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

Posted on September 11, 2021 by particularkev

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

Is the plan ‘set in stone’?

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

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

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

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

The national plan expressly says at the bottom:

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

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

What does the national plan say about border closures?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Anne Twomey, Professor of Constitutional Law, University of Sydney

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

Grattan on Friday: The compassion quotient in Morrison’s Afghan response needs a boost

Posted on August 21, 2021 by particularkev

Michelle Grattan, University of CanberraPrime Minister Scott Morrison this week pointed to the government’s closure of Australia’s embassy in Afghanistan in May as a good decision for which he had been criticised.

More credibly, it was a bad decision, on principle but also very likely for practical reasons.

The scramble by Western countries to evacuate their nationals and Afghans who had assisted them was always destined to be chaotic.

But it is possible, if we had retained a small contingent of embassy staff in place to the end, we might have been able to process the Afghans more efficiently, thus smoothing — even slightly — the exit.

When shutting the embassy, the government emphasised the security danger. That could have been minimised, as some other countries did. Anyway, diplomats should be the last to turn off the lights, not the first.

The Morrison government’s slowness in processing the Afghans helpers has left it open to the criticism of “too little too late” (inevitably it was likened to the vaccine rollout).

Viewed broadly, its reaction to the Taliban takeover has found the government scoring relatively low on the compassion meter, and relatively high on that measuring risk avoidance. And keeping an eye on the politics.

The crisis has put three cohorts of Afghans in the spotlight – the former interpreters and others who assisted the Australians; people offshore (in Afghanistan or elsewhere) who will seek entry as refugees; and those in Australia on temporary protection visas (TPVs) who arrived by boat.

The government says 430 former local staff and their family members have been brought out since April (before the current evacuation). But there are more former helpers to come.

Defence Minister Peter Dutton is particularly concerned with risk minimisation in the assessment process.

Dutton told the ABC’s Patricia Karvelas, “You and many other journalists would be screaming down the line at me if one person was brought in that committed an atrocity in our country”.

Dutton is highly attuned to security issues; he also probably has in mind the Coalition base.

Nobody denies there must be stringent vetting. In some cases, people who assisted Australia later changed allegiance – that’s the nature of Afghanistan. Obviously they don’t get through.

But while all reasonable care has to be taken, it is impossible – realistically – to avoid a small element of risk (on a strict no-risk principle, many people would never be let out of our gaols).

A number of Australian veterans who served in Afghanistan have been vocal about doing the right thing by the interpreters. Given how solicitous it is of the veterans community, criticism from them — which is also mixed with their wider critiques of the war and the withdrawal – is uncomfortable for the government.

Separate from the evacuation of Afghans, the government announced Australia will take 3,000 refugees this financial year, while anticipating the number would be higher.

The modest figure was immediately (to Morrison’s annoyance) set against the ambition of countries such as Canada, which has pledged to accept 20,000. Then there were comparisons with the performance of former prime ministers (Fraser, 55,000 Vietnamese refugees; Hawke 42,000 Chinese students after the Tiananmen Square massacre; Abbott, 12,000 Syrians after the civil war).

Moreover, the government said Afghans would be accommodated within Australia’s 13,750 annual humanitarian program (which, incidentally, has a lot of spare capacity due to COVID). So the bottom line was substitution – more Afghan refugees and fewer refugees from some other places.

It was quickly clear demand for places would be strong. Andrew Hastie, assistant minister for defence who fought with the SAS in Afghanistan, said his office had been “deluged over the last four or five days with requests. I know other MPs and senators across the country are having the same experience.”

After a meeting with Afghan community leaders on Thursday Morrison, who’s under pressure to do more, said: “We see that as a floor, not a ceiling, so we think we can achieve more than three. If the overall program has to be expanded[…] it will be.

“Our humanitarian program runs every single year, and I foresee […] the Afghan cohort in our humanitarian program having a very strong presence in years to come.”

Both the refugees and evacuees will have permanent residency, which brings a secure future as well as the opportunity to sponsor the arrival of family members.

Access to family reunion is a right the Afghans living here on TPVs don’t have (although their family members will be able to apply for the dedicated refugee intake).

All but a handful of the more than 4,500 Afghans on TPVs came here by boat, many years ago. The current crisis has prompted calls for them to be given permanent settlement.

Labor leader Anthony Albanese said: “We need to give them the certainty of Australian citizenship on a permanent basis, rather than some pretence that somehow their circumstances are temporary. They are not. And they need to be given that security.”

But Morrison is adamant. They did not come “the right way”, and affording them permanent status would breach the government’s border control policy.

“I want to be very clear about that. I want to send a very clear message to people smugglers in the region that nothing’s changed,” he said on Wednesday. “I will not give you a product to sell and take advantage of people’s misery. My government won’t do it. We never have and we never will.”

It’s a trade-off of risk and politics on one hand versus compassion on the other. There is no possibility these people will ever be repatriated to Afghanistan. Would giving them permanency really set off the people smugglers? Even if there was any attempt to test the border, we know the navy has capability to deal with that.

The political element is obvious. Labor has always been vulnerable on the border protection issue, and Albanese has given possible ammunition to the government. The Coalition would have to be careful using it, however, when there is a lot of public sympathy for the Afghans.

On the government’s policy, these Afghans who have become members of the Australian community, many of them working in occupations where labour is in demand, are forever to be denied the assurance about their futures that permanent residency brings. They deserve better.

