Australia Must Pivot To COVID-19 ‘Normality’ Once All Residents Are Offered Vaccination

In February 2020 I was one of the first to speak publicly of the need for Australia to shut the borders and aim to eliminate what was then referred to as ‘the novel coronavirus’.

In my first post on the topic published 3 February “Social Cohesion: The best vaccine against crises” I highlighted the unique situation we faced and what were the likely consequences:

Writing in Australia, in the southern hemisphere, the outlook is somewhat more frightening if I am correct in my analysis that the virus will not be eradicated this northern hemisphere winter. I would be unsurprised if more draconian measures were introduced in Australia than elsewhere in an attempt to prevent its introduction as we will endure a full cold and flu season without any chance of administering a broad vaccination program. This will produce a great deal of anxiety amongst Australians.

As the Australian Government was slow to react, I drew on my experience in biosecurity policy and underlined how our approach to this very serious disease of humans was inconsistent with our approach to diseases affecting primary industries – i.e. for some animal and plant disease we follow what is essentially a zero risk policy, yet with this shaping up to be the most serious pandemic of our time we were even flirting with following a herd immunity strategy after Boris Johnson’s lead in the UK (which I mentioned in my FB post above from 16 March 2020). 

Thank goodness for our federal system and for our independently-minded State leaders whose instincts were more compassionate and whose leadership is most responsible for our favourable position through the pandemic to this point.

I have sort to maintain pressure on all decision-makers to work towards minimising human impacts on a range of issues from arguing against a herd immunity strategy (highlighting that the full human impacts were not at all understood, including long term impacts), in favour of following an elimination strategy, to monitoring abattoir workers and managing risks with cold storage chains, to discussing the risks posed by the broad host range of the virus, to factors around vaccines and their rollout in Australia.

At the same time I tried to be a contributor to the discourse on the Australian economy, and more importantly, on seeing humanity progress through the Great Reset era in a more inclusive and fair manner to produce cohesive societies which are necessary to address the major issues we confront.

From my earliest posts on COVID-19 I stressed the importance of seasonality in the global and Australia’s experience of the pandemic.

Even though at that early stage seasonality was not understood with the newly emergent pandemic disease, the similarity of symptoms to other respiratory viral diseases suggested it likely would be an issue, and even if not, the co-occurrence with those seasonal respiratory viruses would create management issues and create a general level of anxiety in society.

I stated those concerns frequently in my daily “Coronavirus Updates” from early March, including on March 5:

It is clear that all European countries are desperately hoping that warmer summer will arrive and provide some respite, give health authorities time to regroup and get ready for the presumed re-intensification in autumn sic (fall), and hope (or pray as the case may be) for an effective vaccine to be administered in the northern hemisphere before the depths of the next winter.

As I have been saying from my very first report, this is something that we in the southern hemisphere cannot even dare to hope for – this will be a long, tense winter down under.

And on March 9:

I want to address something specifically in what I have been saying about the “special” circumstances that Australia faces being unique amongst the developed countries being situated in the southern hemisphere, and thus heading into the cold and flu season of winter instead of heading out of it. The WHO has been careful to ensure that it is understood that there is no evidence that the pandemic will let up in the northern hemisphere as the weather warms up. I have said frequently that if the northern hemisphere countries are fortunate then they will have a seasonal reprieve.

The reality is that they will receive a benefit regardless of whether spread of the coronavirus that causes COVID-19 slows in warmer months in that we already know that cold and flu viruses certainly will. Thus, even if COVID-19 continues to spread in warmer conditions – and I won’t get into the probability of that because I cannot contribute anything of value other than to add that I do not know how valuable observations are that COVID-19 appear not be spreading in countries with more equatorial climates – the reduction in other respiratory infections will aid in detection and thus containment efforts.

Again, this is something that Australia will not experience as we are heading into the flu and cold season. That is why I have stated all along that Australia must be advanced ahead of all other nations in the fight against COVID-19, and I have been clear in my views that our federal Government has not made the most of our opportunities.

I draw particular attention to my post “Australian ‘Followship‘”, posted on 23 March 2020, to give full effect to the situation at the time and my efforts to see Australia’s response improved.

I humbly suggest that the reader consider these arguments now in the light of what has occurred in the northern hemisphere and especially in Europe since I wrote those passages.

Europe did experience a reprieve with much lower pandemic pressure during the warmer months of Summer 2020, but the pandemic exploded again as weather cooled in Autumn. 

The re-emergent pandemic has been traumatic to a level that much of Europe has been almost continuously in some form of lockdown for the last 5 months.

