Police access to COVID check-in data is an affront to our privacy. We need stronger and more consistent rules in place

Graham Greenleaf, UNSW and Katharine Kemp, UNSWThe Australian Information Commissioner this week called for a ban on police accessing QR code check-in data, unless for COVID-19 contact tracing purposes.

State police have already accessed this data on at least six occasions for unrelated criminal investigations, including in Queensland and Western Australia — the latter of which has now banned this. Victorian police also attempted access at least three times, according to reports, but were unsuccessful.

The ACT is considering a law preventing police from engaging in such activity, but the position is different in every state and territory.

We need cooperation and clarity regarding how COVID surveillance data is handled, to protect people’s privacy and maintain public trust in surveillance measures. There is currently no consistent, overarching law that governs these various measures — which range from QR code check-ins to vaccine certificates.

Read more:
Australia has all but abandoned the COVIDSafe app in favour of QR codes (so make sure you check in)

Last week the Office of the Australian Information Commissioner released a set of five national COVID-19 privacy principles as a guide to “best practice” for governments and businesses handling personal COVID surveillance data.

But we believe these principles are vague and fail to address a range of issues, including whether or not police can access our data. We propose more detailed and consistent laws to be enacted throughout Australia, covering all COVID surveillance.

Multiple surveillance tools are being used

There are multiple COVID surveillance tools currently in use in Australia.

Proximity tracking through the COVIDSafe app has been available since last year, aiming to identify individuals who have come into contact with an infected person. But despite costing millions to develop, the app has reportedly disclosed only 17 unique unknown cases.

Over the past year we’ve also seen widespread attendance tracking via QR codes, now required by every state and territory government. This is probably the most extensive surveillance operation Australia has ever seen, with millions of check-ins each week. Fake apps have even emerged in an effort to bypass contact tracing.

In addition, COVID status certificates showing vaccination status are now available on MyGov (subject to problems of registration failure and forgery). They don’t yet display COVID test results or COVID recovery status (as they do in countries in the European Union).

It’s unclear exactly where Australian residents will need to show COVID status certificates, but this will likely include for travel between states or local government areas, attendance at events (such as sport events and funerals) and hospitality venues, and in some “no jab no job” workplaces.

As a possible substitute for hotel quarantine, South Australia is currently testing precise location tracking to enable home quarantine. This combines geolocation tracking of phones with facial recognition of the person answering the phone.

The proposed principles don’t go far enough

The vague privacy principles proposed by Australia’s privacy watchdogs are completely inadequate in the face of this complexity. They are mostly “privacy 101” requirements of existing privacy laws.

Here they are summarised, with some weaknesses noted.

  1. Data minimisation. The personal information collected should be limited to the minimum necessary to achieve a legitimate purpose.
  2. Purpose limitation. Information collected to mitigate COVID-19 risks “should generally not be used for other purposes”. The term “generally” is undefined, and police are not specifically excluded.
  3. Security. “Reasonable steps” should be taken to protect this data. Data localisation (storing it in Australia) is mentioned in the principles, but data encryption is not.
  4. Data retention/deletion. The data should be deleted once no longer needed for the purpose for which it was collected. But there is no mention of a “sunset clause” requiring whole surveillance systems to also be dismantled when no longer needed.
  5. Regulation under privacy law. The data should be protected by “an enforceable privacy law to ensure individuals have redress if their information is mishandled”. The implied call for South Australia and Western Australia to enact privacy laws is welcome.

A proposal for detailed and consistent laws

Since COVID-19 surveillance requirements are justified as “emergency measures”, they also require emergency quality protections.

Last year, the federal COVIDSafe Act provided the strongest privacy protections for any category of personal information collected in Australia. Although the app was a dud, the Act was not.

The EU has enacted thorough legislation for EU COVID digital certificates, which are being used across EU country borders. We can learn from this and establish principles that apply to all types of COVID surveillance in Australia. Here’s what we recommend:

