Dr. Kerryn Phelps, in The Guardian, 4 January 2022, where the tile runs thus: “A shambolic mess’: the only example Australia is giving the world now is how not to manage Covid”
Where did it all go wrong? How did Australia go from being the envy of the world with our best practice public health measures, low case numbers, a prepared health system and an economy ticking along nicely to what can only be described as a shambolic mess?
The only example Australia is providing to the world now is a warning about what not to do with the Covid-19 pandemic.
Testing, tracing, isolation and quarantine, the so-called “TTIQ” along with ventilation and improved air quality of indoor spaces were essential parts of the response. We thought the government would develop a robust strategy for the months and years ahead after our 2021 lockdown. The government needed to heed practical, experienced public health experts, epidemiologists and clinicians.
While vaccines were, and remain, an important part of the response, we were warned not to rely on vaccines alone. As time went by, our warnings were proven correct as the Omicron variant emerged and the virus infected the vaccinated and unvaccinated, picking off the medically vulnerable, immunocompromised people and children.
We learned that two-dose vaccine immunity was only temporary and that a third dose or a “booster” would be needed. Even that is likely to wane within months. Long Covid remains a risk, even in “mild cases”, and even if people are vaccinated.
With the new New South Wales premier, Dominic Perrottet, in charge, the chief health officer, Kerry Chant, was sidelined as the new policy to “let it rip” was rolled out. 15 December 2021 was a pivotal moment in the pandemic. The population was softened up with a false narrative that “Omicron causes mild disease”, “this could be the gift we have been waiting for”, and “this could end the pandemic”.
Perhaps the most insidious piece of messaging was the pronouncement that “everyone in Australia is going to get it”. In other words, why bother trying to prevent transmission? In one previously unimaginable act, the NSW premier, in a double act with Scott Morrison, announced a lifting of all restrictions including mandatory mask wearing and QR code check-ins.
Despite the warnings that the health system was under pressure and that party season was about to kick off, the message to the community was: “Go out there and spend, head to the pub and get back to normal.”
Meanwhile, Covid-infected NSW residents were expected to do their own testing, contact tracing, and home Covid care.
“Personal responsibility,” they said. As the holiday period approached, many testing facilities would be closed down with little warning, leading to queues stretching for kilometres and waiting times blowing out to hours. In some cases, ill people waited in their cars overnight. Results were taking five or six days to be reported.
It ruined Christmas for many, who could not get a result in time for 25 December.
As case numbers exploded, a week after they were removed, QR codes and indoor mask wearing were reinstated – but the horse had bolted.
We were all told to go and get rapid antigen tests. The government resisted providing the tests for free as the UK had done, with Morrison saying he “did not want to undercut businesses”.
When a journalist specifically put to him that “not everyone can afford rapid antigen tests”, the PM casually replied: “Some people can, some people can’t.”
In another throwaway comment that will not age well, he said: “We’re at a stage of the pandemic where you just can’t make everything free.”
I thought that was why we had a public hospital system, public health units, Medicare and the Pharmaceutical Benefits Scheme – so that basic healthcare is affordable and accessible for all. This is exactly the stage of the pandemic where affordability should not be a barrier to disease control.
The minimalist approach to pandemic control has hurt businesses more than it has helped, with many cancellations at restaurants and hospitality venues. Supermarkets are now struggling with supplies because employees at every stage of the supply chain are becoming ill.
Meanwhile, last year’s toilet paper wars became this year’s RAT wars as limited supplies of that precious commodity flew off the shelves at often exorbitant prices. Many who are ill with Covid have self-diagnosed with a RAT but have not undergone PCR testing. These numbers are invisible to official case counts.
Citizens are being told to not call 000, to not attend hospital, and to look after themselves if they are 65 or under and have Covid.
People on limited incomes have been left to fend for themselves, without even basic home care plans or advice on testing, ventilation and masks.
Medicare is supposed to provide a basic level of health care to all Australians. That includes prevention and public health initiatives.
If the government wanted to limit PCR tests, they could have offered both PCR and RATs at the testing sites depending on your situation. Money would be saved and we would still have a handle on the caseload in the community and business would have fared better.
The government should have procured and provided Covid preparedness kits to be delivered to people who test positive so they could monitor their condition at home.
Meanwhile, there’s no national rapid antigen test strategy and the government has had plenty of notice.
In the final days of 2021, national cabinet was somehow convinced to agree to a redefinition of a “close contact” as a person in the same household as a Covid case for more than four hours. There is no science behind this change of definition: the evidence shows 15 minutes is the time it takes to get infected.
We are told by our leaders not to look at the case numbers, and to look at hospitalisations and ICU admissions instead. Meanwhile, hospitalisations and ICU admissions are escalating and many who would normally be treated in hospital are being told to manage their condition at home.
“Letting it rip” will not end the pandemic, nor will it help business or the economy. “Letting it rip” will not turn this into an endemic disease with herd immunity. There will be another wave of another variant.
In the absence of leadership from the government, people will need to increasingly look to credible medical leadership, as political leaders tell Australians to take matters into their own hands.
Preventing transmission is our only way out of this.
- Dr Kerryn Phelps is a GP, past AMA president and member of OzSAGE