The current situation in Europe is summed up well in this article and there are real concerns that Europe will not be ‘open’ this Summer as it was last.

Australia has experienced lesser impacts from the pandemic than very many other nations to this point. That is because the measures that I argued for from those first few weeks of the pandemic were ultimately adopted, primarily because the State political leaders and health officials supported them and/or enforced them in their own jurisdictions.

Having observed closely the spread and impacts of COVID-19 globally I have continually warned of the need for Australia to not become complacent to the very serious risks we continue to confront. Realising that even Europe had slipped into complacency in Summer 2020, partly out of the desire for economic reasons to have a more normal intra-European tourism season, I warned against complacency in Australia and proposed awareness programs for the public and businesses.

State Premiers together with their respective health officials have very effectively contained the outbreaks of COVID-19 that have occurred over this Summer (with all sources being returning Australian residents in quarantine or in hospitals), quickly moving to enact lockdowns and masking mandates, and using contact tracing to contain chains of transmission. Undoubtedly the warmer weather with more people spending more time outdoors has benefited our containment efforts.

One of the major benefits of success at containing COVID-19 in Australia, that I have continually highlighted from early in the pandemic (see the FB post on 25 April 2020 in the slideshow above), is that we have bought time and flexibility in terms of how we continue to respond to the pandemic, especially in relation to vaccines.

The timetable for the rollout of vaccinations in Australia has become a political issue, much to my disappointment, but what is emphasised mostly are comparisons to vaccine rollouts in other countries and the risks to the Australian economy from further shutdowns. Those country comparisons barely acknowledge that these other nations, especially the US and UK, have been severely impacted and needed to roll out vaccines quickly to protect lives due to inadequate response measures to the pandemic. Moreover, these countries have suffered more serious impacts to their economies, while still suffering much more loss of life.

The well-publicised complications with the AstraZeneca and now the Johnson & Johnson vaccines due to blood clots has meant that Australia has limited the use of the former vaccine to over 50s and will not seek to order the latter (even though the latter is a one-shot vaccine, and if the likelihood of clots forming after each injection was equivalent would mean a reduction of risk by 50% using the Johnson & Johnson vaccine). The bulk of the almost 54 million doses of the AstraZeneca vaccine Australia has ordered will be produced on-shore by CSL which is already producing doses.

When the blood clotting issue was first discussed by Dr Michael Kidd, Acting CMO, he sort to explain the situation using probabilities of adverse outcomes – he said that the probability of developing a blood clot after receiving the AstraZeneca vaccine was 1-2 per million, but that the probability of death if infected with the virus causing COVID-19 is 1-2 per hundred. Thus in a nation where the probability of being infected with the virus is high the reward of significant protection from serious disease after vaccination is well worth the very low risk of developing blood clots from the vaccination.

Since Dr Kidd delivered this explanation, however, European officials have suggested that the risk of blood clotting in young adults following AstraZeneca vaccination is 1 in 100,000. Moreover, in a nation where through adept biosecurity measures there is not a high likelihood of being infected, as in Australia, the risk-reward balance is starkly different to where the incidence of the virus is high.

Even in Europe, however, where official figures record one million lives have been lost in the COVID-19 pandemic, national health officials have sort to better balance the risks of taking the AstraZeneca vaccine with the benefits by introducing restrictions. Think about that for a moment – with a population around 750 million, more than 1 in 1,000 Europeans have died from COVID-19.

However, whereas Australia’s limit for recommending against using the AstraZeneca vaccine is 50 years, most of these European countries more impacted by COVID-19 have set more stringent recommendations either discontinuing its use or limiting its use to those older than 60.

The mRNA vaccine from Pfizer/BioNTech will be recommended for under 50s resident in Australia and now 40 million doses have been ordered which is enough to vaccinate 20 million. This and the other mRNA vaccine developed by Moderna has proven to be highly effective, and have been used predominantly by wealthy countries (that can handle the cold-chain logistics required) and especially the US. Australia will receive the bulk of the 40 million doses late 2021.

The other highly prospective vaccine currently being rolled out is by NovaVax and Australia has orders for 51 million which will also be delivered late in 2021, and may be produced on shore by CSL.

So residents of Australia, while being mostly unvaccinated this southern hemisphere Winter, can have a reasonable expectation of being vaccinated prior to Winter 2022.

That is in strong contrast to low-income countries, most of which have been severely impacted by COVID-19, one exception being Rwanda which largely followed the MacroEdgo playbook of ‘throwing the kitchen sink’ at minimising spread, that have received just 0.2% of all COVID-19 shots given to this point. Even Europe has had an “unacceptably slow” vaccine rollout according to the WHO regional office.

