International borders are about to open, but our research shows the plight of stranded Australians is not over

Posted on October 17, 2021 by particularkev

Holly Seale, UNSW; Adam Craig, UNSW, and Meru Sheel, Australian National UniversityAustralia’s international borders are due to reopen next month for people returning to states with 80% vaccination rates.

Australian citizens and permanent residents who are fully vaccinated with an approved vaccine will be allowed to quarantine at home. They will also be able to leave Australia without exemption from early November.

But this does not mean the plight of Australians who have been stranded overseas during the pandemic is over.

We have been tracking the experience of this group during the pandemic. Our research shows not just the inadequacy of government support to this group, but some of the immediate and potentially long-term impacts on their lives. In this piece, we also set out some of the other barriers that continue to make coming home to Australia so difficult.

More people stranded than we think?

In a bid to stop the spread of COVID, in March 2020 Australia closed its borders to all non-citizens and non-residents, giving it some of the world’s strictest border rules. While Australian citizens could still officially travel to Australia, the huge reduction in available flights made it all but impossible for many to get home.

A family arriving in Canberra after a repatriation flight in 2020. — Australia’s international border has been shut for more than 18 months.
Lukas Coch/AAP

According to the Department of Foreign Affairs, there are currently more than 45,000 Australians overseas registered as needing help to come home.

But advocacy group Reconnect Australia says the number could be much higher. This is based on an estimated one million Australians living abroad, 30% of Australians born overseas and two million temporary visa holders in Australia – most of whom would not be eligible for DFAT reparations or do not fit a category of travel exemption.

Survey: psychological and financial impacts

Over the past 18 months, countless distressing stories have been shared across the mainstream media and social media of stranded travellers who have had flights postponed or cancelled. This includes people missing funerals of close family members, being separated from their partners and children, or being unable to visit sick family members.

To better understand this phenomenon, we examined the psychological and financial impacts of being stranded abroad during this pandemic.

In September this year, we surveyed 1,330 stranded travellers from around the world (including Australians) and identified that 64% had moderate to extreme depression. While others reported anxiety (42%) and stress (58%) resulting from their situation.

Some of our participants also reported homelessness, significant financial distress, and little to no support being given from their national governments.

Government support for those stuck overseas

The responsibility to assist these stranded travellers generally falls on “home” governments for support.

In an upcoming study lead by Pippa McDermid, we analysed the availability of government assistance, including financial help, emergency housing and mental health support to citizens of eleven countries stranded overseas by COVID restrictions. This includes Australia, New Zealand, Canada, the United States, United Kingdom, France and Thailand.

No country provided comprehensive assistance in all areas.

Passengers arrive in Brisbane in April 2020. — Australian children under five can only come back to Australia if they travel with an adult.
Dan Peled/AAP

Only Spain and France appeared to have developed a solution to emergency housing needs for citizens in need stuck abroad, with Spanish or French nationals either hosting citizens in need or requesting emergency accommodation on the respective platforms.

Australia was one of six countries to provided some form of mental health support to citizens, with detailed resources and referrals to mental health support services abroad.

It was also one of five that provided financial assistance. However, loan applications were not straightforward and funds were required to be be paid back within six months. Other countries, including France, appeared to be more flexible with the financial support provided.

In terms of the clarity of information provided on government websites, Australia’s was rated as “fairly difficult to difficult” to read, based on standard readability scores. This was worse than scores for the UK, France and Canada.

Enough flights to get everyone back?

While Australia reopening borders is good news, concerns remain about airlines’ capacity to bring stranded travellers home. For example, it took approximately ten minutes for a recently announced DFAT repatriation flight from London to sell out.

Labor senator Kristina Keneally holds up photos of Australians stranded. — Labor senator Kristina Keneally holds up photos of Australians stranded overseas, during a Canberra press conference in 2020.
Lukas Coch/AAP

Concerns have also been raised that Qantas doesn’t have enough planes to operate all the international flights it is currently selling for next year. Other international carriers are waiting for clarity from the Australian government before resuming their flights schedules

Falling through cracks

Meanwhile, some Australian citizens stranded abroad are watching their visas edge towards expiry. Through our research, we have heard stories these people cannot find flights home and so end up applying for a temporary visa, often in a third country, adding to the disruption, stress and costs imposed on them by the travel restrictions.

One traveller we spoke to during our research, based in China, simply cannot afford the costs of the flights. They also need to give their employer 30 days’ notice if they intend to leave the country. If their flights get cancelled, they risk being left without a work permit. Australian government funding does not meet the cost of flights.

Realistically, we expect that it will take a couple of months for the reopening to be sorted out in different states. As much as we would love to be home for Christmas, we think sometime in the first quarter of next year will be more likely.

Those stranded want to clarify is they have tried to get home – but the availability and predictability of flights is a huge hurdle.

What about unaccompanied kids and non-citizens?

Another issue of concern is the plight of children who remain stranded abroad without their parents.

As of July this year, there were 438 unaccompanied Australian children still stranded overseas due to COVID restrictions. Complicating this, those under four are not allowed to travel on their own, while children aged between five and 11 can only travel alone only if their flight is less than four hours.

Meanwhile, little has been said about what rights Australian-based non-citizen residents will have once travels starts again. These include people studying or working temporarily in Australia, who have not been able to return short-term to their country of origin.

If they leave Australia, there are still no guarantees they will be able to return in a timely way to complete their studies or work contracts.

