How will the next weeks and months look like for people who are more vulnerable to COVID-19 in NSW?
An interview with epidemiologist Professor Alexandra Martiniuk from the University of Sydney

Older woman with mask
For people who can’t be vaccinated against COVID-19, or who are vaccinated but who build a weaker immune response to the vaccine due to their condition, the experience of re-opening NSW will likely be very different to the one of healthy, fully vaccinated people.
We talked to Alexandra Martiniuk, a Professor of Epidemiology at the University of Sydney, about what to expect.
Professor Martiniuk, how much bigger will the chance be of catching Covid-19 in Sydney and NSW at the 70% and 80% fully vaccinated milestones?
Unfortunately, an increase in the number of daily cases of COVID-19 is expected in Sydney and NSW once lockdown restrictions begin to ease on Monday. However, the increasing proportion of the population that is vaccinated against COVID-19 will reduce the proportion of cases requiring hospitalisation and ICU.
In your opinion, what does this mean for people who can’t be vaccinated against Covid-19 for medical reasons or who are fully vaccinated but for whom the vaccine might not work as well and those with underlying health conditions?
For people who are not able to be vaccinated, or who do not mount a typical immune response to vaccines – the easing of restrictions, and likely increase in COVID-19 cases in the community, may increase the risk of catching COVID-19.
People who are vaccinated against COVID-19, and who get a COVID infection, are less likely to transmit the virus. So, on the one hand, people who are vaccinated against COVID19 are “safer” to hang out with.
But we also know that when people are vaccinated their behaviours change and they may be more likely to increase the number of people they see, the number of places they visit… and this can increase their chances of coming into contact with someone infected with COVID-19 and becoming infected themselves.
What can these people do to reduce the likelihood of falling ill with Covid-19 in the weeks and months ahead?
If you can, you should consider getting vaccinated against COVID-19. If you are already vaccinated, you may wish to watch for announcements regarding booster vaccinations (3rd doses) in NSW and speak to your health team regarding whether a booster is/will be appropriate for you.
Wearing a mask (and others around you wearing masks too) reduces the transmission of COVID-19.
You may also consider reducing the number of crowded, indoor environments you visit. This can reduce the risk of becoming infected with COVID-19. Use food delivery instead of going to the supermarket, reduce the number of social contacts and meet with people in the outdoors. Covid-19 is less likely to be transmitted outdoors than indoors. And try to stay on top of your existing health conditions so you don’t require urgent care.
What can the health system do to support this group of people in NSW better?
The public, and those in the health system, can remain vigilant in protecting themselves and all others by wearing a mask, ensuring good ventilation of indoor spaces, social distancing, separating people infected with COVID-19 from those not infected, and ensuring health care continues as best as possible for non-COVID-19 needs.
Vulnerable Australians may need to enter their own self-imposed, strict lockdown as restrictions ease. These people may need greater social and emotional support than previously as they may feel left out as the world moves forward without them.
What can the general community in NSW do to protect our more vulnerable community members?
Get vaccinated, wear a mask, stay socially distanced and offer to assist vulnerable community members – eg offer to grocery shop for them, or run other errands.
Most importantly, remain empathetic to the individual experience of the pandemic. Remember that vulnerable people may not be visibly vulnerable and can be any age.
Is there some light at the end of the tunnel for this group too? How do you think next year will look like?
The effects of COVID-19 on Australians and the world will ideally continue to improve. As vaccination coverage increases in Australia (including potentially vaccinating children under 12 years) and with some public health measures (eg masks, improved indoor ventilation) the burden on the health system should reduce. This will also assist vulnerable people who need to attend for care for other needs.
Further treatments for COVID-19, boosters and possibly more effective vaccines may be on their way.
Already there is a new treatment that has been announced in the past week or so – which may reduce the severity of illness in people who are newly infected with COVID19.
It has been suggested that people who are not able to be vaccinated should be the first to receive such medication should they become infected with COVID19.
And finally, there is no approved Covid-19 vaccine for children under the age of 12 yet, how much at risk are our healthy children when they start going back to school from mid-October?
COVID-19 can transmit in schools (as we see from UK, USA, Canadian and European data) and we should expect to see more transmission in schools when they return to full-in-class teaching from mid-October.
Fortunately, data continue to show that children mostly have asymptomatic or mild COVID-19 illness. Unfortunately, an infected child can infect others.
Children should stay home when sick and get tested. Rapid tests are likely to be useful and I anticipate we will hear more on this in NSW in time. Ventilation (with outside air, and/or filtration), masks and cohorting (keep children in the same groups not mixing with others) – are all useful to reduce transmission of COVID19.
As the total number of children who get COVID-19 increases, we are likely to see some needing hospitalisation and ICU care, and children can also die of Covid-19, though this is likely to be very rare.
Thank you very much for this interview!
To find out how to get vaccinated in NSW visit: https://www.nsw.gov.au/covid-19/vaccination/get-vaccinated
If you have concerns or queries about the Covid-19 vaccines or your suitability to get vaccinated, speak to your GP or medical professional/team to make an informed decision.
If you feel down and would like to talk to somebody, you can reach out to these organisations
Beyond Blue: Talk to a trained mental health professional any time of the day or night. Calls are confidential. They will listen, provide information and advice and point you in the right direction to seek further support. Beyond Blue, 1300 22 4636, Open 24/7
Lifeline24-hour crisis support telephone service: Lifeline provides 24/7 crisis support and suicide prevention services, Lifeline, 131 114
Kids Helpline: A telephone counselling support line for children and young people ages 5 to 25 and available 24 hours a day, 7 days a week, Kids Helpline, 1800 551 800
NSW Mental Health Line: A mental health professional will answer your call about mental health concerns for you or someone you are concerned about, including children, teens, adults and older people, Mental Health Line, 1800 011 511
Suicide Call Back Service: National service that provides free 24/7 phone, video and online professional counselling to people who are affected by suicide, Suicide Call Back Service, 1300 659 467
