In 1987, in a fascinating and most useful talk on ABC radio, John Tranter said: “From the 1960s, for a mixture of reasons, Aborigines have been more publicly visible than in earlier times. They have been subjects of greater controversy, and they have been participants in controversy as never before.”
Tranter did us all a great service by analysing in considerable detail the background for these developments. His piece is more relevant now than ever before and, potentially, more useful than the current agonies surrounding the fate of the proposal for a Voice
John Tranter and his work were unknown to me until I came across a transcript of the episode of Helicon, ABC radio’s national arts program, broadcast on 26 January 1987.
Tranter died on 21 April 2023. I only wish I had had the chance to thank him for a wonderful piece dealing so clearly with many aspects of policies in Australia relating to its Aboriginal and Torres Strait Islander peoples. Over thirty six years ago Tranter was able to provide a most readable summary and analysis, with numerous historical facts and opinions, of issues that still trouble us greatly today.
John Tranter produced Helicon in 1987-1988. Later in his work for the ABC, and with others, he devised the radio program Books and Writing. He was also the founding editor and publisher of Jacket, an award-winning internet literary magazine.
A long-term view
The subject piece is entitled From 1788 to 1988: Visions of Australian History. I came across it in a hard copy that does not credit an author. It is dated January 1987. Given the dates of his tenure at Helicon, what I have already discovered of the breadth of his study and the style of his writing, I have assumed that John Tranter was its sole or main author.
If this assumption is false I sincerely hope that the other people involved will forgive me. My purpose is to give greater publicity and notice to the clearest of expositions of matters even more contested today, in 2023, than they were in 1987.
The piece is marvelous in the breadth of its coverage, in many senses prescient, and so clearly written. It is erudite but still accessible.
It pleases me to know that it is (back?) in the public domain, albeit on a very modest platform. My hope is that John Tranter would find my motives and intentions to be entirely worthy.
I beg you to read the article full. If it means to you a fraction of what it already means to me, it will be well worth your time.
The excessive geographic spread of major cities has long been a problem in Australia. Newly-established residential areas face issues like the cost and shortage of infrastructure and services, including public transport. There are also resource-use problems such as the loss of ecologically significant areas and of productive agricultural land.
Both of Australia’s major conurbations provide a few more opportunities for reasonably priced homes in their western suburbs than in other parts. Those who choose these options have to deal with the commuting motorist’s syndrome: you travel to work by car into the sunrise and travel home after work into the sunset.
My (slightly poetic) interest in these phenomena was recently piqued by a brief trip to Melbourne which had me overnighting in a western suburb apparently unknown to some of the otherwise helpful VicRail staff at Flinders Street while, at the same time, a couple I love very dearly are considering a move that might offer the attraction of a home with a third bedroom.
What began as a piece of doggerel kept in mind through the earworm ‘The last train to Werribee’ somehow became a sad reminder to people thinking of ‘moving further out’ to take every care with their decision.
It may be fruitless to hope that the publication of this piece might also contribute to a wider understanding of the social and ethical obligations of those in both government and private sectors who are in the housing industry.
Please note: Those parties should understand that I have sought indemnity against the possibility that this piece has the effect of reducing house prices in the outer suburbs.
Next stop after Altona
The last train to Werribee goes at ten-to-nine at night.
Will I see the kids at bedtime? With any luck I might.
From Werribee to Flinders Street it isn't very far
But you'll have to leave home early if you haven't got a car.
The station staff at Flinders Street know nothing of Westona;
More central sites are hard to find for hopeful first home-owners.
Our mortgage was six hundred thou.; but little did we know
That soon they would all rise again: they couldn't stay that lowe.
The last train to Werribee
Goes at ten-to-nine at night.
Will I see the kids at bedtime?
Can the price I paid be right?
I'm lucky that my modest block is serviced by VicRail -
But from the city after work the train's of no avail.
The next stop from Altona's where Westona can be found -
A place whose major industry's still chem-ically bound.
Toyota cars were built right here 'til twenty-seventeen.
And other heavy industries regarded as unclean.
With less regard to tyres and oils, and plastics of all kind,
Our table talk at dinner was a little more refined.
The last train to Werribee
Goes at ten-to-nine at night.
Will the kids have a certain future?
Can the price we paid be right?
At last the weekend comes around; the kids are up 'til 10.
I spend some time among their toys and pack them up again.
But it's not enough for both of us: their mother tries so hard
But finds too little freedom in a small suburban yard.
I'm on the last train to Werribee; numb is how I feel,
With a carry-bag of groceries to make an evening meal.
Will I see the kids at bedtime? No, they're with their mum instead
So no one's home to play with me or share the double bed.
Our budget made us move out here though never truly poor;
But the effect on our relationship surprised us, that's for sure.
The distance is what ruined it, we knew that time would tell
And the last train to Werribee has played a part as well.
We knew the stress would challenge us
As father and as mother,
But never did we think to swap
One good-buy for another.
Above and Below: Altona beach, VictoriaEarly morning cityscape of Melbourne across Port Phillip Bay
Those hoping for clarification on the national COVID-19 plan from last week’s national cabinet meeting will be disappointed. The main outcome from the meeting was a statement about the importance of its discussions and documents remaining “cabinet in confidence”.
“Cabinet confidentiality ensures that members of national cabinet may exchange differing views and achieve outcomes together.” (Media statement, September 17, 2021)
Sensitivity analyses were considered in relation to two of the Doherty model’s variables, the standard or level of test, trace, isolate and quarantine (TTIQ) practices, and of public health and social measures (PHSMs).
But as far as we know, consideration was not given to the variable which almost all experts thought ought to be changed: the 54 per cent and 65 per cent full vaccination thresholds for the whole population (70 per cent and 80 per cent of “the eligible population”).
There may have been an unwillingness to accept that those original vaccination thresholds were too low. At any rate, national cabinet concluded that “with high vaccination and appropriate TTIQ and PHSMs to constrain outbreaks, overall cases and deaths are expected to be similar in order of magnitude to annual influenza”. (emphasis added)
So the question for each state and territory is what levels of TTIQ and PHSM are appropriate given the incidence of infection that exists in their jurisdiction at any given time.
The trouble is that the dependent variable in the model — the thing against which the level of TTIQ and PHSM is tested for a yes or no answer — is movement from phase A to phase B. And the meaning or significance of such a move is unclear. Phase B lists a number of actions that may be taken by a jurisdiction. There is nothing that a jurisdiction must do — just a list of possible actions.
In what will be a challenge to “the NSW approach”, the Doherty Institute’s revised advice to national cabinet was:
“At high caseloads, maintenance of optimal TTIQ is unlikely to be possible. In such instances, flexibility to strengthen PHSMs generally or locally will be needed (as envisaged in the national plan) to regain epidemic control. The required intensity and duration of measures should be informed by ongoing situational assessment of transmission and its related health impacts.”
Despite this warning, the cabinet’s confidentiality statement issued to the public assumes enough TTIQ and PHSMs to constrain outbreaks. This assumption is what allows it to conclude that cases and deaths would be similar in order of magnitude to influenza.
