COVID Zero will soon be behind us

Over the past few weeks as the number of COVID infections in NSW first began and then continued to rise in Sydney and NSW various commentators and experts have questioned the idea that we need to learn to live with COVID. The idea seems to be that not only should we be aiming for COVID Zero in the short term (the next month or so) but that this should continue to be the strategy for the medium (in 6 months to a year) and perhaps even long term (for the next 5 to 10 years). Personally, I have no doubt that COVID will become endemic in Australia, as it now is in the rest of the world. The difference is that we still have the opportunity to exert some control over the virus and mitigate the consequences of its spread, albeit primarily through our vaccination programme. We should therefore be thinking about how to effectively manage the spread of the virus across Australia and how we should respond to various scenarios as they develop.

Whilst this does not mean we should immediately abandon our existing strategy of COVID Zero, it does mean that we need to think about when it is appropriate to change gears. The federal government’s four phase plan is an example of such thinking, albeit one that only scratches to surface of what needs to be considered. As such, and in contrast to the aforementioned commentators, I do think COVID-19 is something we need to learn to live with. Part of my reasoning is what the consequences what refusing to live with COVID-19 might look like. What are the decisions that we will need to make if we are to continue with the COVID Zero strategy in the medium and longer term?

The federal government four phase plan indicates that changes to current restrictions on international travel will be made when around 70% of the eligible population has been fully vaccinated. Maintaining a strategy of COVID Zero will mean these sorts of changes will not be made. Unfortunately, vaccination does not prevent infection and neither does it prevent subsequent transmission. This means that quarantining those who enter the country will need to continue. Indeed, if COVID Zero is our long term strategy, then it seem clear that we should immediately invest in the construction of high-quality quarantine facilities to accommodate those we do allow to travel internationally.

We should also give serious consideration to the future of two major sectors of the Australian economy. Whilst the construction of quarantine facilities may eventually mean some international students can come to Australian universities, the numbers will be severely diminished. Some universities will inevitably close, and all universities will need to consider large scale redundancies. Unfortunately quarantine facilities will not help the Australian tourism industry. Even if they could afford the financial costs, the time costs imposed by quarantining will mean that no one will choose to vacation in Australia. Certainly, domestic tourism may increase, but it will not be enough to prevent the decimation of the industry, including air travel.

In effect, the refusal to live with COVID means living with significant consequences for the Australian economy. It means prioritising what is rapidly becoming an apparently irrational fear of a virus despite the fact that vaccination will mean significantly lower rates of transmission and far fewer deaths than would otherwise be the case. Indeed, if the initial effects of COVID-19 were of the sort that we see developing in vaccinated populations, it is far from clear that a pandemic would have been declared in the first place. The decrease in deaths caused by the virus would mean that global response would have been far slower and whilst there would have been an awareness of the virus and the threat it presented, incurring the costs of a global shut down would have been unthinkable.

Nevertheless, indefinitely continuing to exist in an ongoing state of public health emergency seems to be what some in Australia are currently considering. For some COVID-19 seems to have become a kind of spectre, an amorphous danger they are incapable of addressing rationally. Of course, contemplating epidemiological models that indicate rates of infection and death is discomforting and not something we would ordinarily do. Nevertheless, similar information is commonly available to us. For example, the fact is that the influenza virus kills between 700 to 1,500 Australian per year, and a similar number die on Australia’s roads annually. Nevertheless, no one seems to be suggesting that engaging in annual winter lockdowns or eliminating private cars is an appropriate response.

Certainly, current COVID-19 modelling suggests that it will cause more deaths than the flu, even in a population that 70-80% vaccinated. However, the difference will not be an order of magnitude, there will not be tens of thousands of deaths. It will more likely be an amount similar to the number of deaths caused by flu and automobile accidents combined. Furthermore, as the virus circulates and our immune systems begin to respond to it, it is highly likely that future years will see a fall in the number of deaths that occur because of or alongside the COVID-19 virus.

The question we need to ask ourselves is what a proportionate response to the risks posed by COVID-19 might be. Today, continuing the strategy of COVID Zero seems advisable but it is unrealistic to suppose that it will prove successful, even in the short term. As the vaccination programme rolls out and as the spring and summer months arrive, continuing with this strategy will become increasingly untenable. One cannot expect the populations of Sydney, Adelaide, Melbourne or even Canberra to accept a lockdown once both levels of vaccination and temperatures begin to rise. 

As Professor Dore has pointed out, “long-term zero COVID is public health la la land” and it is arguably inevitable that the politics of the situation will soon result in its abandonment as a medium and even short term strategy. At present the voices that speak the loudest are those that are expressing nothing but fear of COVID-19. It is likely that other voices will soon come to the fore. Many wish to see some level of international travel becoming possible once again, enabling them to see family members once more. Others, particularly younger people, simply wish to continue with their lives, and put the pandemic behind them. We should not lose sight of the fact that managing public health means balancing between differing kinds of goods and interests.