Government rejects Royal Commission’s claim of no aged care plan, as commission set to grill regulator


Michelle Grattan, University of Canberra

The federal government has clashed with the Royal Commission into Aged Care, strongly rejecting the claim by senior counsel assisting the inquiry Peter Rozen that it had no specific COVID-19 plan for the sector.

Aged Care Minister Richard Colbeck told a news conference: “We have had a plan to deal with COVID-19 in residential aged care, going right back to the beginnings of our preparations.

“We’ve been engaged with the sector since late January, and continuously working with the sector to ensure they have all the information they require and the support that they need in the circumstance that they might have an outbreak of COVID-19.”

Acting chief medical officer Paul Kelly said: “We have been planning for our aged population as a vulnerable group since the beginning of our planning in relation to COVID-19”. And there had been “very strong communication with the sector throughout,” he said.

Rozen, in a Monday statement at the opening of this week’s hearings on COVID in the aged care sector, said while much was done to prepare the health sector more generally for the pandemic, “neither the Commonwealth Department of Health nor the aged care regulator developed a COVID-19 plan specifically for the aged care sector”.

The sector had been underprepared, he said.

Asked whether the government’s plan had failed, Colbeck admitted there had been “some circumstances where things haven’t gone as we would like”, saying “the circumstance at St Basil’s [in Melbourne] is one, where we didn’t get it all right”.

On Wednesday the commission will take evidence from Janet Anderson, head of the Commonwealth regulator, the Aged Care Quality and Safety Commission, which Rozen said “did not have an appropriate aged care sector COVID-19 response plan”.

The government has left Anderson out to dry, after it was belatedly discovered her body was told of an outbreak at St Basil’s two days after a staffer was diagnosed, but it failed to pass on the information.

Quizzed about this, Colbeck said under the protocols, “the Commonwealth should have been advised of the outbreak on 9 July by either the Victorian health department or St Basil’s management or both. Instead it was formally informed on July 14.”

But he was also critical of the Quality and Safety Commission which was informed of the outbreak when it was speaking to the home as part of a survey about preparedness and infection control.

“The disappointing thing, from my perspective, is that the information that was gleaned … about a positive outbreak wasn’t passed on to anyone else,” Colbeck said.

“There was an assumption made … that information had already been passed on. It wasn’t.

“The gap in the supply chain, or the information chain, has now been closed. … There should not have been a hole in our systems. That’s been rectified appropriately, as it should have been.”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.

Australians highly confident of government’s handling of coronavirus and economic recovery: new research




Mark Evans, University of Canberra

Australians have exhibited high levels of trust in federal government during the coronavirus pandemic, a marked shift from most people’s views of government before the crisis began, new research shows.

Australians are also putting their trust in government at far higher rates than people in three other countries badly affected by the virus – the US, Italy and the UK.

The findings, published today in a new report, “Is Australia still the lucky country?”, are part of a broader comparative research collaboration between the Democracy 2025 initiative at the Museum of Australian Democracy and the TrustGov Project at the University of Southampton in the UK.

The research involved surveys of adults aged between 18 and 75 in all four countries in June to gauge whether public attitudes toward democratic institutions and practices had changed during the pandemic. We also asked about people’s compliance with coronavirus restrictions and their resilience to meet the challenge of the post-pandemic recovery.

The main proposition behind our research is that public trust is critical in times like this. Without it, the changes to public behaviour necessary to contain the spread of infection are slower and more resource-intensive.




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Levels of trust higher for most institutions

Australians are now exhibiting much higher levels of political trust in federal government (from 25% in 2019 to 54% in our survey), and the Australian public service (from 38% in 2018 to 54% in our survey).

Compared to the other three countries in our research, Australia’s trust in government also comes out on top. In the UK, only 41% of participants had high trust in government, while in Italy it was at 40% and the US just 34%.


Confidence in key institutions

Percentage who say they have ‘a great deal’ or ‘quite a lot’ of confidence. (Note: the survey collect data on the Australian parliament as it didn’t convene during the period of data collection.)
Democracy 2025/TrustGov survey; Author provided

Australians also have high levels of confidence in institutions related to defence and law and order, such as the army (78%), police (75%) and the courts (55%). Levels of trust are also high in the health services (77%), cultural institutions (70%) and universities (61%). Notably, Australians exhibit high levels of trust in scientists and experts (77%).

These figures were comparable with the other countries in the survey, with the notable exception of Americans’ confidence in the health services, which stood at just 48%.

Although Australians continue to have low levels of trust in social media (from 20% in 2018 to 19% in our survey), confidence is gaining in other forms of news dissemination, such as TV (from 32% in 2018 to 39%), radio (from 38% in 2018 to 41%) and newspapers (from 29% in 2018 to 37%).


Public trust in various media, scientists and experts

Public trust in various media, scientists and experts (by percentage).
Democracy 2025/TrustGov survey; Author provided

How does Morrison compare with Trump and other leaders?

