With the peak of Queensland's latest COVID wave still weeks away, there are concerns several big events have the potential to become "superspreaders" putting further strain on the state's already stretched health system.
Queensland has recorded 22 COVID-related deaths in the latest recording period, just two shy of the state's record number of COVID fatalities in a single day.
The current peak is inching closer to other record highs too, with the 921 people in hospital with COVID in Queensland on Saturday, just seven fewer than the state's all time high of 928.
Fourteen patients are in intensive care.
Infectious diseases physician Paul Griffin said the rising number of hospitalisations paints a clearer picture of the burden on the state.
"If you want to know whether this is a significant event, that number itself I think reflects the fact that it really is," Dr Griffin said.
More than 5,795 new cases were reported on Saturday and there are about 46,100 active cases across the state but there are expected to be many more cases going unrecorded by authorities.
He said the surge, driven by the new, ultra-contagious BA.4 and BA.5 sub-variants, was concerning and reflects the severity of the current wave.
"The case numbers [going up] every day … [only] tell a fraction of the story," Dr Griffin said.
Queensland's Chief Health Officer John Gerrard said the situation will get worse before it gets better, with the peak of the current wave not expected until early August, still three weeks away.
Hospital admissions soar
COVID cases are rising across Australia and currently Queensland has the second-highest number of hospitalisations in the nation.
It has considerably more people in hospital with COVID than Victoria, which reported about 750 hospitalisations on Friday.
Dr Griffin said it was likely due to a combination of factors, including reinfection rates and a low booster uptake in Queensland — one of the worst in the country.
"There's so many things that contribute to those numbers … maybe the fact that people have had more exposure to the virus previously [in Victoria] may confer some additional immunity," Dr Griffin said.
"Queensland had a zero COVID strategy that … was relatively effective right up until perhaps the end of December so maybe there's been fewer past infections here so less of a contribution of immunity from past infection.
"And measures … to control transmission and the uptake of those in terms of mask-wearing, social distancing and ventilation — I would think that we would perhaps be one of the state's that's probably doing a bit worse there."
'Superspreader' risk
Living with COVID has meant the return of major events in Queensland.
In the past week, the state has hosted the State of Origin decider, a Wallabies test match and the Big Red Bash in Birdsville — where several attendees have reported testing positive days after attending the music festival.
Thousands of Queenslanders will head to the Splendour in the Grass festival in Byron Bay next weekend for the first time in two years, while Brisbane's Ekka — also back from a pandemic forced break — starts in the first week of August.
Dr Griffin said there was "absolutely" potential for those events to worsen the impact of the current wave.
"The only situation where there's zero risk is where you're by yourself and not in proximity to anybody.
"We know outdoors there's less risk … but the risk isn't zero, particularly if you're in crowded areas."
Dr Griffin said the state is likely to see the COVID caseload increase about two to six days after a major event is held, and called for people to stay home if they are sick or test positive.
"We need people to take notice at the moment — we're not trying to propagate fear but we really need people to understand that we need to respond to this current situation," Dr Griffin said.
"Just the simple things — vaccination, antivirals if you're eligible … wear a mask, socially distance where possible.
"We need all of those simple things to come back, at least for a few weeks, until we get this back under control."
Indoor ventilation a 'proven' measure to curb spread
School has been back for a week in Queensland and classrooms have been sites of COVID spread in the past, with a significant number of outbreaks in earlier waves.
Dr Griffin said air ventilation is a proven and effective measure to reduce the spread of COVID in indoor areas.
Education Minister Grace Grace said a working committee, that included state and non-government education stakeholders, is still investigating ventilation at Queensland schools.
Air quality and health expert Lidia Morawska said while preventative measures like hand hygiene are important, there was an urgent need to improve natural air flow and roll out air filtration systems in schools.
"The virus is airborne, it is in the air and has to be removed by ventilation from the air," Professor Morawska said.
"This has been recognised internationally and by other states in Australia, it is very surprising that the Queensland government is still insisting on the old measures.
Ms Grace said all Queensland classrooms, staff rooms and libraries were fully air-conditioned with units that brought in fresh air.
Associate Professor Donna Green from the University of New South Wales said indoor air quality in schools is "absolutely crucial".
"One of the superspreader events across the country was through school kids," she said.
"Unfortunately they share the air between staff and other families and other children and they bring it home … and the cycle continues.
"I find it mind-boggling and many other health practitioners and public health policymakers cannot understand why we're not taking this approach to protecting the health of children and also the wider community."
