Marie McInerney writes:
The continuing increase in COVID-19 cases in Victoria, which hit a new daily record of 484 on Wednesday, is shining a harsh spotlight on the broader risks of insecure work – just as the Federal Government signals cuts to income support and the reintroduction of ‘mutual obligation’ requirements.
Victorian Premier Daniel Andrews revealed a detailed analysis of 3,810 COVID-19 cases in Victoria over two weeks in July, showing that nearly nine in ten people failed to isolate between when they first felt sick and when they went to take a COVID-19 test.
Andrews said he was “equally saddened” to report that, having been tested, 53 percent of those cases did not isolate until they received the results of the tests.
“People have felt sick, got symptoms, and they’ve kept going shopping, just kept going to work…just gone about their business,” he told a media conference.
“(They’ve been) at the height of their infectivity and just continued on as usual,” he said, warning that continued breaches would mean the current six week Stage 3 lockdown in Melbourne and the Shire of Mitchell will “run much longer than that”.
Victoria’s ongoing coronavirus surge has prompted the Australian Medical Association to call for National Cabinet to urgently convene to adopt a nation-wide position on face masks, which became mandatory in Melbourne at midnight, and to strengthen domestic border controls.
Meanwhile, justice advocates and Aboriginal and Torres Strait Islander organisations have renewed calls for dramatic reductions in prison numbers, following news that six adult prisons and two juvenile detention centres in Victoria are now under lockdown after a prison guard, an education officer and a remand prisoner tested positive this week.
“The Victorian Government must urgently and responsibly release at risk Aboriginal and Torres Strait Islander people from adult and youth prisons, due to our high vulnerability to severe and lethal impacts of COVID-19,” said Nerita Waight, co-chair of the National Aboriginal and Torres Strait Islander Legal Service (NATSILS), warning COVID-19 could “spread like wildfire” in prisons, as it has in the United States.
Global rates “accelerating”
Victoria’s struggle to contain the virus and keep it out of high risk settings comes as global coronavirus infections surged past 15 million on Wednesday, and show “no signs of slowing”, according to a Reuters tally.
The United States still tops the count, with 3.91 million infections, followed by Brazil, India, Russia and South Africa, but Reuters reports that coronavirus case numbers are accelerating the fastest in the Americas, as new waves emerge in Hong Kong, Spain and France.
“After the first COVID-19 case was reported in Wuhan, China, in early January, it took about 15 weeks to reach 2 million cases,” it said. “By contrast, it took just eight days to climb above 15 million from the 13 million reached on July 13.”
The head of the UK’s Wellcome Trust, Sir Jeremy Farrar, warned that failure by world leaders to wisely and equitably manage the pandemic’s implications for global health, society and governance could “shake the world order to its foundations”.
“How world powers choose look after themselves (versus the) rest of world will define global politics over decades,” he said in a powerful Twitter thread (see it in full below).
The AMA also sounded a warning for the National Cabinet to address growing concerns in Australia, saying the country benefited from its quick and decisive action during the early COVID-19 phase “when nationally consistent community messages were issued”.
“It is time for the National Cabinet to reassert its leadership with strong and decisive policies and messaging on mask use, border management, mobilising national contact tracing resources, and commitment to zero health worker deaths,” said AMA President Dr Tony Bartone.
The AMA wants National Cabinet to commit to:
- Releasing community transmission modelling to inform the community about virus spread patterns.
- Developing a national network of contact tracing to allow targeting of resources to areas of high need during community transmission outbreaks.
- Zero health worker deaths.
Both the AMA Northern Territory branch and the Aboriginal Medical Services Alliance of the NT (AMSANT) have criticised the Northern Territory’s response, which relies on self-quarantine, with AMSANT warning this approach is “a disaster waiting to happen”.
Australia’s health report card
The latest report card on Australia’s health, launched on Thursday by the Australian Institute of Health and Welfare, highlights the high risk of COVID-19 outbreaks for Aboriginal and Torres Strait Islander people and communities. Among other reasons, it cites overcrowding of housing and “other barriers related to institutional racism”.
Australia’s Health 2020 says that, while the number of COVID-19 cases in Australian Indigenous communities has been low, there have been outbreaks in Indigenous populations in Brazil and in Navajo Native Americans in the USA.
The World Health Organization also this week focused on the risk of COVID-19 to Indigenous people, saying it was particularly concerned about the impact of the virus on Indigenous peoples in the Americas, “which remains the current epicentre of the pandemic”.
The AIHW biennial report found that Australians are living longer – life expectancy for males born in 2016–2018 was 80.7 years and 84.9 years for females, up from 55.2 and 58.8 years, respectively, for those born in 1901–1910.