What needs to change now

As we begin to emerge from restrictions, there are many things the federal government could do to improve the conditions for those stranded, and speed up their return home. These include:

provide clarity about when and how stranded passengers will be repatriated
work closely with airlines to ensure that flights and services reflect the countries where stranded travellers are located
provide easier access to financial loans
revise government information online to ensure that it is timely, relevant, and easy to access
include temporary visa holders in the group of those able to access home quarantine
develop a fair plan for those who have been unable to access vaccinations overseas or who are vaccinated with an unrecognised vaccine
ensure mental health services are available for those abroad.

While the role of border control as a highly effective strategy in the control of COVID cannot be underrated, it raises serious questions about how to protect public health without long-term disruption to and negative impact on people’s well-being.

When updating guidelines for future pandemics and other emergency events, it is critical we also change how we support citizens, residents and temporary visa holders who are stranded abroad.

The authors would like to thank Pippa McDermid and Siobhán Talty for their contributions to the article.

Holly Seale, Associate professor, UNSW; Adam Craig, Senior Lecturer in Global Health, UNSW, and Meru Sheel, Epidemiologist | Senior Research Fellow, Australian National University

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

Australia’s international borders to reopen from November. It’s one big step towards living with COVID

Posted on October 14, 2021 by particularkev

Catherine Bennett, Deakin University“Australia will be ready for takeoff very soon” said Prime Minister Scott Morrison today as he announced the ban on international travel will be lifted some time next month.

Returning Australian citizens and permanent residents will be able to quarantine at home for seven days if fully vaccinated with a TGA-approved vaccine.

The recognised vaccines include those already approved for use in Australia by Pfizer, AstraZeneca, Moderna and Johnson and Johnson/Janssen, as well as Sinovac and Covishield (Covishield is AstraZeneca’s vaccine made in India).

Unvaccinated returnees will still need to enter managed hotel quarantine for 14 days until Australia moves beyond Phase C of the National Plan.

Those who can’t be vaccinated, including young children and those with a medical exemption, will be counted as vaccinated for travel.

Arrival caps will also be abolished for fully vaccinated returnees.

Today’s announcement is one big step towards allowing vaccinated Australians to return home soon, as we move to a future that somewhat resembles pre-COVID life.

Is seven days enough?

Home quarantine trials in South Australia and New South Wales will answer this question.

Authorities will be testing returnees and the proportion of those who are COVID-positive, as well as when they test positive, will inform decision-making. This will also be monitored on an ongoing basis once we open up and can be adjusted if it turns out a higher than acceptable number of travellers test positive between day seven and 14.

Currently, NSW data tell us less than half of 1% of returnees in hotel quarantine are testing positive. The NSW Surveillance report from August 21 shows only 4% of those positive cases were in fully vaccinated.

The low percentage of returnees who are positive will matter less anyway as Australia progressively moves towards “living with COVID” with a background rate of the virus in the community.

We know fully vaccinated people can still get infected, but at much lower rates. There’s also mounting evidence suggesting their infectious period is shorter than unvaccinated people, so they’re less likely to pass the virus on. Importantly, there’s now a better than 70% reduction in risk of having a serious infection requiring hospitalisation in all of the vaccines the TGA has recognised for international arrivals.

How will we ensure people stay home?

South Australia is currently trialling an app that uses geo-tagged facial recognition software to ensure people stay home during quarantine.

If this app proves successful it might be rolled out across Australia.

It might also include supports for other aspects of compliance, like prompts to get tested, a checklist of symptoms and other ways to check in with returnees.

Random checks by police or ADF personnel have proven home quarantine and isolation have high levels of compliance. Something similar could also be brought in at some point if there were compliance concerns.

One thing that’s more difficult to monitor is whether other people come into the house of a person meant to be isolating. The risk of transmission to the visitor is much higher than if the returnee ventured out. But this is the same risk we currently have with isolating close contacts locally.

Ultimately the system will need to rely, in part, on trust. We know Australians are generally very compliant, and many people will be desperate to travel again and reunite with family and friends. The majority will be likely to comply with the requirements to facilitate keeping travel open.

The system will be safe enough — and that’s all we need going forward.

What about other household members?

One question yet to be answered is whether everyone else in the house has to quarantine if housing a returned traveller.

With the risk of a fully vaccinated returnee being positive very low, so too is the risk to the household. If they do return a positive test on one of their test days, their household members may also be required to quarantine. Rapid Antigen Tests might be useful for early detection of infection in these cases.

Another question is whether we will still have offshore screening, requiring a negative test prior to departure for Australia?

The finer details will emerge and probably change over time as we collect data and manage changing risks. We’ll probably start conservatively and then gradually open things up more and more as we learn which components of risk mitigation are proportionate.

window view from plan — Some details of home quarantine on return from overseas still need clarification.
Unsplash/Eva Darron, CC BY

Which states will go first?

International travel will open to states and territories gradually as they reach 80% of over-16s fully vaccinated. So we won’t have to wait until all jurisdictions have individually hit the threshold.

Based on vaccination uptake rates, the ACT and NSW will likely be the first to open, followed by Victoria.

Tasmania is still tracking well but other states are lagging behind. Queensland and Western Australia will probably be the last to open their borders.

This is broadly in line with the national plan, but is coming probably a month or two earlier than looked possible in June. Vaccination rates, particularly in NSW, Victoria and the ACT, have been spurred on by significant COVID outbreaks. States are also assessing the distribution of vaccine coverage to ensure there are no parts of the community left behind by the time of opening.

What about travel bubbles?

The Prime Minister flagged potential bubble arrangements with countries like New Zealand where there’d be no quarantine requirements. The list of such countries will likely change over time, depending on circulating variants and country risk profiles.

We’re probably heading in the direction of eventually not requiring quarantine for returnees at all, only testing. For now, it’s clear we’re moving towards a system that manages risks rather than operating with zero risk tolerance.

Will contact tracers be able to cope?