  1. Legislation, not regulations, of “emergency quality”. Regulations can be changed at will by the responsible minister, whereas changes in legislation require parliamentary approval. Regarding COVID surveillance data, a separate act in each jurisdiction should state the main rules and there should be no exceptions to these — not even for police or ASIO.
  2. Prevent unjustifiable discrimination. This would include preventing discrimination against those who are unable to get vaccinated such as for health reasons, or those without access to digital technology such as mobile phones. In the EU, it’s free to obtain a paper certificate and these must be accepted.
  3. Prohibit and penalise unauthorised use of data. Permitted uses of surveillance data should be limited, with no exceptions for police or intelligence. COVID status certificates may be abused by employers or venues that decide to grant certain rights privileges based on them, without authorisation by law.
  4. Give individuals the right to sue. If anyone breaches the acts we propose above for each state, individuals concerned should be able to sue in the courts for compensation for an interference with privacy.
  5. Prevent surveillance creep. The law should make it as difficult as possible for any extra uses of the data to be authorised, say for marketing or town planning.
  6. Minimise data collection. The minimum data necessary should be collected, and not collected with other data. If data is only needed for inspection, it should not be retained.
  7. Ongoing data deletion. Data must be deleted periodically once it is no longer needed for pandemic purposes. In the EU, COVID certificate data inspected for border crossings is not recorded or retained.
  8. A “sunset clause” for the whole system. Emergency measures should provide for their own termination. The law requires the COVIDSafe app to be terminated when it’s no longer required or effective, along with its data. A similar plan should be in place for QR-code data and COVID status certificates.
  9. Active supervision and reports. Privacy authorities should have clear obligations to report on COVID surveillance operations, and express views on termination of the system.
  10. Transparency. Overarching all of these principles should be requirements for transparency. This should include publicly releasing medical/epidemiological advice on necessary measures, open-source software in all cases of digital COVID surveillance, initial privacy impact assessments and sunset clause recommendations.

COVID-19 has necessitated the most pervasive surveillance most of us have ever experienced. But such surveillance is really only justifiable as an emergency measure. It must not become a permanent part of state surveillance.

Read more:
Coronavirus: digital contact tracing doesn’t have to sacrifice privacy

The Conversation

Graham Greenleaf, Professor of Law and Information Systems, UNSW and Katharine Kemp, Senior Lecturer, Faculty of Law & Justice, UNSW, UNSW

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

We’re sick of COVID. So government messaging needs to change if it’s to cut through


Ernesta Sofija, Griffith University and Natalie Reyes Bernard, Griffith UniversityMost people want to do the “right thing” when it comes to following public health measures, such as wearing a mask or not mixing with friends and family.

Yet after what feels like a never-ending 18 months of lockdowns and COVID-19 saturated government messages, we’re all just a bit over it.

So government communications must adapt to our changing needs and emotions to reach people suffering pandemic fatigue. Here’s how government messaging needs to change at this stage of the pandemic.

Read more:
Sick of COVID-19? Here’s why you might have pandemic fatigue

Pandemic fatigue is real

Pandemic fatigue describes how, over time, we can naturally lose motivation or become complacent about following COVID-19 public health advice or seeking information about it.

Certain groups — such as health-care workers and young malesare already experiencing it. You might be feeling it too.

Gradual exhaustion and inability to engage with government public health messaging is not unusual and is part of a complex interplay of factors, including those relating to risk and control.

Perception of risk

First, someone’s motivation to follow COVID-19 health advice relates to how likely they think they’ll be infected or have serious disease.

Despite increasing rates of the disease in the community, as time goes on, some people start to consider the personal, social and economic consequences of restrictions greater than the actual risk related to the virus.

A degree of control

Second, the need for self-determination, or controlling what happens in your life, begins to set in. The urge for freedom may incite certain groups to act out.

Read more:
Public protest or selfish ratbaggery? Why free speech doesn’t give you the right to endanger other people’s health

Pandemic fatigue is a concern

Pandemic fatigue is a concern as people are more tempted to cut corners, putting themselves and others at risk. So governments must recognise the potential consequence of monotonous messaging, making it all too easy for people to switch off.

They must acknowledge what makes it hard or easy for people to adopt protective behaviours.

And as pandemic fatigue sets in, we also need to see some light at the end of the tunnel. Governments can provide this by explaining how specific actions taken can make a difference to overall outcomes.

Without fostering hope, the public’s commitment to limiting the impact of this crisis is likely to continue to slide.

Here are four ways government messaging needs to change to stave off pandemic fatigue.

1. Understand people

Governments must identify and understand population groups who have notable pandemic fatigue, such as people with lower education, young males or health-care workers.

Then they need to tailor and test new evidence-based messages with these target groups. It’s best to have fewer quality messages hitting the right spot than many lower quality messages distributed widely.

Read more:
Why telling stories could be a more powerful way of convincing some people to take a COVID vaccine than just the facts

2. Engage people as part of the solution

We know one of the main drivers of resistance to following government public health messages is the need to feel in control and have a sense of autonomy. Governments must engage people by reframing messages as much as possible to be positive and hopeful.

By using personal stories as motivators, collective words like “we”, a two-way dialogue and trusted voices in the community, governments can engage and inspire communities to have self-determination.

When we studied Prime Minister Scott Morrison’s communications during the first wave of the pandemic, we found he used limited personal stories and empathetic language.