But back to the national plan. It would help if its meaning was clear. When Scott Morrison announced the plan on the evening of July 30, he read carefully from his prepared notes, presumably in recognition of the plan’s complexity and the need to get the words exactly right. (He was so keen to spell it out that he asked for the light to be turned on so he could see his notes.)
What he said was:
“At each stage, I want to be clear about what the vaccination targets mean for phase B and phase C. States and territories move into the next phase when 1) the national average for the vaccination program, as a percentage of eligible adults, is achieved nationally, and then 2) that state itself has achieved the vaccination threshold in their own state. So, it’s like a two key process. To get to that next phase, all of Australia has to get there together, on average. And, then beyond that each state and territory will pass into that second and third phase based when they reach those thresholds.
Later in his address: “Phase B, which is achieved by the whole country reaching 70 per cent, and then each state and territory reaching 70 per cent…”
Later still: “When we reach 80 per cent, that is, first again, nationally an average of 80 per cent, and the state or territory has reached 80 per cent, we will move into Phase C.”
So here is the problem. The references to a national average suggest an average across the eight jurisdictions. Most telling are the bolded words on the plan document itself that say: “Average vaccination rates across the nation”.
So, let’s say the percentage of the eligible population with two doses in the jurisdictions is 80 per cent in two, 75 per cent in two, 65 per cent in two and 40 per cent in two, the national average, per jurisdiction, would be 65 per cent. That would be a fail. If the laggard two got up to 60 per cent, with no changes in the other six, the average would be 70 per cent — a pass.
The other interpretation, encouraged by the term “achieved nationally” and “by the whole country reaching 70 per cent ” is that the national criterion refers to whether or not a majority of the Australian population has reached the threshold. It is a long stretch, but not completely ruled out for people who are cavalier with words and meaning, to deem “average vaccination rates across the nation” to mean a majority.
This second is the interpretation ACT Chief Minister Andrew Barr had when he gave his daily update on September 12:
“New South Wales are not enacting the national plan if they do things at 70 per cent ahead of the rest of the nation reaching 70 per cent. They are entitled to make changes to their local restrictions, as they have been doing and that’s their purview entirely. But the national plan is very clear that the nation needs to reach the 70 per cent threshold and the nation needs to reach the 80 per cent threshold. Those same constraints apply to the ACT as well. Based on the current vaccination trajectory it will be New South Wales and the ACT that will get to those thresholds first. But our actions under the national plan are limited by where the rest of the country is at.
“Having said that I think it’s important to note that when the nation crosses 70 per cent and 80 per cent is very highly contingent on the vaccination programs in New South Wales and Victoria because together they are nearly 60 per cent of the national population … It’s important that people understand that and their reporting of the national plan reflects that — it’s in bold at the top of the national plan.”
Those bolded words are: Phases triggered in a jurisdiction when the average vaccination rates across the nation have reached the threshold and that rate is achieved in a jurisdiction expressed as a percentage of the eligible population (16+), based on the scientific modelling conducted for the COVID-19 Risk Analysis and Response Task Force.
It’s hard to see how individual jurisdictions can be free to make changes to their local restrictions while at the same time their actions are limited by the provisions of a national plan. They are certainly not going to be restrained by something as ambiguous and unfocused as the present Plan.
But perhaps there isn’t a real national plan at all — just a Clayton’s one used for federal window-dressing. That would explain why there has been so little comment on it, save by Laura Tingle and the Grattan Institute.
If that’s the case, the prime minister should come clean and stop using the term.
And perhaps the next time there is a national emergency, a pandemic or something equally national in its implications, the first thing to do in Australia is to implement new emergency arrangements that have been developed through the experiences of the COVID-19 pandemic.
One of the most critical matters to have been agreed must be the means by which an uneven (or natural) distribution of the emergency does not allow the situation in the various jurisdictions to become so widely varied.
We need to be “in this all together” — but clearly as yet we are not.
Note: this piece was first published in John Menadue’s Pearls and Irritations on 26 September 2021.
I have recently posted to www.aggravations.org several pieces on the pandemic in Australia – written between 26 August and 2 September but posted all together. (There was a delay as I tried unsuccessfully to get them published elsewhere.) Here’s an overview of the most recent four.
Covid – five things National Cabinet should agree (20 Aug) entreats someone (anyone!) to give the public a detailed schedule of expected receipt by Australia of Pfizer and Moderna over the next 12 months. There may well be uncertainty due to contracts yet to be agreed, negotiations unfinished, quality issues or even suppliers reneging on agreements. But the Federal Government owes it to its public to keep us informed and allow us to share the joy and pain (think ‘accountability’).
Speaking of which, it would be a tragedy if the commitment made to the groups in priority ranking 1a is not completed.
The Commonwealth must take the lead in developing protocols for determining which employees in which sectors will have a mandated requirement for vaccination. Resources need to be made available to community organisations that are helping to ensure that particular groups who are marginalised are getting vaccinated. And, fifth of all, someone (anyone!) needs to provide public data on all aspects of management of the pandemic in Australia. To date it’s been an information-free zone. Think black box.
Vaccinating Australia: insufficient urgency, too much choice? (26 Aug) begins with the assertion that the Gift of vaccination is being Stawelled and although it isn’t a race, Australia is coming last.
No-one seems to have been in a hurry, and those whose turn it is to run are confronted with so many different lanes and handicaps that some of them have been confused. This second article in the group bemoans the lack of urgency and innovation; (the U.K.’s first drive-through vaccinations were given in December 2020). The Federal Government, responsible for aged care, gave the job of vaccination of aged care patients and staff to private enterprises. It allowed a range of other parties to be involved (PHNs, GPs, State and Commonwealth hubs, hospitals) and, confronted with so many options, staff of aged care who were left to their own devices were uncertain and unmotivated. There was no understanding of the importance of individual convenience of accessing a jab.
When things have settled down it will be useful to understand why the covid vaccination campaign doesn’t seem to have benefited from the successful models for life-time (inc. children’s) public health and workplace vaccinations.
The third piece, Vaccine: Let’s not forget the first priorities (1 Sept), focuses in more detail on the failure to get residential aged care patients covered. The unimpressive history of the Government’s ‘national vaccine rollout strategy’, from early January 2021 to (the forthcoming) mandating of vaccination for aged care staff (17 Sept) is briefly rehearsed. (There are two chances that this target will be met – one of which is Buckley’s.)
In the early days the first criterion for setting the priority of a particular group of people was the extent to which they were vulnerable to serious illness and, potentially, to death. No-one objected to this criterion but unfortunately the same people (no-one) bothered to manage the work that needed to follow.
Analysis of what went wrong has to considerthe shortage of vaccine supply (obviously), generalised incompetence and lack of urgency, the absence of public information, confusion or overlap between federal and state jurisdictions and, in particular, an ill-disciplined approach to setting priorities for vaccination and acting on them. This last is critical when there is a shortage of supply.
With the Delta variant rampant, vaccination became the key asset in efforts to limit the number of infections, not simply the means of protecting the vulnerable. New criteria for allocation included where a person lives and what contribution they are likely to make to spread of the disease.
The piece ends with consideration of how vaccine supply has to be cross-matched with demand. Such an exercise must be happening behind the scenes, but without it being known to the public (see above!) the Government can maintain its mal-practice of trumpeting success in obtaining extra vaccine supply without emphasis on the fine print ie that the bulk of it doesn’t arrive until month x or next year.