As fully vaccinated people contribute less to transmission and are at less risk of severe COVID-19 symptoms, all states and territories will progressively shift the risk settings that underpin contact tracing. We have used comprehensive contact tracing, casting the epidemiological net wide to ensure not one contact of a case who might have contracted the virus was missed.

The chance of someone being positive drops away the more casual the exposure. Once you no longer have to be fearful of missing even just one case, we can make the net smaller and just trace the people at highest risk.

We might reach a stage where even close contacts just have to get a test, without having to quarantine.

This shift brings with it some risk of cases to the community, but we’re likely to have an ongoing, even if low, level of cases in the community. A low rate of introduction across international borders will not materially add to that. It’s about managing risk and being much more selective about identifying who’s at risk in a highly vaccinated population.

What about new variants from overseas?

Watching what variants are circulating will be a priority and some border rules changes might be needed if new risks are identified. For example, stricter arrangements for people arriving from “high-risk” areas where a particularly worrisome variant has emerged.

The system can be adapted for changing risks. There might be more transmissible variants which emerge, but we also might start using next-generation COVID vaccines which are a better fit for variants and precautions can be dialled down.

Being highly vaccinated allows Australia to move away from the ultra-conservative ways we’ve had to manage the pandemic previously, and allows us to start reopening to the world.

Catherine Bennett, Chair in Epidemiology, Deakin University

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

The federal government just made it even harder for Australians overseas to come home. Is this legal? Or reasonable?

Posted on August 9, 2021 by particularkev

Liz Hicks, The University of Melbourne; Jane McAdam AO, UNSW, and Regina Jefferies, UNSWThe COVID-19 pandemic has meant huge restrictions on Australians’ ability to travel both within Australia and overseas. But until now, Australian citizens ordinarily resident in other countries have been able to return to Australia and then leave without requiring additional permission.

However, last week, the federal government quietly removed that exemption. This is designed to deter Australians from coming home in the first place, thereby reducing demand on quarantine places. It will come into effect on Wednesday August 11.

It follows lobbying from state premiers (who have to quarantine people) to limit the movement of fly-in fly-out workers.

This means Australians who live abroad and return to Australia (even if it is to see family) will not automatically be able to leave again unless they meet narrow grounds for an exemption. They will need to prove they have an “established and settled” home overseas, via documents like a residency permit, tenancy agreement, letter from an employer or utility bills. This is not necessarily straightforward, particularly as lives, jobs and visas continued to be disrupted by the pandemic.

Is this latest move legal? Are there any grounds to challenge this?

The Biosecurity Act

The government’s power to ban people from leaving Australia comes from the Biosecurity Act. In an emergency, section 477(1) gives the health minister sweeping powers to prevent and control the entry of diseases into Australia.

Since COVID began, Health Minister Greg Hunt has issued determinations to stop Australian citizens and residents from leaving without permission, to ban them from travelling on from the New Zealand “travel bubble” to another country, and to ban people from returning to Australia from India during the second wave. If people breach these rules, they can be subject to penalties of up to five years’ imprisonment, a fine of up to $66,000, or both.

By contrast to other legislative instruments, these determinations by the health minister cannot be “disallowed” (or overturned) by federal parliament.

This means parliament can’t block the health minister’s decision to stop Australians who live abroad from leaving without permission.

What about constitutional rights?

Australia is one of the only liberal democracies in the world without a bill of rights.

In countries such as Germany, Slovenia, and Spain, citizens and residents have been able to challenge COVID restrictions in courts by arguing they breach their constitutional rights. Courts then consider whether a restriction is a proportionate way of controlling the virus.

There is a strong argument the new restriction for Australians is disproportionate. This is because its objective — managing the entry of COVID by deterring demand for quarantine places — is already achieved via caps on the number of people who can enter Australia. There are also other means of managing risk that would place a lesser burden on rights to leave and return to Australia, such as tailoring restrictions to vaccination status.

Reducing demand for already regulated spaces, as the new restriction does, is really about reducing political pressure on government to expand quarantine systems.

What does the India experience tell us?

Because Australia doesn’t have a bill of rights, citizens can’t challenge the proportionality of Hunt’s determinations.

This was clear in the challenge to the ban on citizens returning from India, where the Biosecurity Act was described by counsel for the Commonwealth as a “legislative bulldozer” — knocking over any other statutory protections or common law rights that people might have. The ban was found to be legal.

The minister does need to consider whether there are less intrusive ways of controlling the entry of COVID when making a determination. But the challenge to the India ban shows courts will allow a great deal of discretion to the health minister in making that call. As long as there is a basis for the minister to make that call — such as health advice — courts will not look too deeply into the premises underlying that advice or its proportionality.

Commonwealth power

One argument against stopping Australians who ordinarily live abroad from leaving is the Commonwealth must have a power explicitly listed in the Constitution to make a law about this.

The federal government is likely relying on the Constitution’s quarantine power to stop Australians from leaving. The explanatory statement tabled in parliament last Thursday makes clear the Commonwealth is removing the exemption on people who ordinarily live abroad to reduce demand on quarantine places.

Passengers at Sydney airport line up to check package. — Australians will find it even harder to travel overseas from August 11.
Dan Himbrechts/AAP

There is an argument stopping people from leaving doesn’t have enough of a connection to the Commonwealth’s power over quarantine. Given the broad approach courts have taken to emergency powers during the pandemic, a court may nonetheless find restrictions on people leaving is incidental to managing quarantine.

International human rights law

What about Australian citizens’ rights under international law?

Under international law, everyone must be free to leave any country, including their own. In exceptional and very limited circumstances, this right may be restricted – for instance, if it is necessary to protect public health. However, the restrictions must be clearly set out in domestic law, consistent with other human rights (including the right to family life), and “the least intrusive” way of achieving the desired aim.

