Australia has finally backed a plan to let developing countries make cheap COVID-19 vaccines — what matters is what it does next

covaxx.
Dimitris Barletis/Shutterstock

Deborah Gleeson, La Trobe UniversityAfter months of holding out, Australia has at last joined other members of the World Trade Organisation in backing a waiver of patents and other intellectual property rights on vaccines, treatments, diagnostic tests and devices needed to fight COVID-19.

The organisation’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires WTO members to provide patent protection of at least 20 years for new inventions along with a slew of other intellectual property rights.

These rules make it difficult or impossible for developing nations to provide COVID-19 medical products, even where it would be straightforward to manufacture them.

TRIPS provides for exemptions, but the provisions are onerous and time-consuming. They apply only to patents, and don’t free up the rights to the information about the manufacturing process needed to make the treatments.

India and South Africa proposed the so-called TRIPS waiver in October 2020.

Later revised and sponsored by more countries, it would have enabled developing nations to manufacture diagnostics, therapeutics and vaccines for COVID-19 during the pandemic without fear of legal action.

The United States, home to some of the world’s biggest pharmaceutical companies, was at first hesitant until President Joe Biden backed a waiver — albeit limited to vaccines — in May.

Australia waited for the US, then waited

Australia held out longer than the US, even though US companies had more at stake. But unless Australia and other wealthy nations do more to merely vote for the waiver, “grotesque” vaccination gaps are set to continue for years to come.

Trade Minister Dan Tehan came out in support of the waiver at a meeting with several community organisations last Tuesday. He confirmed Australia’s changed stance in comments to The Guardian the following day.

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The shift raises the chances of the waiver proposal getting through, boosting the global supply of vaccines, treatments and testing kits — a move that would benefit every nation afflicted by supply shortages, including Australia.

More than 100 of the WTO’s 164 member nations support it. But there are still wealthy nations holding out — including Canada, Japan, Norway, Switzerland, the United Kingdom and the European Union.

Why the world urgently needs a waiver

COVAX, the global program for distributing vaccines equitably, originally intended to deliver two billion doses of vaccine by the end of 2021. So far, it has delivered less than 260 million.

On September 8, it revised its forecast to only 1.4 billion doses during 2021.

The World Health Organisation says less than 20% of the doses administered have gone to low and lower middle income countries, and while high-income countries have on average administered 100 doses for each 100 people, low-income countries have only managed 1.5 doses for each 100 people.

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Underlying the problem has been a global undersupply made worse by a mere handful of companies holding the exclusive rights to manufacture the vaccines and the right to keep other companies out.

Pfizer and Moderna have so far declined requests to enter into voluntary licensing agreements with low and middle-income countries.

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US support for waiving COVID vaccine IP is a huge step.

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Unless rich countries including Australia support efforts to expand the global supply, many countries won’t achieve widespread vaccination coverage until at least 2023.

Variants emerging in areas of unvaccinated regions in the meantime could threaten the progress of the whole world in bringing the pandemic to an end.

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Australia’s stance is complicated

In a letter to community organisations in August, trade minister Tehan indicated that while the Australian government was “focused on progressing discussions” in the World Trade Organisation, it saw voluntary mechanisms as the best chance for delivering broad access to COVID-19 vaccines.

The letter suggested that a scarcity of raw materials and lack of manufacturing capacity were the chief barriers to increasing vaccine production. It also pointed to the key role of intellectual property protections in encouraging the development of new vaccines and tests and treatments.

Right now there is probably little risk a TRIPS waiver would undermine the incentives needed to develop vaccines and drugs. There is an awful lot of money to be made from the well-off countries that would keep patents in place.

Bioreactor bags in short supply.
Alicat Scientific

And the development of COVID-19 vaccines and therapeutics and testing kits has been underpinned by huge injections of public funding that are unlikely to dry up.

Shortages of inputs are certainly part of the problem, although these are themselves partly created by intellectual property rights that limit the number of companies with rights to provide those inputs.

One example is the bioreactor bags used to mix cell cultures and gasses in vaccine manufacturing. They are produced by a small number of companies and heavily protected by patents.

Waiving those patents could help end shortages.

While manufacturing capacity most certainly does need to be increased, there is a lot of it in less-developed countries such as Brazil, India and South Africa.

What matters is what Australia does next

The trade minister’s words have to be matched by actions at the World Trade Organisation. Unless Australia gets fully behind the TRIPS waiver in the negotiations set to climax in October, it mightn’t get up.

The head of the World Health Organisation has described the inequities in access to COVID-19 vaccines as “grotesque”. They are being made worse by hold-ups in allowing more countries to manufacture vaccines themselves.

Deborah Gleeson, Associate Professor in Public Health, La Trobe University

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

Opening up when 80% of eligible adults are vaccinated won’t be ‘safe’ for all Australians

Anne Kavanagh, The University of Melbourne; Helen Dickinson, UNSW, and Nancy Baxter, The University of MelbourneWe’ve all grown tired of lockdowns, border closures and other restrictions. So the promise of a freer life, when 70% and then 80% of Australians aged 16 and older are vaccinated, feels like a beacon on the horizon.

Prime Minister Scott Morrison, some premiers, and leading public servants have promised us at 80% we can live “safely” with COVID-19, or come out of our “caves” in the PM’s parlance.

The narrative is one of Team Australia and we are “all in this together”. But are we really?

Risks of COVID-19 infection, serious disease and death are not equitably distributed. They disproportionally cluster among the most disadvantaged. Vaccine access and uptake is also lower in many disadvantaged groups.

