Australia: COVID's escape from Sydney is a nightmare scenario. Could a 'ring of steel' have stopped it?

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Emily Swift spent two days this week cancelling reservations for events and tastings at her family's award-winning winery near Nashdale, a few minutes' drive west of the NSW town of Orange.

It's a devastating blow, says Swift, who estimates 70 per cent of Printhie Wines' business has disappeared in the past month as COVID-19 first locked out tourists from Sydney and this week shut down to all customers after two removalists and a truck driver carried COVID-19's Delta variant into the region.

"We've had all our events cancelled pretty much up until Christmas now. The loss of income overnight is dramatic," says Swift. Printhie Wines is now relying on its online business and strategies learnt during the 2020 lockdown to keep afloat.

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It had been a bumper year for many businesses in Orange, a boutique food and wine town built into the fertile slopes of an extinct volcano. With international and even much interstate travel on hold, travellers from cities like Sydney and Canberra had turned to tourism jewels closer to home. Orange — with its vineyards, quality restaurants and gorgeous landscapes — was a popular choice.

"The main street was busy, the restaurants were packed," says Joanne McRae, who has found herself at the heart of the town's COVID crisis as both a councillor with Orange City Council and manager of a local GP clinic.

But the shopping strip is now quiet and closed signs hang on most shop windows.

The lockdown — that swept up the neighbouring Cabonne and Blayney council areas too — was implemented with lightning speed on Tuesday, McRae says, catching even the council off guard with many first hearing of the NSW government's decision from the media.

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A nightmare scenario

COVID-19's escape from Sydney into regional centres like Orange, as well as from Melbourne to Mildura near the Victorian-NSW border and Adelaide Hills in South Australia, is a nightmare scenario in many ways.

It provides opportunity for the Delta variant to spread into more remote communities that are often home to vulnerable demographics – retirees, Indigenous communities and lower socio-economic groups – where medical resources are already stretched.

Yet while you might expect Orange locals to be angry that their thriving town has been crippled by a failure to contain the virus, the mood is one of disbelief.

"No one could believe that these removalists would knowingly come to a regional area while positive," says Swift. "Everyone was incredibly disappointed that someone made that decision without thinking of the impact. There's a great sense of frustration."

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Of course, the removalists themselves have also been profoundly affected; their mother died of the disease this week.

Swift says the community has shared unsettling stories of non-essential items, like a dishwasher, being delivered to Orange from COVID hot spots like Liverpool. "We just can't believe that those non-essential deliveries haven't been stopped."

Nevertheless, McRae says, many in Orange feel lucky. The town has a large and highly-regarded local hospital with boosted ICU capacity, four COVID testing sites have been quickly set up in local facilities including a Bunnings and the Orange Showground, public health orders are in place and local police are available to enforce compliance.

Swift agrees: "The general feeling is that people are glad a quick decision about lockdown was made because we hope to get the shutdown over with as quickly as possible."

Did Sydney do enough?

But was enough done to stop the Delta variant spreading from Sydney in the first place?

Epidemiologist Marylouise McLaws told the ABC yesterday that NSW "waited too long" to lock down the city.

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It's a issue that has heightened the emotions of locals, some of whom have hit out on social media calling for checkpoints at Lithgow to screen anyone travelling further west and others, in desperation, wanting to "build a wall".

During Melbourne's lockdown last year a "ring of steel" was put in place around the city and patrolled with checkpoints and fines of $5,000 for trying to sneak into the regions. The goal was to aggressively protect rural communities from COVID's spread.

The current spread of COVID to Mildura is not blamed on Melbourne's lockdown settings because the transmission — at the MCG — occurred before anyone was aware that Delta was on the march.

Yet NSW is a different situation.

While Sydney residents were directed not to leave the metropolitan area early in the outbreak the strategy relied mostly on trust: police cars patrolled the routes out of Sydney and fines were issued. Yet anyone determined enough could still just take their chances.

Victorian Premier Daniel Andrews yesterday pointed out this difference and called for NSW to adopt his state's "ring of steel" strategy to prevent further cases of Delta spreading from Sydney.

"We need a ring of steel around Sydney so that this is not spreading to other parts of the nation," Andrews said.

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"If it is a national emergency, then there is a national responsibility to do everything possible to contain it where it is now, not to see it spread."

A move towards tighter surveillance of who goes in and out of the Sydney area appears unlikely.

McLaws believes it's just too late: "That horse has bolted," she said.

