compared to Australia and are in stage four lockdown - the final and most strict lockdown phase. This includes New Zealand, Italy, Spain and India.

Under stage four lockdown, only essential services such as supermarkets, petrol stations, banks and pharmacies remain open. It means no retail shops are open, such as clothes stores or Bunnings, and restaurants and cafes are completely closed, with no takeaway options.

Everyone not involved in essential service areas must work from home.

People must only have physical contact with people in their household. In New Zealand, the people you start lockdown with – known as your ‘bubble’ - are the only people you should be in physical contact with during the lockdown. That means no visitors are allowed to your household. You can still go to the supermarket or exercise in your suburb but strictly only with people in your ‘bubble’.

The trigger for stage four lockdown is high daily increases in cases that are deemed community transmission – that's when we don’t know the source of infection.

Currently, Queensland has very little community transmission, with more than 92% of our confirmed cases had recently returned from overseas or had been in close contact with someone who recently returned from overseas.

If people follow the current restrictions and we continue to get less cases, further restrictions may not be needed.

How long will restrictions last?

At this time, it’s difficult to know how long the current measures will be in place. While we know flattening – and then lowering – the curve could take at least six months, that doesn’t mean the current restrictions will be in place that long, or they could be in place for longer.

Every state and territory is different. In Queensland, many of the directions are in place until 19 May, 2020 at this time – with the possibility of extension. In New South Wales, directions are in place until the end of June 2020.

It’s possible that some restrictions could be lifted, but others remain for weeks or months.

The Australian Government has said it could be six months until we’re in a place where the risk of local transmission is low enough for restrictions to be lifted.

It may take longer – and it could be many months until we can travel overseas again.

While Australia could get the spread of COVID-19 under control in coming months, other countries may not. You wouldn’t want Australia to limit the spread, only to have it brought back in by travellers that have visited countries where COVID-19 is still around.

Governments are always looking at the modelling to determine how the COVID-19 pandemic may develop in Australia over time and what measures we might need to continue flattening - and then lowering – the curve. We are looking at how the pandemic is affecting other countries to inform our modelling.

Social distancing measures and travel restrictions were added in a phased approach, and it’s possible they will be removed in the same way – when it’s the best time to do so.

Will COVID-19 become a seasonal virus like the flu?

It’s too early to tell if SARS-CoV-2 – the virus that causes COVID-19 disease – will become another seasonal virus like the flu, or even how long it will take for cases to decrease around the world.

In many countries, COVID-19 cases continue to increase in the tens of thousands each day.

SARS-CoV-2 is a new virus. We’re still learning about the virus, the disease it causes (COVID-19) and what measures, medication and vaccine can be used to limit or stop its spread and help people suffering severe illness from the disease.

Because it’s a new virus, we don’t have any immunity yet against it.

For example, we all have some immunity to the flu - because we’ve been exposed to it before.

After infection with these viruses, your body produces antibodies, building your immunity to these viruses. However, these antibodies lessen over time and you increasingly become more likely to catch the virus again.

That’s why we have a vaccine for the flu, however the strains change each season, which is why it’s important Queenslanders get vaccinated every year.

Research is now underway to figure out if COVID-19 patients develop antibodies that will reduce their chances to catch the virus again or develop serious illness if they do get it again.

We don’t know yet if you can develop an immunity to the virus and how long that immunity may last. It may be different for everyone.

Experts are looking at other types of coronaviruses such as SARS and MERS to get clues on how people’s bodies may respond after contracting SARS-CoV-2.

COVID-19 does not currently have a vaccine, but researchers around the world are currently trying to develop a vaccine and researching what existing anti-virals may assist with treating COVID-19 patients.

However, there’s no guarantee yet that a vaccine can be developed.

If a vaccine can be developed, we don’t know yet how often you will need to get it.

Research will continue on SARS-CoV-2 and it has been indicated that a vaccine could be available within 12-18 months.