In this Afghanistan moment – which is one of reflection and regret for the failure of the allies’ aspirations for that nation – we show the world what sort of country we are. We should display a more generous character.

Michelle Grattan, Professorial Fellow, University of Canberra

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

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

Posted on August 21, 2021 by particularkev

Michael Toole, Burnet InstituteCases of COVID-19 are surging around the world, but the course of the pandemic varies widely country to country. To provide you with a global view as we approach a year and a half since the official declaration of the pandemic, The Conversation editors from around the world commissioned articles looking at specific countries and where they are now in combating the pandemic.

Here, Mike Toole, Professor of International Health at the Burnet Institute, writes about how China went from pandemic epicentre with a dark history of silencing those who spoke out about the risks of the virus, to rapidly containing the virus in its latest outbreak. You can see the whole collection of articles here.

On January 5, 2020, the World Health Organization (WHO) issued a statement that five days earlier, it was informed of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province.

By January 3, 2020, a total of 44 cases had been detected. According to Chinese authorities, some patients were vendors and customers in the Huanan Seafood market.

And so it began

The outbreak was not widely reported at the time, although the BBC posted a piece two days before the WHO statement. I first learnt of it on January 8 from the New York Times. Having been involved in many epidemic responses and knowing that several viral pandemics – such as SARS and avian influenza – had originated in China, the story piqued my interest.

By then, the causative agent had been identified – a novel coronavirus named SARS-CoV-2. Investigators had not yet found evidence of person-to-person transmission.

And where did this virus come from? Well, we don’t really know. The WHO investigative team came to the following conclusion:

At this stage, it is not possible to determine precisely how humans in China were initially infected with SARS-CoV-2. However, all available evidence suggests that it has a natural animal origin and is not a manipulated or constructed virus. SARS-CoV-2 virus most probably has its ecological reservoir in bats.

China’s response to the Wuhan outbreak

During early January 2020, a group of doctors in Wuhan who had been trying to alert colleagues to the risks of the outbreak were apprehended by security police and forced to sign statements denouncing their warnings. One of them, Dr Li Wenliang, later died of coronavirus infection.

On January 23, authorities sealed off Wuhan, a city of 11 million. However, the mayor estimated up to five million people were able to leave beforehand during Spring Festival and the virus spread to every province and region in the country.

By then, person-to-person transmission had been confirmed.

On January 30, the WHO declared a public health emergency of international concern. By this time, China had reported 9,692 cases and 213 deaths.

Among patients, about 20% had become seriously ill and the rest had a mild illness, the WHO said.

On February 11, the WHO announced the official name of the novel disease: COVID-19. While the virus had been detected in more than 20 countries, the majority of cases were in China.

By mid-February, the country had reported more than 66,000 cases and 1,600 deaths. The health system was quickly overwhelmed and measures were taken like building two large new hospitals in Wuhan with a combined 2,500 bed capacity in the space of two weeks.

And then it was over

The seven day rolling average of new daily cases reached a peak of 4,670 on February 13. Just 30 days later it was down to 19. However, it should be noted that China only reports cases that are symptomatic, which may underestimate total SARS-CoV-2 infections.

This remains one of the most rapidly contained outbreaks of COVID-19 in the world during the entire pandemic.

Since that first wave, China has been determined to maintain zero COVID with just an occasional cluster disturbing the peace. By almost every metric, China ranks highly in containing the coronavirus.

Since April 1, 2020, the country has reported just over 12,800 new cases in a population of 1.4 billion. That’s about the same number recorded in Timor-Leste with a population one thousandth the size of China.

Overall, China has reported 66 cases per million population compared to 112,362 per million in the United States. This low number has been due to a combination of quick, early lockdowns, widespread testing and sometimes harsh limitations on people’s movements. The latter have been criticised by human rights advocates.

The vaccine rollout has picked up pace and 1.8 billion doses of CoronaVac and Sinopharm, both manufactured in China, have been administered, enough to vaccinate 66% of the population.

While there have been concerns about these vaccines, real world data in Chile indicate CoronaVac is 67% effective against infection and 85% effective against hospitalisation.

A study in Bahrain found Sinopharm is 90% effective against infection and higher against hospitalisation.

Since late July, China has faced its biggest challenge since the first wave in Wuhan. An outbreak of the Delta strain, which began at Nanjing airport, led to 526 cases in Jiangsu province in the first two weeks of August and has spread to 12 cities, including Wuhan.

This prompted the activation of epidemic containment protocols including mass testing, demarcating neighbourhoods deemed risky and restricting movement in affected cities.

The strategy seems to be working – by August 15, new daily cases declined for the fifth consecutive day.

What lessons can China offer the world?

It’s hard to compare China with any other country. Its mass urban testing strategy, for example, is not feasible in most countries.

But, what China has clearly demonstrated is that zero tolerance of COVID-19 reaps enormous health and economic benefits. While China’s economy shrank by 6.8% in the first quarter of 2020, it grew by a record 18.3% in the first quarter of 2021.

By contrast, the Eurozone economy shrunk by 0.6% and the UK economy shrunk by 1.5% in the same quarter.

That should be food for thought for those who agitate for “living with COVID-19”.