I knew very early in the pandemic that our world had changed, and I spelled out that humanity had a difficult challenge ahead. I stressed that we needed to be on a war footing to respond to the pandemic.

I implored all to hope with their hearts, for an attenuation in the virulence of the virus or for speedy and effective vaccines, but to prepare for the worst. In my “Coronavirus Update” of 11 March 2020 I explained it this way:

In my SMSF positioning paper I said that I hoped, for the sake of humanity, that I was wrong but I had to invest with my head and hope with my heart. Unfortunately my head was right but my heart still hopes for the quickest vaccine or pharmaceutical remedy in the history of mankind.

In many different avenues I stressed that this is “the battle of our lives” and that we all would remain vulnerable while others remained vulnerable.

Our scientists – from Dr Shi Zhengli, whose group rapidly detected and isolated the virus, through to the vaccinologists, all standing on the shoulders of humanity’s curiosity and enduring thirst for knowledge – responded wonderfully and we are in about as favourable a position with vaccines as anybody would have dared dream.

When I look back at what I wrote in February 2020 about scientists rushing to have a vaccine by the next northern hemisphere Summer, some times I have questioned myself on how deluded I was to think that might even be possible (out of shock at the size of the challenge humanity faced). Yet our scientists did achieve just that!

Still, the simple reality is that vaccines are not likely to eradicate this virus because it is likely to continue mutating faster than vaccines can be produced and delivered across the globe. In fact, present indications are that it will take several years to deploy the first generation of vaccines to the original strain even though variants are already more common in most regions. 

Humanity finding a better way to balance the loss of human life with the profit imperative of the pharmaceutical companies using their legal rights to prevent broader manufacture of vaccines with the capacity that already exists, and which could be used but for enforcement of intellectual property rights, would certainly speed up the process. Even so, while better for humanity in terms of reduced loss of life and economic impacts on poor nations, eradication would still seem unlikely.

Hopefully the vaccines will confer a reasonable level of protection as the virus mutates, but measures to reduce the spread of COVID-19 are likely to be with us for many years and COVID-19 will be associated with deaths, concentrated in some regions, perhaps seasonally, and perhaps worse in some years if significant mutation occurs, for example, by passing through animal hosts.

The point is this, unlike in wars where there is a definite conclusion with the declaration of peace, there is unlikely to ever be a moment when we will all be able to claim victory against this foe.

There will be no joyous day where people dance in the streets with confetti drifting and floating through air laden with laughter and music, and young effervescent and ebullient people rush to embrace the heroes of this war with careless abandon.

The scars of this period will not be soothed in any way. We will just move forward in the knowledge that humanity is as vulnerable as any other organism on our beautiful planet.
With that in mind, we in Australia cannot live indefinitely as we have since March 2020; we will need to pivot to our ‘COVID normality’.

We are very fortunate to live in these times with the tools we have had at our disposal to fight this ultra-microscopic foe, as well as to have developed such highly effective vaccines so quickly.

There is the hope that broad-spectrum coronavirus vaccines or treatments may be developed in the future, but we cannot know when or even if these will be successfully developed.

At some point, however, we will need to go about our lives accepting a certain level of risk above what we did, or at least most were aware of, pre-COVID. The exact level of risk we each accept, as always, will be determined by individual decisions and behaviours, within a framework that society accepts as sufficiently protective of broad society while providing civil liberties and freedoms that are broadly accepted.

I would suggest that that point for Australia would be early to mid Autumn 2022 by which time most people resident in Australia should have had the chance to be vaccinated.

While the original vaccine rollout strategy envisioned an October 2021 completion date, the truth is – as has been our experience this past Australian Summer – pandemic pressure is lessened over the warmer period and our biosecurity know-how has proven adept at protecting our residents.

In other words, since few Australians will be protected this Winter, and because we have proven ourselves adept at protecting ourselves over Summer, we need to think altruistically and compassionately for other people suffering far greater impacts than us in the COVID-19 pandemic.

Australians have a rare opportunity to stand up and be a beacon for good for humanity. In a global community where co-operation has given way to vaccine nationalism, we can tell vaccine suppliers that we will wait. Furthermore we can divert vaccine supplies produced onshore to poor nations directly and/or via the COVAX program.

And we should speak loudly and proudly of our actions, and forthrightly let it be known that this is how things should be done, and that we are in this fortunate and privileged position to help humanity because we are a progressive and innovative nation that understood early the implications of the pandemic and we decided to put the protection of lives at the centre of our response.