Opening the country at 80% without ensuring these groups have met or exceeded those targets will result in substantial avoidable illness and death.

Who is most vulnerable to serious disease?

The risk of serious COVID-19 and death is related to “clinical vulnerability”, such as whether the person has underlying health conditions like diabetes or respiratory disease.

First Nations Australians, disabled Australians, prisoners and people living in rural and remote Australia have much higher levels of chronic conditions, which have their roots in social and economic disadvantage.

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On top of their clinical vulnerability, these groups face multiple barriers to accessing quality health care, including intensive care. These barriers might include lack of physical access, discrimination, an inability to access culturally competent care, and/or geographical distance.

What have we learnt from other countries?

Across the world, COVID-19 infection rates have occurred at higher rates in aged-care facilities, disability group homes and institutions and jails.

Besides aged-care residents, Australia hasn’t yet seen the high death rates in clinically vulnerable groups that other countries have witnessed.

In the United States, Indigenous Americans have had the highest rate of COVID-19 deaths – dying at three times the rate of white Americans (when adjusting for the fact that Indigenous Americans are younger than non-Indigenous Americans).

High rates of death have also been seen among:

• Black and Hispanic Americans
• those in rural areas
• prisoners, who were three times as likely than the rest of the population to die of COVID-19 (after taking into account the differences in age and sex between the prison and general populations).

The death rate among clinically vulnerable groups has been up to three times higher in the US.
Stacey Plaisance/AP

In the United Kingdom, people with intellectual disability were eight times more likely than the rest of the population to die of COVID and disabled people made up 60% of the deaths.

Intellectual disability was second only to age as a risk factor for death from COVID-19 in the US.

What’s happening in Australia?

COVID-19 infections are more common in disadvantaged areas, both in Australia and internationally.

Residents in disadvantaged communities are more mobile, live and work in close proximity to other people, and are more likely to be essential workers who can’t work from home. These areas also tend to have high concentrations of ethnic minority and migrant communities.

Victoria’s second wave included outbreaks among residents and workers in aged-care facilities, along with outbreaks in health care, meatworks, and disability group homes.

In NSW’s current wave, outbreaks are spreading rapidly in First Nations communities in western NSW and in prisons.

Who is getting vaccinated?

Australia’s vaccine rollout strategy prioritised people at most risk of serious disease and death from COVID-19.

Phase 1A included aged-care and disability group home residents and the workers who support them.

In Phase 1B, First Nations Australians over 55 years and people with disability with chronic conditions were eligible.

People prioritised in these phases were meant to be vaccinated by April.

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More recently, all participants in the National Disability Insurance Scheme and Indigenous Australians 12 years and older became eligible.

Prisoners are not explicitly included as a priority population.

But the strategy came without an implementation plan and vaccination levels are appallingly low in many groups.

Vaccination rates are substantially lower among Indigenous Australians than the population rates in every state and territory, except Victoria where Indigenous vaccination rates are much higher.

In western NSW, where COVID-19 is rapidly spreading through First Nations communities, 11.6% if Indigenous Australians are fully vaccinated compared with 28.9% of non-Indigenous Australians.

Information about vaccination rates among disabled people and workers are not routinely shared and tend to be leaked to the media. On August 22, for example, the Sunday Age revealed just 27% of NDIS participants were fully vaccinated, lagging behind the national rate.

Vaccination of prisoners and prison staff has also been slow. Many states only started their prison vaccination rollout in the last couple of months and data on vaccination coverage in correctional services have not been released (or perhaps even collected).

No targets yet for vaccinating vulnerable groups

The Doherty-led COVID-19 vaccination modelling is cited as justifying the federal government’s 80% target. The modelling report acknowledges:

particular attention should be paid to groups in whom socioeconomic, cultural and other determinants are anticipated to result in higher transmission and/or disease outcomes.

The Doherty Institute’s director, Professor Sharon Lewin, emphasised that we need to achieve 80% targets for all Australians including our most disadvantaged citizens.

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However, the model itself did not specifically evaluate the potential impact on high-risk groups. Nor does the Commonwealth National Transition Plan focus on equity.

Disadvantaged Australians face triple jeopardy – low vaccination rates, greater likelihood of being infected with COVID-19, and higher risks of serious disease and death from COVID-19.

These risk factors are significant individually. But some individuals face intersectional disadvantage. Indigenous people, for example, experience disability at a higher level than the general population. And people with mental health issues are over-represented in prisons.

Until now, we have relied on public health measures to contain the spread of COVID-19. If we relax these and move quickly to rely mainly on vaccination without ensuring equitable delivery, those most at risk will face a disproportionately greater burden of serious illness and death.

What can be done?

Thankfully, vaccine supply is improving. Australians are being vaccinated at unprecedented levels, particularly in NSW.

However, unless we explicitly move to an equity-based strategy for vaccination, “at risk” populations will be left even further behind.

All Australians should have an opportunity to be vaccinated before the nation opens up.
Atoms/Unsplash

Equitable allocation of vaccines requires:

1. defining priority groups and geographical areas
2. allocating an increased share of vaccines or vaccination appointments
3. tailoring outreach and communication
4. offering vaccinations close to or in workplaces and places where people live including private homes, aged-care facilities, and prisons
5. monitoring vaccination uptake
6. inclusion of vaccine targets for priority groups in the national plan.

Continuing our current strategy will mean that when we decide the time is right to “live with COVID”, many people who should have been the highest priority for vaccination could die.

