Our Covid mindset must change if we are ever to open up
Australia is finally beginning the most important mental adjustment of this pandemic as it grasps what the rest of the world has known for months: the price of freedom.
Australia is finally beginning the most important mental adjustment of this pandemic as it grasps what the rest of the world has known for months – that the unavoidable price of freedom from Covid-19 is the acceptance of death.
We are not talking about just a few deaths but many deaths, possibly in the thousands, if Australia is to join the rest of the Western world in opening up and resuming something approximating normal life.
It’s a jarring but necessary transition for a country that prided itself on a low death count during the deadliest phase of the pandemic last year and then became addicted to the fantasy idea that zero Covid was possible into the future.
This week saw a historic tipping point in Australia’s debate over the pandemic. For the first time, the momentum is clearly swinging towards accepting and understanding the need for deadly trade-offs to regain freedoms as soon as vaccination rates meet the threshold targets of 70 and 80 per cent of the eligible population.
The change in rhetoric is being led by the Morrison government, especially Josh Frydenberg. But the mood is also changing among epidemiologists, health professionals and business operators who are increasingly taking a broader view of the growing social, economic and health costs of endless lockdowns in NSW and Victoria.
It is also being powered by changing public opinion, as exhausted locked-down populations in NSW and Victoria realise the Delta variant cannot be contained and that there is no choice but to live with it.
Nothing better illustrated this changing debate than NSW Premier Gladys Berejiklian this week announcing an easing of restrictions of social gatherings on the same day as her state clocked up 1029 new Covid cases, a new national record.
But this mood shift is not yet a uniform one or a national one. The Morrison government and the NSW Premier are sharply at odds with the premiers of low-Covid states, especially Western Australia and Queensland, who have threatened to delay reopening if it means Covid coming into their state.
A very uncivil war is also being fought in suburbs across the country where the debate over freedoms versus health risks continues to pit neighbour against neighbour. Social media is a sewer of abuse as dominant left-leaning voices continue to portray lockdown critics as reckless granny killers.
The fast-growing pace of the vaccine rollout, after a disastrously slow start, has emboldened a previously cautious Morrison government to finally take more assertive leadership in trying to change the national psyche to accept the necessity of death as a price for reopening the country.
“The only long-term solution for Australia is to live with Covid, and people expect their leaders to be upfront with them as to what that means,” the Treasurer tells Inquirer.
“More cases, severe illness and, tragically, the loss of life will occur. People need to be conditioned to this reality given that, to date, states have used the bluntest of instruments, namely lockdowns, but in the process Australia has avoided the loss of life seen elsewhere.
“Now that we have the vaccine rollout gaining real momentum there is an alternative.”
Scott Morrison, who says the country must “adjust” its mindset, has warned Australians will be stuck “in the cave forever” if any premiers abandon the agreed national plan to progressively ease Covid restrictions at 70 and 80 per cent vaccination rates.
WA and Queensland have baulked at reopening borders or ruling out lockdowns once the vaccination targets are reached, knowing that this will inject Covid into their state – especially if NSW continues to have high case numbers.
“Just because the NSW government has made a mess of it doesn’t mean the rest of us should suffer,” WA Premier Mark McGowan says.
“We should do everything we can to stay in the state we are currently in, and at the same time vaccinate like hell.”
But the Prime Minister has, in effect called their bluff, by posing the logical question: “If not at 70 per cent and 80 per cent, then when?
“We must make that move and we must prepare to make that move and we must prepare the country to make that move,” Morrison says.
As Berejiklian says, a zero-Covid target by any state is “completely unrealistic”. “I don’t know any state or nation on the planet who abides by those rules,” she says. “It’s just not possible. We can’t pretend we’re special or very different from other places.”
The bottom line is that McGowan and Queensland Premier Annastacia Palaszczuk are avoiding having an honest conversation with their own voters about the inevitable infections, illness and deaths that will be a consequence of Australia’s reopening.
The standoff has pushed the Doherty Institute, the modeller of the Covid national vaccination plan, into the spotlight after Queensland this week argued that the 70 and 80 per cent inoculation targets were not modelled on having such a large Covid outbreak in NSW.
It was a potentially perilous moment for the national reopening plan, but the plan remains intact after the institute publicly denied the claim, stating that its modelling is still valid even with higher case numbers in NSW and elsewhere.
The institute has also given Australians the first glimpse of the projected deaths involved in reopening once the initial 70 per cent vaccination target has been reached.
“Opening up at 70 per cent ‘with partial health measures’ we predict 385,983 symptomatic cases and 1457 deaths over six months,” the institute says.
This quote was spotlighted by the media and by those who support higher vaccination rates before reopening, but Health Minister Greg Hunt argued it was the second Doherty projection, involving “optimal” not “partial” health measures which was more relevant – “With optimal public health measures (and no lockdowns) this can be significantly reduced to 2737 infections and 13 deaths,” the Doherty Institute says.
The institute also places these projected deaths in context, pointing out that some 600 Australians die of the flu each year: “Any death is a tragedy but our health system can cope with this.”
However, it did say there would be no “freedom day” like in Britain and any easing of restrictions would need to be a progressive one even after vaccination targets have been met.
The experience of other highly vaccinated nations – although not a direct apples-for-apples comparison – suggests infection rates and deaths upon reopening could be higher than the Doherty Institute estimates.
Britain, with 67 million people, has about 75 per cent over 12 years of age fully vaccinated and is currently experiencing about 33,000 new Covid cases a day with 100 daily deaths.
The United States, with 330 million people, has about 52 per cent fully vaccinated and is recording about 150,000 new cases a day with some 900 daily deaths. However, the key statistic in both of these countries – and also throughout the rest of Europe – is that more than 95 per cent of all Covid deaths are people who are unvaccinated by choice.