But Norway’s government recognised the community as experts of their own lives and engaged them in creating solutions, for example, flexible ways of reopening kindergartens.

Read more:
Even with a vaccine, we need to adjust our mindset to playing the COVID-19 long game

3. Allow people to live their lives but reduce risk

As the pandemic progresses, the “all or nothing” approach to public health advice may be overly daunting, and risks alienating and demotivating people.

So government messaging should move beyond “do not” to “doing things differently”, allowing us to incorporate the things we value into our “new” way of living.

This acknowledges people will want to hug others and celebrate birthdays, and advises how to minimise the risks when doing so.

For instance, the Netherlands government released specific guidance for people seeking intimacy during the pandemic, advising people find a “cuddle buddy” rather than being intimate with several partners.

This harm reduction approach recognises abstinence is not an option for many.

4. Acknowledge and address people’s hardship

While lockdowns and other stringent measures are crucial to control the spread of virus, they have taken a toll on the mental health and well-being of populations across the globe and affected everyday life through loss of jobs and security.

Governments should acknowledge this hardship through messages of empathy and hope. They should also create opportunities to ease the feelings of life being put on hold.

Norway’s health minister provided a great example of this, where he acknowledged the hardship young people faced, thanking them for their contribution to society. He also called on them to come up with safe solutions for university events.

This seemed to have had a positive impact with young people in Norway more likely to follow COVID-19 restrictions than those over 50.

Yes, communicating in a pandemic is hard

During such a prolonged crisis, there is no “one size fits all” communication strategy. An initial analysis of national pandemic responses around the world showed many leaders found it hard to balance communicating public health measures with the growing impatience to return to some sense of normalcy.

And by the end of Australia’s first wave, we showed Morrison’s communication was dominated by political and economic actions. Repeating the same old themes may contribute to pandemic fatigue.

Now it’s time for government messaging to adapt and adjust to our level of fatigue, taking into account ways in which current methods may actually be contributing to levels of disengagement.

If governments don’t do this, people may miss or purposefully avoid public health advice. And that makes it harder for us to ever recover.The Conversation

Ernesta Sofija, Lecturer, public health and health promotion, Griffith University and Natalie Reyes Bernard, Research assistant, Griffith University

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

Coronavirus Update: Australia

The Philippines passes the 2 million mark as COVID-19 cases surge in Southeast Asia

Mark R. Cristino/AP

Michael Toole, Burnet InstituteSince May, the Delta variant of the SARS-CoV-2 virus has spread rapidly through most of Southeast Asia.

Of the ten member nations of ASEAN (Association of Southeast Asian Nations), all but Brunei have experienced recent surges, most of which have seen the highest number of cases since the pandemic began. However, these nine countries have experienced different COVID-19 trends.

Thailand, Laos, Cambodia and Vietnam reported very low daily cases throughout 2020 but are all now experiencing record surges in cases. Vietnam and Thailand are reporting 13,000-14,000 cases daily.

Singapore had a huge first wave in early 2020, reaching 1,000 cases a day, mainly affecting migrant workers. The country has now fully vaccinated 79% of its entire population but is currently experiencing a spike in new cases.

Myanmar had a surge in late 2020 and a lethal second wave this July, and cases are once again increasing.

Read more:
How a perfect storm of events is turning Myanmar into a ‘super-spreader’ COVID state

The three outliers that have struggled throughout most of the pandemic are Indonesia, Malaysia and the Philippines. Indonesia’s massive third wave is now in steep decline but more than 80,000 deaths have occurred since early June.

Malaysia began to report an increase in cases in September 2020, which led to a peak in February and then to a huge ongoing third wave.

It’s now the Philippines that is cause for most concern in the region. The country has reported more than two million cases and 34,000 deaths. The daily case rate is the second highest in Southeast Asia, after Malaysia.

Our World In Data/Johns Hopkins University

Read more:
Indonesia records its highest increase in COVID cases – and numbers are likely to rise again before they fall

The Philippines’ fourth wave

The Philippines has experienced four waves of COVID-19. The first wave was modest, reaching a peak seven-day rolling average of 316 in early April 2020.

From early June 2020, cases began to steadily increase leading into the second wave, which reached a peak of around 4,300 daily cases in late August.

The third wave reached a peak of 11,000 average daily cases in mid-April 2021.

However, it is the fourth wave, fuelled by the Delta variant, which is the most severe since the pandemic began and shows no sign of slowing. By September 8, the daily average had reached almost 19,000 cases.

How has the Philippines responded?

The Philippines government imposed strict restrictions early in the pandemic. In mid-March 2020, President Rodrigo Duterte ordered Metro Manila and adjacent provinces to be put under “enhanced community quarantine” (ECQ).

