The principal public health message is very simple: if you haven't been vaccinated this year, get vaccinated now! But reliance on vaccinations alone has never been an adequate public health strategy to combat COVID. So, what else should government be doing now, as COVID hospitalisations and deaths rise, seemingly inexorably.
It took Australia two years to suffer 5000 COVID deaths, despite the negligence of the Morrison government and its manifold pandemic failures. But it has taken only a further six months to suffer the second 5000 deaths.
The Morrison government continually undermined the state and territory social license to regulate, and it talked up personal responsibility, simultaneously talking down any role for government. It dichotomised the COVID response as personal responsibility or interminable lockdowns. This legacy, coupled with a public antipathy to enduring more lockdowns, is shackling the current government response, and making it harder to slow the impact of the pandemic.
But bemoaning the ills of the past will not avert a single COVID death. The Albanese government needs to step up and put its stamp on the nation's fight to live safely with COVID.
There are three actions that the government needs to take.
The first is easy and has already been started - acknowledging COVID exists and ending the old COVID-denying ways. This means talking up the need for vaccinations and working from home, acknowledging that hospitals are being overwhelmed, and discussing the prevalence and consequences of long COVID. The government has a crucial role in shaping public perceptions, and it has the legitimacy to talk about COVID in a way the previous government refused to do.
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Rhetoric is important but needs to be accompanied by actions. We saw powerful demonstration of action with the almost universal voluntary mask wearing by the government, Greens, and independents in the first sitting week of the new parliament, a visible contrast to the shameful behaviour of the opposition.
The second action is to fund a more vigorous campaign to increase the vaccination rate among all those eligible. The combination of vaccine waning and low third and fourth dose uptake, even coupled with the short-term immunity provided by the current high rate of infections, means that Australia is close to falling below the weak opening up thresholds specified in the August 2021 National Plan. The government should make clear that having had two doses is no longer good enough to be regarded as "fully vaccinated" and should shift statistical reporting accordingly. It should also set targets for vaccination rates among key equity groups.
The public has been encouraged to think of the Omicron variant as mild, but a low hospitalisation or death rate multiplied by a very large incidence of infections still leads to bad consequences, the evidence of which we see in overcrowded public hospital emergency departments and in morgues across Australia. Long COVID is real and should also be used to encourage vaccination.
Thirdly, the government needs to assist state governments on mask mandates. Perhaps the first step for the Commonwealth government should be to mandate masks in all public service offices and centres across the country, for staff and clients.
Masks are not lockdowns, despite some media suggesting they are synonyms. Mask mandates are a low-cost intervention - to government, businesses, and individuals - which slow the spread of infections. Mask mandates are increasingly being recommended by chief health officers around the country. The Albanese government should also ensure that all public service offices meet contemporary ventilation standards.
With this lead, the Albanese government could then encourage states to introduce their own mask mandates.
Now is a good time for mask mandates as there are early signs that the current wave has peaked and so, with a bit of encouragement, the virus will slow and the mask mandates could be lifted in the near term. Importantly, a relatively short mask mandate now will make it easier to reintroduce one to counter the next COVID wave.
COVID is real, and people are still dying from infections. Although we are all tired of public health restrictions, especially those of us who live in Melbourne, public health measures are still required to minimise the ongoing impact of the pandemic.
- Stephen Duckett is an honorary enterprise professor in the school of population and global health at the University of Melbourne.