Prime Minister Scott Morrison is perceived to be performing strongly in his management of the crisis by a significant majority of Australians (69%).

Indeed, he possesses the strongest performance measures in comparison with Italy (52% had high confidence in Prime Minister Giuseppe Conte), the UK (37% for Prime Minister Boris Johnson) and the US (35% for President Donald Trump).

Morrison also scores highly when it comes to listening to experts, with 73% of Australians saying he does, compared to just 33% of Americans believing Trump does.


Public perceptions of leadership

Percentage of respondents in four countries who ‘agree’ or ‘strongly agree’ with statements about how their leader is handling COVID-19.
Democracy 2025/TrustGov survey; Author provided

Interestingly, Morrison’s approval numbers are also far higher than the state premiers in Australia. Only 37% of our respondents on average think their state premier or chief minister is “handling the coronavirus situation well”. Tasmanians (52%) and Western Australians (49%) had the highest confidence in their leaders’ handling of the crisis.

This suggests that in Australia, the politics of national unity (the “rally around the flag” phenomenon) is strong in times of crisis, whereas people tend to view the leaders of states or territories as acting in their own self-interest.


Perceptions of the quality of state and territory leadership

Perceptions of the quality of state and territory leadership during COVID-19.
Democracy 2025/TrustGov survey; Author provided

Compliance and resilience

Our findings also showed most Australians were complying with the key government measures to combat COVID-19, but were marginally less compliant than their counterparts in the UK. (Australians are relatively equal with Italians and Americans.)

Among the states and territories, Victorians have been the most compliant with anti-COVID-19 measures, while the ACT, Tasmania and the Northern Territory were the least compliant. This is in line with the low levels of reported cases in these jurisdictions and by the lower public perception of the risk of infection.




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When it comes to resilience to meet the challenges of the post-pandemic recovery, we considered confidence in social, economic and political factors.

Although a majority of Australians (60%) expect COVID-19 to have a “high” or “very high” level of financial threat for them and their families, they are less worried than their counterparts in Italy, the UK and US about the threat COVID-19 poses “to the country” (33%), “to them personally” (19%), or “to their job or business” (29%).


Perceptions of the level of threat posed by COVID-19

Percentage of respondents who agree or strongly agree with the statements about the economic threat posed by coronavirus.
Democracy 2025/TrustGov survey; Author provided.

About half of all Australians believe the economy will get worse in the next year (this is slightly higher than in the US but much lower than in the UK and Italy). In Australia, women, young people, Labor voters and those on lower incomes with lower levels of qualifications are the most pessimistic on all confidence measures.

However, Australians remain highly confident the country will bounce back from COVID-19, with most believing Australia is “more resilient than most other countries” (72%).


Perceptions of Australian resilience

Perceptions of Australian resilience compared to other countries.
Democracy 2025/TrustGov survey; Author provided

We also assessed whether views about how democracy works should change as a result of the pandemic. An overwhelming majority of people said they wanted politicians to be more honest and fair (87%), be more decisive but accountable for their actions (82%) and be more collaborative and less adversarial (82%).

Staying lucky

Australia has been lucky in terms of its relative geographical isolation from international air passenger traffic during the pandemic.

But Australia has also benefited from effective governance – facilitated by strong political bipartisanship from Labor – and by atypical coordination of state and federal governments via the National Cabinet.

The big question now is whether Morrison can sustain strong levels of public trust in the recovery period.




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There are two positive lessons to be drawn from the government’s management of COVID-19 in this regard.

First, the Australian people expects their governments to continue to listen to the experts, as reflected in the high regard that Australians have for evidence-based decision-making observed in the survey.

Second, the focus on collaboration and bipartisanship has played well with an Australian public fed up with adversarial politics.

The critical insight then is clear: Australia needs to embrace this new style of politics – one that is cleaner, collaborative and evidence-based – to drive post-COVID-19 recovery and remain a lucky country.The Conversation

Mark Evans, Professor of Governance and Director of Democracy 2025 – bridging the trust divide at Old Parliament House, University of Canberra

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

Alert but not alarmed: what to make of new H1N1 swine flu with ‘pandemic potential’ found in China



Shutterstock

Ian M. Mackay, The University of Queensland

Researchers have found a new strain of flu virus with “pandemic potential” in China that can jump from pigs to humans, triggering a suite of worrying headlines.

It’s excellent this virus has been found early, and raising the alarm quickly allows virologists to swing into action developing new specific tests for this particular flu virus.

But it’s important to understand that, as yet, there is no evidence of human-to-human transmission of this particular virus. And while antibody tests found swine workers in China have had it in the past, there’s no evidence yet that it’s particularly deadly.




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What we know so far

China has a wonderful influenza surveillance system across all its provinces. They keep track of bird, human and swine flus because, as the researchers note in their paper, “systematic surveillance of influenza viruses in pigs is essential for early warning and preparedness for the next potential pandemic.”

