Covid vaccine rollout: Australia’s mistakes, missteps and squandered opportunities
Mistakes, missteps and squandered opportunities have brought us to the brink of losing control of Covid, says the professor who led our response to HIV/AIDS.
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Australia is one of just two countries that had managed to achieved zero Covid thanks to the hard yards put in through lockdowns and border closures. Now we are on the precipice of losing control as the Delta variant, two to three times more contagious, stalks a nation whose vaccination rate is still below 5 per cent.
With some state chief medical officers in open conflict with advice given by the Prime Minster regarding who can have the AstraZeneca vaccine, thousands of visitors and business people coming and going through our supposed closed borders, frontline workers still unvaccinated and leaks from hotel quarantine, it is as if nothing has been learnt from those early lessons such as the Ruby Princess outbreak.
Confusion reigns.
The man who led the last major viral pandemic response in Australia is brutal in his assessment of the public response to the current pandemic.
As 12 million Australians bunker down in lockdown, adjunct University of NSW Professor Bill Bowtell shares his views on the “squandered” opportunities that have led to the current debacle.
First it was the 1A and 1B rollout that never really rolled out, with thousands of disability, aged care and front line workers still unvaccinated. Then the mixed messages about the AstraZeneca vaccine.
Originally saved for anyone in 1A or 1B category, the serious but minuscule clot risk led to an edict that only the over-50s should get it. Then after a 52-year-old died of the condition, the advice shifted to the over 60s.
Then on Monday night, Prime Minister Scott Morrison said anyone who wanted AstraZeneca could approach their GP and request it.
The decision has not been backed by the Australian Medical Association, and contradicted advice from the independent Australian Technical Advisory Group on Immunisation – that Pfizer is the preferred vaccine for under-60s due to an increased risk of rare clotting events. Queensland Premier Annastacia Palaszczuk, and her chief medical officer Dr Jeanette Young lobbed the grenade that the call had not been approved by national cabinet.
No wonder Australians are confused when our leaders can’t even agree.
AstraZeneca, which was meant to be the workhorse of our vaccine response, has received such bad PR many say they would rather take nothing.
On the other hand, everyone aged 40-60 is scrambling to get their hands on the limited amount of the Pfizer vaccine available while the highly contagious Delta variant, directly imported from overseas, is out and spreading through the community.
It has an R nought of 6, which means that for every one person with the variant, they can pass it on to six other people.
As the architect of health response to Australia’s last great viral crisis – HIV/AIDS, Professor Bill Bowtell is blunt.
“This is about the greatest failure of public health administration in the history of this country,” he said.
“I was involved 30 years ago when tens of thousands of lives were saved when we had to deal with HIV and AIDS, but it was done openly and honestly. Now it is secret, the advice is secret and it’s often been wrong or slow.”
Just look at the current situation.
A medical receptionist sitting outside a Covid-19 ward in a Queensland hospital tested positive. She was unvaccinated – and went on holidays.
A traveller who flew in and out of Indonesia was also positive. At a time when stranded Australians cannot get home, this person had done hotel quarantine several times.
The limousine driver, responsible for the Bondi outbreak, was also not vaccinated yet he was ferrying positive cases to and from the airport – without wearing a mask, and breathtakingly, he had broken no law.
A student nurse in NSW, also positive, also unvaccinated, worked at Fairfield Hospital and Royal North Shore Hospital while infectious from June 24 to June 28. The nurse infected an aged care worker who was also unvaccinated.
An unvaccinated air steward was positive while flying between Sydney, the Gold Coast, Melbourne and Brisbane. It is as if nothing has been learned in the past 18 months. Everyone has been outsmarted by an invisible bit of RNA.
“Those 1A and 1B categories fell to bits, aged care, disability, the vulnerable, it is six months and they are still not done,” Bowtell said.
“Going into deep winter, Delta is out there and running, lockdowns, cost to the economy in the billions. None of this is bad luck, its bad management. Nature creates viruses, but politicians prolong pandemics by the decisions they make, it is a text book case of that.”
What Australia missed, he said, was the opportunity to order enough Pfizer and Moderna, both mRNA vaccines, way back in June 2020 when they were offered to every country. Instead, Australia backed a two horse race – the AstraZeneca Vaccine and the Queensland University candidate that fell over.
If we had enough Pfizer, in addition to our previous zero Covid status, we could have capitalised on “a golden opportunity”, instead, we are left scrambling.
