Inside Australia’s very CUTE plan for tackling pandemics before Covid

Despite some noisy protests and international scrutiny, Australia has overseen one of the world’s most effective responses to Covid.

Our relatively small population and geographic isolation were natural advantages in reducing the worst impacts of the pandemic.

Just over 2000 deaths, while tragic, pale in comparison with totals such as 790,000 fatalities in the US, 146,000 in the UK and 144,000 in our near neighbour, Indonesia.

But Australians also experienced some of the harshest lockdowns in the world, particularly in Sydney and Melbourne, lengthy closures of workplaces, universities and schools – while some workers were forced to get vaccinated or face the sack. 

The reasons for these decisions were not always clear to the broader public, sparking small but highly vocal protests and civil resistance around the country.  

To many Australians, it looked like governments were making it up as they went along.

In fact, Australia had a plan to deal with a pandemic before Covid arrived. 

The reason for decisions on Covid restrictions were not always clear to the broader public, sparking small but highly vocal protests and civil resistance around the country. Pictured: Protesters arguing against mandatory vaccinations on Macquarie St, Sydney

It was called the Australian Health Management Plan for Pandemic Influenza – yes, influenza. The latest version was created in August 2019 just six months before the first case of Covid was diagnosed in Australia.

It’s measures were largely based on the swine flu pandemic of 2009. 

The word ‘lockdown’ is mentioned nowhere in the document. The idea entire industries would need workers vaccinated before being able to return to work is also absent. Quarantine is mentioned, but not quarantine in not-fit-for-purpose hotels.

‘In our pandemic preparedness, we’d looked at things like what would happen if there was an influenza pandemic with a five per cent mortality rate,’ Professor Emma McBryde, an infectious diseases physician from James Cook University, told Daily Mail Australia.

‘There was never in our plans the idea to force people into their homes,’ Professor Emma McBryde from James Cook University said

‘There was never in our plans the idea to force people into their homes – we just didn’t think anyone would do that. 

‘It’s changed the whole landscape about what public health levers might be available.’

Social distancing, PPE, quarantine, improved hygiene, border controls and potential school and work closures are all addressed in the 2019 plan, but in the context of a major flu outbreak.

‘Acceptability will depend on the business,’ stated the 2019 plan about the possible shutdown of a workplace in a flu pandemic. 

‘Closure is likely to be acceptable to employees, particularly if they are sufficiently compensated, although data about this is not available in the Australian context.

‘Measures will rely on voluntary compliance rather than legal enforcement wherever possible,’ the plan states hopefully in another section, discussing existing laws about controlling pandemics.

In reality since the beginning of 2020, thousands of businesses were shut, JobKeeper was hastily introduced to keep people on the books, and sometimes stringent public health orders and fines were introduced to ensure compliance.

Daily Mail Australia spoke with a number of experts who have been prominent spokespeople throughout the pandemic to see whether they think Australia’s pandemic plan needs to be overhauled, and what we should do better.

Professor Paul Griffin, infectious diseases physician and microbiologist from the University of Queensland: ‘We didn’t really have a plan for a virus that behaved differently to influenza, as its clear [Covid] very much did… and it’s clear we were ill-prepared’

‘Some of the explanation of rationale has been lacking at times, and that has led to people being suspicious of the motivation of some of these [restrictions],’ Professor Griffin said

Federal Health Minister Greg Hunt speaks to the media during a press conference at Parliament House in Canberra in October

Professor Paul Griffin, infectious diseases physician and microbiologist from the University of Queensland, is one of many experts in the field who thinks Australia needs a national body not dissimilar to the USA’s Centers for Disease Control and Prevention (CDC) to deal with future pandemics.

‘We didn’t really have a plan for a virus that behaved differently to influenza, as it’s clear [Covid] very much did… and it’s clear we were ill-prepared,’ he said.

‘Something that can unify our response and enable us to do more coordinated planning ahead of time, such as a CDC or equivalent, would be a really big step forward.’ 

Professor Catherine Bennett, chair of epidemiology at Deakin University, agrees, though is wary of the CDC comparison. 

‘Everyone I know in infectious disease has said [we need such a body] since last century… but it has to be really carefully set up,’ she said. 

‘The CDC in America is basically a military organisation. We need an independent but respected voice… people have cobbled groups together but it’s been people who just have a strong opinion on things.

‘It’s got to be about evidence.’ 

Professor Catherine Bennett, chair of epidemiology at Deakin University: ‘What happened at state level is we had premiers becoming the public health messengers and I don’t think that’s appropriate’

Professor McBryde said a major lesson of the pandemic was the way scientists communicate with government.

‘Our government has been disappointing in this respect, it has brought certain groups into the fold with very little transparency in the process, very little public discussion, very little merit-based selection at all, with other groups contributing in other ways on the fringes.’

The 2019 plan emphasises the need for clear public communication of government strategies to deal with a pandemic as well as up-to-date data. But while we received a lot of information, how it was delivered often became confusing.

‘What happened at state level is we had premiers becoming the public health messengers and I don’t think that’s appropriate,’ Professor Bennett said.

‘A lot of the language used was understandable – people were scared, politicians were scared, we had cases taking off from hotel breaches … But some of it was the sort of public health messaging we stopped doing last century. 

‘We were in lockdown to prevent outbreaks, not because there were outbreaks or we were doing anything wrong.

‘If they had messaged that, it would have been truthful and might have brought us together about the best way to do it, rather than the language around the virus getting bigger and bigger, building fear, adding to anxiety and depression and all the other things in the community. 

‘[If these decisions] could be communicated more by expert groups rather than seemingly being politically motivated, the acceptance of some of these things may be improved.’

