COVID-19: scrapping isolation "a pretty dark day"

FRIDAY’S decision by National Cabinet to scrap mandatory isolation periods and support payments from 14 October, except for aged care workers, disability workers and healthcare workers, has drawn criticism from some big names in medicine.

Professor Brendan Crabb AC, CEO and Director of the Burnet Institute, called it a “dark day”.

“It’s disappointing, a pretty dark day actually. You know, it’s illogical and uninformed, for me I find it distressing,” reported Reuters.

In an interview with Sunrise, Professor Crabb said:

“Australians think it’s over. COVID is still here and the biggest problem we have at the moment is a messaging one.”

The scrapping of mandatory isolation sends the wrong message that the pandemic is over @CrabbBrendan tells @sunriseon7 "COVID is still here, and the biggest problem we have at the moment is a messaging one …" @RealOzSAGE @amapresident pic.twitter.com/gUu5R9v1QS

— Burnet Institute (@BurnetInstitute) October 1, 2022

Professor Steve Robson, President of the Australian Medical Association, told Reuters that:

“I think people who are pushing for the isolation periods to be cut are not scientifically literate.”

• Podcast with Professor Brendan Crabb AC
• Podcast with Professor Stephen Robson

Later, after the National Cabinet announcement, Professor Robson posted a telling meme on his Twitter stream:

😉 pic.twitter.com/AJ5tzsax4z

— AMA President (@amapresident) September 30, 2022

Despite faring relatively well in an otherwise scathing global report, Australia risks falling behind in its response to the continuing COVID-19 pandemic, particularly as Omicron variants continue to emerge.

The Lancet Commission on lessons for the future from the COVID-19 pandemic report was published last month and was critical of “multiple failures of international cooperation”.

“Too many governments have failed to adhere to basic norms of institutional rationality and transparency, too many people — often influenced by misinformation — have disrespected and protested against basic public health precautions, and the world’s major powers have failed to collaborate to control the pandemic,” wrote the report’s authors, including Australian contributor, Professor John Thwaites, Chair of the Monash Sustainable Development Institute and Climateworks Centre.

There was praise for Australia’s early response, as part of the Western Pacific region.

“Australia, New Zealand and other Western Pacific nations generally performed better than other regions of the world,” Professor Thwaites told InSight+.

“That was largely because of the region’s previous experience with SARS 1 in 2003, which resulted in the development of a suppression strategy based on the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies; so our response was faster.

“There also seemed to be much greater compliance by the public with public health measures. There was greater trust in government and health authorities in Australia than in a lot of countries such as the US. So that was another positive,” he said.

Nevertheless, there were lessons to be learned in Australia, as the Lancet Commission report pointed out.

“The need to have a localised approach to public health – it took us quite a long time to do that in Australia,” said Professor Thwaites.

“The need to incorporate behavioural and social science insights into policy interventions – that was a fairly mixed bag.”

The good news ended in the latter stages of 2021, however, when the Omicron variant reached here “and both the feasibility and desirability of continuing the suppression strategy were called into question”, according to the Lancet Commission report.

“Most of the countries of the Western Pacific region relaxed their suppression strategies in early 2022, reverting to a more limited mitigation strategy. Cases of COVID-19 rapidly increased in Australia, Hong Kong SAR, New Zealand, Singapore, and Viet Nam in the first months of 2022, and deaths rose too, yet the death rates remained low because of the vaccination coverage.

“As a result, cumulative deaths per 100 000 population as of May, 2022, in the Western Pacific region were far lower than in any other region of the world. The suppression strategy during 2020 and 2021 therefore had a lasting benefit, as it gave time for high rates of vaccination coverage.”

“The report calls for a ‘vaccine plus’ strategy, which certainly recognises the great benefit of maximising vaccination, but also the need to complement that with strong public health initiatives,” Professor Thwaites told InSight+.

“That’s where we’re falling behind.

“We’ve dropped most of the public health initiatives, and that’s making us vulnerable to the variants that we’re seeing with Omicron.

“We’re now seeing by far the highest death rates in Australia for the whole of the pandemic, but the big problem is long COVID.

“Unfortunately, this virus seems to have a devastating impact on a number of organs of the body. It’s not just respiratory issues. It’s also increased risk of heart disease, of diabetes, and other severe illnesses that are associated with COVID-19.

“A significant proportion of people who have had COVID-19 are now suffering from long COVID, which is very persistent, and unfortunately, proving hard to treat. The cost for the individuals and for society of long COVID is likely to be huge.

“We’ve got to do everything we can to reduce the number of cases. The idea of living with COVID-19 has a presumption that you get it and recover. But unfortunately, a lot of people don’t recover.

“Living with COVID-19 for them means living with the serious effects for many months, and perhaps years.”

But in an environment where we’re apparently comfortable packing 100 000 into the Melbourne Cricket Ground without masks, and where schools and hospitals are struggling to adequately staff themselves because of illness and ongoing disability, how do we mitigate the effects of COVID-19?

“Behavioural insights tell us that the community is desperate to be over this,” said Professor Thwaites.

“People have sacrificed a lot and so there’s a natural human predisposition to want to put it behind them and not think about it.

“It’s not an easy issue, to come up with solutions that are going to be widely accepted. Therefore, we have to be really smart about it because simply imposing rules that people aren’t going to follow is not going to be the solution.

“We have to do everything we can to create safe environments. That means safe buildings, good ventilation, safe schools – all of the things that we can do that don’t require individual behaviour change – are a good start.

“There does have to be information and knowledge sharing about the real risks of long COVID. Frankly, I actually think the words ‘long COVID’ are a challenge in themselves because they make people think it just means you’re suffering from the same thing for a longer period.

“We need to highlight that there are a whole lot of other specific problems with specific organs, like your heart, which could affect your whole life.”

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