The coronavirus learning experience

Openness and honesty are leaders’ most important lessons from Covid-19

At the dawn of 2021 Australia basked in the world’s acclaim. We were the object lesson in keeping the dreaded virus at bay. Six months later we have been dramatically marked down, the global object lesson in what not to do.

That reputation is not entirely deserved. Australia can still claim that timely financial support kept its economy afloat, and that its growing skills in managing people and tracing contacts have kept thousands alive who would have died under other pandemic regimes.

But those skills weren’t enough to suppress Delta, the coronavirus variant now sweeping the world. We were caught out by lockdown politics, specifically the belief that NSW could avoid lockdowns by using other measures. That was a mistake.

The other big question is vaccination. In the vaccine development phase Australia banked heavily on the UK-created AstraZeneca (AZ), which we could make in Australia. The government counted on AZ to see us through, ordering limited stocks of messenger-RNA (MRNA) vaccines. Another mistake.

With the lives and livelihoods of every individual in every business and community on the line, actually or potentially, this has to be the wickedest public policy challenge imaginable. While heeding scientific evidence, all leaders and officials – in government or not, elected or not – must also manage public perceptions.

Australia’s vaccine plans were thrown into disarray in April by European reports that AZ shots could lead to a dangerous blood-clotting disorder that disproportionately affected younger people. The Australian Technical Advisory Group on Immunisation (ATAGI) advised that only people aged over 50 should get AZ, then in mid-June limited it to over-60.

As an AZ recipient I followed these events with a keen interest. I have now had both shots, with no discomfort and no side-effects, but I appreciate that some people, especially those with other health issues, would have been nervous at hearing ATAGI’s advice.

The central issue here is the risk from the clotting disorder. ATAGI says the risk of a person under 50 getting the disorder after receiving a first dose of AZ is 3.1 per 100,000 doses, or 0.0031 per cent.

The risk of dying from an AZ-induced blood clotting disorder is much lower. In June Melbourne epidemiologist Hassan Vally calculated that it’s about the same as being killed by a lightning strike and less than a 50th of the risk of dying in a car accident. Melbourne’s Alfred Hospital reports that new treatments are reducing that risk still further.

Which puts the ATAGI advice into context. If the risk of death from receiving the vaccine is so tiny, should the nation regard that advice as the last word, or rather as a caution, to be assessed in light of the overarching need to limit the damage caused by Covid-19 itself? 

ATAGI is thinking about this, and a fortnight ago advised that in an outbreak, younger people unable to get a Pfizer dose should “reassess the benefits” of AstraZeneca as opposed to “the rare risk of a serious side effect”. Last weekend it went a step further, saying Sydney people should “strongly consider” an AZ dose if the preferred alternative, Pfizer, was not available. 

The PM seems to have had a hand in this changed stance. He told a media conference last week that he was “constantly” appealing to ATAGI to review its AZ advice as “the balance of risk” changed. That was a potentially dangerous misstep: the independence of this crucial government agency is essential to its public credibility. 

But Morrison was right in his analysis of the situation. The spread of the virus’s Delta variant, with our biggest city as its epicenter, is clearly a greater risk than death from the clotting disorder. We should be rolling out AZ as fast as we can manufacture it.

The Sydney outbreak has done what Melbourne’s multiple waves could not – change the prime minister’s mind about lockdowns. Once a fierce opponent of restricting the movement  of people, the PM said on Sunday that it was the key to getting cases down. 

We don’t want miracles from our leaders, but in this public health emergency we rightly expect them to be open and honest. From the outset the government sought to cover up its critical vaccine supply failure. Of all its mistakes, that was the worst.

The only sure way to end lockdowns is mass vaccination. Scott Morrison can only hope that ATAGI’s new advice on AZ and a vastly better advertising campaign will bring forward the day when we can breath, move and mingle as we used to, all those long months ago.

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