International borders are about to open, but our research shows the plight of stranded Australians is not over


James Ross/AAP

Holly Seale, UNSW; Adam Craig, UNSW, and Meru Sheel, Australian National UniversityAustralia’s international borders are due to reopen next month for people returning to states with 80% vaccination rates.

Australian citizens and permanent residents who are fully vaccinated with an approved vaccine will be allowed to quarantine at home. They will also be able to leave Australia without exemption from early November.

But this does not mean the plight of Australians who have been stranded overseas during the pandemic is over.

We have been tracking the experience of this group during the pandemic. Our research shows not just the inadequacy of government support to this group, but some of the immediate and potentially long-term impacts on their lives. In this piece, we also set out some of the other barriers that continue to make coming home to Australia so difficult.

More people stranded than we think?

In a bid to stop the spread of COVID, in March 2020 Australia closed its borders to all non-citizens and non-residents, giving it some of the world’s strictest border rules. While Australian citizens could still officially travel to Australia, the huge reduction in available flights made it all but impossible for many to get home.

A family arriving in Canberra after a repatriation flight in 2020.
Australia’s international border has been shut for more than 18 months.
Lukas Coch/AAP

According to the Department of Foreign Affairs, there are currently more than 45,000 Australians overseas registered as needing help to come home.

But advocacy group Reconnect Australia says the number could be much higher. This is based on an estimated one million Australians living abroad, 30% of Australians born overseas and two million temporary visa holders in Australia – most of whom would not be eligible for DFAT reparations or do not fit a category of travel exemption.

Survey: psychological and financial impacts

Over the past 18 months, countless distressing stories have been shared across the mainstream media and social media of stranded travellers who have had flights postponed or cancelled. This includes people missing funerals of close family members, being separated from their partners and children, or being unable to visit sick family members.

To better understand this phenomenon, we examined the psychological and financial impacts of being stranded abroad during this pandemic.




Read more:
Australians don’t have a ‘right’ to travel. Does COVID mean our days of carefree overseas trips are over?


In September this year, we surveyed 1,330 stranded travellers from around the world (including Australians) and identified that 64% had moderate to extreme depression. While others reported anxiety (42%) and stress (58%) resulting from their situation.

Some of our participants also reported homelessness, significant financial distress, and little to no support being given from their national governments.

Government support for those stuck overseas

The responsibility to assist these stranded travellers generally falls on “home” governments for support.

In an upcoming study lead by Pippa McDermid, we analysed the availability of government assistance, including financial help, emergency housing and mental health support to citizens of eleven countries stranded overseas by COVID restrictions. This includes Australia, New Zealand, Canada, the United States, United Kingdom, France and Thailand.

No country provided comprehensive assistance in all areas.

Passengers arrive in Brisbane in April 2020.
Australian children under five can only come back to Australia if they travel with an adult.
Dan Peled/AAP

Only Spain and France appeared to have developed a solution to emergency housing needs for citizens in need stuck abroad, with Spanish or French nationals either hosting citizens in need or requesting emergency accommodation on the respective platforms.

Australia was one of six countries to provided some form of mental health support to citizens, with detailed resources and referrals to mental health support services abroad.

It was also one of five that provided financial assistance. However, loan applications were not straightforward and funds were required to be be paid back within six months. Other countries, including France, appeared to be more flexible with the financial support provided.

In terms of the clarity of information provided on government websites, Australia’s was rated as “fairly difficult to difficult” to read, based on standard readability scores. This was worse than scores for the UK, France and Canada.

Enough flights to get everyone back?

While Australia reopening borders is good news, concerns remain about airlines’ capacity to bring stranded travellers home. For example, it took approximately ten minutes for a recently announced DFAT repatriation flight from London to sell out.

Labor senator Kristina Keneally holds up photos of Australians stranded.
Labor senator Kristina Keneally holds up photos of Australians stranded overseas, during a Canberra press conference in 2020.
Lukas Coch/AAP

Concerns have also been raised that Qantas doesn’t have enough planes to operate all the international flights it is currently selling for next year. Other international carriers are waiting for clarity from the Australian government before resuming their flights schedules

Falling through cracks

Meanwhile, some Australian citizens stranded abroad are watching their visas edge towards expiry. Through our research, we have heard stories these people cannot find flights home and so end up applying for a temporary visa, often in a third country, adding to the disruption, stress and costs imposed on them by the travel restrictions.

One traveller we spoke to during our research, based in China, simply cannot afford the costs of the flights. They also need to give their employer 30 days’ notice if they intend to leave the country. If their flights get cancelled, they risk being left without a work permit. Australian government funding does not meet the cost of flights.

Realistically, we expect that it will take a couple of months for the reopening to be sorted out in different states. As much as we would love to be home for Christmas, we think sometime in the first quarter of next year will be more likely.

Those stranded want to clarify is they have tried to get home – but the availability and predictability of flights is a huge hurdle.

What about unaccompanied kids and non-citizens?

Another issue of concern is the plight of children who remain stranded abroad without their parents.

As of July this year, there were 438 unaccompanied Australian children still stranded overseas due to COVID restrictions. Complicating this, those under four are not allowed to travel on their own, while children aged between five and 11 can only travel alone only if their flight is less than four hours.




Read more:
The crisis in India is a terrifying example of why we need a better way to get Australians home


Meanwhile, little has been said about what rights Australian-based non-citizen residents will have once travels starts again. These include people studying or working temporarily in Australia, who have not been able to return short-term to their country of origin.

If they leave Australia, there are still no guarantees they will be able to return in a timely way to complete their studies or work contracts.

What needs to change now

As we begin to emerge from restrictions, there are many things the federal government could do to improve the conditions for those stranded, and speed up their return home. These include:

  • provide clarity about when and how stranded passengers will be repatriated
  • work closely with airlines to ensure that flights and services reflect the countries where stranded travellers are located
  • provide easier access to financial loans
  • revise government information online to ensure that it is timely, relevant, and easy to access
  • include temporary visa holders in the group of those able to access home quarantine
  • develop a fair plan for those who have been unable to access vaccinations overseas or who are vaccinated with an unrecognised vaccine
  • ensure mental health services are available for those abroad.

While the role of border control as a highly effective strategy in the control of COVID cannot be underrated, it raises serious questions about how to protect public health without long-term disruption to and negative impact on people’s well-being.

When updating guidelines for future pandemics and other emergency events, it is critical we also change how we support citizens, residents and temporary visa holders who are stranded abroad.