Between you and me, this particular piece was written in the middle of the night after I had bumped in to a television re-broadcast of the day’s Question Time. What upset my sleep were bits of the Prime Minister’s responses in which he claimed that the speed at which vaccinations were by then occurring had made up for the 4-month delay, so much so that the original target would be met by Christmas “or even sooner”. He credited this turnaround to the fact that the government had “been able to bring forward doses” and had “been able to achieve and realise additional supplies”. [It’s clear now that this referred, inter alia, to the swap with Boris.]
In that same Question Time the Prime Minister reported that double-dosed vaccination rates in aged care facilities were “upwards of 80%”. He seemed to regard this as a success, despite the too long history of the issue, and attributed it to the priority given to vaccinations in aged care “which has enabled us to visit all of these facilities to ensure that the double doses are done”. It is not clear what ‘upwards of 80%’ means, or how many of the other 20% have had their first.
The last piece posted in this batch is Vaccination: Accounting for the muddle.
A ledger is needed for Australia’s vaccination program:
‘An account represents a detailed record of changes that have occurred in a particular asset during the accounting period. All these separate accounts are kept in a loose leaf binder, and the entire group of accounts is called a ledger. The ledger is a record which provides all important information.’
The ledger must provide information to the public in an open format and in language people can understand.
Both sides of the ledger must be considered – vaccine supply and demand for vaccine. The Federal Government should inform the public even when things are uncertain and, especially, when plans become unavoidably changed.
The supply side of the ledger is affected by variations in the planned period between a first and second jab. It seems extraordinary that there is no readily available chart showing the best estimates from the research community around the world of the changes in efficacy for the various vaccines consequent upon changes to the time between first and second dose.
The undisciplined approach to priorities for vaccination has extended to a lack of action on them. It’s as if the system’s managers have colluded with public opinion: ‘The highest priorities are still not met – so let’s focus on new ones!’
Instead of a blitz approach to vaccine in aged care facilities, a complicated system developed led by private enterprise entities. Decision makers and commentators were able, in effect, to hide behind the phrase ‘the most vulnerable’. To this vulnerability criterion was added the seriousness of the impact on health and other essential services of sickness and the resulting absence of members of the workforce. This is still important.
With the Delta variant, where a person lives and what contribution they are likely to make to spread of the disease have become as important as the extent to which someone’s health is likely to be severely affected by the condition, should they be infected.
The magnitude of the challenge of allocating scarce vaccine is illustrated by listing those groups who have recently been suggested as being of the highest priority. They include the original highest priorities, hospital staff, Aboriginal and Torres Strait Islander communities, year 12 students, people in selected hot-spots, teachers, inter-State transport workers, children, the 16-39 year olds, childcare and disability support workers, and paramedics.
Unless and until there are ample supplies of vaccine, some extremely difficult decisions will have to be made. If they are not, people will have unrealistic expectations and there is a real risk that they would then be alienated from the program.
Lecturer: Have you done the assignment?
Student: Yes – but I haven’t had time to write the short one.
Note: this is the third of three posts that have been delayed as I tried unsuccessfully to have them published elsewhere.
‘An account represents a detailed record of changes that have occurred in a particular asset during the accounting period. All these separate accounts are kept in a loose leaf binder, and the entire group of accounts is called a ledger. The ledger is a record which provides all important information.’
A ledger is needed for Australia’s vaccination program. To date it has been a muddle, but there’s plenty more to do and therefore plenty of opportunity to improve it.
The ledger must provide information to the public. This means that it must be both open and constructed and written in a language people can understand.
The asset is the vaccine, still in short supply. The business is Australia. The Board is the government. The CEO is Scott Morrison. (There is soon to be a shareholders’ meeting and the Board will be looking to the CEO to protect their reputation and their remuneration.)
Both sides of the ledger need to be considered.
Vaccine supply
Of all factors in the vaccination muddle, nothing has been more significant than the shortage of vaccine supply.
The Morrison government must show more trust in the public and take them into their confidence where vaccine supply is concerned. The public needs and deserves to see the details of expected supply of vaccine over the next 12 months and more.
What is the anticipated delivery schedule for Pfizer and Moderna? Will there possibly be others? What progress on a vaccine for under 12 year olds? Greg Hunt has said that a million doses of Moderna will arrive in Australia in late September and 10 million Moderna shots are scheduled to be delivered to Australia this year.
AstraZeneca: in economic terms, an inferior good??
Just this week 1 million doses of Pfizer have been received in a swap deal with Singapore. Are more such arrangements possible?
The Federal Government may not be certain how much will be delivered from overseas or when. But the public should kept informed. The Government should inform them even when things are uncertain and, especially, when plans become unavoidably changed – when targets can’t be met. Given such information the public will feel more involved and more supportive of whatever timeline is necessary.
The supply side of the ledger is also being affected on an almost daily basis by variations in the planned period between a first and second jab. It seems extraordinary that there is no readily available chart showing the best estimates from the research community around the world of the changes in efficacy for the various vaccines consequent upon changes to the time between first and second dose.
Individuals are making decisions every day without information about changes in efficacy and the gap between the first and second. GPs have been trusted with providing decisive advice to their patients without clear knowledge of projected changes in efficacy.
Vaccine demand
One of the most egregious problems is that there has been a very undisciplined approach to the setting of priorities for vaccination and, more importantly, of action to meet them.
In January 2021 a priority ranking per population group for vaccination was agreed. The highest priority (‘1a’) was allocated to quarantine and border workers, front-line health officials, aged and disability care workers, and aged and disability care residents (emphasis added).
This order might have been forgotten but it has never been changed. How is it possible, then, that during Question Time on Monday 30 August the Prime Minister – with no sense of contrition or regret, said:
“And what we have been able to achieve this year, prior to these most recent waves hitting New South Wales, Victoria and the ACT, is that we have double-dose vaccination rates in our aged-care facilities upwards of 80 per cent. And what that has meant is that our most vulnerable in our community this year, because of the vaccines, compared to last year, and in particular the priority we placed on vaccinating those in residential aged-care facilities and ensuring that we were able to visit all of those facilities to ensure that those double-dose vaccinations were provided – that has saved hundreds (sic) and hundreds (sic sic) and hundreds of lives.”
An earlier piece on this blog has discussed the forthcoming vaccination requirements for aged care workers. Not including aged care in the home, this will apply to some 154,000 people in more than 2,700 facilities.
An analysis by the Guardian Australia, published on 25 Aug, revealed that 582 centres had vaccinated less than 50% of their workforce with a single dose, while 60 centres hade vaccinated less than 20%. (Only one in five aged care homes close to vaccinating all staff against Covid as deadline looms, Sarah Martin and Nick Evershed, Guardian, 25 Aug 2021.)
The priority order has not been discussed or changed but what has happened is that a number of other priorities have emerged and jostled with those original population groups for a place in the sun.
The process can be characterised as “The highest priorities are still not met – so let’s focus on new ones!”
