New research examining almost 1000 different COVID-19 scenarios for Victoria in 2023 has laid out possible strategies for the state’s response, including swift moves to thwart any new dangerous variants and beefing up vaccination coverage.

While we are all living with the virus now, there is little evidence the pandemic is close to an end.

New research from the University of Melbourne modelled the scenarios for the 12 months to October this year, examining different COVID variants and public health policies or restrictions.

Although the work is not a prediction of the future, all of these scenarios saw more than a million infections, with deaths ranging from about 2000 to 20,000. More than 6600 Victorians have died of COVID-19 to date.

University of Melbourne public health medicine registrar Dr Joshua Szanyi, a lead researcher on the study, said: “These findings tell us that we need to be prepared for this pandemic to continue.”

During 2020 and 2021, policies that helped keep COVID-19 out of the country had a clear overall benefit, Szanyi said, but now the value of different public health interventions and recommendations are becoming more challenging and complex to weigh up.

“Before we had other options it was much clearer, particularly in a country like Australia, that was pursuing a zero-COVID policy, what the right thing to do was,” he said.

“Now we’re in a situation where we have vaccines, we have antiviral medications, we have good evidence around the effectiveness of masks … actually it’s really tricky to know what to do now.”

However, the research did identify three key messages about what might work in the future.

First, the state should consider having a low bar for increasing restrictions, such as working from home and social distancing, in the face of any variant that is more dangerous and infectious than Omicron.

Second, it found rising rates of vaccination were very effective at reducing severe harm from COVID-19. Almost 30 per cent of Victorians aged 16 and over are yet to receive their third vaccine dose.

“Ongoing good uptake of vaccines in this model reduces deaths by around 30 per cent on average, but it also reduces pressure on health services and the need for other public health and social measures, which meant that when we looked at the costs, often ongoing vaccinations saved money,” Szanyi said.

The modelling showed increasing mask use, and government provision of respirators like N95 masks, during large COVID waves only marginally helped to reduce the rate of infection.

“For masks to have maximum effect, we likely need widespread use when transmission is moderate, not just during large surges. Whether society would accept such a policy, however, is another trade-off to consider,” Szanyi said.

Professor Adrian Esterman, epidemiologist with the University of South Australia, said none of the key messages of the paper were a surprise.

“Most of us who have been following what’s happening in Australia and overseas for three years now understand that the optimal strategy is the vaccine-plus strategy. You get as many people vaccinated as possible … On top of that, you add in some public health measures,” Esterman said.

“If I was in charge of the government, I would be running a campaign to try to increase the percentage of people who are up-to-date in terms of their vaccination. I would be running a campaign to persuade people, especially vulnerable people, to wear face masks and what ones to wear and how to wear them.

“And I would be doing everything I could to improve ventilation in buildings. I think those things alone would do a huge amount to dampen down case numbers, and they don’t cost a lot of money.”

​There are currently 324 COVID patients in Victorian hospitals, with 14 in intensive care and six on a ventilator, according to the latest update from the state’s chief health officer on Friday.

In the past three months, some 6000 COVID patients were hospitalised in Victoria Of, those, 41 per cent had not received their third vaccine dose and 30.6 per cent were unvaccinated.

There were 156 COVID-related deaths reported in the state in the past week, an average of 22 per day.

While new case numbers are continuing to trend down, multiple Omicron variants are still driving transmission.

Two cases of the subvariant XBB.1.5, which has been wreaking havoc in the US, have been detected in Victoria through genomic surveillance testing.

While the variant dubbed the “extra bad boy” has been spreading fast in the US and has been linked to rising hospitalisations, there is no evidence it causes more severe disease than any of the other hundreds of Omicron subvariants already circulating, experts say.

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