Burning questions: why has the pandemic hit so much harder in Victoria?

As most of Australia enjoys the lead-up to summer, Victorians will still be locked down until late October. And while the Andrews government hopes a cautious reopening will mean the state can have a close to normal, virus-free Christmas, there are still plenty of frustrating, unanswered questions about how the hell Victoria landed in such a mess.

Is NSW better at contact tracing?

Prime Minister Scott Morrison has lauded NSW as the “gold standard” in contact tracing. Its highly efficient and quick test and trace system has been praised for helping keep new case numbers at a manageable level.

Victoria, meanwhile, has been criticised for an underfunded and ill-resourced contact tracing team, which was quickly swamped when cases began growing exponentially in Melbourne, and has been playing catch-up on huge backlogs ever since.

But are the two states really that different? ABC health reporter Norman Swan told ABC News Breakfast yesterday: “NSW isn’t the gold standard. NSW is lucky.”

University of NSW Kirby Institute head of biosecurity Raina MacIntyre writes that critics of the Victorian system overlook the fact that the process of contact tracing in both states is the same. The difference is the number of cases Victoria’s team had to deal with.

“If NSW were facing 700 cases a day, it would be in a similar situation to Victoria,” MacIntyre said.

And because NSW hasn’t had to deal with such high case numbers, we don’t know whether the system is that much better than Victoria’s, said Grattan Institute health program director Stephen Duckett.

But he also suspects NSW system is more successful because of the more detailed public data about cases and their movements its Health Department has been able to provide.

“They have consistently, over a longer period of time, been publishing data on how effective they are, and how quickly they contact cases … Because they are publishing that on the web, I suspect they’ve been using that information themselves. They jump on it when things are going awry.”

Finally, there are structural differences. For decades, successive Victorian governments stripped funds from public health — the state spends less on public health than any other.

And unlike Victoria, where public health has always been centralised, NSW follows a devolved model where it is managed in 15 local health districts. That model allows teams with a knowledge of the local area to do the tracing, something Victoria is now trying to emulate.

Is the modelling wrong?

Victorian Premier Daniel Andrews justified his conservative approach to easing restrictions by pointing to modelling which suggested easing up too quickly would be likely to put Victoria back in lockdown by Christmas.

But there’s been plenty of criticism of that modelling. Speaking to Crikey yesterday, Deakin University epidemiology chair Catherine Bennett said the modellers didn’t provide enough transparency around the parameters used or the questions asked by the government.

Today we got a little more detail on what the modelling didn’t factor in.

According to The Age, the model’s projections relied on outdated assumptions about Victoria’s contact tracing capacity. And speaking to ABC Radio National Breakfast this morning, the University of Melbourne’s Jason Thompson, one of the model’s developers, said it did not factor in local data — it didn’t consider the fact that most cases were happening in settings like health and aged care.

Can’t we just lockdown the hotspots?

In regional Victoria, the daily case average is now under five. Several local government areas in the regions have gone weeks without a case, and conservative politicians don’t want the whole state bound by Melbourne’s rules.

While regional Victoria is under looser restrictions, there are still limits on gatherings and restaurants until September 13.

But within greater Melbourne a localised plan which ring-fences “hotspot” postcodes hasn’t had great success — Victoria tried that approach in late June. Within a week all Melbourne was locked down.

“We saw from the early stages that ring-fencing postcodes in Melbourne didn’t work,” says Duckett.

We also can’t isolate hotspot settings, like aged care and health workers, because as Duckett points out, those workers mingled in the community, caught the virus and brought it in.

Why did hotel quarantine fail?

Good question. It’s still the topic of a wide-ranging inquiry now in its final days. So far, the hearings have exposed a shambolic system that let the virus get out. For months, nobody really knew who was in charge — responsibility seemed to bounce between health, employment and the police.

Infection control was inadequate and responsibility was placed on private security contractors who were often recruited via WhatsApp, given scant training and told to bring their own PPE.

And while there was criticism of guards’ poor behaviour, nobody has been able to work out who decided to use them.