Experts are calling for ventilation upgrades for schools and businesses, the vaccination of children, mask wearing and booster vaccines for frontline workers.
A new independent pandemic advisory group is warning high vaccination rates alone will not be enough to avoid a resurgence of
COVID-19 once restrictions are lifted.
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Professor Raina MacIntyre, head of the biosecurity research program at the University of NSW's Kirby Institute, is one of 48 expert members of new pandemic advisory group OzSAGE which says the spread of the virus will be "turbocharged" without additional measures.
"One area that has not been well addressed to date is ventilation and mitigation of airborne transmission, which is the dominant mode of transmission of SARS-Cov-2," Prof MacIntyre told InSight+, the weekly online news magazine of the Medical Journal of Australia.
NSW has announced an easing of restrictions once the state achieves 70 per cent full vaccination rates - expected in mid-October.
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OzSAGE is calling for a 'Ventilation and Vaccine-Plus' strategy for safely lifting COVID-19 restrictions, including urgent ventilation upgrades for schools and businesses, the vaccination of children, continued mask wearing and third-dose booster vaccines for frontline health workers.
Other recommendations include mask mandates for all school children and the approval of rapid antigen home test kits.
OzSAGE also wants a higher target for full vaccination before restrictions ease, nominating 80 per cent or more of the population aged 12 years and over, rather than the adults only at 70- 80 per cent that is in national plan, and which corresponds to just 56-64 per cent of the whole population.
"Without ventilation, vaccine-plus and higher vaccine uptake, reopening at [the proposed] levels will turbocharge COVID-19, as seen in countries that lifted restrictions at about 60 per cent whole population vaccination rates," the group wrote in a report supplied to federal and NSW government stakeholders.
OzSAGE says vaccines are highly protective against severe disease but also warns that increasing evidence suggests efficacy wanes after about six months.
"Our health workforce was vaccinated in March 2021, and its immunity may be waning just as the COVID-19 epidemic in NSW surges," the report says.
Professor Guy Marks, a respiratory physician and OzSAGE member, said that in the short to medium term vaccination alone would not end the increase in cases.
"We need to do lots of different things - mask wearing, improving ventilation in indoor spaces, retaining some restrictions on mixing," he said.
For frontline health workers in southwest and western Sydney, the likelihood is that things will get worse before they get better," he said.
"Without the workforce, we won't be able to deliver the care," he said.
"Anything we do that does not achieve that is going to have serious consequences."