It reports that an estimated 11.6 percent of Australian adults (aged 18+) were daily smokers in 2019 – a decrease from 12.8 percent in 2016, and 25 percent in 1991, and that the coronary heart disease death rate has fallen 82 percent since 1980 but it is still our leading single cause of death.
It said about 7 in 10 (69 per cent) people survived at least 5 years after a cancer diagnosis during 2012–2016 – an improvement from about 5 in 10 (51 per cent) people during 1987–1991.
It also noted improvements in the health of Indigenous Australians in recent years, including a fall in the Indigenous death rate across all age groups – except for those aged 75 and over – between 2008 and 2018 and decreasing rates of ear disease among Indigenous children.
The report also contains data on the first four months of COVID-19 in Australia, from 25 January 2020 (when the first Australian cases were confirmed) to the end of May, and says the pandemic has the “potential to seriously affect not just those who are elderly or in very poor health, but also people who may not have been considered to be at the highest risk”.
Despite the perception that most people who die from COVID-19 did not have a long expected life span prior to developing it, Australians who died lost more years of their expected lifespan on average than those who died of our three leading causes of death: coronary heart disease, dementia and stroke.
The report notes that the large scale changes to society required to contain this virus also have a number of potential adverse health and welfare effects, “although there are interventions that can be put in place to reduce the risk of these”.
It does not go into detail about these interventions, but outlines some possible negative impacts: increased psychological stress in the first lockdown, changes to diet, exercise and alcohol intake, concerns about family violence, and – observing the positive impact of Job Keeper and Job Seeker support – large-scale loss of employment and the general economic downturn.
It is also looks at the potential for positive impacts: reduced influenza rates (due to social distancing), and possible lower mortality from traffic accidents and air pollution, but says “it is very complex to weigh the positive and negative effects against each other”.
Challenging phase
Victoria’s new daily peak in cases on Wednesday brought the Australian total to a record 502 cases of COVID-19, the single largest daily number of cases nationally since the pandemic began. Another 16 cases were reported in New South Wales, with one each in Queensland and South Australia.
The five million residents of Melbourne and the neighbouring Shire of Mitchell face at least another month in Stage 3 lockdown, and as at midnight, $200 fines if found not wearing masks out of their homes, although there are a small number of exemptions on health, work and activity grounds.
“We’re at a really, really challenging phase of this pandemic,” Victoria’s Chief Health Officer Professor Brett Sutton said, saying the state’s coronavirus battleground was now very different to the first national lockdown when cases were mostly driven by people returning from overseas.
Hundreds of Victoria’s current cases have now been identified in 45 separate aged care facilities across the state, including 69 linked to one facility in the northern suburbs.
Sutton told a media conference that the spread of cases in Victoria now involves much more complex populations and environments than earlier, with the added problem that people were becoming fatigued and “inured to the numbers”.
If any of the states had recorded numbers close to 500 in March or April, “we would have been staying in our bedrooms and not leaving the house”, he said.
“Desperate circumstances”
Andrews said the Government’s focus was not on implementing Stage Four restrictions but instead on high risk workplaces, such as aged care, meatworks and supply chain businesses – low paid, highly casualised workforces where many people might have to risk going to work while sick because they do not have sick leave.
“This is a commentary on insecure work,” he said, stressing that he was not looking to blame or shame people who felt they could not afford not to work.
Victoria has already introduced a $1,500 hardship payment for people who have to quarantine or isolate but don’t have sick leave, and Andrews foreshadowed further support.
Federal Health Minister Greg Hunt announced this week funding for residential and home care providers to:
- Ensure aged care employers can cover any additional entitlements to enable employees to work at a single site
- Engage and train additional staff where existing employees are unable to work due to self-isolation requirements and/or where a more intensive workforce mix is required
- Support aged care workers who are unable to work due to symptoms, self‑isolation or travel restrictions, regardless of whether they would usually receive paid leave
- Provide alternative accommodation so workers who live or work in hotspots can continue to work.
But calls for the Federal Government to roll out paid pandemic leave for all workers to encourage Australians to self-isolate if they need to have gone unheeded to date, despite Andrews revealing that about 80 percent of Victoria’s cases since May have been driven by transmission in workplaces.
That will likely add to the pressure on the Federal Government’s income support, after it announced this week the coronavirus income supplement of $550 a fortnight will be cut by $300 in September, and that it would be “reintroducing mutual obligation” again, despite the unemployment rate climbing in July to a 22 year high of 7.4 percent.