We demand a rethink of our vaccine strategy to have an explicit focus on equitable vaccine allocation. Otherwise, it’s simply not “safe” for many Australians to come out of Morrison’s proverbial cave.

Anne Kavanagh, Professor of Disability and Health, Melbourne School of Population and Global Health, The University of Melbourne; Helen Dickinson, Professor, Public Service Research, UNSW, and Nancy Baxter, Professor and Head of Melbourne School of Population & Global Health, The University of Melbourne

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

Opening with 70% of adults vaccinated, the Doherty report predicts 1.5K deaths in 6 months. We need a revised plan

Stephen Duckett, Grattan Institute and Anika Stobart, Grattan InstituteOne consequence of the escalating COVID outbreak in New South Wales has been increased political tension around the “national plan” for COVID reopening.

The prime minister has argued that states signed up to the plan – albeit “in principle”, whatever that means – and they should do whatever the plan says, whenever the plan says to do it.

Some premiers are now pushing back, arguing the Doherty Institute modelling was based on certain assumptions which no longer hold true so the previous agreement no longer stands.

There are three distinct questions at issue here. Is the Doherty Institute modelling still applicable? How does the national plan stack up? And what should happen next?

1. Is the Doherty Institute modelling still applicable?

The Doherty Institute was given a very specific remit. It was asked “to define a target level of vaccine coverage for transition to Phase B of the national plan”, where lockdowns would be “less likely, but possible”.

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In identifying the vaccination coverage target for the transition to Phase B, Doherty’s experts assumed that testing, tracing, isolation, and quarantine (TTIQ), would be central to maintaining lower case numbers.

They highlighted two scenarios in terms of testing-tracing-isolation-quarantine capacity – an “optimal” scenario and a “partially effective” scenario – summarised in the table below.

Doherty Institute modelling outcomes

TTIQ = testing, tracing, isolation, and quarantine. This assumes an all adults vaccination allocation strategy.
Doherty Institute

While these numbers may look acceptable, the assumptions underlying them are now hanging by a thread.

Case numbers have been rising rapidly, putting significant pressure on testing-tracing-isolation-quarantine capacity.

Doherty Institute described its assumptions thus:

We assume that once community transmission becomes established leading to high caseloads, TTIQ [testing-tracing-isolation-quarantine] is less efficacious than the optimal levels observed in Australia because public health response capacity is finite.

This tells us that given our current high case numbers, we can probably only assume, at best, “partially effective” testing-tracing-isolation-quarantine capacity.

It’s also important to note the Doherty modelling did not incorporate scenarios where the virus was in uncontrolled spread after target vaccination levels are achieved.

But it now seems unlikely that NSW – and maybe even Victoria – will be able to suppress COVID down to zero before any vaccination target is reached.

If lockdowns are eased according to the modelled targets, while there is still substantial community transmission, testing-tracing-isolation-quarantine is unlikely to be enough to suppress further spread sufficiently, potentially resulting in higher numbers of hospitalisations and deaths than initially modelled.

2. How does the national plan stack-up?

The federal government used the Doherty Institute report’s findings as the basis of the “national plan” it put to National Cabinet.

But it glossed over the options, scenarios, and caveats in the Doherty modelling, and assumed the most optimistic testing-tracing-isolation-quarantine scenario: that everything would be rosy if Australia started opening up once 70% of adults (equivalent to only just over half the population) are vaccinated.

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The transition to Phase C, where lockdowns would be targeted and vaccinated people would be exempt from restrictions, was also optimistically adopted at 80% adult vaccination, despite the lack of modelling for this scenario in the Doherty report.

In a bid to make it appear convincing – but also realistic, given all the uncertainty – a veil of vagueness was cast over the national plan. The document is full of weasel-words and caveats, which means it is impossible for anyone to be held to account.

The equivocal “in-principle” condition on National Cabinet’s approval makes it even harder to know exactly what premiers signed up to.

But the severity of the New South Wales outbreak has forced some of our leaders to take off the rose-coloured glasses and adopt a more realistic view. Premiers are now saying they did not sign up to high death tolls.

According to Doherty modelling, deaths could reach 1,500 within six months of implementing Phase B. Agreeing to such a scenario is politically untenable for states that currently have zero cases.

3. So, what should happen next?

With states divided over the national plan, and the modelling potentially out of date, it’s time for National Cabinet to come back with a new approach. We need a revised national plan – one that all states can sign up to, one that is not full of caveats and conditions.

This should include a realistic plan for scaling up testing-tracing-isolation-quarantine capacity so that it can manage in a feasible way when each infected person could have at least ten new contacts per day.

And it should include a plan to protect primary schools and childcare centres while a vaccine remains unavailable for younger children.

Grattan Institute has also done its own modelling.

But our model was about Phase D – what Australia needs to do to avoid obtrusive restrictions such as lockdowns altogether – which was not modelled by the Doherty Institute.

We argued that it is only safe to open the borders, to lift restrictions, and to manage without lockdowns and use only unobtrusive measures such as masks on public transport, if we vaccinate at least 80% of the total population and continue the vaccination rollout to 90% throughout 2022.

Recent modelling from other academics has come to similar conclusions, with some even suggesting a slightly higher threshold for safe re-opening.

Governments cannot keep making unrealistic promises about easing restrictions at 70% and 80% adult vaccination, a plan that relied on optimistic scenarios in the first place, and one that now bears little relation to the real world. It is irresponsible to build public momentum and hope around targets that are unlikely going to be enough.

