The pandemic's progress
25 September 2021
Vaccination
The national progress of vaccination is in two graphs below – updates of graphs we have been showing every two weeks. The only difference is that they now include, starting from a small base, people aged 12-15. The first graph shows the percentage of people, by age group, who have had at least one dose of vaccination. It is reasonable to assume that everyone with one dose will go on to get a second dose.
The second graph is of full (two-dose) vaccination. Note the strong growth in vaccination over the last two weeks in almost all age groups, particularly people under 70, who have served their time waiting for a second dose.
For both single-dose and full vaccination, the percentage of people vaccinated is growing at roughly one per cent every two days. There is considerable variation in the pace of vaccination between different states and territories, however. New South Wales and the ACT are on the same track to reach the vaccination targets in mid-October (“70 per cent”) and late October (“80 per cent”), with most other states reaching these targets in mid-November and early December. But note that these targets refer to the adult (16+) population. They actually equate to 56 and 64 per cent of the whole population, or, re-framing to focus on the percentage of the unvaccinated, to 44 and 36 percent of the population still unvaccinated.
New South Wales and Victoria
It is safe to say that infections in New South Wales are not rising. They may even be falling. But in line with the state government’s apparent laxity in controlling infections, and indifference abuot imposing a heavy load on the health care sector, the construction industry is permitted to return to 100 per cent capacity from Monday, regardless of workers’ vaccination levels. Is it that New South Wales construction companies, unlike their counterparts in Victoria, are models of civic responsibility determined to abide by public health orders?
Cases in Victoria are still growing. So far it looks like exponential growth, but it may have slowed in the last few days. (The equation for Victoria’s number of infections is N = 9.3065e0.917, where N is the number of days since August 5. The coefficient of correlation of 0.978. The doubling time so far has been 8 days.)
Cases in the ACT are not shown. Following an initial surge, they have stabilised at around 17 cases a day suggesting that the reproduction number R is pretty close to 1.0. That’s in spite of a tough lockdown with a largely compliant population and the highest rate of full vaccination of all states and territories – “60 per cent” (48 per cent of the whole territory population)
The main issue is about what happens in these states when they start to open up as those “70 per cent” and “80 per cent” targets are met next month. In light of emerging findings that the Delta variant is not only more transmissible but also more virulent – more likely to hospitalise or kill – than the original variant, Tony Blakely and a team of researchers at the University of Melbourne have developed what is essentially an update of the Doherty model: 2022 will be better: COVID-19 Pandemic Tradeoffs modelling.
It’s a warning about the folly of opening up substantially at the “80 per cent” target (actually 64 per cent). We can do it while putting not too high a load on the hospital system, but in order to contain the hospital load at this level, we would have to be in lockdown for more than half the year. “We have to do better than this”.
To do better we must increase vaccine coverage to 90 per cent of adults and children. That will “slash the hospitalisation and death rates by about 80%, and we will most likely have no time in lockdown at all (so long as we keep moderate public health and social measures in place at all times).” It would also require strong border controls to reduce the incursion of vaccinated but infected arrivals – many of whom would be asymptomatic carriers.
Those moderate public health and social measures to which he refers include a third dose of mRNA for all those double-dosed with AstraZeneca, improved air filtration in buildings, ongoing use of masks, mass testing on occasions when infection is rising, and technological improvements to improve tracing. In a message that seems to be addressed to those policymakers who are putting too much faith in vaccination alone, the report states:
It is critical to note that it is not the vaccination coverage alone that determines what opening up and 2022 will be like. Rather, it is the full package of measures – of which vaccination coverage is just one. Public and policy discourse should reflect this reality.
The report is detailed. The authors include an online model, in which the user can plug in his or her assumptions about vaccination coverage, policy objectives and levels of restriction, and track the path of infections over 80 weeks. For those who would prefer a general summary Tony Blakely is interviewed on ABC Breakfast – The recipe for a better 2022 – where he covers the main points. (10 minutes.)
Who doesn’t want to be vaccinated?
“Vaccine hesitancy” – a term for those who are unwilling to be vaccinated or who don’t know, peaked in April this year at 35.4 per cent and had fallen to 16.7 per cent by September 12 (9.4 per cent “unwilling”, 7.3 per cent “don’t know”), according to survey data shown in he Melbourne Institute’s Vaccine hesitancy tracker. Unsurprisingly people in New South Wales and Victoria are more willing to be vaccinated than people in states that are still free of the virus. Also there is much more hesitancy among younger people than among older people.
The Melbourne Institute has also surveyed Australians about attitudes to forms of vaccine mandates. Most of us (57 per cent) believe businesses have a right to deny service to the unvaccinated, and 50 per cent of us believe the government should require businesses to deny service to the unvaccinated. Its most telling finding is a disaggregation, by industry of people’s employment, of answers to the question “are you willing to be vaccinated?”. At one end of the scale are those who work in the “professional, scientific and technical services” sector – only 8 per cent “hesitant”. At the other end are those in the “construction and utilities sector – 35 per cent “hesitant”. Workers in “wholesale trade, transport, postal and warehousing”, a sector that includes truck drivers, also exhibit high hesitancy – 29 per cent.
The world
Worldwide 60.2 percent of the population has received at least one dose of vaccine, and 38.8 per cent have received two doses.
The lowest levels of vaccination are in Africa: in Nigeria and Ethiopia, Africa’s two largest countries, less than one per cent of the population has been fully vaccinated. In India, a country with its own vaccine manufacturing capacity, only fifteen per cent of the population has been fully vaccinated.
The WHO Weekly Epidemiological Update shows a declining number of Covid-19 deaths, but we know these figures are heavily biased to “developed” countries that keep reasonably reliable death statistics. Even within this qualification, it is extraordinary that the USA, which is considered to be “developed” by some criteria, had 24 per cent of the world’s deaths last week, even though it has only 4 per cent of the world’s population.
The scatter diagram below is an update of the same diagram from previous weeks, of vaccination levels and recent death rates in high-income “developed” countries. The green markers are islands that have had strong border controls. We have added Portugal because it now has achieved 83 per cent vaccination – around the level urged by Tony Blakely and much higher than our governments’ 80 per cent of the adult population target (i.e. only 64 per cent of the population).
We have left the USA off the chart this week, because at 6.1 daily deaths per million it would be way off the scale, visually squashing all other countries’ markers along the X axis. That’s American exceptionalism. A daily death rate of 6.0 per million would equate to about 60 000 deaths a year in Australia, while a rate around 0.5 per million, as achieved in many countries, would equate to about 5 000 deaths a year in Australia.
In presenting these figures we note the usual caveats. Different countries have different levels of public health and safety regulations and levels of compliance, and in many European countries there would be a substantial number of people who have already contracted Covid-19 and would therefore have some level of immunity.
In updating these diagrams every two weeks we note that many countries in Europe and the USA are making only slow progress in getting past 60 to 70 per cent vaccination. In fact the USA seems to be stuck at around 55 per cent vaccination.
Data sources
See our separate web page of hyperlinks to generally reliable information and analysis about Covid-19, including data on vaccination and the WHO Covid-19 epidemiological updates.