Health advice is just a consideration

Threats by China to retaliate against countries that seek to protect their borders against a spike in cases of Covid-19 in the Middle Kingdom are an unhelpful development. Health experts in China are predicting three winter waves of Covid transmission, with the current spike predicted to run until mid-month, followed by peaks in late January and late February as citizens celebrate the Lunar New Year and return to work.

One of the concerns is that a rapid spread of Covid in China will promote the development of new strains of the virus. Health authorities already are watching closely the new Omicron variant dubbed XBB that is gaining a foothold in the US and elsewhere. Reports suggest XBB isn’t necessarily more lethal than other variants but its mutations enable it to evade antibodies from prior infection and vaccines as well as existing monoclonal antibody treatments. Growing evidence also suggests repeated vaccinations may make people more susceptible to XBB and could be fuelling the virus’s rapid evolution, a concerning development for the delivery of a coherent message on vaccines.

In response, Australia has joined a range of countries to impose new requirements for travellers from China. These countries include India, Japan, South Korea, the US Taiwan, Malaysia, Spain, France, Britain and Italy. New testing requirements have been introduced despite medical advice in Europe that a surge in cases in China is not expected to affect the Covid epidemiological situation. More broadly, testing visitors from China is unlikely to stop any new strains of the virus from spreading internationally. The evidence from the pandemic is that the virus simply will find a way to circumvent obstacles. The failure of the Covid-zero approach is evidence of this. The XBB strain is already well entrenched.

The latest advice to government from chief medical officer Paul Kelly is that “any restrictions to travel from China at this time would be inconsistent with the current national approach to the management of Covid-19 and disproportionate to the risk”. As a result, there is a growing chorus of complaint about who should be making the decisions. The argument centres on what attention should be paid to the real-time messaging of health officials by those who are paid to make the decisions, politicians. We remain firmly on the side of politicians, not bureaucrats, making the decisions and being held accountable for the consequences. Throughout the pandemic we have argued that good leadership requires our political class to treat health advice seriously but for what it is – advice. There is good reason the Albanese government is more comfortable following the example of other countries in putting in place measures to better track what is happening in China as Beijing’s zero-Covid position is surrendered, just as there will be a need for government to make its own decisions on what is best for the country and economy overall should the health advice become more pessimistic.

The current advice from Professor Kelly is geographically based and time limited. It was “based on available information, and in the absence of a specific threat from a variant with increased pathogenicity and immune escape”. Professor Kelly said each of the countries that had moved to implement response measures were in the northern hemisphere winter and no other southern hemisphere country had announced border measures. Aside from the hot weather, Australia was protected by high levels of vaccination, high levels of immunity from prior infection, and ready access to treatment and testing. The BF.7 Omicron subvariant that appears to be a key driver to the outbreak in China has been present in Australia for some time and has been superseded by other circulating subvariants.

These things can change. Professor Kelly has suggested consideration of four proposals to further strengthen Australia’s capacity to detect and rapidly respond to emerging variants of Covid-19, and contribute to strengthening global surveillance capacity. These include: exploring the feasibility of implementing an aircraft wastewater testing program; a program of voluntary sampling of incoming travellers on arrival; increasing coverage of existing community sentinel wastewater testing; and enhancing national consistency in follow-up of people who test positive to Covid and have a history of overseas travel in the preceding 14 days. Professor Kelly offered federal Health Minister Mark Butler a full report in coming days. Peter Dutton has accused the government of “making it up as they go along”.

Given the projections from China, it is likely that Covid will figure prominently on the political agenda during coming weeks. The government must continue to make its own decisions, mindful of the cost and consequences of whatever action it takes. Placating a belligerent Beijing should not be part of the equation.