Covid-19 and public policy
Vaccination
We still have some way to go. The Commonwealth says we have reached 80 percent vaccination, but that refers only to the 16+ population rather than the eligible 12+ population. The more accurate estimate is that 65 percent of the whole population has been fully vaccinated, but that is a nation-wide figure. In the south-eastern corner of the mainland – New South Wales, Victoria and the ACT – 72 percent of the population is vaccinated (85 percent of the 12+ population). In the other five states and territories only 55 percent of the population (65 percent of the 12+ population) is vaccinated.
The graphs below, updated every two weeks, present our national full and first-dose vaccination progress over the latest two months. Assuming that everyone with a first dose is on a pathway to full vaccination, it’s a reasonable guess that we will soon reach at least 90 percent vaccination for the half of the population over 40. The ACT government, for example, claims that 94 percent of its 12+ population is now fully vaccinated and there is no technical reason why this cannot be achieved throughout Australia. We can do even better once vaccines for children aged 5 to 11 are approved in Australia as they have been in the US. That would mean 94 percent of Australians are eligible for vaccination.
But these graphs, particularly the graph on partial vaccination, suggest there has been some slowing in the rate of vaccination among those in the 25 to 39 age groups – younger, mobile people. This could explain why the New South Wales government has brought forward the easing of restrictions for the vaccinated, while delaying them for the unvaccinated.
From here on the task of reaching the unvaccinated will become harder, but given the benefits of bringing down the number of people left unvaccinated, any reasonable effort would pay off. Policymakers are used to situations of diminishing marginal returns as more resources are devoted to a problem, but this is a situation where there are still significant returns as we approach high levels of vaccination.
There is already a great deal of attention to poor vaccination rates among certain groups of indigenous Australians. In the Northern Territory, most of Queensland outside the southeast corner, outback South Australia and most of Western Australia, vaccination rates among indigenous Australians are below 50 percentand in some regions in Queensland and Western Australia even first-dose rates are below 50 percent. The ABC’s Mayeta Clark describes in detail the struggle to vaccinate the residents of Yarrabah in far north Queensland. The Commonwealth’s rollout plan would have put it at the front of the queue in March this year, but the Commonwealth, instead of helping the competent and well-connected local health service, neglected it until they sent in a contractor only two months ago. Clark doesn’t reveal what the contractor was paid, but it would have been much more that the local health services had been asking for.
Then there is a percentage of people – conspiracy theorists, extreme libertarians, alternative lifestylers, “sovereign citizen” nutters – lacking any political communality other than an aversion to science, who are refusing to get vaccinated. Sarah Moulds of the Adelaide University Law School, in an article in The Conversation – No, that’s not the law: the danger of using pseudolegal arguments against COVID-19 rules – takes us on a journey through their weird but dangerous ideas.
What can other countries’ experience tell us?
The diagram below is the weekly update of the scatter diagram of vaccination rates and death rates in developed countries with high rates of vaccination or low death rates. I have been expecting to see some general rise in death rates as restrictions ease and as vaccination levels plateau, as they have in most of western Europe, but that rise hasn’t happened. Netherlands for example has had a recent surge, but from a low level, and has re-imposed some mask requirements. Germany, too, has had a rise in death rates. Its rise in infections and deaths is attributed to a pandemic of the unvaccinated – a timely warning to Australia given the similarity of our present vaccination levels. Germany is considering tougher sanctions and strong incentives for the unvaccinated, to breathe some life into its stalled vaccination program.
There is a fair bit of attention to Israel because after initial success it saw a surge in cases, but it has managed to bring down the death rate in spite of having only a modest level of vaccination. The tentative theory explaining its experience is that because it was an early mover on vaccination it has also been early in experiencing waning immunity, and is now achieving an improved death rate with booster shots.
Japan is another country interesting researchers: why is its death rate so low even though its mandated restrictions are so light? The ABC’s Joshua Boscaini puts some tentative explanations in his article Japan's success in smashing its latest wave of COVID has 'puzzled' health experts.
A country not to emulate is the USA: their death rate is off the chart. In that country vaccination is a partisan issue. To put it simply, almost all Democrats get vaccinated while many Republicans don’t, and the inland and southern states are experiencing tremendous strain on their health systems.
Australia’s position on the scatter diagram is a little deceptive, because we are in effect still two nations, as pointed out above. Victoria, New South Wales and the ACT, when considered as a “nation”, would have a vaccination level of 72 percent and a daily death rate of 0.94 per million, occupying a spot near Belgium in the diagram, while the rest of Australia would be down on the X axis halfway between New Zealand and Taiwan.
Covid-19 cases and deaths
Cases and deaths in New South Wales and Victoria are shown in the diagrams below.
Not too much should be read into the chart on deaths, particularly for New South Wales. When deaths are running in single digits even the smoothed series become very lumpy.
We would not be experiencing this wave in infections and deaths had we kept Australia essentially virus-free up to now. This wave occurred because the New South Wales government failed to contain the spread from an infected limousine driver. Jeremy Fernandez of the ABC Video Lab has a 30-minute presentation Outbreak: how Australia lost control of the Delta variant. In ABC-style he refrains from laying blame, but he makes it clear that, in spite of knowledge of the Delta variant and its high R number (it originated in India in 2020), the New South Wales Government deliberately took a “wait and see” approach to the outbreak for quite a few crucial days. (Perhaps, in spite of the best efforts of the Chief Health Officer and her staff to warn the state cabinet, they didn’t understand exponential growth. It is more likely that the government was under immense pressure from business lobbies not to impose tight restrictions.) Fernandez also notes how the question of lockdown became “a showdown of ideologies”, without naming names.
Had they jumped on the outbreak with a short, sharp lockdown, they probably could have contained the outbreak, and continued for another 4 months without any further restrictions, but such a move would have been politically thankless, because lobby groups, particularly business lobbies, never support governments when they avert catastrophes. This is the perennial problem with public health. So as a result New South Wales experienced 533 Covid-19 deaths and 4 months of full or partial lockdown, and Victoria experienced 345 deaths and 3 months of full or partial lockdown. One lesson policymakers should learn from this outbreak is to keep business lobbies, particularly small business lobbies, at arm’s length. We shouldn’t have had to go through this demonstration, costly in lives and economic livelihood, to confirm once again that the supposed trade-off between “health” and the “economy” is a false choice.
As for other states, with the exception of Western Australia (which looks like being closed until February), they will be opening their borders to New South Wales and Victoria progressively – at this stage dates look like being November 19 for Queensland, November 23 for South Australia, and December 15 for Tasmania, but some of these initial openings still impose tough entry requirements. Travellers to Tasmania, for example, even if they are vaccinated, will have to have a negative Covid-19 test, and if the test is positive they would lose their ferry or airline places, and any payment for fixed-date fares. It will be some time before our borders will be truly opened, even to the vaccinated.
Data sources
See the separate web page of hyperlinks to generally reliable information and analysis about Covid-19, including data on vaccination and the WHO Covid-19 epidemiological updates.