Australia needs the National Cabinet to come clean and accept that the changing circumstances require a change in the plan.

Stephen Duckett, Director, Health and Aged Care Program, Grattan Institute and Anika Stobart, Associate, Grattan Institute

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

National Cabinet’s plan out of COVID aims too low on vaccinations and leaves crucial questions unanswered

Danielle Wood, Grattan Institute; Stephen Duckett, Grattan Institute, and Tom Crowley, Grattan InstituteAt Friday’s National Cabinet meeting, our nation’s leaders put some meat on the bones of their 4-stage plan to reopen Australia.

The plan includes target vaccination thresholds and some details on restrictions that might be lifted at each stage. So far so good.

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But the plan raises two major concerns.

First, the reopening threshold is low. We won’t know until we see the modelling, but it looks like the National Cabinet is taking a gamble that the outcomes of re-opening will be at the more rosy end of plausible scenarios.

Second, many important details are still missing, including the timing of each stage and, crucially, the steps the government is taking to get more jabs in arms.

The vaccine coverage thresholds for re-opening look low

The key stage of the plan is stage C. In stage C, the government commits to no more mass lockdowns, and vaccinated Australians can leave the country and return without quarantine.

ScreenShot from Scott Morrison’s LinkedIn page

The government says we need 80% of Australians over 16 vaccinated before we get to stage C.

The over-16 qualifier matters a lot. The virus doesn’t care who is eligible. Children can still transmit the virus and so transmissibility depends on vaccine rates across the population.

Getting to 80% of Australians over 16 I equates to just under 65% of all Australians – far lower than the 80% threshold Grattan Institute recommends for starting to re-open international borders.

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The Doherty Institute modelling that informed the plan has not been released. The institute likely presented a range of scenarios. The Australian public have a right to understand the health outcomes in each and the way in which National Cabinet weighed the uncertainty in the modelling.

Committing to a vaccine coverage threshold that is too low risks a rapid surge in COVID cases that could overwhelm our hospitals and impose a high death toll. State governments would almost certainly impose lockdowns to contain this type of spread, pushing “real” reopening further back.

Coverage too low to loosen restrictions for the vaccinated

The steps discussed in stage B also contribute to a greater risk of a disorderly re-opening. Stage B envisages loosening some quarantine requirements and public health restrictions for vaccinated residents.

The main concern is that stage B kicks in at 70% of the eligible population (56% of the total population).

Under almost any scenario, the reproduction number for the Delta strain of the virus is still well above 1 at this point. That means each infected person on average infects more than one other person.

Relaxing international arrival and quarantine restrictions for vaccinated adults – who can still transmit the virus (albeit less so than the unvaccinated) – means more Delta will get in. And allowing exemptions from public health measures for vaccinated residents means the measures to contain the spread of the virus will be less effective.

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With only 56% of the population vaccinated, any uncontrolled spread will translate into high rates of serious illness and hospitalisation.

Our governments will be walking a very fine line indeed.

No details on ramping up the vaccine program

The other major concern is the lack of detail about how the National Cabinet plans to ramp up the vaccine program, and timeframes for doing so.

The most concerning line of the prime minister’s Friday evening press conference was “it is all up to us” – suggesting success is largely out of the government’s hands.

Getting enough jabs into arms as quickly as humanly possible is a job for government. We need a step change in the planning and professionalism of the rollout if we are going to have any hope of making these targets in a reasonable timeframe.

Grattan’s Race to 80 report, released last week, set out the necessary steps.

On logistics, it means delivering vaccines not just through GPs but via state-run mass vaccination hubs, pharmacists, schools, workplaces, and through pop-up clinics at community halls, public transport stations, and sporting events.

On messaging, it means high-quality national campaigns but also more targeted messaging for hesitant and harder-to-reach groups, including women, young people, and those from culturally and linguistically diverse communities.

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It looks like National Cabinet has not yet considered the crucial question of whether we need vaccine passports in high-risk settings such as restaurants and major events, to encourage people to get the vaccine and to reduce the risks of superspreading events.

And there is no plan to vaccinate children, even though Australia’s regulator, the Therapeutic Goods Administration (TGA), has already approved Pfizer for 12-to-16 year olds.

More to do

Australia can’t afford much more delay. The key planks of the logistics, messaging, and incentive campaigns need to be in place very soon if we are going to substantially increase the pace of the rollout as more Pfizer doses arrive in coming months.

At the same time, governments should release the Doherty modelling to help Australians understand the expected health outcomes under each of the four stages.

Vaccinations are the route back to normal life. This means all Australians have a stake in making sure our governments get this plan right.

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Danielle Wood, Chief executive officer, Grattan Institute; Stephen Duckett, Director, Health Program, Grattan Institute, and Tom Crowley, Associate, Grattan Institute

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

Australia has a new four-phase plan for a return to normality. Here’s what we know so far

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Adrian Esterman, University of South AustraliaPrime Minister Scott Morrison has received criticism from the general public for not having a concrete plan to take us out of the COVID-19 pandemic.

However, he went some way to addressing this on Friday, announcing national cabinet had agreed to a four-phase plan to get us back to something resembling our pre-COVID way of life.

It’s not yet very detailed, and no dates have been set out for the various phases. But we do have some idea of what’s being proposed, and Morrison said moving through each phase will depend on reaching vaccination targets determined from modelling, currently being undertaken by Melbourne’s Peter Doherty Institute.

