Abstract
Background: Many parts of the world that succeeded in suppressing epidemic coronavirus spread in 2020 have been caught out by recent changes in the transmission dynamics of SARS-CoV-2. Australia's early success in suppressing COVID-19 resulted in lengthy periods without community transmission. However, a slow vaccine rollout leaves this geographically isolated population vulnerable to leakage of new variants from quarantine, which requires internal travel restrictions, disruptive lockdowns, contact tracing and testing surges.Methods: To assist long term sustainment of limited public health resources, we sought a method of continuous, real-time COVID-19 risk monitoring that could be used to alert non-specialists to the level of epidemic risk on a sub-national scale. After an exploratory data assessment, we selected four COVID-19 metrics used by public health in their periodic threat assessments, applied a business continuity matrix and derived a numeric indicator; the COVID-19 Risk Estimate (CRE), to generate a daily spot CRE, a 3 day net rise and a seven day rolling average. We used open source data updated daily from all Australian states and territories to monitor the CRE for over a year.Results: Upper and lower CRE thresholds were established for the CRE seven day rolling average, corresponding to risk of sustained and potential outbreak propagation, respectively. These CRE thresholds were used in a real-time map of Australian COVID-19 risk estimate distribution by state and territory.Conclusions: The CRE toolkit we developed complements other COVID-19 risk management techniques and provides an early indication of emerging threats to business continuity.
Highlights
Australia’s recent experience with COVID demonstrates how complex disease control becomes during pandemic decline
We took continuously reported data from each state and territory, and subjected it to multidimensional analysis to achieve a contemporaneous measure of risk. In this account we report our experience generating actionable COVID risk estimates continuously for over a year during the gradual decline of the national COVID epidemic, with interruptions by state-wide and multi-state outbreaks
As the first pandemic wave ebbed in every state and territory the seven day rolling average of the COVID risk estimate (SDRA) fell sharply (Figure 5)
Summary
Australia’s recent experience with COVID demonstrates how complex disease control becomes during pandemic decline. Australia’s early emergence from the first wave of the COVID-19 pandemic gave public health authorities reason to hope for disease elimination, but slow vaccine rollout and the emergence of new SARS-CoV-2 variants have dented that early confidence. We took continuously reported data from each state and territory, and subjected it to multidimensional analysis to achieve a contemporaneous measure of risk. In this account we report our experience generating actionable COVID risk estimates continuously for over a year during the gradual decline of the national COVID epidemic, with interruptions by state-wide and multi-state outbreaks. A slow vaccine rollout leaves this geographically isolated population vulnerable to leakage of new variants from quarantine, which requires internal travel restrictions, disruptive lockdowns, contact tracing and testing surges
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