As an explosion of COVID cases on the east coast obliterates government projections of how quickly the virus spreads, questions remain about how the WA health system will cope as the reclusive state finally moves to open its border.
Behind its hard border, Western Australia is the last place in the nation where daily case numbers remain in single digits.
Since April 2020, WA has seen minimal impact from COVID, with a little more than 1,200 cases recorded in the past two years. The state has only had three lockdowns, two lasting less than a week.
The WA government announced late last year it was opening its border on February 5.
Premier Mark McGowan promised the "softest landing" for the people of WA if they reached a target vaccination rate of 90 per cent.
This was informed by modelling — where different scenarios were played out mathematically — by the WA Health Department.
It assumes there will be public health safety measures, including mask mandates in some circumstances, medium levels of testing, tracing, isolation and quarantine and mandatory PCR testing pre-departure and testing upon arrival in WA for all international and domestic arrivals.
According to these numbers, the base model assumes community infections will become prevalent 120 days from the border opening.
The numbers looked far worse with just 80 per cent vaccination.
That model predicted 313 West Australians would die within 360 days of the outbreak, compared to 117 at 90 per cent.
And it forecast 987 cases per day at the peak of infection, with 178 general hospital ward and 32 ICU beds needed.
The WA Health Department points out that, as is the case for all models, actual outcomes are influenced by multiple factors that cannot be predicted or accurately modelled.
The scenarios provide a simulation, not forecast, of epidemic growth of the virus to 360 days following the onset of an outbreak.
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The Omicron effect
With the advent of Omicron, the rate of infection in the eastern states far outstrips the base model numbers.
Jurisdictions similar to WA that also had border controls in place have much higher daily case numbers.
In South Australia, which has a population of about 1.8 million people, daily infections this week have averaged 3,200.
Tasmania, where 540,000 people live, recorded 1,489 COVID cases on Friday, almost double the previous day's 751 cases.
WA Deputy Premier Roger Cook said on Friday the state was still on track to relax border restrictions on February 5.
"That's the date we're working to, that's the date everyone's working to," he said.
"Obviously we continue to be advised and there's a few weeks to go yet."
Still waiting on updated modelling
Mr Cook said the WA government was watching what was happening with Omicron over east.
"Anecdotally, what we see is that there is a high uplift in relation to the number of … cases because of the transmissibility of the Omicron variant," he said.
"But we see it's not as impactful in terms of the acuity … in our hospital settings."
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Mr Cook said while there was a large number of cases in ICU in the eastern states, it was primarily Delta cases making their way through the system.
He said the type and level of restrictions post-February 5 would not be set until closer to the date, and "would ultimately depend on the situation we're confronting".
"We know masks go a long way to making our people safer in the community. We know vaccination goes a long way," he said.
"We also know keeping people away from high-risk events and venues is another way we can keep people safe."
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He said the government was waiting on stronger evidence about the impact of Omicron to come through from the east coast and internationally.
WA Chief Health Officer Andy Robertson said new modelling taking into account Omicron data was underway and he expected to deliver it to the government in about a "week or so".
Dr Robertson said waiting to open the border until after other states' infection rates peaked wouldn't make a difference.
"[Post-peak] they'll still have large numbers of cases within their community, so the actual total cases in the community will still be widespread," he said.
Doctors, nurses warn of outbreak impact on hospitals
Earlier this week, Dr Robertson and acting director-general of health Angela Kelly released an update reassuring hospital staff the health service was ready to respond when COVID arrived in WA.
The ANF called on the government to delay reopening the border by a month, to better assess the impact of Omicron and allow time for fit testing of PPE to take place.
They also wanted to delay the reopening so the hundreds of graduate nurses due to start in February did not immediately become overwhelmed amid the outbreak, which the union warned would lead to high numbers leaving in their first year.
Nurses are concerned WA hospitals will be swamped once Omicron arrives in WA.(Supplied: Alyssa Currie)
They said this would further deplete a hospital system already struggling with staffing levels, and which would be placed under pressure as medical staff with COVID can't work.
ANF state secretary Mark Olson said if there was a serious Omicron outbreak, he expected elective surgery in WA would be cancelled within six weeks.
AMA WA president Mark Duncan-Smith said his expectation was the government would re-introduce public health controls similar to what was recently seen in Western Australia.
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Dr Duncan-Smith said strong public health measures "all the way up to lockdown" post-February 5 should be considered to slow the burn of COVID through the community.
"I don't expect lockdown would be needed unless we get the ultimate crisis, which is a medical system that is imminently about to collapse," he said.
But he said the hospital system didn't have the capacity to do business as usual at the moment, without a flood of COVID community cases.
"As evidenced by wards closing in Broome, going from 31 to 21 beds in the general wards, Geraldton emergency department struggling to find doctors to keep it open, Bunbury Hospital having one theatre shut because of staff shortages," he said.
"South Australia lasted less than two weeks before it had to compromise its elective surgery, and I expect that will happen in Western Australia."
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