With an appropriate amount of urgency, energy and innovation, it would have been possible to provide vaccinations to every patient and staff member in residential aged care in three weeks, never mind three months. What was required was an almost exclusive focus on the top priorities for a short time. Every facility could have been visited by a vaccination team, flying-squad style.
It’s the kind of logistical exercise the military are good at, as evidenced by its work after a national disaster. It would have required open, effective liaison with the facilities themselves, collaboration between State and Territory agencies, and with local government, local volunteers, the SES and local health staff. But it could have been done. It must now be done.
Instead of this blitz approach, a complicated system was devised led by private enterprise entities to deliver the vaccines. There was the occasional mention of the lack of progress, but the stronger interest shifted to other priorities, as if leaders, experts, the media and their public were bored with the old priorities and were more interested in ‘discovering’ and promoting new ones.
Decision makers and commentators have, in effect, hidden behind the phrase ‘the most vulnerable’. It has been easy to defer to this term without actually converting it into action. Now that the Delta strain has written a new script, someone has to decide on a daily basis whether to allocate the last vial of vaccine, as it were, to an elderly person, a nurse, an infant, a mobile 25-year-old, someone with a disability, an Aboriginal or Torres Strait Islander person, a year 12 student, an interstate truck driver, or a paramedic.
To this vulnerability criterion were added practical, commonsense criteria about the potential seriousness of the impact on health and other essential services of sickness and the resulting absence of members of their workforce. This is still an important consideration.
With the Delta variant, the key criteria for allocation include geographical and demographic characteristics. Where you live and what contribution you are likely to make to spread of the disease have become as important as the extent to which your health is likely to be severely affected by the condition. Some might even dare to whisper that the elderly ought to have no higher priority than young adults – the mixers and spreaders – and Aboriginal and Torres Strait Islander people.
Both sides of the vaccine ledger need to be openly discussed. Matching projected receipt of vaccine with agreed priorities will be very difficult. Some horrible options will have to be chosen.
But with an open book and full information provided to the public, there will be greater certainty about the path towards ‘full vaccination’ and unrealistic expectations can be avoided.
It will be vital that people in priority groups do not face the same frustrations and logistical difficulties that many have already experienced. If the supply schedule suggests that there will be inadequate doses for aged and disability care, for all hospital staff (now clearly a top priority), special rollout to Aboriginal and Torres Strait Islander communities, year 12 students, selected hot-spots, et cetera, then the expectations of people in those cohorts should not be raised above what can be accomplished.
The situation is serious. The following groups have already started to fill positions in the queue for vaccine or are scheduled to do so:
all aged care staff (by 17 Sept.)
more aged care residents (“As of August 20, 86 per cent of aged care residents and 67 per cent of NDIS participants in residential accommodation have had at least one dose of vaccine.” ABC News, Tracking Australia’s COVID vaccine rollout numbers, Digital Story Innovation Team, 2 Sep 2021.)
in NSW: “New public health order requires staff to have their first vaccine dose by September 30. To continue working, staff must either be fully vaccinated by November 30 or have their second appointment booked.” (“The nation’s leaders should mandate COVID-19 vaccination for doctors, nurses and hospital cleaners, according to Australia’s peak medical body, with the federal government declaring the issue is ‘very high on the agenda’ of all state and territory chief health officers.” ABC News, Doctors back mandatory COVID-19 vaccination for health worker, Stephanie Dalzell, 31 Aug 2021.)
Aboriginal and Torres Strait Islander people. (Is there a priority order? By place? Age group?)
Teachers? “last week many teachers felt betrayed after the announcement that New South Wales teachers will need to be vaccinated as part of the ‘road map’ to getting students back in school, – “ “There was little detail to the announcement apart from it being implemented from November 9.”
inter-State truck drivers?
“On August 20, NSW mandated that childcare and disability support workers who live or work in a council ‘of concern’ must have received their first vaccination dose by August 30.”
In NSW: “Authorised workers who live in an LGA of concern and need to leave it for work are only permitted to do so if their employer has implemented rapid antigen testing, or they have had their first vaccination dose by August 30.” NSW Government website,COVID-19 vaccination for workers, 1 September 2021.
paramedics?
And let’s not forget that it has been agreed that the next cohorts will be 16-39-year-olds (from early Sept) and 12-15-year-olds from 13 September.
While ever there is a shortage it will be essential to set priorities and stick to them.
Let’s get on board with Buckley. They’re all we have.
Note: this is the third of three posts that have been delayed as I tried unsuccessfully to have them published elsewhere.
In two weeks’ time, as part of their employment arrangements, all staff of residential aged care facilities will be required to have had at least one coronavirus vaccination. That’s around 150,000 people in over 2,600 facilities.
There are two chances that this target will be met – one of which is Buckley’s.
Note: this is the second of three posts that have been delayed as I tried unsuccessfully to have them published elsewhere.
A sad, brief history
The Government’s national vaccine rollout strategy was released in early January 2021. The target population (c.20 million) was all of those 18 and over.
The highest priority (‘1a’) was allocated to quarantine and border workers, front-line health officials, aged and disability care workers, and aged and disability care residents.
On 1 February the Prime Minister said he expected to “offer all Australians the opportunity to be vaccinated by October of this year”. Later he said 4 million would be vaccinated by the end of March.
On 2 July National Cabinet agreed to adopt the “strong advice” from the Australian Health Protection Principal Committee (AHPPC) to make vaccination against covid mandatory for all staff of residential aged care facilities.
This action will be underwritten by a grant program to help the centres and, through them, their individual staff members. Eligible payments will help with travel to the nearest vaccination site and cover for lost wages. The Federal Government will oversee compliance – which does not inspire great confidence.
What went wrong
Many things can explain what has gone wrong. In particular they include the shortage of vaccine supply, generalised incompetence and lack of urgency, an ill-disciplined approach to setting priorities for vaccinations, a curious absence of public information, and the usual confusion or overlap between federal and state jurisdictions.
Supply
Nothing has been more significant than the fact that, from the beginning, there has been an overall shortage of vaccine supply. This has cast a dark shadow over all aspects of the vaccination program. The shadow remains despite the arrival of Spring.
The government failed to make sufficient contractual arrangements to meet its commitment to have Australians at the front of the queue for vaccine. This was compounded by the failure of leaders, experts and commentators to ‘make real’ the different probabilities of sickness from coronavirus as distinct from blood clots.
An ill-disciplined approach to setting priorities for vaccination
Agreement on the priorities for allocation of vaccine, and action on them, will be critical for as long as there is a shortage of vaccine supply. Public debate on the matter has been impossible because most of the planning and management has been done secretly.
A sad and surprising feature of the response to the covid pandemic has been the failure to assemble, analyse and utilise data on all aspects of the phenomenon and to keep the public informed. There is so much the public (and, apparently, researchers) don’t know about a disease that threatens everyone.
Setting and acting on agreed priorities should have been a matter of the most importance. But unfortunately, as a nation, Australia has had a superficial approach to the matter.
Initially this could perhaps be attributed to disinterest or complacency. With very little covid around, the main criterion for setting the priority for a particular group of people was the extent to which they were vulnerable to serious illness and, potentially, to death. No one could object to the residents of aged care facilities being a top priority and, through them, the workers who care for them. In the unlikely event that the virus did appear it was the elderly who would be most vulnerable to serious illness and death. And society owed a debt of gratitude to the grandparent generation.
