The New South Wales government announced this week its roadmap for reopening once 70% of adults in the state are fully vaccinated against Covid-19.
Once that target is reached – expected to be in late October – double vaccinated people will be able to have indoor gatherings and return to pubs, gyms and entertainment venues.
But experts have advised the need for a cautious reopening, amid reports the NSW chief health officer, Dr Kerry Chant, wanted to delay reopening until 80% of adults in the state are double vaccinated.
NSW’s opening up will be an Australian test case for living with Covid. How does Australia’s reopening plans compare to other countries which have already eased restrictions, and what lessons might be learned?
UK
In the UK, prime minister Boris Johnson ended most Covid-19 restrictions in England on 19 July – dubbed “freedom day”. England reopened in the same week as the UK recorded 50,000 daily cases, its highest daily figure since January, and amid dire predictions from 1,200 scientists, who called freedom day a “dangerous and unethical experiment” that would give rise to new Covid variants. At that point, 67% of the the UK population over 16 had been fully vaccinated.
New daily cases in the UK dropped in July and August following the reopening – though never below 20,000. But Covid cases have since risen again – with a seven-day average hovering above 36,000 daily – as have hospitalisations and deaths. These latter two figures are far lower than the peak of the second wave, due to the protective effect of vaccines. At present, 80% of the adult population – 65% of the total population – is fully vaccinated.
This week, 8,000 people were in hospital with Covid – almost a six-month high – and there were more than 200 deaths on Tuesday, the highest figure since March. The government has said it would consider a two-week circuit breaker lockdown if the NHS becomes overwhelmed.
US
With 65% of the adult population fully vaccinated and amid high case numbers, the director of the National Institute of Allergy and Infectious Diseases Dr Anthony Fauci has warned it is too early for the US to see an end to the pandemic.
The country’s seven-day average is at 140,000 new daily cases, and Fauci has warned against easing restrictions until the case numbers drop below 10,000.
Many states have reopened. New York lifted restrictions on 15 June after 70% of adults had received their first dose of the vaccine. Cases there have since risen to more than 4,000 a day, and hospitalisations have also trended upwards. California, which similarly eased restrictions in June, has seen an increase in cases and hospitalisations.
US officials have described Covid as a “pandemic of the unvaccinated”. By the end of August, ICUs were more than 90% full in five states: Alabama, Arkansas, Florida, Georgia, and Texas. Of these, Florida has the highest double vaccination rate of 54%.
Denmark
On Friday, Denmark became the first country in the EU to fully lift Covid restrictions, with more than 73% of its total population double vaccinated. It was also among the first in Europe to impose lockdown restrictions last year.
Amid low hospitalisation rates, Denmark’s health ministry declared Covid was “no longer a critical threat to society”. Denmark is also doing away with its coronapas system, which helped the country reopen when it launched in April.
Prof Catherine Bennett, chair in epidemiology at Deakin University, said Denmark was able to bring down case numbers with an excellent vaccination rollout. “They got the numbers down to a level where they can live with it, a bit like NSW probably will look as they start to ease restrictions.”
Iceland
In Iceland, 72% of the total population – and 84% of people over 12 – is fully vaccinated. It lifted all domestic restrictions in June, but reimposed some in July following a rise in case numbers.
The Delta variant led to a spike in infections at the beginning of August, but there were few deaths as a result of the country’s high vaccination rate. The country has recorded a total of 33 deaths since the beginning of the Covid pandemic.
Israel
Israel lifted virtually all its Covid restrictions in June, when more than half the population was fully vaccinated. Its successful vaccination program had slowed new cases to a trickle, which have since surged with the Delta variant. On 31 August, the country recorded its highest ever daily infections figure of almost 11,000 cases.
The government has reintroduced measures to curtail the spread, including mask wearing indoors and limits on gatherings.
Bennett said: “They put so much emphasis on the vaccine, and it worked for the old variants, that they were sideswiped by Delta.”
Israel’s early reopening may have also slowed down its vaccination rollout: the proportion of the population who had received one dose increased from 50% in February to only 68% in September. Currently, 63% of the population is fully vaccinated.
The country has also begun giving booster vaccinations, with more than 2.5m third doses already administered to fully vaccinated people.
Singapore
With 81% of its total population fully vaccinated, Singapore has one of the highest Covid jab rates in the world. It announced in late August that it would shift from a zero-Covid strategy to living with the virus, when it reached the 80% threshold.
Despite its high vaccination rates, the country has been cautious in its reopening, said Bennett.
As some restrictions have eased, cases there rose this week to a one-year high. In response, the government has encouraged people to limit their social gatherings to one per day, is ramping up testing and has not ruled out reimposing restrictions.
“We are looking a lot to Singapore,” said Bennett. “We’ll learn a lot from them” particularly with regards to Covid testing in the community and how to “change your priorities to give you a level of sustainable control”, she said.