Under ECQ, mass gatherings were prohibited, government employees worked from home, school and university classes were suspended, only essential businesses stayed open, mass transportation was restricted, and people were ordered to observe social distancing.

When ECQ was imposed on March 15, the country had reported just 140 cases and 12 deaths. Despite the restrictions, the totals reached 5,453 cases and 349 deaths one month later.

The government relied heavily on the police and military to ensure all health protocols were followed. This led critics to denounce its militarist approach. Some civic groups providing assistance to communities faced harassment and attacks.

Philippine President Rodrigo Duterte delivers his State of the Nation Address (SONA) in Quezon City, Metro Manila, Philippines, 26 July 2021.
Philippine President Rodrigo Duterte’s early response to COVID was among the strictest in the world.
Lisa Marie David/Pool/EPA

Others criticised the government for taking a war-like approach that focused on identifying and punishing those who breached the rules rather than working cooperatively with, and providing financial support to, affected communities.

The term “pasaway”, a Filipino word referring to a stubborn person, became a punitive target in government communications. Amid the lockdown, the term pasaway referred to people violating government-imposed health protocols.

At the end of May 2020, restrictions were gradually loosened, entailing the re-introduction of mass transportation and the opening of government offices and certain businesses. At this time, the average had risen to 578 daily cases, the highest since the pandemic began.

Read more:
Why is Delta such a worry? It’s more infectious, probably causes more severe disease, and challenges our vaccines

The easing of restrictions was driven by economic factors – the unemployment rate had risen to 17.7% and 26% of businesses had closed.

Amid the gradual easing of quarantine restrictions, the Philippines saw an accelerating increase of COVID-19 cases. By the end of July, 75% of beds in intensive care units, 82% of isolation beds and 85% of ward beds in Metro Manila were occupied.

The fourth lockdown

Fast forward to early August 2021 as daily cases surged past 8,000. A new lockdown was announced in the National Capital District, which comprises more than half the country’s economy.

By August 20, Manila and surrounding provinces had been in either ECQ (enhanced community quarantine) or modified community quarantine for a total of 170 days since the beginning of the pandemic.

On that day, restrictions were eased even as daily cases surged to a record high of 17,231 and 317 deaths. More than 26% of samples tested positive, the country’s highest positivity rate so far.

The Philippines is trying desperately to spur activity in an economy that contracted a record 9.5% last year.

However, this risks having the health system totally overwhelmed. Many hospitals fear a mass exodus of nurses who are overworked, underpaid and constantly exposed to the virus. Filipino nurses are paid the lowest salaries among nurses in Southeast Asia.

What’s needed now?

The response by the Philippines has often been among the strictest in the world. However, the imposition and lifting of restrictions have not always been based on the caseload. The easing of restrictions has been driven by a desire for economic revival.

With only 14% of the population fully vaccinated and case numbers continuing to soar, the country is unlikely to vaccinate itself out of this outbreak before the health system is overwhelmed.

With cases now occurring in all 17 provinces, a clear national “vaccine plus” policy needs to be urgently implemented to save both lives and livelihoods.

This means while accelerating the vaccine rollout, there also need to be other preventive measures, such as mask wearing, physical distancing, attention to indoor ventilation, an effective test-trace-isolate system and, when necessary, localised lockdowns.

Read more:
From ground zero to zero tolerance – how China learnt from its COVID response to quickly stamp out its latest outbreak

The Conversation

Michael Toole, Professor of International Health, Burnet Institute

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

When will I need my COVID vaccine booster shot? And can I switch to a different brand?

Nicholas Wood, University of SydneyAustralia’s vaccine rollout is really starting to gain pace, especially in New South Wales and Victoria.

We need to get two doses of vaccine into as many adults as possible — firstly because that helps reduce severity of illness and infection, but also because reaching vaccination targets is likely to bring some new freedoms.

The COVID-19 vaccines (Pfizer, Moderna and Astra Zeneca) continue to be highly effective in reducing risk of severe disease, hospitalisation and death, even against the Delta variant.

But as soon as we finish one vaccine rollout we may need to begin the next rollout of booster doses.

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

When will I need my booster shot?

First, we need to differentiate between a booster dose and a third dose as part of the initial round of vaccinations. They are two very different things.

Some people who are immunosupressed might need a third dose as part of their primary COVID-19 vaccination schedule. In other words, their third dose comes not long after their second dose and is given to improve their initial protection.

A booster shot is given much later after the initial two dose round of shots. A good example is the way we give tetanus and whooping cough booster vaccines.

There’s a great explainer on who might need a third dose as part of their primary vaccination schedule over here.