The idea is to transition from our current priority of suppressing transmission of the virus, to a focus on the prevention of serious illness, hospitalisation and deaths.

Let me take you through each phase and what we know so far.

Phase 1: vaccinate, prepare and pilot

We are in Phase 1 now, and the aim is to continue to minimise community transmission.

Lockdowns may continue to be used in this phase, although only as a last resort.

The international arrivals cap will now be reduced by 50% to take pressure off our hotel quarantine system due to the increased infectiousness of the Delta variant.

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Morrison has indicated he expects the cap to stay in place until at least the beginning of 2022.

However, the federal government will facilitate increased repatriation flights to Darwin for quarantine at Howard Springs.

Also, as part of this current phase, there will be a trial of home quarantine for fully vaccinated returnees. This will be for seven days rather than 14.

South Australia has already indicated it would be willing to take part in this trial.

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Phase 2: post-vaccination

In this phase, the international arrival cap will be restored to current levels for unvaccinated passengers, and a larger cap applied to fully vaccinated passengers.

Lockdowns would rarely be needed, and fully vaccinated people would have eased restrictions in any outbreak with respect to lockdowns or border closures. More students and economic visitors will also be allowed in.

Although no dates or vaccine rollout targets have been set, for us to reach Phase 2, we would clearly need a high percentage of our population to be fully vaccinated.

As it will take at least until the end of year for the whole adult population to have received their first dose, Phase 2 is likely to kick in some time in the first half of 2022.

Phase 3: consolidation

In Phase 3, COVID would be treated more like the flu, presumably with annual booster shots to account for new variants. Fully vaccinated Australians would be able to travel abroad.

There would be no lockdowns, no cap on returning vaccinated travellers, and no domestic restrictions for vaccinated residents. We would be able to have travel bubbles with countries in a similar situation.

There would also be increased, albeit still capped, entries for international students.

Realistically, we are probably talking about the second half of 2022 before we can enter Phase 3.

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Phase 4: final

Here life returns to relative normality, very similar to the way it was before the pandemic began. However, there would still be pre- and post-flight testing for unvaccinated arrivals, and a vaccine passport system will likely be in place. I imagine there will still be a focus on hand hygiene and coughing etiquette.

The plan depends to a large extent on vaccine availability, any new and more transmissible variants arising, and persuading enough Australians to get vaccinated.

It will create a two-class system of those who are fully vaccinated and who will have lots of freedoms, and those not. Although there are some people who, for medical or even religious reasons, might not be able to be vaccinated, for the vast majority, it is a choice.

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Morrison’s statement says the plan will depend very much on the percentage of Australians 16 years and older who are fully vaccinated.

However, the Delta variant may be spreading more easily in children, although it’s not yet clear whether this is simply a function of the variant being more transmissible in general. It’s also unclear whether this leads to increased serious illness in those children infected.

Overall, I think the plan is sensible, if somewhat vague. Phase 1 calls for lockdowns to be a last resort, although I think this a big ask given the low percentage of the population currently fully vaccinated. Singapore has proposed a similar plan, but is way ahead of us in its vaccine rollout, with more than 60% of its population likely to be fully vaccinated by August.

So, for those desperate for international holidays, there is light at the end of the tunnel. You can potentially start packing in the second half of next year.

Adrian Esterman, Professor of Biostatistics and Epidemiology, University of South Australia

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

View from The Hill: COVID transition plan has bad news for returning travellers

Michelle Grattan, University of CanberraThe plan to transition Australia from COVID-as-crisis to COVID-like-flu that Scott Morrison has announced is designed to send a positive message – and an exhortation – to a community jaded by lockdowns, aborted holidays and closed borders.

But its most immediate and concrete measure is a negative.

The caps on returning travellers coming on commercial flights will be halved, as the country deals with the highly infectious Delta strain. The reduced caps, which several states pressed for, are set to last into next year.

Weekly arrivals will be cut to 3,035.

The federal government will increase the number on its sponsored flights bringing people to the Howard Springs quarantine centre. But that won’t compensate for the slashed cap, in what will be a blow to many people already finding it hard to return home.

On the more positive side, alternative quarantine options will be trialled, including home quarantine for returning vaccinated travellers, and there will be expanded commercial trials for limited entry of student and economic visas holders.

Under huge political pressure over the slow vaccine rollout – jabs are currently around eight million – a major aim of Morrison’s four stage plan is to incentivise people to get vaccinated.

At present the rollout is being held back not just by vaccine shortages and other problems but also by hesitancy – and in some cases complacency. The bad publicity around AstraZeneca has contributed to hesitancy.

Under the plan, yet-to-be specified vaccination coverage will be the key to eventually managing COVID like other infectious diseases, notably the flu.

But the “post-vaccination” second stage of the plan won’t be reached until next year – and that’s assuming all goes well.

A vaccination threshold for the easing, minimising or eschewing of restrictions, including lockdowns will be set on the basis of medical evidence and scientific modelling currently being done at Melbourne’s Peter Doherty Institute.

Morrison said of the vaccination threshold: “This will be a scientific number. It won’t be a political number, it won’t be an arbitrary number.” It could include targets for vulnerable populations such as the over-70s.

Experts give a wide range of rates for the appropriate level of vaccination needed for adequate community immunity.

Morrison announced the plan after national cabinet, at the end of a week that has seen brawling over his encouragement for younger people to take AstraZeneca, despite mixed health advice.

He denied his Monday comments had been inconsistent with the official advice.

