Hello, I’m Paul Richards with the Latest from Science.
After flattening the curve of COVID-19 cases in Australia, states and territories have
begun easing restrictions. Guiding decisions on easing restrictions is the Roadmap to Recovery
report, by more than 100 researchers. The two strategies that have been presented include
elimination and controlled adaptation.
Here to explain some of the details is Australian Academy of Science Fellow and past President
of the Australian Health and Medical Sciences, Professor Ian Frazer.
Welcome Ian. Welcome Paul. It's good to be with you again.
Now, based on the current figures, is it feasible that Australia could eliminate COVID-19 without
a vaccine and what needs to be done? Paul, I think it is now feasible that we could
eradicate the virus from Australia. It's not an easy task because it will require the cooperation,
for quite a considerable period of time, of all of the people of Australia. But we've
managed to get the number of new cases in many of the states down to zero over several
days. And if we can go about doing rigorous testing, contact tracing and getting people
to comply with the various restrictions that were put on their movements and behaviour
up until now, within two or three months, we could declare that we have no remaining
cases of COVID-19 in Australia.
That's quite exciting to have reached that point. Now in relation to, I guess this next
phase then as we're sort of controlling the number of cases. This report that's been produced,
Road to Recovery, can you explain controlled adaptation and is it the same as suppression
or reducing transmission?
Effectively, yes. I mean the adaptation is the idea of Australia living in a world where
there's a lot of coronavirus outside of Australia and we're doing our very best to make sure
that there's not a significant amount within Australia. Again, the requirement is very
much the same. It requires people to follow the rules their given for probably an indefinite
period of time, but more importantly, lots of contact tracing, lots of testing to make
sure that should there be a case or two in Australia, we can bring fences and make sure
it doesn't become more of an epidemic. Of course, for both of the two strategies and
the report, it's also necessary, effectively, to close the borders, to stop people coming
into Australia without being screened in quarantine for a lengthy period of time.
What are the benefits of elimination compared to controlled adaptation?
Eventually, it's almost the same thing. But elimination would probably feel more normal
because we could go about all of our activities of normal life in Australia. The contact tracing
and screening would have to still be there in the background in case we had a case or
two that came in from outside. But for practical purposes, we would feel we were back to normal
within Australia. The difference between now and then would be significant. On the other
hand, the difference between what it would then be like and what life was like before
would be that we would be an island in a sea of coronavirus infections. So that we would
really have to see our borders are closed.
In terms of these methods then, do you agree with those approaches and those descriptions?
Is there, is there another method, or do you favour either of them?
There are two challenges I see with either of the two proposals and with any other approach
to some extent, but one is that both of them are in the long run dependent on us developing
a vaccine. And if there is no vaccine then there will be no reduction in the external
burden of infection around about Australia and there will always be the chance that the
virus will come back in through some accident of people arriving from the wrong place at
the wrong time. So, as a strategy to get everything back to normal, it does eventually depend
on the development of an effective vaccine and it's global delivery. And the development
of a vaccine within the next year or so might be possible, but if you start thinking about
global delivery of vaccines, then we're really not that good at it. We struggled to deliver
the standard childhood vaccines across the whole planet in an effective manner.
And we keep having outbreaks with common infectious diseases like measles and also more serious
ones like polio, despite all the global effort to get universal vaccination. So universal
vaccination is going to be really hard. The second thing of course, is it actually depends
on the compliance of everybody within Australia with the rules. It just takes one person to
take a boat off from Australia to one of the near neighbour islands, come back with the
virus and the campaign stops. And it's really quite hard to expect everybody to behave in
a perfect manner over the course of a period of time.
So we have to think about whether there really is another alternative. And the only other
alternative that makes sense is to allow the gradual spread of infections through the community
in a way that doesn't overload the health system until we actually build up herd immunity.
That, of course this means that there will be more deaths than been carrying through
either of the other two possible approaches. That also is to some extent a risky one because
we really don't know how well the natural immunity after infection is going to last
and until we have those information, it's really very hard to decide between the three
different alternatives. In the short term, I suspect that the basically controlled adaptation
approach will be the one that we will choose to adopt because it allows people to go about
their natural lives in a more effective way and accepts that there may be the occasional
case occurred within the country. The big challenge with that will be for the impact
on the economy, given that it will not be easy for people to move in and out of the
country. We do repat. We send a million people every year or every day. I think it is overseas,
something like that. And so it's very important part of the Australian business life.
Well indeed that controlled adaptation method seems to be what is now occurring with some
states starting to ease restrictions. Is that a sign that we're, in some way, out of the
woods, and how should the public, I guess, respond to the fact that restrictions are
being eased?
Look, I think we are in a very good position in Australia, unique almost across the world,
that we have got to the stage that we've been through an epidemic. We've got rid of it,
come through people behaving appropriately and testing and containment. We've managed
to get the disease largely under control in Australia. And I think we will be able to
maintain that, but it's still worrying that within the last couple of weeks we've had
two significant outbreaks in healthcare facilities amongst particularly vulnerable populations
that we didn't manage to prevent. And there will continue to be such outbreaks for sure,
regardless of how we look about trying to control things.
Can you give me any update now, Ian, on the work being done on vaccines from the University
of Queensland and beyond? We're very fortunate that we have got great
vaccine technologies available now that were simply not available 20/30 years ago. And
within Australia there are several vaccine programmes under development, including one
at the University of Queensland, based on what I would regard as one of the best possible
techniques for making such a vaccine because it's a protein based vaccine using what I
would regard as fairly standard and routine technologies for developing a vaccine. So
I would guess that would be one that would have a high chance of success if any vaccine
is going to work. But worldwide there are over 80 known vaccines under development and
using all of the available technologies, (we have essentially five quite different technologies),
we're developing vaccines now and one or other of them I'm sure will give some sort of protection.
Whether any of them will end up giving us lifelong protection against the infection
is another matter because that depends on the nature of the immune response and control
will prevent infection. But yes, the progress is good. The University of Queensland vaccines
demonstrated that it can neutralise the virus in animals and that's probably the most important
first step towards getting a vaccine to humans. It still doesn't show up in a process of a
minimum of a year if we're going to demonstrate safety, efficacy and then scale up for production
so you can start immunising the general public.
While we're waiting for a viable vaccine, where do you see the most exciting research
taking place at the moment?
It was very exciting to hear that the first positive result from a drug study given to
patients with the infection, which appears to have shortened the course of the disease,
a drug called Remdesivir, which is an antiviral agent which has been developed for Ebola virus,
in fact has the insurance to be at least at some level effective. Not yet at the level
you could say, "Wow, we've got a potential treatment for this disease". But it does mean
that there is a weakness in the virus that can be targeted and maybe with better drugs
developed with Remdesivir as a model, we can get to the stage where we can get a drug which
will be as good as the treatments we now have for controlling for example, HIV infection.
Whereas 20 years ago we were struggling to find a single drug that would be useful.
Alright Ian Frazer, thank you very much for your time.
Thank you. Thank you Paul.
And if you have a question about COVID-19 just send us a message on social media. Or
head to our website science.org.au. I'm Paul Richards, see you soon.