COVID isn’t in rearview mirror

COVID-19 isn’t in the rearview mirror, and we need to change our mindset accordingly in order to reach a low COVID sustainable future, says Burnet Institute Director and CEO Professor Brendan Crabb AC.

In a broad-ranging interview with ABC NewsRadio‘s Thomas Oriti, Professor Crabb spoke about mask mandates, COVID complacency, and how we need some straight talking about the current COVID situation in Australia.

A transcript of the interview is provided below.

Thomas Oriti:

With thousands of new COVID cases being reported across Australia, hospitals as well under enormous strain, elective surgery is once again at risk of being suspended in parts of the country. The most recent national statistics show wait times deteriorated significantly during the first year of the pandemic, doctors and patient advocates say the situation has deteriorated further now.

Meanwhile, a lot happening in this space, the head of the Australian Medical Association Dr Omar Khorshid says it’s time to bring back mask mandates as the peak of the latest wave of COVID is still a few weeks away.

Let’s get more on the COVID situation. I’m joined now by the Director and CEO of the Burnet Institute in Victoria, Professor Brendan Crabb. Professor, good morning. Thanks for joining us.

Professor Crabb:

Good morning Tom. Good morning everybody.

Thomas Oriti:

Can we start with that suggestion by Omar Khorshid from the AMA, governments should seriously consider bringing back mask mandates to help curb the latest wave of COVID? Do you agree with that?

Professor Crabb:

Well, we’re in an emergency situation once again. And vaccines as brilliant as they are, are not a force shield, they’re not enough. And masks are one of the few tools we have to curb transmission. So I certainly support mask use, and I am a supporter of mandates in certain circumstances. The real question though Tom, is whether we’re mentally prepared as a country. You know, it’s sort of like going from zero to a hundred.

We’ve been in the mindset for most of this year – a wrong one from my perspective – that COVID is in the rearview mirror, that it was yesterday’s problem. It never was yesterday’s problem, but it made us quite complacent. And now all of a sudden, we’re being asked to dust off the masks.

So it’s a big challenge, and I think it needs to be framed in the context of a bit of a mea culpa, you know, things have not gone according to plan, we have far more cases than we thought we would have. And as a result, we’ve got more death. We’ve got vastly more disruption to our society than we thought. And we’ve got this long COVID burden already, and one that’s growing. So yes, I do support the call for mask mandates. But I think the context that that’s presented to the Australian people is a very important one.

Thomas Oriti:

Yeah and I note, the Chief Health Officer, Professor Paul Kelly held that news conference yesterday warning Australia was at the start of this wave and not the end, urging businesses to let employees work from home, if possible. This all seems like deja vu, it’s happening again, is this just the new normal now? We will keep seeing these variants, it will continue to mutate, and it’s just not going away?

Professor Crabb:

I don’t think it needs to be the new normal, if our strategy changes. You know we currently have a strategy that says we’re not too worried about how much transmission there is, how much COVID there is in the community, provided we protect the most vulnerable people in our community, our elderly and our immunocompromised, and try and protect our hospital system.

Now, that’s my point about the strategy, it just hasn’t worked well enough, it has worked a bit, the case fatality rate has dropped a lot. But what wasn’t anticipated was just how many cases of COVID there would be and the frequency of reinfection, the speed of virus evolution, and how poor it was at inducing immunity even against itself.

So a change of mindset to say, we can put in place sustainable, non-disruptive measures: clean air – and if you don’t have clean air, wearing a mask – getting tested and isolating if you’re positive, of course getting vaccinated.

And if you do these things in peacetime in inverted commas, not just when in an emergency circumstance, we can keep a lid on these emergencies. But for the moment, we are- I support Paul Kelly and Mark Butler struck a good tone yesterday. People should be under no illusion, this is a very difficult time ahead. We need business to do their bit, just as we need individuals to do their bit.

But working from home is not a sustainable solution. And so this mind shift is really important, that it accompanies this emergency. And we don’t think at the end of it, we’ve pushed through, that’s it. We’ll face another wave after this one and probably another wave after that. So our society needs to be much better prepared so we don’t face these peaks.

Thomas Oriti:

I mentioned just before our interview elective surgery. I just want to ask you about that because some doctors are calling for a plan to address the blowout in elective surgery wait times. Some doctors we’ve spoken to on the program in recent times have even expressed concern about that very term. It might be called elective surgery, doesn’t mean it’s not serious, doesn’t mean it shouldn’t be done. Do you think there should be a national response to increasing elective surgery wait times? I mean, what are some of the solutions that we could be seeing in this situation at the moment?