If over the next 6 months these actions led to the vaccination of perhaps 20 million people, then we will have saved thousands of lives.

To make that decision we need to accept a little more risk, accept a higher likelihood of additional measures impacting economic activity, and exercise patience.

For a nation with a growing ‘image’ problem for being slow and even obstructionist on addressing climate change, thus being increasingly viewed as conservative and lacking an innovative and forward-thinking culture, such altruism and innovative-thinking will certainly help with our international relationships and attract significant goodwill.

While maintaining a positive attitude since the beginning of the pandemic towards the chances of humanity’s scientists achieving effective vaccines, in my seminal post “How Society Will Change If A COVID-19 Vaccine Is Elusive” I allowed myself to contemplate a future where humanity must continue under the shroud of a prolonged COVID-19 pandemic.

If we are very fortunate at least one of the 140 vaccine candidates currently being developed might be effective. Or perhaps a protocol with one or several might be effective. However, as we approach the end of this year, as the northern hemisphere enters autumn (fall), then I expect that we will begin to hear more honest assessments of the chances of success.

If success seems to be more elusive than humanity has dared to hope, then we will move into a new phase for society and individuals to deal with the challenge…

In the event that at the end of the year assessments of the likelihood of herd immunity being achieved by a mass vaccination program are not optimistic, then everyone will need to begin to consider exactly how we will go about our lives for an uncertain but prolonged period with COVID-19 severely impacting us increasingly as we age.

As hinted at in that final sentence, I went on to discuss how people would need to accept that life expectancy would fall for the first time in modern history in many nations, and as a consequence middle-aged people would confront their own mortality as the first generation in many that are unlikely to live longer than their parents.

Humanity’s scientists have excelled and we are in the fortunate position of highly effective vaccines being rolled out within a year of the pandemic commencing.

On the other hand, the virus is so widespread, and the variants that I feared have emerged, and it remains unclear how that will affect current vaccines and whether the virus has developed the “characteristic of mutating sufficiently within a year so that immunity from prior infection does not make the person refractory or immune to infection when exposed the following year”.

Even though we are going to live with this uncertainty for a number of years ahead, and while I realise many have considered me extremely risk averse, and so may be surprised by this view, I believe that once all Australians have been offered vaccination than we need to pivot to opening back up to the world.

When I argued passionately for a strong biosecurity response by Australia to COVID-19 in late February 2020 I was clear that measures must be temporary:

Australia’s isolation really is a huge advantage for us, and it is time that we made use of that very significant advantage. As COVID-19 begins to rage globally, we should strongly consider whether we should close our borders to people flows and tightly manage vessels carrying freight to and from Australia.

It really is as simple as that; we could close our borders and significantly cut down the opportunity to reintroduce the virus while we threw everything at containing the virus within the country. That would minimise the human cost while we wait for a vaccine to become available.

There is no doubt that we have the biosecurity know how to manage a very significant program.

The politicians just have to decide to enact that program…

Being very much a globalist and extremely pro multiculturalism, I do not say such things lightly. These measures need to be enacted in a way that makes it clear to the world that in this time of crisis we are doing our best to combat the disease not only for our people but for all of humanity. As comments from the World Health Organisation make clear, every country has a responsibility to all other countries to proactively manage this outbreak in their own country. Where we can, we should also assist other countries that could do with the help as the WHO has been pleading.

So in enacting any such program it must be made crystal clear that this is absolutely an extraordinary and temporary measure, and that when the pandemic is over we will proudly open up and take in even more people from the rest of the world, especially our brothers and sisters from our Asian neighbourhood, to continue proudly building one of the most successful multicultural societies in the world.

It was always my view that humanity deserved the chance to be protected from the pandemic in buying time for our scientists to apply all of the knowledge and tools we have at our disposal. However, once that is done we must again acknowledge that we cannot live risk-free lives, as we human beings have always needed to accept.

Once everyone in the nation has been offered vaccination, which should be possible ahead of the southern hemisphere Winter 2022 by an intensive vaccination program over Summer, by that time around 2 years after the pandemic began, would be an appropriate time for us to collectively accept that our scientific knowledge and skill has been applied to its fullest. At that point we should pivot to our form of ‘COVID normal’ which will be based on individual perceptions of risk and consequent behaviours, and how that feeds through to Government policy.

