Australia’s chief health officer has issued this advice on masks

Amid Australia’s winter COVID case spike, the nation’s chief health officer Paul Kelly has recommended a return to measures – like face masks – designed to reduce the spread of the coronavirus.

Although state governments are yet to reintroduce restrictions, health officials are calling for the public to get back to the practices that were in force during the “summer wave” of the first Omicron variants in December and January.

“Although three or four doses of vaccine remain very effective at providing protection against severe disease from BA.4 and BA.5, vaccination alone is not effective at stopping infection or transmission of the virus from person to person,” Kelly says.

Australia currently has one of the world’s highest daily case and death rates from the disease, with almost 800 fatalities recorded in the past 16 days.

And although vaccination hit peaks in line with widespread jab availability in winter 2020, and in line with the case surge in January, uptake has dropped off substantially since then.

Current vaccines aren’t built on Omicron, but are still useful

Australia’s Health Minister Mark Butler believes the number of people with COVID-19 is “likely to be more than double” the almost 300,000 cases reported in the past week.

Kelly points to the new BA.4 and BA.5 subvariants being capable of escaping immunity (irrespective of vaccination history or previous infection) combined with relaxed personal protection measures as drivers of the current spike in case numbers.

He expects that spike to increase.

And although vaccinations have been found to protect against severe disease and death, they don’t provide a silver bullet. That’s partly because the vaccines we have are built on the earlier strains of the virus, and Omicron continues to evolve away from those strains.

That said, the Australian Technical Advisory Group on Immunisation (ATAGI) points to data showing that antibody effectiveness against Omicron subvariants wanes to a “quite modest” level four months after the second dose. Boosters have been shown to bump up protection against symptomatic disease to 50–75% for three months following a booster, declining to 40–50% in the 4–6 months after.

But because the effectiveness against new variants is in decline, health experts have started to strengthen their language around personal protection measures.

“We know that wearing masks does reduce the spread and protects yourself or protects others,” Kelly said this week. “If you’re away from home and indoors in a crowded place, I really very strongly suggest that you do wear masks.

“For the next few weeks, this is the way we can actually influence the spread of the virus, protect vulnerable people in our community, and also protect our healthcare systems, which are already under strain.”

As at 19 July, more than 5,200 people were currently hospitalised with COVID-19.

Masks mandates haven’t been enhanced, but they still exist in some settings

Face masks can provide an important barrier to transmission, particularly when worn by both infected and non-infected people.  

P2 or N95 respirators are considered most effective at reducing transmission, followed by surgical masks and cloth masks, assuming they have been fitted properly.

But although governments have decided not to tighten mask-wearing requirements in public places, there are some requirements still in place.

In general, most jurisdictions require people of a certain age (usually those 12 or 13 and over) to wear face masks in public transport; in taxis and rideshares; in hospitals, health, aged, residential, mental health and disability care facilities; on aircraft; and in correctional facilities. Mask mandates often extend to those with COVID-19, or who are close contacts when outside the home.

Face mask requirements for Australian states

• New South Wales
• Victoria
• Queensland
• Western Australia
• South Australia
• Tasmania
• Australian Capital Territory
• Northern Territory

The Australian Health Protection Principal Committee (AHPPC), which is comprised of all state and territory chief health officers, also provided updated information to the public when it decreased the COVID-19 reinfection period from 12 weeks to 28 days at the beginning of July.

Along with its recommendation to maintain an up-to-date vaccination card, it also extended its advice to wear masks “outside your home when in crowded, indoor environments including on public transport”, and to stay home when COVID-19 symptoms present, irrespective of severity.

Other recommended measures include good respiratory and hand hygiene, maintaining well-ventilated indoor spaces, and for employers to review workplace practices to allow work-from-home and COVID-related sick leave arrangements.

“I think we should adopt a precautionary approach and continue using available control measures to avoid large outbreaks,” says Dr Abrar Chughtai, from UNSW Sydney’s School of Public Health and Community Medicine. “Large outbreaks will not only result in more deaths, but will also overwhelm the heath system.  

“If a universal mask mandate is not possible for the next few months, then it may be introduced at crowded and high-risk places – such as public transports, shopping centres, large gatherings. This will also avoid other unwanted measures such as lockdowns.

“We are still not out of the pandemic and new variants are emerging, so we cannot be complacent. Though vaccines are less effective against these new variants, we should still promote vaccines as they are safe and still prevent hospitalisations and deaths. Most deaths are still among unvaccinated and people without booster doses.”

Vaccine given provisional approval for kids six months to five years of age

Australia’s Therapeutic Goods Administration (TGA) has provisionally approved Moderna’s COVID-19 vaccine for use in children aged six months to five years. That doesn’t mean parents are able to get this vaccine for their children just yet, as it still requires approval from ATAGI.

While confirming the TGA’s provisional approval for the vaccine, Butler instead recommends seasonal flu vaccines for this group.

“If I had a message to parents of children under the age of five… it is to consider getting your child vaccinated for flu,” he says.

“Our vaccination rates for influenza for under five year olds are lagging where they historically have been at this point in the flu season. They are lagging quite considerably.

“Children under the age of five and particularly children under the age of two are a very high-risk category for influenza.”

Australia reported 50,248 cases in the 24 hours to its most recent report date – this is the nation’s highest daily case total in two months.