In their influenza virus surveillance of pigs from 2011 to 2018, the researchers found what they called “a recently emerged genotype 4 (G4) reassortant Eurasian avian-like (EA) H1N1 virus.” In their paper, they call the virus G4 EA H1N1. It has been ticking over since 2013 and became the majority swine H1N1 virus in China in 2018.

In plain English, they discovered a new flu that’s a mix of our human H1N1 flu and an avian-based flu.

What’s interesting is antibody tests picked up that workers handling swine in these areas have been infected. Among those workers they tested, about 10% (35 people out of 338 tested) showed signs of having had the new G4 EA H1N1 virus in the past. People aged between 18 to 35 years old seemed more likely to have had it.

Of note, though, was that a small percentage of general household blood samples from people who were expected to have had little pig contact were also antibody positive (meaning they had the virus in the past).

Importantly, the researchers found no evidence yet of human-to-human transmission. They did find “efficient infectivity and aerosol transmission in ferrets” – meaning there’s evidence the new virus can spread by aerosol droplets from ferret to ferret (which we often use as surrogates for humans in flu studies). G4-infected ferrets became sick, lost weight and acquired lung damage, just like those infected with one of our seasonal human H1N1 flu strains.

They also found the virus can infect human airway cells. Most humans don’t already have antibodies to the G4 viruses meaning most people’s immune systems don’t have the necessary tools to prevent disease if they get infected by a G4 virus.

In summary, this virus has been around a few years, we know it can jump from pigs to humans and it ticks all the boxes to be what infectious disease scholars call a PPP — a potential pandemic pathogen.

If a human does get this new G4 EA H1N1 virus, how severe is it?

We don’t have much evidence to work with yet but it’s likely people who got these infections in the past didn’t find it too memorable. There’s not a huge amount of detail in the new paper but of the people the researchers sampled, none died from this virus.

There’s no sign this new virus has taken off or spread in the regions of China where it was found. China has excellent virus surveillance systems and right now we don’t need to panic.

The World Health Organisation has said it is keeping a close eye on these developments and “it also highlights that we cannot let down our guard on influenza”.




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What’s next?

People in my field — infectious disease research — are alert but not alarmed. New strains of flu do pop up from time to time and we need to be ready to respond when they do, watching carefully for signs of human-to-human transmission.

As far as I can tell, the specific tests we use for influenza in humans won’t identify this new G4 EA H1N1 virus, so we should design new tests and have them ready. Our general flu A screening test should work though.

In other words, we can tell if someone has what’s called “Influenza A” (one kind of flu virus we usually see in flu season) but that’s a catch-all term, and there are many strains of flu within that category. We don’t yet have a customised test to detect this new particular strain of flu identified in China. But we can make one quickly.

Being prepared at the laboratory level if we see strange upticks in influenza is essential and underscores the importance of pandemic planning, ongoing virus surveillance and comprehensive public health policies.

And as with all flus, our best defences are meticulous hand washing and keeping physical distance from others if you, or they, are at all unwell.The Conversation

Ian M. Mackay, Adjunct assistant professor, The University of Queensland

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

The next once-a-century pandemic is coming sooner than you think – but COVID-19 can help us get ready



Shutterstock/bydvvid

David Murdoch, University of Otago

COVID-19 is being referred to as a “once in a century event” – but the next pandemic is likely to hit sooner than you think.

In the next few decades, we will likely see other pandemics. We can predict that with reasonable confidence because of the recent increased frequency of major epidemics (such as SARS and Ebola), and because of social and environmental changes driven by humans that may have contributed to COVID-19’s emergence.

A COVID-19-type pandemic had long been predicted, but scientists’ warnings weren’t heeded. Right now, while we have the full attention of politicians and other key decision-makers, we need to start rethinking our approaches to future preparedness internationally and within our own nations. That includes countries like New Zealand, where – despite getting its active COVID-19 cases down to zero in June 2020 – big challenges remain.




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We can’t say we weren’t warned

Less than five years ago, I was one of about 100 global experts invited to a World Health Organization (WHO) meeting in Geneva, prompted by the then ongoing Ebola outbreak in West Africa.

Then, as now, WHO was criticised for its response to the outbreak. The December 2015 meeting was meant to improve international collaboration and preparation for future epidemics and other infectious disease risks.

The very last presentation was from Dr David Nabarro, then the United Nations Special Envoy on Ebola (and now a Special Envoy on COVID-19).

In the wake of the Ebola outbreak, politicians were more focused on public health than ever before. Nabarro urged us to show greater leadership and capture that interest, before political and public attention moved on. He stressed the importance of trust, respect, transparent communication, and working with nature.

Yet five years later, we’re still talking about inadequate funding for pandemic preparedness; delays in adopting preventive measures; failure to develop surge capacity in health systems, laboratories and supply chain logistics; and reduced infectious disease expertise.