The authors would like to thank Pippa McDermid and Siobhán Talty for their contributions to the article.The Conversation

Holly Seale, Associate professor, UNSW; Adam Craig, Senior Lecturer in Global Health, UNSW, and Meru Sheel, Epidemiologist | Senior Research Fellow, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How a random sampling regime could help detect COVID and highlight infection hotspots


Hannah Peters/Getty Images

Stephen John Haslett, Massey University and Richard Arnold, Te Herenga Waka — Victoria University of WellingtonFor the detection of community transmission of COVID-19, New Zealand currently relies on contact tracing, testing of self-selected people with symptoms and those with permission to travel between different alert levels, and surveillance testing of staff at businesses permitted to operate in higher alert levels.

Surveillance testing has picked up cases before they knew they were contacts of another infected person. But people who are only tested after they feel unwell may have already passed the virus on to several others. Others who have COVID-19 may not display symptoms.

As a supplement to current testing, we suggest a sound, properly designed random sampling regime of certain areas or workplaces to provide a cost-effective way to determine, with known probability, if there is any COVID-19 in a specified area or group.

The critical point is that such COVID Clearance Check surveys must be random.

Continued wastewater testing, contact tracing and community testing stations remain critically important. But they don’t provide any measures of accuracy because currently they don’t incorporate formal sampling designs.

Probability theory behind random sampling

A statistically designed random sampling scheme, based on as few as 100 people or households from key sub-populations, would give a very high probability of detecting if there are any COVID-19 cases. However, to determine this probability, it is critical the sampling is random.

Geographical locations could include certain neighbourhoods and wastewater catchment areas. Workplace sampling could focus on large businesses, rest homes, hospitals and prisons.

COVID Clearance Checks based on random sampling could shorten lockdowns, lessen social impact, save money and support businesses. Once Aotearoa’s borders reopen, they would provide critical information of known accuracy about infection hotspots.




Read more:
COVID will likely shift from pandemic to endemic — but what does that mean?


The formal sampling scheme is based on probability theory, which provides the mathematical connection between COVID prevalence (p₀), sample size (n) and the probability of detecting the virus in the subpopulation (p).

Unless a subpopulation is very small, its size has little effect on the sample size required. For a simple random sample, which selects people or households essentially independently and with equal probability, the probability of detecting COVID is:

p = 1-(1-p₀)ⁿ

For example, for a 3% prevalence of COVID and a random sample of 100, the chance of detecting the virus is over 95%. A larger sample would be required to detect COVID at lower prevalence, for clustered random sampling schemes, or for higher levels of detection probability.

Instead of simple random sampling of households, systematic sampling (which selects households at a fixed interval in a list or along a route) could be used to simplify fieldwork without loss of accuracy.

Survey design and structured fieldwork would provide the mechanism for implementing the random selection of people and safe work conditions for the sampling team. For random sampling, this is now feasible because saliva tests have recently been approved by the Ministry of Health.

Using self-administered saliva tests would reduce close contact between field staff and household members, minimising the risk of spread.

A rapid antigen testing kit
New Zealand has approved the use of rapid antigen testing as a screening tool to protect critical worksites.
Phil Walter/Getty Images

How it would work

Examples where a COVID Clearance Check survey would be useful include towns or city suburbs, and households in catchment areas with positive wastewater results. Sampling areas around MIQ facilities, but not including them, would provide information on possible community transmission.

As a first step, the Ministry of Health would identify particular areas or groups of interest, and then randomly select a sample within it, using statistically sound methods, to ensure every person had a known non-zero chance of being included.

For area sampling, having pre-notified residents, field staff would drop off saliva tests at each sampled household. Household tests would then be collected, either for separate individuals or combined, using set safety protocols.




Read more:
Antigen tests for COVID-19 are fast and easy – and could solve the coronavirus testing problem despite being somewhat inaccurate


Any selected households which do not return test results would be contacted again to reduce non-response bias. Any detected cases would bring other current control mechanisms into play.

Detecting all cases in an area is different and more difficult than detecting whether there are any cases. Cases detected by COVID Clearance Check sampling provide a searchlight rather than fully illuminating the situation. Finding all cases would require much larger sample sizes, which is why such checks supplement rather than replace current surveillance methods.

Using well-designed and implemented random sampling schemes can be an effective, rapid and low-cost way of assessing whether there are any community cases, without testing thousands of people who are not necessarily those of greatest interest. When useful, such surveys can be repeated, using another sample from the same area or group.

As we are now all realising, keeping COVID-19 out of Aotearoa cannot be a long-term plan. Once vaccination rates are high and borders begin to reopen, COVID Clearance Checks using random sampling to monitor possible hotspots will become increasingly useful, even necessary, for surveillance.


Alistair Gray, at Statistics Research Associates, is also a member of the Ministry of Health COVID-19 Expert Advisory Network and has collaborated with us on this article.The Conversation

Stephen John Haslett, Emeritus Professor of Statistics, Massey University and Richard Arnold, Professor of Statistics and Data Science, Te Herenga Waka — Victoria University of Wellington

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Vital Signs: JobKeeper delivered what was needed to save the patient


Wes Mountain/The Conversation, CC BY-ND

Richard Holden, UNSWTo the critics, the Treasury has just marked “its own homework”.

It has produced a 60-page report entitled Insights from the first six months of JobKeeper.


Commonwealth Treasury, October 11, 2021

And it finds the A$89 billion program it designed and delivered held up pretty well last year at the time Australia needed it most.

As with the Labor government’s economic rescue programs during the global financial crisis, there are critics claiming it was wasteful, this time from the Labor side of politics.

But they’ve exceedingly short memories.

In the first week of March 2020, Australia had 93 COVID-19 cases and three deaths.

The prime minister said he was “going to the footy” and “looking forward to it”, at a time when medical experts were calling for people to do no such thing and a quarter of Italy was locked down.

Italian tourists were coming in freely. We were sleepwalking into a calamity.

The way we were

On March 10 last year, I wrote that we needed to close our international border totally and immediately, and spend about $100 billion to support workers and business while we shut down the economy and got health measures in place.

On March 20 the borders were closed. Treasury forecast that if we had to lock down as hard as Italy or Spain our economy (GDP) would collapse by 24%.

That wouldn’t be a mere recession or even a depression. It would be economic and financial Armageddon. The government needed to plug an unimaginable hole quickly. And it did.




