Covid-19: Next few days will decide outcome
Australia has reached a critical point in its fight against coronavirus, with the next few days set to determine whether the health system can cope, or the infection rate explodes beyond capacity.
Leaders, officials and external advisers working on the entwined strategies to manage both the dire health emergency and the tanking economy agree the explosion can be prevented only if Australians immediately distance themselves from one another. Actions taken this coming week are crucial, they say.
If contact is not dramatically curtailed, officials fear the current rate of infection could see the virus take hold in Australia as it has in the worst-hit parts of Europe and the United States.
But the Morrison government’s decision this week to suspend parliament until August as it deals with the crisis has sparked concern across the political spectrum.
“My intention is that parliament continues to meet in the normal way,” Labor’s manager of opposition business, Tony Burke, says. “It needs to meet sooner and we shouldn’t be having five months with no parliament. That’s ridiculous in a crisis.”
Some members of the Liberal Party are also troubled by the lack of sitting and were displeased they weren’t consulted about the contents of the government’s extensive spending measures – nor shown the stimulus legislation before they had to vote on it on Monday night.
“A lot of people were very concerned at the amount of money that is being spent,” one Liberal MP said this week. “We weren’t given the opportunity to understand how the decisions were being reached.”
Beyond parliament, Australia’s leaders have been grappling with the dramatic health implications of Covid-19, particularly whether people would distance voluntarily or have to be forced into action through mass closures – and how widespread the closures would need to be to restrict transmission to manageable levels.
Victorian emergency physician and former Australian Medical Association vice-president Dr Stephen Parnis, currently in self-isolation after displaying virus-like symptoms, agrees Australia is now at a crossroads.
“There’s no doubt that now I think it is a sort of now-or-never scenario,” he tells The Saturday Paper. “Those stories we are seeing from northern Italy and some parts of the United States are certainly that.”
Parnis is frustrated he is not currently able to help his critical-care colleagues and haunted by what is playing out in Europe.
“The thing that keeps me awake at night is the northern Italian scenario,” he said on ABC Radio this week. “… Who gets a ventilator and who doesn’t. That literally has woken me up with a cold sweat.”
But the dramatic steps that must be taken to address the health crisis are at odds with what is required to keep the economy moving. And federal, state and territory governments are trying to address both crises at once.
If the health system is swamped, they fear people will be left to die without access to ventilators.
But all levels of government have been reluctant to restrict activity entirely because those decisions are forcing businesses to shut down – some temporarily, others likely permanently – and seeing hundreds of thousands of people left without paid work. From here, the domino effect has potentially disastrous social and financial consequences.
What began as a stimulus strategy to give money to people who would spend it fast has since become a series of emergency measures for economic survival, currently worth more than $80 billion.
On Monday, parliament authorised the government to draw on a further $40 billion for medical supplies and equipment if necessary.
The government has also extended its own borrowing limit from $600 billion to $850 billion.
The governor-general declared a three-month emergency under the Biosecurity Act, giving Health Minister Greg Hunt sweeping powers to order evacuations, restrictions on movement, closures and lockdowns.
Social Services Minister Anne Ruston was also granted powers to make out-of-session changes to laws relating to welfare payments.
Since then, businesses that host group events and activities have been shut down, along with those designed for social gatherings or entertainment and those providing close-contact personal services – with the exception of hairdressers and “boot camp” trainers. Weddings are restricted to five people, funerals to 10, with limited exceptions. Those in attendance must be spaced at least 1.5 metres apart.
Knock-on effects from each decision have been emerging.
General retailers remained open at time of press but were already struggling from the dropoff in customers as people stayed away. Some chose to close and stand down staff – with or without pay – calculating it would be less costly.
The government-imposed 30-minute time limit on haircuts was reversed within 24 hours, after feedback it was impractical.
One non-profit agency that places and manages workers with disabilities was suddenly struggling. The National Disability Insurance Scheme pays its participants directly through their support plans and the government has insisted that such agencies not hold large reserves of taxpayers’ funds. With many worried parents keeping their adult disabled children at home now, the service suddenly found itself without funds to operate beyond a month.
National cabinet has also been drafting new tenancy rules this week to avoid jobless renters being evicted and property owners being left unpaid.
While the country’s leaders are trying to ensure the economy does not collapse completely, and can be rebuilt when the pandemic passes, many medical experts – focused on the preservation of life – are urging the government to move faster and lock down all but essential services.
A group of 22 specialists from the Group of Eight major universities have been pressing that case.
They were among up to 30 who assembled last weekend at the request of the Australian health protection principal committee – made up of the chief medical and health officers of the states, territories and Commonwealth – to provide advice on physical distancing.
The 22 epidemiologist signatories to the subsequent advisory paper recommended moving swiftly to community lockdown. Others who attended, primarily social scientists, advocated against it because of other possible consequences.
“There are two schools of thought,” Stephen Parnis says. “Do we go for intermittent isolation or do we go hard and fast now, knowing that either thing is a wrecking ball to the economy?”
Like the Group of Eight experts, Parnis favours a lockdown.
He says a dramatic escalation of physical distancing should start to show results in two to four weeks. But the distancing would need to last longer than that to be successful.
“My position and most of my colleagues’ is … work out what your artillery is and focus it where it will make the greatest difference,” Parnis says. “And our biggest weapon is social isolation.”
