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Lucky break or gold standard? How NSW got Covid under control

<span>Photograph: Loren Elliott/Reuters</span>
Photograph: Loren Elliott/Reuters

In late December, the phrases #GladysCluster, #GladysTheCovidiot and #GladysOutbreak began to trend periodically on Twitter, as some users of the social media platform began calling on the New South Wales premier to #LockNSWdown.

It was a response to a slowly growing but concerning number of cases and clusters of Covid-19 in the New South Wales community. After weeks of no reported community cases of the virus, a man from south-west Sydney tested positive on 16 December. He had been working as a van driver shuttling airline crew between Sydney airport and their accommodation.

By the end of that day, two further cases were announced, affecting Sydney’s northern beaches. Over the ensuing weeks, the outbreak grew in the northern beaches and another cluster broke out centred around the Berala BWS bottle shop in western Sydney, with other cases appearing as far away as the Blue Mountains, Wollongong and Orange. By mid-January, the summer outbreaks had reached a total of 217 cases.

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(January 25, 2020) First novel coronavirus case detected

The first case of novel coronavirus, which will later be named Sars-CoV-2, is identified in Australia, in a traveller who flew from China to Melbourne.

(February 1, 2020) China travel ban

Prime minister Scott Morrison announces foreign arrivals from mainland China will not be allowed entry into Australia, as part of measures to tackle the escalating crisis.

(March 1, 2020) First person to die of Covid-19 in Australia

James Kwan is the first person in Australia to die after being diagnosed with Covid-19. The 78-year-old Perth man was a passenger on board the Diamond Princess, a cruise ship that was forced to quarantine in the Japanese port of Yokohama in February.

(March 3, 2020) First community transmission

Australia reports its first community transmission of Covid-19 in a 53-year-old health worker diagnosed in New South Wales.

(March 12, 2020) Pandemic declared

The World Health Organization declares a pandemic.

(March 19, 2020) Ruby Princess docks

The Ruby Princess cruise ship is given permission to dock in Sydney and passengers disembark. Over the coming weeks, more than 900 virus cases and 28 deaths will be linked to the ship, including 20 deaths in Australia and eight in the US.

(March 20, 2020) International travel ban implemented

An international travel ban comes into force. Domestic travel is discouraged.

(March 23, 2020) Widespread lockdown begins

Widespread closure of businesses begins across the country, with only supermarkets and other essential services remaining open. Working from home begins, with only essential workers allowed to leave their home for work. People are told to stay at home to slow the spread of the virus. Australians are told these measures could last six months. Most schools are closed.

(March 28, 2020) Mandatory quarantine begins

All returning international travellers are now required to undertake 14 days of quarantine in hotels managed by the states and territories. Previously, travellers were asked to self-isolate.

(March 4, 2020) Western Australia closes its borders

For the first time, Western Australia closes its border to the eastern states. The measure takes effect from 11.59pm.

(April 8, 2020) Wage subsidy package passes parliament

The government’s $130bn wage subsidy package, including jobkeeper, passes both houses of parliament. It follows childcare being made free by the government earlier in the month.

(April 9, 2020) Australian cases fall

Throughout the month Australian cases continue to fall and modelling shows the curve is being flattened.

(May 8, 2020) Morrison announces national 'roadmap'

Morrison announces the national cabinet’s three-stage ‘roadmap’ to ease Covid-19 restrictions, with this to occur sooner than anticipated due to continuing low case numbers. Some states – Queensland, South Australia and Tasmania – indicate their own initial changes to restrictions.

(June 30, 2020) Spike in Victorian cases

Ten Victorian postcodes go back into lockdown from midnight and international flights coming into Melbourne are diverted elsewhere, as the state struggles to get on top of Covid-19 outbreaks and community transmission. It will later emerge the virus leaked into the community out of hotel quarantine.

(July 8, 2020) 191 cases of Covid-19 recorded in Victoria in a 24 hour period

The greater Melbourne area and Mitchell shire also return to lockdown after Victoria records 191 new cases of Covid-19 in 24 hours, the largest number of positive cases since the pandemic began. Premier Daniel Andrews says he knows “there will be enormous amounts of damage that will be done because of this”.