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But there are signs that some lessons may have been learned. For example, countries most affected by SARS (such as Taiwan and Singapore) have tended to respond more quickly and decisively to COVID-19 than other countries.

Primed and ready, vaccine developers have progressed at enormous pace, with several COVID-19 vaccine candidates already undergoing clinical trials. The volume and pace of sharing scientific information about COVID-19 has been unprecedented.

We’ve also seen a number of rapid reports urging us to learn from this pandemic and past epidemics to protect us from future events – especially by taking an holistic “One Health” approach. This brings together expertise across human health, animal health and the environment.

For instance, last month the Lancet One Health Commission called for more transdisciplinary collaboration to solve complex health challenges. Similarly, the World Wide Fund for Nature’s March 2020 report on The Loss of Nature and Rise of Pandemics highlighted the likely animal origin of COVID-19, and how intimately connected the health of humans is to animal and environmental health.




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What New Zealand can learn from COVID-19

As well as working more effectively together internationally, each country will need its own strategy. So what should we be doing to protect New Zealand from future infectious diseases threats?

Our health system has, for the most part, responded well to COVID-19. Our research institutions and universities have engaged quickly and effectively to provide scientific support for the public health response.

Yet we can and must still do better. Our expertise and systems are not always well joined up – vital for coordinated and timely responses to challenges like COVID-19.

We allow scientists to work in silos, despite obvious overlapping interests and skill sets. Of particular importance for tackling infectious diseases is the need to break down artificial barriers between human, animal and environmental health.

This approach makes particular sense in New Zealand. We are an island nation vulnerable to introduced infectious diseases, and economically dependent on agriculture and the physical environment. But we’re also home to an existing indigenous Māori worldview and knowledge system that emphasises interconnectivity between humans, animals and the environment.

University-led efforts, such as One Health Aotearoa, have brought together professionals and researchers from different disciplines. But more investment is needed to get even better value from such collaborations.

We need to strengthen capability in such areas as epidemiology, modelling and outbreak management, and build pandemic plans that are flexible enough to respond to all eventualities. New Zealand has a Centre of Research Excellence in plant biosecurity – but not in animal biosecurity or infectious diseases.

We also need to better integrate science and research into the health system, a key feature of the New Zealand Health Research Strategy 2017-2027. This requires a culture change so research is regarded as business as usual for district health boards, providing the science needed to inform policy, preparedness and best practice.




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Crucially, we need a new generation of scientists and professionals who are systems thinkers and comfortable working with multiple disciplines and across the human-animal-environment interface.

And we need the kind of leadership Nabarro called for: science-informed and forward-looking, rather than reactive.

We have seen good leadership based on science in the highest levels of New Zealand’s government in response to COVID-19.

We now need to see this at all levels of health, research and politics to get us out of this pandemic in the best shape possible – and be better prepared for our next pandemic.The Conversation

David Murdoch, Dean and Head of Campus, University of Otago

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

Pandemic policing needs to be done with the public’s trust, not confusion


Darren Palmer, Deakin University

The law on what we can and can’t do during the coronavirus outbreak is changing on an almost hourly basis. Some of what is written now might be overtaken by the shifts in the pandemic powers of control.

But we need to make sure people have trust in any new powers given to authorities. These need to be clear to all, and applied consistently and transparently, which is not the case at the moment.

For example, over the weekend a Victorian teenager was fined A$1,652 for leaving home to go for a driving lesson with her mother. Police said their activities were “non-essential travel”.

The advice from New South Wales police at that time said such activities were fine in NSW. Victoria police have since withdrawn the fine.

But NSW Police Commissioner Mick Fuller told the ABC’s Fran Kelly that in NSW you cannot travel to your holiday home unless it is “essential”. Victorians are told they can head to their holiday homes over Easter as long as they otherwise maintain strict quarantining on arrival.




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These are just two examples in two states of a broader underlying problem that Americans would deem unconstitutionally “void for vagueness”, a law invalid because it’s not sufficiently clear.

Calls for common sense do little to ease concerns that things are likely to worsen. The broad coronavirus containment and mitigation strategies might continue for many more months.

Remember the Fitzgerald inquiry

Perhaps we can learn from the landmark Fitzgerald inquiry into Queensland policing, more than three decades ago.




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The inquiry identified widespread systemic corruption in police, politics and civil society. This inquiry represented a change in police accountability.

There is another, lesser-known or appreciated aspect of the Fitzgerald inquiry. It emphasised that police must have the consent of the community: police have to ensure their practices generate trust that people will be treated fairly and police discretion will be used appropriately.

These are standard issues in the policing scholarship.

Pandemic policing raises many issues that cut to the core of policing by consent.

How policing resources are mobilised and the decision-making processes and practices on the ground are vital. Just look at the confused circumstances of the disembarkation of the Ruby Princess cruise ship in Sydney, which has been a key cause of the spread of COVID-19 in NSW and beyond.

