Australians fear China-US military conflict but want to stay neutral: Lowy 2021 Poll


Michelle Grattan, University of CanberraChina’s aggressive stands and the sharp deterioration of the bilateral relationship are flowing through strongly to produce record negativity by Australians towards our biggest trading partner.

The Lowy Institute’s annual poll for the first time finds most Australians (52%) see “a military conflict between the United States and China over Taiwan” as a critical threat. This is 17 points up on just a year before.

More than half (56%) think Australia-China relations pose a critical threat.

The poll, “Understanding Australian attitudes to the world”, was done in the second half of March with a sample of 2222. The report is authored by Natasha Kassam. The results on climate and COVID have already been published.




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China-Australia relations have plummeted in recent years, with obstacles currently in place against a range of Australian exports, frequent denunciations of Australia by China, and its government’s continued refusal to return Australian ministers’ calls.

Since the poll was taken, the bilateral relationship has worsened; Scott Morrison at the G7 emphasised the challenge China presented and rallied support for resisting its economic coercion.

Trust in China has continued “its steep decline” according to the poll, reaching a new low. Only 16% of Australians trust China to act responsibly in the world, a 7-point decline from last year. As recently as 2018, 52% trusted China.


Lowy Institute

Just 10% of Australians have confidence in China’s president Xi Jinping to “do the right thing regarding world affairs”. This has halved since 2020 (22%) and fallen 33 points since 2018.

While people were critical of China on almost everything they were asked about in the poll, a majority do not want Australia dragged into a military conflict between China and the United States – 57% say Australia should remain neutral in such a conflict, well above the 41% who believe Australia should support the US.

There is a big age difference on this question: only 21% of those aged 18-29 say Australia should support the US in a conflict, but 58% of those over 60 believe it should.

In one small sign of optimism about China, 72% say it is possible for Australia to have good relations with both the US and China – although this is 15 points lower than in 2013.

China has fallen to the bottom of the Lowy Institute’s “feelings thermometer”, with a 7-point drop to 32 degrees – a 26 degree decline from 2018. This compares, for instance, with the rating of India (56 degrees), Indonesia (55 degrees), and the US (62 degrees),

Asked whether China is more of an economic partner to Australia or a security threat, more than six in ten (63%) see China as “more of a security threat” – a 22-point rise from last year. In contrast, only a third (34%) say China is “more of an economic partner to Australia”. This is 21 points lower than last year.


Lowy Institute

Some 56% believe China is more to blame than Australia for the bilateral tensions, although 38% attribute blame equally.

Having an increasingly negative influence on views of China are its investment in Australia (79%), its environmental policies (79%), its system of government (92%) and its military activity in the region (93%).


Lowy Institute

“Even in relation to China’s strong economic growth story, Australian attitudes have shifted significantly in recent years’, the Lowy report says.

“In 2021, less than half the population (47%) say China’s economic growth has a positive influence on their view of China, a steep 28-point fall since 2016”

The replacement of US president Donald Trump by Joe Biden has been wholeheartedly welcomed by Australians, the poll shows.

Some 69% have confidence in Biden to do the right thing regarding world affairs, 39 points higher than Australians’ confidence in Trump last year. More than six in ten (61%) now trust the US, 10 points higher than last year, but 22 points lower than reached in Barack Obama’s presidency.

There is strong support for the importance of the US alliance (78%), steady since last year) and confidence America would come to Australia’s defence if it were under threat (75%).

Commenting on the poll results, Kassam said “Australia’s China story has changed dramatically since 2018, from one of economic opportunity to concerns about foreign interference and human rights.

“Views of China are to some extent inseparable from the crackdown in Hong Kong, the detention of Uighurs, the disappearance of Australian citizens in China…” she said.

“A year of targeted economic coercion has clearly left its mark on the Australian public, and in a remarkable shift, now even China’s economic growth is seen as a negative. It would also appear that the uptick in China’s military incursions in the Taiwan Strait has not gone unnoticed by the Australian public, though the majority would still prefer to avoid a conflict between the superpowers.”




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China ‘dogged by insecurity’, says outgoing secretary of foreign affair department

China, despite being a great power, was still “dogged by insecurity as much as driven by ambition,” the outgoing secretary of the foreign affairs department, Frances Adamson, said on Wednesday.

In an address before leaving the department later this week, Adamson – a former ambassador to Beijing – said China “has a deeply defensive mindset, perceiving external threats even as it pushes its interests over those of others”.

“It is too ready to suspect ‘containment’ instead of judging issues on their individual merits,” she told the National Press Club.

“And I always find it useful to remind myself when faced with strident official representations that the pressure exerted outwards on other countries must also be felt within, at an individual level, by those subject to that system.

“Insecurity and power can be a volatile combination, more so if inadvertently mishandled. We need to understand what we are dealing with.”

Lamenting the shrinking number of Western journalists in China, Adamson also said less access and less dialogue meant less understanding.

“This siege mentality – this unwillingness to countenance scrutiny and genuine discussion of differences – serves nobody’s interests.

“It means, among other things, that China is undergoing a steep loss of influence in Australia and many other countries.” This was confirmed, she said, by the Lowy poll showing Australians’ trust in China down to record lows.

“What we tell the Chinese government is that we are not interested in promoting containment or regime change.

“We want to understand and respond carefully – for shared advantage. Not to feed its insecurity or proceed down a spiral of miscalculation.

“Nor do we see the world through a simplistic lens of zero-sum competition.

“What we are interested in, and will continue to strive for, is a peaceful, secure region underpinned by a commitment to the rules that have served all of us – China included.”

Adamson said China might hope for Australia to have a fundamental rethink of policy but such hopes would be in denial of the impact of China’s behaviour on Australia, and the broad bipartisanship of its most fundamental policy settings.

“So we approach China with confidence, realism, and an open mind.

“National resilience and internal cohesion are important when dealing with China – but that doesn’t mean we should demand uniformity of viewpoint,” she said.

