An open letter to all Australian State and Territory Premiers, State and Territory Chief Health Officers, Prime Minister Morrison, Minister Hunt, and the Australian CMO
Hello distinguished group.
Firstly please allow me to thank you sincerely for collectively managing our response to the COVID-19 pandemic that has been very successful in comparison to most nations, and has prevented many deaths within our borders, and which has been a valuable contribution to international efforts and knowledge on many levels.
I especially wish to thank Victoria – their people and their leaders – for their exceptional response to what was a very threatening outbreak. I believe it was a powerful demonstration to other regions and nations that it is indeed possible to clamp down on an outbreak of COVID-19 in the depths of Winter with determined local leadership which concentrates on quality scientific and medical advice.
Premier Andrews and Prof Sutton, for the remainder of your years you will know that you saved Victorians an awful lot of pain and loss by your brave actions in standing strong in the face of vocal (at times bordering on hysterical) opposition!
As somebody who has not experienced direct personal loss in this pandemic, I can accept that errors will be made in a crisis like this one. What is key, however, is that we learn from our mistakes and that we continue to be motivated by the primacy of protecting human life.
I also wish to thank my own State Premier Palaszczuk for managing border closures well while the extent of reseeding events in the southern States have remained uncertain. Similarly I recognise that other States made good decisions on border closures, in the face of political opposition, for the same reasons.
I, personally, did not think that land borders would become critical to managing the pandemic, but I did not anticipate the level of disagreement at the political level over the primacy of protecting human life. (Perhaps the removal of a certain politician from his position of influence now will allow for the temperature to drop on some of those debates?) I also agree that a time will come for tentatively progressing to opening borders with the clear reservation of the right to close borders again if it becomes apparent that the primacy of protecting human life is not shared by other jurisdictions, or if another flare up otherwise necessitates their re-introduction (as the very recent Adelaide cluster shows.)
I recognise the strong efforts of New South Wales, and especially their contact tracing, but I need to express regret at how politicisation increased the pressure on these critical personnel.
I also need to recognise and offer my heartfelt thanks to the frontline responders throughout the nation who have been so vital to keeping us all safe and for caring for the sick and dying.
Finally I express my appreciation to the Federal Government for their proactivity in securing vaccine doses in advance of their production which is so crucial to our future strategies.
I wish to address how we move forward in our response to COVID-19 in Australia as I am concerned that at certain levels our success at managing the pandemic is giving rise to a view that our most pressing concern now is looking forward to rebuilding our economy. That would be an error as our most pressing concern for the foreseeable future will remain responding to the pandemic.
First, however, I should address why it is that I feel sure in my views to write to you all.
I operate a blog at http://macroedgo.com and there I list my full professional background in research science (pathobiology, virology, biosecurity, etc) along with my policy experience in national and international biosecurity.
Since January I have followed the pandemic closely and have posted regularly demonstrating a rare level of prescience to the pandemic and in appreciating the significance of developments. As a far from complete list (easily verified at my site and/or in your own records):
- At MacroEdgo in early February I said it was clear that the virus had escaped the biosecurity net around Wuhan;
- in mid-February I said that the consequences of pandemic were unavoidable and that economic consequences would be severe but stimulative measures must be carefully designed to not worsen the pandemic;
- in early March I implored the closure of our international border (including in my first open letter to PM Morrison);
- in mid-March I warned that the full human cost of COVID-19 were not understood including potential long-term impacts from infections (hence how ill-advised was a strategy of herd immunity from natural infection);
- end of April I warned of risks of spreading the pandemic geographically and temporally with processed fresh meat requiring management in high-risk facilities and potentially at the international border with imported fresh products (in an open letter to Premier Palaszczuk and second open letter to PM Morrison); and
- in August I warned of risks posed by the broad host range of SARS-CoV-2.
I have not been correct on everything, obviously. As I said above I did not foresee the importance of land borders, and our experience has proven that school openings were handled well even though I disagreed at the time (as in my letters to Premier Palaszczuk and PM Morrison).
Still I am certain that any objective assessment would rate my record very highly in comparison with all others who have made their views public through this year.
Winter 2021 is a critical risk for Australia
The experience from the northern hemisphere has confirmed the concerns I expressed in my earliest writing that Winter would present a particular risk. That experience shows that if the virus is circulating at the end of Summer, because measures to limit spread were de-prioritised in favour of economic activity, then case numbers will explode as temperatures drop and people spend more time indoors (in more confined and lower humidity conditions).
I am as pleased as anybody about the preliminary data from the two groups developing mRNA vaccines. That Pfizer/BioNTech today have been able to confirm the very high efficacy is consistent across ethnicities and into the higher-risk older age cohorts is especially pleasing, and that early evidence exists that immunogenicity persists for a reasonable period, is extremely welcome news.
In my view this holds very significant promise to end the pandemic for populations where a high proportion of individuals have been vaccinated. I also note that according to public reports the Federal Government has already ordered sufficient doses to vaccinate 5 million people commencing March 2021. Moreover the Government envisages that all Australians who wish to be vaccinated, I assume with this or other vaccines, will have that opportunity prior to the end of 2021.
