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Rethinking COVID hegemony

Introduction by Croakey: Recently on ABC’s 7.30 report, Professor Brendan Crabb, Director and CEO of the Burnet Institute, spoke of the growing disconnect between the devastating toll of COVID in Australia and the benign public perception and Government narrative about the pandemic.

Other health leaders have also raised concerns about the lack of political and media focus on the numbers of Australians dying or experiencing ongoing adverse health impacts due to COVID.

This disconnect is being echoed worldwide with the World Health Organization releasing a statement reiterating that the pandemic remains a public health emergency of international concern while individual countries (including most recently the USA) wind back public health measures, sometimes with devastating results.

At this Friday’s National Cabinet meeting, the Prime Minister, state premiers and chief ministers have the opportunity to shift Australia’s dominant COVID narrative towards one focused on reducing the ongoing harms caused by this disease.

In the article below, Dr Blair Williams from Monash University provides some useful advice on how to achieve this aim, and outlines a theory of “COVID Hegemony” to describe the process of normalising the impact of COVID on our population.


Blair Williams writes:

Since the “let it rip” approach gained bipartisan support in 2022, most Australians have been infected at least once, with at least 10 percent expected to then develop “long COVID”, a multi-organ condition frequently signalled by severe symptoms.

COVID has now become the third highest cause of death in this country. As a result, mortality rates are at a historic high while average life expectancy has fallen for the first time in living memory – decreasing by 0.4 years in 2021-22 and a further 0.2 years for men and 0.3 years for women in 2022-23.

For the first 18 months of the pandemic, in 2020-21, Australia was the envy of the world. As we enter our fourth year of living with COVID, however, Australians must now face widespread infection, mass disability and a high excess mortality rate.

Why did we agree to this?

COVID Hegemony

Earlier this year, writing for The Canberra Times, I proposed the idea of “COVID Hegemony” to explain the transformation of our pandemic outlook. Hegemony, in short, refers to the dominance maintained by those in power to ensure that their preferred worldview is seen as natural, inevitable and beneficial to all, largely by manufacturing the consent of the people.

COVID Hegemony, then, can be understood as the normalisation of widespread infection achieved by those with power through coercive persuasion, to gain our consent and even approval. Divorced from realities of widespread transmission, the media, politicians and certain experts have been pushing for a “return to normal”, to “live with COVID” and to move away from “COVID exceptionalism”.

Our governments and mainstream media have persuaded Australians to accept increasing morbidity, mortality, and the erosion of our public health systems using four key strategies.

First, by adopting and promoting myths about the virus which downplay its severity – “it’s mild”, “it’s just like the flu”, “we’re all going to get COVID” and, more recently, “the pandemic is over”. As such, we perceive the pandemic as less risky and any protective measure as an overreaction.

Second, by suppressing COVID-related statistics and other information, as for example with deliberate under-testing of suspected cases, the move from daily to weekly announcements of cases and deaths or, as the ABC’s Casey Briggs recently identified, by suppressing government-commissioned COVID research, forecasts, and modelling.

Third, by adapting pre-existing beliefs or public opinion, such as using the idea of “pandemic fatigue” to remove mandated protections.

And lastly, by prioritising a hyper-individualistic discourse over a collective approach that champions shared responsibility, as for example with the mantra of “personal responsibility” and the neoliberal ideals of rugged individualism and small government on which this depends, shifting blame from the state to the citizen.

Living with COVID is only beneficial to those in business who desire a speedy return to a pre-pandemic capitalist status quo, or for those in government who want to shirk responsibility.

Professor Brendan Crabb, Director of the Burnet Institute, recently called on the ABC’s 7:30 Report for a re-set of COVID policy, arguing for an “anti-transmission strategy”. Crucial to this would be a change in mindset that could be led by the Albanese government.

The persuasive framework identified above could easily be adapted to change the current pandemic narrative and bring people onboard.

Adopting myths, suppressing information, manipulating public opinion, and prioritising hyper-individualism could, for example, be replaced by a countering of myths and misinformation, transparency around data, more inclusive pandemic discourse, and highlighting of empathy and collective responsibility.

Three key strategies

First, it is important for the Government to counter the myths minimising COVID that have taken hold throughout the pandemic. Unsupported by scientific evidence, claims like “COVID is just like the flu” or that it’s “not exceptional” create the false impression that the pandemic is over and the infection is minor, resulting in a lowered risk perception that will only accelerate transmission.

By obscuring the realities of COVID infections and the increasing rates of long-term disability with each reinfection, the Government also enables anti-vaxxers to take advantage of this information deficit to promote mis/disinformation.

For example, numerous studies have shown that COVID infection increases the risk of cardiovascular issues and even elevates the risk of sudden death in both the short and long term. The anti-vaccine community has since have taken advantage of this, arguing that the notable increase in sudden deaths is due to the vaccine – they even released an anti-vax propaganda film on the topic late last year.