One of the most challenging risks to consider and manage will be international movements of people. In many ways the degree of risk that we will accept when travelling in our new ‘COVID normal’ world will be, I imagine, much as it was 40-50 years ago when mass international travel really ‘took off’ after the development of the jumbo jet. Less risk averse people, or those who perceive greater rewards from international travel, for personal or professional reasons, will be first to travel internationally. Extra biosecurity measures are a certainty and will likely include mandatory masking during travelling, attestation of vaccination, testing for COVID-19, possibly quarantine periods, and there might even be a seasonality applied to travelling to and from certain regions.

Exactly how many measures and for how long they are applied will depend on the success of the international vaccine campaign. How quickly poor nations can get access to vaccines and how humanity deals with the intellectual property challenges will be a key determinant.

In my personal view, humanity needs to question how much of that intellectual property belongs to all of humanity from the thousands of years of curious people and through the centuries of scientific endeavour which have culminated in our present understanding of DNA/RNA, virology and immunology. In other words, during times of crisis normal business protections need to be modified to acknowledge that all businesses have and must make sacrifices for the greater good, and that it is to the ultimate benefit of the business community.

In Australia, PM Morrison has shown interesting developments in recent weeks which at first glance might suggest a change of attitude towards greater risk aversion with respect to the pandemic, for example warning Australians that cases would reach the thousands per week if borders were opened. Certainly it is clear that his political challenges, dealing with outpourings of public concern for a broad range of issues from gendered violence and sexual harassment to indigenous deaths in custody, have resulted in him seeking out any and all opportunities to augment his public image with empathy and sincerity. Far be it from me to criticise anybody from seeking to undergo personal growth as a consequence of recent experiences exposing personal shortcomings, and he has certainly been humbled by the damage to his political reputation. Nonetheless, it is entirely possible that the apparent changed attitude is in fact a crafty attempt at using reverse psychology to encourage Australians to think forward to how they really want to live going forward in our COVID normality.

It is of little consequence, however, because the public has squarely laid the blame for the widely held perception of a stalled COVID-19 vaccination program at PM Morrison’s feet, a perception of his own making given earlier remarks about the vaccination timetable, so that politically his Government is certain to pay a very high price for any serious incursions.

Even though business stakeholders continue to seek certainty and rapid progress towards reducing measures which have protected Australians from experiencing the personal loss residents of other nations have experienced in the pandemic, it will be necessary that stringent measures are maintained until the critical Winter period has passed and until all resident in Australian have had the opportunity to be vaccinated. Then, and only then, must we pivot to our ‘COVID normal’ existence knowing that we are more vulnerable than we were, or at least realised we were, before the COVID-19 pandemic. That is the nature of our existence and always will be, and that is what we must accept in the knowledge that we have learned before, that we must be ‘citizens of the world, members of the human community‘.

The first World War lasted four and a half years and the second lasted six. We are just over one year into our generations’, and though it seems an eternity, as the actual wars must have, this will likely last longer even if the intense period may be over in much of the developed world in the next year.

We must maintain flexibility – of thought and in action – if we are to maintain our hard-won advantage over this foe. What we have achieved thus far, and what we must do in the future, has an underlying humanitarian truth – that human life is more cherished and valued by society than percentage points of national GDP (gross domestic product, a questionable measure of economic output in any case) or the financial earnings of our legacy ‘national carrier’ and dividends paid to shareholders. Even if the rate of growth of GDP of the US surpasses ours in the next few months, who honestly, in the absence of the largest of life’s enticements being love, family or career, would rather have been there over here in Australia in safety in a society that has shown that it values human life above wealth?

The long term benefits to our society and economy from our compassionate actions through the COVID-19 pandemic are incalculable.

Over the next few months and years there will be times when it feels like we are experiencing a genuine victory day, like the opening of a travel bubble, then there will be hiccups such as news of a new variant reducing vaccine effectiveness or the waning of vaccine immunity more rapidly than hoped. Nothing will be smooth or easy, and little will be predictable, so nothing can be certain or set in stone. Flexibility has been our great ally thus far, and for us to continue to be successful then it must remain our ally for the foreseeable future.

Out of the shock and hurt of the COVID-19 pandemic emerges a significant opportunity for Australia which is so rare that it would be squandered only by the most inauthentic of non-leaders.

For a nation of people, especially its men, lost amongst outdated, non-inclusive, patriarchal, white-washed imagery of a colonialist outback frontier, larrikin bravery of past war heroes from a century earlier, and a fictional crocodile-wrestling caricature, let this be the moment Australians stand in our modern truth and where we live up to the ideals of authentic bravery and generosity of spirit.

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© Copyright Brett Edgerton 2021

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