The hard lockdowns placed on Melbourne’s public housing towers may be a first in Australia, but similar scenes have played out in countries around the world.
Acting Chief Medical Officer Paul Kelly said earlier this week the tower block lockdown was a “major escalation” and something we had not seen in the country before.
But he said it was a similar decision to those made by officials in other parts of the world, such as “New York, China and in Europe”.
“The way [the increase in cases in Victoria] will come under control is very clear, we know how to do that, it is led by the data,” Professor Kelly said.
“Testing, trace and isolate [are] crucial and fundamental public health responses.”
Lockdowns in India and New Zealand also made headlines due to their speed, size and, at least initially, apparent success.
So, what exactly do Victorian authorities seem to have learned from their overseas counterparts? What could they do better?
The new coronavirus is believed to have originated in Wuhan, the sprawling capital of China’s central Hubei province.
By late January, some 60 million people were locked down across Hubei, as hospitals were pushed to breaking point.
The unprecedented restrictions meant public transport, shops, supermarkets and flights were all shut down or suspended, with residents describing the city as akin to a real-life horror movie.
Officials and volunteers sealed off buildings, erected barricades and stepped up surveillance to ensure compliance with the ban on movement.
There were also reports that the doors of some flats had been welded shut to keep people inside.
Wuhan authorities also constructed two purpose-built field hospitals in a matter of weeks to treat COVID-19 patients.
Wuhan’s lockdown lasted close to 80 days after new cases had dropped to just a handful a week.
Stephen Duckett, health program director at the Grattan Institute, told the ABC there was no obvious evidence Victorian officials had taken cues from previous lockdown scenarios.
However, he said it’s likely public health officials would have considered the available options when forming a plan to lockdown the Melbourne towers based on the experiences of different states or countries.
“It’s almost impossible to get an identical situation because there’ll be different cultures … so you’ve just got to work out what your principles are and then make a decision based on that,” he said.
Mary-Louise McLaws, a professor of infectious diseases at UNSW and member of the World Health Organization’s COVID-19 advisory panel, told the ABC it was time Australia started considering purpose-built facilities to move large groups of people to.
She has previously described the densely populated Melbourne towers as “pressure cooker environments” for the virus, adding the infection had the potential to spread through the towers quickly.
“Within these complexes, everybody knows everybody so they stop, they have a chat. And there’s a hyper-connectivity socially as well, so if somebody has some symptoms and they stop and they talk to people, then they can spread it really rapidly,” she told ABC’s PM program on Monday.
“It’s very difficult for somebody to be looked after at home in crowded conditions.”
She added that people who test positive needed to be put somewhere safe “where they can be looked after mentally, pastorally as well, and of course, medically.”
“You don’t want to lock up this building so that eventually 100 per cent of people become a case — that’s just not ethical.”
The speed of the lockdown in India was astounding, and the pace and scope of the snap curfew caught many by surprise.
When confirmed cases of the coronavirus had just passed 500, India shut down almost everything except essential services and businesses related to food or medicine.
Congregations, for sport or religion, were strictly prohibited.
In announcing the lockdown during a nationally televised address, Prime Minister Narendra Modi gave the public fewer than four hours’ notice before the three-week lockdown began.
It meant thousands of working poor, who often sleep wherever they can find work, were left without an income or a place to sleep as factories, shops and warehouses were abruptly closed.
As soon as the restrictions were in place, they were enforced ruthlessly by police.
Some people who were caught on the streets during lockdown were caned by police, others were made to do frog jumps.
According to researchers at Oxford University, who have rated the strength of lockdowns across the world from zero to 100 using a “stringency index”, India’s lockdown scored the highest rating of 100.
Since the harsh lockdowns were lifted, India’s case numbers have surged and it is now battling an outbreak of more than 20,000 new cases each day.
The country of 1.3 billion has the third-highest number of infected people, behind the US and Brazil.
Professor McLaws said the duration and stringency of a lockdown was important because people could not be kept in a “ring-fenced area” for a long period of time.
“The duration is important because we see that the average incubation period is five or six days, but not everybody has the same incubation period and it could be a little longer. So, time is important,” she said.
