COVID-19, Top Stories

Fighting COVID-19: Australia’s (Largely Untold) Success Story

On Friday, May 15th, pubs around Sydney re-opened after being closed for two months, a development that caused one delighted Sydneysider to observe: “Clinking that first glass… felt like I’d sloughed off a thousand years of sadness.” In fact, it had been roughly two months—a period during which 24 million Australians, myself included, observed a lockdown on all non-essential services.

There are still many restrictions in place. And it will be months, if not years, before all aspects of society return to business as usual. But overall, the easing of restrictions has come faster than many Australians expected, in large part because the lockdown policies worked. The country has witnessed only about 7,000 confirmed cases of COVID-19 with 103 deaths. Daily new cases spiked in late March in the low 400s, but then plummeted rapidly, and now are typically within single digits. It was once believed that, absent a vaccine, long-term herd immunity might be the only way to stop this pandemic. But examples such as Australia show that many countries may be able to suppress the disease—especially when testing and contact-tracing technologies are scaled up while becoming more precise and sophisticated.

Australians know that other countries are still suffering under lockdown, and that even within Australia, some regions are still suffering terribly. Hundreds of thousands of jobs have vanished, and many small businesses will never recover. When I visit my usual shopping district, I am struck by how many shopfronts have been vacated. The experience of “slough[ing] off a thousand years of sadness” shouldn’t be confused with an attitude of celebration. Many of us remain sobered and saddened.

Yet we also are curious as to why the world hasn’t paid more attention to our success story. Like New Zealand, we are also essentially COVID free. Albania, Norway, Vietnam, and Barbados, and many other small nations have witnessed great success. Dystopian scenes from deeply afflicted countries such as Ecuador, the United States, and Brazil understandably generate more dramatic news footage than scenes of pubs coming back to life in Sydney. But the relentless focus on bad news has obscured the progress being made in other societies.

And ironically, the one country whose policies have been frequently lauded in the international press—Sweden—isn’t exactly a public-health exemplar. Just the opposite: The Swedes now are afflicted with the highest per-capita daily COVID-19 fatality rate of any country in the world. Sweden’s population is less than half of Australia’s, yet its death toll is 40 times higher. Put another way: If Australia had Sweden’s COVID-19 death rate, about 10,000 more Australians would be dead.

However, many of the international observers lauding Sweden’s example seem less interested in the concrete numbers, and more interested in abstract public-health philosophy. Writing in the Lancet, Swedish physician and Professor Emeritus at the Karolinska Institute, Johan Giesecke, explained this attitude as being based upon the grim presumption that “everyone will be exposed to [COVID-19], and most people will become infected… our most important task is not to stop spread, which is all but futile, but to concentrate on giving the unfortunate victims optimal care.”

This kind of fatalism wasn’t entirely baseless in the face of a new and unknown virus. Back in March, some experts did argue that containing the disease was most likely an impossible task, and that most of the world’s population would get sick, no matter how much social distancing we practiced. Sweden has operated around this assumption, keeping children in school and refusing to shut down restaurants and other retail businesses. As a result, the Swedes were cast by some as unsentimental realists who resisted the draconian methods imposed by other nations while protecting their citizens’ natural right to go about their lives freely. Writers in conservative publications such as the Telegraph and Spectator suddenly became Swedophiles. And the Wall Street Journal editorial board urged state governors to “study the Swedish model as they begin relaxing state-wide lockdowns.”

In formulating policy, we should study all models, of course, but in comparing them, the most important criteria to examine are how many citizens live and how many citizens die. Denmark and Sweden are similar societies. Yet the Danes have died from COVID-19 at a per-capita rate that is roughly one-quarter that of their Scandinavian neighbours to the north-east.

Those who argue in favour of the Swedish approach might wave away short-term fatalities, on the supposition that since we’ll all be exposed to the virus eventually, aggressive public-health measures merely delay the pain. If we’re all eventually going to get sick, what’s the point in destroying the economy? Best to get the inevitable pandemic over with quickly, achieve ‘herd immunity,’ bury the dead, and get on with life in a post-COVID-19 world.

The problem with this attitude is that one of its key presumptions is questionable: Even with no vaccine, limited testing capacity, and highly imperfect contact-tracing, many societies have crushed their COVID-19 numbers. And while infectious diseases tend to come and go in seasonal patterns, there is no reason to believe that the methods we have developed to monitor and suppress the disease can’t be successfully applied in the future. Many international jurisdictions, including various Canadian provinces, already have opened up large swathes of their economy without incurring a tidal wave of new cases.