“Debate about our approach is a strength, not a weakness. Indeed, in an era when political and social freedoms are being rolled back in many parts of the world, a healthy open debate is one of the hallmarks of a liberal system.

“And the best policy always comes from contestability. This is as true of the China challenge as it is of economic or social policy.”

Adamson has been appointed governor of South Australia.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

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

Our research shows COVID has made Australians more conservative and care less about others


James Gourley/AAP

Julie Anne Lee, The University of Western Australia; Anat Bardi, Royal Holloway University of London; Ella Daniel, Tel Aviv University; Maya Benish-Weisman, Hebrew University of Jerusalem, and Ronald Fischer, Te Herenga Waka — Victoria University of WellingtonThe COVID-19 pandemic has already changed so many things about our society and our lives. While some of the impacts can be seen clearly and straight away, others take more digging.

Our new research, based on surveys with Australians before and during the pandemic, suggests COVID also shifted our values. This is surprising because values in adulthood rarely change.

It is also concerning as it showed as a society, we have become less caring and less open to new ideas.

Our research

As part of a larger project at the Centre for Human and Cultural Values, we asked Australian adults aged 18-75 how important different values are in their life.

We asked the same questions to the same group in 2017, 2018, and 2019. When the pandemic started, we were able to ask them the questions early on (April, 2020) and again in November-December 2020. During the pandemic, we also asked how worried respondents were about getting the virus.

Patrons sit outside a pub.
Values in adulthood rarely change, but can be shifted by major events.
Erik Anderson/AAP

We began with a near nationally representative sample of more than 2,300 people, who answered our survey from 2017 onwards. More than half (1,440 people) also responded in the last round in November-December 2020.

This gave us a rare opportunity to look at what impact the pandemic may have had on Australians’ values.

What are values?

Values are broad goals relating to things we think are desirable or worthy, like kindness, safety, adventure or success. There are no “bad” values, but our values can lead us to prioritise very different things.

We may not think about our values all the time, but they direct our way of thinking, and even our behaviour. They direct everyday decisions, such as whether to help a friend in need, or throw an item in the recycling bin. They also guide major decisions, such as which party to vote for, and which profession to choose.

Based on the work of psychologist Shalom Schwartz, our research grouped values into four categories.

  1. Self-transcendence — seeking to care for the welfare of others and nature
  2. Self-enhancement — seeking self-interest through ambition, success, and control
  3. Conservatism — seeking to preserve the status quo through traditions, compliance, and security
  4. Openness to change — seeking creativity, independence, novelty, and excitement

We care less about others

Our research found the values that motivate us to care for people and for nature (“self-transcendence”) were stable before 2020 and very early in the pandemic. But they decreased significantly in importance by late 2020.

One possible explanation is people who worried about what COVID might mean for them became especially less caring about the people around them. After suffering months of worry, lockdowns, border closures, and social distancing, people were less likely to prioritise others over themselves.

We are more conservative

We also found values that prioritise maintaining the status quo (“conservation”) were stable prior to COVID, but increased in importance early in 2020.

When the pandemic started, Australians immediately started prioritising safety and security, and traditions around one’s family, culture and religion. The increased importance of conservative values may have helped to motivate compliance with the new pandemic health and safety rules.

Again, this trend happened more in people who were worried about getting COVID early in the pandemic.




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While the increase in importance of these more conservative values lingered later in the pandemic, this increase was no longer associated with worry over getting COVID.

In fact, it was somewhat surprising that the increase in more conservative values lingered throughout 2020, given that the pandemic situation in Australia was largely under control. This shows the pervasiveness of subtle changes taking place as a consequence of the pandemic.

Reassessing our priorities

Early in the pandemic, as more conservative values increased in importance, opposing values like adventure, excitement and enjoyment (“openness to change”) became less important for Australians.

Later in 2020, in contrast to the more conservative values that remained more important than before the pandemic, the importance of “openness to change” values began to change.

While people continued to disregard values that promote pleasure and enjoyment, values that prioritise independence and intellectual pursuits increased in importance. This suggests the pandemic restrictions may have led people to critically examine what’s important in life, and to seek out interesting things they can do independently of others.

COVID has changed us — and done it quickly

Our study shows major events such as the COVID pandemic can change values in society in a relatively short period of time.

Central to these value changes appear to be worries about getting infected, which was linked to more conservative values, less openness values, and decreased importance of values related to caring about others and the environment.

Football crowd sitting on a hill.
The pandemic saw people less likely to prioritise others over themselves.
Darren England/AAP

As values have been linked with social and political opinions and voting, these changes have important implications for Australian society.

Australians may vote more conservatively as a result. It’s noted that pandemic elections have seen Australians back incumbents (whether they be Coalition or Labor). Although interestingly, both the successful Queensland and West Australian ALP governments have had very tough state border regimes.

If these value changes linger on, we might see people objecting more to immigration, caring less about human rights, and being less likely to enact random acts of kindness. Indeed, separate survey results have already shown many Australians back the strict international border controls during COVID.

We may also see less volunteering and donations to a wide range of causes. We know volunteering rates have dropped since COVID hit Australia, and are yet to recover.

Our findings suggest the pandemic has significantly affected our values. Follow up surveys will be critical to understand our values as we emerge from the pandemic.




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The Conversation


Julie Anne Lee, Professor in Marketing, Founding Director of the Centre for Human and Cultural Values, and Director of Research at the UWA Business School, The University of Western Australia; Anat Bardi, Professor of Social/Personality Psychology, Royal Holloway University of London; Ella Daniel, Research assistant professor, Tel Aviv University; Maya Benish-Weisman, Professor, Hebrew University of Jerusalem, and Ronald Fischer, Professor, Te Herenga Waka — Victoria University of Wellington

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

Media reports about vaccine hesitancy could contribute to the problem


Heather Green, Griffith University and Joan Carlini, Griffith UniversityAlongside logistical and supply issues, vaccine hesitancy has been a notable hurdle in Australia’s troubled vaccine rollout.

