In January, Covid-19 became Australia’s second leading cause of death after cancer. Although the disease is now less fatal, more people have died this year than in the past two years combined. By Max Opray.

Counting Australia’s Covid-19 deaths

An emergency department nurse with a patient.
An emergency department nurse with a patient.
Credit: Lisa Maree Williams / Getty Images

Professor Marilyn Cruickshank had just wrapped up a workshop on writing for medical journals last Tuesday afternoon when she asked those in attendance if any of them did other kinds of writing in their own capacity.

One nurse came forward with a poem about her experiences working through the pandemic. The poetry touched on monitoring patients remotely, a workplace in constant flux, and watching children farewell sick parents.

“It made me cry. I’m still in tears,” the University of Technology Sydney nursing professor tells The Saturday Paper. “For people who think Covid has gone away or is not important anymore, well, this is how it’s been for nurses. They are still carrying around these experiences, and yet we’re all supposed to be getting back to normal. It’s a tough time for healthcare workers – there are still all these people in hospital, people dying every day. There’s still no end in sight.”

With a highly vaccinated population, and milder strains of the virus becoming dominant, Australia has in a matter of months lifted almost all Covid-19 restrictions, prompting a sense in the general population that the pandemic is over.

Although the virus is now less likely to be fatal, so many more people are getting infected that Covid-19 has killed more Australians in the first months of 2022 than in the entire first two years of the pandemic combined.

Federal Department of Health data as of May 3 recorded 7311 deaths related to Covid-19 across the entire pandemic, of which 5072 were registered since the end of 2021.

The virus became the second leading cause of death nationally in January, behind only cancer, according to Australian Bureau of Statistics data released last week. The data showed deaths from all causes in the first month of the year were 22 per cent higher than the historical average, coinciding with a large increase in Covid-19 infections.

Although weekly death tolls have roughly halved from their January highs, Australia is still recording more than 200 fatalities a week.

Daily case numbers remain in the tens of thousands, with experts warning the consequences of long Covid remain poorly understood. In the week ended May 2, there were 108,792 new cases reported.

So many people being forced into isolation has caused significant disruption to the workforce – including in the hospitals trying to contend with the pandemic. Large swaths of healthcare workers are out of action at any one moment due to Covid-19 exposure, while burnout has caused others to leave the industry altogether.

Due to staff shortages, a handful of regional hospitals in Victoria declared a “code yellow” in April, which signals an internal emergency and can lead hospitals to redeploy staff to areas of most need, delay services and call on private health partners.

Portland hospital, in the state’s south-west, suspended its birthing suite and went without overnight urgent care doctors for more than a week.

Across the border in South Australia, Mount Gambier hospital declared a three-day “code white” alert, which means that no emergency hospital beds are available. The alert was triggered by a shortage of up to 60 staff.

Cruickshank said the loss of senior nurses in particular means junior nurses are thrust into roles where they have to oversee the sickest patients.

“This just shouldn’t have happened – we have strategies to prevent transmission but the politicians in charge just want to move on and are no longer taking health advice,” she said.

“From my point of view, strategies that could temper this are minimal – just continue mask-wearing and social distancing. You don’t need lockdowns. It’s quite easy and the majority of people were happy to do that.”

Other healthcare experts consulted by The Saturday Paper agreed that mask use and social distancing were the key measures to maintain, along with vaccination.

Professor Julie Leask, a social scientist at the University of Sydney specialising in risk communication and vaccination uptake, says that the public is exhausted after years of restrictions, and the challenge is to get the balance right.

“In March 2020 our death rate peaked at 15.6 per cent [of positive Covid-19 cases]. Now it’s 0.13 per cent,” she says. “Yet now that Covid is out there, that tiny percentage in a big population is still a large number of people. So for the families of the 39 Australians dying each day with Covid-19, the question is, are we doing enough or has the pendulum swung too far?”

Leask says one issue is that Australia’s pandemic response relied on strict policing of enforced rules, which are now rolled back.

“The messages from governments tend to be ‘you are required to’ or ‘you are not required to’ rather than ‘this is very important so please try to do this’,” she says. “So when the rule relaxes many interpret that as ‘this doesn’t matter anymore’.”

Leask would like to see improved public communication of which health measures are most important to maintain, even if they are no longer mandatory.

This includes encouraging vaccine booster uptake, which she notes represents just 69 per cent of the eligible population.

Of those yet to get boosted, Leask says sentiment data suggests that 15 per cent intend to do so but haven’t got round to it, and another 15 per cent are unaware of when their third dose is due.

“This data suggests we need a national campaign, particularly as we head into winter,” she says. “To be sure of that, we need better data, tracking sentiment in all its dimensions and measuring how much people are affected by the other practical barriers to vaccination. It’s impossible to solve low vaccination without knowing why it’s happening.”

Dr Danish Ahmad, an expert in public health and research data analytics at the University of Canberra, expects that the mortality rate will continue to decline, but that Covid-19 may remain the second leading cause of death until the end of winter.

He warns that flu season converging with widespread Covid-19 transmission will put elderly Australians at particular risk of co-infection.

“Covid fatigue seems to have set in with reduced reporting by the media and officials and also a general sense of exhaustion by the public,” he says. “We must remember that Covid is very much around us … and while newer  recent strains here may be less fatal, this is likely to change as it is in the virus’s nature to mutate to a more virulent strain. In the interim, safe and cost-effective Covid-safe behaviours, especially appropriate mask-wearing, need to be highlighted and encouraged.”

Health experts say improved Covid-aware behaviours wouldn’t just reduce the number of Australians getting sick and help ease the strain on beleaguered healthcare staff. Any return to Covid-conscious behaviour would be of comfort to those who have lost loved ones, says Cruickshank, in addition to improving the work environment of the nurses she deals with.

“With hundreds of deaths a week, it’s just been devastating for families losing family members at this time,” she says. “Their losses are just not acknowledged anymore. And the way things are currently, they don’t see any sign at all that the problem is actually being addressed.”

This article was first published in the print edition of The Saturday Paper on May 7, 2022 as "Counting Covid".

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