Today’s announcement of additional postcodes returning to stage 3 restrictions and a total lockdown for 3,000 people in public housing could be encouraging:
It implies that governments are following public health advice to ensure the hospitals do not get overwhelmed.
There is still no recognition that the need for this retreat indicates that the current level of opening up is already unsustainable. But perhaps it indicates that if and when that does become clear, the resulting shutdown will be clearly aimed at Eradication.
Even with successful Eradication (at least a month with no new cases) it can be expected that occasional sporadic outbreaks would occur (both from quarantine failures and the very long tail of asymptomatic or pre-clinical carriers). The point is that sporadic outbreaks can be contained by the sort of local measures successfully undertaken relatively easily in regional Northern Tasmania and now being taken with greater difficulty in suburban Melbourne. The resources available for testing, contact tracing and isolation can contain an outbreak that really is just local, sporadic and occasional.
But with any level of underlying “community transmission” there is simply no way to avoid the statistical certainty that some of the regular inevitable clusters resulting from that will become outbreaks, some of which will again become epidemics.
According to the current testing results we now have an unacceptable level of community transmission from untraced sources whose contacts are unknown and cannot be isolated. That level is higher than when Australia abruptly went into stage 3 physical distancing. We are now restoring the same level of “stay at home” orders in 12 postcodes that we had more widely in March, plus a total lockdown for 3,000 people (enforced by 500 police, 1 for every two or three households!).
It may well be feasible to contain the current epidemic wave without the wider response that was needed in March, because:
- We are able to do far more testing now and can be more confident that the level of community transmission is not already dramatically higher than we are aware of.
- The surge capacity of the hopsitals has been greatly increased.
- We know that if containment fails we can revert to stage 3 restrictions and expect them to work rapidly enough to avoid the increased surge capacity being overwhelmed.
Obviously it is better to impose these restrictions locally than nationally if that can work, just as it is better to isolate large numbers of “contacts” than to shutdown the whole society.
But the main reason for confidence that these local shutdowns could work is the genomic evidence that they originate from a single common cause. The virus strains of many current cases were not known in Victoria prior to the shutdown and so can reasonably be assumed to have arisen from failures of quarantine of incoming travellers rather than from underlying
If that was not the case, it would be illogical to attempt just shutting down local areas, except as a way of preparing for a wider shutdown. The underlying community transmission could not reasonably be assumed to be sufficiently localised for that to work.
We won’t know if it is sufficiently localised now until the current efforts have either succeeded or failed. But we do at least have a path towards a full shutdown again by simply adding postcodes as the efforts fail. Obviously the public health authorities making the local attempt are in a better position to judge the likelihood of success than anybody else and are entitled to a “margin for appreciation” in not knowing what to do quickly enough.
But is that situation acceptable?
Assuming they are right and the current second wave is contained locally, what does that tell us about the policy of “Suppression”?
No matter how egregious the blunders that produced this particular outbreak might be, we know that there will be more outbreaks regardless of how well those particular blunders are dealt with. The public health officials in charge have confirmed this repeatedly.
We also now know that at the present levels of social distancing etc a small single cause outbreak can easily become an epidemic.
To me that necessarily implies the present levels need to be tightened. Yet Government policy continues to be for further loosening and opening up.
So far that policy has not cost many lives. Do we really have to wait until it does before reversing it? The USA and Brazil are not outliers. The UK and several European countries where public health advice is not being spectacularly ignored still have larger death rates and are pressing on to open up their economies. There doesn’t seem to be much other than “luck” preventing Australia joining the club.
The least developed countries do not have an option for attempting Eradication. China, including Taiwan and Hong Kong have demonstrated that it is at least worth attempting. Australia and New Zealand still have the option.
That option was explained in the “Group of Eight” Universities Report to Government but has been rejected.
I am not competent to say whether Eradication is feasible in Australia. It will certainly take a lot longer for States with community transmission. We are now more or less back to the starting point level of community transmission in Victoria, just from one major outbreak becoming an epidemic wave.
But I am competent to say that there has been no clear coherent justification for the current policy of not attempting Eradication. An attempt may not work and could take much longer than people hope, without working. That much has been coherently explained.
But we also know that the policy of Suppression is not working. The current level of opening up has already led to one epidemic wave and can be expected to result in more, even though economic activity is nowhere normal levels.
If we narrowly escape having to go back into Stage 3 more widely, how much worse off would we be if we had instead prolonged the previous Stage 3 for longer? The government proclaims that an “on off” policy of successive waves would be worse. True enough. But why would narrowly avoiding the first “on off” be confirmation that they are on the right track? Doesn’t it rather confirm that their policy of lifting the restrictions to the present level was a blunder that has not resulted in opening up the economy but rather left us in limbo waiting for the next outbreak?
There needs to be some serious detailed study based on scientific evidence.
That is not the function of an administrative inquiry.
But there is now an administrative inquiry. If it does its job it should at least spell out the need for a scientific inquiry:
The administrative inquiry to examine the operation of Victoria’s hotel quarantine program for returning travellers will begin promptly to examine a range of matters that includes “policies” and “decisions and actions” of government agencies.
With a budget of $3 million a report is due by Friday, 25 September 2020. That is about 10 weeks.
The inquiry is headed by one of the former Royal Commissioners into Institutional Responses to Child Sexual Abuse with experience on the Coroner’s Court.
The necessary administrative changes have presumably already been made. A formal inquiry may or may not contribute to fully absorbing lessons learned, and either deflecting or promoting political, and legal accountability both civil and criminal.
But wouldn’t it be interesting if the inquiry did take up its mandate to examine “policies”?
It has been proclaimed loud and clear that the underlying policies are “suppression” as opposed to “eradication”, that outbreaks and deaths are to be expected as part of the “new normal” in adapting and learning to live with the virus.
The aim of that policy is to avoid overwhelming the hospitals with a surge of cases while opening up the economy as rapidly and safely as feasible. The current lockdowns in Victoria are cited by public health officials as a textbook example of that policy in action, with deaths expected as a result.
That policy is the underlying root of this and every future outbreak, any one of which could become another epidemic wave as long as there is no vaccine and the current lack of restrictions remains in place.
Any coroner investigating the deaths should be able to draw attention to the underlying problems that will result in more such deaths and do so with sufficient vigour to result in a scientific inquiry.
Here’s a submission rebutting the “evidence” from business pleading to open up faster:
This play was censored in China following performances in September 2018.
The audience recognized that the Norwegian local business interests rejecting medical advice to protect public health were exactly like the Chinese officials who initially covered up the Wuhan outbreak of covid-19 a year later. The Chinese officials recognized the resemblance too and simply cancelled the play.
It is available as video Starring Steve McQueen:
Well worth watching. I initially thought the play presented the behaviour of local businesses a bit too crudely.
But a glance at today’s media in full cry for “opening up” shows a level of shamelessness that is hard to caricature.
Our national government told everybody that it was their patriotic duty to download the Covid-safe app in order to enable the government to safely open up the economy.
A large majority decided not to do so.
There are many reasons why people don’t trust governments. But governments do know they are not trusted.
The lie that the economy is being opened up “safely” should be exposed.
Promotion of Henrik Ibsen’s play could be a major contribution.