The Australian Border Force, NSW health authorities and NSW police were variously blamed, so surely there needs to be a major investigation into network failure and specific responsibilities.

Police discretion needs to be fair

Everyday street policing is central to pandemic policing: when do police decide to intervene and ask someone their purpose for being out and about?

Vague legislative provisions are often the source of poor use of discretion by police. But the answer is not to be found in taking away any discretion, the hallmark of “zero-tolerance policing”.

There are many things that might be done, but a few simple ones come to mind.

Any legislation or regulation must be precisely drafted. This has not been happening and is causing confusion. Just look at the level of uncertainty in NSW, Queensland and Victoria.

We need clearly stated offences, clear lines of reasoning and a clear demarcation between preferred practice or guidance and regulated conduct.

For instance, what does staying in your own “area” for permitted out-of-home travel mean?

A discussion on ABC radio in Melbourne recently descended into callers chastising a man who thought he would like to travel to the beach for exercise well away from his residence. Live on air, he asked Victoria Police Chief Commissioner Graham Ashton if that was okay.

The chief commissioner didn’t say yes or no, he just called for “common sense”. But what would be reasonable and common sense – 1km, 2km, 5km or 10km, etc? Is driving to exercise allowed?

More than common sense

Common sense is not the way to ensure police discretion is going to be used appropriately, nor does it give the community confidence in the law. It might only be the odd case here and there at the moment causing confusion or consternation but it is changing daily.

Data on the use of this discretion must be recorded and made publicly available in close to real time. Equally important is the need to have data on policing activities.

Most jurisdictions have a crime statistics agency and these agencies should be given responsibility to collate data to identify who is being stopped, where, for what offence and with what outcomes. Report this every day as we do health data.

It does not need to be data on the final outcome that determines whether the fine is paid or challenged in the courts some months later. But it needs to reflect the immediate policing activities and it needs to be made public and in a timely manner.




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As the pandemic continues, and it may get worse, pandemic policing might head in directions the broader population has never experienced.

So 30 years on from Fitzgerald, we need to reinforce the notion that policing by consent, with transparency and accountability, is vital.

If public support is to be maintained over the course of the pandemic we need to make sure we have legal clarity and a detailed understanding of what is being done in the name of the exception. Pandemic policing must have very real limits and robust, real-time accountability.The Conversation

Darren Palmer, Associate professor, Deakin University

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

We’ve known about pandemic health messaging since 1918. So when it comes to coronavirus, what has Australia learnt?



GPA Photoarchive/US Dept of State, CC BY-NC

Elizabeth Stephens, The University of Queensland

Australia’s coronavirus public health messaging has been criticised as confusing during a time when health guidelines and regulations are changing rapidly, and educating the public about health is more vital than ever.

The slow roll-out of its public information campaign of videos and posters, urging people to wash their hands and keep their distance, has also been criticised.

But we’ve known how pandemic public health messaging works since the 1918 influenza pandemic, a largely forgotten, but important historical precedent for the current crisis.

We know from 1918 that pandemic public health messages need to be communicated widely and clearly, and to be consistent with government messaging and policies.

For this, messaging needs to be regulated by centralised, government agencies.

So which lessons has Australia learnt from the past?




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Communicating widely works

This 1918 advertisement warns about the spread of influenza.
National Museum of Health and Medicine, Author provided

Public health education campaigns have long played a pivotal role in managing public health, especially in moments of crisis.

Public health education, as we know it, is just over a century old. It is a product of the first world war, when more soldiers died of disease than injury.

Many of the earliest public health education campaigns focused on curbing the transmission of infectious diseases, more specifically, using posters to warn about venereal diseases (sexually transmitted infections).

But there are only a handful of posters warning about the influenza pandemic of 1918, which would go on to kill 50-100 million people, many times more than the war itself.

Partly this is because influenza broke out during the final stages of the war, when national resources were stretched thin.

It is also perhaps because it was initially overshadowed by that other great epidemic disease of the 19th century: tuberculosis.

Flyer warning about the spread of common infectious diseases made during the 1918 influenza epidemic.
US Library of Congress, Author provided

However, as influenza spread around the world with returning servicemen in 1918, efforts were made to slow its transmission through new public health education initiatives, such as distributing information flyers.

The US city of Philadelphia, for instance, distributed 20,000 flyers warning about the transmission of influenza in 1918.

At the same time, however, it also decided to proceed with a large public parade, which attracted 200,000 thousand people.

Within three days, every hospital in Philadelphia was full. By the end of the first week, 2,600 people had died. Six weeks later, over 12,000 were dead.

But the city of St Louis moved quickly to introduce measures like the ones we see today: shutting schools, cinemas, churches, and businesses. Some 700 died.

The difference between Philadelphia and St Louis is one of the most important lessons to learn from the 1918 influenza epidemic: “flattening the curve” works to limit transmission of infectious diseases, minimising the impact on health services.