Moreover, it has become clear that ‘herd immunity’ is still a distant dream, even in Sweden. Seroprevalence studies conducted in late April show that only about seven percent of surveyed individuals in Stockholm carried antibodies to COVID-19, an order of magnitude off the 60 – 80 percent goal. Until a vaccine is discovered, a person won’t become immune unless and until he gets sick and survives. As Sam Bowman has observed in the Critic, such data suggest that “criticisms of lockdowns tend to ignore that the real counterfactual would not be business as usual, nor a rapid attainment of herd immunity, but a slow, brutal, and uncontrolled spread of the disease throughout the population, killing many people.”

* * *

Much in the way that individuals develop antibodies to a disease once they’ve become infected, whole societies can develop defence mechanisms to large-scale external threats. In fighting COVID-19, Israel may have benefited indirectly from an advanced health and communications network that has developed in part from decades spent under threat of war and terrorism. Even in peaceful Australia, COVID-19 struck when the country had just emerged from a summer of catastrophic bushfires, in which 24 people died and 60,000 square kilometres were incinerated. Just a few months ago, the navy was mobilized to evacuate citizens from coastal areas, and the army delivered food and water to besieged towns. Major cities such as Sydney and Melbourne were dusted with black ash for days. By the end of the 2019 – 20 summer (we’re in the Southern Hemisphere, remember), every Australian had been freshly acquainted with the fragility of life and the need to heed emergency warnings from public authorities.

Leadership has mattered, as well. Australia’s Prime Minister, Scott Morrison, was subjected to fierce criticism during the bushfire crisis because he went on holiday when the fires started. Reeling from those missteps, Morrison was disposed to take the initiative when the next emergency arrived in the form of COVID-19; just as ordinary Australians were disposed to play their part in the campaign that Morrison led. As in all countries that have excelled in the fight against COVID-19—a spirit of social trust and solidarity has thrived.

Even as early as January 23rd, scarcely three weeks after the first Chinese patients were infected, Australian biosecurity officials boarded the last plane from Wuhan to Sydney, where they helped organize efforts to protect Australians. By February 27, Australia formally declared that the country was facing a pandemic—this being two weeks before the World Health Organisation made a similar declaration (which was around the same time that Donald Trump was helpfully comparing COVID-19 to the “common flu”). In late January and early February, the Australian Government was announcing travel bans while the WHO was declaring them unnecessary.

As Oxford researcher Thomas Hale recently argued on the Quillette podcast, it is impossible, as yet, to determine the exact statistical relationship between lockdown stringency and health outcomes. But even so, we may concede that “lockdown skeptics,” as they often are called, do offer many valid arguments—not least of which being that citizens’ mental health cannot survive indefinitely while their usual activities are curtailed and social lives cut off. And it is entirely possible that historians will one day point to lockdown fatigue as contributing to the destructive riots now unfolding across the United States. Social unrest is an ever-present threat in disadvantaged communities. And the stress, isolation, unemployment, and impoverishment associated with lockdowns can become the final straw for those who feel frustrated and victimized.

But it is already clear that political ideology has little to do with suppressing a pandemic swiftly and efficiently. New Zealand, Singapore, Vietnam, Taiwan, and China all were successful in suppressing COVID-19 once public-health efforts were launched. Yet all of these places have very different political systems. Australia and the United States are both led by right-of-centre governments, but have embraced radically different pandemic-suppression strategies, with radically different results. Anyone trying to tease out patterns in the COVID-19 epidemiological data to support this or that political ideology are going to come away disappointed.

Notwithstanding the media’s relentless focus on political subplots surrounding COVID-19, the real task of fighting the disease is based around apolitical, labour-intensive tasks such as screening travellers at airports, educating citizens in social distancing, crafting industry-specific regulations that balance safety and economic recovery, and developing phone apps that allow us to log our social encounters. These are not glamorous tasks, nor are they associated with the lofty rhetoric you would normally hear in political speeches. Yet taken together, they have saved thousands of lives of my fellow Australians from this terrible disease.

 

Claire Lehmann is the founding editor of Quillette. Follow her on Twitter @clairlemon.

Feature photo: Australian Health Minister Greg Hunt (L) and Australian Prime Minister Scott Morrison (R) speak to media in the Blue Room at Parliament House on March 03, 2020 in Canberra, Australia outlining plans to help deal with the economic impact of the global coronavirus outbreak. (Photo by Tracey Nearmy/Getty Images)

Comments

  1. Yet we also are curious as to why the world hasn’t paid more attention to our success story.

    It’s rather too early to call it a success, I think.

    The virus is still in play and there is not yet a vaccine.

  2. The original goal of flattening the curve to prevent overloading the healthcare system was promptly forgotten and Australia pursued a strategy of eradication instead. That all sounds very nice but for one small flaw: Australia now has no herd immunity in a world full of virus. Australia is cut off from the world. There is no plan for how to re-open international borders and the government is just hoping a vaccine will be available before the economy completely collapses.