Thus far, the committee and the federal government have chosen not to follow that majority advice from the Group of Eight.
“Any measures we place, we believe need to be for the long haul,” chief medical officer Professor Brendan Murphy said on Tuesday.
“The idea that you can put measures in place for four weeks and suddenly stop them and the virus will be gone is not credible. So we are very keen to put as restrictive measures in place [as possible] without completely destroying life as we know it. If Australians all do the right thing with these measures … and behave completely differently and practise distancing at every point, that will achieve the outcomes that we want.”
If not, he warned, “we may have to introduce some harder measures”.
A study published this week by University of New South Wales medical data experts Dr Tim Churches and Professor Louisa Jorm outlines six scenarios involving differing approaches to physical distancing, quarantine, self-isolation and lockdown.
It shows the Japanese and South Korean approach of vigorous early testing and tracing, along with enforcement of self-isolation and quarantine, had resulted in “almost complete suppression” of the epidemic with no rebound.
It is too late, however, for Australia to adopt that.
The scenario most closely matching Australia’s current approach – with testing based on symptoms, travel and direct contact, as well as a ramp-up of self-isolation and physical distancing – is predicted to cut cases and deaths by about a third compared with no action. But the research predicted a rebound in cases after 90 days, much bigger than the original suppressed peak.
It found total “lockdown” of 30 or 60 days with only moderate self-isolation compliance would see a similar rebound. But a 60-day lockdown plus high compliance with self-isolation – requiring highly effective testing and tracing of contacts of infected people – would flatten the curve.
This week, the Victorian and NSW premiers split from the rest of national cabinet in foreshadowing “stage 3” restrictions sooner than the rest of the country.
The divergence began last Sunday, when national cabinet was originally not scheduled to meet, The Saturday Paper has been told.
Instead, Prime Minister Morrison was due to announce his second round of stimulus measures, worth $66 billion.
But several leaders, horrified by images of crowds on Bondi Beach ignoring distancing advice, requested an urgent meeting to address the problem.
Victorian Premier Daniel Andrews and NSW Premier Gladys Berejiklian were also concerned that national cabinet’s deliberations were not accounting for each state’s differing circumstances. They made their own announcements on Sunday about school closures.
National cabinet met that night and the prime minister then announced the first round of restrictions on social and group gatherings, which were extended after the next meeting on Tuesday night.
But he continued to resist calls to lock down the whole community.
“I am very concerned about the economic crisis that could also take a great toll on people’s lives, not just their livelihoods,” Morrison said.
“… The things that can happen when families are under stress. I’m as concerned about those outcomes as I am about the health outcomes of managing the outbreak of the coronavirus … I will not be cavalier about it, and neither will other premiers and chief ministers.”
But the prime minister confirmed they had agreed there would be different levels of response in different jurisdictions.
Andrews announced on Wednesday that stage 3 measures in his state were likely. Berejiklian also foreshadowed further restrictions in NSW. Queensland, Tasmania, Western Australia, South Australia and the Northern Territory all announced border closures.
But state-level sources insist that despite the different time lines and measures, the leaders are still working effectively together.
Morrison says the same.
“Sure, there may be the odd time where there might be a bit of difference at the edge,” he said on Wednesday. “But I can tell you in my entire working life in public life, I have never seen the states and territories work together like they are working together right now. And I thank them for that.”
The federal opposition has also co-operated, facilitating the enormous spending the crisis is requiring.
It worked with the government on changing parliament’s operating rules after the pandemic highlighted a lack of flexibility in existing arrangements.
Parliament held a one-day sitting on Monday involving senators and 90 of the 151 members of the house of representatives to minimise the infection risk.
The MPs agreed on rule changes so parliament can sit again with fewer people and possibly with some members participating by video or phone link, if necessary.
In the final minutes of Monday’s sitting, the house backed two motions to amend the standing and sessional orders.
They authorised leader of the house Christian Porter and Tony Burke to negotiate future arrangements to sit, if required, “in a manner and form not otherwise provided in the standing orders” and make other changes to facilitate a sitting.
They removed the requirement for an absolute majority of 76 members. In future, votes will be able to pass on a simple majority of however many members are present, above the required quorum of 31.
Porter and Burke have also been authorised to negotiate future arrangements with the speaker and apply a flexible definition of being “present”, which may include the use of technology for remote attendance as a last resort.
Both undertook to consult the Greens and other crossbenchers beforehand.
Labor is calling for health considerations to be the government’s absolute priority.
“You need to deal with the health emergency first because by doing that, you will have less economic consequences of the health crisis,” Opposition Leader Anthony Albanese said on Thursday. “It’s not either-or.”
The opposition was also challenging some economic decisions made by the government, including the way business support is being paid and the early access to superannuation.
Late this week, Sydney University’s policy lab devised a set of principles it said should guide policymakers through the Covid-19 crisis.
They call for fair and equal access to healthcare; shared economic sacrifice; enhancing social relationships (while distancing physically); protecting democracy, rights and liberties, including holding government accountable; and building a sustainable future.
Access to healthcare was at the top.
“We all know what’s coming,” Stephen Parnis says. “What we want to try and do is mitigate it. And that lies in the hands of the Australian people.”
This article was first published in the print edition of The Saturday Paper on Mar 28, 2020 as "Covid-19: Next few days will dictate outcome".
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