For the rest of us, we don’t know for sure when you will need a booster shot. You’ll read lots of different figures on this — six months, eight months, more — and that’s because the research is ongoing. We don’t yet have a definite answer to the best timing for a booster dose.

Pfizer recently announced its research had shown a booster dose resulted an increase in antibodies against the initial virus as well as against the highly infectious Delta variant. These results are awaiting publication and the safety of the booster dose needs to be known. The European regulator (known as the European Medicines Agency) has also started to evaluate an application for the use of a booster dose of the Pfizer vaccine.

We know that there is a decline in antibodies after the primary course and some evidence of waning protection against infection.

In a recent letter to The New England Journal of Medicine, published online earlier this month, doctors and public health experts at University of California San Diego said their data suggested vaccine effectiveness against any symptomatic disease may wane over time since vaccination:

Vaccine effectiveness exceeded 90% from March through June but fell to 65.5% […] in July.

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

Over time, data will emerge on immune responses and safety after a booster dose.

It may be that booster doses are particularly needed for certain groups in our community — for example, older people or frontline workers. There is also discussion of whether severely immunosuppressed people should get a booster dose from around six months after their third primary dose.

The US is planning to make COVID booster shots widely available to Americans from September onwards, starting eight months after people’s second dose of the Pfizer or Moderna vaccines.

The US booster plan is dependent on the Food and Drug Administration determining that a third dose of the two-dose vaccines is safe and effective, and following advice from the Centers for Disease Control.

Israel’s booster rollout has begun, with people there becoming eligible for a booster five months after their second dose.

The European Centre for Disease Prevention and Control recently said that there is

no urgent need for the administration of booster doses of vaccines to fully vaccinated individuals in the general population.

Can we mix and match, by getting a different brand of vaccine for the booster?

We don’t yet know for sure.

There may be benefits to getting a different vaccine to the one you first got as a booster. We also know that new vaccines designed specifically to target novel variants are in development and it may be better to receive a booster of a variant-specific vaccine.

It will be worth keeping a close eye on a key trial by the UK-based COV-BOOST group, which is aiming to find out which vaccines against COVID-19 are most effective as a booster vaccination, depending on which vaccine was used to provide the initial primary vaccine course.

This study will give us good information on whether it will be better to get a booster shot that is the same brand as your primary dose, or whether to switch to another.

For example, should a person who initially got Pfizer for their first two doses get an AstraZeneca shot for their booster? Or vice versa? Or should they get a booster of a new variant vaccine?

A trial is underway in the US looking at the safety and immune responses of using a different booster vaccine to the first two doses, but also includes a Beta (B.1.351) variant vaccine.

It’s possible mixing and matching different vaccines might broaden your protection — but the research is ongoing, and it’s too early to say.

Hopefully, supply chain issues for the Pfizer vaccine will improve in the coming months.

The prime minister recently announced Australia has secured an extra four million doses as part of a deal with the UK, on top of extra doses coming as part of deals with Singapore and Poland.

This will help with the rollout of initial doses.

For now, the priority is getting the two doses into arms

Monitoring of the effectiveness of the COVID vaccines will continue, particularly against the delta variant and any new variants that emerge.

Trials are also underway of the safety and immune responses to a variety of different booster vaccines, including the next generation variant vaccines.

The World Health Organization said in August:

In the context of ongoing global vaccine supply constraints, administration of booster doses will exacerbate inequities by driving up demand and consuming scarce supply while priority populations in some countries, or subnational settings, have not yet received a primary vaccination series.

The focus for the time being remains on increasing global vaccination coverage with the primary series.

For now, Australia must focus on getting our primary adult coverage as high as possible in order to protect against severe disease, hospitalisation, and death.

Read more:
Why we’ll get COVID booster vaccines quickly and how we know they’re safe

The Conversation

Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of Sydney

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

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

AAP/Lukas Coch

Anne Twomey, University of SydneyIn August 2021, the national cabinet agreed to a National Plan to transition Australia’s National COVID-19 Response. It was based upon epidemiological modelling of the Delta variant by the Doherty Institute. It sets out four phases, with phase B starting when about 70% of those aged 16 and over are fully vaccinated, and phase C starting when over 80% are fully vaccinated.

Read more:
Morrison battles to get hardline premiers to accept the inevitable spread of COVID

Is the plan ‘set in stone’?

The national plan is based on modelling that relies on a range of assumptions. In its advice, the Doherty Institute stated:

Ongoing situational assessment of measured transmission potential and circulating SARS-CoV-2 variants in the Australian population over coming months will allow benchmarking of these hypothetical scenarios to guide real time policy decision making about the transition to phase B of the national plan.