Criticising the moves, Australian Council of Social Service (ACOSS) CEO Dr Cassandra Goldie said people “need financial security and certainty at this anxious time”.
She urged an adequate, permanent fix to income support and called on the Government to close gaps that have left temporary migrants “in desperate circumstances”, and to rule out any plans to bring forward income tax cuts that would mainly benefit people earning more than $100,000 per year, “doing nothing to help the millions in desperate financial need”.
(In this CroakeyVoices podcast, ACTU assistant secretary Liam O’Brien says Australia “holds the world record” when it comes to insecure work, with “one in ten workers going to work while sick” because of lack of sick leave entitlements. This earlier Croakey story also outlines the issues).
Hope and ruin
Despite the unrelenting surge of the coronavirus globally, WHO Secretary General Dr Tedros Adhanom Ghebreyesus struck a hopeful tone at his most recent media conference.
Recalling the success of efforts in Africa to fight Ebola, despite poverty and conflict, he said “no matter how bad the situation there is always hope”.
“With strong leadership, community engagement and a comprehensive strategy to suppress transmission and save lives COVID-19 can be stopped,” he said.
“We do not have to wait for a vaccine.”
However, the risks of ruin are high, according to Sir Jeremy Farrar’s Twitter thread, which said:
It is discomforting that most people still underestimate true impact of #Covid19. Immediate effects are so shocking that we are all caught up in them.
But longer-term implications may be more profound still. If we are not careful, they will shake the world order to its foundations
To understand the crisis fully, imagine concentric ripples generated by a stone thrown into a pond. Innermost circle is immediate impact of the virus: fear, illness and death.
The second, larger circle describes COVID-19’s indirect health effects, such as missed cancer screenings. In the 2014 Ebola outbreak, more people died of malaria in west Africa than of the virus itself. It can take years for people to regain trust in health care systems.
The third circle, the social and economic impact of rising joblessness & shrinking economies, is larger still. Like every crisis, pandemic will amplify existing social fractures and inequalities. This will have political consequences. Some governments may fall as result COVID-19.
Leads to 4th & biggest circle-geopolitics. How world powers choose to look after themselves vs rest of world will define global politics over decades. Many governments come to face criticism for their perceived/actual failure protect citizens natural response will be blame others.
Still, none of the above ripple effects are inevitable.
Of the first two circles, it is not too late to improve disease-surveillance measures, public health and clinical care measures to reduce the impact of Covid-19’s first wave, and to prepare for potential second waves.
We must invest the $31bn needed in diagnostics, treatments and vaccines & build health systems for all, regardless of ability to pay. This is the only true exit strategy from the pandemic.
Social & political impacts 3rd circle can be mitigated. Most vitally needed responses: debt relief poorer countries; investment help digital transition; support green technologies &a carbon neutral world; better education; anti-corruption fighting; enhanced democratic institutions
There is the 4th circle we also face a choice. We can choose nationalistic routes that blame others for our problems. Or we can work together to forge a better, shared future.
There are historical parallels. International institutions such as UN, WB & WHO that were established after WW2, were born of a moment of enlightened self-interest by leading nations. These institutions have been central to the world’s largely peaceful order of the last 75 years.
Today, they require reform. But they are also needed more than ever. Giant social,scientific & technological advances humanity saw during the later half 20thC grew out of global commitment to sharing. This did not happen by chance. It happened as a result of choices that were made
The effects of COVID-19 have been & will continue to be devastating. But infectious disease & pandemics are not only global challenges that we face. We urgently need to address other issues, including climate change, access to clean water, antimicrobial resistance & mental health
Like coronavirus these problems transcend borders. Will not be defeated insular nationalism, blaming others or drifting into more polarised world – this leaves everyone more vulnerable. Rather they can be solved enhancing international co-operation & developing sense shared destiny.
Not inevitable #COVID19 ripples out these 4 circles of ruinous effects. But avoiding this requires leaders who lay out honestly challenges that we face & then, equally honestly, how to deal with them. Choices we make today will help define the 21st century.”
Note: Croakey has asked NT Health Minister Natasha Fyles if the NT is considering tightening its border, particularly given concerns of high risks to Aboriginal and Torres Strait Islander people, and to remote communities, which shut down urgently in the first phase of the pandemic.
In a series of questions, we have also asked the Minister to provide advice on the deployment of US Marines to Darwin through the pandemic, after a marine tested positive earlier this month on arrival in the Northern Territory. We will update this post with any response.
See Croakey’s previous coverage of COVID-19
the #JusticeCOVID series on prisoner health
and the #HealthReImagined series