By the time Australia reaches the Doherty Institute vaccination targets, everyone over the age of 16 who wants a vaccine will have had the opportunity to have one. So the deaths that will occur here in Australia later this year when the country opens up will overwhelmingly be among those who have chosen not to get vaccinated.
A more balanced debate in Australia about the trade-off between Covid deaths and freedoms has been long overdue compared to the rest of the Western world where high infections and deaths are accepted as an unfortunate price for freedoms once people have had a chance to be vaccinated. The debate here is now being fast-tracked by the situation in NSW, where the uncontrolled Covid outbreak has led Berejiklian to rely on vaccination rates rather than suppression as the only realistic path to lifting the state’s lockdown.
This focus on vaccinations rather than new cases is now the most relevant statistic for Australians as they race towards the Doherty targets but most premiers have yet to adjust their thinking as they continue to fixate on case numbers.
Victoria also appears to have lost control of its Covid outbreak, with about 50 to 80 new cases a day dashing hopes of any reprieve from that state’s lockdown for many weeks and possibly months.
The inability of Victoria’s lockdown-prone Premier Daniel Andrews to quell the Delta outbreak in Melbourne, despite locking down early and hard, sends a message to the rest of the country that it is all but impossible to keep the highly infectious Delta variant out of large cities in the long term. But Andrews, who is easily the country’s least sympathetic premier when it comes to understanding the broader costs of lockdowns, shows no sign of following Berejiklian in relaxing lockdown rules in the face of ongoing infections.
Some epidemiologists are now softening their advice to account for this new Delta reality, even if some premiers refuse to listen.
University of Melbourne epidemiologist Professor Tony Blakely says it may be time to consider a “soft lockdown” in Victoria if the state cannot get below 40 cases a day by September 2.
He expressed concern about the impact of another prolonged lockdown on people’s mental health and the economy and says certain freedoms like bubbles between vaccinated households, industries resuming work and curfews being ditched could be part of the plan.
“I think we need a week as a civil society to start chatting about these things,” Blakely says.
But Andrews, who has not given up the notion of defeating the latest outbreak, rejected Blakely’s idea, saying Covid case numbers would inevitably rise under a softer lockdown.
This week another prominent infectious diseases expert, Professor Peter Collignon of Canberra’s ANU, also flagged the need to take a more balanced approach to the debate as Australia gets closer to the vaccination targets.
“We will need to start thinking about how our mindset will need to change if we want to not just minimise deaths but also minimise the many long-term social, education, psychological and economic impacts caused by severe restrictions to slow transmission,” he says.
“The Delta variant has made ‘zero Covid’ an unlikely sustainable long-term, or even medium-term strategy,” he adds.
Former deputy chief medical officer Nick Coatsworth now says he regrets that the country’s medical establishment did not more aggressively challenge those commentators and academics who for so long have called for an indefinite zero Covid strategy.
“We should have been a lot firmer. We needed stronger voices out there,” he says.
But the government’s plan for a unified national reopening is also being threatened by the growing disparity in vaccination rates around the country.
In NSW, where fear of catching Covid is highest, about 60 per cent of first doses have been delivered, putting the state on track to reach its 70 per cent double jab target around October 29 and 80 per cent around November 16.
Victoria is set to reach the 70 per cent full vaccination threshold around November 3 and 80 per cent around November 21. But the national laggards are the largely Covid-free states of Western Australia and Queensland which are sitting at around 46 per cent for the first dose.
At current rates, Queensland is not expected to reach a 70 per cent full vaccination rate until about December 4 and 80 per cent around December 28, while WA is not projected to reach 70 per cent until around November 11 and 80 per cent around November 29.
Unless this changes, the Morrison government will be faced with an uneven relaxation of restrictions around the country including the continued imposition of cross-border travel bans between Covid-free states and those with ongoing outbreaks, which will include NSW and probably Victoria.
With the country’s two biggest states in a prolonged lockdown, the Morrison government’s political fortunes are hugely dependent on reaching the Doherty Institute targets as quickly as possible.
As a new part of this plan, national cabinet this week examined proposals to encourage jabs by allowing fully vaccinated Australians to fly freely on planes and visit restaurants, sporting venues and bars under a uniform standard.
Polls show that such a move, which is similar in practice to a so-called vaccination passport, would be welcomed by most Australians if it restores many of the basic freedoms they have lost in lockdowns.
Recent opinion polls show that Australians, especially those in lockdowns, are now restless to open up as vaccination rates continue to rise.
A new poll taken for the Centre for Independent Studies found the NSW lockdown has sparked a marked shift in public attitudes towards Covid-19 restrictions. More than two-thirds of Australians, 71 per cent, now want restrictions and lockdowns to end as soon as possible or when vaccine targets are met and do not believe that returning to zero Covid-19 cases is possible. Only 10 per cent argue that everyone should be vaccinated before restrictions are lifted.
The dilemma for the Morrison government will be if full vaccination rates stall short of the 70 and 80 per cent rates.
Public opinion is unlikely to support ongoing lockdowns and restrictions regardless of the Doherty targets if every Australian who wants a vaccine has had the opportunity to get one. Failure to lift restrictions at this point would mean that the country was being held hostage by anti-vaxxers.
But for now, this remains a hypothetical problem for the government because the vaccine take up is strong and vaccine hesitancy is falling.
As Frydenberg puts it, the Doherty Institute plan is the only credible and safe way out of the country’s Covid crisis.
“The plan must be adhered to if we are going to give people hope,” he says.
“The plan is the right plan and it is the agreed plan. The health of the Australian public and the economy depend on it being followed.”
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