Michael Toole, Professor of International Health, Burnet Institute

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

If I’ve already had COVID, do I need a vaccine? And how does the immune system respond? An expert explains

Posted on August 3, 2021 by particularkev

Sunit K. Singh, Banaras Hindu UniversityOver a year into the pandemic, questions around immune responses after COVID continue to confound.

One question many people are asking is whether the immunity you get from contracting COVID and recovering is enough to protect you in the future.

The answer is no, it’s not.

Here’s why.

Remind me, how does our immune response work?

Immune responses are innate or acquired. Innate, or short-term immunity, occurs when immune cells that are the body’s first line of defence are activated against a pathogen like a virus or bacteria.

If the pathogen is able to cross the first line of defence, T-cells and B-cells are triggered into action. B-cells fight through secreted proteins called antibodies, specific to each pathogen. T-cells can be categorised into helper T-cells and killer T-cells. Helper T-cells “help” B-cells in making antibodies. Killer T-cells directly kill infected cells.

Once the battle is over, B-cells and T-cells develop “memory” and can recognise the invading pathogen next time. This is known as acquired or adaptive immunity, which triggers long-term protection.

What happens when you get reinfected? Memory B-cells don’t just produce identical antibodies, they also produce antibody variants. These diverse set of antibodies form an elaborate security ring to fight SARS-CoV-2 variants.

Natural immunity is not enough

Getting COVID and recovering (known as “natural infection”) doesn’t appear to generate protection as robust as that generated after vaccination.

And the immune response generated post-infection and vaccination, known as hybrid immunity, is more potent than either natural infection or vaccination alone.

People who have had COVID and recovered and then been vaccinated against COVID have more diverse and high-quality memory B-cell responses than people who’ve just been vaccinated.

Studies indicate mRNA vaccines generate a more potent immune response with previous infection, at least against some variants including Alpha and Beta.

And studies have shown that antibody levels were higher among those who’d recovered from COVID and were subsequently vaccinated than those who’d only had the infection.

Memory B-cells against the coronavirus have been reported to be five to ten times higher in people vaccinated post-infection than natural infection or vaccination alone.

Is one dose enough after COVID?

Some reports have suggested people who’ve had COVID need only one dose of the vaccine. Clinical trials of approved vaccines didn’t generate relevant data because people who’d already had COVID were excluded from phase 3 trials.

One study from June showed people with previous exposure to SARS-CoV-2 tended to mount powerful immune responses to a single mRNA shot. They didn’t gain much benefit from a second jab.

A single dose of an mRNA vaccine after infection achieves similar levels of antibodies against the spike protein’s receptor binding domain (which allows the virus to attach to our cells) compared to double doses of vaccination in people never exposed to SARS-CoV-2.

We need more studies to fully understand how long memory B-cell and T-cell responses will last in both groups.

Also, a single dose strategy has only been studied for mRNA-based vaccines. More data is required to understand whether one jab post-infection would be effective for all the vaccines.

At this stage, it’s still good to have both doses of a COVID vaccine after recovering from COVID.

Does Delta change things?

The development of new vaccines must keep pace with the evolution of the coronavirus.

At least one variant seems to have evolved enough to overtake others, Delta, which is about 60% more transmissible than the Alpha variant. Delta is moderately resistant to vaccines, meaning it can reduce how well the vaccines work, particularly in people who’ve only had one dose.

There’s no data available yet about how effective a single jab is for people who were previously infected with Delta and recovered.

The most important thing you can do to protect yourself from Delta is to get fully vaccinated.

According to a Public Health England report, one dose of Pfizer offered only about 33% protection against symptomatic disease with Delta, but two doses was 88% effective. Two doses was also 96% effective against hospitalisation from Delta. The AstraZeneca vaccine was 92% effective against hospitalisation from Delta after two doses.

A few vaccine manufacturers, including Pfizer, are now planning to use a potential third dose as a booster to combat the Delta variant.

Sunit K. Singh, Professor of Molecular Immunology and Virology, Institute of Medical Sciences, Banaras Hindu University

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

Public trust in the government’s COVID response is slowly eroding. Here’s how to get it back on track

Posted on July 14, 2021 by particularkev

Mark Griffith Evans, University of CanberraPublic trust is critically important during the pandemic. Without it, the changes to public behaviour that are necessary to contain and ultimately prevent the spread of infection are slower and more difficult to achieve.

In mid-2020, Australia was widely viewed by the public as having successfully managed the pandemic, especially compared to the US, UK and other European countries. Australians’ trust in their government almost doubled in a year from 29% to 54%.

The same is not the case today. Australia remains locked down with a stalled vaccine rollout, while the US, UK and other countries are opening up. And public trust in the government is eroding.

The latest Essential poll last week showed people’s support of the government’s handling of the pandemic sliding nine points from 53% to 44%. And 30% of respondents described the government’s COVID strategy as poor, compared to 24% a month earlier.

Why people tend to trust government in crises

It’s common for people to show support for their leaders during crises. In the initial stages of the pandemic in early 2020, surveys showed leaders in a large number of countries enjoyed an increase in public confidence.

The approval rating of Italian Prime Minister Giuseppe Conte hit 71% in March 2020 – 27 points higher than the previous month – despite the fact his country was in the throes of a deadly first wave of the pandemic.

German Chancellor Angela Merkel saw her approval rise to 79%, while the prime ministers of Canada and Australia, Justin Trudeau and Scott Morrison, saw similar surges in popularity during the early months of the pandemic.