The United Nations Human Rights Committee has been very plain.

The application of restrictions in any individual case must be based on clear legal grounds and meet the test of necessity and the requirements of proportionality.

In other words, a “one size fits all approach” will not cut it.

The current restrictions do not take into consideration vaccination status, nor the fact a cohort of Australian citizens have their permanent home abroad.

Particularly when considered in conjunction with the barriers the government has already put in place that limit these Australians’ right to return home, this additional exit requirement truly seems like overreach.

Liz Hicks, PhD / Dr. iur. candidate, The University of Melbourne; Jane McAdam AO, Scientia Professor and Director of the Kaldor Centre for International Refugee Law, UNSW, and Regina Jefferies, Affiliate, Andrew and Renata Kaldor Centre for International Refugee Law, UNSW

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

Australia shouldn’t ‘open up’ before we vaccinate at least 80% of the population. Here’s why

Posted on July 31, 2021 by particularkev

Stephen Duckett, Grattan Institute and Will Mackey, Grattan InstituteEarlier this month National Cabinet released a four-phase COVID response plan. It wasn’t so much a plan – it had no dates and no thresholds – but more a back-of-the-napkin thought bubble. It was sensible, but vague.

National Cabinet now faces the hard task of converting vagueness into a real plan. To do this it must answer the question: what proportion of the Australian population needs to be vaccinated before we can open our international borders?

This means allowing stranded Australians to return, letting footloose people travel overseas, and welcoming international tourists and students again.

Well qualified experts differ on the requisite threshold for vaccination partly because there are so many unknowns, such as how quickly the Delta variant of COVID would spread through Australia if we open up, and how effective the different vaccines will prove to be in preventing transmission.

But new Grattan Institute modelling shows it would be dangerous for Australia to open up before at least 80% of the population is vaccinated.

Here’s what we found, and how we came to the 80% figure. Let’s start with the good news.

Vaccines offer substantial protection

Both vaccines on offer in Australia – Pfizer and AstraZeneca – are effective at preventing infections from the Delta strain. Two doses of Pfizer offers about 88% protection against infection, while two doses of AstraZeneca offers about 67% protection.

Vaccinated people can still catch COVID, but those that do pass it on to about half as many others compared to the unvaccinated.

Evidence from the United Kingdom, Canada, and the European Union – areas with higher vaccination levels than Australia – also suggests both vaccines offer substantial protection against hospitalisation and death from COVID. A vaccinated person is about 95% less likely than an unvaccinated person to end up in hospital with COVID.

Now for the bad news.

The delta strain is far more infectious

Researchers estimate the Delta variant is 50% to 100% more infectious than the Alpha variant, which itself was more transmissible than the variant that was dominant throughout 2020.

The effective reproduction number, or Reff, tells us how many people one infected person will spread the virus to, taking into account behaviour and public health measures in place designed to reduce transmission, such as masks and physical distancing.

A masked supermarket check out operator scans products. — The Reff changes according to the public health measures in place, such as mask mandates.
Shutterstock

If the Reff of the Delta variant in Australia is around 6 without vaccination, having 50% vaccination coverage will reduce the Reff to 3.

But the national goal must be to bring the Reff down to below 1, which would mean each person who was infected would infect less than one other person – and the virus would eventually peter out.

The higher the vaccination rate, the lower the effective reproduction number. Each person vaccinated offers a chance of breaking a chain of transmission that might lead to an outbreak.

Not only are vaccinated people less likely to become infected, they are also less likely to pass the virus onto others if they are.

The higher the vaccination rate, the lower the effective reproduction number

Effective reproduction number (Reff) by population vaccination rate.
Grattan Institute

So why do we need 80% of people vaccinated?

Grattan Institute’s model simulates the spread of COVID within a partially vaccinated population, and helps us peek into the future.

It uses age-based hospitalisation and intensive care unit (ICU) admission rates from more than a year of COVID data from Australian ICU units. It also assumes children under 16 are about one-fifth less likely to get COVID, and children over the age of two are able to be vaccinated.

In most of our simulations, older people have higher rates of vaccination, and no age group has more than 95% vaccine coverage.

We ran thousands of simulations of different vaccination rates, and different estimates of the Reff. The outcomes for 12 distinct scenarios are shown in the table below.

You can see why we recommend Australia not open up until at least 80% of the population is vaccinated – it is the only scenario where the virus is managed, with hospitalisations and deaths kept down to reasonable levels, even if the Reff is high.

Let’s break it down

Our simulations show that opening up at 50% vaccination rate (scenario 1) is a very bad idea, with many, many thousands of deaths.

Scenarios 2 and 3 are the optimist’s and gambler’s scenarios. If you are lucky and the Reff of Delta in Australia is 4 (with 70% vaccination rate) or 5 (with 75% vaccination rate), deaths and hospitalisations would not rise above moderate levels, and lockdowns could end and the borders could reopen.

But if you gambled on the wrong Reff, our hospitals would be overwhelmed and deaths would be unacceptably high. Opening the borders is a one-shot gamble: if you make the wrong call, the virus will quickly spread and all the good work and hard yards of living through lock-downs over the previous two years will have been wasted.

Public health decision-making is often risk averse, for the best of reasons. The difference in virus spread, hospitalisations and deaths between opening at 75% and at 80% are big, but the wait between the two thresholds may only be a month or two.
This is why we recommend an 80% vaccination rate (scenario 4) as the threshold for opening up.

Even if the Reff of Delta is 6, our hospital system will not be overwhelmed, and deaths will not rise above the number of deaths in a moderate flu season, such as 2010, when there were 2,364 flu deaths.