In other words, there will have to be ongoing assessment of the facts to help decide when to move to phase B. For example, the breadth of coverage of vaccinations would have to be considered, to ensure there are no under-vaccinated groups, such as Indigenous communities. The emergence of any new variants would have to be assessed to see how they respond to the vaccine.

Whether a State’s health system was coping with existing numbers of infections and its “test, trace, isolate, quarantine” capacity was running effectively or swamped would also need to be considered.

The national plan expressly says at the bottom:

The plan is based on the current situation and is subject to change if required.

So, the national plan is not set in stone. It was always intended to be adjusted to take into account changed facts.

What does the national plan say about border closures?

The national plan does not say anything about state border closures. It does refer to lockdowns being less likely to occur in phase B – but lockdowns are different from border closures. States that close their borders primarily do so to keep the disease out so they don’t need to impose lockdowns.

Phase B also refers to the easing of restrictions on vaccinated residents, but it does not make clear what they are.

As for borders, phase B only explicitly refers to international border caps, including increasing caps for inbound travellers, allowing capped entry of students and economic visa holders and introducing reduced quarantine arrangements for vaccinated residents. This is primarily a federal matter, as the Commonwealth has power over entry to Australia, even though the states have been managing hotel quarantine for incoming passengers.

Phase C does not refer to state border closures either. But it does refer to exempting vaccinated residents from all domestic restrictions. This could be interpreted as exempting vaccinated Australians from border restrictions, but does not seem to deal with the unvaccinated.

Read more:
Nowhere to hide: the significance of national cabinet not being a cabinet

If national cabinet makes a law, don’t all the states have to comply with it?

The national cabinet does not make laws. It has no legal powers at all. It is simply an intergovernmental body whose members discuss and agree on matters. As with any inter-governmental agreement, the national plan is not legally enforceable.

The members of the national cabinet – the prime minister, state premiers and chief ministers – are each responsible to their own parliament and, through it, their own people. The decisions of the national cabinet can only be implemented by each jurisdiction in accordance with its own laws. If a state government and parliament object to something agreed on by national cabinet, then it can choose not to implement it.

The national cabinet does not make laws and has no legal powers.
Mick Tsikas/AAP

This was recognised when the national cabinet was created. The minutes of the national cabinet meeting of March 15 2020, which record its terms of reference, state:

The National Cabinet does not derogate from the sovereign authority and powers of the Commonwealth or any State or Territory government. The Commonwealth and the States and Territories, as appropriate, remain responsible for the implementation of responses to the Coronavirus.

The prime minister also recognised this in a press conference on May 5 2020. He said:

We’re a federation and, at the end of the day, states have sovereignty over decisions that fall specifically within their domain […] At the end of the day, every Premier, every Chief Minister has to stand in front of their state and justify the decisions that they’re taking in terms of the extent of the restrictions that are in place […] I respect the fact that they’ve each got to make their own call, just like I do, and they’ve got to explain it to the people who live in their state and they’ve got to justify it. And I think that’s the appropriate transparency and accountability.

Isn’t the Commonwealth boss in the federation? Can’t it just override state laws?

The Australian Constitution gives certain specific powers to the Commonwealth and general powers to the states. Where their laws conflict, Commonwealth laws override state laws.

For example, the Commonwealth parliament could rely on its external affairs power to enact a law that guarantees freedom of movement, which could override a state law. But this could be difficult while the Commonwealth is restricting movement in and out of Australia.

Alternatively, the Commonwealth parliament could enact a comprehensive quarantine law that covers the whole field of quarantine and associated restriction on movement, to the exclusion of any state law. But the Commonwealth has chosen not to do so. It has left the states to deal with quarantine and public health measures, as they have greater competence and public health facilities to manage the situation.

What about the Constitution? Doesn’t reaching 80% vaccination mean a state can no longer block my right to cross state borders?

Section 92 of the Constitution protects freedom of movement among the states. But the High Court has long accepted there may be exceptions if a law is reasonably necessary and proportionate to achieving another legitimate purpose, such as the protection of public health.

In the Palmer case, it upheld the validity of the Western Australian law that empowered the closure of state borders. In doing so, the Justices noted the restrictions on movement were severe, but were amply justified by the importance of protecting public health.

If it became the case that border restrictions were no longer reasonably necessary and proportionate to protect public health, a challenge might well be successful.

But a court would be likely to take into account all the relevant facts at the time, rather than simply whether a particular percentage of the population has been vaccinated. By the time such a challenge was heard, there would be new evidence to inform the assumptions on which the Doherty Institute relied and a court would be able to take this new evidence into account in making a more informed assessment.

