Pearls and Irritations

The plan envisages progressing through four ‘phases’. The current phase A is premised on continued suppression through restricted international travel at the current very low rates; further ‘stringent and short’ lockdowns if outbreaks occur; and a rapidly accelerating vaccination program. Phase B kicks off once 70% of the adult population has received a second dose. In describing phase B, suppression drops out of the language used; now the aim is to ‘minimise serious illness’. Increased vaccination rates are to be achieved through ‘encouraging uptake through incentives and other measures’.

Phase C comes into existence once 80% are vaccinated, when most if not all international travel restrictions are lifted. The final phase D is envisaged as a ‘steady state’ in which we live with COVID-19 in the community and deploy various health management measures to limit its impact. With each phase, there is a change in emphasis on the use of lockdowns and internal border closures, although they remain in place in some form right up to phase C, with ‘highly targeted lockdowns only’.

The reliance on vaccination targets leaves progression through the phases hostage to opt-outs or vetos by two key players: state government political leaders and the unvaccinated portion of the population.

The reluctance of state premiers to commit to a wholly national approach is explicitly embedded in the plan, albeit in somewhat tortured language. It is worth quoting in full:

‘Phases [are] triggered in a jurisdiction when the average vaccination rates across the nation have reached the threshold and that rate is achieved in a jurisdiction expressed as a percentage of the eligible population (16+)…’

I take this to mean there are two conditions to trigger moving to the next phase. To get beyond phase A we require 70% of the adult population to be vaccinated in each state and territory as well 70% as across the nation. In principle, if WA (for example) reaches 60% but all other conditions are met, they have a veto over moving to phase B. This is in one sense simply a statement of constitutional fact: the states have powers to act unilaterally despite the existence of the plan, and the national government has no enforcement mechanisms.

So, this is a federal, not a national, plan. In this spirit, maybe there is a potential federal get-out: if 70% is reached both nationally and in New South Wales, Sydney Airport might open following a bilateral agreement between New South Wales and the Commonwealth (although border closures by other states would no doubt follow).

In sum, everything is being put off to a future National Cabinet meeting when there will be a state-federal wrangle about moving to phase B when the 70% target is met nationally, even though it is stuck at less than 70% in one or more states or territories.

Just as the political realities of the federal system shape these uncertainties, so also do they help frame the other flaw in the plan: the lack of timelines. The simple political fact is that no commitment to timelines among the nation’s state and federal leaders would be credible. In the case of a Prime Minster facing an upcoming election, it would be political suicide to open international borders before Queenslanders (for example) felt tolerably safe. The state premier and the federal opposition would have a field day. Agreeing to meaningless timelines now would simply discredit the ‘National Plan’ even more. Their absence also gives the Prime Minister ‘cover’ (and others to blame) when he faces an election.

The second veto player obstructing the implementation of the plan is the unvaccinated minority. The success of the plan depends on the willingness of enough Australians in each state to get vaccinated. So, the minority who aren’t vaccinated (even a minority in one state) are being granted the power to deny all of us the full benefits of ‘getting back to normal’. Little new is proposed explicitly to incentivise accelerated uptake so that the thresholds for progressing from one phase to the next are reached. ‘Easing of restrictions on vaccinated residents’ is proposed as a carrot to get vaccinated in phase B, but this is qualified by a ‘TBD’ in parenthesis (presumably in part to cater for state premiers who don’t want to give up border closures as an option).

For the most part, state premiers have been rewarded by their electorates for locking down their states and keeping the virus at bay. For the vaccine complacent and hesitant, border closure and lockdowns will remain an alternative, credible way of staying safe. They may prefer to stick to what they know.

Of course, the best scenario is the most optimistic one – that access to vaccines is made easy for everyone and that enough Australians in each state and territory will see the benefit and need of vaccination so as to achieve the targets swiftly. Perhaps also the inconvenience and pain of lockdowns, which are still likely during phase B, might be an incentive to encourage greater vaccine uptake. But experience so far (albeit with a botched vaccine rollout) does not unequivocally support either scenario.

Perversely, perhaps the key to the plan working is that lockdowns and border controls cease to be successful. New South Wales in its current state of lockdown strife is the model. Facing the threat posed by growing community spread, residents of New South Wales are showing by far the most rapid increase in vaccination rates. The new risk/benefit calculation seems to have encouraged many even to opt for the much-maligned Astra Zeneca vaccine. ‘Short, sharp’ lockdowns in other states in response to small local case numbers seem to be having only a minimal effect (if any) on vaccination rates.

At some point, if the vaccination rate stalls and phases B or C appear unreachable, consideration should be given to adding credible timelines to accompany the targets. The looming or present existence of community spread is what is most likely to urge the more complacent or reluctant to visit a clinic, a pharmacy, or their GP to get vaccinated. My guess is that if we all knew that by January the international borders would be open (and assuming by then all our vaccine supply and access problems were solved) we would hit 70% well before New Year’s Eve and 80% once international travellers began arriving in significant numbers.

Such a scenario would also require governments to proceed much more urgently with a range of stepped-up public health management measures that would enhance community protection against growing case numbers in the absence of lockdowns. These are flagged at various points in the plan – alternative and improved quarantine options, digital vaccination certificates, enhanced testing at borders and in the community, vaccine booster programs and so on.

We could then proceed to achieving the desired outcome envisaged in phase D, one that all our political leaders have apparently agreed to, namely a steady state where we ‘manage COVID-19 consistent with public health management of other infectious diseases.’

Martin Painter is Emeritus Professor of Public Administration, City University of Hong Kong. He is a graduate of the ANU and lectured at the University of Sydney Department of Government before moving to Hong Kong. He is currently a resident of Canberra, a keen birder and writes a blog at anthropocenebirder.com