Victoria is now facing a difficult choice: to continue stringent lockdowns in the hope of getting COVID-19 cases down to zero, or accepting the lesser goal of opening up once cases are in single digits.
The choice has implications for all Australians, because Victorian infections have sparked outbreaks in New South Wales and Queensland, and state border closures have had a damaging impact on domestic tourism in all states. As the New Zealand experience has shown, an ‘elimination’ strategy still has risks of the deadly virus reappearing.
In a new report released by Grattan Institute today, we show that there is no conflict between choices which are essentially made to protect public health and those which give priority to the economy. In both cases the right thing to do is to pursue a goal of zero cases before restrictions are completely eased.
The impact of the virus, public reaction to it, and public health-oriented measures in response to it, have all fallen unevenly in society. Poor people and suburbs have suffered more infections and more unemployment. Students in Year 12 are having to deal with disrupted schooling at one of the most critical times of their lives, and all school-age children have had to cope with remote schooling and reduced opportunities for interaction with friends. JobSeeker benefits have been restricted, which one consequence being that some migrants have had to rely on food-handouts to survive. More than 500 Victorians have died in the second wave.
According to the federal Health Department, about 40 per cent of the Australia population is at high risk during this pandemic. That is, about 10 million Australians are advised to be particularly careful about going outside, mixing with other people, and are warned off working in high-risk industries such as health and age care. A return to normal life for this 40 per cent will be possible only when the risk of further infections is minimised – and this essentially can only occur with zero cases.
The Grattan report estimates that Victoria will probably have to stay with restrictions until November, but restrictions can be slowly and cautiously eased from the end of the current lockdown period. The criteria for each phase of easing should be absolutely explicit, and it should also be explicit that restrictions would be reimposed if trends revesred. That will require the Victorian population giving the government the social license to maintain restrictions, and it will require the overwhelming majority of Victorians adhering to the restrictions designed to ensure social distancing. The evidence we present suggests that if Victoria ‘opens up’ completely too soon, then a zero target is essentially unachievable. That would be a devastating result. It would mean Victorians would live in a yo-yo economy, with on-again, off-again remote schooling, and uncertainty until a vaccine is found – and sadly, there is no guarantee that a vaccine will ever be found. Opening up too early would mean more outbreaks, and more deaths.
If restrictions are fully lifted before zero cases, the Victorian Government has two strategies to follow if outbreaks occur – and it should be clear about which one it has chosen.
One strategy is for lockdowns: if outbreaks occur, lockdown quickly. Under this scenario, all Victorians would be exposed to the yo-yo life.
The alternative is the test-and-trace and cross-your-fingers strategy: if outbreaks occur, rely on testing and tracing and hope that there is no super-spreader event which causes the virus to go out of control.
The Victorian Government and people should be in no doubt that either of these ‘suppression’ strategies involve uncertainty for business and the population, and both have a higher risk of lockdowns into the future. Business uncertainty and future lockdowns carry greater cost for the economy than the zero target strategy.
The politically easy answer, at least in the short term (and advocated by people who won’t bear the burden of being accountable for the decision), is to lift all restrictions sooner. But this ignores the cost to the 10 million most at-risk Victorians, and it is blind to the cost to the economy in the long term.
The Victorian government should maintain the course and continue restrictions, but with cautious and phased easing. The goal of zero active cases should be reaffirmed. That will be best for the economy in the long term – and it will save lives.
Stephen Duckett, an economist, is an Honorary Enterprise Professor in General Practice and in Population and Global Health at the University of Melbourne, Chair of the Board of Eastern Melbourne Primary Health Network, and a member of the Strengthening Medicare task force.
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