‘A lot of the language used was understandable… people were scared, politicians were scared… but some of it was the sort of public health messaging we stopped doing last century, Professor Bennett said. Pictured: Victorian Premier Daniel Andrews during a Covid-19 update press conference in November 

An university representative welcomes back international students as they arrive at Sydney Airport in December, as Australia’s borders began to re-open

Professor Griffin said the reasons Covid restrictions were imposed was not always ‘clear and consistent’. 

‘In the end we have done a good job and the response has largely been the right one but how it’s been delivered – some of the explanation of rationale has been lacking at times, and that has led to people being suspicious of the motivation of some of these things.

‘An expert group could coordinate and and explain some of these things to put us in a better position.

‘People still say to me they struggle to find reputable sources of information to address some fairly basic concerns.’

Professor Nancy Baxter, head of Melbourne University’s School of Population and Global Health, said investment in public health infrastructure, particularly at state level, needed to be maintained between pandemic events.

‘Look at contact tracing in NSW versus the contact tracing in Victoria. 

‘NSW was able to jump into action because they had the structure there, which requires investment.

‘Victoria was a total shambles until they got things together and eventually the contact tracking was fantastic in Victoria… but you need the infrastructure there to start with.

‘That caused us the second wave [in Victoria], basically.’

Professor Baxter also believes there was a reluctance to ‘adapt to new evidence’ once Covid hit Australia, making earlier plans and some public health messages largely redundant. 

‘I specifically refer to the airborne transmission of Covid-19,’ she said.

Instead, much of the public health messaging on the virus was about hygiene and hand-washing, Professor Baxter lamented. 

‘There was insufficient emphasis or preparation of the public to protect themselves from airborne transmission,’ Professor Baxter said.

All the experts agree that our experience of this pandemic will provide years of study and research in their field of epidemiology and communicable diseases. 

‘We’ve been fortunate to apply huge scientific advances to this pandemic,’ Professor Griffin says.

‘There was insufficient emphasis or preparation of the public to protect themselves from airborne transmission,’ Professor Nancy Baxter from Melbourne University said

‘One of the things we’re going to have to do is go back to the start and look at every stage and ask what we should have done differently,’ Professor McBryde said. Pictured: Border barriers between Coolangatta and Tweed Heads at the NSW-Queensland border

‘We’ve mapped the evolution [of the virus] in real time with access to genomic sequencing, that’s never been done before.

‘There are over 130 vaccines in clinical trials now, coming behind the first ones. They might have additional properties that will help us combat this virus, and we’ll apply the learnings from these vaccines to other pathogens.’

Professor McBryde added: ‘One of the things we’re going to have to do is go back to the start and look at every stage and ask what we should have done differently.’ 

Professor Bennett said the arrival of Covid-19 had been ‘overdue’, with infectious diseases experts predicting a global pandemic as far back as 2000. 

‘We had some scares with SARs and MERS and flu, but nothing that took off globally,’ she observed.

In the meantime, however, the world became more connected, allowing easier passage of the virus once it eventually arrived. 

‘Cheaper flights, we moved into high density living in Australia, we built gyms and public entertainment areas, and it all had to be closed down,’ Professor Bennett noted.

‘We built a world the virus liked.’

KEY THOUGHTS FROM EXPERTS ON WHAT WE’VE LEARNT FROM THE COVID-19 PANDEMIC 

Professor Emma McBryde, infectious diseases physician from James Cook University: 

‘It’s changed the perception of epidemiologists and modellers as fringe people with small interests in tiny things, to putting them front and centre.  

‘One of the things we’re going to have to do is go back to the start and look at every stage and ask what we should have done differently. 

‘One of the things we could have done differently is shut down the whole country really fast and have avoided the first wave altogether.

‘In order to do that, we would need to have some sort of ‘rainy day’ fund to help industries, like the airline industry, survive.’

Professor Paul Griffin, infectious diseases physician and microbiologist from the University of Queensland:

‘We didn’t have any existing vaccines so we had to start from the ground up – we obviously had technologies that helped us do that.

‘We had no effective therapy [against Covid], that was something that was lacking initially. That’s why I guess our response was more heavy-handed than we would have planned for in an influenza pandemic.

‘Plus there was no background immunity. There were lots of reasons this was more challenging than what we expected from influenza but it did show we needed a broader plan to deal with other pathogens as well.’ 

Professor Catherine Bennett, chair of epidemiology at Deakin University:

‘We’ve now identified as risks things like workers working across multiple workplaces in aged care or health care. We learn from that and hopefully design some of those things out, so they’re no longer part of our workplace structure.

‘The massive outbreaks that came quite quickly in aged care – that whole process of having to furlough so many staff and bring in nurses from the hospital system when the hospitals were stretched – all of that is really hard to plan for but we now know you have to do that type of modelling.

‘Modelling is a major tool but we also have to look back as to what worked and what didn’t work.

‘We have much better data than anywhere else in the world because of the effort we put into contact tracing. We now need to do really detailed analysis of that data. Who gave the virus to who, that level of detail.’

Professor Nancy Baxter: ‘Why on earth would the Commonwealth decide it wanted to run part of the [vaccine] program?

Professor Nancy Baxter, head of Melbourne University’s School of Population and Global Health:

‘One of the key areas that should never happen again is the vaccine rollout. 

‘The states have run the vaccine programs through public health units, and they run them well and know how to do it.

‘Why on earth would the Commonwealth decide it wanted to run part of the program? You had a disjointed program and a body that doesn’t really know how to deliver trying to deliver. That should never happen again.

‘You can say you’re going to prioritise certain communities but then you actually have to do it. 

‘Specifically I mean the Aboriginal and Torres Strait Islander and disabled communities – both of them were prioritised and yet neither was reached adequately. 

‘The reason these communities are at risk is because they’re difficult to reach so you actually have to prioritise reaching them.’