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Four years later, a call for better public health communications on COVID amid the ongoing “global threat”

Introduction by Croakey: This month marks four years since the first COVID case in Australia.

While approximately 40 percent of Australians no longer consider COVID “much of a continuing risk” according to a 2023 survey by Professor Deborah Lupton, the World Health Organization COVID-19 technical lead Dr Maria Van Kerkhove recently said “COVID is still a global threat”.

“We don’t know everything about the virus,” including potential long-term cardiology, pulmonary and neurological complications, but it is causing too much preventable burden, Van Kerkhove said.

Tweet by @UNGeneva. #COVID19

To date, more than 11.7 million cases have been reported and more than 24,265 deaths have been attributed to COVID in Australia, noting that due to varying reporting and protocols, these data – particularly for case numbers – are likely to be much higher.

The ABS reports that 20,755 deaths between March 2020 and November 2023 were people who had died with or from COVID.

SARS-COV-2 variant of interest JN.1 has become dominant across Australia and many countries across the globe. The monovalent vaccines approved in Australia remain effective against the JN.1 variant, according to a recent article by Associate Professor Suman Majumdar, Professor Brendan Crabb, Emma Pakula and Associate Professor Stuart Turville published in The Conversation.

However, as recently reported at Croakey (here and here), vaccine uptake is unequal. This highlights the importance of identifying barriers to uptake and targeting vaccine programs to people most at-risk of under vaccination. Additionally, “comprehensive strategies to reduce COVID transmission and impacts, with the least imposition (such as clean indoor air interventions)” are important, Majumdar and colleagues wrote.

Lupton, from the University of New South Wales and member of OzSage, has been exploring Australian’s experiences of the pandemic “to track how Australians’ attitudes around COVID have changed” since May 2020.

In the article below, first published in The Conversation, Lupton writes that experiences have evolved from confusion to trust in leaders to losing trust in leaders and now, complacency. She calls for leaders to provide “much better and more frequent public health campaigns and risk communication”.


Deborah Lupton writes:

It might be hard to believe, but four years have now passed since the first COVID case was confirmed in Australia on 25 January, 2020.

Five days later, the World Health Organization (WHO) declared a “public health emergency of international concern”, as the novel coronavirus (later named SARS-CoV-2) began to spread worldwide.

On 11 March, the WHO would declare COVID a pandemic, while around the same time Australian federal and state governments hastily introduced measures to “stop the spread” of the virus. These included shutting Australia’s international borders, closing non-essential businesses, schools and universities, and limiting people’s movements outside their homes.

I began my project, Australians’ Experiences of COVID-19, in May 2020. This research has continued each year to date, allowing me to track how Australians’ attitudes around COVID have changed over the course of the pandemic.

Evolving pandemic experiences

We recruited participants from across Australia, including people living in regional cities and towns. Participants range in age from early adulthood to people in their 80s.

The first three stages of the project each involved 40 interviews with separate groups of participants (so 120 people in total). These interviews were done in May to July 2020 (stage 1), September to October 2021 (stage 2), and September 2022 (stage 3). Stage 4 was an online survey with 1,000 respondents, conducted in September 2023.

Limitations of this project include the small sample sizes for the first three stages (as is common with qualitative interview-based research). This means the findings from those phases are not generalisable, but they do provide rich insights into the experiences of the interviewees. The quantitative stage 4 survey, however, is representative of the Australian population.

The findings show that as the conditions of the pandemic and government management have changed across these years, so have Australians’ experiences.

In the early months of the pandemic, some people reported becoming confused, distressed and overwhelmed by the plethora of information sources and the fast-changing news environment. On the other hand, seeking out information provided reassurance and comfort in response to their anxiety and uncertainty about this new disease.

Australians continued to rely heavily on news reports and government announcements in the first two years of the pandemic. Regular briefings from premiers and chief health officers in particular were highly important for how they learned what was happening, as were updates in the media on case numbers, hospitalisations, deaths and progress towards vaccination targets.