Perceptions of political leadership during the pandemic, July 2020.
Adapted from Will Jennings and others, 2020, Political Trust and the Covid-19 Crisis – pushing populism to the backburner?, Author provided

The upsurge of support is partly explained by what is called the “rally-round-the-flag” effect.

In Australia, Morrison’s approval rating soared on the back of his effective handling of the initial threat, judicious decision-making on early closure of international borders and an atypical coordination of state and federal governments via the National Cabinet.

Moreover, a severe threat like a pandemic can make people more information-hungry, anxious and fearful. COVID has become a powerful shared experience for people. It touched most households through people’s connections with health and social care workers and their communication with relatives, co-workers or friends who were in lockdown or unfortunate enough to get sick.

Yet, research also suggests many people do not lose their capacity for reason or critical judgement in a crisis. For example, people can oppose wars or other heavy-handed responses to terrorist attacks even if such attacks make them more anxious or fearful.

Above all, the competence and outcomes of the government’s actions matter. If the government is perceived as not able or willing to adequately respond to a threat, then public support will fade.

How government can get public trust back

Fast-forward to today. The Australian public is disenchanted with the slow rollout of the vaccine program and mixed government messaging over the relative risks of the AstraZeneca vaccine. This has punctured public trust in government in a very short period of time.

At the same time, people are proving highly vulnerable to fake news and conspiracy theorists, who are taking advantage of mixed messaging by government to try to sow more confusion.

The dangerous implication of all of this: it’s fuelling vaccine hesitancy. One in six Australians now say they will never get a COVID vaccine, according to a recent poll.

So, what needs to be done to reverse the decline in public trust of the government? The Organisation for Economic Cooperation and Development (OECD) has provided some timely guidelines that suggest the need for greater community engagement.

This can be achieved by the government taking these steps:

proactively releasing timely information on vaccination strategies, forms of delivery and accomplishments in a user-friendly format
providing transparent and coherent public communication to address misinformation and what is known as the “infodemic”
engaging the public when developing vaccination strategies.

The public needs to have its say

At the start of the pandemic, co-designing strategies with citizens was a low priority. But in the later stages of crisis management when behavioural change – in this case, vaccine take-up – becomes critical to containing the virus, you ignore the views of citizens at your peril.

Moreover, in the recovery stage – when it’s time to reflect on the government response, take accountability for missteps and draw lessons for the future – citizen engagement becomes even more important.

As inquiries are eventually launched to explore what went right and what went wrong with the coronavirus response, the public must be invited to the discussion.

And there are models for how to do this. Just look at the citizen’s assemblies that have been formed in France and the UK to push for greater action on climate change in the post-COVID global recovery.

There’s no way of knowing if COVID-19 could have been managed more successfully if there had been more public participation and debate from the start, given the whirlwind of uncertainty and the need for rapid decisions to tackle a crisis.

But there is little doubt that at some point the public will have to have their say. Important nationwide discussions need to be had on how best to limit the creep of executive power, how to better facilitate public debate in a period of high anxiety, and how to get the best out of the experts.

How to combat misinformation?

And what about the longer-term problem of combating truth decay in society?

Finland, Sweden and the Netherlands have an effective weapon to combat fake news: education. These countries all include digital literacy and critical thinking about misinformation in their national curriculums.

Moreover, the Finnish fact-checking organisation Faktabaari provides professional fact-checking methods for use in Finnish schools, focusing on misinformation, disinformation and malinformation (stories that are intended to cause harm).

This is where Australian public universities can play a critical role by providing independent, evidence-based, fact-checking services in their areas of expertise to the community. This is essential not only to combat truth decay, but to strengthen our responses to future crises.

Mark Griffith Evans, Professor of Governance and Director of Democracy 2025 – strengthening democratic practice at Old Parliament House, University of Canberra

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

Grattan on Friday: General’s vaccine advance waits on more fuel

Posted on July 11, 2021 by particularkev

Michelle Grattan, University of CanberraDespite some questioning about a military man being in charge of the vaccine rollout, when it comes to communicating, Lieutenant General JJ Frewen is a refreshing change from the pollie-speak and fudges we hear all the time.

At a Tuesday news conference, after his virtual meeting with the states and territories, Frewen answered questions directly and briefly.

He was distinctly “forward leaning”, indeed pre-empting the content of the roundtable Treasurer Josh Frydenberg and he were to have with business representatives the following day.

Frewen sounds like a man who knows what he’s doing. Coming days will tell whether that’s the reality. (You can find a touch of scepticism in certain state quarters.)

Prime Minister Scott Morrison is naturally inclined to put faith in the military, especially after his Sovereign Borders experience. But bringing in Frewen was also a response to what was becoming a desperate situation. It was a call to Triple Zero. He’s now very impressed with the general and relying on him heavily.

While critics baulk at the “men in uniform” pictures (Frewen flanked by colleagues), a degree of concern is also being expressed from quite another quarter. Some defence sources are wary of the danger of politicising the military.

The Australia Defence Association tweeted this week: “Relying on the ADF to head emergency efforts (not just assist the civil community) risks dragging a necessarily non-partisan institution into #auspol controversy”.

The ADA referenced the 2007 Northern Territory intervention over child sex abuse, when the seconded general heading a multi-departmental operation was targeted in a highly politicised environment.