Under the plan, the country is presently in phase one – dubbed “vaccinate, prepare and pilot” – when the strategy is to “continue to suppress the virus for the purpose of minimising community transmission”.

The plan has been agreed to “in principle” by the states and territories. But given they have the power over lockdowns and other restrictions, they won’t be bound by its specifics. Also the stages contain menus of measures rather than hard-and-fast commitments.

The “post vaccination” second phase would “seek to minimise serious illness, hospitalisation and fatality” from COVID

The Prime Minister said national cabinet had agreed on a “mind-set change”.

“Our mind-set on managing COVID-19 has to change once you move from pre-vaccination to post-vaccination. That’s the deal for Australians,” said Morrison, who is just out of quarantine after his overseas trip.

The plan says measures in the second phase may include easing restrictions on vaccinated residents, such as lockdowns and border controls. There would be lockdowns only in extreme circumstances to prevent escalating hospitalisations and deaths.

In this stage, inbound passenger caps would be restored at previous levels for unvaccinated returning travellers and there would be larger caps for vaccinated returning travellers.

Capped entry of student and economic visa holders would be allowed, subject to quarantine arrangements.

New reduced quarantine arrangements would apply for vaccinated residents.

The third – “consolidation” – phase would see COVID-19 managed like the public health management of other infectious diseases. There would be no lockdowns and restrictions would be lifted for outbound travellers who were vaccinated. Stage four would bring a final loosening.

There are not indicative timetables for the last two phases to start.

The plan is largely a work-in-progress, as is the vexed rollout, but Morrison hopes it will help drive the jabs, and provide him with some political cover.

Michelle Grattan, Professorial Fellow, University of Canberra

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

The LNP’s child-care subsidy plan: how it works, and what it means for families and the economy

MariaNikiforova/Shutterstock

Danielle Wood, Grattan Institute; Kate Griffiths, Grattan Institute, and Owain Emslie, Grattan InstituteThe federal government is pitching its 2021 budget as “women-friendly”. Yesterday it announced a key feature of that – more money to make child care cheaper and boost women’s workforce participation.

The Coalition’s policy will increase spending on the child-care subsidy from July 2022 by an extra A$1.7 billion over three years. That is about a 6% increase on the current investment of A$9 billion a year.

Key changes

The policy has two main components.

First, it drops the “annual cap” that limits the total yearly subsidy to A$10,560 per child for families with combined income of more than $189,390. After that – generally if they have their children in care for four or more days a week – they pay the full cost of care. These costs are often a big disincentive for women with high-earning partners to work more than three days a week.

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Read more:
An extra $1.7 billion for child care will help some. It won’t improve affordability for most

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Second, it boosts the subsidy for second and subsequent children in care by up to 30 percentage points (capped at 95%). This means families currently eligible for a 50% subsidy would now be eligible for an 80% subsidy on their second child if both children are aged under six. Older children using after school care are not eligible for any extra subsidy.

This will reduce fees for families paying some of the highest out-of-pocket childcare care costs – those with multiple children in long day care.

So how does it work?

Consider a middle-income family where one parent earns A$85,000 and the other parent earns A$65,000, with two young children in day care paying the average cost of A$110 a day per child. Under the current scheme they are eligible for a 60% subsidy for both children. So they pay A$88 a day and the government pays A$132.

Under the new policy, the subsidy will rise to 90% for the second child (with the first child still on a 60% subsidy). This means the parents will pay $55 a day for both children, and get a $165 subsidy. If they have the children in care for four days a week, they will be $132 a week better off.

Effect on workforce participation and family budgets

Currently, for families with two children in long day care, the primary care giver (typically the mother) can lose more than 80% – in some cases 100% – of take-home pay in the move to take a fourth or fifth day’s work. Child-care costs on those extra days are the main contributor.

The new policy reduces the disincentives for those families.

The first graph shows a family where the father earns A$60,000 and the mother would earn the same if she worked full time. The current system means she loses 90% of what she earns on her fourth day and more than 100% on the fifth day.

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Primary earner works full time, 2 children requiring care. Each day of work for second earner results in 2 days of approved care, costing $110 each.

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The new policy will lower these “workforce disincentive rates”.

The mother will now lose 75% on the fourth day and 90% on the fifth day.

As the next graph shows, the family will be A$5,000 a year better off if the second earner works four days, and $7,500 a year better off if she works full-time.

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Primary earner works full time, 2 children requiring care. Each day of work for second earner results in 2 days of approved care, costing $110 each.

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For a family where both parents have the potential to earn A$100,000 working five days a week, the new policy will almost halve the current workforce disincentive rate for working a fifth day – from 100% to 55%. This is because such a family will benefit from both the extra subsidy for the second child and the removal of the annual cap.

Workforce disincentives remain high even with the new policy. But it is a significant improvement on the status quo.

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The flip side of a highly targeted policy is that it benefits only a small segment of families. On the federal government’s numbers, up to 270,000 families may benefit. This compares with almost 1 million families now accessing some subsidised child care and many more who would like to access it if they could afford it.

How the Coalition’s policy compare to Labor’s

Labor announced its child-care policy in the budget reply last year.

Like the Coalition’s, it removes the annual cap. But it also increases the base subsidy (for all children) to 90%. It also reduces the rate at which the subsidy reduces as family income increases. This is one of the big contributors to growing out-of-pocket costs as mothers work more and use more child care.

So Labor’s policy is broader, with all families who use child care standing to gain, regardless of the number of children, their age and the family income.