Read more:
The key to the success of JobKeeper is retrospective paid work


JobKeeper provided six months of financial support to businesses who expected their revenues to drop. At the time, that was almost every business in the country.

It was designed to be easy to understand, and to get money onto business and household balance sheets immediately.

Most importantly, it was designed to give recipients certainty in a time of calamitous uncertainty.

These are facts. They are undisputed.

What the critics say now

From the safety of the present day, critics point out that JobKeeper excluded certain industries and workers: short-term casuals and universities among them.

And they say $19.7 billion went to businesses whose revenues increased in the three months they received the payment.




Read more:
Quick, dirty, effective: there was no time to make JobKeeper perfect


It would have been better, they say, not to spend the money on businesses that turned out to have rising revenues, and it would have been good to include short-term casuals and universities.

JobKeeper should have included a “clawback” provision, they say.

They are right. It would have been better had it been designed in that way. But they are taking insufficient account of what things were like at the time.

What things were like then

The context for the development of JobKeeper was a once-in-a-century event, with a government in power whose entire political brand had been railing against “debt and deficits”.

Economists were concerned the government might do too little, or nothing at all.

There are the three things worth noting:

  • Treasury had to act incredibly quickly, in a matter of days. I like an academic seminar as much as the next person, but Treasury didn’t have the luxury of years of work, refinement and debate. It had to perform battlefield surgery.
  • A key reason so many businesses were able to increase revenues after JobKeeper began was that it was so effective. A smaller scheme, with more requirements and red tape, would have meant fewer workers and business would have got support, leaving the whole economy worse off.
  • The more carve-outs and exclusions from JobKeeper the less effective it was likely to be. Fine-tuning rules creates uncertainty. It provides scope for gaming (getting around the rules). If we want public programs to have force, they need to be simple.

The real choice in March 2020 was JobKeeper as it was or no JobKeeper at all.

We saved the patient

In early March 2020 the Australian economy was critically ill .

Doctors Josh Frydenberg (Treasurer) and Steven Kennedy (Treasury Secretary) saved the patient. That’s what matters.

Did they use ECG machines, blood bags, gauze and stitches? You bet.

Did it cost economic resources? Probably, although had the worst had happened even more resources might have been used.

Insurance can look wasteful after the fact, but that doesn’t make it unwise.




Read more:
The GFC provided the sauce we used to ward off the COVID recession


I am glad they erred on the side of too many stitches rather than too few.

They provided the only thing that can really help in times of extreme uncertainty, which is certainty.The Conversation

Richard Holden, Professor of Economics, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

IBAC vs ICAC: what are these anti-corruption commissions and how do they compare?


James Ross/AAP

Yee-Fui Ng, Monash UniversityToday Victoria’s anti-corruption commission begins public hearings into allegations of branch stacking by Labor MPs and their staff.

This follows news Victorian Premier Daniel Andrews is being questioned by the Victorian Independent Broad‑based Anti‑corruption Commission (IBAC) over his dealings with the firefighters union (Andrews says he has behaved “appropriately”).

It also comes as New South Wales Premier Gladys Berejiklian sensationally fell on her sword last month. She resigned after revelations the NSW Independent Commission Against Corruption (ICAC) was investigating whether there was a conflict between her public duties and private interests, which she denies.

This has all further heated up the debate about the proposed federal integrity commission. The Morrison government is expected to introduce legislation establishing the Commonwealth commission by the end of the year. But its proposed model has been criticised as being too weak.

So, what are these anti-corruption commissions? And what are differences between ICAC in NSW and IBAC in Victoria?

What are anti-corruption commissions?

Anti-corruption commissions investigate corruption in government. They can be given strong coercive powers to do so, including the power to compel documents and witnesses.

Former NSW premier Gladys Berejiklian
Former NSW Premier Gladys Berejiklian quit her role last month, in the face of an ICAC investigation.
Bianca De Marchi/AAP

ICAC was established in NSW in 1988 by then premier Nick Greiner. A few years later, Greiner became the first premier to resign due to an ICAC investigation. Victoria’s IBAC was set up in 2012 following an election commitment by the Baillieu Coalition government (who made the pledge during opposition).

There are three main differences between IBAC and ICAC – jurisdiction, power and procedures.

IBAC vs ICAC

When IBAC was set up, it was criticised by prominent former judges at the Accountability Roundtable as a “toothless tiger,” given the high threshold of what it could investigate – it must be “serious corrupt conduct” before an investigation can start.

We should note here, the investigation threshold for the proposed Commonwealth Integrity Commission is even higher, requiring a reasonable suspicion of corruption amounting to a criminal offence before an inquiry can even begin. This is a difficult hurdle to clear.




Read more:
A federal ICAC must end the confusion between integrity questions and corruption


The Andrews government increased the jurisdiction of IBAC in 2016, removing the requirement for corrupt conduct to be “serious”, and adding the ability to investigate misconduct in public office.

But IBAC’s jurisdiction remains more limited than ICAC’s, which has broad powers to investigate any allegation upon suspicion of corruption. This includes alleged substantial breaches of the ministerial and MP codes of conduct.

IBAC’s powers are also more limited than ICAC. It is unable to use coercive powers to conduct preliminary investigations to determine whether matters warrant full examination. By contrast, ICAC has the full use of coercive powers, including for preliminary investigations.




Read more:
As a NSW premier falls and SA guts its anti-corruption commission, what are the lessons for integrity bodies in Australia?


Finally, ICAC holds public hearings as a matter of course. But IBAC can only hold public hearings in exceptional circumstances and when it is in the public interest to do so.

In short, ICAC is a more powerful commission than IBAC.

Who watches the watchdogs?

A big question is about how we ensure anti-corruption commissions do not overstep their bounds. Given their broad coercive powers, how do we hold them to account?

In Australia, anti-corruption commissions are subject to a strong system of accountability through parliaments and the courts.

Victorian Premier Daniel Andrews.
Daniel Andrews says he will not stand down over news IBAC is looking at his dealings with the firefighters union.
James Ross/AAP

IBAC and ICAC report to dedicated parliamentary committees who scrutinise their actions and decisions. Complaints against IBAC and ICAC can be made to a dedicated inspectorate – an independent statutory officer who oversees their actions.

Where the anti-corruption commissions go beyond the legal boundaries of their roles, the courts will police it. For example, in 2015, the High Court shut down an investigation against crown prosecutor, Margaret Cunneen. The court found ICAC had no power to investigate allegations Cunneen had advised her son’s girlfriend to fake chest pains to avoid a breath test after a car crash. This is because Cunneen’s actions occurred when acting as a private citizen (not as crown prosecutor) – and so did not fit the definition of “corrupt conduct” in the NSW legislation.

