Visiting Western Australia (WA) in August 2022 I cannot help noticing the similarities with post-pandemic England. Life seemingly runs along as normal; there are sporadic mask mandates in place, although these are clearly communicated to the public, and plenty of hand sanitiser on offer.
In August around 1,200 covid cases were diagnosed daily – that’s about 0.5% of the population (Government of WA Dept of Health). By contrast, the UK reported around 2.7% of the population with Covid for the same period (ONS data).
However, step back to 2020 and the comparison changes dramatically. WA shut its borders completely in mid-March 2020 and offered extensive support packages for many sectors. A state-wide lockdown was enforced and despite virtually no infection, two things were notable:
- There was high compliance with lockdown rules (even in areas where no cases were ever reported).
- Strong political leadership initiatives were respected, perhaps due to the rigorous enforcement of local lockdown rules.
After an initial 3-4 weeks of general lockdown, when local cases started to be reported a series of shorter 5-day lockdowns were announced. Some shops and most schools remained open. These short restrictions gave time for each case to be fully contact traced and isolated. Mask wearing was enforced anywhere outside the home. This cycle was repeated as often as one case was diagnosed but the real challenge came when the decision was made to reopen borders.
The WA Department of Health was clear that the main concern was the effect higher Covid numbers would have on hospital bed occupancy. WA is a vast state, over 10 times the size of the UK with a tiny population in comparison. Hospital beds are spread thinly across the state and the risk they would be overwhelmed was a real worry. The WA government response was a forensic analysis of existing provision and new ICU beds opened in March 2022 in Perth before the national and international borders reopened.
In England, vaccination was actively encouraged but never mandatory. In WA, vaccination was originally mandated for the first and second dose in many sectors of society, in healthcare settings including hospitals and aged care facilities, and on public transport, taxis and aircraft, making it very difficult to avoid. Nearly 85% of the whole population are now fully vaccinated, despite a slower start to the programme.
What can be learned from the WA approach?
- Tougher enforcement of local lockdown rules may have contributed to higher rates of compliance and significantly lower rates of infection.
- Shutting all borders for a prolonged period kept infection rates down in WA and gave time for vaccination delivery to reach a high level, and for more ICU beds to be commissioned.
- Full contact tracing for the early part of the pandemic may also have slowed the rate of infection at a crucial time.
Social factors may also be responsible for the lower WA death rate; overall a younger population, less accommodation overcrowding, and a more diffuse rural population inevitably had an impact by contrast with more urban populations in England, however quick and decisive action by the WA government appears to have played a significant part in slowing the spread of the virus and reducing the number of deaths among its people.