At the moment, however, Frewen has more immediate worries. The general has landed on the beach, reworked the maps, and is marshalling available forces. But his advance is hampered by the shortage of fit-for-purpose fuel.

As each day goes by, the limited quantities of Pfizer and the absence of any other currently available alternative to AstraZeneca (which is subject to restrictive health advice) is being highlighted more starkly.

The fact this will change later (we are assured) doesn’t help when the here-and-now is urgent, as the Sydney outbreak and the extension of the lockdown there underline.

It’s a time-gap that up until now Australia has not been able to significantly narrow.

We’re hearing about vaccine transfers abroad – for example, Israel is providing doses to South Korea, to be repaid later.

But it is hard for a country like Australia, with relatively few cases, to make a plea. Morrison was asked why we haven’t been able to use our “special relationship” with the US to get some of its surplus doses. Unsurprisingly, others have greater needs or better arrangements.

Announcing on Thursday a liberalising of the COVID disaster payment to assist in the Sydney outbreak, Morrison also said the state would be provided with 300,000 extra vaccine doses next week, equally divided between Pfizer and AstraZeneca. This won’t affect what other states receive (on the per head of population formula), and NSW’s numbers will be smoothed out later.

The federal government has now rustled up additional shots of Pfizer.

On Friday, it was announced the supply of Pfizer had been brought forward, with 4.5 million doses expected to be available in August instead of September.

The supply problem came through strongly when Frydenberg and Frewen spoke after Wednesday’s business meeting.

The roundtable canvassed workplace vaccinations. Frydenberg said there were a lot of offers. Virgin Group CEO Jayne Hrdlicka said, “Big employers have the ability to stand up vaccination programs very quickly and would welcome the opportunity to be able to vaccinate as much of the workforce as quickly as possible”.

According to Treasury sources, when the rollout was being prepared, Treasury put forward the view that employers should be used as a channel, as with the flu vaccine. But up to now, we’ve heard little from the government about such an obvious way to boost rates. And, among other things, that goes back to supply.

If we had more Pfizer, there is no reason why this could not have been happening now. (Except where there’s lockdown and work from home!) But employers can’t be in the thick of the rollout when the supply problem means the younger people in their workforces could not be given the vaccine preferred for them. The workplace sites will be for later in the year.

If there had been more Pfizer, the under 40 cohort could have been brought into the general rollout program much earlier – these people are still waiting, unless their job or health puts them into a special category, or they choose AstraZeneca.

And with adequate Pfizer supplies the PM wouldn’t have needed to encourage younger people to consult their doctor about taking AstraZeneca.

The extension for another week of the Sydney lockdown further removes the special status NSW has claimed – and has been accorded by the federal government – as the gold standard for handling COVID without having to resort to extreme measures. The virus again has proved itself the great leveller.

NSW’s decision would be especially disappointing to Morrison. But there is a tone of greater tolerance towards his home state than he displayed to Victoria, in its recent troubles, when he held out for some days before announcing assistance. (In fairness, the Delta outbreak in Sydney is particularly bad.)

“We’re working very cooperatively and positively together [with NSW] because let me be clear – what is happening in Sydney just doesn’t have implications for Sydney,” he said.

“What is happening in Sydney has very serious implications not only for the health of Sydneysiders but also for the economy of Sydney, but also the economy of NSW and indeed the national economy.”

At the moment, one in three eligible people in Australia has had a first vaccine dose, and one in ten has received both doses.

The government has been foreshadowing for a while that by year’s end, all eligible Australians will have had the opportunity of a first jab. On Thursday, Morrison pointedly said this was the government’s intention “based on the advice of Lieutenant General John Frewen that that will be possible”.

That’s assuming “the supply lines hold”.

The PM said this would mean the vaccination program would be only two months behind the schedule the government had when it talked about an October deadline.

No pressure, JJ.

This article has been updated to take into account the prime minister’s Friday announcement on bringing forward Pfizer doses

Michelle Grattan, Professorial Fellow, University of Canberra

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

Too late, already bolted: how a faster WHO response could have slowed COVID-19’s spread

Posted on May 16, 2021 by particularkev

Michael Toole, Burnet InstituteUrgent global action is needed to end the COVID-19 pandemic and prepare for future threats, according to a new report by the Independent Panel for Pandemic Preparedness and Response.

The panel, co-chaired by former New Zealand prime minister Helen Clark and former Liberian president Ellen Johnson Sirleaf, criticises the World Health Organization (WHO) for its tardy actions during the first months of 2020.

The WHO was slow to warn of person-to-person transmission after it first received this information in Wuhan, China, in early January.

And it was slow to declare a public health emergency of international concern (PHEIC), which it did on January 30.

The WHO also opposed international travel restrictions that, if implemented earlier, might have slowed the international spread of the virus. By the time the PHEIC was declared, COVID-19 had spread to 18 countries outside China.

But WHO’s hands were tied

While this may appear just a scathing criticism of the world’s peak health body, the WHO had its hands tied by the international framework that governs the response to emerging infectious diseases and pandemics, the International Health Regulations (IHR).

These regulations were drafted in 2005 in response to the SARS (severe acute respiratory syndrome) and H5N1 (avian flu) pandemics and endorsed by member nations in 2007.

The regulations imposed new requirements that must be met before the WHO director general could act on emergencies, rather than enabling the WHO to act immediately and independently.