The news the Australian Technical Advisory Group on Immunisation (ATAGI) now recommends Pfizer over AstraZeneca for everyone under 60, owing to a rare blood clotting disorder, is proving another blow to vaccine confidence.

With active local COVID cases in Victoria and New South Wales, it’s timely to be considering all possible factors which may be contributing to vaccine hesitancy.

One is the media. While news reports of vaccine hesitancy may well be describing genuine community concerns, they could be inadvertently fuelling COVID vaccine fears.

Why are some Australians reluctant to get a COVID vaccine?

While Australians perceive their environment is safe and relatively free from COVID-19, some will remain unmotivated to have the jab. They may hesitate to be immunised as they believe the vaccine could pose a greater risk than the virus itself.

This is not the case. ATAGI’s evolving recommendations ensure the benefit of getting vaccinated against COVID outweighs the risk for every age group.

Fear, meanwhile, is a behavioural motivator. The latest outbreak in Melbourne saw record numbers of Victorians turn up for vaccination.




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A Griffith University survey conducted in the middle of 2020 found 68% of people would take a COVID-19 vaccine if one was available. Those who said they wouldn’t had concerns regarding side effects, quality of testing, and speed of vaccine development.

So we can see even when community transmission in Australia was higher, and before we knew about rare adverse events like the blood clots, safety was a key concern.

A person puts their hand up against their upper arm, so as to block an injection.
Vaccine hesitancy can stem from concerns about the safety of the vaccine.
Shutterstock

Reporting on vaccine hesitancy could worsen the problem

For the past several months, it seems as though every other day there’s been a new report or survey in the news, revealing x proportion of people are hesitant about getting a COVID vaccine.

Our attitudes and behaviours are shaped by what others in society do — social norms. A recent study found university students in the United States who perceived their peers felt COVID-19 vaccination was important were more likely to report they intended to get a vaccine themselves.

Similarly, it’s important to acknowledge there’s a real danger hesitancy and delay in vaccination, when reported widely in the media, could catch on to more people.




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A review of 34 studies found the way parents interpreted media reports about vaccination depended on their pre-existing beliefs. For example, a report of a “rare” side effect might reassure parents who already believed vaccine benefits outweigh risks, whereas the same report could discourage parents who were already concerned about side effects.

Indeed, humans are prone to confirmation bias — paying more attention to information that fits with prior beliefs. Seeking and considering evidence which goes against our beliefs is hard for our brains.

But the media can help with this in the way they frame their reports. For example, emphasising that the majority of Australians want to and intend to vaccinate is a better option than focusing on the number who don’t.

For people already hesitating, another report could further shift the balance away from vaccination. So reporters should think carefully about the way they present vaccine hesitancy stories (and the need to present them in the first instance).

Reporting on vaccine safety also must be handled carefully

In Italy, media reporting about a small number of deaths following a batch of influenza vaccines in the winter of 2014/2015 was linked to a 10% reduction in influenza vaccination among people 65 and older compared to the previous season.

These deaths were quickly confirmed as unrelated to vaccination, but it seems the early reports had a significant effect on behaviour.

In a global study, three of 13 national and state level immunisation managers interviewed said “negative information conveyed in the mass media” contributed to vaccine hesitancy in their countries.

On the flip side, media reports about influenza and vaccination can also increase vaccination uptake. In this study, careful data analysis showed higher numbers of news reports with “influenza” or “flu” in the headline corresponded with higher flu vaccination uptake in the same year.

A man on a tablet computer.
Media coverage about vaccines can both help and hinder vaccine confidence.
Shutterstock

What should the media aim for in reporting on COVID vaccination?

Any reporting on Australians’ inclination to vaccinate should reinforce what is in fact the social norm — the intention of the majority to receive a COVID vaccine.

Further, media reporting on COVID vaccines should be careful to contextualise the benefits alongside the risks, and regularly remind consumers of reliable sources such as federal and state health departments and ATAGI.




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And while the media must be cognisant of its role, the government needs to act quickly to reverse the hesitancy trend. People are looking for reasons to have the jab; they are desperate for a national roadmap out of COVID-19.

If Australians could see how becoming vaccinated would contribute to economic prosperity (for example, reopening tourism and international education), and facilitate other things returning to normal, such as our ability to travel overseas, they would be motivated into action.The Conversation

Heather Green, Senior Lecturer, School of Applied Psychology, Griffith University and Joan Carlini, Lecturer, Department of Marketing, Griffith University

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

At last, health, aged care and quarantine workers get the right masks to protect against airborne coronavirus


Shutterstock

C Raina MacIntyre, UNSW; Benjamin Veness, CQUniversity Australia, and Michelle Ananda-Rajah, Monash UniversityAlmost a year ago, in July 2020, our calls for the government to urgently upgrade the guidelines to protect health workers from airborne SARS-CoV-2 fell on deaf ears.

The existing guidelines said health providers working around COVID-19 patients should wear a surgical mask. It restricted use of the more protective P2 or N95 masks, which stop airborne particles getting through, to very limited scenarios. These involved “aerosol-generating procedures”, such as inserting a breathing tube. This was expanded slightly in August 2020 but still left most health workers without access to P2/N95 masks.

More than 4,000 Australian health workers were infected by COVID-19 during the Victorian second wave. Health authorities denied the importance of airborne transmission and blamed clinical staff for “poor habits” and “apathy”. Health workers expressed despair and a sense of abandonment, cataloguing the opposition they faced to get adequate protection against COVID-19.

Last week, 15 months after the COVID-19 pandemic was declared, the Australian guidelines on personal protective equipment (PPE) for health workers, including masks, were finally revised.

What do the new guidelines say?

