Coronavirus: How Australia’s ‘suppression’ approach is rapidly flattening the curve

Country lauded for acting ‘brave and early’, writes Gary Nunn in Sydney

Wednesday 22 April 2020 12:44
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Lockdown: two cyclists bike through the empty streets of central Sydney
Lockdown: two cyclists bike through the empty streets of central Sydney

Against all odds, Australian epidemiologist Professor John Mathews is in good spirits.

Australia has every right to hold its head up and say we’ve done well,” he tells The Independent. “I’m pretty proud of what Australia has done, really. My reckoning is we’ll come out in pretty good shape.”

As of Wednesday 22 April, in the fights against coronavirus, Australia has suffered 74 deaths and 6,625 cases, far less than the UK at 17,337 deaths and more than 129,000 cases. What is behind this apparent success?

Closing borders and locking down

Prof Mathews, a professorial fellow specialising in infectious diseases at the University of Melbourne, says a key reason behind Australia’s comparatively low statistics was its “brave and early” move to close international borders and suppress the virus.

Unlike the UK, which wasted crucial time debating herd immunity, Australia went straight for full suppression.

This involved strict limits on social gatherings – first at 500 people, then 10 then two – the goal being to contain the spread so as not to overwhelm hospitals (unlike New Zealand, which went one further with the goal of full elimination).

“They started by stopping international arrivals from China and other countries ahead of WHO advice,” he says. “We questioned what the WHO were saying early on – and got it right.”

He also cites early social distancing measures with good compliance (at least 80 per cent of the population is following the rules) and contact tracing coupled with isolation of those potentially exposed, as key factors Australia’s numbers didn’t get totally out of control.

Anyone landing in Australia from overseas had to self-isolate for two weeks and people infected on cruise ships and hotspots were traced. It was, however, mainly manual tracing, but it is set to become more sophisticated with an app later down the line.

“This meant Australia caught the curve before it took off,” he says.

Dr Norman Swan is a health broadcaster for the ABC news channel and hosts the Coronacast podcast, which has had 2 million downloads. He’s become Australia’s trusted voice of reason on Covid-19: he speaks in plain English and has been criticial of the official line. Early on, urging for a stricter lockdown, he told the government to “stop dicking around.”

“I think we’ve moved beyond flattening the curve,” he tells The Independent. “In Australia the curve is now turning right down to zero.”

“Tantalisingly, within a month we could get to no new cases. And if that lasts another month – two reproductive cycles of the virus – Australia could be left with no more cases.”

He also said that squishing the curve was the wrong goal to be talking about. “That only extends the epidemic. What you want to do is get rid of it.”

Leadership from below the PM

Leadership on the efforts to tackle Covid-19 has come from unexpected places – not from Scott Morrison, the prime minister, Swan says, but from state premiers. It’s a rare occasion when Australia’s federalism is a political advantage, he says: “The states acted independently of the federal government, who were playing catch up.”

Notably, swift, bipartisan and decisive action from the premiers of the country’s two most populous states – conservative Gladys Berejiklian in New South Wales (incorporating Sydney) and progressive Daniel Andrews in Victoria (incorporating Melbourne) – has often left the prime minister straggling.

“The federal government was slow to respond,” Dr Swan says. “The state governments didn’t wait for direction from them to act. They were consistently ahead with more pragmatic traditional public health activities.”

For example, both states announced they were proceeding with a more comprehensive shutdown of all non-essential services on 23 March, beating the government to its own, more tepid announcement that they’d be shutting indoor entertainment, sporting and religious venues.

These public health activities included preserving hospital capacity by cutting down on elective surgery and strict, early social distancing.

The ramping up of testing has also helped. According to the prime minister, Australia now has one of the highest rates of testing in the world.

This has resulted in the country’s low mortality rate, Dr Swan says.

Prof Mathers says the early action, wherever it came from, was crucial: “Australia put in serious infection control measures before things got out of control,” he says. “Almost every other country in Europe acted about a week too late – and things got out of control in that week.”

The boon of Australia’s geography

In addition to these suppression activities and public health interventions there were, however, incidental and natural advantages afforded to Australia.

This includes the fact it’s an island, with a relatively low population of 25 million spread over a large land mass. Almost half the country lives in the wider metropolitan areas of Sydney and Melbourne, which have a much lower population density than cities like New York or London.

The seasonal climate may also have helped, Prof Mathers says: “If it’s similar to the flu, warmer weather could help prevent spread,” he says.

The twenty years of uninterrupted growth it enjoyed before the pandemic also helped. “People tend to live in larger houses, spaced further apart than the stacked apartments you commonly find in Europe” he says. “There are excellent facilities and an excellent health system, making sanitisation and social distancing doable.”

Is it fair to position Australia as an emerging world leader in the efforts against coronavirus spread when it made some early mistakes? Dr Swan is cautious. “Retrospection is a dangerous thing. We were very close to becoming Britain. We were two weeks behind Italy. Authorities will deny that but it’s true,” he says.

There were also controversies over school closures (they remained open or partially open in some states) and two major cruise ship debacles – one of which, the Ruby Princess, led to infected passengers disembarking with no testing or quarantine, and contributing majorly to Australia’s spread. “We haven’t covered ourselves in glory” Swan says.

The PM may’ve been relatively slow to respond at first, but he still compares favourably to his UK counterpart, Boris Johnson, whose governance was woeful, Prof Mathers says. “The fact he missed emergency Covid meetings early on exemplifies the problem – the person ultimately responsible didn’t take it seriously enough early enough,” he says.

“The political advantage of shaking hands seemed more important than preventing infections, and he seemed to believe it wasn’t as risky as experts were trying to tell him. His actions spoke louder than words – but even his words were lacking early on.”

Based on Australia’s emerging progress, Dr Swan’s advice for Britain is to immediately close international borders, quarantine all new arrivals and all infected people for two weeks, do not reopen the economy prematurely and induce a Singaporean second wave of infections and have an incredibly extensive testing regime. “Test everyone in the country with a cough or cold – it’ll return very few positives – but it will save lives,” he says.

The next step for Australia is a contact tracing app.Forty per cent of the population needs to download it for it to be effective but levels of trust around government handling of data are low.

For Dr Swan, 67, whose Scottish accent hasn’t softened since moving to Australia in 1978, watching the spiral in his home country is “heartrending”. “I worked in the NHS and love it dearly for all its flaws. The people who have to deal with the effects of government decisions are healthcare workers – and they’re the ones who catch the disease” he says.

“It’s terribly sad because it was so preventable.”

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