(July 10, 2020) States other than Victoria begin to ease restrictions

States and territories aside from Victoria start easing more restrictions, after a national cabinet meeting, but these restrictions will ease at different times depending on the jurisdiction.

(July 22, 2020) Face masks made mandatory in Victoria

From 11.59pm masks are made mandatory in Victoria. The fine for not wearing a face covering is $200.

(August 2, 2020) State of disaster declared in Victoria; curfew implemented

Andrews declares a state of disaster in Victoria halfway through what is supposed to be a six-week lockdown. He implements a curfew for greater Melbourne and Mitchell shire residents, and people are not to travel outside of a 5km radius from their homes. Regional Victoria is also placed under lockdown restrictions.

(August 6, 2020) Victorian 'roadmap' revealed

As cases fall in Victoria the state government reveals a roadmap for easing lockdown restrictions. Face masks will remain compulsory.

(October 18, 2020) Restrictions ease across Victoria

From 11.59pm a number of restrictions begin easing across Victoria.

(October 26, 2020) First 'donut day' in Victoria since June

Victoria records the first day of zero new cases of community transmission since 9 June.

(December 10, 2020) Australian government terminates vaccine agreement with CSL and University of Queensland

The Australian government terminates its agreement with Australian biotech company CSL to supply 51m doses of a Covid-19 vaccine being developed by the University of Queensland, after vaccine trial participants return false positive test results for HIV.

(December 16, 2020) Spike in NSW cases

NSW records three cases of locally-acquired Covid-19, including an airport bus driver from south-west Sydney and two people in their 60s and 70s from the northern beaches.

(December 29, 2020) Victoria records 60 consecutive days of zero cases of community transmission


(January 1, 2021) Victoria closes border with NSW

Eight cases of community transmission of Covid-19 in Victoria prompt the state government to swiftly close the border with NSW and introduce new restrictions.

(January 7, 2021) Government announces vaccine rollout

The federal government announces it will bring forward the rollout of the Covid-19 vaccine in Australia to February, and aims to have four million people receive the first dose by March.

(January 8, 2021) Queensland lockdown following B117 variant detection

Queensland premier Annastacia Palaszczuk announces a three-day lockdown of greater Brisbane after a hotel quarantine worker is infected with a concerning and more transmissible variant of Covid-19 known as the B117 variant. The federal government announces new testing requirements for travellers triggered by fears of the variant entering the Australian community.

(January 14, 2021) Queensland considers using mining camps to house returning travellers

Fears about a cluster of Covid-19 cases spreading within a Brisbane quarantine hotel grow, as the Queensland government considers using regional mining camps to house returned travellers.

But not long after, on 26 January, NSW marked eight days in a row without any new cases of the virus in the community.

NSW’s containment was achieved without the premier, Gladys Berejikian, resorting to the drastic statewide lockdowns or business closures that many called for. Instead, the NSW approach was to focus lockdowns on the most affected suburbs and to reintroduce limits on indoor and outdoor gatherings without banning them altogether.

Manly beach on Sydney’s northern beaches on 26 December during a localised lockdown as NSW tried to contain the so-called ‘Avalon cluster’.
A sign on Manly beach on Sydney’s northern beaches on 26 December as NSW tried to contain the so-called ‘Avalon cluster’. Photograph: Dan Himbrechts/EPA

It is not the first time NSW has contained an outbreak with potential to spiral beyond control. The Ruby Princess, a cruise ship that was authorised by federal and state authorities to dock in Sydney in March, led to hundreds of cases of the virus in NSW and 28 deaths. But by 28 May, the state reported no new cases of community transmission of the virus, averting a lasting disaster. Victoria did not reach the same milestone until 6 June and would later go on to experience a second wave.

In July, NSW experienced another scare after two cases of Covid-19 announced on 10 July were found to have attended the Crossroads Hotel in Casula. The Crossroads Hotel cluster grew, and by 1 August, 14 new community cases were announced and one death was linked to the venue. Another cluster linked to the Thai Rock restaurant was announced on 17 July and grew to more than 150 cases by 19 August.