Stephen Duckett, Director, Health Program, Grattan Institute and Will Mackey, Senior Associate, Grattan Institute

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

Posted on July 4, 2021 by particularkev

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.

Who’s being allowed to leave Australia during COVID? FOI data show it is murky and arbitrary

Posted on July 2, 2021 by particularkev

Regina Jefferies, UNSW and Jane McAdam, UNSWWith outbreaks of COVID-19 in most states and territories, and low rates of vaccination, concerns have arisen again about who is being permitted to exit (and re-enter) the country.

Western Australia Premier Mark McGowan, for instance, said there should be stricter measures for people wanting to leave Australia “while there’s a pandemic running wild around the world because inevitably they want to come back”, posing a health risk to the community.

Questions have also been raised about where travellers are being permitted to go, and for what reasons.

Even though we are more than a year into the pandemic, the Commonwealth’s general prohibition on citizens and permanent residents leaving Australia remains in effect. Despite the passage of time and the increasingly widespread availability of vaccines, Australia is among a small number of countries that continues to rely on border restrictions as the primary pandemic response.

What statistics from Home Affairs show

We recently obtained detailed data from the Department of Home Affairs through a Freedom of Information request that answer these questions. The statistics show who has been allowed to leave Australia, which countries they are going to, and why.

The data cover the period from August 1 2020 to April 25 2021, and reveal some concerning trends.

In particular, the figures show that while the top countries of intended destination were India (25,443 requests), followed by China (21,547) and the UK (15,703), approval rates to the UK (68%) were 22 percentage points higher than India (46%), and 11 points higher than China (59%).

This was at a time when the UK was experiencing a drastic second wave of COVID-19 — but India’s second wave had only just begun.

The figures are reminiscent of approval rates for travel exemptions to enter Australia, which precipitated allegations of racial bias earlier this year. Those numbers were even more stark: only 7.17% of requests from India were approved, compared to 23.48% from the UK and 30.73% from South Africa.

Who can leave Australia?

Some people don’t require permission to leave Australia (and are not counted in the numbers above).

These include people who usually live overseas (as well as New Zealanders who ordinarily live here), aircraft crew or maintenance staff, freight workers, those who have “essential work at an offshore facility in Australian waters”, those travelling on official government business, and those travelling directly to New Zealand (who are not transiting from another country).

But most of us do need permission. Among the reasons would-be travellers are able to leave the country:

it’s part of the response to the COVID-19 outbreak (including the provision of aid)
business-related
necessary to receive urgent medical treatment that is not available in Australia
for a compelling reason for three months or longer
for compelling or compassionate reasons
or in the national interest.

Many of these concepts are very murky, and it is up to the decision-maker to determine the appropriate level of evidence required.

The data show that travelling overseas for a compelling reason for at least three months made up the vast majority of exemption approvals (71,249), while comparatively fewer requests were approved on compassionate and compelling grounds (28,391). By contrast, only 4,797 requests were approved for urgent and unavoidable personal business.

Some of these numbers are still fuzzy due to category adjustments. For example, “travelling overseas for at least three months” was included in the “urgent and unavoidable personal business” category prior to September 30, 2020.

Similarly, on January 8, 2021, “travelling overseas for at least three months” became “travelling overseas for a compelling reason for at least three months”.

We were unable to calculate the percentage of approvals from this data because no reason was available for a sizeable number of requests (25,966).

Objective decision-making?

Although the Australian Border Force has released an operational directive to clarify how departure exemptions are granted, the data we obtained suggest the thresholds for decision-making are not as systematic (or objective) as desired.

In the period we examined, officials assessed 208,791 exemption requests and approved 119,922 applications. A further 17,017 requests were deemed not to require an individual exemption.

This means roughly 65% of requests were either approved or deemed not to require an exemption.

However, anyone granted an exemption to travel to India who had not yet left by early May had it revoked, following “expert health advice” that considered India a high-risk COVID-19 country.

Similar travel bans were not enacted for other countries — including the UK and US — despite the fact that, as of October 16 2020, the Department of Health has considered travellers arriving from any country besides New Zealand to be high risk.

Policy being made behind closed doors

In short, these data reveal the arbitrary nature of exit requests being granted or denied. It rings true with the anecdotal evidence we have heard from lawyers trying to assist people to leave, as well as would-be travellers themselves.

Much depends on who the decision-maker is in Home Affairs or the Australian Border Force, how they choose to exercise their discretion, and — based on these figures — where the person wants to go and for how long.

Without the opportunity for appeal, there is no independent review of how the factors are weighed, and little, if any oversight of the decisions being reached.

When viewed alongside the barriers preventing the return home of thousands of Australian citizens and permanent residents, the highly variable rates of exit permissions suggest an arbitrariness stemming, in part, from the fact that both individual and policy decisions are being made behind closed doors.

While the Commonwealth, state and territory governments consistently premise their decisions on “the medical advice”, there is not always uniform consensus among medical experts.

Indeed, we have seen in the past week how slippery that notion can be — especially when the prime minister decides to make a unilateral decision about access to vaccines. Governments are effectively making political decisions dressed up as scientific ones, without any oversight from parliament or the public.

Regina Jefferies, Affiliate, Andrew and Renata Kaldor Centre for International Refugee Law, UNSW and Jane McAdam, Scientia Professor and Director of the Kaldor Centre for International Refugee Law, UNSW

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

Should we vaccinate all returned travellers in hotel quarantine? It’s no magic fix but it could reduce risks

Posted on May 16, 2021 by particularkev

Catherine Bennett, Deakin UniversityThis week, a returned traveller who was quarantining in South Australia seems to have been infected with the virus during his stay, before testing positive once returning to Melbourne. It’s the latest in a long line of hotel quarantine leaks in Australia.

