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Since word got out at the beginning of the year that some new virus had hit the streets overseas, and it was going to be “big”, the messaging from our leaders has been critical in informing, or in some cases misinforming, the public of what we can or can’t do, and why.
The general public, through the media and political leaders, has had to instantly get up to speed with epidemiology, mathematical models, infectious diseases, infection control and health economics to understand what is happening. Experts in these areas also provide information and advice to governments who then have to make extremely difficult and complex decisions based on the best interests of the community.
There are still some who provide misinformation, saying for 99.9% of the community Covid-19 is a minor sniffle – what’s the fuss? That’s despite the fact at the height of the second wave in Victoria there were just shy of 8,000 active cases, of which about 10% were in our hospitals with a life-threatening escalating pneumonia illness. Our health system was on the edge and our hero healthcare workers were being confronted with a very significant virus that was infecting their fellow workers. I know of cases in which healthcare workers indeed got infected and then unknowingly went on to infect their own children. Some sniffle!
Victoria has copped the lion’s share of Covid cases in Australia and the second wave has been brutal to a community not only coping with living in isolation, but with the uncertainty of whether there is a job to go back to. After the announcement of a state of disaster, stage four lockdowns and curfews, many were putting significant pressure on the government to produce a magical plan out of lockdown.
Even though we had a clear reason to shut the state down – a rapidly increasing number of cases – the plan to open up is much more difficult mainly because we now have a pool of cases in the community, but we don’t necessarily know where. A plan was produced based on epidemiological modelling, which used a number of assumptions, and described a roadmap thought to be safe for the community and thus avoiding a third wave.
Clearly, the government and the community do not want to go through this again. The majority of Victorians were happy, which is understandable, while others thought the roadmap was too conservative, and would have too great an impact on the economy. At this juncture messaging is now critical.
To be fair, there was plenty of epidemiological modelling going on, however health economics and economic modelling had been relatively scant. If it has indeed been done then the messaging has been lost.
After a number of weeks living in a state of disaster and stage four lockdowns, new infections and active cases reduced considerably, and the state government started relaxing restrictions. This was critical, irrespective of the numbers, because the community needed something otherwise compliance was likely to be compromised. It was better to give the community something that was low risk as opposed to dogmatically sticking to the plan.
Last weekend, the average number of new cases was less than the magical five, and the community was full of expectations that we could open up in a significant way. Unfortunately, that didn’t happen, as there were still a number of cases being processed which potentially were of unknown cause.
By this stage emotions were running high with the community wanting answers. Was the premier right to hold off announcing any changes to the roadmap? If you follow the precautionary principle, then yes. We are well aware that it only takes a few cases to lead to a cluster, which then leads to a wider outbreak. However, messaging is again critical, and boundaries to the conversation needed to be put in place. Yes, there was evidence of a small cluster that we needed to resolve. But as soon as that result was in there could be an immediate announcement. As it happened, all went as expected, and we have now had the long-awaited announcement to start opening up.
Is it still too slow? For some, yes, but following the precautionary principle it is likely to be appropriate although this has to be balanced with the economic costs. The question now is what happens if testing on Tuesday demonstrates 10 new cases? Messaging will be critical.
• Prof Bruce Thompson is an epidemiologist and the dean of health sciences at Swinburne University
Source: The Guardian
Keyword: Was the premier right to delay the easing of restrictions? The precautionary principle says yes | Opinion