Yet by 27 September, NSW was back to reporting no new cases of community transmission. While further cases were reported during October, the spread was largely contained. It took four months to stamp out completely, but NSW Health managed the outbreak by regularly updating venues of concern and relying on contact tracing and testing to manage persisting cases of community transmission.

Many health experts agreed it was not just excellent contact tracing but good luck that led to these outbreaks being contained.

Large crowds queue in their vehicles at a Bondi Beach Covid-19 drive-through testing clinic on 22 July 2020 as health authorities work to contain several cluster outbreaks linked to virus strains in Victoria.
A drive-through Covid testing clinic at Bondi Beach on 22 July as health authorities worked to contain several NSW clusters linked to virus strains in Victoria. Photograph: Lisa Maree Williams/Getty Images

NSW tolerated low levels of community transmission, many of them linked to known cases, until 16 December when the northern beaches cases emerged. The NSW response to the outbreak came down to enormous confidence in its contact tracing system and ability to track cases. The prime minister, Scott Morrison, told reporters on 17 December: “NSW is the gold standard [of contact tracing]. I don’t spend too much time worrying about NSW.”

Berejiklian even allowed modest increases in visitors to people’s homes for Christmas Day as Covid clusters grew, saying mental health needed to be considered.

Related: Pfizer Covid vaccine approved for Australia rollout but PM warns jabs not 'a silver bullet'

The feared large outbreak of cases over Christmas and New Year never eventuated. NSW appears once again to have contained the virus, although Berejiklian has repeatedly said many times that testing rates need to be much higher before the state can rest easy. However, she has been confident enough to reduce the already minimal restrictions. So can the success of NSW still be put down to luck?

The chair of epidemiology at Deakin University, Prof Catherine Bennett, said: “I think what NSW has done really well is taken a nuanced approach, and tailor their approach to wherever the outbreak is, whatever the challenges are, whatever the opportunities are, and to put the restrictions in place as needed. And it’s proven to be enough.”

Bennett said most of the outbreaks in NSW had been contained within three to five generations of spread, which she described as a “good hallmark of strong containment”. But Bennett said where NSW failed was in its approach to masks.

Despite calls from peak medical bodies and infectious diseases physicians, Berejiklian did not mandate masks until 4 January. Even as the number of cases has dwindled in NSW, masks now remain mandatory for many indoor settings, in airports and on flights, raising questions as to why they were not mandatory when case numbers first began increasing.

The situations in Victoria and NSW proves there’s multiple ways to get to the same outcome.

Prof Catherine Bennett

“NSW weren’t gold standard on masks,” Bennett said. “Mandatory masks might have meant the person who went to the BWS store while infectious had a mask on and the person serving them had a mask on, and that might have been enough to stop the Berala cluster. We’ll never know what might have happened but I would argue, at least, the number of people infected through the BWS cluster could have been smaller or prevented in the first place.”

A sign on a light rail service in Sydney on 18 January warns passengers to wear a face mask.
A sign on a light rail service in Sydney on 18 January warns passengers to wear a face mask. Photograph: Joel Carrett/AAP

Bennett said it was difficult to compare the responses of Victoria and NSW given the differences in the outbreaks. In Victoria, for example, the virus got into high-risk and essential workplaces such as healthcare, aged care and abattoirs, which meant even lockdowns could only do so much to contain the spread.

“I think we have to we see every outbreak as a learning exercise even when we ‘win’ at containing it. The situations in Victoria and NSW proves there’s multiple ways to get to the same outcome, and we need to learn from both.”

Related: New UK and South Africa Covid variants may spread more easily, so what does this mean for the fight against coronavirus?

Epidemiologist and associate professor in public health with La Trobe University, Hassan Vally, said “time and time again” NSW had shown it could keep the virus under control.

But he said he believes luck is still playing a role.

“Yes, the state brought things under control without a wide-scale, lengthy lockdown so all credit to them,” Vally said.

“But if you are successful you can’t assume you can take that approach every single time and it will turn out well. If NSW had that situation 10 times over, 10 out of 10 would it have worked? The way randomness works, maybe it could have got away with them. We just don’t know.

“But you’ve got to give credit where credit’s due. At the end of the day, they got transmission under control, and that’s a really positive thing for NSW and also for Australia.”