And in this week’s federal budget, the government has committed to welcoming back over 17,000 Australians stranded overseas over the next year, which will likely place more pressure on our hotel quarantine system.

In light of the seemingly continued spillover of hotel quarantine infections into the community, one researcher raised an intriguing possibility online: should we vaccinate all arrivals on day one of their stay in hotel quarantine?

There may be reasonably high vaccination rates among our arrivals already. But, if not, it’s definitely something worth thinking about.

In my view, overseas travellers should be considered equivalent to frontline workers, as they traverse the routes into Australia and cross through border quarantine. Therefore, they could be included in phase 1a of the vaccine rollout alongside these frontline workers.

It’s complex and there’s a lot to take into account, and vaccinating all arrivals won’t be the magic fix to our hotel quarantine troubles. But it might take the edge off some of the transmission risks.

You only have to prevent one case, which could have otherwise led to community spread and lockdown, for such a scheme to pay for itself many times over.

Here’s how it could work.

Vaccinating all arrivals could reduce infection risk

There are a number of potential ways this strategy could reduce infection risk, by:

preventing severe illness in people already infected
reducing the chance returnees will pass the virus on if they are infected, or become infected
protecting them from infection should they be exposed to the virus while in quarantine.

A Public Health England study found that a case who has had a single dose of either the Pfizer or AstraZeneca vaccine is up to 50% less likely to pass the virus on to their close household contacts.

However, when the researchers looked more closely at the timing, they found the full 40-50% reduction in transmission risk only occurred when the case received their first dose five or six weeks before becoming infected. In fact Pfizer didn’t reduce the transmission risk cases posed to others unless the first dose was given at least 14 days before the case became infected. In other words, giving returned travellers a dose of Pfizer while in quarantine might be too late to protect others.

In saying that, the same study shows AstraZeneca’s vaccine does appear to at least partly reduce the transmission potential of cases even when the dose is given on the same day that person was infected.

In those who’ve received the AstraZeneca vaccine on day zero of their infection, the chance of them transmitting the virus to their close contacts over the ten days or so they’re infectious was on average roughly 20% lower than positive cases who weren’t vaccinated.

Getting the AstraZeneca vaccine when exposed to the virus, or soon after, might therefore marginally protect the wider population if, for example, a traveller contracts the virus late in quarantine and it isn’t picked up in day 12 testing and is released from quarantine.

Both Pfizer and AstraZeneca do provide partial protection from infection within 12 days of the first dose. While this is too late for those already infected, it might still provide some protection from infection for those exposed to the virus in the later stages of their stay in quarantine.

Both vaccines also appear to reduce the risk of subsequently dying from COVID-19 with an 80% reduction in deaths reported in the UK. Some in this study were infected within seven days of their first vaccine dose, but we do not know how this effectiveness against deaths changes with time since vaccination from this report.

Nevertheless, there might be some additional value in offering vaccines to both slightly reduce transmission rates and mitigate against serious illness and death in people who do become infected.

One challenge is that AstraZeneca has more to offer in reducing transmission risk in the first critical two weeks after receiving the first jab, but Australia currently doesn’t advise it for people under 50. Pfizer is in limited supply and our vaccine rollout phase 1a and 1b recipients haven’t all been fully vaccinated yet. The relative risks and benefits of reallocating some of our vaccine supply and delivery must be carefully thought through.

Many of those arriving in Australia will likely have opted for vaccination before travel, if available to them, even if just to increase their chances of testing negative and being allowed to board their flights home. Many are arriving from countries that began their vaccination programs months before Australia.

How many returnees are already vaccinated?

The number of positive cases in hotel quarantine has grown month on month, from 160 in February to 469 in April.

New South Wales provides the most detailed information on returned travellers. Its latest surveillance report on about 21,000 returnees shows 180, or 0.8%, tested positive to COVID-19. About 75% of these positive cases tested positive by day two, suggesting they were exposed before arriving in Australia or in transit.

The report does include information on how many arrivals have been vaccinated since March 1. Of the 302 positive cases reported to the start of May, 20 had been vaccinated, with six fully vaccinated (two doses at least two weeks prior) and 14 partially vaccinated. Although, those considered “fully vaccinated” might not have been two weeks post-vaccine at the time they actually contracted the virus.

We haven’t been provided the overall vaccination rates for returnees across Australian hotel quarantine, so we can’t yet work out what percentage of arrivals are vaccinated. But if this is quite low, it strengthens the argument for offering vaccines to travellers on arrival.

Catherine Bennett, Chair in Epidemiology, Deakin University

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

COVID has made one thing very clear — we do not know enough about Australians overseas

Posted on May 9, 2021 by particularkev

George Tan, Charles Darwin University; Andrew Taylor, Charles Darwin University, and Kelly McDougall, University of South AustraliaThe COVID-19 crisis has thrust a largely unseen part of Australia’s population firmly into the national spotlight.

These are the Australians who live and work abroad — our diaspora.

For more than a year, we have been hearing harrowing stories of Australians unable to get home. Most recently, there is the distress of those in India, currently banned from even trying to return.

But despite increasing awareness of this group, there is still much we don’t know about our diaspora. The bottom line is, we don’t have precise or up-to-date information about Australians overseas.

This lack of knowledge and understanding highlights the need for a national diaspora policy that truly reflects contemporary, multicultural Australia.

What do we know about Australians overseas?

Australia’s diaspora is estimated to include around one million people, but this would be significantly higher if former residents, such as international students, were included.