So the idea that anti-corruption commissions are not accountable is simply untrue.

Under attack

Anti-corruption commissions like IBAC and ICAC tend to be unpopular within governments because they scrutinise government action and may expose improper conduct or corruption within their ranks.

It is regrettably common for governments hostile to anti-corruption commissions to attack them, including by reducing their powers or funding.




Read more:
ICAC is not a curse, and probity in government matters. The Australian media would do well to remember that


In this vein, the latest barrage of criticisms by politicians of ICAC following Berejiklian’s resignation is rather predictable. It is part of a broader pattern of attacks on oversight bodies that police government action.

This is despite their integral role in our democracy. Alongside other oversight bodies such as the ombudsman and auditor-general, anti-corruption commissions form part of an intricate, interlocking integrity framework that monitors executive action.

In this light, the design of the proposed Commonwealth Integrity Commission is fundamental. Australians deserve a robust system of accountability that will keep our politicians honest.The Conversation

Yee-Fui Ng, Associate Professor, Faculty of Law, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

PNG and Fiji were both facing COVID catastrophes. Why has one vaccine rollout surged and the other stalled?


Hannah Peters/Getty Images

Ian Kemish, The University of QueenslandThings were looking very bad three months ago for both Papua New Guinea and Fiji. The two Pacific countries were each looking very vulnerable to the COVID Delta variant, albeit in different ways.

On July 10, PNG recorded its first official Delta case, and the nation’s health professionals were soon warning the combination of very low testing rates, high percentage of positive tests and an extremely slow vaccine rollout provided a “recipe for a major spread”.

Fiji was already in the thick of it at the time. After the deadly Delta strain entered the country via a quarantine breach in April, per capita infection rates became the highest in the world in the middle of the year.

Daily infections reached more than 1,800 in mid-July – a huge number for a country of only 900,000 people. The crisis caused 647 deaths.

Fast forward several months and PNG and Fiji are heading in opposite directions. More than 95% of eligible Fijians over the age of 18 have now received their first jab, and 80% are now fully vaccinated.

By contrast, PNG is in the grips of a major wave, with less than 1% of the total population fully vaccinated. PNG is trailing much of the world.

Why have two Pacific countries, which share Melanesian cultural connections, handled their vaccine rollouts so differently?

Not a matter of geography or vaccine supply

Fiji’s daily infection rate today is 4% of what it was at the peak, and it’s falling. Less than 50 new cases are currently being reported on average each day.

In PNG, the official infection rate is now averaging just under 300 new cases per day, but this drastically understates the reality of what is happening in the country.

Extremely low testing rates simply cannot be relied upon. The country’s own health data reportedly shows 2.6 million cases of flu- and pneumonia-like symptoms over the last year, and Port Moresby General Hospital is now reporting positive COVID testing rates of 60%. Like other hospitals across the country, it risks being overwhelmed by the virus.




Read more:
The Pacific went a year without COVID. Now, it’s all under threat


It’s not simply a vaccine supply issue. At this stage of the global crisis, PNG, like Fiji, has received substantial vaccine deliveries – principally from Australia, New Zealand and the COVAX vaccine delivery initiative.

In fact, thousands of PNG’s early deliveries went to waste because the health authorities were unable to use them. The PNG government has recently made the best of a bad situation by re-gifting 30,000 vials donated by New Zealand to Vietnam.

We can also set aside any suggestion Australia, as the major regional donor, is somehow favouring one country over the other.

The Australian government has put a high priority on providing vaccines to both countries in recent months. Its assistance has also extended to education and logistical efforts, along with targeted medical emergency teams and support for those with expertise and capacity on the ground.

Nor is it really a matter of distribution.

PNG’s geography does present some challenging physical barriers to distributing vaccines – its legendary mountainous terrain and the remoteness of many of its inhabitants are well known.




Read more:
Australia wants to send 1 million vaccine doses to PNG – but without reliable electricity, how will they be kept cold?


But companies from Digicel to South Pacific Brewery manage to penetrate the most inaccessible areas with their products despite these difficulties. And the authorities manage to deliver the vote across the nation every five years in what is one of the world’s most extraordinary democratic exercises.

With its own rugged terrain and dispersed populations across multiple islands, Fiji has also faced major physical impediments to its vaccine rollout.

The major difference: leadership and belief

We get closer to the problem when we think in terms of trust, understanding and belief.

Fijians have embraced the vaccination rollout almost as one, following the guidance of their medical authorities and falling in line with the firm “no jabs, no job” policy of its prime minister, former military commander Frank Bainimarama.

In PNG, the term “vaccine hesitancy” understates the problem. One survey earlier this year showed worrying low willingness to take the vaccine, and another survey of university students showed a mere 6% wanted it.

Vaccine patrols have received death threats in some areas, and any politician who speaks out in favour of vaccination risks a political backlash. Strong efforts are now being made to overcome this problem, with the health authorities preparing a fresh approach and iconic figures such as rugby star Mal Meninga supporting the publicity effort.

These dramatically contrasting pictures cannot be explained fully through differences in education standards, or the quality of medical advice and attention.
To be sure, Fiji leads PNG in these respects – Fiji has 99% literacy compared to just over 63% in PNG, according to the latest available figures. And while Fiji’s medical system has its challenges, the decline in PNG’s health services due to chronic lack of investment puts it in a very different category.




Read more:
Pacific nations grapple with COVID’s terrible toll and the desperate need for vaccines


In PNG, trust in leadership has flagged following decades of frustration with growing wealth inequality and concerns over governance and transparency.

Rather than trust official sources, people often look to Facebook and other social media for their information, and are thus vulnerable to the dangerous nonsense peddled by the anti-vaccination movement in the west.

I know how quickly Papua New Guineans tap into what’s happening in neighbouring Australia, too. They will have seen how the public debate here has dented confidence in the AstraZeneca brand – the mainstay of their own vaccine supply.

But perhaps most troubling of all is the sense that many Papua New Guineans have developed a fatalistic belief that COVID is just another health challenge to add to the litany of other serious problems facing the country, among them maternal mortality, malaria and tuberculosis.