The wisdom of making aged care staff one of the highest priorities had been tragically illustrated by the second wave in Victoria. Of the 730 covid-related deaths in that State in the period from early July to late October 2020, 655 were of patients in residential aged care.
With the Delta variant rampant the competition for scarce vaccine has become even stronger. Given the second wave in Sydney and the rest of NSW, the balance between the potential criteria for prioritisation has shifted. It is no longer universally agreed that ‘vulnerability’ is the key criterion. Vaccination is now a key asset in the battle to limit the number of infections.
The new key criteria for allocation include geographical and demographic characteristics. Where you live and what contribution you are likely to make to spread of the disease have become as important as the extent to which your health is likely to be severely affected by the condition.
With the narrative changing from the suppression of cases to ‘living with covid’, the main purpose of vaccination will to some extent switch back and once again be to minimise illness and death.
A lack of public information
Surprising though it may seem in a country that has generally been well-served by agencies that collect and use quantitative information, the absence of data and public information on many aspects of the pandemic has been an ongoing problem.
Despite the fact that the aged care workforce had been a top priority since January, in the first week of June the responsible Federal Ministers, Greg Hunt and Richard Colbeck, admitted that they were not able to say what number of aged care staff had received zero, 1 and 2 covid vaccinations. Greg Hunt, Minister for Health, apologised to Parliament for an incorrect report on the matter. He confirmed in early June that 20 aged care facilities had not yet been visited as part of the national vaccination rollout.
It was a problem that, unlike the situation with vaccinations they previously required, the status of staff with respect to covid inoculation was not linked to payroll. Furthermore, it was not until June 2021 that operators were required to report each week to the Federal Health Department on the covid immunisation status of their staff.
Matching supply with priorities
Details of the schedule for receipt of vaccine supply must be matched against the priorities determined and thus the number of people who are eligible and who expect to be able to get vaccinated.
There is a State-by-State schedule of ‘allocation horizons’ but it is impossible for outsiders to understand. (https://www.health.gov.au/resources/publications/covid-19-vaccination-covid-vaccination-allocations-horizons)
This might be because the Federal Government itself cannot be sure of how much will be delivered from overseas or when. In Parliament this week the Prime Minister claimed that the speed at which vaccinations are now occurring has made up for the 4-month delay. He has even suggested that the rollout is going so well that the original target will be met by Christmas “or even sooner”. He credited this turnaround to the fact that the government has “been able to bring forward doses” and “has been able to achieve and realise additional supplies”.
In the same Question Time reply he said “We have more irons in the fire that will see further doses being made available”. [These are quotes taken verbatim from the PM’s QT speech. Some changes have been made to the Hansard record between ‘Proof’ and Final.]
All this is terribly imprecise. The uncertainty about how much is being received and where it is was illustrated by the on-again, off-again switching of some supply to Sydney’s worst affected suburbs. Just this week there seems to be the same uncertainty about special deliveries set aside for Aboriginal and Torres Strait Islander communities.
Hopefully what is happening is that a detailed schedule for supply of Pfizer and Moderna is cross-checked against the planned rollout, which must be subject to agreed priorities. The next population groups to be eligible are the 16-39 year olds (from this week) and 12-15 year olds from 13 September.
It will be vital that these people do not face the same frustrations and logistical difficulties that many older people have already experienced. If the supply schedule suggests that there will be inadequate doses for aged and disability care, for all hospital staff (now very clearly a top priority), special rollout to Aboriginal and Torres Strait Islander communities, year 12 students, selected hot-spots et cetera et cetera then the expectations of these other cohorts should not be raised.
The current situation
In Question Time this week the Prime Minister reported that double-dosed vaccination rates in aged care facilities is “upwards of 80%”. He seemed to regard this as a success, despite the long history of the issue, and attributed it to the priority he has given to vaccinations in aged care “which has enabled us to visit all of these facilities to ensure that the double doses are done”. It is not clear what “upwards of 80%” means, or how many of the other 20% have had their first.
The public now has a better appreciation of the uncertain nature of statements such as these. It needs to be clear, for instance, whether they refer to adults only and whether they mean the first jab or full inoculation.
The next key target for aged care staff is mandatory vaccination, to begin on 17 September. Every effort must be made to complete the task on time with a high level of competence and effectiveness.
Let’s get on board with Buckley. They’re all we have.
Note: this is the second of three posts that have been delayed as I tried unsuccessfully to have them published elsewhere.
Jacob Despard of Tas. wins the Stawell Gift on April 2, 2018. (Photo by Darrian Traynor/Getty Images)
The Gift of vaccination is being Stawelled and although it isn’t a race, Australia is coming last. No one seems to be in a hurry, and those whose turn it is to run are confronted with so many different lanes that it is quite confusing.
The basic problem is the imbalance between demand and supply. ‘The market’ has proved to be imperfect again. Demand is being limited by regulation about whose turn it is – by population group, calendar dates and choice of vaccine.
My wife was accommodated by her GP. My GP seems not to have been favoured so I tried the local field hospital – recalling some of my previous trips to the place when it was a cricket pitch. But it was the wrong day or the wrong brand and all I came away with was the phone number to call.
The hold music was not too bad at first but after an hour I accepted The Voice’s offer to leave my mobile number and it would get back to me.
I don’t always carry my phone with me unless I’m photographing Nature; so a few days passed.
Having tried the leave-my-number routine a couple more times, I thought surely I could be provided with the necessary material if I attended in person. Upon arrival at the correct hospital I was the fourth person around. One of the other three was keeping guard and however hard I tried I couldn’t get more than the phone number. No appointment, no access, no worries. Very firm. (Someone who only has one job can really concentrate.)
At the hospital’s main entry I had better luck. I quickly had a small sticky label and very soon thereafter a lollipop.
One might think that a large and diverse system would be a good thing, given the number of people to be serviced. In fact I think people have been uncertain about how to get the job done and the queuing and appointments system has been slow and clunky.
In a previous piece I suggested that a one-off boost to the number of people who have had the jab could be given by offering all those who, like me, had the first AstraZeneca some time ago the option of bringing forward the second one. Granted there is uncertainty about the extent to which this would affect, week by week, the efficacy of the vaccine.
Governments have been slow to realise the value of localised, targeted, culturally appropriate options for vaccine delivery. So many commentators on media have argued that the main barrier or disincentive is the lack of convenience in getting it done.
Perhaps because the processes in train have not been under any single agency’s control, active management of the program has been missing. Things have just drifted.
Initiatives such as pop-up and drive-through vaccination clinics, local support for local rollout to specific cultural groups, and a flying-squad type approach to communities facing special risks were slow to emerge, despite the demonstrated success of such activities in other countries. The U.K.’s first drive-through vaccinations were given in December.
The most serious result of the underperforming program has been the failure to meet the earliest targets, such as protecting through inoculation the staff and patients of residential health, aged and disability care facilities. One of the results of this failure has been the loss of capacity, especially in hospitals, when staff members have had to be isolated.