The regulations also prohibit international travel restrictions in public health emergencies.

Many member nations failed to act

The report describes February 2020 as a “lost month”, referring to the time between the declaration of a PHEIC and the WHO statement on March 11 that characterised COVID-19 as a pandemic.

The panel found this was due to a lack of understanding that the PHEIC declaration was the loudest possible alarm open to the director general. The pandemic declaration was not based on International Health Regulation guidelines.

The panel found a number of countries took a wait-and-see attitude during February 2020, allowing the virus to spread uncontrollably.

Effective and high-level coordinating bodies were critical to a country’s ability to adapt to changing information. Yet only a few countries set in motion comprehensive and coordinated COVID-19 protection and response measures.

Of the 28 country responses the panel analysed in depth, only a handful adopted aggressive containment strategies, including China, New Zealand, South Korea, Singapore, Thailand and Vietnam.

Some others had uncoordinated approaches that devalued science, denied the potential impact of the pandemic, delayed comprehensive action and allowed distrust to undermine efforts. While not named, the United States and Brazil were probably among them.

The report praises the role of the African Union and the Africa CDC in leading a continent-wide coordinated response.

It also singles out research and development as a major achievement, especially in vaccine development.

Preparation was inadequate

Despite the lessons learned from previous outbreaks of SARS, H1N1 (avian flu), Zika, MERS (Middle East respiratory syndrome) and Ebola, preparedness was vastly underfunded.

The US government, led by the Centres for Disease Control, established the Global Health Security Agenda, a group of 70 countries — including Australia – committed to building global capabilities to implement the International Health Regulations. But the Trump administration defunded most of the US CDC’s activities under the agenda.

After the H1N1 pandemic, Australia reviewed its health sector response and made many recommendations for future preparedness. However, inaction followed. Australia has not run a large-scale pandemic simulation exercise since 2008.

Australia also dropped the ball on regional pandemic preparedness. After the SARS outbreak in 2003, the government developed a five-year regional emerging diseases and pandemics strategy, which received A$100 million from the Howard government. Yet the second five-year strategy attracted very little funding.

Fixing the global system

The panel urges immediate action to end the pandemic through:

accelerated vaccination
proven measures such as masks and social distancing
testing and contact tracing.

However, the focus of its recommendations is on future preparedness.

The panel is convinced a Global Health Threats Council at the most senior level is vital to future success. It would help secure high-level political leadership and ensure attention to pandemic prevention, preparedness and response is sustained over time. Such a body is long overdue.

To ensure the WHO is more agile, the panel recommends an increase in the proportion of funding that is unearmarked for specific programs and countries. This would allow for financial reserves to respond to sudden, unexpected events. It also needs an improved surveillance system, quicker alerts for emerging virus threats, and authority to publish information and dispatch expert missions immediately.

Transparency, speed, flexibility to act more independently and better resourcing are critical to the reforms proposed. Efforts to do this will need unqualified support from its member nations, starting at this month’s World Health Assembly.

After the disruptive years of the Trump presidency, the WHO needs restoration. Australia is influential and should be at the forefront of ensuring this happens.

Michael Toole, Professor of International Health, Burnet Institute

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

What’s the new coronavirus variant in India and how should it change their COVID response?

Posted on April 9, 2021 by particularkev

Prafulla Shriyan, Indian Institute of Public Health, Gandhinagar and Giridhara R Babu, Indian Institute of Public Health, GandhinagarAfter genome sequencing of over 10,000 COVID-19 cases in India, researchers have discovered a new variant with two new mutations which may be better at evading the immune system.

In 15-20% of samples from the Indian state of Maharashtra (the state accounting for 62% of cases in the country) a new, double mutation in key areas of the virus has been detected. These are now known as the E484Q and L452R mutations.

What makes the variant different?

Both these mutations are concerning because they are located in a key portion of the virus – the spike protein – that it uses to penetrate human cells. Spike proteins attach via a “receptor binding domain”, meaning the virus can attach to receptors in our cells.

These new mutations include changes to the spike protein that make it a “better fit” for human cells. This means the virus can gain entry more easily and multiply faster. Given what we have seen with other similar mutations, it might also make it harder for our immune system to recognise the virus due to its slightly different shape. This means our immune system may not be able to recognise the virus as something it has to produce antibodies against.

The emergence of these new variants has only been possible because of the continued viral replication in areas with high circulation.

Though the Indian government has said the data on the variants circulating in India (including this new Indian variant and others including the UK strain) are not sufficient to link them to the rapid increase in the number of cases in the country, we think it’s the most likely explanation. The country had managed to bring down the rate in February, but a sudden increase in the number of reported cases is now being reported.

Implications

The implications of these developments are greatly concerning – not just for India, but for the rest of the world. Mutations can result in 20% more in-hospital deaths, as we witnessed during the second wave in South Africa. This is because some mutant variants have the ability to spread faster, resulting in sudden surges and, therefore, an overburdened health system.

But there’s hope. Places around the world with higher vaccination coverage such as the UK and Israel are witnessing a steady decrease in cases.

Most of the currently approved vaccines around the world have been found to evoke an immune response to some extent against multiple variants. But no trials have yet been undertaken on the effectiveness of vaccines against these new Indian mutations.

To make it difficult for the mutant strains to develop vaccine resistance, we have to ensure wider and faster vaccine coverage across the world.