It’s almost as if they believe this is all somehow PNG’s lot. But it doesn’t need to be.The Conversation

Ian Kemish, Former Ambassador and Adjunct Professor, School of Historical and Philosophical Inquiry, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

No, COVID vaccines don’t stay in your body for years


Vasso Apostolopoulos, Victoria University; Jack Feehan, Victoria University, and Maja Husaric, Victoria UniversityAs Australia strives to reach its national COVID vaccination targets, there’s unprecedented focus on the biological effects of vaccines.

While there’s an enormous amount of information available online, it’s increasingly difficult to discern truth from falsehood or even conspiracy.

A common myth of vaccines that has appeared in recent months is the accusation they remain active in the body for extended periods of time – a claim which has increased vaccine hesitancy in some people.

However, vaccines are cleared from your body in mere days or weeks. It’s the immune response against the SARS-CoV-2 virus that appears to last for a long time.

This isn’t due to the vaccines themselves remaining in the body. Instead, the vaccines stimulate our immune system and teach it how to respond if we’re ever exposed to the coronavirus.

Let’s explain.

How do vaccines work?

All vaccines, no matter the technology, have the same fundamental goal – to introduce the immune system to an infectious agent, without the risk that comes from disease.

The vaccine needs to follow a similar pathway a virus would have taken to produce an adequate immune response. Viruses enter our cells and use them to replicate themselves. So, the vaccines also need to be delivered in cells where proteins are produced, which mimics a component of the virus itself.

The COVID vaccines all do this by delivering information into our muscle cells, usually in our upper arm. They do this in different ways, such as using mRNA, like Pfizer’s and Moderna’s, or viral vectors, like AstraZeneca’s.

Regardless of the technology, the effect is similar. Our cells use the genetic template in the vaccine to produce the coronavirus’ spike protein, which is a part of the virus that helps it enter our cells. The spike protein is transported to the surface of the cell where it’s detected by the immune cells nearby.

There are also other specialised immune cells nearby, which take up the spike proteins and use them to inform more immune cells – targeting them specifically against COVID.

These immune cells include B cells, which produce antibodies, and T cells, which kill virus-infected cells. They then become long-lasting memory cells, which wait and monitor for the next time it sees a spike protein.

If you’re exposed to the virus, these memory B and T cells allow a faster and larger immune response, destroying the virus before it can cause disease.




Read more:
Revealed: the protein ‘spike’ that lets the 2019-nCoV coronavirus pierce and invade human cells


So what happens to the vaccine?

Once they’ve initiated the immune response, the vaccines themselves are rapidly broken down and cleared from the body.

The mRNA vaccines consist of a fatty shell, which encapsulates a group of mRNA particles – the genetic recipe for the spike protein. Once this enters a cell, the shell is degraded to harmless fats, and the mRNA is used by the cells to produce spike proteins.

Once the mRNA has been used to produce proteins, it’s broken down and cleared from the cell along with the rest of the mRNAs produced by the normal function of the cell.

In fact, mRNA is very fragile, with the most long lasting only able to survive for a few days. This is why the Pfizer and Moderna vaccines have to be so carefully preserved at ultra-low temperatures.

The vector vaccines (AstraZeneca and Johnson and Johnson) use an adenovirus, which is harmless in humans, as a vector to deliver a genetic template for the spike protein to the cells.

The vector virus has all of its infectious components removed, so it’s unable to multiply or cause disease. Then a genetic template for the spike protein is inserted into the vector.

Once the vaccine is injected, the vector virus binds to your cells and inserts its genetic components, before the shell breaks down and is removed.




Read more:
How long does immunity last after COVID vaccination? Do we need booster shots? 2 immunology experts explain


The viral machinery gets the genetic template into the control room of the cell, the nucleus, where it takes advantage of our normal protein building activity. The vaccine doesn’t cause any alteration to our DNA.

Normally, this would cause the cell to start producing more copies of the virus, but since this was all removed, all that’s produced is the spike protein.

Again, after making a large amount of the spike, the genetic templates are broken down in a matter of days or weeks.

What about the spike protein?

While the vaccines themselves are rapidly removed, what then happens to all the spike proteins that are produced as a result?

They’re identified as foreign by the immune system and destroyed – teaching the cells to recognise the coronavirus in the process.

The spike proteins are fully cleared from the body after a few weeks. In this time, they don’t appear to leave the vaccination site (most often your upper arm).

But antibodies specifically targeting the spike protein produced by your immune system remain in the body for many months after vaccination.

The vaccines also stimulate your immune system to produce memory immune cells. This means even once antibody levels diminish, your immune system is ready to produce more antibodies and other immune cells to tackle the virus if you’re ever exposed to it.




Read more:
How long does immunity last after COVID vaccination? Do we need booster shots? 2 immunology experts explain


The Conversation


Vasso Apostolopoulos, Professor of Immunology and Associate Provost, Research Partnerships, Victoria University; Jack Feehan, Research Officer – Immunology and Translational Research, Victoria University, and Maja Husaric, Senior Lecturer; MD, Victoria University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

ICAC is not a curse, and probity in government matters. The Australian media would do well to remember that


AAP/Bianca de Marchi

Denis Muller, The University of MelbourneJournalists are adept at creating and reflecting public sentiment. It is a reciprocating process: journalistic portrayal creates the sentiment, then the sentiment feeds back into journalistic portrayal.

This phenomenon can be seen clearly in the way the resignation of New South Wales Premier Gladys Berejiklian has been reported and commented on.

The problem is that public sentiment does not always remain tethered to the underlying facts, so journalism that continues to reflect that sentiment likewise tends to become unmoored.

The sentiment about Berejiklian is based on a narrative about a good woman and excellent state premier led astray by a rogue boyfriend who abused his relationship with her to advance his interests in ways that led to his being investigated for corruption. In the process, he dragged her down with him.

In essence, it is a tale we are familiar with, may even have experienced at close hand: a good person making decisions of the heart until confronted by an ugly reality. Beats there a heart so cold that cannot sympathise with this predicament?

Much of the coverage of Berejiklian’s resignation has drawn on and fed into this narrative.

It had worked for her previously when she first appeared before ICAC in October 2020, so she no doubt thought it would work again. To a large extent, she has been proved right.




Read more:
Berejiklian’s downfall derailed a career built on accountability and control. Now, who will replace her?


In this telling, the NSW Independent Commission Against Corruption deliberately brought down this paragon at the height of her powers to the detriment of the public welfare, disrupting the government at a crucial moment in the pandemic.

In this telling, too, ICAC becomes the wrongdoer. Instead of stalling its investigation until heaven knows when – the pandemic is over, the federal election is done – it irresponsibly pushes on regardless.