Australian family returning to Canberra in November 2020. — COVID-19 has seen more than 400,000 Australians return home, but more than 30,000 are still registered as wanting to come back.
Mick Tsikas/AAP

Large-scale studies in 2003 and 2006 told us Australians overseas tend to be highly educated and highly valued by employers. Many also retain links with family and friends in Australia. They continue to identify as Australian and intend to eventually come back.

In 2004, without putting a number on them, the Lowy Institute identified five sub-groups of expats.

The who’s who — people at the pinnacle of their careers in significant international positions
Gold collar workers — highly-skilled, well-paid Australians developing their careers on the international stage
Other professionals — including nurses or teachers
Return migrants — first or second generation Australians, going to their family’s original country for family or professional reasons
Rite of passage travellers — young Australians living or working overseas.

Organisations such as Advance (which is supported by federal government funding) work to connect Australians overseas with each other and Australia. The focus here is on high-profile or very successful expats and how we can leverage their skills and networks to Australia’s advantage.

Traditionally, the majority of departures from Australia have been to Europe, the United States and New Zealand. This has lead to a narrative that doesn’t necessarily reflect the make-up of Australia’s population living overseas and Australia’s multicultural story.

We know from immigration and short-term travel data (those away for less than a year) that Asia, and in particular countries such as India, China, Indonesia, Thailand and Japan, are increasingly important for Australians.

Long-term departure data present a similar picture. Our analysis of Australian Bureau of Statistics data shows India saw a 54% increase as a destination for Australian residents between 2007-08 and 2016-17.

So, the idea that Australia’s diaspora is largely made up of young Aussies backpacking in Europe, or hyper-successful entrepreneurs in Silicon Valley is an outdated one. There is every indication today’s diaspora is complex, and largely made up of everyday Australians doing everyday things.

Yet, we don’t have comprehensive or up-to-date data on where Australians are overseas, what they are doing and whether they are planning to come back.

Why don’t we have a clearer picture?

At a broader level, Australia’s national focus has been on our immigrants, for whom detailed data are recorded and available from the Department of Home Affairs and Bureau of Statistics.

Emigrants have long been an understudied element of Australia’s migration story.

Qantas plane leaving Perth from London in 2018. — Australia does not have a dedicated policy to keep track of and make use of its citizens living overseas.
Tony McDonough/AAP

One of the reasons for our limited and outdated information on our diaspora is the voluntary nature of registration with the Department of Foreign Affairs’ SmartTraveller program.

In 2017, Australia also stopped collecting information on intended destination and reasons for travel on outgoing passenger cards. This was to improve the “traveller experience” and streamline the border clearance process.

Meanwhile, despite recommendations from Senate committees in 2005 and 2013, Australia has not set up a dedicated diaspora policy and monitoring unit within government.

Why do we need a diaspora policy?

At a basic level, a diaspora policy would provide a formal commitment to strengthen links and maintain connections with Australians abroad.

Aside from taking advantage of the knowledge and skills of Australians overseas (which can influence bilateral trade, business and investment opportunities), a diaspora policy should also foster engagement by attending to the welfare of Australians overseas.

COVID-19 has shown us how important it is to understand where Australians are and their circumstances in a time of crisis.

This lack of information makes it difficult to plan and help people quickly. A holistic, consistent and ongoing dataset would tell governments where the pressure points are in times of crisis — where are most of our citizens? How old are they? How vulnerable might they be?

How can we do it better?

A commitment to deeper engagement with our diaspora is fundamental. In addition to a diaspora policy, a relatively easy way to get a better grip on Australians overseas would be to improve how Australians interact with SmartTraveller, so it becomes second nature for travellers to register and update their movements when overseas.

Another alternative is to use census data from destination countries. This requires greater synchronisation among national censuses as suggested by the United Nations. However, this also means we are relying on other countries’ data collection, not our own.

We could also look at regular large scale “census-like” surveys of Australians living overseas.

Getting a better grip on Australians overseas will have huge benefits in terms of planning, our economy and national identity. Bringing our diaspora back into our national population and migration story will help us understand its true character, nature and value.

Importantly, it will also move beyond the narrative of Australians overseas as either a “burden” or an “asset”.

George Tan, Research Fellow, Charles Darwin University; Andrew Taylor, Associate professor, Charles Darwin University, and Kelly McDougall, Research fellow, University of South Australia

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

Official medical advice warned of health risks Australians stranded in India face

Posted on May 8, 2021 by particularkev

Michelle Grattan, University of CanberraThe official medical advice to the Morrison government recommending “pausing” Australian arrivals from India also contained a blunt warning that those stranded risk serious illness and even death.

Chief Medical Officer Paul Kelly’s advice said: “It is important in any measures we implement that we balance the burden on our quarantine and health systems and the protection of our community with the need to help Australians to get home, including those currently residing in high risk countries”.

Kelly said COVID-19 continued to be “a severe and immediate threat” to health in Australia and India was a high risk country, with a sharp increase recently in the number and proportion of overseas-acquired cases coming from there.

“Each new case identified in quarantine increases the risk of leakage into the Australian community through transmission to quarantine workers or other quarantined returnees and subsequently into the Australian community more broadly,” Kelly wrote in his Friday advice to Health Minister Greg Hunt.

“This quarantine ‘leakage’ presents a significant risk to the Australian community.”

The advice was in relation to the government’s determination under the Biosecurity Act – announced in the early hours of Saturday – which makes it an offence for anyone to enter Australia if they have been in India in the preceding two weeks.

This was to close any loopholes enabling people to arrive via third countries after the government suspended flights from India until at least May 15.

Kelly said in his advice, running to more than three pages, that Australia’s quarantine and health resources to prevent and control COVID from international arrivals were limited.

