The big mistake we made was that we not just hoped for the best, but we planned for the best. The first principle of public health is to hope for the best but plan for the worst, and with a pandemic that could not be more true.AUSTRALIANS love a mandate, but only when they are convinced about the reason for it, something successive governments have failed to do when it comes to mask-wearing for the reduction of SARS-CoV-2 transmission, says one of the country’s leading researchers.
Professor Brendan Crabb, Director and CEO of the Burnet Institute, spoke exclusively with InSight+ and said the government of the day pulled the wrong rein when deciding how the country should deal with Omicron when it emerged in December 2021. At the time of writing, there were 327 464 active cases of COVID-19 in Australia, 171 284 of them in New South Wales alone. Over 12 026 people have died from COVID-19, most of them in 2022, and we are well on the way to 10 million total cases since the start of the pandemic, again most of them in 2022.
“I think the biggest issue for Australia at the moment is a messaging one, and it’s a hard message,” Professor Crabb said in an exclusive podcast.
“[If I were in charge,] I would be saying, in as diplomatic and genuinely polite and respectful way as I could, that the strategy that we adopted when Omicron arose was the wrong one.
“We have been more casual with infection than we should have been. And we thought it was going to be okay.
“I would be saying this sobering message to capture the country’s attention and then saying, but there’s some very good news. This is something we can do something about, and it won’t be difficult to do it.
“It’s not COVID that’s in the rearview mirror – lockdowns are in the rearview mirror. We don’t need the tools we used in 2020 and a bit of 2021. We have fantastic vaccines. We know so much more about how it’s transmitted – it’s transmitted through the air – we know how to stop that and mitigate that.
“And we know the value of some other tools, particularly of getting tested, and using therapy if you’re positive or staying home to stay away from other people when you’re positive.”
Professor Crabb said he did not believe Australians in general were aware of the extent of the problem presented by the Omicron variant.
“Until the Prime Minister and the Premiers and Chief Ministers get up and give the sort of talk I’ve just given, I don’t think we will change the minds of Australians,” he said.
“We’ve got to become intolerant of lots of virus in our community, and that has to be made an explicitly clear message from the top.
“You don’t need a mandate if you’ve won over the community. What we’re worried about now with mask mandates is that the community will revolt – and that’s probably true.
“The reason for that is that we’ve not won them over. The community doesn’t know what value there is in it.
“Australians love a mandate – a seatbelt or a helmet or a speed limit or a drink-driving rule or smokers outside. We love a mandate, but only when we’ve bought in to the reason for the mandate.
“And with COVID we have not bought into that – that’s why that mindset shift is so important.”
The Burnet Institute has done modelling (not yet released by the government) showing that if masks were introduced now “we could still save 14% or so of the deaths, maybe 20% of the cases by October”, Professor Crabb.
“There are very significant gains to be had, and of course, if [masks] had been introduced earlier, much more.
“The fact of the matter is, despite a lot of good encouragement to wear masks from the Prime Minister to the Premiers, and on down, not many people are – probably not much better than 20–25%.
“We know that mandating does work. There’s good evidence to say that it makes a big difference. It’s not a trigger you’d want to pull that often, and it’s certainly not something that needs to be in every circumstance.
“This particular modeling said, if masks were mandated in schools, and then there was a sliding window of increase in use in the wider community, then these [reductions in deaths and cases] would be the effects.”
Professor Crabb said when it came to deciding on a strategy for dealing with Omicron, the government committed a cardinal sin.
“The big mistake we made was that we not just hoped for the best, but we planned for the best,” he said.
“The first principle of public health is to hope for the best but plan for the worst, and with a pandemic that could not be more true.”
And the bad news is, another problem is looming: monkeypox.
“Monkeypox, as it is emerging, has some very weird features to it,” Professor Crabb told InSight+.
“We should be acting in a precautionary way, not hand waving it away as a disease of gay men. That’s not the way you [should] treat new things emerging this way. You act in a in a strong ‘precautionary principle way’. You shut it down until you know more, and unfortunately, we’re not doing that.
“We have the big lessons from COVID-19 which we just don’t seem to have learned with respect to monkeypox.”
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