COVID is less severe, but elderly still at high risk

The COVID-19 pandemic is no longer a public health emergency of international concern or, in Australia, a disease incident of national significance. It’s 4 years since the first cases of the disease were reported in China, and life is slowly getting back to normal.

And yet the virus shows little sign of going away.

“It’s not going to disappear, it’s going to be here forever,” says Nigel McMillan, program director of infectious disease and immunology at Menzies Health Institute Queensland.

But the virus that causes COVID-19 is stubbornly refusing to join its respiratory illness-causing comrades in shifting to a wintertime infection pattern.

While they can be caught at any time of the year, infection waves for the flu, RSV and common cold tend to be seasonal. Not so for COVID-19, which across Australia has seen regular half-yearly bumps.

“We predicted this to be a winter sort of illness – respiratory illnesses go up in winter – but it’s pretty clear from 2 years of data now, worldwide, that we are getting peaks in that December timeframe, and then that June-July timeframe,” says McMillan.

The latest Omicron variant is JN.1, a descendent of BA.2.86. It’s now the most prevalent form of the virus in many parts of the world and is surging in Australia.

Getting a precise indicator of infections is impractical, given the end to the compulsory reporting rules in place during the pandemic.

One dataset does, however, provide one accurate snapshot.

Obligatory reporting for hospital and ICU admissions gives a clearer picture of the worst effects of COVID-19 in the community – cases where it’s serious enough to send someone for emergency care.

“The most robust measure of what is going on is looking at severe disease and, of course, hospitalisation. That is confirming […] the impact of these new variants and these waves,” says Hassan Vally, a visiting epidemiologist at Deakin University.

“This is what happens when immunity in a population develops and matures, that’s happened through infection and vaccination, it’s why we did what we did with vaccination, because it protects us from severe disease and that protection from severe disease holds up pretty well.”

While Australia is clearly amid a new wave, the scale of people with the disease in emergency rooms is far less pronounced than previous surges.

Data from the federal health department shows the 2022/23 summer wave began building in early November, peaked at 510 daily hospital admissions (on a rolling 7-day average) on Christmas Eve, and sharply declined through January.

Compare that to the current wave – a gradual rise from October to an average of around 230 daily cases in mid-November which has fluctuated since. While it’s unclear when this wave will diminish – and hospital admissions have stubbornly remained at similar levels throughout the summer so far – there is some cold comfort that numbers appear, thankfully, lower than previous spikes.

Pattern likely to continue, vaccines needed for the vulnerable

Reports suggest JN.1 is milder than previous wave-causers, though that would be little comfort for a person badly hit by an infection.

Milder or not, COVID-19 continues to pose a risk for vulnerable people in the community, chief among them the elderly and immunocompromised.

That’s why the number of outbreaks in aged care facilities is concerning experts and authorities.

459 aged care homes have reported outbreaks this season – that’s more than the winter’s high point of 454.

This rise in aged care COVID has been on the cards with under-vaccination among these most vulnerable groups an ongoing challenge.

“The degree to which people obviously come together through the Christmas and New Year season, unsurprisingly has kept case numbers up. Visits to aged care facilities by family members to see their loved ones, their mum or grandma […] has also seen an increase in resident infections over the last couple of weeks,” federal health minister Mark Butler said last week.

Under-vaccination – where a previously inoculated person may not be up to date with their vaccine schedule – is prominent in these settings. In its latest update on vaccination rates of those in aged care facilities, the Department of Health reports just 30% have received a booster in the last 6 months.

In its statement, the department says it is “working with both the aged care and primary care sectors to ensure residents have access to the COVID-19 vaccine. It continues to target support for residential aged care facilities to arrange COVID-19 vaccinations with local primary care providers such as GPs, community pharmacists and Aboriginal Community Controlled Health Services”.

Despite that commitment, it’s the lowest rate of residents with booster doses since May last year.


This story’s introduction originally stated the COVID-19 pandemic was officially over. It has been corrected to reflect the ending of official declarations by the WHO of a global health emergency, and by Australia’s Chief Medical Officer and Health Protection Principal Committee of COVID-19 as a Communicable Disease Incident of National Significance.

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