Read more:
Clive Palmer just lost his WA border challenge — but the legality of state closures is still uncertain

The Conversation

Anne Twomey, Professor of Constitutional Law, University of Sydney

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

Why are we seeing more COVID cases in fully vaccinated people? An expert explains

Nathan Bartlett, University of NewcastleMany people are worried about reports of “breakthrough” COVID-19 infections overseas, from places like Israel and the United States.

A breakthrough infection is when someone tests positive for COVID after being fully vaccinated, regardless of symptoms.

The good news is most breakthrough infections usually result in mild symptoms or none at all, which shows us that vaccines are doing exactly what they’re supposed to do — protecting us from severe disease and death. Vaccines aren’t designed to protect us from getting infected at all (known as “sterilising immunity”).

People with breakthrough infections can go on to infect others. Preliminary evidence indicates immunised people can have high levels of virus in the nose, potentially as high as unvaccinated people.

However, if you’re vaccinated you’ll clear the virus more quickly, reducing the length of time you’re infectious and can pass the virus on.

Here’s why breakthrough cases are happening, and why you shouldn’t worry too much.

Waning immunity

Two studies from the United Kingdom suggest the immunity we get from COVID vaccines wanes over time, after about four to six months.

While the more-infectious Delta variant continues to circulate, waning immunity will lead to more breakthrough infections.

But the reduction isn’t large currently. Vaccine effectiveness is very high to begin with, so incremental reductions due to waning won’t have a significant effect on protection for some time.

Israeli data shows some vaccinated people are becoming ill with COVID. But we need to keep in mind Israel’s vaccine rollout began in December 2020, and the majority of the population were vaccinated in early 2021. Most are now past six months since being fully vaccinated.

Given most people in Israel are vaccinated, many COVID cases in hospital are vaccinated. However, the majority (87%) of hospitalised cases are 60 or older. This highlights what’s known about adaptive immunity and vaccine protection — it declines with age.

Therefore we’d expect vulnerable groups like the elderly to be the first at risk of disease as immunity wanes, as will people whose immune systems are compromised. Managing this as we adjust to living with COVID will be an ongoing challenge for all countries.

What would be concerning is if we started seeing a big increase in fully vaccinated people getting really sick and dying — but that’s not happening.

Globally, the vast majority of people with severe COVID are unvaccinated.

Read more:
COVID cases are rising in highly vaccinated Israel. But it doesn’t mean Australia should give up and ‘live with’ the virus

We’ll probably need booster doses

Waning immunity means booster doses will likely be needed to top up protection, at least for the next couple of years while the virus continues to circulate at such high levels.

Our currently approved vaccines were modelled on the original strain of the virus isolated in Wuhan, not the Delta variant, which is currently dominant across most of the world. This imperfect match between vaccine and virus means the level of protection against Delta is just a little lower.

Read more:
What’s the Mu variant? And will we keep seeing more concerning variants?

Because the level of effectiveness is so high to begin with, this small reduction is negligible in the short term. But the effects of waning over time may lead to breakthrough infections appearing sooner.

mRNA vaccines in particular, like Pfizer’s and Moderna’s, can be efficiently updated to target prevalent variants, in this case Delta. So, a third immunisation based on Delta will “tweak”, as well as boost, existing immunity to an even higher starting point for longer-lasting protection.

We could see different variants become endemic in different countries. One example might be the Mu variant, currently dominant in Colombia. We might be able to match vaccines to whichever variant is circulating in specific areas.

The dose makes the poison

Your level of exposure to the virus is likely another reason for breakthrough infections.

If you’re fully vaccinated and have merely fleeting contact with a positive case, you likely won’t breathe in much virus and therefore are unlikely to develop symptomatic infection.

But if you’re in the same room as a positive case for a long period of time, you may breathe in a huge amount of virus. This makes it harder for your immune system to fight off.

This may be one reason we’re seeing some health-care workers get breakthrough infections, because they’re being exposed to high viral loads. They could be a priority for booster doses.

Might unvaccinated kids be playing a role?

It’s unclear if children are contributing to breakthrough infections.

Vaccines aren’t approved for young children yet (aged under 12), so we’re seeing increasing cases in kids relative to older people. Early studies, before the rise of Delta, indicated children didn’t significantly contribute to transmission.

More recent studies in populations with vaccinated adults, and where Delta is the dominant virus, have suggested children might contribute to transmission. This requires further investigation, but it’s possible that if you’re living with an unvaccinated child who contracts COVID, you’re likely to be exposed for many, many hours of the day, hence you’ll breathe in a large amount of virus.

The larger the viral dose, the more likely you’ll get a breakthrough infection.

