It shouldn't be this hard to suppress COVID-19

Passengers onboard a Sydney train. Most restrictions across Sydney will be extended for another week despite no new local cases of the virus. Picture: Getty Images
Passengers onboard a Sydney train. Most restrictions across Sydney will be extended for another week despite no new local cases of the virus. Picture: Getty Images

One key issue sits at the heart of Australia's abandonment of its citizens trapped in India: our Covid strategy is falling apart.

The early, successful model needed to keep evolving to dynamically respond to a dangerous disease. Instead it remained ossified in place and now we're paying the price. Despite the fact that early steps effectively protected the country, it's now obvious the government has failed to implement measures that would allow the country to reopen to international travel; chose a haphazard and inadequate rollout process; and, perhaps most critically, chose to back the wrong vaccine simply because it was cheaper and could be manufactured here.

Let's take the issues in reverse order.

Deficiencies in our chosen vaccine will leave Australia increasingly vulnerable to a disastrous second wave Covid mutates and continues to spread insidiously through the world.

Scott Morrison's early decision to plump for the AstraZeneca vaccine is easily understandable. It's considerably cheaper than Moderna's model; easier to distribute; and could be made here. At the beginning of the year, however, the wheels began falling off the chosen solution. Instead of gaining international acceptance, Europe introduced temporary bans as information began circulating about rare incidents of blood clots developing in otherwise healthy people. Although it was confirmed these were linked to the vaccine in that continent, where the virus was still raging uncontrollably, the public health benefits of increasing resistance overcame initial hesitancy.

Not so here. Since March, however, a far more serious deficiency has become apparent. Australia's chosen vaccine, AstraZeneca, fails to clear the bar for efficacy against the South African strain of the disease which is now spreading throughout Indonesia. This is why it has not, and will not, be authorised for use in America. After conducting a vigorous and detailed study of our vaccine against those of Pfizer and Moderna, the US refused to permit its use. This decision was not driven by nationalism - it was based on a simple analysis of medical effectiveness. Different trials have produced slightly contrasting findings but none apparently offer a greater than 30 percent effectiveness. Far worse was a finding of the South African Medical Research Council in March. It suggested AstraZeneca's effectiveness was just 10.4 percent.

This is the critical factor that's responsible for the sudden inversion of our own program which is now directing Pfizer to younger people. The (private) assessment is older people are less likely to be exposed to the new variant and so AstraZeneca might, at least, confer some immunity.

Nevertheless, and for almost two months since that study was published, senior health officials have continued publicly backing a vaccine which appears substandard. The obvious conclusion is simply that Morrison is refusing to admit he chose the wrong strategy to begin with. That would explain the current rush to distribute AstraZeneca now, simply to use up all the doses before it becomes obvious a tweaked Moderna vaccine will also be needed.

The second issue is the government failed to nut down distribution of its chosen, second-rate option. Instead of implementing a central scheme that would ensure swift immunisation the Health Department adopted a haphazard and inconsistent approach, seemingly more concerned with bureaucratic requirements and keeping stakeholders happy rather than putting needles into arms.

The result has been confusion and delays. Public health experts find the failure to implement simple systems inexplicable. It's as if the internet had never been invented. Instead of leveraging the My Health system to provide a foundation for contacting individuals and automatically booking appointments a slipshod implementation has proven the current health system is broken when it comes to a public health emergency. Instead of reinforcing the GP system, this process has divided this crucial network into those that can and those that can't deliver vaccines. The result has been to provide patients with an unfortunate and simplistic guide as to which practitioners the government believes are more effective, or perhaps dynamic, than others.

The government has also been unable to implement other seemingly simple processes that will, eventually, be necessary to protect the country. There is, for example, still no nation-wide vaccine "passport" - either document or app - that can be shown to prove someone's current status. And the multimillion-dollar grant provided, without tender, for the development of an app allowing contact-tracing now appears to have simply vanished without trace.

The final issue is the sclerotic nature of government's apparent inability to re-open international borders.

The barely hidden assumptions that led in turn to, last year, the separate processing of travellers from China and now banning of Australians returning from India have been exposed as nothing other than racial stereotyping. Europeans, together with North and South Americans, have been welcomed despite proportionally worse rates of infection. As soon as the crisis comes to Asia, however, the government rushed to slam the door in our citizen's face.

It's been a disgusting episode that reveals the unconscious bias that permeates our politics and bureaucracy. Forget all that talk about how the so-called Quad (the US, Japan, Australia and India) will face China - the four have very suddenly become a three. And forget any ideas about our tertiary education system suddenly bouncing back because students feel welcome here. The reality of our actions is speaking far louder than any platitudes about receptiveness. It will take a long time before the costs of the government's current policies finally hit home but, eventually, they will.

In the meantime the failure to implement simple measures, such as distinguishing between those returning from low danger countries and others more likely to have been infected says a huge amount about the inability of Australia to even get basic quarantine procedures right.

Basking in the glow of luck and early measures to combat the virus, the country went to sleep. It's time to wake up.

  • Nicholas Stuart is a Canberra writer and a regular columnist.
This story It shouldn't be this hard to suppress COVID-19 first appeared on The Canberra Times.


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