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The silent, high-tech measures that will drive the next wave of our virus battle

Insights

From tracking people on their mobile phones to monitoring the sewers, health authorities are investigating every option to keep up with the novel coronavirus.

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National Cabinet on Thursday will discuss whether any future easing of restrictions on travel and mass gatherings should be accompanied by unprecedented surveillance measures.

While bans and social distancing have lowered the infection rate, any move to open up communities to boost the economy would heighten the risk of the virus spreading. Faced with an inevitable increase in cases, authorities want to be able to respond more rapidly and efficiently to infections and also be confident in the ability of the health system to cope.

Even as Australians are still being encouraged to stay at home, Queensland has been experiencing an increase in COVID-19 cases attributed to interstate travel. At least 17 Queenslanders have now caught the virus interstate and brought it back with them – separate to those returning from cruises or overseas flights – adding to the challenge of contact tracing to determine who else might be at risk.

Queensland’s Chief Health Officer, Jeannette Young, today said she was “getting a little bit concerned” that the virus was still spreading across borders, something Health Minister Steven Miles said cast a shadow over the state’s success in keeping the infection rate low.

As of Wednesday, there were 999 confirmed cases of COVID-19 in Queensland, an increase of five overnight – the lowest daily increase since early March, and well below the peak of 78 on March 24. About 75,480 tests have been conducted in Queensland.

“A concerning number of the positive tests coming through are from those people who have travelled interstate so we would re-emphasise the importance of those domestic border travel restrictions,” Miles said.

“Nobody is above or beyond those restrictions and if it is not essential you should not be travelling to other states.”

Ahead of the next meeting of government leaders tomorrow, it appears Australia will use a mobile phone app to facilitate contact tracing if and when bans are lifted and restrictions eased. The Sydney Morning Herald has reported that Prime Minister Scott Morrison wants at least 40 per cent of the community to voluntarily use a version of the TraceTogether app that has allowed Singapore to track infected people in recent weeks.

On Tuesday, the Federal Government’s Chief Medical Officer, Brendan Murphy, told a New Zealand parliamentary hearing “we’re very keen to use it and use it perhaps more extensively than Singapore”.

The app would help overcome information-sharing challenges between governments – early in the outbreak, some states had difficulty accessing airline passenger lists – and be a helpful addition to the interviews and alerts currently used to determine potential contacts. It might also allow police conducting business, home and vehicle checks to return to normal duties.

However, the app would need a high uptake, across all populated areas, to be beneficial. It is understood governments will consider directing certain groups, such as mobile workers or those in at-risk industries, to download the app as part of their employment conditions.

Governments are already working on new modelling, based on Australian data, to plot the infection curve under various scenarios. InQueensland understands that modelling would need to show a “slow, declining tail” of COVID-19 cases before Australia shifted from the prevention and containment phase to an overt elimination strategy – and the new surveillance measures would need to be in place first.

Under the Singaporean model, officials can access the phone of an infected person to send an alert to recent close contacts, whether known to them or not. However, it requires all of those people to have the app and Bluetooth switched on, and in Australia, similar government intervention in the phone network has raised privacy and security concerns.

Federal Attorney-General Christian Porter is in talks with the Privacy Commissioner, Angelene Falk, on how Australia might adopt such technology. Researchers at Macquarie University and the University of Melbourne have previously warned of the potential for population-wide data logs to be misused.

“We must not ignore privacy concerns and implications of TraceTogether or similar apps that may be rolled out in Australia,” the researchers found.

“While many of the legal considerations could be relaxed at the discretion of enforcement authorities during times of crisis such as the current public health emergency, privacy issues could markedly hinder the adoption of these mobile apps.”

The debate comes as technology already used to monitor illicit drug use in communities – without identifying any individual user – is about to be trialled to see if it can pick up what testing and contact tracing cannot. Wastewater testing has been shown overseas to have the potential to determine whether the novel coronavirus is detectable in a community or has passed through, which could prove valuable in the event of widespread transmission.

In Canberra, researchers from Australian National University, including prominent infectious diseases expert Peter Collignon, are set to trial such methods on local wastewater. They believe wastewater testing could be used to validate existing public health data, or provide early warning of outbreaks yet to come to the attention of authorities.

Another consideration in deciding whether, or when, to lift bans and ease restrictions is the ability of the health system to cope with an influx in COVID-19 cases or second wave of infection.

Miles said Queensland’s hospital system was well-prepared and, due to the recent success in lowering the infection rate, might resume some elective surgery before the situation changes.

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