Australia has but one advantage in the war against COVID-19; our knowledge of what is happening around the globe. We are squandering that as we distance ourselves from the rest of the world but not from each other.

Snapshot Sydney, Saturday morning. Driving through Woollahra the cafes are packed with people happily imbibing their coffee, cheek to jowl. The social distancing imperative, so fundamental to our fight against COVID-19 is not resonating here. A taxi pulls up and two young girls alight and greet a friend waiting for them with enthusiastic hugs and kisses. The Kings Cross market is bustling and in the adjacent playground are dozens of children playing excitedly, pushing and shoving (ie touching) each other as they climb the ladder to the slide. Four mums are huddled together on a bench centimetres apart; clearly no thought of the crucial need for social distancing rules. In South Korea’s terrible epidemic, most adults who died were infected by contact with infected but asymptomatic children.

On to Coles at Bondi Junction where the store is crowded with people anything but two metres from each other. You can practically see the virus jumping around the store and falling on solid surfaces waiting for a human hand. How ridiculous (and dangerous) to have the elderly given a special time to congregate at shop and supermarkets. Clustering the most susceptible makes a mockery of social distancing. TV footage of large numbers of “oldies” jostling for service is distressing.

Beachgoers at Bondi Beach on Saturday morning before the beach was closed.Credit:Steven Siewert

Down at Bondi Beach thousands are on the beach, mingling on the grass, packing cafes with not a COVID-19 care in the world. Health Minister Hunt rightly criticised such a cavalier attitude to the epidemic and councils have done the right thing in closing our most popular beaches. The necessity, however, is further evidence that for too many of us there is little appreciation of the urgency associated with the need to stay away from each other.

Australia, maximum gain requires maximum pain now. Look at the tragedy unfolding in the US. Over the past six weeks authorities there have gradually introduced additional measures to keep Americans apart as the number of infected and dying soars. As in Australia, far too many Americans were not responding appropriately, so increasing authoritarian action was required. By not acting soon enough they now have 45 million Californians locked down in their homes.

Australia should avoid incremental measures that will be too little too late – we must adopt all evidence-based tactics now. If we don’t, we will see the same tragedy that has engulfed Europe and the US occur here. There are many hundreds (perhaps thousands) of Australians in circulation, infected but experiencing only mild symptoms or no symptoms at all, yet infectious. This is true for children as well as adults.

I am terrified by the very real prospect that in coming months hospital capacity will be overwhelmed and we will have distraught health professionals who simply can’t care for patients.

The total disruption of the normal harmony and rhythm of our lives for at least the next six months will be painful, frustrating and a terrible nuisance. Let’s do it.

Cafes, restaurants, pubs, clubs, cinemas, markets and even churches, synagogues and mosques must close. Government instructions that non-essential gatherings should involve fewer than 100 people is an unacceptable compromise. At a recent wedding, 37 people were infected with coronavirus.

Large supermarkets must reduce the number of people in their stores at any one time to make required social distancing possible, perhaps by restricting access on specific days based on the first initial of one’s surname. It is irrational to practice safe social distancing for five days a week but on two days go shopping and expose yourself to the dangerous situations you have otherwise managed to avoid. For now no playdates for children and no parties, both of which bring adults as well as children into close contact.

Public transport is another major source of infection. Many studies have shown that if you commute on trams, trains or buses in winter you are six times more likely to get influenza. We should all avoid public transport if possible and transport authorities need to at least introduce a policy that prevents people from standing while commuting.

Perhaps our focus on the need to protect our older Australians (65+) who are most likely to die if infected has left younger Australians with a false sense of invulnerability. This may have contributed to so many ignoring infection control guidelines. While we would hope that most of us would now realise that protecting ourselves has become a major societal responsibility as we try and protect our most vulnerable, the truth is that many younger people have succumbed to this infection. Around the world, between 20 and 40 per cent of admissions involve people less than 50 years of age.

While we address the urgent need for increased availability of testing, and move heaven and earth to prepare our hospitals for the stress to come, we must all take seriously the imperative that we stay away from each other. Otherwise there will be many fewer Australians for us to stay away from.

Professor John Dwyer, AO, immunologist and Emeritus Professor of Medicine UNSW.

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