The Conversation/PNAS, CC BY-ND

It’s a message that’s been stressed in the current health messaging, not only by government, but by medical professionals and statistical modellers.

Current public health messaging to “flatten the curve” has had a demonstrable effect on public behaviour, encouraging widespread social distancing and self-isolation.

However, this message was undermined by what many perceived as the government’s slowness in introducing social distancing measures as a containment policy, and mixed messaging around their implementation.

In the middle of March, as events like the Melbourne Grand Prix seemed prepared to go ahead, some feared we were watching another Philadelphia in the making.




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Effective government health messaging helps stem misinformation

Before the launch of the Australian government’s public education campaign, a wave of posts from the public on social media urged people to wash their hands for 20 seconds and physically distance from older relatives.

Millions of people watched the video of Arnold Schwarzenegger feeding carrots to a miniature donkey and pony, while encouraging his audience to stay inside.

And in the UK, a 17-year-old boy created a popular online tool that adds 20 seconds of your chosen song lyrics to a poster on hand-washing.

These examples represent something new: public health messages produced and circulated by the public, perhaps one of the most significant legacies of COVID-19, changing a century of practice in public health education.




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While such initiatives are doubtlessly well-intentioned, they have moved public health education from government agencies and traditional media online, into a largely unregulated space.

Inevitably, we are seeing the circulation of medical misinformation.




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This was also evident in the unregulated health sector of 1918, with a flourishing market in quack medical treatments, including ones that contained arsenic, camphor or mercury.

One of the key lessons of the 1918 influenza epidemic was, precisely, the importance of efficient and regulated public health communication.

This led directly to the foundation of national health organisations and media outlets. In the UK, the Ministry of Health was established in 1919, the BBC in 1922. In Australia, the Department of Health was established in 1921, the ABC in 1932.

However, with health regulations changing daily and announcements often made late at night, we need to ensure public health communication keeps pace with government health policy, and public messaging about both is clear and consistent.

How about future health campaigns?

The coronavirus is pushing so much of life online and the digital sphere grows more culturally influential.

To stem misinformation, robustly funded and well-resourced government health agencies and government public information campaigns are more important than ever.

During the current crisis, we have the opportunity to learn from the past, while taking advantage of new possibilities.

For instance, government health education can make greater use of social media to explain changing public health policy and regulations.

As Australia prepares for an extended and unprecedented period of mandatory self-isolating, ongoing clear and consistent messaging will be more important than ever.The Conversation

Elizabeth Stephens, ARC Future Fellow and Associate Professor of Cultural Studies, The University of Queensland

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

‘Pandemic drones’: useful for enforcing social distancing, or for creating a police state?



BAGUS INDAHONO/EPA

Michael Richardson, UNSW

People in Western Australia may soon see more than birds in the sky, as the state’s police force has announced plans to deploy drones to enforce social distancing. The drones will visit parks, beaches and cafe strips, ensuring people comply with the most recent round of gathering rules.

As COVID-19 restrictions tighten around the world, governments are harnessing the potential of drones. From delivering medical supplies, to helping keep people indoors – drones can do a lot in a pandemic.

Since the outbreak began, China has used drones to deliver medical supplies and food, disinfect villages, and even provide lighting to build a hospital in Wuhan in nine days. Drone medical deliveries have cut transit times, reduced the strain on health personnel and enabled contactless handovers, reducing the risk of infection.

It’s clear drones are helping combat COVID-19, as governments use them to control and monitor.

But these measures may be difficult to rollback once the pandemic passes. And safeguards will be needed to prevent unwanted surveillance in the future.




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Drone use: clever, quirky and sometimes concerning

With cities on lockdown, drones have shown uncanny images of emptied urban landscapes from Wuhan and metros across the globe.

Social distancing has inspired some quirky uses by individuals, including walking the dog and asking for a date.

But the main game has been about control. China is using drones to enforce quarantine rules and deter gatherings that violate social distancing rules.

One viral video showed a drone scolding an elderly woman for not wearing a mask. In some cases, traffic police and municipal officials used drones fitted with speakers to order people home and break up mahjong games.

Flying at high altitudes, drones can help police and other officials monitor large areas to identify those violating restrictions. Similar tactics are being used in Madrid and Nice, with talk of deployment in many other places.

A defence for the ‘good drone’?

There are huge advantages in sending drones into disaster zones such as bushfires, or remote landscapes for search and rescue. Pilots can safely stream crucial vision from a drone’s optical and thermal cameras.




Read more:
Drones help track wildfires, count wildlife and map plants


But while “good drones” can be valuable in disaster, they have been criticised for giving drone warfare an ethical veneer by association with humanitarian work. Some have even argued that using drones at all risks tainting relief work, because militaries have played a major role in developing drone technologies that are also responsible for humanitarian tragedies.