What has to happen now?

Apart from vaccine manufacturers’ efforts to update the composition of vaccines to better deal with new strains, it is important to contain transmission across the world. Countries can use the World Health Organisation’s SARS-CoV-2 Risk Monitoring and Evaluation Framework to help identify, monitor and assess variants of concern, swiftly.

To establish a direct link between a variant and a steep rise in cases in a short time, it is important to use genomic sequencing to link clusters together. But unless contact tracing is done meticulously, it isn’t easy to do so.

It is also important to understand the mechanisms involved in the infectiousness and virulence of the newer variants. For this, lab models are needed to mimic spread and virulence mechanisms efficiently.

To combat the consequences of mutations in India, its pandemic response will have to incorporate several measures. Genomic surveillance will have to be proactive and coincide with the epidemiological investigation of the cluster of cases for early identification and swift action.

As some variants can escape naturally induced immunity, vaccine manufacturers in India will need to develop better vaccines to cover these new variants. Ongoing surveillance and containment measures need to be strengthened to prevent the emergence of new variants by minimising viral replication.

And finally, swift and rapid vaccine coverage is not only necessary but essential for ensuring any modest levels of success in tackling this pandemic.

Prafulla Shriyan, Research Fellow, Public Health Foundation of India, Indian Institute of Public Health, Gandhinagar., Indian Institute of Public Health, Gandhinagar and Giridhara R Babu, Professor, Head-Lifecourse Epidemiology, Indian Institute of Public Health, Indian Institute of Public Health, Gandhinagar

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

Could the Morrison government’s response to sexual assault claims cost it the next election?

Posted on March 15, 2021 by particularkev

Sarah Cameron, University of Sydney

Today, thousands of Australians are expected to march around the country, angry and fed up at the treatment of women. In Canberra they will form a ring of protest around Parliament House.

This comes after Melbourne academic and entrepreneur Janine Hendry wondered how many “extremely disgruntled” women it would take to link arms around parliament to tell the government “we’ve had enough” (the answer is about 4,000).

It follows Brittany Higgins’ allegation of rape in a minister’s office in 2019 and an allegation Attorney-General Christian Porter raped a 16-year-old in 1988 (which he denies). It also comes amid multiple claims of a toxic work culture at Parliament House.

While Higgins’ case has sparked numerous inquiries, she claims she was not supported in the aftermath of her alleged assault. Regarding Porter, the government is resisting calls for an independent inquiry, with Prime Minister Scott Morrison declaring him an “innocent man under our law”.

As Australia heads into another pre-election season, questions have been raised about the potential impact of recent events.

Women are obviously a significant demographic, and data shows they are already drifting away from the Liberal Party.

So, what’s at stake when it comes to women voters and the Liberals at the next election?

Gender and voting behaviour

The Australian Election Study is a nationally representative survey of voter behaviour that has run after all federal elections since 1987.

In 2019, it showed that although the Liberal-National Coalition won the federal election, the Liberal Party attracted the lowest proportion of women’s votes since 1987.

While 45% of men gave their first preference to the Liberal Party, just 35% of women did so. Parties on the political left also had an advantage among women, with 6% more women than men voting for the Greens, and a smaller margin of 3% more women voting for Labor.

Looking at the gender gap over time, we see it has actually reversed over the past 30 years. Back in the 1990s, women were slightly more likely to vote for the Liberal party, and men were more likely to vote Labor.

This has gradually switched, so men now prefer the Liberal Party and women prefer Labor. The gender gap in voting Liberal is now at its greatest point on record.

This reversal of the gender gap in voting behaviour isn’t unique to Australia, it has also been observed in other democracies including in Europe and North America.

Why are we seeing a gender gap?

There are a number of factors underpinning this transformation of gender and voting in Australia.

This includes tremendous social change, such as women’s increased participation in higher education. Higher education is associated with political ideology that is further to the left.

Women’s increased participation in the labour force is also a factor. The election study shows in 1990, 41% of union members were women, by 2019, that figure had increased to 55%.

But womens’ voting behaviour can also be attributed to major changes in Australia’s major political parties. Back in the early 1990s, women were similarly underrepresented in both the major parties — just 13% of parliamentarians in 1990 were women.

Since then, Labor has dramatically increased its proportion of women in parliament, reaching 47% through party quotas as of the last election. The Liberal Party on the other hand, has made slower progress, reaching just 23% at the most recent election.

New research published in the journal Electoral Studies shows left-leaning women are more likely to support female candidates.

The Liberal Party’s ‘women problem’

So, even before the current crisis, the Liberal party was losing the electoral support of women.

The Liberal Party’s “women problem” has become a common criticism, not just by political opponents but also prominent Liberal Party figures including former Prime Minister Malcolm Turnbull.

The current crisis has the potential to exacerbate the gender gap in voting behaviour.

That said, election results are often influenced by the most important issues at the time of the election. The salience of different issues — shaped to a large degree by media coverage — can change considerably over time.

Approval ratings of Morrison from the Essential Poll show he lost a lot of support during the bushfires in late 2019 and early 2020, which he was perceived as handling poorly.

Since then, Morrison has benefited from Australia’s relative success in managing the COVID-19 pandemic. As a result of a phenomenon known as “rallying ‘round the flag,” voters have supported him and the government during this time of crisis.

