NSW will need to tighten social-distancing restrictions if it cannot stem coronavirus cases arriving from Victoria, according to epidemiologists who say infected people are likely already in the state undetected.
On Wednesday, health authorities in NSW were scrambling to contain two major breaches of the tough new border restrictions, after plane passengers from Melbourne left Sydney Airport without screening and a Victorian child tested positive for the virus while holidaying on the NSW South Coast.
Mary-Louise McLaws, an epidemiologist and World Health Organisation adviser, said there was a “magic number” of active cases in NSW where authorities were so overwhelmed they could no longer do effective contact tracing.
“If it gets to about 100 cases across two incubation periods – about 14 days each – in very quick succession it doubles and then after that, it can double and triple each period,” she said.
On Wednesday, there were 454 active cases of COVID-19 in NSW, although the majority of those are overseas travellers in hotel quarantine.
The state reported 13 more cases on Thursday morning – 11 in quarantined travellers and two in the border city of Albury. There is also another positive infection linked to the Albury outbreak, but it was not included in Thursday’s numbers.
Professor McLaws said infected travellers crossing the NSW border could mean the virus spread rapidly.
“A few cases coming over the border from Victoria [can] tip that magic number into outbreaks that are going to be very hard to control,” she said.
On Wednesday, NSW Health confirmed a Melbourne teenager had tested positive for coronavirus while holidaying on the South Coast, after Victorian authorities had mistakenly given him a clean bill of health when he was swabbed for COVID-19 there.
The teenager’s family had visited the Tathra Hotel while infectious, prompting the contact tracing and swabbing of more than 80 people who also attended the venue.
In the ACT, three new cases of coronavirus were also traced back to the outbreak in Victoria, more than a month since the last known positive case in the territory.
Fiona Stanaway, a clinical epidemiologist from the University of Sydney, said it was highly likely carriers of the virus from Melbourne were already in NSW.
“If there’s been some transmission from people coming back from Melbourne, and people having contact with those people, we won’t really see that until another couple of weeks or so,” Dr Stanaway said.
“That really emphasises the importance of people getting tested.”
Professor McLaws said up to 18 per cent of COVID-19 cases were asymptomatic, but those people were still capable of spreading the virus.
“We know that 100 per cent of cases have a pre-symptomatic period … two days before they start to become symptomatic they can cause a risk to others because they can be infectious,” she said.
Both experts said bringing back tighter social-distancing restrictions – something the NSW Premier Gladys Berejiklian has repeatedly said she wants to avoid – was a possibility.
Anyone who comes from Victoria to NSW must self-isolate for 14 days, but the state government said it was considering forcing them into hotel quarantine.
Ms Berejiklian also said creating a second set of checkpoints around Albury was a possibility, which would make it more difficult for travellers to get deep into NSW.
Dr Stanaway said she had noticed people in NSW become more complacent about social-distancing.
“I think it’s really still important for people to try to social distance as much as they can,” Dr Stanaway said.
“It’s hard because I think we’re all quite exhausted by the whole thing and because we’ve had things open up, people have felt that it’s quite safe to go back to what was a much more normal life.
“This shouldn’t just be thought of as Melbourne’s problem and we really need to realise that this can happen anywhere and can happen again.”
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