A couple of weekends ago in Melbourne, the question on many peoples’ minds was, “Are we there yet?” Namely, had the rate of new Covid-19 cases slowed down to the point where we could start to emerge from one of the longest and strictest lock-downs in the world? The answer was, “Yes, but not to the satisfaction of the government and their public health advisers.” So the opening up was pushed back again, having been brought forward by the very same government. It felt like the goal posts had been moved, and despite the huge sacrifices made by the general population, we were being asked to take a “cautious pause”.
No wonder some people got a bit uptight, and it took some tedious questioning from the media to establish what the Premier could have said at the outset of his umpteenth daily press conference. Yes, the Premier was tired, and he had been up late the night before, and he’d done over 100 pressers on the trot by that point. But you could hear and see the exasperation in his voice and in his body language as he realised how he’d managed to miscommunicate what should have been positive news – i.e., “We’re very close, everyone, and thank you all for your efforts, but just to be absolutely sure, please give me a couple of days more before I can confirm the decisions the government have already made.”
At the time of writing, people in Melbourne are still under pandemic restrictions, some of which have been in place since March:
- If you can work from home, you must work from home
- There is a limit on the number of people who can come to your home
- There is also a limit on the size of gatherings in public
- You can’t travel more than 25km from home
- You can’t travel outside the Greater Melbourne area
- Retail and hospitality are only allowed to open under strict conditions
- Everyone must wear a face mask in public
And while there are some exceptions to each of the above, under the current State of Emergency, the government can rescind or reimpose each and every condition, or add new ones as they deem appropriate – including re-introduction of the overnight curfew, which seems to have been a political decision as much as one made on grounds of public health or public order.
I should say that I was in favour of the first lock-down in Victoria. In fact, I was actually glad that the Victorian Premier took a more conservative approach than some of his counterparts, which meant that during lock-down #1, Victoria appeared to be doing a much better job than NSW in containing the spread of the virus, when comparing the daily number of new cases in March and April. But I think the Victorian government should have gone harder when they had the chance, to nip it in the bud:
However, masks weren’t made compulsory until much later during the so-called second wave, and lock-down #2. There could be several reasons for this:
- Medical opinion was divided as to the efficacy of masks
- The government wanted to reserve supplies for medical and other front line workers
- There was inadequate public supply, partly because stocks had been diverted to regions impacted by the summer bush fires (and, initially, some local stocks had been donated to aid projects and sent overseas to China)
- There were already too many other social behaviour changes that were needed, and which were deemed a higher priority
I’m not sure why there is still so much local resistance to wearing masks in public. Many people think it’s an infringement of their civil liberties, or they question the science, or they simply don’t like being told what to do. For men, I wonder if they feel that wearing a mask somehow emasculates them? For women, does it make them feel even more invisible than they already are in society? And for the ardent civil libbers, don’t any of them understand the concept of the mutual duty of care we each owe to our fellow citizens (even the self-styled, self-sovereign ones)? Having spent a lot of time in Asia, where social norms mean it is quite common to see people wearing masks in public, I guess I am less resistant to the idea. So much so, that I started wearing them in Melbourne before they became mandatory.
Of course, over 90% of locally-acquired cases which caused the second wave of new infections were directly the result of the failed hotel quarantine programme in two Melbourne hotels. I’ve commented on this fiasco before, and now the recent Board of Inquiry set up to investigate what happened has asked for an extension before delivering its verdict, owing to the late submission of evidence by key witnesses, including civil servants, public officials and elected representatives. As I wrote previously, the decision to engage private security to manage the quarantine programme is not the issue – it’s the decision-making process itself (referred to as “creeping assumptions”), and the oversight of the programme once it was established.
At this stage, we still don’t know who made the decision to hire private security companies; it’s not entirely clear which government department had oversight of the programme, as there was confusion and poor communication between departments; it’s also not clear whether the chosen security companies were on existing lists of Commonwealth- or State- approved contractors – and if they weren’t, what criteria were applied to employ them? And how did the other states manage to avoid the same level of community transmission that could have come from their own quarantine measures?