Prime Minister Scott Morrison said yesterday: "The only view that matters on this is the view of the New South Wales Premier, because they are responsible for how they manage the lockdown in New South Wales. There is nothing light about the lockdown in Sydney, I can assure you. My family are in it."

'The game has changed'

Regional communities that may have avoided COVID cases last year are more vulnerable to the Delta variant that is dominating the current outbreak, according to James Trauer, head of the Epidemiological Modelling Unit in the School of Public Health and Preventative Medicine at Monash University in Melbourne

"The game has really changed since Delta has come through," he says. "A lot of settings that were at low-to-moderate risk last year are now facing a significant risk."

And with the relatively porous settings in place in NSW, it was in many ways inevitable that the virus would leak out.

"Delta makes everything more difficult, but the thing it makes almost totally impractical is suppression," Trauer believes. "I would say NSW is currently suppressing Delta but it's doing so through restrictions that are not feasible to maintain indefinitely.

"Suppression is just not really a viable strategy. The goal must be elimination but it's still not officially our national strategy and yet it's really the only approach that is effective."

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McRae isn't surprised the virus has spread to a town like Orange which is not only a tourist destination for Sydneysiders but a regional distribution hub for goods to be sent on to the rest of western NSW.

"We've not only had a lot of visitors but we have a local workforce that goes back and forth," she says.

"We've got large education, health and government departments and we know that there's permeability in our workforce. It's sad but I'm proud of how our community has has come together."

Orange is the new COVID frontline

Orange now finds itself in a difficult new role.

With metropolitan Sydney's COVID containment lines breached, Orange has become the key bulwark against COVID-19's further spread west where the Delta strain has already threatened the towns of Parkes and Forbes.

It's an extremely difficult logistical proposition for the region which includes a community of around 350,000 people and transport links via road, rail and also air – all of these continuing to deliver outsiders into the region.

How should that task be approached?

Trauer once again believes elimination is the way to go.

"I just think that no other strategy is really viable anymore, particularly with the Delta variant," he says, adding elimination, not aggressive suppression, needs to be Australia's national strategy until vaccination picks up.

It's a responsibility locals like Swift feel acutely.

"If I was further west I'd be concerned," she says. "That's why there is such an impetus on putting Orange into lockdown as there are concerns that if COVID spreads further into regional areas that just aren't the support mechanisms for people."

In far western NSW where towns are more remote with fewer resources, the stakes jump even higher.

Peta Rutherford, CEO of the Rural Doctors Association of Australia, points out that remote towns lack an equivalent level of medical support: if COVID-19 emerges in a small rural community that is likely serviced by just one GP clinic, for example, it can wipe out medical facilities for the entire population until a contingency is in place. That affects not just COVID-positive patients but those needing routine medical care too.

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Local health districts have done an excellent job, Rutherford says, in planning additional resources including ventilators, PPE and ICU beds or investing in the construction of isolation rooms to keep potential future COVID-19 patients apart from others.

Is vaccination the answer?

One of the core strategies to chart a path out of COVID – vaccination – is just that much more difficult if you are living in a regional town. Orange residents now have access to Pfizer and Astra Zeneca and Mayor Reg Kidd posted a photograph of himself getting the jab a few weeks ago.

But for residents of more remote regional towns, accessing vaccines may require travelling for several hours to an authorised vaccination hub and that can mean a day off work or difficulty with transport.

Vaccine take-up rates are also unsteady. Emily Swift in Orange says most people she knows are keen to be vaccinated but confirming an appointment right now is difficult.

Trauer believes it's "months away" until vaccination can provide a genuine herd immunity but maintaining a lockdown until that goal is reached is also unlikely to be sustainable.

"Elimination is going to be really hard from the position NSW is in at the moment," Trauer says. "It is tricky for NSW."

The Rural Doctors' Peta Rutherford believes there will be debate for years over where the blame should be laid for the NSW COVID outbreak but she says right now attention should be focused elsewhere. More important, she believes, is preventing complacency.

"Complacency is probably the biggest risk we have in rural communities. The important thing now is to focus on what you can do to stop the spread and what's within your control," she says.

Rutherford also believes it's important to remain positive: "I don't think it's out of control and I think, comparatively, Australia is still doing a huge job in controlling this."

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Murray River border businesses angry at Victoria's tightening of restrictions .
Business owners along the Murray River want Victorian and New South Wales decision makers to visit the regions before enforcing tighter restrictions."It's harsh for the regional people," Barham Newsagency owner Tish Conder said.

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