“Australia decided they would pick two winners but not back every horse. They did a deal with AstraZeneca and tied it with doing a manufacturing deal with CSL. But last year Pfizer and Moderna went around the world and said if you want to pay cash, we’ll give you priority access, they made that offer to many countries and had discussions in Australia in June. It was on offer, it was no secret. The Australians refused to go after either Pfizer or Moderna”.
According to testimony given by Louse Graham, director of market access for Pfizer before the Senate Select Committee on January 28 this year she said: “Pfizer commenced talks at the end of June in 2020 through engagement — writing a letter inviting the government to begin discussions about the possibility of supplying the Pfizer vaccine, should it get through clinical trials and regulatory approval.”
While 34 other countries ordered around 1 billion doses, Australia dragged its feet and made an agreement on December 24 for just 10 million doses, enough for one in five Australians.
“Pfizer is, as we all are, responding to a global pandemic and has been trying to ensure there is provision equitably and fairly across the globe. The available doses that we’re able to bring to Australia at this time, and during those discussions, are in the quantity of 10 million. That is the quantity that is the basis of the initial arrangement,” Graham told the committee.
Said Bowtell: “10 million is turning up but (it is) not enough for the demand, we had zero Covid and they squandered the opportunity, they didn’t organise vaccine supply and did it with eyes wide open.They thought they had two aces but they were two deuces.
“Today, six months later we are far less than 8 per cent full vaccinated, Israel is 56 per cent, the Americans and UK about 45 per cent fully and much more with one jab.
“Unsurprisingly Pfizer has said we’ll get around to it. Even the 40 million ordered earlier in the year, 28 million does are not coming until the fourth quarter of this year.”
Other missteps that history will judge harshly Bowtell says, include our current hotel quarantine arrangements which continue to fail due to the aerosol transmission of the virus.
In all states except the Northern Territory, whose Howard Springs facility has not had one breach, Covid positive cases are shipped each day throughout the nation right into the centre of high population capital cities.
“At end of last year, Delta started to emerge, and in last six months there have been 25 leakages from quarantine, predominantly with Delta because it walks through ventilation systems,” Bowtell said.
“There’s been people on infection control group kidding themselves this was not spread from aerosols, but all big global players changed advice when the science was in. Delta kept stretching the limits and many people said you have got to junk hotel quarantine, it’s a danger, it’s a risk.
“Howard Springs works because it is like cabin accommodation. There is not a common corridor or ventilation system. You could do caravans if you had to, could have all been done in a month, but no, we have an infection control group whose advice has been epically wrong that it was not easily spread via aerosol.”
Over three next weeks, Australia will find out if it has managed to contain the Delta strain through harsh lockdowns. The price of such an approach now runs into the billions.
“People have pleaded, cajoled for months to junk hotel quarantine, they have not, they dragged feet on approval, they dragged feet on securing vaccine, dragged feet on frontline quarantine workers not vaccinated and it has now got out and spread around Australia, it is really serious,” Bowtell said.
“They have let thousands of people in and out of Australia who are travelling, thousands on their exemptions and they have let thousands of people in who have Covid Delta and it got out.”
NSW FALLING BEHIND
As the numbers of COVID-19 in the community continues to rise in NSW despite the lockdown, with 31 new locally acquired cases reported on Friday, vaccine shortage continues to frustrate health authorities.
“At the moment we have scarcity of supply,” NSW Chief Health Officer Dr Kerry Chant said referring to the Pfizer jab.
There are now 226 locally acquired cases reported since 16 June 2021, when the first case of the Bondi cluster, a driver who transported international flight crew, was reported. Of these, 188 are now directly linked to other cases in the Bondi cluster NSW Health said.
With half the nation still in lockdown, bickering between state premiers, and doctors, about the advice from Scott Morrison for anyone under 40 to have the AstraZenca vaccines, various unvaccinated frontline workers in both NSW and Queensland testing positive and spreading the virus, and limited supply of Pfizer, the preferred vaccine for everyone under the age of 60, confusion reigns.
Co-chair of the Australian Technical Advisory Board on Vaccination Associate Professor Christopher Blyth told media ATAGI’s advice was unchanged and still recommends the Pfizer vaccine as the “preferred” option for under-60s.
“I do not believe, at this stage, that young people should be receiving AstraZeneca … There are some situations where that would be warranted, but they are quite small,” he said.
Originally published as Covid vaccine rollout: Australia’s mistakes, missteps and squandered opportunities
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