It would cost about A$2 billion per year – roughly three times more than the Coalition’s. But it would also have bigger benefits, sharpening workforce incentives for a much wider group of families. The boost to GDP from higher workforce participation is likely to also be about three times bigger.

In terms of the impact on family budgets, the big difference between the policies is the number of children aged under six in care.

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Read more:
Permanently raising the Child Care Subsidy is an economic opportunity too good to miss

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Families with only one child under six in care (or only older children in after-school care) would be unambiguously better off under the Labor policy.

For families with two children under six in care, there is little difference at most family income levels. For families with three children under six in care (probably less than 20,000 families at any given time), almost all would be better off under the Coalition policy.

A step forward, but not a game changer

Overall, the Coalition’s policy is a helpful and well-targeted package that tackles some of the worst out-of-pocket costs and workforce disincentives. It will mean a real improvement for up to 270,000 families.

What’s missing is support for all the other families using child care. Almost 1 million families now use child care, and many would like to work more if they could afford to do so.

A broader policy supporting more families would have much larger and more widespread economic benefits. Of course, it would cost more too, but our research shows such an investment can be expected to deliver a boost to GDP of at least twice the cost.

This is a step in the right direction, but much more needs to be done to create a system that truly supports women’s workforce participation and long-term economic security.

Danielle Wood, Chief executive officer, Grattan Institute; Kate Griffiths, Fellow, Grattan Institute, and Owain Emslie, Senior Associate, Grattan Institute

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

Forget JobKeeper — what the government and the country need now is a JabMaker plan

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Mark Kenny, Australian National UniversityForget last week’s healthy 5.6% unemployment rate.

It might be “comfortably below” the Coalition’s 6% threshold for commencing “fiscal repair” (another term for unpopular spending cuts), but the government is under unforeseen political pressure and is anything but relaxed and comfortable.

In any event, this 5.6% figure was from March, which is an important detail because it predated the wind-up of the JobKeeper wage subsidy.

Who knows what that means.

It could mean nothing much or we might see an uptick in jobs lost — employees shed from debt-addled “zombie” firms, which survived the crisis only to perish in the recovery.

At $90-plus billion, the JobKeeper wage subsidy scheme was the biggest single program in Australian history. And by any metric, it was a shining success. Any metric that is, if you exclude the country’s fourth biggest pre-pandemic export sector, education.

Higher education’s ‘long COVID’

Universities suffered a triple COVID hit — denied access to the JobKeeper program due to the way they were structured, denied overseas students from whom (admittedly too much) revenue was relied upon and denied any certainty about their return due to a snail-paced vaccine rollout.

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Read more:
The government keeps shelving plans to bring international students back to Australia. It owes them an explanation

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As a result, a country that led the world through the 2020 pandemic trails it in 2021 through a bungled recovery program, while perhaps permanently hobbling one of its most lucrative and reliable exports.

Ever innovative, Australia may have found a way to give its university sector and therefore its own future growth the economic version of long COVID.

A terrible start to 2021

Politically, Prime Minister Scott Morrison’s options at the start of 2021 looked pretty inviting. Flush with that 2020 success — a combination of good judgement, good luck, and state government front-footedness — Morrison was riding high in public opinion. Inevitably, talk turned to a possible spring election to capitalise.

Labor’s end of the see-saw was weighed down. Doubts were aired about leader Anthony Albanese’s cut-through, his chances in an early poll, the pros and cons of a challenge.

Talk of an early election in 2021 has melted away.
Lukas Coch/AAP

But events since have changed everything. Two months of attempting to politically nuance a series of negative stories and allegations regarding the treatment of women in politics have damaged the government, consumed its oxygen, and pricked the prime minister’s inflated reputation as the supreme pragmatist.

His unwillingness to get in front of the problem has instead evinced a strange defensiveness. His grudging late-stage efforts at political rescue have been less effective for their pointless delay and for the tightly qualified nature of the language used.

The Christine Holgate saga is merely the latest iteration.

It was clear weeks ago that Holgate had been prejudicially forced from her job at Australia Post. The most senior political leverage in the land had been summarily and publicly applied. A prime ministerial apology was the obvious solution, not just for her but for him also.

The vaccine ‘eekout’

Twice-weekly national cabinet meetings began again on Monday, in a sign the prime minister understands the seriousness of Australia’s vaccine bungles.
But his reluctant acknowledgement of multiple problems in the rollout to date reinforces his instinctive stubbornness.

The abject helplessness of Australia at the vaccine stage is also all the more jarring for its contrast with the 2020 suppression of the virus and the glowing vaccination expectations the government itself created.

Australia’s vaccination rollout has been plagued by supply issues and health concerns.
James Ross/AAP

On these grounds alone, the prime minister’s political judgement is questionable. Australians were promised a world-class vaccine program in which we would be at the front of the queue. What it would lack in immediacy (a luxury of zero community infection, we were assured) would be more than made up for in logistical precision.

In fact, it has failed to materialise. Opaque and piecemeal, the rollout feels more like an eekout.

What will decide the next election?

Now, the Coalition looks to the May 11 Budget for political salvation.

Even with a jobless number of just 5.6%, it has limited political capital to spend and must use the balance sheet to repair its political stocks rather than the nation’s books.

JobKeeper, JobSeeker, and even JobMaker, have either gone or will not make enough difference to matter at the ballot box next year.

What the government really needs is what the country needs — JabMaker.

