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Posted: 2020-04-30 05:34:31

As state governments begin to slowly wind back coronavirus restrictions, many Australians are breathing a small sigh of relief.

So far, Australia has had fewer than 100 deaths related to COVID-19, and new case numbers remain small.

On Sunday, both Queensland and Western Australia governments announced they would be scaling back some social distancing rules, and from Friday, New South Wales will allow groups of two adults to visit other households.

But even as the curve flattens, is it too early to ease coronavirus restrictions, given the risk of a second wave?

We asked four health experts about what Australia should be doing next.

Making things more sustainable

Think about these coronavirus restrictions being fine-tuned rather than lifted, advises infectious disease epidemiologist Kathryn Snow of the University of Melbourne.

"Easing and relaxing and lifting [restrictions] makes it sound like we're on our way back to normal, and I don't think we are," Dr Snow says.

Easing restrictions is going to be a gradual process, and there are overseas lessons to consider.

"The lesson that we've learned from Singapore, for example, is that the risk of a second wave is very, very real," Dr Snow says.

Another sobering lesson from the US, UK and Italy is that, once the virus gets out of control, even if you put in very strong restrictions, if they're put in place too late they don't work the same way.

Australia is lucky that the virus hasn't gotten into very many nursing homes, we haven't had huge prison-based outbreaks, and it hasn't impacted our more vulnerable regional towns, Dr Snow says.

But that doesn't mean these sort of events couldn't occur in the future.

Dr Snow says the basics we keep being reminded about are going to be important all year, no matter what happens.

"That's going to be washing our hands regularly, minimising our physical contact with other people," she says.

"And if we are feeling even the slightest bit ill … it's going to be really, really important that we're not going to work and we're not going to social events."

No right or wrong way

"I think what we are doing is reasonable," says Sanjaya Senanayake, an infectious diseases specialist at the Australian National University Medical School.

"The issue is that there is no right or wrong way to do this.

But we do have the advantage of learning from what's happening elsewhere in the world.

Lifting restrictions slowly and keeping a close eye on the effects by testing extensively is the way forward, Dr Senanayake says.

The last restriction we should expect to see lifted is our international borders, and he reckons that's still a long way off.

"I think given the seriousness of this outbreak, it will be a while before a lot of social distancing measures are lifted. I, for instance, can't see people shaking hands for the rest of this year."

As for whether we have a chance of eradicating the virus?

"I'd like to see it. And I think we and New Zealand have got a better chance than anyone else at the moment."

But he says the likelihood is that it will stick around.

"But that doesn't mean that we continue doing what we're doing. Even if we lift the restrictions, we look hard for infections and any surge, we clamp down on any clusters and stop those people infecting other people."

'Australia has bought time'

There are two important criteria we should use to decide when coronavirus restrictions are eased, says respiratory physician Greg Fox of the Woolcock Institute of Medical Research.

The first is: are we aiming to eradicate or suppress the virus so that we can ensure it doesn't overwhelm the health system?

The second is whether the health system is ready to cope with any possible surges in the future.

"Australia's been very fortunate to have bought time to be able to prepare for this pandemic because of the rapid measures that were taken," says Dr Fox, who also works at Royal Prince Alfred Hospital.

That has allowed health systems around the country to prepare additional intensive care beds, to be able to do large-scale testing, and implement effective telehealth programs for community monitoring of people with mild symptoms.

"Based on those two criteria, I think that we are prepared," he says.

Lots of people sit on the grass at Kings Park next to a large row of tall trees.
How do we balance the health benefits of human connection and getting outside with controlling the spread of virus?(ABC News: Keane Bourke)

But Dr Fox cautions, we don't yet know what is going to be the impact of easing some of the restrictions that have been in place, because we don't know exactly which part of our response has been effective.

Singapore is a good example of how it's possible in any society — even if measures are put in place — for there to be pockets of transmission which can rapidly get out of control, he says.

Another important point is that Australia has only had a very small number of cases relative to our population.

"What that means is that 99.9 per cent of the Australian population is still susceptible to getting the infection," Dr Fox says.

"And so really, until either a vaccine is developed or until there's some more effective drug treatment, we're going to have to protect those 99.9 per cent of people from becoming infected if we want to avoid the worst outcomes."

A good thing for mental health

Almost everybody's wellbeing has been impacted by COVID-19, with lots of us reporting increased levels of anxiety, despair, and even grief at how life has changed.

The idea of being able to see friends and family once again, and spend more time outside is welcome news for our mental and emotional health, says Susan Rossell, professor of neuropsychology at Swinburne University.

"[Lifting restrictions] is definitely a good thing for people's mental health. It's been a very stressful few months," Professor Rossell says.

But she's urging people to take some caution when easing back into their social lives — not expecting too much too soon.

"There are going to be some very long-term ramifications and this is not going to go away in the next few months," Professor Rossell says.

"People have to really stay in the moment … and not get so excited as to plan big birthday parties or overseas trips, because that's not something that's going to happen straight away."

If people stopped seeking mental health care during the lockdown, or now feel they need some extra support, it's a good time to seek out help, Professor Rossell says.

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