Halfway through the year, and Victoria is in the grips of another COVID-19 wave.
It’s believed about half of people with the virus haven’t been officially recorded, leading to a worrying number of people in hospital during the state’s deadliest month on record.
But as the state inches out of winter, there are signs the worst could be behind us.
Here’s what authorities have had to say.
Only about half of cases are being reported to authorities
Gone are the days when the number of people infected with COVID-19 each day dictated the level of public health measures in place across the state.
It is now estimated only about 45 per cent of people infected with the virus are officially reported to the Department of Health.
Authorities believe that is due to a range of possible reasons — not everyone displays symptoms, not everyone with symptoms will test, the tests are not entirely sensitive, and not everyone who tests positive will report their test result.
“We don’t know what we don’t know,” Chief Health Officer Brett Sutton said.
“If people haven’t notified with a positive RAT to the department, we don’t know that they are COVID cases.”
About 10 per cent of the cases we do know about at the moment are people being infected for a second or third time, a much higher proportion than in the January Omicron surge.
“Maybe that doesn’t sound like a lot, but an additional 10 per cent burden for those who’ve already had an infection is quite significant,” Professor Sutton said.
But we appear to be past the peak of new infections
While the official infection rate may not be an accurate reflection of the exact number of people in the community with the virus, the Chief Health Officer is now optimistic of turning a corner.
“We’re certainly seeing a peak in our case numbers,” Professor Sutton said.
The seven-day average of new infections was last week 11,703, which had fallen on Monday to 10,199.
“We look to be on the downslope there with about a 10 per cent reduction in case numbers compared to last week, so that’s good news,” Professor Sutton said.
Hospitalisations are plateauing but tough times lie ahead
The state saw a significant spike in hospitalisations as winter took hold.
Burnet Institute modelling suggests one explanation for the recent spike is the number of cases going undiagnosed or unreported to the health department.
Once an infection is reported to authorities, Victorians can have access to a range of treatments and therapies which can significantly reduce the risk of serious illness.
“There’s too big a proportion of those presenting to hospital, clearly with COVID, and either testing positive on arrival either at the emergency department during their admission in hospital or as they’re arriving, who haven’t taken oral therapies,” Professor Sutton said.
Experts have repeatedly stressed that access to the antivirals at the start of infection is essential to slowing the illness.
The most recent modelling by the Burnet Institute suggested the state was approaching a peak of hospitalisations in early August, of between 900 and 1,000 patients in hospital with the virus.
But as case numbers have begun to decrease, Professor Sutton said the number of people in hospital was “plateauing, if not past the peak”.
He cautioned “the pressures on the health system will be substantial for some weeks to come”.
“Mask-wearing, meeting outdoors, ventilation, getting your vaccine if you’re eligible — they still make a difference on this downslope,” he said.
“So please see this through the lens of our healthcare workers who continue to battle at the frontline.”
Deaths are still surging, particularly in older Victorians
While the number of people in hospital is lower than in the January Omicron peak, July was the month with the highest COVID-related death toll since the pandemic began in both Victoria and the country.
Of the 4,661 deaths recorded in the state since the pandemic began, 3,050 were reported in 2022.
“We still do have a significant number of deaths, that average has gone up in recent weeks,” Professor Sutton said.
Experts and authorities have partially attributed the rise to the BA.4 and BA.5 sub-variants of the Omicron strain, which appear to be more infectious.
Department of Health data shows the BA.4/BA.5 sub-variants were detected in 89 per cent of clinical genomic samples in the two weeks to July 28 and in 87 per cent of all wastewater detections to July 21.
Professor Sutton said another reason for the high mortality rate was “we’ve seen a higher proportion of the very elderly as part of this wave”.
“They are over-represented in our hospital numbers compared to previous peaks and about half of our hospitalised cases are over 75 years of age,” he said.
The older demographic of those infected generally means a longer stay in hospital. A person aged 25 has an average length of stay in a hospital bed of two and a half days, compared to four days for a 75-year-old.
Data released in mid-July showed one third of deaths in the first half of 2022 occurred in unvaccinated people, despite them only making up less than 5 per cent of the population.
Only about 73 per cent of eligible Victorians have had a third dose of a vaccine, and only about 32 per cent have had a fourth shot.
Safety measures will remain important long into the future
The SARS-COV-19 virus which causes COVID-19 has shifted and changed as the pandemic has dragged on.
Professor Sutton cautioned that “in all likelihood, we are facing a new variant and another wave every three, four, five months”.
“I think that will be the picture across the world for some time to come,” he said, adding more effective vaccines would spell an end to the current state of play.
He said that meant measures such as mask-wearing, physical distancing, good ventilation and regular testing would remain important well into the future.
“Even if we can’t avoid it for the rest of our lives, deferring the period of time when we’re getting a COVID infection, reducing the frequency in the number of times that we might get COVID … remains a critically important thing,” he said.