The new guidelines expand the range of situations in which P2/N95 masks should be available to staff – essentially anywhere where COVID-19-infected people are expected to be – and remove all references to “aerosol-generating procedures”.

This recognises that breathing, speaking, sneezing and coughing all generate aerosols which can accumulate in indoor spaces, posing a higher risk than “aerosol-generating procedures”.




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“Fit testing” is an annual procedure that should be done for all workers wearing a P2/N95 mask or higher grade respirator, to ensure air can’t leak around the edges.

But this was previously denied to many Australian health workers.

The new guidelines unequivocally state fit-tested P2/N95 masks are required for all staff managing patients with suspected or confirmed COVID-19. This means health workers can finally receive similar levels of respiratory protection to workers on mining and construction sites.

The new guidelines leave ambiguity around which workplaces are within the scope by stating that health care:

may include hospitals, non-inpatient settings, managed quarantine, residential care facilities, COVID-19 testing clinics, in-home care and other environments where clinical care is provided.

The guidelines also allow employers to decide what comprises a high risk and what doesn’t, allowing more wiggle room to deny workers a P2/N95 mask.

N95 and surgical masks on a table.
N95 masks (top) protect against airborne transmission, while surgical masks (bottom) don’t.
Shutterstock

The guidelines say when a suitable P2/N95 mask can’t be used, a re-usable respirator (powered air purifying respirators, or PAPRs) should be considered.

But the guideline’s claim that a PAPR may not provide any additional protection compared to a “well-sealed” disposable P2/N95 mask, is not accurate. In fact, re-usable respirators such as PAPRs afford a higher level of protection than disposable N95 masks.

The new guidelines should also apply to workers in hotel quarantine – both health care and non-clinical staff. This will help strengthen our biosecurity, as long as they’re interpreted in the most precautionary way.

That means not using the wiggle room that allows workplaces to deem a situation lower risk than it actually is or that their workplace is exempt. When working around a suspected or confirmed COVID-19 case, all workers must be provided with a fit-tested P2/N95 mask. Otherwise they are not protected from inhaling SARS-CoV-2 from the air.

In aged care and health care, where cases linked to quarantine breaches can be amplified and re-seeded to the community, the new guidelines go some way towards better protecting our essential first responders and their patients.




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Guidelines miss the mark on ventilation

The guidelines fail to explicitly acknowledge COVID-19 spreads through air but nonetheless recommend the use of airborne precautions for staff.

Airborne particles are usually less than 100 microns in diameter and can accumulate indoors, which means they’re an inhalation risk.

The old guidelines focused on “large droplets”, which were thought to fall quickly to the ground and didn’t pose a risk in breathed air. This was based on debunked theories about airborne versus droplet transmission.

The new guidelines fail to comprehensively address ventilation, which is only mentioned in passing with a reference to separate guidelines for health-care facilities. This may not cover aged care or hotel quarantine.




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We must ensure institutions such as hospitals, hotel quarantine facilities, residential care, schools, businesses and public transport have plans to mitigate the airborne risk of COVID-19 and other pandemic viruses through improved ventilation and air filtration.

Australia could follow Germany, which has invested €500 million (A$787 million) in improving ventilation in indoor spaces.

Meanwhile, Belgium is mandating the use of carbon dioxide monitors in public spaces such as restaurants and gyms so customers can assess whether the ventilation is adequate.

Cleaning shared air would add an additional layer of protection beyond vaccination and mask-wearing. Secondary benefits include decreased transmission of other respiratory viruses and improved productivity due to higher attention and concentration levels.

No updated advice on hand-washing

The United States Centers for Disease Control and Prevention (CDC) now acknowledges exposure to SARS-CoV-2 occurs through “very fine respiratory droplets and aerosol particles” and states the risk of transmission through touching surfaces is “low”.

Yet this is not acknowledged in the latest Australian health-care guidelines.

Australians have been repeatedly reminded to wash or sanitise their hands, wipe down surfaces and stand behind near-useless plexiglass barriers.

The promotion of hand hygiene and cleaning surfaces is not based on science, which shows it is the air we breathe that matters most.

Revised public messaging is needed for Australians to understand shared air is the most important risk for COVID-19.The Conversation

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW; Benjamin Veness, Adjunct Professorial Fellow, CQUniversity Australia, and Michelle Ananda-Rajah, Consultant physician General Medicine & Infectious Diseases, Alfred Health, past MRFF TRIP Fellow, Monash University

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

Australians under 60 will no longer receive the AstraZeneca vaccine. So what’s changed?


Paul Griffin, The University of QueenslandAustralians aged under 60 will no longer receive first doses of the AstraZeneca vaccine due to the rare risk of a serious blood clotting disorder among people aged 50 to 59.

The government has accepted the advice of the Australian Technical Advisory Group on Immunisation (ATAGI), which recommends those aged under 60 now receive the Pfizer vaccine. It previously recommended Pfizer to those aged under 50.

The change is based on the advisory group’s assessment of the risks of the clotting disorder, called thrombosis and thrombocytopenia syndrome or TTS, versus benefits of the AstraZeneca vaccine in protecting against COVID-19.

While the risk of TTS is still very low overall, it is more common in younger age groups. And younger people are less likely to die or become seriously ill from COVID-19.

What is the clotting disorder and how common is it?

Thrombosis with thrombocytopenia syndrome (TTS) is a rare clotting problem that can occur after vaccination with the AstraZeneca vaccine.

We don’t fully understand why TTS occurs, but we know it’s caused by an overactive immune response. This is a very different mechanism to clots people might get after travelling or being immobile for lengthy periods.

The condition involves blood clots as well as a depletion in blood clotting cells known as platelets. The clots associated with TTS can appear in parts of the body where we don’t normally see blood clots, like the brain or the abdomen.




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In Australia we have now seen 60 cases of TTS, with 37 confirmed and 23 probable.

Of the 12 recent cases, seven occurred in people aged between 50 and 59.

Sadly, two people have died.