Studies show that people are more likely to believe such conspiracies when they feel disempowered and anxious. Furthermore, allowing disinformation to run rampant also fosters political distrust. To counter this, governments must clearly communicate why certain public health responses are needed as well as their efficacy in order to foster trust, reduce conspiratorial thinking, and increase the uptake of COVID protections.

Second, it is likewise imperative to be transparent with COVID-related data. A first step would be to publish the data and modelling that the Government has collected throughout the pandemic. This, as Monash Professor Rob Hyndman argues, would “lead to a better society” whereas the current lack of transparency feeds political distrust, as “it is not clear why decisions are being made”.

Third, the current framing of the pandemic must be changed from one of complacency to a renewed focus on reducing transmission and harm – from “living with COVID” to “living safely with COVID”.

Integral to this would be a powerful public health campaign informing Australians of the airborne nature of the virus, encouraging businesses to install mechanisms to clean indoor air, and empowering us all with the knowledge of how we can protect ourselves and the community, for instance with a well-fitting N95 mask.

One clear and achievable goal would be to reclaim the narrative around mask-wearing – from one that impedes individual freedoms to one that protects the community, to help immobilise the imported culture war on masks that has grown domestically since we transitioned to living with COVID.

Another would be to emphasise the importance of clean air in public spaces, which has numerous long-lasting benefits, especially in schools.

Reframing the narrative

Australia has a history of successful public health campaigns and slogans, from “every cigarette is doing you damage” to “slip, slop, slap”, so an effective and positive campaign emphasising the importance of community, solidarity and care should be relatively easy and effective.

In line with this, COVID “restrictions” should be renamed “protections”. The former infers that curbing transmission is a limitation on “individual freedom”, while the latter is not only more accurate but also promotes a collective and inclusive response.

Lastly, the Labor Government – who, after all, won the 2022 election on a platform of care – must embrace empathy, collectivism, and systemic responses.

Albanese must first acknowledge the more than 10,000 COVID deaths that occurred under his watch and then admit that the current national plan is not working. As Public Health Association of Australia President, Adjunct Professor Tarun Weeramanthri, recently told Croakey: “the first decline in life expectancy in Australia in living memory … alone should trigger a rethink and potentially a reset of the COVID-19 Management Plan.”

An empathetic and comprehensive approach to the pandemic is needed. Instead of promoting a “you do you” attitude that pushes vulnerable people out of all areas of public life, governments should be ensuring the safety and the social rights of those most at risk.

What we all can do

As Chris Wallace has noted, Albanese is currently receiving high approval ratings, which means there is little incentive for policy change, yet “poll leads can turn around quickly for even the most popular governments.”

It is up to us to put pressure on this Government to reset the pandemic strategy.

Richard Denniss recently made a compelling case for why we need to care, noting the long-lasting health impacts, increasing risk of death, shorter life spans, shortages (both of materials and skills) and accumulative damage to the economy.

Just as we expect clean, drinkable water at the twist of a handle, we should likewise expect the same from air shared in public spaces. We each have the ability to push back against the laissez-faire narratives favoured by the Government.

We can also model good behaviour in our own lives by wearing well-fitting N95 masks in public spaces and encouraging others to follow suit, ensuring the COVID-safety of organised events and asking about those you’re attending, as well as informing yourself and others of the realities of the virus.

The pandemic is not going away any time soon and will only be prolonged if we continue to let it spread unmitigated.

We are currently at a crossroads. Our governments have the ability to reset the narrative, but the question comes down to whether they have the will.

Instead of ignoring the virus, we need to adapt to a new reality. One that focuses on reducing transmission and embraces living safely with COVID, for all Australians.

Note from Croakey on 19 July 2023 in response to readers’ comments: Dr Blair Williams drew on these sources for the statements on life expectancy – the Australian Government 2022 Population Statement, signalling a fall in life expectancy in 2021-2022 and 2022-23, and a related report in The Guardian. The Government’s paper states:

The increase in deaths in 2021–22 and 2022–23 has resulted in a temporary drop in life expectancy in these 2 years. Compared to 2020–21, life expectancies are projected to decrease by 0.4 years for both females and males in 2021–22 and 0.2 years for males and 0.3 years for females in 2022–23. From 2023–24, life expectancies are projected to return to their long-term trend of gradual increase, reaching 87.0 years for females and 83.5 years for males by 2032–33.”


Recent related tweets

Read the JAMA Network Open article. “In this study, COVID-19 posed a significant disease burden for children and young people, so pharmaceutical and nonpharmaceutical interventions continue to be important to limit transmission of the virus and to mitigate severe disease.”


For more on this issue, see these recent Croakey stories on how health leaders are calling for increased COVID control measures and what we can learn from previous disease control strategies.

 

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