Even as Victoria's daily coronavirus case numbers show signs of stabilising, other grim records of hospitalisation rates and daily deaths are being broken in the state — a trend which experts say may continue.
Victoria today set a grim new record for deaths from COVID-19 in a single day, reporting 19 deaths.
By Sunday, there were 1,748 active cases linked to aged care; a mix of residents, staff and to a smaller extent, their close contacts.
Speaking before today's death toll was released, Mary-Louise McLaws, an advisor to the World Health Organization and UNSW epidemiologist, said the number of infected aged care residents meant the state should prepare for a "large number" of further deaths.
She said without data of how the residents were presenting their symptoms, and their underlying health conditions, it was difficult to know how many would be expected to recover.
But she said more coronavirus deaths connected to aged care facilities would be certain.
"Victoria needs to brace itself for more grief," Professor McLaws said.
About one death for every 100 cases in Australia
There have been signs the stage 4 lockdown in Melbourne and stage 3 stay-at-home orders across the rest of Victoria are stabilising the number of daily cases and have prevented new infections.
Australian National University infectious diseases physician Peter Collignon said the curve was being flattened, and with the additional restrictions "it should be turned around".
But he said about one death occurs for every 100 cases in Australia, and deaths lagged behind notifications of new infections by about two weeks.
The number of people in hospital has been steadily climbing as cases have risen, up to the record-high 591 hospitalisations on Sunday.
Of those in hospital, 43 were receiving intensive care, including 29 on ventilators, Mr Andrews said.
Professor Collignon co-authored a May study comparing Australia's COVID-19 fatality rate to that of South Korea's.
The "crude" mortality rate of 1.4 per cent for Australia was based on data from late January to mid-May — lower than the rate of 2.4 per cent determined for Korea.
The study found as the age of the patient increased, so did the mortality rate, with a rate of about 20.1 per cent for people aged over the age of 80.
Professor Collignon said the second wave in Victoria was much bigger than when the study was completed, meaning there was the possibility more cases were not being detected.
Authorities are still concerned by the number of "mystery" community transmission cases, where the infection cannot be traced back to a known source.
Professor Collignon said the large number of nursing home residents, who are more likely to have underlying health issues, was also playing a role.
"The fact that this has gotten into nursing homes in Victoria … means the mortality rate may be higher," he said.
Whether deaths have peaked could depend on the ages of new cases
Melbourne University epidemiologist Tony Blakely said the lag time between new infections being detected and people becoming seriously ill "would suggest deaths are yet to peak".
The state's three highest daily increases were recorded in the week between July 30 — with 675 infections recorded — and August 5 — an all-time high of 725 new cases.
But Professor Blakely cautioned it depended on the age profile of those who were being diagnosed with COVID-19.
For instance, he said, if the rates of older people getting infected peaked as the virus spread through aged care homes, "then we may have already peaked" if numbers are now trending younger again.
The Victorian Department of Health and Human Services (DHHS) does not provide an age breakdown for each daily case.
Professor Collignon agreed the age of confirmed cases would have an impact on how the next few weeks would play out in Victoria.
"Young people are not immune from getting the virus and having quite severe complications, they just happen to do it less often than people over the age of 80," he said.
He said preventing deaths came down to "the basics" — preventing the virus from spreading in droplets by staying away from each other and practising good infection control.