The risk of TTS reduces with age. For people aged under 50, there are 3.1 cases of TTS per 100,000 doses. This reduces to 1.9 cases for those aged 80 and above:

As awareness of TTS grows, clinicians’ ability to detect and diagnose the condition has also improved. This means the risk of becoming severely ill and dying from this condition has fallen dramatically.

How does this compare to the chance of dying from COVID-19?

Globally, 177 million cases of COVID-19 have been reported, with around 3.83 million deaths, or just over 2%.

The risk of dying from COVID-19 increases with age. The rates depend on the country you live in and your sex. In China, for instance, the death rate was reportedly:

  • for under-50s, less than 1%
  • 50 to 59 years, 1.3%
  • 60 to 69 years, 3.6%
  • 70 to 79 years, 8%
  • 80 and above, 14.8%.

In terms of data from Australia, in 2020, for every 600 people with COVID-19 aged in their 50s, one person died and 18 required admission to a hospital intensive care unit (ICU).

For every 600 people aged in their 70s with COVID-19, 24 died and 42 were admitted to ICU.

So the benefits of vaccination to prevent severe COVID-19 are greater among older age groups.




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A history of blood clots is not usually any reason to avoid the AstraZeneca vaccine


What if you’ve already had one dose?

If you’re aged 50 to 59 and have already had one dose, and didn’t have a significant reaction, the advice is for you to return for your second dose.

Relatively few Australians have received a second dose of the AstraZeneca vaccine. But data from the United Kingdom shows TTS appears much less commonly after second doses – 1.5 cases per million doses.

If you have concerns about the risk of TTS, talk to your doctor or vaccine provider.

In the future, as more evidence emerges and is assessed by Australia’s regulators, we may use other vaccines for follow-up doses. But this is not currently the recommendation.




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How does the advisory group decide?

ATAGI is a group of experts that closely monitors vaccines both in Australia and internationally for side effects, as well as how well they are working.

It also considers the amount of disease circulating that the vaccine is designed to protect from.

These factors are considered at the time of initial approval, and then monitored continuously. When some of these factors change, the way we use vaccines also needs to change.

Today’s change demonstrates the strength and robustness of the ongoing surveillance of adverse events of vaccines and our regulators’ commitment to ensure the safety of the community receiving these vaccines.

We’re fortunate to have excellent control of COVID-19 in Australia and low rates of severe disease. We’re also fortunate to have an alternate vaccine in the form of Pfizer, albeit still in relatively short supply.

Out of an abundance of caution and considering all of these and other factors, it makes sense to increase the age cut-off for the use of this vaccine in our country at present.

This may be subject to further changes in the future, in either direction, as the situation around us continues to evolve.




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The Conversation


Paul Griffin, Associate Professor, Infectious Diseases and Microbiology, The University of Queensland

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

Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk


Hassan Vally, La Trobe UniversityYesterday’s announcement the AstraZeneca COVID vaccine would now only be recommended for the over 60s has highlighted the many ways we think about risk.

The decision reflects a greater understanding of the real, but extremely low, risk of the clotting disorder called thrombosis with thrombocytopenia (TTS) for people aged 50-59, who are now recommended to have the Pfizer vaccine.

But errors in the way we perceive these extremely small risks, called cognitive biases, reflect the fact that when our brains evolved we did not have to grapple with risks this small. So we struggle to make sense of them and perceive these events as being much more likely than they actually are.

This can lead us to make decisions, such as not having a vaccine that could potentially save our life. And the misperception of the likelihood of TTS is one of the main reasons many are hesitant about receiving the AstraZeneca vaccine.

So let’s start with what we know about the risk of dying from TTS associated with the AstraZeneca vaccine, expressed the traditional way, with words and numbers. Then we’ll present the same numbers graphically.




Read more:
Australians under 60 will no longer receive the AstraZeneca vaccine. So what’s changed?


What’s the risk of dying from TTS?

Initially, we thought about 25% of people with TTS associated with the vaccine would die. But as we learnt more about how to recognise and treat these rare blood clots, the risk of dying from it has changed. In Australia, mortality is now down to around 4%.

This is a low risk of dying from a syndrome with a small likelihood of occurring. So we can express TTS risk in another way.

Two people in Australia have died from TTS after 3.8 million doses of the AstraZeneca vaccine delivered. This makes the likelihood of dying from this syndrome about 0.5 in a million, or if you prefer whole numbers, about 1 in 2 million.




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And now, with graphics

Here’s one way of representing 1 in 2 million visually. This figure shows just how small this risk is. Are you ready for some scrolling?


The Conversation, CC BY-ND

As you can see, the risk of TTS is so small it is almost too small to communicate effectively in this format.

Perhaps even more visually powerful is to compare the risk of dying from TTS to other risks we face in our lives, using a risk scale. This allows you to compare a range of risks and put them into perspective.

As the risk of TTS is a one-off risk normally associated with the first dose of the AstraZeneca vaccine, one interesting comparison is with other one-off risks, such as adventure sports.



As you can see, the risk of dying from TTS is far lower than many activities some of us get up to at the weekend.

But not all of us spend our weekends scuba diving or rock climbing. So let’s look at the more common risks we take in our everyday lives but do not pay much attention to.

This is not a perfect comparison, as the risks are averaged across the whole population, across the entire year. But it’s useful nevertheless.



So the risk of dying from TTS after the first dose of the AstraZeneca vaccine is similar to the risk of being killed by lightning in a year in Australia. And this pales in comparison when compared to other risks, such as the risk of dying in a car accident.

So what happens next?

One of the challenges for public health has always been putting the risks and benefits of our health choices into perspective. This task is even harder when the risks involved are so small.

Using visualisations like these is one way to effectively communicate just how small the risk of TTS is and also put this risk into perspective by comparing it to other risks we incur in our lives.

