Below, public health policy consultant Glen Ramos shares his dismay over the removal of mandatory isolation for people with COVID-19 and what it means for people who are at increased risk from reduced public health protections.
Ramos makes a strong argument for those making public health policy “to remember that health equity requires attention to privileging the needs and concerns of those most at risk from current structures and policies”.
Glen Ramos writes:
I have a trifecta of health issues. I’ve had cancer for over 17 years, a previous serious heart condition, and severe tinnitus. Although serious, my health issues were hardly affected by basic life activities such as work, shopping, having kids at school and meeting up with family, friends, and work colleagues.
That was before COVID. With acute and Long-COVID powering immunological dysregulation, neurological disorders, and cardiovascular disease and injury, my trifecta puts me, like many others, at an elevated risk of serious negative health consequences.
When I read that mandatory isolation would be reduced to five days and then removed altogether, I was in disbelief. The Cirque du Soleil style verbal gymnastics required to pretend that it wasn’t an economic and electorally driven decision served only to fuel continued mistrust in government and public health policy.
When I heard Premier Daniel Andrews and others declare that “COVID exceptionalism” had to end, I thought I must have missed the memo advising that COVID had somehow magically disappeared, and its various health and economic effects waned into insignificance…but they hadn’t.
So, as the last vestiges of COVID protections were abandoned, it would seem that we have finally descended into Dante’s 9th circle of hell – treachery. This frozen landscape was reserved for what he deemed the worst kind of sinners – people that betray the trust of others.
When we reflect upon the famous (perhaps soon to be infamous) words from Prime Minister Albanese in his acceptance speech “no one left behind”, instead of warming our hearts at its generosity, it now sounds empty. Clearly, the reference to “no one” excluded those people who are at most risk from COVID.
In announcing the changes to mandatory isolation, the Prime Minister claimed to be following the medical advice, referring to a letter he requested from the Chief Medical Officer the evening before the National Cabinet meeting.
If this is how policy affecting millions of people is made, then it is facetious at best, incompetence or negligence at worst. It certainly reeks of Morrison-esque practices. The removal of mandatory isolation periods essentially completes the privatising of COVID public health policy by transferring all responsibilities to individuals. Perhaps we’ll be asked to make and administer our own vaccines next!
If you sense an undercurrent of anger and frustration when reading this, then you’d be more accurate than a rapid antigen test. For people at risk, those with disabilities, the immunocompromised, the chronically ill, the elderly, and many others simply seeking to avoid COVID, removal of mandatory isolation effectively banishes them from much of society.
We now find ourselves in the political expediency driven “personal responsibility” phase of the pandemic where those least able are advised to fend for themselves. A world in which taking public transport, attending shopping centers and doctors’ appointments, or any other essential service which is indoors, becomes a high-risk, potentially life-threatening experience.
So while mandatory isolation of those who are infected with COVID is removed it has been traded for the personal isolation of the most vulnerable. These same people who continually suffer numerous challenges and discriminations now have the exceptional benefit of adding COVID ableism to that list.
It should be no surprise then that having had to keep a lid on pent-up frustrations fomented from a life-long engagement with a world that is generally dismissive of their contributions – past, present, and now, future – these feelings are boiling over.
Before the pandemic, at risk people managed to function capably and productively in society. However, the real and perceived risks COVID poses is so high that they assess their circumstances to be better in their own shadow lockdown.
Forcing people back to work (by removing pandemic payments) and allowing infectious people to wander about creates and transfers emotional, psychological, and physical trauma to the most disadvantaged (already under enormous burdens) in order to simply pretend it’s 2019.
Excluding the most vulnerable from participating equally in society is a moral judgement on their worth, one that is primarily based on economics and essentially assesses them as inconsequential. Whilst this perception may have been previously hidden, current COVID public health policies have made it glaringly obvious.
Public health policy
Public health policy is inherently political. It is a perpetual balancing act between the collective health of the community and its economic, social, and other needs. Consequently, the relative weighting given to those different aspects will vary with different circumstances.
As we saw in the early days of the pandemic, an incredibly heavy weighting was given to the health aspects with numerous protective measures put in place, at the expense of many economic, social, and individual needs – the pendulum swung too far.
As the pandemic has progressed, and in Australia significantly worsened, with 2022 having the highest number of cases, deaths, and Long-COVID disablement so far, politicians have ironically reduced the importance of the health component putting other considerations, especially economics, on a pedestal.
The pendulum now swinging back has again gone too far.
We’ve moved from a position of COVID cautiousness where everyone’s health and wellbeing was considered, to one of COVID normalcy, where those with economic contributions appear to have higher value and consideration.
So whilst the past few weeks, with the lowest cases numbers this year (although with no incentive to test they are clearly an underestimate) have provided a brief reprieve, the tide has turned once more. Cases and hospitalisations are surging once more.
Waning immunity, low vaccine booster uptake (why get a booster when all other mitigations have been reduced – that’s the oxymoronic message at present) and a ‘vaxxed and relaxed’ attitude will simply hasten the oncoming COVID wave. Regular waves which wash away the most vulnerable out of sight.
It would serve those making public health policy well to remember that health equity requires attention to privileging the needs and concerns of those most at risk from current structures and policies. Unfortunately, it seems our governments are intent on increasing health inequities and proclaiming this is just “normal” whilst those most vulnerable are the collateral damage.
Glen Ramos is a Public Health Policy consultant with over 25 years experience in health, engineering, and strategy. He currently serves on the boards or committees of a number of non-profit medical, allied health, patient support, and patient advocacy, and local community groups.
See Croakey’s extensive archive of articles on COVID-19.