The case of aged care workers
At the outset the task looked like one that would provide many political benefits, given the generally positive view of vaccination. It was therefore no surprise when the Prime Minister said that responsibility for the vaccination program was the Commonwealth’s. There was the usual caveat that its management would be in collaboration with the States and Territories.
So arguably the uncertainty began early, with the potential for overlap and task shifting between Federal and State departments. The program grew like Topsy.
Consider, for example, the case of workers in aged care.
The Commonwealth contracted commercial entities to deliver vaccinations to the 2566 Commonwealth-subsidised residential aged care facilities for residents and, where additional vaccines were available, workers. (Giving staff doses that were left over at the end of a clinic for residents must have given a negative message?)
Staff of aged care facilities could also attend a GP’s rooms, or a State clinic (in a public hospital), or one of the specially established state vaccination hubs.
But Primary Health Networks (PHNs) were nominated as the primary point of contact for residential aged care facilities on vaccination for residents and workers, and were allocated Pfizer doses for this purpose. The PHNs liaised with the contracted providers, which could provide in reach, mobile and hub models for residential aged care workers and residents.
Workers from residential aged care facilities located in the same PHN as disability vaccination hubs could access a Pfizer vaccine at these hubs.
Turning their back on Pfizer?
A forward schedule of dedicated Covid-19 vaccination clinics was available to aged care provider peaks and unions to provide local information on upcoming clinics to residential aged care workers.
From August selected pharmacies have been providing Pfizer vaccines.
Convenience has been a major issue. For many people, getting the vaccination involves the loss of a shift, loss of wages, logistical issues with access, or finding information in an appropriate language.
The menu was extensive but many who consulted it found its fair and its language to be quite alien.
Alternative means
Some people believe the Commonwealth should not manage new, large-scale programs because of a poor track record in such things. The alternative view is that no agency is in a better position than the Commonwealth to oversee a program which requires uniform eligibility checks and national data and tracking.
The experience to date from covid-19 suggests that what is required is national leadership and record-keeping, with the actual rollout being undertaken by a limited number of agency types. State and Territory arrangements should allow for local providers to work in settings and with population groups who require the deliverers to have special skills. For example, delivery to those who do not have English as a first language should involve people with whom they are familiar and language they know well.
This principle should be applied whenever possible to meet the special requirements of people who are disadvantaged in economic, social and cultural terms.
In setting up the program for covid consideration was presumably given to scaling up the National Immigration Program (NIP) which has a good reputation as a provider of a range of vaccinations over a person’s lifetime. It would be valuable to understand why such a model was not developed.
Workplace vaccination against flu has also been successful in many instances and must also have provided lessons for covid.
STAWELL, AUSTRALIA – APRIL 17: A general view of the Strickland Family Women’s Gift during the 2017 Stawell Gift. (Photo by Scott Barbour/Getty Images)
For as long as vaccine remains in short supply relative to demand, setting priorities for its use will remain critical. The priority order for allocation of a scarce resource that saves lives is something that should be openly discussed and understood. To date little evidence on the matter has been publically available.
With greater understanding of the importance of vaccination and how decisions relating to it are made, people are likely to be more invested in the campaign and thus more willing to comply with and support it.
Note: this is the first of three posts that have been delayed as I tried unsuccessfully to have them published elsewhere.
Thanks to the Delta variant, the Covid-19 pandemic is now a national crisis. If the vaccine roll-out can find both the urgency and the administrative efficiency required, the immediate challenge stemming from an excess supply of AstraZeneca and an acute shortage of Pfizer can be met. While steps are being taken to divert Pfizer from second doses to first, the large numbers who are waiting for the second AstraZeneca can be invited to have their second after less than 12 weeks have elapsed.
With just one critical piece of scientific evidence plus considerably more administrative dexterity than has been shown to date, much of the AstraZeneca already available can be used effectively in the next 4 to 6 weeks. This would utilise a valuable resource, boost the national vaccination rate, and provide time for an information, incentive and campaigning blitz to encourage greater confidence in AstraZeneca in the future.
The evidence available online is that the first AstraZeneca jab results in something between “barely any” efficacy against infection (as reported in a recent article in Nature) and 30% (as reported in an interview last week on RN with Assoc. Prof. Margie Danchin). For immunity given by the first AstraZeneca jab against hospitalisation due to Covid, the range is from “barely any” to 71%.
Those same two sources report the efficacy of the second AstraZeneca vaccination, given 12 weeks after the first, results in 67% against infection, and 92% against hospitalisation.
If the relationship between time and the effect of bringing forward the second jab is a straight line pro rata, the efficacy vis-à-vis infection after 4 weeks would be 42%, and against hospitalisation, 78%.
The significant discrepancy between various reported studies of the efficacy after the first jab (‘barely any’ to 30%; and barely any to 71%) are a problem – but not in the context of the proposal described in this piece. That is because the people involved in it are those who have already had the first. The decision they would be asked to make is determined by the evidence about the effect of the second.
Belief in the case that reducing the gap to less than 12 weeks has little impact on efficacy is strengthened by a heroic use of anecdotal evidence – as distinct from good science. On 11 July Norman Swan reported on Twitter that he had just had his second AstraZeneca vaccination:
“A bit less than nine weeks since the first. Willing to accept a little lower immune response to get protection against severe disease.” (Norman Swan, 11 July 2021)
If one needs to make a heroic assumption based on a single case, in my view there could hardly be anyone in a better position of trust than Dr Norman Swan.
There have been 6.1 million doses of AstraZeneca given, the majority of them to people over 60, but a significant number (c. 900,000) to 50-60 year olds and a smaller number of people younger still. These younger people are those who responded positively to the (controversial) encouragement by the Prime Minister on 28 June to make ‘a risk-based decision’ following consultation with the a GP – who would be indemnified against any risks resulting from an AstraZeneca vaccination to persons under 60 who requested it.
There is about a 4-8 week window of opportunity for a rapid surge in uptake of AstraZeneca. The 6.1 million are people who have already demonstrated their readiness to take AstraZeneca – although some may now be more AstraZeneca shy than they were initially. Given the 12-week delay normally required, and the fact that AstraZeneca jabs only started in early March, there must be 3 to 4 million who have got some further time to wait before their regular second, all of whom could be encouraged to bring forward that second. (Some have been turned off AstraZeneca so much that they have postponed their second.)
The threshold fact is what the science tells us about the loss of efficacy per week of advancement.
If the evidence is that there is just a modest loss, then we could be sure that a significant proportion of the 3 to 4 million would volunteer to sacrifice some immunity for temporal (and national community) gain. Some would go out of their way and take on board some level of risk to contribute to a demonstration of Australia’s community spirit. And it would give our governments another string to their bow – although to date they have shown themselves to be pretty hapless archers.
To be successful the roll-out would need effective national leadership to:
put the initiative firmly and clearly on the public agenda;
back the announcement with a clear statement from a reputable body or bodies about how much efficacy is lost per week from bringing the second dose forward;
get it done – through the hubs specially established, through GPs and maybe through pharmacists, who are now joining the campaign in number.
The initiative could be one of the special reserves of pharmacy in the rollout, giving them a greater sense of ownership and investment in the national operation.