When you fully appreciate how small the risk of TTS is, the decision to have the AstraZeneca vaccine to protect yourself and others becomes a much easier one to make.The Conversation

Hassan Vally, Associate Professor, La Trobe University

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

Which COVID vaccine is best? Here’s why that’s really hard to answer


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Wen Shi Lee, The Peter Doherty Institute for Infection and Immunity and Hyon Xhi Tan, The Peter Doherty Institute for Infection and ImmunityWith the rollout of COVID-19 vaccines accelerating, people are increasingly asking which vaccine is best?

According to Google Trends, more and more people want to know.

Even if we tried to answer this question, defining which vaccine is “best” is not simple. Does that mean the vaccine better at protecting you from serious disease? The one that protects you from whichever variant is circulating near you? The one that needs fewer booster shots? The one for your age group? Or is it another measure entirely?

Even if we could define what’s “best”, it’s not as if you get a choice of vaccine. Until a suite of vaccines become available, the vast majority of people around the world will be vaccinated with whichever vaccine is available. That’s based on available clinical data and health authorities’ recommendations, or by what your doctor advises if you have an underlying medical condition. So the candid answer to which COVID vaccine is “best” is simply the one available to you right now.

Still not convinced? Here’s why it’s so difficult to compare COVID vaccines.

Clinical trial results only go so far

You might think clinical trials might provide some answers about which vaccine is “best”, particularly the large phase 3 trials used as the basis of approval by regulatory authorities around the world.

These trials, usually in tens of thousands of people, compare the number of COVID-19 cases in people who get the vaccine, versus those who get a placebo. This gives a measure of efficacy, or how well the vaccine works under the tightly controlled conditions of a clinical trial.

And we know the efficacy of different COVID vaccines differ. For instance, we learned from clinical trials that the Pfizer vaccine reported an efficacy of 95% in preventing symptoms, whereas AstraZeneca had an efficacy of 62-90%, depending on the dosing regime.




Read more:
How to read results from COVID vaccine trials like a pro


But direct comparison of phase 3 trials is complex as they take place at different locations and times. This means rates of infection in the community, public health measures and the mix of distinct viral variants can vary. Trial participants can also differ in age, ethnicity and potential underlying medical conditions.

It’s tempting to compare COVID vaccines. But in a pandemic, when vaccines are scarce, that can be dangerous.

We might compare vaccines head to head

One way we can compare vaccine efficacy directly is to run head-to-head studies. These compare outcomes of people receiving one vaccine with those who receive another, in the same trial.

In these trials, how we measure efficacy, the study population and every other factor is the same. So we know any differences in outcomes must be down to differences between the vaccines.

For instance, a head-to-head trial is under way in the UK to compare the AstraZeneca and Valneva vaccines. The phase 3 trial is expected to be completed later this year.

How about out in the real world?

Until we wait for the results of head-to-head studies, there’s much we can learn from how vaccines work in the general community, outside clinical trials. Real-world data tells us about vaccine effectiveness (not efficacy).

And the effectiveness of COVID vaccines can be compared in countries that have rolled out different vaccines to the same populations.

For instance, the latest data from the UK show both Pfizer and AstraZeneca vaccines have similar effectiveness. They both reliably prevent COVID-19 symptoms, hospitalisation and death, even after a single dose.

So what at first glance looks “best” according to efficacy results from clinical trials doesn’t always translate to the real world.

What about the future?

The COVID vaccine you get today is not likely to be your last. As immunity naturally wanes after immunisation, periodic boosters will become necessary to maintain effective protection.

There is now promising data from Spain that mix-and-matching vaccines is safe and can trigger very potent immune responses. So this may be a viable strategy to maintain high vaccine effectiveness over time.

In other words, the “best” vaccine might in fact be a number of different vaccines.

Variant viruses have started to circulate, and while current vaccines show reduced protection against these variants, they still protect.

Companies, including Moderna, are rapidly updating their vaccines to be administered as variant-specific boosters to combat this.

So, while one vaccine might have a greater efficacy in a phase 3 trial, that vaccine might not necessarily be “best” at protecting against future variants of concern circulating near you.




Read more:
Can I get AstraZeneca now and Pfizer later? Why mixing and matching COVID vaccines could help solve many rollout problems


The best vaccine is the one you can get now

It is entirely rational to want the “best” vaccine available. But the best vaccine is the one available to you right now because it stops you from catching COVID-19, reduces transmission to vulnerable members of our community and substantially reduces your risk of severe disease.

All available vaccines do this job and do it well. From a collective perspective, these benefits are compounded. The more people get vaccinated, the more the community becomes immune (also known as herd immunity), further curtailing the spread of COVID-19.

The global pandemic is a highly dynamic situation, with emerging viral variants of concern, uncertain global vaccine supply, patchy governmental action and potential for explosive outbreaks in many regions.

So waiting for the perfect vaccine is an unattainable ambition. Every vaccine delivered is a small but significant step towards global normality.The Conversation

Wen Shi Lee, Postdoctoral researcher, The Peter Doherty Institute for Infection and Immunity and Hyon Xhi Tan, Postdoctoral researcher, The Peter Doherty Institute for Infection and Immunity

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

Home quarantine for vaccinated returned travellers is extremely low risk, and won’t damage their mental health


Matt Dunham/AP/AAP

Gregory Dore, UNSWMany thousands of people need to return to Australia, and many at home wish to reunite with partners and family abroad.

A move away from a one-size-fits-all approach to quarantine is a way to make this happen — including home quarantine for vaccinated returnees.

The federal government implemented home quarantine over a short period in March 2020, before switching to mandatory hotel quarantine for returned residents and other incoming passengers.

But the considerably changed circumstances — most importantly, access to effective vaccines — calls for its reintroduction despite caution among politicians and the community.

The low rate of positive cases, and proven effectiveness of further safeguards to limit breaches, make home quarantine a persuasive strategy.

It’s worth remembering people who contract COVID, and their contacts, have successfully self-isolated at home since the pandemic began.