The surprising thing is that this line of chat has been accepted uncritically by so many elements of the media.

Their understanding is not improved by coverage like this.

The facts are that ICAC is investigating the suspected corrupt allocation of about $35.5 million in taxpayers’ money: $30 million to the Riverina conservatorium of music at Wagga Wagga and $5.5 million to the local clay-shooting club.

ICAC is investigating whether Berejiklian, while NSW treasurer, allowed or encouraged corrupt conduct by her ex-boyfriend, the disgraced former Liberal MP for Wagga Wagga, Daryl Maguire, in respect of those allocations.

ICAC says it is investigating whether, between 2012 and 2018, Berejiklian engaged in conduct that “constituted or involved a breach of public trust” by exercising public functions relating to her public role and her private personal relationship with Maguire.

It says it will begin a four-week inquiry into these questions on October 18.

It should not be presumed that ICAC will make adverse findings against Berejiklian. In similar circumstances in 1983, Neville Wran stood aside as premier during a royal commission into corruption in rugby league. He was exonerated and resumed office.

So a further fact in the present case is that Berejiklian chose to resign rather than stand aside.

It is a fair bet she was unnerved by the prospect of NSW being in the hands of her National Party deputy John Barilaro for any length of time. By her resigning, the state gets a new premier from within the Liberal Party. It was a calculated choice.

ICAC is not a curse. Anyone involved in public affairs in NSW before 1988 when ICAC was established – public officials, politicians, journalists – knew that certain parts of the state administration were riven with corruption. Police, planning, prisons, even the magistracy: repeated scandals engulfed them all.

ICAC has been and remains a remarkable force for good.

A sad irony was that Nick Greiner, the Liberal premier who had the courage to establish it, became one of its early victims. In 1992 ICAC found he had misused his position to secure an independent MP’s resignation for political advantage. Greiner fell on his sword.




Read more:
History repeats: how O’Farrell and Greiner fell foul of ICAC


It is instructive to consider how many of the Morrison cabinet would survive exposure to an ICAC investigation.

Berejiklian’s alleged conflict of interest is not a trivial matter. It involves substantial sums of public money in an exercise that she has previously dismissed as “pork-barrelling”.

This disarming term, rendered harmless by repetition, is actually about the improper distribution of public money. It is a form of vote-buying, as has been shown in the procession of rorts engaged in by the federal government over sports grants, community security grants and car parks.

ICAC exists to root out these and other ways by which the democratic process is corrupted.

It is undoubtedly a personal tragedy for Berejiklian that she has found it necessary to resign, and a misfortune for the state to lose a premier who was held in high public regard.

However, sentiment that draws a misty veil over underlying issues of probity in public life does not serve the public well.




Read more:
The ‘car park rorts’ story is scandalous. But it will keep happening unless we close grant loopholes


The Conversation


Denis Muller, Senior Research Fellow, Centre for Advancing Journalism, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How COVID health advice and modelling has been opaque, slow to change and politicised in Australia


William Bowtell, UNSWIn a recent article, The Australian’s health reporter asked: “has any modelling put forward by scientific institutes throughout the pandemic ever proved accurate?”

It’s a good question but the answer lies in understanding the truth about modelling — it cannot predict the future.

Rather, it’s a process that identifies variables most likely to shape the course of, say, a pandemic and to quantify their impacts over time.

Politicians commission modellers to assess the present state of things then consider what might happen if various policy settings were to be adjusted.

By providing assessments of the costs, benefits and impacts of proposed policies, good modelling provides governments with a firm foundation for deciding which policies will have what effects.

Politicians know invoking “health modelling” generates public support for their policies.

This week, federal Treasurer Josh Frydenberg claimed his decision to scrap COVID support payments at 80% double-dosed vaccination coverage accorded with the National Plan as informed by the Doherty Institute modelling.

But in neither the plan nor the modelling is any connection drawn between ending support payments at any level of vaccination coverage.

Nor was any modelling apparently commissioned on the likely impact of removing financial support for the most vulnerable when infection rates are high – as in Sydney – and rising alarmingly as in Melbourne.




Read more:
Scientific modelling is steering our response to coronavirus. But what is scientific modelling?


The power of ‘health advice’

Since the beginning of the COVID pandemic, politicians have justified the many difficult decisions they’ve had to make as being based on “health advice”.

As it should be, “health advice” provided to politicians by chief health officers is informed by modelling commissioned from a range of well-respected and credentialed scientific research institutes.

The public draws a strong causal link between health modelling inputs and policy outcomes.

They are more likely to accept policies buttressed by modelling and health advice than not.

Modelling is therefore a powerful political tool.

In a pandemic, political decisions have human and economic impacts that are irrevocable, significant and for many a matter of life and death.

Even more reason, therefore, for the scientific integrity of modelling that informs those decisions to be beyond reproach.

The brief given to the modellers is critically important in setting parameters and assumptions and selecting the variables that will be assessed and measured.

Transparency is essential

The key to building public trust in modelling is full transparency.

But in Australia, these briefs and processes are often shrouded and opaque. Secrecy and a lack of transparency has greatly affected the quality of Australia’s response to COVID.

At the beginning of the pandemic, the federal government’s Emergency Response Plan for Novel Coronavirus did not canvass the cessation of international travel and closure of borders, domestic lockdowns and the use of masks as possible or desirable responses to the pandemic.

Yet within weeks of this advice being published, the modelling had been overtaken by events.

Travel from some but not all countries was stopped, international and domestic borders closed from late March 2020, and lockdowns implemented across Australia.

In the initial planning and options, lockdowns, cessation of travel and masks were not among the assumptions. The entire response was based on a paradigm of influenza rather than the facts of coronavirus and need for rapid, preventive responses.

The assumptions informing the initial modelling should have been published, interrogated and debated before, and not after, the initial and ineffectual policy settings were adopted.




Read more:
Australia’s COVID plan was designed before we knew how Delta would hit us. We need more flexibility


Separating science from politics

Over the course of the pandemic, the assumptions of modelling commissioned by governments should have been published, scrutinised and debated before, not after, the modelling was undertaken.

Modelling ought to have been commissioned from a range of Australia’s excellent scientific institutions.

Open debate might have meant aerosol transmission of first Alpha and then Delta would have been factored into projections and policy-making about the efficacy of hotel quarantine and border protection far earlier than it was.

This unnecessary addiction to secrecy has eroded the trust and confidence that should exist between governments and the people.