    Despite all of that, and even though there have been just tens of new cases per day for well over a month, Australians are still living under some of the strictest lockdown policies on earth while most other countries are well on their ways to reopening. People are not even benefiting from having suppressed the virus locally.

    The Australian approach is not a success. It’s an example of bare authoritarianism, bureaucratic shortsightedness, and a lack of critical thinking on the part of the Australian people. If a vaccine appears in the very near future, everything may work out all right and the government will of course take the credit. But if no vaccine is forthcoming, then what?

  3. Or there is a vaccine and it is only 50% effective, if that?

  4. It’s not true that Australia is pursuing eradication, nor that our lockdown measures are some of the most authoritarian out there. We are just more willing than other nations (notably the US) to accept what the experts advised us to do, and stick to it. The initial lockdown conditions were restrictive, but have been gradually relaxed as the virus was brought under control, to the point that from next week pubs and larger venues will be reopening to bring back a sense of normality to our community.

    So far our response has worked very well, despite being a prime destination for Chinese students and visitors from areas affected by COVID-19. There may be future economic consequences arising from closing down the economy, but in fairness to our government (who I largely dislike) they were faced with a major crisis with no clear and guaranteed solution to adopt. They did what the experts told them to do (and notably, most economists supported their decision), the country overwhelmingly followed suit, and the results thus far have been astounding.

    As for your claim that Australia has no backup plan should we have a resurgence of the virus, that suggests that other countries are prepared in such circumstances. They don’t, and if they eventually do work out an effective response I would wager that Australia will look at the empirical evidence and adopt whatever appears most likely to work.

    I certainly wouldn’t want to swap our response with that of any other country - why would we accept an inferior approach that leads to more deaths and the prospect of ongoing future lockdowns?

  5. Nicely done Claire, as usual. There’s a lot still to play out with this virus but so far our response has been successful.

    To our credit, as Australians, we have largely taken on board the social distancing measures when the concern was, early on, that we wouldn’t because of our healthy disdain for authority. Turns out we can do both. In turn, the States need to let go of some the temporary power that we have granted them, lest they get a taste for authoritarianism!

  6. Is there a general belief among the people of Australia that there might not be future economic consequences from closing down the Australian economy?

    Or that matter, closing down the global economy that profoundly effects the Australian economy?

  7. The government is not officially calling their strategy eradication, but that’s effectively what it is. Flattening the curve was about modulating the load on health services while reaching herd immunity as quickly as possible. Making the curve literally flat is counterproductive to that goal. Other than perhaps New Zealand, I’m not aware of any democratic country that had tighter restrictions or higher penalties for violators during similar points in the course of their outbreaks. The number of new cases has been negligible for over six weeks, but restrictions have only begun to slightly ease in the last week or so. Nothing approaching normal business activity is scheduled to resume until July (in QLD at least), international travel is shut indefinitely, interstate borders are still closed, and there is no timeline for full removal of restrictions. And that is all contingent on there being no resurgence in cases. Many other countries started easing restrictions as soon as the immediate threat to their healthcare systems were mitigated.

    As for your claim that Australia has no backup plan should we have a resurgence of the virus, that suggests that other countries are prepared in such circumstances.

    Herd immunity is the backup plan. Other countries have been working on it right along. There are only two possible ways this can end: an effective vaccine is developed or 50-80% of the population have to get the virus. Permanent isolation is not economically or socially possible, and the moment international travel resumes the virus will pour into the country.

    why would we accept an inferior approach that leads to more deaths and the prospect of ongoing future lockdowns?

    There’s no evidence that the Australian approach will lead to fewer deaths when all is said and done. If there’s no vaccine, it’s just a question of timing. Rather than reducing the prospect of future lockdowns, the Australian approach virtually guarantees it. While other countries are making progress towards an endpoint, Australia is treading water hoping a vaccine arrives before the economy sinks and everybody gets the virus anyway.

  8. Good luck. Winter is coming.

  9. the infectious disease control system that was initiated in Australia has clearly been successful. Look at the numbers. the methodology that was used in Australia was already planned for. For the relevant professionals the pandemic was not a surprise. They were just not sure when it would actually happen. The plans were already in place.
    So we in Australia shut the borders, reminded people of the basic essentials of personal hygiene (hand washing) and keeping a reasonable distance from each other, applied the established principles of contact tracing improved them over time and put methods in place too protect the especially vulnerable (the elderly). We established extreme social distancing for a few months to minimize the extent of the infection and spent the time preparing our public health system.
    The General Practice clinics put clear and sensible plans into action. The major hospital established fever clinics and prepared for a possible rush of cases, The PPE was sourced and distributed, the testing regime was ramped up and was made simple and effective. the research laboratories and the whole world of virology went into overdrive, .
    We planned for the worst and hoped for the best.
    and lo and behold we did OK.
    Now we will learn to live with the virus for the foreseeable future.