Anyone who has worked in or around government procurement will know how difficult it is to get on a contractor “panel”, and even then, the tendering process can be arduous and opaque. From my own experience, governments often use RFI/RFP/RFQ processes to glean as much intelligence as they can (with a view to keeping the project in-house), or to simply drive down the price, rather than to get the most qualified supplier at the best and most appropriate commercial rate. (And of course, there are examples of ex-civil servants forming their own businusses in order to tender for work they used to allocate – using their insider knowledge to the detriment of other bidders. In some cases, the civil servants don’t even wait to leave office….)
I appreciate there is a widely-held view that the breakdown in the hotel quarantine programme was not the only or direct cause of the second wave in Melbourne; but even if it were, it was the failure of the Commonwealth government to manage properly the private aged care facilities under their jurisdiction, which in turn revealed huge vulnerabilities in that sector, leading to the death of around 800 elderly Victorian residents from Covid-19. While I don’t doubt the inadequacies in aged care “settings”, I would have more sympathy with this argument if we had seen the same level of infections in aged care facilities in other states, particularly NSW, given that each state is under the same regime. The “mishaps” of the hotel quarantine programme sit front and centre as the root causes of the second wave, leading to the much severer lock-down #2.
Meanwhile, although the Premier likes to thank everyone for “doing the right thing” during the lock-down, he and his administration had a highly subjective attitude towards those members of the public who clearly weren’t doing the right thing. At times the rhetoric was merely ambivalent; other times it was highly ambiguous; occasionally it was disingenuous (if not wrong). This inconsistency and selective admonishment helped create further confusion among the public about how/when the various lock-down restrictions would be enforced. Worse, it sowed the seeds of growing discontent and underlying resentment in many parts of the community. And not helped by the apparent assertion that community cases among health care workers were all acquired in domestic “settings”, rather than in workplace “settings”.
Some of the other factors that may have contributed to Victoria’s second wave (and which have inter-state and national implications going forward as the domestic borders begin to re-open) include:
- A highly centralised public health system (the current Premier was formerly the state Minister for Health, so no doubt he will have some views on that)
- Inadequate PPE supplied to front-line medical staff and health workers in hospitals and clinics
- Poor inter-departmental and inter-agency communication and co-ordination (plus those “creeping assumptions”)
- A poor culture of “managing up” within ministerial offices (oh, and those “creeping assumptions”)
- Confusion over respective roles and responsibilities, for example, as between the Chief Health Officer, the Chief Medical Officer and the Chief Preventive Health Officer
- “Track and trace” systems not fit for purpose
- Lack of common definitions across the country – e.g., hot spot, complex case, mystery case, locally acquired case, quarantine and isolation periods, close contact, etc.
- Lack of common IT systems for “track and trace” – so without inter-state interoperability, how is that going to work as people start traveling around the country again?
One “common” definition that definitely needs to be established is what constitutes a “household”? I’m not sure if there is a practical legal definition – maybe the Census form is one point of reference? (Perhaps another “test” is the supermarket offer, which usually says “only 1 per household”?) I would have said that a “household” is defined as a group of people who ordinarily live in the same dwelling or residence (whether a house, apartment, unit, rooming house, care home or hostel), regardless of whether they are related to one another, and regardless of whether they consider themselves as “living together”. Conversely “household” does not automatically mean everyone in your immediate or extended family. Where the lines have become blurred is when family members are frequently in each other’s homes for the purposes of sharing meals, care-giving or child-minding. The issue is not one of mere semantics – as we have seen, it is critical both in terms of preventing community transmission, and in enforcing quarantine and isolation measures.
Finally, I should also stress that I am very grateful to be living in Australia at present during this global pandemic, especially given the situation in many other countries. But at the risk of sounding parochial, I really would like to understand why Victoria got it so wrong (and has had to endure a second and onerous lock-down), and how NSW (so far) appears to have got it just about right.
Next week: From Brussels With Love (Revisited)