Like all technologies, the question with drones should be about how they are used. For instance, inspecting the breached nuclear reactor at Fukushima with drones is sensible. But embedding systems of control that can be turned against civilians is its own disaster in the making.

Normalising surveillance

With high definition and infrared images streamed to command stations, China’s drones may be able to use facial recognition to identify specific individuals using its Social Credit System, and fine them for indiscretions.




Read more:
Hundreds of Chinese citizens told me what they thought about the controversial social credit system


This level of social control may be appealing in a pandemic that could cost millions of lives. But it could also have chilling effects on social and political life.

Surveillance tools typically work best for social control when people know they are being watched. Even in liberal societies, people might think twice about joining climate or racial justice protests if they know they’ll be recorded by a drone overhead.

The Federal Bureau of Investigation (FBI) used drones to capture scenes from the 2017 Black Lives Matter protests in Baltimore.
FBI / ACLU

Feeling like you’re constantly being watched can can create a kind of atmospheric anxiety, particularly for marginalised groups that are already closely monitored because of their religion or welfare status.

Putting more drones in the sky raises concerns about trust, privacy, data protection and ownership. In a crisis, those questions are often ignored. This was clear after 9/11, when the world learnt the lessons of surveillance systems and draconian national security laws.

The impact would hit home

Police in the west are already deploying drones for various purposes, including at sporting events in Australia. Our defence force is buying Reaper MQ-9B drones because they are cleared for use in civilian airspace.

We might be fine with delivery drones in Canberra, or disaster drones ferrying urgent medical supplies, but how would we feel if they were indistinguishable from drones piloted by police, the military or private security companies?

A team at the University of South Australia is currently designing a “pandemic” drone to detect virus symptoms such as fever and coughing from a distance. Valuable as that is now, this tool could easily be used to intrusively manage the public’s health after the crisis is over.

It can be difficult to see the long term impacts of choices made in an emergency. But now is the best time for policymakers to set limits on how drones an be used in public space.

They need to write sunset clauses into new laws so that surveillance and control systems are rolled back once the pandemic eases, and create accountability mechanisms to ensure oversight.The Conversation

Michael Richardson, Senior Research Fellow, UNSW

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

The coronavirus pandemic is forcing us to ask some very hard questions. But are we ready for the answers?



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Paul Komesaroff, Monash University and Ian Kerridge, University of Sydney

The global coronavirus pandemic poses immediate, wide-ranging ethical challenges for governments, health authorities, health workers and the public.

At the heart of these challenges is how best to respond to COVID-19 urgently, yet safely and fairly.

How do we ensure rapid development and delivery of vaccines and other medicines, ethically and with proper oversight? How do we ration and distribute limited healthcare resources? How many of our personal freedoms are we willing to forgo to contain the pandemic?

How do we do this while protecting the vulnerable?




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This situation is unique

We ask these hard questions in a unique and rapidly changing environment, with the number of cases and deaths due to COVID-19 rising daily, and with increased global mobility leading to unstoppable transmission across borders.

The urgency of the situation is even forcing us to rethink how we answer these questions.

Traditionally, we make ethical decisions after open dialogue to achieve mutual understanding.

Such dialogue is placed under stress in times of crisis where, because decisions have to be made rapidly, authorities seek to suspend or dispense with time-honoured checks and balances.

However, it is precisely in these potentially dangerous situations that we most need nuanced ethical conversations.

Here are three key examples of the ethical challenges we face.

1. How do we develop new drugs quickly yet safely?

The first is how to balance the unknown risks associated with developing a vaccine or other drugs with the need for a response rapid enough to limit spread of the virus.

Part of that challenge is to ensure there is enough oversight of clinical trials when we are also accelerating the delivery of new therapies.

We will have to decide whether it is appropriate to accept higher levels of risk to research participants and patients when the stakes are higher.




Read more:
Infecting healthy people in vaccine research can be ethical and necessary


As well as the risks there are also potential benefits.

It has taken many years to construct an elaborate framework to ensure clinical research is conducted ethically.

However, under the pressure of the current emergency we may be able to find ways to reduce bureaucracy and red tape, speed up decision-making and make the system more responsive.

These changes may serve us well in the future, when we return to “business as usual”.




Read more:
Here’s why the WHO says a coronavirus vaccine is 18 months away


2. How prepared are we to give up some personal freedoms?

Balancing our personal freedoms – such as freedom of movement and the right to choose or decline medical treatment – with limiting the spread of disease is another major challenge.

We have seen disturbing images from Wuhan in China of officials apparently detaining citizens walking along the street, or dragging them from their homes.

How prepared are we to give up our personal freedoms, such as the right to choose or decline medical treatment?

Australia has announced plans for legislation allowing people to be detained or isolated when they are said to pose a threat to public safety.




Read more:
Explainer: what are the Australian government’s powers to quarantine people in a coronavirus outbreak?