  10. Substitute “Hawaii” for “Australia” and comment remains 100% accurate. The goal posts moved from “flatten the curve” to “absolutely, positively no one can be allowed to catch this virus.”

    So, now what?

    IDK about Australia, but Hawaii is F’d without tourism.

    Sweden has taken a lot of flak about their approach. Let’s wait five years before declaring “success story.”

  11. New Zealand, Singapore, Vietnam, Taiwan, and China all were successful in suppressing COVID-19 once public-health efforts were launched.

    China? You lost me there. Very disappointing Claire.

    Making accurate comparisons between whatever nations will have to wait until (or if) we get accurate info about what went on in those countries, how deaths were counted (e.g. Germany not counting deaths if any other factor was involved), what the demographic makeup of victims was and where precisely they lived (population density, use of public transportation, climate/season), etc.

    Personally I feel there are no mistakes, only experiments. It will take years to sort this out and draw conclusions. So let’s give each other a break (except China) --and hooray for Australia. I wish them the best.

  12. The Swedes now are afflicted with the highest per-capita daily COVID-19 fatality rate of any country in the world.

    Untrue. See below for the real winners, all lockdown fanatics :

    Pays Nombre de cas Nombre de décès Population Mortalité/1 000 000 habitants
    Belgium 58 186 9 453 11 589 623 815,6
    Spain 239 228 27 125 46 754 778 580,2
    United Kingdom 274 219 38 458 67 886 011 566,5
    Italy 232 664 33 340 60 461 826 551,4
    France 188 752 28 774 65 273 511 440,8
    Sweden 37 113 4 395 10 099 265 435,2
    Netherlands 46 460 5 970 17 134 872 348,4
    Ireland 24 929 1 651 4 937 786 334,4
    United States 1 769 776 103 674 331 002 651 313,2
    Switzerland 30 845 1 919 8 654 622 221,7
    Ecuador 38 571 3 334 17 643 054 189,0
    Canada 91 640 7 063 37 742 154 187,1
    Portugal 32 203 1 396 10 196 709 136,9
    Brazil 498 440 28 834 212 559 417 135,7

    As you can check, Germany is not even in the list, where no lockdown, except in two landers, have been enforced.

    You talk much about Australia. Why not? But I know many other exotic countries, at least for me, with no lockdown at all and with a fatality rate even smaller than Australia : Senegal, Gabon, Costa-Rica, Jamaica, Liberia and so on.
    My guess : the only good thing done in these countries, including yours, have been done by the sun : warm and sunny days are the real good medecine as it seems.

    I think the real good politics in the course of this epidemic were the complete shutdown of borders in the beginning and a large scale of testing just after that. but they were not curative mesures, only preventive. That’s why Germany (many tests) and Australia (safe borders) have been so good. And of course, it is much more easy to enforce a strict border check-out in islands far from all like Australia or New-Zealand.

    Finally, I wish to add that India seems to do well, if you consider the huge number of its population. Its method is to give malaria drugs (chloroquine, a bit like the famous Trump medecine) in prevention and for now, it seems to work out.

  13. I’m not disagreeing wth the main thrust of your comment. But citing economists as any kind of authority for anything at all is not very persuasive.

    Remember the 364:

  14. Articles like this continue to remind us of the most important tactic in defeating COVID-19:

    Be isolated.

    Australia, New Zealand, et al are much more isolated than cosmopolitan places like Italy, the UK, and the US. Because of their relative lack of international mingling, their case counts remained very low until the point where international examples demonstrated the value of quarantine. At that point, quarantine was socially acceptable and could quickly snuff out any local instances of the disease.

    Those poor unfortunate regions of the world full of globetrotters (New York City chief among them) already had thousands of undiagnosed cases hiding in their midst before mitigation was attempted. It was too late.

  15. What is barely addressed in this article is the moral justification for legislating away most of our civil liberties for several months when it was clear within a week or two of effectively closing the border that Australia’s situation was benign.

    Australia has had 4 people under the age of 60 die from Covid. That’s a routine car smash that barely rates a column in the local paper - which is now out of business. Meanwhile tens of millions have lost their liberty and their sense of that liberty.

    We should applaud Sweden for recognising that this disease, whilst nasty and worthy of limited action, is not worth imprisoning the entire population. There 60 people have died under the age of 50. 10% of all deaths this year in Sweden have been with the virus. A significant event but hardly Armageddon.

    Social distancing has happened but without the heavy-handed authoritarianism seen here.

    What amazes me is how few people seem to share this perspective.

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