The next election

The election can be held anytime from August this year, although political observers currently expect it to be next year.

The electoral impact of current events will depend not only on the government’s response to the sexual assault allegations (and voter satisfaction with those responses), but also which issues are salient at election time. A historical sexual assault allegation against former Labor leader Bill Shorten was not a major factor in the lead up to the last election (he denies the claims and in 2014, police said they would not proceed with charges).

Interestingly, the Australian Election Study shows trust in government reached its lowest point on record in 2019 with just one in four voters believing that people in government could be trusted. In contrast, three quarters thought those in government were more interested in looking after themselves.

On the issue of sexual assault, recent polling data also suggests the government is similarly perceived as putting itself first. Of those polled, 65% agreed “the government has been more interested in protecting itself than the interests of those who have been assaulted”. This includes half of Coalition voters, and a similar proportion of men and women.

Woman marching for women's safety in 2019. — Polls suggest voters don’t like they way the government has handled the Porter and Higgins cases.
Jeremy Piper/AAP

Elections are decided on many issues and factors, including what is making headlines closer to election day, and the performance of leaders and parties.

But the growing gender gap in voting will be on the radar of both major parties. The Liberal Party ignores it at its peril.

Sarah Cameron, Lecturer in Politics, University of Sydney

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

Vital Signs: 4 things Australia’s COVID response got right

Posted on December 19, 2020 by particularkev

Richard Holden, UNSW

2020 began simply, if dramatically enough in some sense.

We spent the first months preoccupied with bushfires that blackened both our natural environment and our international reputation for taking climate change seriously. Who would have thought that would have been the easy part?

Then came a global pandemic, the largest public health emergency and greatest economic contraction in a century.

Australia has emerged as the nation that may have dealt with these twin crises the best. But it was not obvious we would do so — certainly not in February 2020.

It is important to scrutinise the reasons for our success. In particular, what parts are due to good policy, and what parts to luck?

Tentative beginnings

Australia’s initial response to COVID-19 was less certain than, for example, New Zealand’s. In debates about shutting schools, for example there was always a pull to the policy with the least economic impact.

While most economists have supported putting public health policy first, not all in academia, government or the media have agreed. There has been much talk about “the Swedish model”, achieving “herd immunity” naturally, and that the costs of lockdowns far outweigh their benefits.

On March 10, I declared the opposite, in article published by the Australian Financial Review. Rather, I wrote, “the economic costs of being reactive are likely to be much larger than the costs of being decisive”.

At the time the article was published there were 93 cases of COVID-19 in Australia and three deaths. It was the week Prime Minister Scott Morrison declared he would attend a rugby league match just moments after outlining the government’s advice to ban large crowd gatherings. Our borders were still gapingly open.

I said in that piece “one doesn’t need to be an epidemiologist to understand the logic of exponential growth”.

We got our dose of exponential growth, with cases and deaths, respectively, growing quickly. Our leaders got the message and acted decisively. Morrison even gave up on his beloved Sharks games.

4 keys to Australia’s COVID success

With relatively swift action, we got four crucial things in place:

we lowered the base rate of infections
we got a serious testing regimen in place
we developed effective contact tracing
we built hospital capacity if things went awry.

These are the facts of the case, and they are undisputed.

The places that didn’t do these things used Olympic ice rings as morgues (Spain) and dug temporary graves in parks (New York). We did better. We would not have done better had we listened to the naysayers.

Bodies of people who died with COVID-19 are buried in a trench on Hart Island, in the Bronx borough of New York, on April 9 2020.
John Minchillo/AP

The year evolved. And so did we. And so did our national debate.

Victoria made a colossal mistake, for which there still needs to be a proper accounting. But if we have learned nothing else from 2020, it is that expertise and informed public debate are essential for good policy.

Top marks for a work in progress

Australia’s economic response has been world-class.

Fiscal support measures such as JobSeeker and JobKeeper were crucial to a public health recovery leading to economic recovery.

But the job is not done.

Sure, the JobSeeker benefits need to taper down over time. But the questions are how much and how fast.

Wage subsidies can’t go on forever, but when to end them without destroying businesses small and large, and jobs along with them?

These will be be the hard questions for Treasurer Josh Frydenberg and the rest of the Morrison government in 2021.

In 2020, nonetheless, it has – through a great measure of skill and some measure of luck – helped avoid a COVID catastrophe in Australia.

Let us hope Scott Morrison deals with the everyday as well as he has dealt with the exceptional.

Richard Holden, Professor of Economics, UNSW

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

Sharing my thoughts with the world from a Particular Baptist perspective

Is the plan ‘set in stone’?

What does the national plan say about border closures?

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

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

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

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And so it began

China’s response to the Wuhan outbreak

And then it was over

What lessons can China offer the world?

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Remind me, how does our immune response work?

Natural immunity is not enough

Is one dose enough after COVID?

Does Delta change things?

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Why people tend to trust government in crises

How government can get public trust back

The public needs to have its say

How to combat misinformation?

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But WHO’s hands were tied

Many member nations failed to act

Preparation was inadequate

Fixing the global system

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What makes the variant different?

Implications

What has to happen now?

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Gender and voting behaviour

Why are we seeing a gender gap?

The Liberal Party’s ‘women problem’

The next election

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Tentative beginnings

4 keys to Australia’s COVID success

Top marks for a work in progress

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