Politics and science each have their separate and distinct roles to play in the managing the pandemic and reducing to the lowest possible levels the damage it causes to lives and livelihoods.

In the response to HIV/AIDS, the politicians of the day ensured scientific advice was provided independently of governments and published as it became available.

The advice became the foundation of the political decision-making process.

Now, as then, Australians expect a similar standard of open and independent scientific advice, information and assessment about the present and likely impact of the pandemic.

Whether commissioned by governments or acting independently, Australia’s pandemic modellers have lived up to their responsibilities to science and the Australian people.

They have applied their expertise to quantifying COVID and the costs and benefits of policy options.

But the critical decisions on assumptions, debate, contestability and transparency are made by politicians, not modellers.

As much as some politicians may wish to deny it, they alone are responsible and accountable to the Australian people for the decisions that have created Australia’s COVID response and will shape its future.

Modelling is integral to building the most robust, sustainable and well-supported response to the increasingly complex challenges of the pandemic.

The Australian people will be best served by separating science from politics.




Read more:
Explainer: do the states have to obey the COVID national plan?


The Conversation


William Bowtell, Adjunct professor, Kirby Institute for Infection and Immunity, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Worksafe’s hotel quarantine breach penalties are a warning for other employers to keep workers safe from COVID


Alex Collie, Monash UniversityVictoria’s occupational health and safety regulator, Worksafe, has charged the state’s health department with 58 breaches for failing to provide hotel quarantine staff with a safe workplace.

The breaches occurred between March and July 2020, and at up to A$1.64 million per breach, could amount to fines of $95 million.

This should serve as a warning to all employers to start assessing their workers’ safety against COVID and how they can mitigate these risks, ahead of the nation reopening.




Read more:
Here’s the proof we need. Many more health workers than we ever thought are catching COVID-19 on the job


Remind me, what is Worksafe?

States and territories have responsibility for enforcing laws designed to keep people safe at work: occupational health and safety (OHS) laws.

Worksafe Victoria is responsible for and regulates OHS in Victoria. It’s responsible for making sure employers and workers comply with OHS laws; and it provides information, advice and support.

Victoria’s parliament has given Worksafe the power to prosecute employers if they breach OHS laws. In 2018-19, it commenced 157 prosecutions which resulted in nearly A$7 million in fines.

Unlike some other state OHS regulators, Worksafe also manages the Victorian workers’ compensation system.

Why did Worksafe charge the health department?

Worksafe charged Victoria’s Department of Health with 58 breaches of sections 21 and 23 of the Victorian Occupational Health and Safety Act.

The Act requires employers to maintain a working environment that is “safe and without risks to health” of employees. These obligations extend to independent contractors or people employed by those contractors.

Worksafe is alleging that in operating the Victorian COVID-19 quarantine hotels between March and July 2020, the Department of Health failed to maintain a working environment that was safe and limited risks to health, both to its own employees and to other people working in the hotels.

Essentially Worksafe is stating that through a series of failures, the department placed government employees and other workers at risk of serious illness or death through contracting COVID-19 at work.

Worksafe alleges the Victorian health department failed to:

  • appoint people with expertise in infection control to work at the quarantine hotels
  • provide sufficient infection prevention and control training to security guards working in the hotels, as evidence shows training can improve employees’ safety practices
  • provide instructions, at least initially, on how to use personal protective equipment, and later did not update instructions on mask wearing in some of the quarantine hotels.

Worksafe undertook a 15-month long investigation, beginning in about July 2020. It’s possible the trigger for this investigation was a referral from the Coate inquiry into hotel quarantine, but that has not been stated.

Is it unusual for a government regulator to fine a government department?

It’s not that unusual. Government departments are subject to the same OHS laws as other employers in the state, and so Worksafe’s powers extend to them as well.

In the past few years, Worksafe has successfully prosecuted the Department of Justice, Parks Victoria and the Department of Health, resulting in fines and convictions.

In 2018, for example, Worksafe prosecuted Corrections Victoria (part of the Department of Justice) after a riot at the Metropolitan Remand Centre in 2015 that put the health and safety of staff at risk.

The riot occurred after the introduction of a smoking ban in prisons. Worksafe considered prisoner unrest was predictable and its impact on staff could have been reduced by having additional security in place in the days leading up to the smoking ban.

In that case the Department of Justice pleaded guilty and was convicted and fined A$300,000 plus legal costs.

What does this mean for other employers?

This case highlights that employers have obligations to provide safe working environments for their staff, and other people in their workplaces. This extends to reducing risks of COVID-19 infection.

These obligations don’t just apply to government departments. They apply to every employer in the state.

Employers should ensure they have appropriate systems and policies in place to reduce COVID-19 infection risk to their staff. This includes, where appropriate, physical distancing, working from home, wearing personal protective equipment (PPE), good hygiene practices, workplace ventilation, and so on.

Employers should consider the risks unique to their environment and address them appropriately, in advance of the nation reopening when we reach high levels of COVID vaccination coverage.

Some employers in high-risk settings – such as health care, retail and hospitality – will need to do more to protect their workers than others.

What happens next for the Vic health department?

The case has been filed in the Magistrates court, with an initial hearing date set for October 22. It will progress through the court system from there. Most prosecutions are heard in the Magistrates Court although some proceed to the County Court.

If the Department of Health pleads guilty, the courts will determine if a fine should be paid and how much. The court may also determine if a conviction is recorded.




Read more:
Soon you’ll need to be vaccinated to enjoy shops, cafes and events — but what about the staff there?


The Conversation


Alex Collie, Professor and ARC Future Fellow, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Relying only on vaccination in NSW from December 1 isn’t enough – here’s what we need for sustained freedom


Dan Himbrechts/AAP

C Raina MacIntyre, UNSW; Anne Kavanagh, The University of Melbourne; Eva Segelov, Monash University, and Lisa Jackson Pulver, University of SydneyThe latest New South Wales roadmap to recovery outlines a range of freedoms for fully vaccinated people in the state when 80% of those aged 16 and over are vaccinated.

Unvaccinated people will remain restricted, but will have the same freedoms by December 1, when 90% of adults are expected to be vaccinated.

The relaxing of restrictions will occur in three stages, at the 70%, 80% and 90% vaccination mark, with many restrictions dropped by December 1.

This includes relaxing the 4 square metre density rule to 2 square metres in most indoor venues; and no indoor mask mandates in most venues except public transport, airports and for front-of-house hospitality staff.