That is a commendable effort by the Morrison Government.
Nonetheless there are nuances to these developments, on which experts will undoubtedly have briefed Governments and, which need to be considered especially in a communication strategy with the public. These relate most significantly to the degree of protection against infection, not just disease, afforded by these first-deployed vaccines, and the timing of the roll out of the vaccination program.
Firstly, the earliest vaccination of Australians will occur in Autumn, too late to play any role in preventing community transmission through Summer.
Secondly, although vaccinations will likely commence with high risk categories, including those working in positions which come into contact with infected individuals, it may not result in a more robust barrier to the broader population if the vaccine does not prevent infections. Moreover, since vaccinated individuals will be protected from developing symptoms, and because asymptomatic transmission is known to occur, infected individuals may not be detected as rapidly as now when a higher proportion of infected individuals develop symptoms. Regular testing of asymptomatic vaccinated individuals in high contact positions will help but the barrier might prove more porous than at present. (And I have to admit to being shocked that not all in-contact or close contact workers are being regularly tested for infection at present – this must be remedied across all jurisdictions.)
If more vulnerable individuals are vaccinated the impact from a more porous barrier should be lessened but the preliminary nature of the data means that it is difficult to have great confidence on this at this stage.
Data on just how effective these vaccines will be at preventing infection in vaccinated individuals will not be forthcoming for a considerable period, and not likely before our Autumn.
Thus, while we all should be optimistic, the best strategy is to assume and prepare for the worst which is an acceptance that if we were to drop our guard then Australia could experience an Autumn\Winter period as dark and challenging as Europe and America is suffering.
Because Winter 2021 will be critical for Australia, this Summer is equally critical as it will determine how much the virus is circulating in our population as we enter this critical period.
That is why we must…
“Make This Summer Count!”
I note the political decision made in the recently released Federal budget to focus heavily on the rebuilding of the Australian economy along with advertising imploring Australians to look forward in order to increase economic activity.
I appeal to you to please desist with this line of strategy. Or at least qualify it heavily in your messaging on the following basis.
What is occurring in the northern hemisphere, and following the US election, it is clear that a far better strategy for all incumbents in position right now is to prioritise the protection of human life above all else. (And in recent days, with the strong response of the Liberal Premier of South Australia, Premier Marshall, to the newly detected cluster and the apparent support for it from Health Minister Greg Hunt, I am hopeful that conservative politicians on the whole might have pivoted in their reaction function.)
That wearing of masks was allowed to become politicised is an enormous pity. And having a reasonable understanding of economics I realise that such obvious signs of the continuing pandemic will have an impact on confidence and thus on consumer and business confidence. I have no doubt that has been the major driver of objection from especially those on the right side of politics.
I do not suggest that measures be made compulsory or stringent over Summer in States or regions that have not experienced community transmission for a significant period of time. To make our societal response enduring I agree that we need to enjoy these moments of respite from intense periods of response.
Moreover, these periods of respite for frontline responders are important to re-energise and re-provision, and to implement improvements based on learnings in an open national collaboration.
However, creating a perception that the major issue from here on is rebuilding the economy gives the impression to our community that we have already won the war. With that will come complacency which, in the event of (likely) further reseeding events, increases the potential for rapid spread prior to detection and, perhaps worse still, creates inertia within the community towards re-introducing containment measures to protect human life.
Now I realise that some, especially in the business community, will quietly be hoping for that complacency as they believe that consumers forgetting about their fears about the pandemic, and slipping back into old habits, is good for their business. Given that many businesses rely heavily even in normal years on Christmas trade, perhaps that is understandable. However, experiences in northern hemisphere developed countries, choosing near normal intra-European tourism in Summer, have shown this to be extremely short-sighted and, frankly, devastating to communities.
Ultimately that is a poor outcome for business and many businesses will not survive further serious outbreaks of pandemic.
I firmly believe that a far better communication strategy for the betterment of Australians collectively is one which eschews complacency amongst the community and builds confidence gradually by continually demonstrating that the full threat of the pandemic is understood and that all efforts will be taken to reduce the number and size of clusters we experience.
Along with a Government communication strategy based around the theme of “Make This Summer Count!”, I am proposing to businesses with significant customer-facing positions in enclosed environments a strategy of treating the COVID-safe plans for each State as just the starting point rather than a “tick a box” necessity to operate.
Preferably these businesses would initiate the strategy “We Mask Because We Care” which at a minimum involves all staff wearing face masks (irrespective of whether they are mandated in the region) and potentially providing masks to customers in store or given as a reward for minimum purchases (perhaps even prospectively if the customer is unmasked).
I am currently drafting this proposal which I will post at http://MacroEdgo.com in the next few days.
I thank you for your time and your consideration.
Dr Brett F Edgerton (B.Sc., Ph.D., GradCertComm.)
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© Copyright Brett Edgerton 2020