Professor McLaws added a good response also involved both infection control and outbreak management.
“It doesn’t use just one method, such as a lockdown, it uses a layering of preventative measures so that people coming from hotspot areas are allowed to go to work or study and don’t get discriminated.”
For 10 weeks, people in New Zealand were locked down and movement was tightly controlled.
All takeaway food was banned and people were even warned about the possible health protocol breaches of playing a game of backyard cricket.
“Just be careful your ball doesn’t go into the neighbour’s house as they won’t be able to touch it or return it,” the New Zealand Government warned on its COVID-19 website.
During its toughest period of lockdown, all schools and public venues were closed and weddings and funerals were banned.
New Zealand’s lockdown was considered strict and Prime Minister Scott Morrison repeatedly said we didn’t need measures as stringent in Australia.
Professor McLaws says Victoria and New South Wales also need to aim for eradication, as New Zealand did.
“But if you go for eradication and get the numbers down to low single digits, even on a daily basis or weekly basis, then the small unexpected cluster can be easily handled, [as well as] economic and emotional disruptions.”
She added that if all states aimed for eradication, then everyone would be able to move across borders.
New York has the highest population density of any major city in the United States, with more than 27,000 people per square mile, according to local authorities.
In late March, as cases began to soar, Governor Andrew Cuomo announced a statewide stay-at-home order for New York.
All non-essential businesses were ordered to close and non-essential workers were told to stay at home.
New York-based Australian expat Fleur Wood told the ABC in March that life had changed “overnight”.
“What was interesting was how quickly New Yorkers accepted it,” she said.
By April, New York state authorities had ordered private labs to do testing and asked private companies to design and distribute 500,000 kits.
Federal emergency teams began assembling tents for field hospitals in Central Park and converting old warehouses and conference centres into makeshift infirmaries.
Alex Scoffel, an Australian living in New York, told the ABC in April that she had barely left her apartment in a month and that people there were resigned to staying indoors for a period of months.
“The sense of community and camaraderie we’re seeing here is just insane — the support that everyone’s giving everyone in the community, especially the health workers.”
After almost 80 days of stay-at-home orders, New York City began reopening in early June, with Mr Cuomo declaring: “We’re back.”
Mayor Bill de Blasio said it was a “triumphant moment for New Yorkers who fought back against this disease”.
US President Donald Trump floated the idea of quarantining three coronavirus hotspot states — New York, New Jersey and Connecticut — but later backed down.
Professor Maximilian de Courten, from Monash University’s Department of Epidemiology and Preventive Medicine, told the ABC that New York was a good case study for Australian authorities.
Unlike the first wave of the virus in Australia, community transmission was a massive problem in New York.
“We all need to understand that, while it’s the same virus, the source has hugely changed,” he said.
“If we have considerable community spread, it’s far more difficult to trace and track.
Professor de Courten strongly advocated widespread use of face masks and said they had been highly effective in New York, Hong Kong, Singapore and South Korea.
If most people wore face masks outside their homes, the lockdown could be halved to three weeks, he said.
“People are spreading the virus now and don’t know it,” he said.
Europe started emerging as the virus’s new epicentre around March when cases spiked in northern Italy, followed by outbreaks in France, Germany and Spain.
Many European countries soon placed limits on non-essential movements and closed all non-essential businesses, schools and universities.
Border restrictions were also put in place and residents were only allowed to leave their homes to buy groceries, seek medical care or undertake permitted forms of exercise.
In Spain — which had one of the strictest lockdowns in Europe — police and military were deployed to help with government efforts, and all non-essential workers were told to stay home for weeks.
Meanwhile in Victoria, after Victorian Premier Daniel Andrews announced that around 3,000 of Melbourne’s “most vulnerable” would be locked in their public housing estates, around 500 Victorian police officers were deployed to guard the buildings.
Dr Duckett, from the Grattan Institute, said sending police rather than security guards or community workers indicated there were likely concerns of potential quarantine breaches.
“They made a decision to prioritise speed over a decision to prioritise engagement with the community,” he said.
Additional reporting by Max Walden