The problem is, other countries such as Israel already tried relying mostly on vaccines to relax restrictions – and failed, albeit at lower vaccination levels than NSW is aiming for.

Vaccines alone may not enough to protect against the highly contagious Delta variant.

So who is most vulnerable under the current plan, and how should the NSW reopening plan change to protect these groups and the wider population?




Read more:
NSW risks a second larger COVID peak by Christmas if it eases restrictions too quickly


Vulnerable group 1: children

About 20% of the population is under 16 years. The 80% adult target corresponds to less than 70% of the whole population, leaving plenty of room for Delta to spread.

One in three children aged 12 to 15 have had a single dose of vaccine, but it may be next year before this age group is fully vaccinated.

Another 1.2 million NSW children under 12 will remain unvaccinated. This is the largest unvaccinated group. With no requirements for unvaccinated primary school children to wear masks, and no plan to ventilate classrooms, outbreaks will almost certainly occur.

Children sit in a classroom, raising their hands.
Children generally get a mild infection from COVID but a small proportion need care in hospital.
Shutterstock

In the US, counties with school mask mandates had much lower rates of COVID in children than counties that did not mandate masks. One unvaccinated teacher who took off her mask to read to a primary school class resulted in 26 people becoming infected.

While children get mild infection compared to adults, around 2% of children who get Delta are hospitalised. Of these, some will require ICU care and a proportion will die. This becomes more apparent when there is high community transmission, and high case numbers in unvaccinated children.

The Doherty report estimates 276,000 Australian children will be infected in the first six months after reopening in the most likely scenario, with 2,400 hospitalisations, 206 ICU admissions and 57 child deaths in that time.

Vulnerable group 2: Aboriginal people

Aboriginal communities in NSW are especially vulnerable to epidemics, contracting COVID and getting severe disease.

There are relatively more children in the under 12 age category in Aboriginal communities, which leaves a much higher proportion of the community unvaccinated.

We saw in the Wilcannia outbreak that a high proportion of cases were in children.




Read more:
COVID in Wilcannia: a national disgrace we all saw coming


Despite this, vaccination rates for Aboriginal communities continue to lag about 20% behind the rest of NSW.

Allowing unrestrained travel into these communities before vaccination rates are high enough to afford protection may be disastrous.

Vulnerable group 3: regional NSW

Remote and regional communities are also vulnerable, because of fewer health services and difficulties with access to care.

An outbreak would disproportionately affect regional NSW.

Vulnerable group 4: people with disability

People with disability, many of whom have significant health conditions, are also at high risk.

Vaccination rates for NSW participants in Australia’s National Disability Insurance Scheme lag state rates by about 14% despite being prioritised in the national rollout.

In the UK, 58% of COVID deaths in the United Kingdom were among people who had a disability. People with intellectual disability were eight times more likely to die of COVID than the general population.

Vulnerable group 5: people with cancer and other conditions

Adults and children living with cancer and other conditions that suppress the immune system may have a poorer response to COVID vaccines, and may need a third dose.




Read more:
Why is a third COVID-19 vaccine dose important for people who are immunocompromised?


The need for third dose boosters in susceptible people is recognised and programs to deliver these are underway in many countries.

Some are vaccinating specific groups: the United States and United Kingdom are providing boosters to all people 65 and 50 years and over respectively.

Others, such as Israel and many European nations, are starting with older adults and immunosuppressed people, and later including the rest of the population.

Australia is yet to formulate such a plan.

Older person's arm with a bandaid after being vaccinated.
Some countries have already started giving boosters.
Shutterstock

Children under 12 years with cancer (not yet eligible for vaccination), also deserve to be protected, by vaccines and/or other measures to stop the spread of COVID in the community.

The consequences of overwhelmed health systems on timely diagnoses and treatment of cancer and other serious illness is already being seen in NSW.

A layered plan for a safer reopening

Currently available vaccines alone will not be enough to control Delta. We will need layered protection including safe indoor air, testing, tracing and masks to continue our lives freely when lockdowns lift.

Here’s what we propose:

1. Implement vaccine targets for at-risk groups

We need to make sure no disadvantaged group is left behind, and that vaccine targets are met for all these groups.

For Aboriginal people, we recommend 85-90% targets be met.

For other groups such as people with disability, particularly those living in congregate settings, higher vaccine targets should also be considered.




Read more:
Vaccinations need to reach 90% of First Nations adults and teens to protect vulnerable communities


2. Make indoor air safer

NSW needs a plan to address indoor ventilation, because the virus is airborne.

This has already occurred in Victorian schools, and should be an important part of lifting restrictions in NSW.




Read more:
From vaccination to ventilation: 5 ways to keep kids safe from COVID when schools reopen


The plan should ensure homes, businesses, schools and other public venues have safe indoor air, and that the community is as well informed on safe air as it is on handwashing, so that people are empowered to mitigate risk in their own homes.

3. Maintain high rates of testing and tracing

We must maintain high testing capacity, make rapid antigen testing widely available, and improve contact tracing capacity.

Suggestions of stopping QR code scanning and thereby reducing contact tracing capacity are misguided, and will result in a resurgence of infection.

We do contact tracing routinely for all serious infections such as TB, meningitis and measles, and need to continue this for COVID-19.

4. Plan for booster doses

We also need to address waning immunity from vaccines and be pro-active about booster doses, particularly for those with reduced immunity or who are immunocompromised, and for health care workers.

For the rest of the population, there is enough real-world evidence protection starts to wane as early as five to six months after vaccination.

It is urgent we address this for health workers and other priority groups such as aged care residents, who were mostly vaccinated six months ago or longer. This is not only for their own safety but to prevent health system collapse from under-staffing due to illness or burnout.

Let’s avoid future lockdowns

In the post-lock down world, NSW will likely face a Delta resurgence if multiple restrictions are simultaneously relaxed, as we have seen in countries overseas.

Dropping most restrictions is also likely to result in repeated stop-start lockdown cycles, prompted by health system strain when cases surge.

Only layered, combined protections will provide a chance of safer and sustainable re-opening until we await the promise of second generation vaccines, boosters and smarter vaccine strategies.The Conversation

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW; Anne Kavanagh, Professor of Disability and Health, Melbourne School of Population and Global Health, The University of Melbourne; Eva Segelov, Professor of Oncology, Monash University, and Lisa Jackson Pulver, Deputy Vice-Chancellor, Professor of Public Health and Epidemiology, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.