Whether pharmacists and a special role or not, the administrative dexterity required would include the capacity to contact all of those who have had a first AstraZeneca vaccination inviting them to have their second before 12 weeks have elapsed.
To date, very little dexterity and absolutely no urgency have been in evidence in the vaccine program. But it is not too late to discover and demonstrate such characteristics.
So while the crisis management is diverting scarce Pfizer resources from second vaccinations to first, a portion of the 3 to 4 million people who have already demonstrated their willingness to have AstraZeneca can be used to mop up the domestically-produced vaccine in which the nation, paradoxically and tragically, is awash.
Even if the news about the immunity lost per week is not so benign, it is likely that a significant proportion of this cohort would provide an immediate and significant boost to the overall coverage of vaccination and confidence in AstraZeneca. Many would be glad to do their bit to attest to the fact that Australia is a strong community and would be happy to receive a call to bring forward their second AstraZeneca jab.
Others in that cohort would make the quite rational decision to trade a little lower immunity for more immediate coverage.
There is limited time to invest in this fix for a part of the crisis we face.
Note: this piece was first published in Pearls and Irritations on 28 July 2021. https://johnmenadue.com/making-good-use-of-the-astrazeneca-in-which-we-are-awash/
One of the aspects of the Covid-19 pandemic which will certainly be the subject of inquiry in Australia once things have settled down is why Victoria has had more lockdowns and cases than the other States. And it’s not the first time Victoria has been in this position. How McDougall Topped the Score, written by Thomas E. Spencer, has been re-made and is shown below. It will remind readers of the Swine Flu epidemic of 2009 in which Victoria also set some records.
(Note: I posted a version of the poem, but not the COVID comments, on 9 March but given what is happening in Victoria it deserves another go. I look forward to the time when it is no longer relevant.)
At the time of writing (29 May 2021) there have been 30,073 cases of COVID-19 in Australia, 20,580 of which have been in Victoria. Of the 910 deaths recorded, 820 have been Victorians.
This represents an extraordinary imbalance between States.
A number of possible explanations for the disparity have been canvassed.
One is that the different structure of public health services in Victoria as distinct from, say, New South Wales has resulted in greater effectiveness in the latter. It may be that the pre-existing New South Wales system was more compatible with what was needed for effective contact tracing. New South Wales has decentralised Local Area Health Districts with public health teams embedded in local communities. These teams work independently while being guided by New South Wales Health centrally.
Catherine Bennett, Chair in Epidemiology at Deakin University and a key contributor to public understanding and debate, wrote in The Conversation in October 2020:
“NSW’s system of devolved public health units and teams meant when local outbreaks occurred, locally embedded health workers were at an advantage. They’re already linked with local area health providers for testing, they already have relationships with community members and community leaders, and they know the physical layout of the area.”
“What’s crucial is a nuanced understanding of local, social, and cultural factors that may facilitate spread or affect how people understand self-isolation and what’s being asked of them. It can also make a critical difference in encouraging people to come forward for testing.”
“If local health workers and contact tracers are already part of a community, they can bring that expert knowledge into the mix; they can make sure public health messaging is meaningful for local communities.”
In contrast to the situation in NSW, Victoria has a public health system which is highly centralised, meaning there was a smaller base upon which to build a surge contact tracing capacity. The fact that some help was provided to Victoria from interstate staff and defence force personnel may be seen as evidence on the matter.
The different capacity of these two State systems may also be due to their recent history of funding relative to need. On the other side of the ledger is the fact that a centralised system may be better able to handle large quantities of data.
Another possible cause of the inter-State disparity is the difference in the structure of residential aged care. Of the 910 deaths recorded nationally, 685 have been in residential aged care facilities. And 655 of these have been in Victoria.
Compared with NSW, Victoria’s residential aged care system has a larger proportion of private for-profit businesses, which may have put profit before service. In Victoria 54% of residential aged care places are in the private, for-profit sector (including both family-owned and public companies) compared with 35% in NSW. In contrast, 37% of Victoria’s aged care places are in the not-for-profit sector (including religious, charitable and community-based organisations), compared with 63% in NSW. Much more evidence would be needed to conclude that the profit motive is at the heart of the difference between the two States.
One of the reasons why Australia has done so well in response to the pandemic is that we have been regularly and expertly provided with scientific evidence. This has contributed to the high level of compliance in Australia with the steps that have been necessary.
In my view, two expert commentators have stood out. Norman Swan has been tremendously busy including with the ABC’s daily Coronavirus podcast. Norman came to the business of COVID with an existing good reputation as a well-credentialed scientist and is a very experienced communicator. Another expert who has worked tirelessly and presented with great clarity, dignity and modesty is Mary-Louise McLaws, Professor of Epidemiology at the University of New South Wales.
On ABC’s weekend breakfast TV show today, when asked for her views on why Victoria has suffered more than the other jurisdictions, Mary-Louise said that Melbourne is a very close-knit community. It is a city that’s easy to get around, she said, so sadly it is easy for a virus to spread. Melbourne is the city of most concern in Australia for explosions of case numbers.
This means that enquiries into Australia’s COVID experience will need to include cultural, logistical, demographic, economic and sociological factors.
History repeating itself?
This is not the first time Victoria has stood out as the worst affected part of Australia in an epidemic. On 8 June 2009 The Australian newspaper informed its readers that, at that time, the State of Victoria had the highest recorded per capita rate of H1N1 Influenza 2 (Human Swine flu) in the world. It had the fourth highest number of infections worldwide after the US, Mexico and Canada, but the highest per capita load.
Victoria was being blamed for exporting the virus around Australia.
Eventually the official record showed 37,537 cases in Australia and 191 deaths associated with Swine Flu were reported by the Department of Health. The actual numbers were probably much larger as only serious cases warranted being tested and treated. Sources say that as many as 1600 Australians may actually have died.
How McDougall Topped the Score, written by Thomas E. Spencer, was first published in The Bulletin in March 1898. The cricketing cred. of the poem was enhanced when a piece entitled The Prerogative of Piper’s Flat was given as an encore to the McDougall poem at a public reception for the great, the elegant Victor Trumper in Sydney Town Hall on 19 December 1903.
In June 2009 I wrote a companion piece to Spencer’s, based on the facts as reported in the Australian. So much of the content of the piece seems relevant today that I am bold enough to hope you will get something out of it.
Reminders
Given the time that has elapsed since June 2009 some further background will be useful for those who read the piece. On 23 May the Federal Government classified the Swine Flu outbreak as being in the CONTAIN phase. Victoria was escalated to the SUSTAIN phase on 3 June. This gave government authorities permission to close schools to slow the spread of the disease. On 17 June 2009 the Department of Health and Ageing introduced a new phase called PROTECT. This modified the response to focus on people with high risk of complications from the disease.
At the time Australia had a stockpile of 8.7 million doses of Tamiflu and Relenza. A large scale immunization effort against swine flu started on Monday 28 September 2009. By then Victoria had 2,440 cases and 24 deaths. The Victorian health authorities closed Clifton Hill Primary School for two days (sic) on 21 May (shock, horror).