“Due to the high proportion of positive cases arising from arrivals from India, I consider a pause until 15 May 2021 on arrivals from India to be an effective and proportionate measure to maintain the integrity of Australia’s quarantine system,” he said.

But Kelly was careful to put on record a clear warning about the dangers faced by Australians who could not get home.

“I wish to note the potential consequences for Australian citizens and permanent residents as a result of this pause on flights and entry into Australia.

“These include the risk of serious illness without access to health care, the potential for Australians to be stranded in a transit country, and in a worst-case scenario, deaths.”

However he said “these serious implications can be mitigated through having the restriction only temporarily in place, i.e a pause, and by ensuring there are categories of exemptions.”

Under the law, action taken must be no more restrictive or intrusive than necessary and in place only so long as needed.

The determination will expire on May 15 unless extended.

The exemptions include crews of aircraft and vessels and associated workers, Australian officials, defence personnel and diplomats and family members, foreign diplomats accredited to Australia and family members, and members of an Australian Medical Assistance Team (AUSMAT).

There are more than 9,000 Australian citizens and residents registered in India of whom 650 are considered vulnerable.

The advice pointed out this would be “the first time that such a determination has been used to prevent Australian citizens and permanent residents entering Australia”.

On Monday Kelly was anxious to say he had nothing to do with the penalties that exist for breaching the determination, which include large fines and up to five years prison and have received much negative publicity. His letter did note the penalties the act carries.

Scott Morrison told 2GB the arrangement was aimed at ensuring Australia did not get a third wave of COVID and its quarantine system could remain strong.

He downplayed the sanctions, saying they would be used appropriately and responsibly.

Morrison said people who had been in third countries for 14 days could return home to Australia. “But if they haven’t, then they have to wait those 14 days.”

Asked on the ABC whether the government should vaccinate Australians stranded in India, Kelly said: “It’s certainly worth looking at. I would say, though, that we know that many of the Australians that are in India at the moment, they’re very scattered. So it’s a huge country; being able to get to them would be a challenge”.

Queensland Nationals senator Matt Canavan has condemned the government’s stand, tweeting:

Michelle Grattan, Professorial Fellow, University of Canberra

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

Human Rights Commission expresses ‘deep concerns’ at ban on returnees from India

Posted on May 3, 2021 by particularkev

Michelle Grattan, University of CanberraThe Australian Human Rights Commission has declared the government’s travel ban on Australians returning from India, including criminal sanctions, “raises serious human rights concerns”.

In a strong statement at the weekend the commission said it held “deep concerns about these extraordinary new restrictions on Australians returning to Australia from India”.

It called on the government to show the measures were “not discriminatory” and were “the only suitable way of dealing with the threat to public health”.

The commission also urged the senate committee on COVID-19 to review the restrictions immediately, and said it was approaching the government directly with its concerns.

Last week the government stopped repatriation and commercial flights from India until at least May 15, and said indirect access was also blocked. After it found there was a loophole through Doha, it took drastic action to close all gaps.

In a statement issued in the early hours of Saturday, the government said all travellers from India would be banned from entering Australia if they had been in that country within 14 days of their intended arrival date in Australia, and anyone who breached the provision could face a large fine, imprisonment for five years, or both.

The government is acting under the Biosecurity Act.

Health Minister Greg Hunt said it was “critical the integrity of the Australian public health and quarantine systems is protected and the number of COVID-19 cases in quarantine facilities is reduced to a manageable level”.

Foreign Minister Marise Payne said the temporary pause on returns from India under the Biosecurity Act was ‘entirely founded” in the advice of the Chief Medical Officer.

She said in the month before the decision on Indian returnees 57% of the COVID positive cases in quarantine were in arrivals from India, up from 10% the month before that.

This was “placing a very, very significant burden on health and medical services in the states and territories and through the quarantine program.”

But she flatly denied this proved the government did not have confidence in the quarantine system, and rejected any suggestion of racism.

The chair of the senate COVID committee, Labor’s Katy Gallagher, said on Sunday she would be looking to schedule a hearing on the matter as soon as the committee could do so.

Meanwhile a poll done by the Lowy Institute and released on Monday found that in the second half of March – before the issue with returnees from India blew up – nearly six in ten people (59%) believed the federal government had done the right amount in helping Australians overseas return home. A third (33%) said the government had not done enough.

The Lowy COVIDpoll, with a sample of 2222 people, is part of the Lowy annual survey of Australian attitudes to the world.

Australians were divided over how much freedom they should have to travel abroad.

The poll found 41% agreed that only Australians granted special exemptions should be allowed to leave, which is the current policy.
But 40% said those who had been vaccinated should be allowed to leave. Only 18% believed all Australians should be free to travel.

People overwhelmingly (95%) said Australia had handled COVID well.

Michelle Grattan, Professorial Fellow, University of Canberra

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

More people stranded than we think?

Survey: psychological and financial impacts

Government support for those stuck overseas

Enough flights to get everyone back?

Falling through cracks

What about unaccompanied kids and non-citizens?

What needs to change now

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Is seven days enough?

How will we ensure people stay home?

What about other household members?

Which states will go first?

What about travel bubbles?

Will contact tracers be able to cope?

What about new variants from overseas?

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The Biosecurity Act

What about constitutional rights?

What does the India experience tell us?

Commonwealth power

International human rights law

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Vaccines offer substantial protection

The delta strain is far more infectious

So why do we need 80% of people vaccinated?

Let’s break it down

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What statistics from Home Affairs show

Who can leave Australia?

Objective decision-making?

Policy being made behind closed doors

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Vaccinating all arrivals could reduce infection risk

How many returnees are already vaccinated?

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What do we know about Australians overseas?

Why don’t we have a clearer picture?

Why do we need a diaspora policy?

How can we do it better?

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