Australia needs to “learn the lessons” of the latest covid wave, which lasted longer than expected and had “a very profound impact on the community, on the hospital system, on the aged care system, and on the thousands of families who are grieving the loss of their loved ones,” Australia’s Minister for Health and Aged Care Mark Butler has said.1
Butler reported that around three to four million Australians, out of a total population of nearly 26 million, were infected during the most recent wave, which began in late October 2022 and is thought to be nearing its end.
“It is my intention to make sure that we learn the lessons of the past few months and constantly make sure that the response that all governments, including the Commonwealth, put in place to deal with what inevitably will be the next wave of covid sometime over the course of 2023 is aligned with the best understanding and the best evidence,” he said.1
Australia has had 11.33 million covid cases and 19 063 deaths from the infection,2 most of these since the end of 2021, and cases are likely to be underreported.
The minister’s comments are in stark contrast to previous comments by government officials in recent months, including Australia’s chief medical officer Paul Kelly, who in September 2022 said it was time for “covid exceptionalism” to end.3
Most mandatory non-pharmaceutical measures in Australia—such as mask wearing on public transport4 and mandatory isolation periods for people with covid-195—were removed by mid-October 2022. Travel restrictions into Australia were lifted in March 2022.
While acknowledging the final changes to mandatory measures did not mean the pandemic was over, Kelly said “the emergency response is probably finished.”
During a press conference on 8 February, Butler and Kelly also accepted the latest advice from the Australian Technical Advisory Group on Immunisation which recommended that Australian adults (18 years and older) get their next dose of covid-19 vaccine if it has been six months since either a covid-19 infection or their last vaccination.6
It is hoped this announcement will encourage more people to have the vaccine.7 Only 30% of eligible Australians have received a fourth dose of a covid vaccine.8
Pressure to reset strategy
The government has been under mounting pressure from Australian health leaders to reset the country’s covid-19 management strategy, and to minimise the impact on the community and health system by reducing transmission.9
While Butler’s comments indicate signs of a shift, Brendan Crabb, an infectious disease researcher and director of the Burnet Institute, said, “We’re still way too comfortable with widespread transmission.”
Crabb is among those who have been calling for a shift in government messaging and strategy. Highlighting the impact of “unfettered transmission” in the community on the elderly and immunocompromised, Crabb recently the need to implement a “sustainable, elevated level of action.”9 In addition, the impact from long covid is of concern—“in the end, it’s pretty clear the only way to prevent long covid is not to get covid,” Crabb said.
A different strategy would make a difference for people at higher risk of severe covid, including Aboriginal and Torres Strait Islander people, people who are immunocompromised, and those living with disability.9
The Aboriginal Medical Services Alliance Northern Territory said that because of high rates of chronic conditions in Aboriginal and Torres Strait Islander people, it is concerned about the increased risk of severe acute covid and long covid.7 It supports a “whole-of-population public health strategy with particular focus on high risk groups.”
Anne Kavanagh, chair of disability and health at the University of Melbourne, said that “because we don’t have mitigation strategies in place to reduce transmission—including safe indoor air, isolation of positive cases, and masking indoors—people who are at risk are forced to isolate themselves from community.”9
Adjunct professor Tarun Weeramanthri, president of the Public Health Association of Australia, said that he supported a reset of covid-19 management policy, saying the increase in Australia’s overall mortality “should trigger a rethink” of the current plan.9
According to Australia’s Actuaries Institute, excess mortality in Australia for 2022 “is likely to be 11% of our prepandemic expectations,” which equates to around 19 000 excess deaths. Karen Cutter, spokesperson for the Actuaries Institute’s covid-19 working group, said that this “is much higher than normal” and around half of the excess deaths are because of covid-19.
Cutter said, “It is way too early to predict mortality outlook for 2023.” It will depend on several factors, including future covid prevalence, long term impacts of infection, and “how our health system might cope, or not, with any covid surges.”
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