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Read more:
To abandon vaccination targets is to abandon the mantle of leadership

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After all, it’s the jabless rate rather than the jobless rate that could decide the next election. It currently sits “comfortably” around 95%, with no certainty that the population will be vaccinated this calendar year.

The end of October target has been junked, replaced with … nothing.

Compare that to calamitous America where they expect to reach the full adult population by the end of July.

Last week, the US inoculated roughly the entire population of Australia. On one of those days alone, 4.6 million people received jabs of either Pfizer or others such as Moderna, and Johnson & Johnson.

Australia is well and truly “jab-ready”.

Its government, not so much.

Mark Kenny, Professor, Australian Studies Institute, Australian National University

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

Australia’s plan for manufacturing missiles to be accelerated

Michelle Grattan, University of CanberraThe government is speeding up the establishment of its planned $1 billion Sovereign Guided Weapons Enterprise, which aims to boost Australia’s own defence production capabilities as it faces a deteriorating security outlook.

The defence department will now start the process of selecting a strategic industry partner to operate a sovereign guided weapons manufacturing capability to produce missiles and other weapons on the government’s behalf .

The new enterprise will specialise in guided missiles for use across the defence force.

The increasing assertiveness of China and Australia’s deteriorating relations with that country, as well as the lessons of COVID, have strengthened the push for greater sovereign capability.

Scott Morrison, who will announce the acceleration in Adelaide on Wednesday, said in a statement, “Creating our own sovereign capability on Australian soil is essential to keep Australians safe, while also providing thousands of local jobs in businesses right across the defence supply chain.

“As the COVID-19 pandemic has shown, having the ability for self-reliance, be it vaccine development or the defence of Australia, is vital to meeting our own requirements in a changing global environment.”

Peter Dutton, who was only sworn into the defence portfolio on Tuesday, said the announcement “builds on the agreement the Morrison government achieved at AUSMIN last year to pursue options to encourage bilateral defence trade and to advance initiative that diversify and harness our industry co-operation”.

Dutton said Australia would work closely with the United States “to ensure that we understand how our enterprise can best support both Australia’s needs and the growing needs of our most important military partner”.

The Australian Strategic Policy Institute, a defence think tank, estimates Australian will spend $100 billion in the next 20 years on buying missiles and guided weapons.

ASPI defence expert Michael Shoebridge wrote in June last year:

“The ADF gets its missiles from US, European and Israeli manufacturers, at the end of long global supply chains. And, when the home nations of these manufacturers need missiles urgently themselves, their needs can get in the way of meeting ours […]

“The deteriorating strategic environment in our region, combined with the heightened understanding of how vulnerable extended global supply chains are, means the current situation has become unacceptable.”

Companies that could be a potential partners include Raytheon Australia, Lockheed Martin Australia, Kongsberg, and BAE Systems Australia. The partner will need to be suitable to work with the US and have strong links with Australian supply chain businesses.

The new Minister for Industry, Science and Technology, Christian Porter released a National Manufacturing Defence Roadmap on Tuesday, for a 10 year plan for investment.

Michelle Grattan, Professorial Fellow, University of Canberra

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

Labor’s plan for $15 billion ‘reconstruction fund’ to promote post-pandemic manufacturing economy

Michelle Grattan, University of CanberraA Labor government would set up a $15 billion National Reconstruction Fund to promote manufacturing in Australia’s post pandemic economy.

The fund, to be announced on Tuesday as Labor begins its national conference, would partner with private investors and superannuation funds, which have access to large reserves of capital.

It would be aimed at helping build new industries and boosting existing ones. The $15 billion would be provided through a combination of loans, equity, co-investment and guarantees.

In a statement on the plan, Anthony Albanese and shadow minister for national reconstruction. Richard Marles, say the pandemic has highlighted the serious deficiencies Australia has in its manufacturing capabilities and its ability to be globally competitive in innovation and technology.

“If there is anything that COVID has taught us, it is the need for Australia to be a place which makes things – to have our own industrial and manufacturing capabilities, our own sovereign capabilities,” they say.

“From commercialising our historic capacity in science and innovation to boosting the development of medical devices and pharmaceuticals, through to reviving our capability to make cars, trains and ships, today’s announcement will support the businesses in these industries to secure the capital and investment to grow and prosper,” Albanese and Marles say.

The fund would concentrate on a range of strategic industries. These would include resources value adding; food and beverage processing; transport; medical science; renewables and low emission technologies; defence capability, and enabling capabilities across engineering, data science and software development.

Objectives of the fund would be to:

• reduce the risk of investment in innovation
• help firms grow by support for new investment especially in regional areas
• strengthen self-sufficiency and industrial diversity in Australia by assisting businesses build national sovereignty and decrease the risks in their supply chains
• support regional developoment by enhancing private sector investment in industries of the future.

Labor would model the fund on entities such as the successful Clean Energy Finance Corporation, which was set up by the Labor government. It has invested billions to promote the transition to renewable energy, energy efficiency and low emissions technologies.

Labor’s proposed fund would have an independent board.

Assistance it provided would need to return rates above the government borrowing rate.

The $15 billion capital provided would be off-budget.

Labor points out that according to the OECD Australia ranks last in manufacturing self-sufficiency among industrialised countries. It produces just over two thirds of what it uses.

The pandemic as well as the deepening Australia-China tensions have increased debate over the past year about the need for greater self-sufficiency especially in certain key areas, such as medical supplies. The pandemic led to supply chain problems which are still being experienced for some products.

Michelle Grattan, Professorial Fellow, University of Canberra

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