Professor Crabb:

Well, elective surgery per se is sort of not my area of expertise, but to the point you’ve just said, it’s not some discretionary, nice to have thing for most people. So extending the time doesn’t really help those people, it hurts those people.

Now, the root cause is having lots of COVID. And that’s what we need to address. And we’ve had lots of COVID all year, the lowest daily count we got down to this year was 20,000 cases, the lowest daily death count was 20. The hospital system has been under enormous pressure since December last year consistently, despite the narrative. And that’s what needs to be addressed.

We have to move from a high COVID position that we’re currently in, to a low COVID sustainable future.

And that’s what’s really going to help the health system in general, including elective surgery. What needs to happen in this emergency time is a matter for the experts, but sustainably, we simply have to get COVID rates down.

Thomas Oriti:

Now, I mean, sobering to hear those numbers you mentioned a minute ago. And you’re right, there has been a feeling among some people we’ve spoken to that this has slipped off the radar, it’s no longer headline news. We’re seeing double digit deaths on a daily basis. And I’ve heard concern that COVID is on track to be our number one killer of all causes of death this year, so outpacing even coronary heart disease. Do you feel there’s been enough effective public messaging at the moment? I note what you said yesterday about striking the right tone with the Chief Health Officer and the Health Minister yesterday, but just in general, do you think that messaging is working at the moment?

Professor Crabb:

Well, they’ve got an uphill battle. I do think the messaging was good yesterday, but we’re coming from a very low base, where everyone from our Prime Minister to every premier and territory leader has led us to believe that COVID is in the rearview mirror, that phrase is literally being used. And of course, it’s been embodied in so many other ways, masks being ripped off with smiles and so on. And as a result, the community has a deeply embedded sense that things are okay.

So it’s very difficult to turn around and suddenly say, actually they were never okay. We were told that deaths were just in the elderly, or in people who had some other condition or in some way, it was minimised. And this was misleading, and really quite a dangerous view to embed in the community.

Because here we are now with deaths looking like they’re going- COVID looking like it’s going to be the number one killer as you said. It’s going to be close enough, no doubt about that.

Somewhere between 10 and 20,000 Australians this year will die of COVID, all of whom would be alive if it wasn’t for COVID, at least for quite some time.

It’s just not true that they were going to die the next day sort of thing. So we’ve kind of been misled on that front I’ve got to say, intentionally or probably unintentionally largely. We need some straight talking about COVID, about its impact on mortality, and its impact on society more generally, work absenteeism, and so on, on our health system, and especially on long COVID because it affects just all of us. And from there, I think the community can move forward, no more minimising is the message.

Thomas Oriti:

Yeah, particularly considering long COVID and the pressures that that could create on the health system going forward. I’ve just got one final question. And thank you for your time Professor, but with people as you’ve worded it, thinking that COVID is in the rearview mirror so to speak, babies and young children aged six months to five, we’re now hearing they’re a step closer to receiving a COVID vaccine, the TGA giving that Moderna paediatric vaccine the green light yesterday. It’s not available yet, it’s got to be approved by and recommended by ATAGI. But if people think it’s in the rearview mirror, and as we’ve heard, even the uptake of the third dose amongst adults hasn’t been as high as a lot of health experts would like to see, do you think there’ll be much uptake for babies?

Professor Crabb:

Well, let’s see what ATAGI says. I mean I think it once again, this relates to the framework that COVID is presented to the community, you know, if it’s presented in realistic terms, that means the bad news and the good news. The bad news is COVID has not gone away. We’re going to continue to face waves of new variants and our immunity’s not good enough to stop that.

The good news is, there are measures that we can put in place around clean air, around masks if you don’t have access to clean air, around testing and isolation, and most especially around vaccination that can sustain us through these difficult times.

Now, vaccination rates in adults and older kids, it’s dropped off tremendously. And I think it’s in and around that messaging. So people need to understand that very real situation. And even if they’ve been vaccinated and previously infected, their likelihood of reinfection is still very high, you’re not magically protected. So it’s that messaging that I think will help vaccine uptake. Vaccines are crucially important. They are the most important thing any of us can do. They’re just not the only thing we should do. And don’t think if you’ve been infected before you’re protected because you’re probably not.

Thomas Oriti:

Professor, it’s a pleasure. Thank you very much for giving us the time this morning. Appreciate it.

Professor Crabb:

Thanks Tom.

Thomas Oriti:

Professor Brendan Crabb there, Director and CEO of the Burnet Institute in Victoria.

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