A leading public policy think tank says Australia can drive active COVID-19 cases down to zero through longer and “smarter” restrictions, with the “short-term pain” providing greater payoff on the other side.

The Grattan Institute report, penned by former federal Department of Health secretary Stephen Duckett, claims Australia’s coronavirus response has been unclear and calls for a “calibrated response” — based on clear data — to help the public understand and accept restrictions.

The report, which uses data modelling and references global country-by-country responses, says Victoria, which is set to announce its roadmap out of phase 4 restrictions on Sunday, should only ease current restrictions when new cases are below 20 a day for five days straight.

Victoria recorded 113 cases on Thursday — the first time it has risen above 100 cases since Sunday, while NSW recorded 12 cases and Queensland reported two cases.

The report argues NSW, Queensland and Victoria — the three states reporting consistent daily cases of the virus — should ease restrictions further only when new cases are below five for five consecutive days.

The report says restrictions should be lifted again when the states hit zero new daily cases for five consecutive days.

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“I think what the public want is clear measurable things that they understand,” Dr Duckett told the ABC.

a number of experts in July calling for a re-think following Victoria’s second wave outbreak.

Following the public debate, the Federal Government in July moved to clear up its stance.

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It said its “aggressive suppression” strategy — which is a goal of no community transmission, or what the Grattan Institute calls “zero cases” — would remain and it would only reintroduce restrictions and close borders “to shut down community transmission where it occurs”.

Acting Chief Medical Officer Paul Kelly told the ABC on Thursday the Government maintained its “aggressive suppression” stance and that eliminating COVID-19 entirely was “unrealistic” in the absence of a COVID-19 vaccine.

“In Australia, we will continue to take realistic, pragmatic and proportionate action to suppress the virus in our nation,” Professor Kelly said.

The Grattan report does not call for elimination, and essentially backs the Federal Government’s stance.

However, Dr Duckett said National Cabinet — which meets on Friday — should “reaffirm and make explicit” Australia’s target of zero active cases in the community.

Dr Duckett said there was still confusion in the general public.

“The goal of zero cases should be public and publicised to rally the community around the shared goal,” he said.

“Each state and territory should have public, actionable plans for reaching zero active cases.

“We know now much more than we did three months ago. The science of treatment and the science of prevention is much better known now.

“And the goal must be zero active cases in the community.”

Elimination ‘window of opportunity’ missed

One of the experts that called for elimination in July, Melbourne University epidemiologist Tony Blakely, told the ABC there were still “pros and cons” of both the elimination and aggressive suppression strategies, but it was a “tough decision”.

“I actually think that if the vaccine does not arrive till mid-2021, a hard-nosed assessment of health and economic numbers would still support going for elimination — and we [Melbourne University] are modelling this right now,” he said.

“But there remains the issue of what the population can endure.”

He said he had not read the Grattan Institute report in great detail, however the recent case number data — and the experience Australian states and countries such as New Zealand — showed how “sneaky” the virus was.

“New Zealand [which has an elimination strategy] was a wakeup call to all of us,” he said.

“Queensland is looking a bit wobbly [and] if community transmission takes hold [there], that is three states that need to eliminate together — a demanding ask, although still do-able.

“NSW has clearly used aggressive suppression [and] ruled out elimination. So unless NSW achieves elimination by mistake, or inducement from other states, it would be difficult for Victoria to achieve and hold elimination given our borders with NSW.”

‘Smarter’ restrictions based on case data: report

The Grattan Institute report outlined a number of scenarios for “smarter restrictions” depending upon the number of daily cases in the community.

Under its modelling which references the Victorian situation, if there are less than 20 cases per day over five days outdoor gatherings of up to 10 people and indoor gatherings of five should be allowed and a removal of the 5km travel restrictions.

The report says when there are less than five cases over a five-day period, cafes and restaurants should be allowed to re-open.

It is advocating for masks indoors and on public transport up until the very last restrictions are lifted.

Dr Duckett said if the Victorian Government, backed by the National Cabinet, chooses to go for zero active cases, the state “must maintain restrictions for longer now” to significantly reduce the chance of outbreaks in future.

He said as Australia approached six months of restrictions — and Victoria prepared to emerge from its stage 4 lockdown — “now is the time to talk about it”.

“Polling shows there is a public appetite for maintaining restrictions longer if it means less spread of the virus,” he said.

“But the trend [of cases] is coming down and people want a target, they’re are saying ‘we’ve done the hard yards, we want to know when relief is coming.”

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