How will we make sure it’s safe?

There are several protective layers which would ensure extremely limited risk of home quarantine for fully vaccinated returned overseas travellers.

The first is requiring a negative COVID test within three days of departure, which is currently a requirement for all returnees.

The second is COVID vaccination. Recent studies indicate full vaccination provides 60-90% infection risk reduction. In cases where fully vaccinated people do get infected, these “breakthrough cases” are less infectious.

It’s also important to test returnees in home quarantine. A positive case would trigger testing of any contacts and may extend self-isolation.

Also, high levels of testing in the broader community can ensure early detection of outbreaks, enabling a rapid public health response to limit spread, if it did leak out of home quarantine.




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


The risk would be extremely low

Data from hotel quarantine in New South Wales, which takes around half of returned travellers in Australia, suggests home quarantine for fully vaccinated returnees would likely present an extremely low risk.

In 2021, NSW has screened around 4,700 returnees a week, with the proportion of positive cases detected during quarantine averaging around 0.6%.

From March 1, since vaccination has become more accessible, only eight of 406 positive cases were fully vaccinated.

Unfortunately we don’t have the overall data on how many returnees were fully vaccinated, but even if only 10-20%, this would equate to a positive rate of around 6-12 per 10,000 among the vaccinated. This is considerably lower than the overall rate of 66 COVID cases per 10,000 since March 1.




Read more:
Hotel quarantine causes 1 outbreak for every 204 infected travellers. It’s far from ‘fit for purpose’


If home quarantine was initially restricted to fully vaccinated returnees from countries with low to moderate caseloads, the rate would be lower again, probably less than five per 10,000.

If NSW increased their quarantine intake by taking an extra 2,500 per week from this population into home quarantine, it would equate to maybe a few positive cases per month, compared to around 120 cases per month in hotel quarantine. As vaccination uptake increases, this capacity could be expanded, with reduced hotel quarantine requirements.

Will people comply?

The enormous desire for stranded Australian residents, overseas partners and family of residents in Australia to return and reunite should ensure a high level of compliance with home quarantine.

Home quarantine has been successfully implemented in other countries with elimination strategies such as Taiwan and Singapore. Taiwan’s system was deployed rapidly and has 99.7% compliance. Singapore uses a grading system to enable lower-risk returnee residents to do seven days in home quarantine, with a negative test required for release on day seven.

Two major reviews of the hotel quarantine system — the Victorian government-commissioned Coate report, and the national review of hotel quarantine — recommended implementing home quarantine with monitoring technology, such as electronic bracelets. Their recommendations were made prior to the approval of vaccines.

Recent data suggests the current hotel quarantine system has harmful effects. Research published in the Medical Journal of Australia in April found mental health issues were responsible for 19% of all emergency department presentations among people in NSW hotel quarantine. It’s highly likely home quarantine would be more beneficial for the mental health of returnees.

What are the barriers?

Issues which would need to be sorted through include:

  • methods for determining how risky different countries are
  • how returnees can prove they’ve been vaccinated
  • how we would test returnees and home-based contacts, and how frequently
  • and how long home quarantine would be for.

But none of these are insurmountable, and small-scale home quarantine already exists in the ACT.

Health authorities could ensure returnees can collect their own COVID testing samples, for example by doing nasal swabs or collecting saliva themselves. This would reduce contact with health workers.

Home quarantine is undoubtedly being considered by major Australian COVID policy committees, along with other measures to enable a larger number of returnees and to increase the safety of the quarantine system.

Australians’ excessive caution continues to have direct consequences for the well-being of many thousands of stranded Australian residents, together with non-resident partners and family members desperate to return.

It’s time to change this situation and make their human rights a public health priority.


The author would like to thank John Kaldor, Esther Rockett, and Liz Hicks for their input.The Conversation

Gregory Dore, Scientia Professor, Kirby Institute; Infectious Diseases Physician, St Vincent’s Hospital, Sydney, UNSW

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

The COVID-19 lab-leak hypothesis is plausible because accidents happen. I should know


Chen Jimin/China News Service via Getty Images

Allen Rodrigo, University of AucklandAt the conclusion of the G7 summit, leaders called for a fresh and transparent investigation to determine how the COVID-19 pandemic began.

I welcome the renewed interest in the potential “lab-leak” origins of SARS-CoV-2, the virus that causes COVID-19. It wouldn’t be the first time an infectious pathogen was accidentally released from a research laboratory.

I know from personal experience. Back in 1994, on my first day of a fellowship at Stanford University, I picked up a damp courier parcel at reception and took it back to the lab. My professor put on latex gloves immediately. The parcel contained a vial with an HIV-infected lymph node.

The dry ice used to pack the sample had evaporated, soaking the cardboard. There I was, someone who had not worked with HIV before, with hands damp from handling a box containing live virus.

I didn’t get infected. But the experience left me acutely aware of how easily accidents happen. A 2018 review found 27 cases of laboratory-acquired infections between 1982 and 2016 in the Asia-Pacific region alone. The list of pathogens included everything from the virus that causes dengue fever to the SARS coronavirus.




Read more:
Fifty-nine labs around world handle the deadliest pathogens – only a quarter score high on safety


The American Biological Safety Association (ABSA) maintains a searchable database of reported laboratory-acquired infections. It documents “leakage from the plastic bag in the negative-pressure transport chamber” and exposure to “droplets when cleaning a spill”, among many other examples.

From a scientific perspective alone, it is important to investigate the lab-leak hypothesis because, if true, we have to tighten safety procedures to prevent future leaks.

Two lab-leak hypotheses

When the virus was first reported from Wuhan almost 18 months ago, people have raised the possibility that it emerged from the Wuhan Institute of Virology, where research on SARS coronaviruses was underway.

This lab-leak hypothesis comes in two flavours. First, the virus could have jumped from an animal (or animal tissue) infected with a SARS coronavirus as part of the research. The infected person subsequently infected others in the community.