At the same time, community organisations are mobilising to protect and support vulnerable members of society by providing food or other services. Health practitioners will continue to serve their patients with courage and dedication, even when this places them in danger.

How can we ensure such ethical values prevail over increasing authoritarian power?

How much of our personal freedom will we be prepared to give up in support of public health demands? Will we accept self-quarantine at home or isolation in a medical facility? Will we allow authorities to enter people’s homes and arrest infected people?

There is a great risk the emergency measures introduced will continue and be absorbed into everyday practice when the crisis ends. Will we be able to prevent this?

3. How do we allocate scarce resources?

Finally, there is the question of how best to allocate scarce resources, such as drugs, access to intensive care treatments, personal protective equipment, staff and research funding.

As the number of cases increases globally the number of critically ill patients will quickly exceed the available facilities, requiring us to make difficult choices.




Read more:
Coronavirus: should frontline doctors and nurses get preferential treatment?


We will have to decide who is treated where, who has access to scarce drugs or technologies, how and for whose benefit health professionals and emergency services are deployed, and how food, protective clothing and other items are rationed.

Medical professionals have long been familiar with such discussions, which are now likely to become more routine.




Read more:
How do we choose who gets the flu vaccine in a pandemic – paramedics, prisoners or the public?


What lies ahead?

We will need to make these decisions in a democratic way with public involvement, rather than leaving them to experts or government authorities.

We will need to struggle to preserve the ethical values of mutual respect and responsibility, fairness, and care for vulnerable members of society, which may be difficult in our present harsh and uncompromising times.

There are no easy solutions to satisfy everyone. However, at least we can start talking about these issues. For now, maybe that’s the best we can do.The Conversation

Paul Komesaroff, Professor of Medicine, Monash University and Ian Kerridge, Professor of Bioethics & Medicine, Sydney Health Ethics, University of Sydney

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

Government triggers emergency plan for COVID-19 pandemic, and considers economic assistance


Michelle Grattan, University of Canberra

The federal government has activated its emergency response plan to deal with a spread of the coronavirus locally, in anticipation of it becoming a “pandemic”.

It is also considering limited assistance for those hardest hit by the economic fallout.

Prime Minister Scott Morrison told a news conference late Thursday Treasurer Josh Frydenberg and Treasury was working on possible measures to give some relief.

Morrison stressed any measures would be “targeted, modest and scalable” – that is, able to be built on if necessary.

“This is a health crisis, not a financial crisis, but it is a health crisis with very significant economic implications,” he said.

“We’re aware, particularly in the export industry, in the marine sector, there are particular issues there especially in North Queensland, but these problems are presenting in many other places,” he said.

The tourism and education sectors are being heavily affected as the crisis worsens. But the government has stressed universities have good liquidity to deal with the situation.

The travel ban on arrivals from China has been extended for at least another week. There will be no carve out for the tens of thousands of university students unable to reach Australia.

Treasury has not yet finalised an estimate of the economic impact of COVID-19.

Cabinet’s national security committee met for three hours on Thursday to discuss the latest information on the virus and what should be done now.

“What has occurred, in particular, in the last 24 hours or so as the data has come in is that the rate of transmission of the virus outside of China is fundamentally changing the way we need to now look at how this issue is being managed here in Australia,” Morrison said.

Stressing Australia had been ahead of the World Health Organisation in its previous response, he said “based on the expert medical advice we’ve received, there is every indication that the world will soon enter a pandemic phase of the coronavirus”.

“So while the WHO is yet to declare … it’s moved towards a pandemic phase, we believe that the risk of a global pandemic is very much upon us and as a result, as a government, we need to take the steps necessary to prepare for such a pandemic.”

The actions were “being taken in an abundance of caution,” Morrison said.

Health ministers will meet on Friday to discuss the emergency planning, to respond to a future situation where there is sustained transmission in Australia – in contrast to the present containment to a handful of cases. As the virus spreads internationally, the chances increase of a major spread in Australia.

The emergency plan covers special wards in hospitals, and ensuring key health workers have access to adequate protective equipment from the medical stockpile.

It includes provision for aged care facilities to be put into lock down if necessary.

There would also be contingency alternative staffing for key facilities if staff got the disease.

On another front, Border Force would if necessary extend screening to passengers arriving from multiple countries.

Morrison said consideration was being given to how school children would be protected.

The Prime Minister emphasised there was no cause to consider cancelling events or for people not to be out and about.

“You can still go to the football, you can still go to the cricket, you can still go and play with your friends down the street, you can go off to the concert, and you can go out for a Chinese meal.

“But to stay ahead of it, we need to now elevate our response to this next phase,” he said.

“There are some challenging months ahead and the government will continue to work closely based on the best possible medical advice to keep Australians safe.”

So far, Australia had had 15 cases who had come from Wuhan and all 15 had now been cleared, he said. Eight other cases had come from the Diamond Princess. There had been no community transmission in 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.