Thank goodness we did all the work

Introduction by Croakey: To see the stony faces at the National Press Club this week, you’d think the Prime Minister had lost the crowd.

What if he’d turned up with a meaningful, long-term plan for pandemic recovery that integrated all of the hard lessons from the past few years?

Dr Ian Mackay, virologist and blogger, has some suggestions for a re-write of recent history, which also opens doors for re-imagining a healthier future.

Ian Mackay writes:

Thank goodness we didn’t hold off on opening up to see what Omicron was capable of. We had to have Christmas. And there were national cabinet agreements. Anyway, how could we have known? Or this is what we expected? I forget.

Masking – everyone understands it now

Over the past two’ish years we’ve made sure to teach everyone about the benefits of masks in preventing us from infecting others and from being infected by others. We’ve spent that time on public communication explaining how to wear masks properly, how to choose the best mask, what masks are and how to fit them well. All really important for being a useful tool for our big toolbox of measures to reduce the risk of infections in others and, because this is what really matters, ourselves.

And thankfully, all of that foolishness about handwashing and droplets was updated to reflect the predominantly airborne spread of SARS-CoV-2. And in the meantime, work on flu, common cold and other respiratory viruses was explored more closely and lo and behold, it was found that they all spread from our breathing as groups of virions wrapped in mucus, floating and accumulating indoors as clouds of particles, moved by subtle air currents or blown on the wind until their structures degraded.

And of course, that, in turn, taught us the need for better masks. Thank goodness we did away with those silly loosely fitting surgical masks and porous cloth masks we’d taken up so eagerly early on. And with all that better and clearly communicated knowledge, there was even less concern about wearing a small piece of cloth. Remember how some groups got so upset about the idea of that? Hard to imagine now. And now we have these home grown mask industries and innovations. It was so good to have that ridiculous “we don’t have enough N95s” refrain put to rest for the lazy excuse for inaction that it was.

We improved the air we breathe

In those two years, we spent a heap of time explaining to the community that air quality was as important to long and short term human health, and to the economy itself, as clean water, a balanced diet and food that isn’t spoiled. How it hadn’t been obvious before is so weird.

And that 4-star rating sticker system easily told communities how much risk they were exposing themselves to when they entered their local shopping centre, school classroom, residential aged care facility, doctor’s waiting room, hospital emergency department, movie cinema, bowling alley, pub, restaurant, gambling establishment, bus or nightclub. The competition between venues to have the cleanest air sure was a driver for change.

Explaining that an aerosol-generating procedure is breathing, not just certain medical procedures, really helped more people understand the risk that had until then been largely unknown to them. Smoke as a metaphor. Brilliant! And the signage! I take my hat off to public health bodies all over Australia for their spectacular efforts in bringing all of this information to the public in such digestible, accessible and authentic ways.

I’m especially grateful to our leaders who took some of the many millions of dollars otherwise spent on important events, carparks, winning large sporting events, travel to face down unfair accusations of poor climate management, weapons of war, memorials to war, re-purchasing weapons of war, subsidising coal, gas and other fossil fuel industries and vehicles, and spent them on improving air quality in all of those places. Ensuring we had suitable numbers of air exchanges. High-efficiency air filtration. Treatment of air to inactivate pathogens. And the local industries and jobs all this created! The innovative uses for more renewable energy to power these newly created needs.

It all came together at a perfect time to show off Australian innovation nation cred. Bravo!

What about the communication?

And the communication! How good was that?! I don’t hold a pen mate, but I haven’t been able to look at a screen in a year without seeing the great works of those who do.

Clear graphics-laden plans for the next phase of managing this pandemic and the one after that. Modelling data from all the best sources was so clearly explained for all to absorb. How we’ve been helping our neighbours and those less fortunate than we to get vaccinated and manage COVID-19.

So many media stories explaining the complexities of vaccine protection from disease but not necessarily from infection, debunking misinformation, untangling academic complexities and constantly returning the focus back to what matters instead of ambulance chasing.

The benefits of preventing early SARS-CoV-2 spread

We also got all that community education around the fact that reducing transmission of SARS-CoV-2 also saved hundreds of lives otherwise lost due to the impacts of influenza on the lungs, brain and cardiovascular system. And we heard about how crap our past understanding of flu numbers have been.

I was jumping for joy when I heard that we will invest in much better virus surveillance and capturing of deaths due to flu and other viruses after the pandemic.

The public was clearly interested in knowing how its health and taxes were impacted by preventable disease and yet we’d missed this desire entirely and were barely sharing any of that information with them, at all.

Sorry. Died “with”, not “due to”. My bad.

We were told how masks along with other efforts also reduced illness and death due to respiratory syncytial virus and human metapneumovirus, common colds and asthma exacerbations due to rhinoviruses, and the annoyance and as yet probably poorly quantified lifelong impacts setup by early and repeated infections by enteroviruses, parainfluenza viruses, adenoviruses, parechoviruses and others.

Thankfully we were told how the changes to air quality will also reduce these impacts, especially in schools and residential aged care facilities, but that we could take some of that responsibility by using masks more than we used to, learning from other nations who have long done this.

Everything is equal now

And what about the work that went into redressing the inequality in caring for our sick, keeping the kids educated and entertained and taking risks to manage the home by shopping and taking the kids to school, the doctor or soccer practices?

Women were given more paid time off, pay levels for the same work done by males were equalised and there were so many improvements to the security and level of pay for their casual caring and service jobs. Men were incentivised to do more to help in these duties (sorry – I simply cannot come up with a valid incentive that would make this happen, even satirically).

Finally, the usefulness of working from home was permanently recognised and no longer a stigmatised or special event: “see you in the office tomorrowww!”. And those national discussions around shorter working weeks and a living wage; so good to finally acknowledge these.

Then that admission that “frontline work” wasn’t just about the healthcare industry and that without better pay and conditions, the economy could be seriously impacted by illness sweeping through so many sectors we’d not thought enough about.

These were all surprises to me – I didn’t think I’d live to see such acknowledgements.

The preparedness and planning for the next virus: priceless

Oh and thank the multiverse and its all-powerful mythological beings for the work that went into creating those local and national stockpiles of essential items. Also for all the preparedness planning which so outstandingly accounted for the risk of nationwide illness theoretically resulting from the sudden import of a new emergent viral strain.

And weren’t those newly prepared pandemic plans a treat? Being ready before the next pandemic starts, applying the new knowledge we’ve gained; so cool.

But more importantly, the workarounds, modelling and thought that went into readying our essential infrastructure should our warehouses, farms, slaughterhouses, trucking networks, shipping routes, air freight, teachers, hospitals, and supermarkets struggle to perform all of their essential duties.

I mean, can you imagine how much uncertainty, anxiety and fear having all those sectors suddenly stumble, seemingly overnight, and without any warning at all, would have resulted for so many?

I imagine it would have been a problem economically as well. But again, communication saved us here. Thank goodness we did all the work.

Dr Ian M. Mackay is a working scientist and an adjunct Associate Professor at the University of Queensland. This article is cross-posted from his blog, Virology Down Under, with permission.

Further reading

Prime Minister’s address to National Press Club

Questions and answers following his address

OzSAGE statement this week: We urgently need better masks…

See Croakey’s extensive archive of articles on health communications. (Maybe we need a new satirical section).