Vaccines and antivirals not enough to combat Australian Omicron surge, experts warn | Omicron variant

Doctors have urged Australia’s political leaders not to rule out reinstating mask mandates and social distancing if chief health officers back these measures to combat rising hospitalizations from the winter Omicron wave.

The president of the Australian Medical Association, Dr Omar Khorshid, said it was important politicians did not block such measures if that was recommended by their medical experts.

He said the measures could prove necessary, despite the federal health minister, Mark Butler, seemingly ruling them out.

Khorshid made the comments as concern was raised that governments were relying too heavily on pharmaceutical measures, such as antivirals and vaccines, to get Australia through the latest surge of Covid-19 cases being driven by the Omicron variant. The pressure on hospitals has already led to some elective surgeries being canceled in Queensland, and paramedics in some states have become overwhelmed.

From Monday, anyone aged 30 and over is eligible to receive their fourth vaccine dose. Meanwhile, the government has expanded eligibility for antivirals that prevent those at highest risk of death from developing severe disease.

Khorshid said this would go “some way” to reducing infections and easing the burden on hospitals.

“But the big issue we have is that an awful lot of people haven’t had their third dose yet,” he said.

“It’s hard to imagine those people going and having a third dose now just because there’s a fourth dose available.”

Chart showing the number of people hospitalized with Covid in Australia, showing the largest peak in January 2022, followed by an emerging peak in July 2022

Khorshid added public health measures combined with pharmaceutical measures would bring cases down further.

Butler said on Monday that Australia had “moved beyond those community-wide mandates, whether they’re lockdowns or mask mandates”.

But Khorshid said “mask mandates in some areas and some level of social distancing may well be necessary”.

“If [politicians] do block it, they need to be really clear and transparent about what advice they’ve received from the chief health officers and why they have gone against it. They should make sure economic considerations, or political considerations, aren’t being placed higher than health issues. Because it’s not just people with Covid who suffer from this pandemic. It’s actually anybody needing hospital care at the moment.”

Khorshid said the government clearly wanted people to take Covid-19 seriously and to get boosted, yet more could be done to have a measurable impact on infections and deaths.

“I’m still really concerned about the mixed messages coming from government,” Khorshid said.

“They’ve pulled Covid leave. They’ve pulled telehealth access for extended appointments at a time we’re about to see a surge in cases. Clearly, we need people to be able to access their GP to get their antivirals, and yet the government have reduced access, which is just a very strange decision and we’re continuing to call on the minister to reverse that decision.”

While short telehealth appointments are still available, among the telehealth-related services now cut are initial and complex specialist items, and GP consultations that last longer than 20 minutes.

Covid battle being fought ‘with only two weapons’

The vice president of the AMA, Dr Chris Moy, who is also a GP, said vulnerable Covid patients needing access to life-saving antivirals also needed extended telehealth consults. He said this was because the antivirals could interact with other medications, making prescribing the medicines complex.

“It takes 20 to 40 minutes to prescribe them at least, and I know because I do it all the time,” Moy said.

“So the government wants to increase access, but they’re making it harder for GPs to do it. They’ve also stopped the subsidy to pharmacies to deliver the medicines to patients who are isolated. So it makes my job even harder because then I have to call their relatives and arrange for them to pick it up and somehow get this medicine to the patient.”

Moy said public health units were increasingly fearful about rising hospitalisations. “The fear-o-meter is through the roof,” he said. “And yet for governments, mask mandates are Voldemort at the moment, they shall not be named.

“On the one hand, the public is hearing from government Covid is serious and we need to get boosters. On the other hand people are hearing, it’s not serious enough for mask mandates.

“The entire Covid battle is being fought with only two weapons; expanded eligibility of vaccines and antivirals. It’s ridiculous.”

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Kirby Institute virologist Prof Stuart Turville said expanded access to a fourth dose “will help level the immune playing field”, because there may be some people who are immunosuppressed and who don’t respond well to two or three vaccine doses, but who don’ don’t realize that they have underlying conditions and are at risk.

“With the absence of mass testing for immune responses, access to a fourth dose will help level the immune playing field, with those at risk, whether they know it or not, covered better,” he said.

But he added “better uptake of mask usage” would also help.

“I realize those who are immunocompromised have already been advised to wear a mask,” he said.

“That said, if the BA.5 wave gets on the high side, others wearing a mask will be a ‘belt and braces’ approach to help those at risk.”

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