The transfer of a pathogen from an animal to people is called a zoonotic transmission. This process also occurs outside of laboratories, perhaps when there is close contact with infected animals or they are eaten.

The second hypothesis suggests a purposeful genetic modification of a coronavirus that gave rise to a more infectious and human-transmissible variant, which then leaked into the community. This type of genetic modification is called gain-of-function, because the engineered virus acquires new biological traits.

It is unfortunate these hypotheses have been miscast as somehow equivalent, and often portrayed as alternative to the “natural origins” hypothesis.

When I and other computational biologists think of origins, we think about evolutionary ancestors: a virus’ evolutionary line of descent. If SARS-CoV-2 had evolved without human intervention from an ancestral variant found in one or more hosts, it is quite possible that such a host animal, or a sample from an infected host animal, was the subject of study in a lab.

Through some unfortunate misadventure, it is plausible that someone in that lab became infected.

Why an investigation is important

Arguments for or against these hypotheses are often couched in terms of likelihoods. In February, the World Health Organisation (WHO) listed four scenarios in its global study of SARS-CoV-2 origins: direct zoonotic transmission, indirect zoonotic transmission through an intermediate host, transmission through cold/food-chain products and accidental laboratory release.

Indirect zoonotic transmission through an intermediate host was deemed “likely to very likely” and accidental lab release “extremely unlikely”. The WHO panel rejected deliberate gain-of-function manipulation because it “has been ruled out by other scientists following analyses of the genome”.

But that wasn’t the last word, because the exact origin of the COVID-19 virus remains a mystery.




Read more:
The COVID-19 lab leak theory highlights a glaring lack of global biosecurity regulation


Genome sequencing of SARS-CoV-2 has shown the virus is related (about 96%) to a strain found in horseshoe bats. Although this seems like a high level of similarity, it implies that SARS-CoV-2 diverged from this strain several decades ago. Therefore, it remains unclear if the spillover was directly to humans or through an intermediate species.

In any case, such evolutionary analysis cannot distinguish between transmission in or outside a laboratory.

The WHO panel considered a lab-acquired infection as extremely unlikely because of the Wuhan laboratories’ strict biosafety protocols. But the ABSA database lists accidental infections happening even in labs with the highest biosafety accreditation, and these include SARS-coronavirus infections.




Read more:
The next pandemic is already happening – targeted disease surveillance can help prevent it


In its arguments for and against accidental lab release, the WHO report noted the Wuhan laboratories moved to a new location near the Huanan market in early December 2019, but “reported no disruptions or incidents caused by the move”. There is no reason to distrust the WHO panel’s conclusions, but it is nonetheless true that lab relocations present opportunities for error.

The lab-leak hypothesis is at least plausible and it’s therefore important to investigate it. If it were related to the operations of the lab, or its relocation, we need to re-examine safety protocols. For relocations, we may want to require independent monitoring and pre- and post-move quarantine of essential personnel.The Conversation

Allen Rodrigo, Professor and Head, The School of Biological Sciences, University of Auckland

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

Liberals’ Dan Andrews questions are a perfect case study in how to manufacture fake news


Premier Dan Andrews shortly after the fall that left him with broken ribs and a damaged spine.
AAP/@DanielAndrewsMP

Denis Muller, The University of MelbourneA case study in the manufacture of fake news is playing out right now in Melbourne.

Victoria’s shadow treasurer, Louise Staley, is putting about suggestive questions hinting darkly at a cover-up of how Victorian Premier Daniel Andrews injured his back three months ago.

She has not produced a shred of evidence to support this suggestion, yet the exercise has gained substantial traction in the media. All the main news outlets have had to pay attention to it.

It is the kind of political chicanery that confronts responsible media with a dilemma: how to hold a public official to account without oxygenating the conspiracy theory in which she is trading.

In this case, the fake-news manufacturing process has worked like this.

A public official puts on the public record some questions that look innocuous but will be associated in some minds with a scurrilous conspiracy theory circulating on social media.

Because it is a public official putting this on the public record, it is then picked up by a journalist.

The journalist in turn asks a question about it at a press conference. In this case, the question was put to Acting Premier James Merlino on June 8.

It necessarily generates a response from Merlino and that adds a further ingredient of apparent legitimacy to the mix.

Ambulance Victoria feels it necessary to issue a statement reiterating the exact circumstances in which an ambulance was called to take Andrews to hospital.

Then the Chief Commissioner of Police, Shane Patton, feels obliged to put out a statement confirming police did not attend the scene.

All this adds to the false impression there is some real news here.

But it doesn’t make the originating material true.

The originating material remains fake, but now the conspiracy theory has accumulated many of the attributes of a real story.

However, responsible media recognise what the real story is.

The real story is the attempt by a senior state Liberal MP to manufacture fake news – so they tell this story without oxygenating the content of the fake news itself.

Shadow Treasurer Louise Staley has been leading the opposition’s questions about Andrews’ fall.
James Ross/AAP

Australia’s professional mass media – television, radio, newspapers – have followed this course.

They have reported Staley’s raising of the conspiracy theory and her formulation of a series of questions to the government, while at the same time quoting condemnation of her antics by Merlino and others in the state government.

Even Sky News, notorious for its anti-Labor politics, has been circumspect. It has contented itself with references to a “torrent” of “amazing rumours” before retreating to safer and more familiar ground by describing Andrews as a Soviet-style paramount leader.

It reflects well on the Australian media – perhaps reinforced in their caution by the oppressiveness of Australia’s defamation laws – that they have handled this nasty outbreak of fakery with decency, accuracy and fairness.

The result is that, in this case, the manufacturing process has been cut off at the point of distribution.

For the record, Andrews slipped on wet stairs at a holiday house in Sorrento on the Mornington Peninsula on March 9, sustaining several broken ribs and a fractured vertebra. He is expected to return to work some time this month.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.