Potentially slowing the number of breakthrough infections is one reason to vaccinate 12 to 15 year olds, and younger children in the future, if ongoing trials prove they’re safe and effective in this age group. Another is to protect kids themselves, and to get closer to herd immunity (if it’s achievable).

Read more:
High priority: why we must vaccinate children aged 12 and over now

A silver lining

Breakthrough infections likely confer extra protection for people who’ve been fully vaccinated — almost like a booster dose.

We don’t have solid real-world data on this yet, but it isn’t surprising as it’s how our immune system works. Infection will re-expose the immune system to the virus’ spike protein and boost antibodies against the spike.

However, it’s never advisable to get COVID, because you could get very sick or die. Extra protection is just a silver lining if you do get a breakthrough infection.

As COVID becomes an endemic disease, meaning it settles into the human population, we’ll need to keep a constant eye on the interaction between vaccines and the virus.

The virus may start to burn out, but it’s also possible it might continually evolve and evade vaccines, like the flu does.

Read more:
How will Delta evolve? Here’s what the theory tells us

The Conversation

Nathan Bartlett, Associate Professor, School of Biomedical Sciences and Pharmacy, University of Newcastle

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

Health Minister Hunt failed to take up Pfizer’s June 2020 invitation to meet

Michelle Grattan, University of CanberraDocuments show Pfizer reached out in June 2020 for a meeting with federal Health Minister Greg Hunt, but he did not take up the invitation.

Labor obtained the documents under freedom of information and the opposition health spokesman Mark Butler said they showed the government “took a deliberate ‘wait and see’ approach to vaccine deals”, a claim Hunt rejected in a statement late Wednesday.

Inadequate supplies of Pfizer slowed the rollout, becoming an increasing problem after AstraZeneca was set back by health warnings for some age groups and resultant hesitancy among many people.

The government announced in November last year it had an agreement to obtain ten million Pfizer doses. More were subsequently purchased, but the supply timetable left persistent shortages.

The government scrambled to bring forward some of the Pfizer doses and recently Scott Morrison intervened with some vaccine diplomacy to get extra doses from Poland, Singapore and Britain. Efforts to get doses from the US failed.

The documents include a letter from the managing director of Pfizer Australia to Hunt dated June 30 2020 requesting “a meeting with you to open discussions regarding your planning for potential COVID-19 vaccination programs”.

“I would welcome an opportunity to discuss our candidate vaccine development in more detail, and open discussions on how we might work together to support planning for potential COVID-19 vaccinations in Australia and continue to build a strong partnership for the future.”

The letter said Pfizer would “be in touch to schedule a meeting. I look forward to meeting you and working with you into the future.”

It canvassed progress on developing a mRNA-based vaccine that, if approved, “could be deployed at unprecedented speed for the prevention of COVID-19 infection”.

The letter foreshadowed Pfizer had the potential to supply millions of vaccine doses by the end of 2020, subject to technical success and regulatory approvals and hundred of millions in 2021.

A covering email from a Pfizer representative noted a request for a formal engagement opportunity with members of the Vaccines Taskforce.

Senior members of Pfizer’s global leadership team would be available for this “particularly if the Minister and/or Departmental leadership can be involved,” it said.

“As the vaccine development landscape is moving swiftly, including through engagements with other nations, I am requesting this meeting occur at the earliest opportunity,” the email said.

On July 3 Lisa Schofield, first assistant secretary, health economics and research division, in the health department, wrote to say she was managing the whole of government work on COVID vaccine and would appreciate an opportunity to talk about Pfizer’s plans.

Pfizer wanted a confidentiality agreement for any detailed talks, which would include several senior global representatives. The alternative it put up was a more general exploratory session, with local Pfizer representatives, including the MD of Pfizer Australia.

Schofield said the confidentiality agreement was being considered, although it was not the government’s usual practice to sign such documents. She proposed the more general session adding “we can always line up subsequent ones as needed”.

On July 23 Pfizer drew Schofield’s attention to “recent news of Pfizer’s agreements with the UK and US on vaccine supply”.

Hunt said in a statement that “both Pfizer and the Health Department have consistently confirmed, including on the public record at Senate Estimates, that the Australian government entered into formal discussions on the purchase of vaccines, as soon as the company was in a position to do so, and were in discussions prior to this”.

“When formal discussions began, no country had a contract with Pfizer.”

Hunt said there had been regular discussions with the minister’s office and Pfizer, including a meeting on 26 June 2020, initiated by his office. This was referenced in an email in the documents, and was followed by the June 30 letter, he said.

“The Australian government moved immediately to formal negotiations with the first step being to agree and negotiate a Confidentiality Disclosure Agreement.”

Hunt said the reference to millions of doses was about global capacity, not to what was on offer to 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.