Trust has eroded

Australians appear to have lost a lot of trust in COVID information sources such as news media reports, health agencies and government leaders. Early strong support of federal, state and territory governments’ pandemic management in 2020 and 2021 has given way to much lower support more recently.

My 2023 survey (this is published as a report, not peer-reviewed) found doctors were considered the most trustworthy sources of COVID information, but even they were trusted by only 60 percent of respondents.

After doctors, participants trusted other experts in the field (53%), Australian government health agencies (52%), global health agencies (49%), scientists (45%) and community health organisations (35%). Australian government leaders were towards the lower end of the spectrum (31%).

In 2021, Australians responded positively to the vaccine targets and “road maps” set by governments. These clear guidelines, and especially the promise that the initial doses would remove the need for lockdowns and border closures, were strong incentives to get vaccinated in 2021.

Unfortunately, the prospect that vaccines would control COVID was shown to be largely unfounded. While COVID vaccines were and continue to be very effective at protecting against severe disease and death, they’re less effective at stopping people becoming infected.

Once very high numbers of eligible Australians became vaccinated against the delta variant, omicron reached Australia, resulting in Australia’s first big wave of infection.

This led to disillusionment about vaccines’ value for many participants.

In the 2023 survey, respondents reported a high uptake of the first three COVID shots. But when asked whether they planned to get another vaccine in the next 12 months, almost two-thirds said they did not, or they were unsure.

Enter complacency

Complacency now seems to have set in for many Australians. This can be linked to the progressive withdrawal of strong public health measures such as quarantine, mandatory isolation when infected, and testing and tracing regimens.

Meanwhile, the media, government leaders and health agencies have played less of an active public role in conveying COVID information. This has led to uncertainty about the extent to which COVID is still a risk and lack of incentive to take protective actions such as mask wearing.

In 2023, after mandates had ended, only nine percent of respondents said they always wore a mask in indoor public places. Only a narrow majority of respondents even supported compulsory masking for workers in healthcare facilities.

The 2023 survey confirmed many Australians no longer feel at risk from COVID. Some 17 percent of respondents said COVID was definitely still posing a risk to Australians, while a further 42 percent saw COVID as somewhat of a risk. This left 28 percent who did not view COVID as much of a continuing risk, and 13 percent who thought it was not a risk at all.

COVID is still a risk

Whether or not people feel at continuing risk from COVID, the pandemic is still significantly affecting Australians.

The 2023 survey found more than two-thirds of respondents (68%) reported having had at least one COVID infection to their knowledge, including 13 percent who had experienced three or more. Of those who’d had COVID, 40 percent said they experienced ongoing symptoms, or long COVID.

If the pandemic loses visibility in public forums, people have no way of knowing the risk of infection continues, and are therefore unlikely to take steps to protect themselves and others.

Updated case, hospitalisation, death and vaccination numbers should be communicated regularly, as used to be the case. To combat confusion, complacency and misinformation, all health advice should be based on the latest robust science.

Australians are operating in a vacuum of information from trusted sources.

They need much better and more frequent public health campaigns and risk communication from their leaders.

About the author

Professor Deborah Lupton is a social researcher at the Centre for Social Research in Health and Social Policy Research Centre, UNSW Sydney. She has a background in sociology, media and cultural studies, as well as training in public health. She has written about the social, cultural and political dimensions of risk, including in medical and health contexts, for around three decades now. She is a member of OzSAGE and is involved in the Clean Air Forum group. This article was first published under the headline, ‘It’s 4 years since the first COVID case in Australia. Here’s how our pandemic experiences have changed over time’.

Further reading

The emergence of JN.1 is an evolutionary ‘step change’ in the COVID pandemic. Why is this significant? by Associate Professor Suman Majumdar, Professor Brendan Crabb, Emma Pakula and Associate Professor Stuart Turville in The Conversation

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