Tamiflu was a Roche product, Relenza a GSK product. (In 2014 researchers threw doubt on the effectiveness of Tamiflu and thus on the value of governments stockpiling it.) In June 2009 the Minister for Health was Nicola Roxon, Member for Gellibrand, an inner-Melbourne electorate. Coincidentally, in 2015 Tadryn bought a house in Footscray, within spitting distance of Whitten Oval. As well as describing folks from Mexico, the term ‘Mexicans’ is used by people from States to the north to refer to people from Victoria. Australia’s Chief Medical Officer in 2009 was Jim Bishop.
How Victoria Topped the Score
A peaceful spot is Gellibrand – and many local folk
Exist by work in railways, and paper, tyres and rope
The views to sea are legend and the people, quite untaught –
Lean naturally to leftwards, as portside people ought
Still the climate is erratic as the natives always knew
And the winters damp and gusty bring on frequent bouts of flu
But the locals now are Tami-rous as never were before
As H1N1 gets around – and Victoria tops the score.
It’s 90 square kilometres right to Port Philip Bay
Embracing Whitten Oval where the Bulldogs hone their play
Includes Altona Meadows where the views are simply grand
And other lovely places now warehousing used to stand
From Spotswood through to Tottenham employment, once serene,
Depends on heavy industry, petrochemical, marine
The local folks are very proud, be they so rich or poor
But they all might be affected as Victoria tops the score.
It’s Inner Metropolitan (GPs’ incentives: nil –
For the local branch of the AMA this is a bitter pill)
So when a virus came along – exclusion was in vain –
The local health care services got ready for the strain.
Local people everywhere did all that they were asked
And courses sprang up all around on kissing through a mask
A local hero came along: Gellibrander to the core
Who meant to keep the lid on it – tho’ Victoria topped the score.
This hero was a lawyer and a trusted one at that
And in the middle order for young Kevin she would bat
She trained her loyal staffers how to listen and to scout
For useful tips, intelligence, whatever was about
And each succeeding night they worked ’til the light it was a blur
Sometimes our hero struck a thought, sometimes a thought struck her
’Til one day news from Mexico of which she’d hear much more
That swine flu was now all the rage – not too long from our shore.
The national plans were then rolled out – even Bishops were involved
Good health care teams and scientists all helped to have it solved
No stone was left un-x-rayed and surveillance was maintained
And people’s sensitivity was measured when de-planed
A hotline was established but it very soon was broke
And crackling then was all it gave to its inquiring folk
The public mind was set at ease, there sure was nothing more
And New South Wales got uppity, as Victoria topped the score.
Victoria’s reached a thousand and some medics now complain
Even tho’ officially it’s-on ‘modified sustain’
If children want to miss exams and have a full week off
They simply visit Gellibrand and then begin to cough
We all will do whate’er we can to try to keep the peace
We’ll quit the smokes and exercise ’gin morbidly obese
This gentle flu, still not a swine, in countries seventy four
And here it’s still Victoria that easy tops the score
This illness from the Mexicans is causing a to-do
And now is a pandemic if you credit you-know-WHO
But guided safely as we are from right the very top
We’re confident that this will pass, it’s likely soon to stop
So raise a glass – or a long pipette – to our Gellibrander boss
‘Cos even tho it’s not too strong it makes us all la-cross
And there may well be an upside – tho’ it’s touchy this to broach
For you won’t catch a cold at all just now if your shares are still with Roche
So let’s consign to history, make part of national lore
The time when, quite unwillingly, Victoria topped the score
The Treasurer says the JobKeeper program needs to end because it’s having the perverse effect of preventing workers “more efficiently moving to other roles across the economy” and because “it can prop up what are unsustainable long-term businesses” (ABC’s 7:30 Report, 11 March 2021).
It is at best ironic or at worst inconsistent that, on the same day, the Government announced a $1.2 billion support package for the airlines and tourism industries. Part of the package will provide 800,000 half-price airfares to (initially) 13 tourism-reliant regions, selected on the basis that they are among the worst-affected by the pandemic.
‘Tourism-related regions’
The new program will commit what market economists regard as one of the greatest sins open to a government: to provide differential support to different places, population groups or industries. The pejorative term is ‘picking winners’.
The sin is compounded when the criteria by which inclusion/exclusion decisions are made are not clear. Accountability is missing. People are already asking about the criteria that led to Darwin and Adelaide being included in the program within 24 hours of its announcement,
Although they are more modest in terms of scope and expenditure, suspicions about how grant programs such as for sports infrastructure and regional growth funds have been managed contribute to the situation in which government intervention is not trusted. One particular issue is the role played by ‘Ministerial discretion’ in the allocations made. The Morrison government is fortunate that the pandemic has given the media and the public bigger fish to fry than assertions about the misallocation of grant funds.
The inconsistency of decisions about JobKeeper and the new tourism package need to be seen in the context of both their immediate effects on employment and their medium-term impact on structural change in the economy. ‘Structural change’ is not a phrase to light up the synapses in many heads, but it is critical.
The economic challenges faced by Australia as a result of the COVID-19 pandemic are just the latest emanations of the need for a national economy to change itself in order to better meet the needs of labour and capital. Without warning or prudent preparation, Australia is experiencing the effects of the radical and sudden downsizing of two of its largest industries
With Australia’s international borders shut, the overseas student sector has virtually disappeared, at least for a year or two. Australian institutions are faced with the urgent need to provide new and different services.
Waiting for normal service to be resumed.
The same applies to the nation’s overseas tourist sector. Before the pandemic, tourism as a whole was a $152 billion industry for Australia, with a substantial part of it being through visitors from overseas.
Unlike most structural change, the loss of jobs in these two industries has been at a stroke, and caused by a single event beyond the control of any government. The precipitous nature of the change has made the job losses that have occurred even more difficult to manage.
A new economy has to be fashioned.
Although the speed at which the change has occurred is unusual, the key policy questions confronting the Government are the same as ever. They concern the ‘best’ speed at which structural change should occur; and the modes of intervention that should be employed.
The first of these policy questions is premised on an indisputable fact: through the degree and nature of its interventions, governments can, to a meaningful extent, manage the national speed of structural change in the economy.
The consequence of the speed of structural change occurring can be measured in terms of the number of people who lose work they used to have, and the number who cannot break into the job market at all. The speed of change determines the amount of stress (unemployment, underemployment, social cohesion, anguish and illness) caused. The more rapid the change, the greater the stress and disruption.
The options available for government intervention include an emphasis on education, training and retraining; payments of social support; incentives for the relocation of people or industries; countervailing government investment in the declining industries; and incentives for economic development or business subsidies – potentially per place or industry, as with the current tourism package.
The best option for Australian Government’s intervention in economic structural change is likely now to be different given the sudden limits to economic globalism that have emerged.
Globalism takes a step back
Structural change is necessary in any economy if it is to maximise the opportunities for work and returns to invested resources. The government of the day must strike a balance. That balance lies somewhere between intervening too much and so slowing down the rate at which desirable change occurs in the mix of industries in the economy; and intervening too little such that the aggregate cost to persons and communities in terms of the stresses experienced is deemed to be excessive.
There are always various judgements from different individuals and agencies about where this best balance lies. It demonstrates once again that policy-making for a national economy is extremely complex. This is particularly the case when there has been a failure to anticipate events that have very serious consequences for employment and income.
