Polarisation in Covid-19 lockdown debate a dangerous prospect

by | Sep 13, 2020 | Government

Michael Tanner weighs the evidence as Victorian Premier Dan Andrews charts a way out of the state’s lockdown. 

The debate over Covid-19 lockdowns has reached fever pitch.

The bipartisanship that was crucial to Australia’s success in the early days has given way to political bickering. Scott Morrison and Josh Frydenberg’s attacks on Annastacia Palaszczuk and Daniel Andrews mark a profound increase in the politicisation and polarisation of the response to Covid-19.

Healthy debate is the cornerstone of a functioning democracy. Intense polarisation is not. One needs only look at America for evidence of that. Deaths are approaching 200,000 and show few signs of abating. Yet US President Donald Trump maintains an approval rating that has not dropped below 85% among Republicans this year; it has not exceeded 15% among Democrats.

This polarisation has been central to the undoing of the American response to Covid-19. The Trump administration was slow to react because a virus that hit Democratic states hard – particularly New York City – was of political benefit. It was only as the pandemic infiltrated the red states of the south that action began. Even then, changes have been half-hearted, and social distancing and mask wearing have become political statements rather than actions of heeding health advice. Meanwhile the virus rampages on.

Back in Melbourne, the insidious beginnings of a similar polarisation have begun. The anger over extended lockdowns is close to bubbling point, with anti-mask and other protests growing.

Roadmap not a political decision

The decisions of the Andrews government are increasingly being viewed through a political lens. But the extended lockdown and the roadmap out are not political decisions. In light of the visceral public anger, frustration and despair, it is obvious these decisions are not made to boost approval ratings.

Victoria’s crisis has been brought about by a failure of both state and federal governments. State Labor’s hotel quarantine disaster was exacerbated by the chronic underfunding of the state’s public health system; particularly the pen-and-paper contact tracing system.

But failures at the federal level abound. The failure of Scott Morrison’s federal government to develop and roll out a comprehensive federal aged-care plan contributed significantly to sky-rocketing case numbers and unnecessary deaths. As did the refusal to demand each aged care home appoint a designated infection control manager, a recommendation made eight years ago by a coroner.

And then there is the increasing casualisation of the workforce in the last decade of Liberal governments, leaving millions of Australians without sick leave, forced to choose between feeding their families and undergoing quarantine to stop the spread.

Path ahead is unclear

There have been calamitous mis-steps. But despite the apoplexy of the business, retail and hospitality sectors and the growing concern among some doctors regarding the reduction in cancer screening and presentations to emergency department, the best path forward is far from clear.

Chief concerns are the shock to the economy and skyrocketing unemployment on the business side; and on the health side, the reduction in people seeking medical care, as well as growing mental health concerns. These are big issues.

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But to what extent are these purely due to the lockdown?

Some point to Sweden as a model of Covid-19 control. Despite one of the highest per capita death rates in the world, the country is now seeing relatively few daily deaths. It is easy to assume Sweden is living as if Covid-19 was not a spectre haunting the horizon. But Sweden should not be compared to Australia. Like other Nordic countries, Sweden has a relatively homogenous culture; trust in government is far higher than in Australia; and 40% of households are single-person households, compared to less than 25% in Australia. These are all factors that promote adherence to the light touch of the government.

Economist Nicholas Gruen points to a 70% decline in road traffic in Sweden in the early days of the pandemic, at a time when Australia’s, in comparison, was 80% under strong lockdown measures. Fear of the virus led to voluntary social distancing and self-isolation.

On a per capita basis, at the height of transmission, the three-day average of infections in Victoria exceeded 90 per million population. This is roughly the same rate as seen in the United Kingdom at the peak of its first wave. It is fanciful to think that the Swedish approach would be effective given what we witnessed in Victoria during our second wave in July – despite the implementation of stringent restrictions.

Nor did Sweden’s light touch mitigate the economic harm. As Greg Jericho reports in The Guardian, countries that saw the greatest number of deaths per capita also experienced the worst economic decline. In the quarter to July 2020, Sweden’s GDP declined 8.6%, more than the 7.4% drop seen in Denmark and the 3.2% fall seen in neighbouring Finland. The EU average sits at 12%. Australia’s declined 7%, by comparison. Sweden also recorded five times more deaths than Denmark, and 10 times more than Finland.

Looser restrctions don’t guarantee a bounce back

Looser restrictions do not guarantee a vibrant economy because, as Bernard Keane noted in Crikey, there will be no recovery without people feeling safe. “Removing lockdown is not going to restore confidence: only when people are no longer concerned about the risk of dying, or infecting a loved one, will they lose their caution and start spending.” Loosening restrictions does, however, guarantee an increase in the number of cases without strict adherence to public health measures.

Health care concerns are valid and important. Cancer diagnoses are down in Australia, and the delay in elective surgery is likely leaving many people in pain.

But cancer diagnoses are down in Sweden, the Netherlands, and in countries all around the world, with or without lockdown. A reduction in preventative health care is largely a result of a global pandemic, of fears of infection, and of overburdening the health system. While lockdowns probably contribute, easing restrictions are not the panacea.

Despite early fears of increases in suicide, a recent coroner’s report found that the number of suicides is no higher than 2019. However, history has shown us time and time again that recessions lead to suicides – the great depression, the economic crises in Russia in the early 1990s and east Asia in the later parts of that decade; the global financial crisis. Restarting the economy is paramount, but failure to control Covid-19 will remain an anchor on growth. The virus remains a health crisis that begat an economic crisis. It must not become politicised.

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Political interests are, however, growing. The closure of state borders remains an ongoing issue, and will hinder economic recovery.

State governments that have closed borders have seen their popularity skyrocket. While NSW, South Australia and Tasmania accepted a definition of a hotspot to try to open borders, Queensland and Western Australia remain obstinate. It remains to be seen whether Prime Minister Scott Morrison is eventually going to risk angering voters in these states by forcing open state and territory borders.

Victoria a pariah state?

If restrictions ease too early in Victoria, cases will rise. State borders will then definitely stay closed. We can then say goodbye to the prospect of state borders opening to Victorians before widespread vaccination is available – which is unlikely to happen before the end of 2021, at the earliest. Victoria, in essence, is likely to remain a pariah state until there is a vaccine. What if one is never found? Do we wish to accept that we will not be able to leave Victoria until there is widespread vaccination? No visiting children, or sick relatives? No interstate travel? I personally do not.

The road map has flaws. The criteria for loosening restrictions should not be based solely on case numbers. This disincentivises testing when people only have mild symptoms. The proportion of tests returning positive should play a major role in deciding when to ease restrictions. The thresholds for easing are too strict – as Tim Colebatch reports, only one of 39 high income countries meets the standard set by the Andrews government.

A campaign to ensure people still visit their GP or hospital should have begun in April, but it is never too late to start. In the Netherlands, such a public awareness campaign appeared to halt the decline in cancer diagnoses that occurred following the first diagnosed case of Covid-19 in the Netherlands – prior to the implementation of strict social distancing measures.

Restrictions should be more targeted to settings where high transmission rates occur. Exercising outdoors with two or three other people, providing there is adequate social distancing, poses a minimal risk. The curfew is contentious, but pragmatic: it is likely to reduce clandestine gatherings and should have a minimal effect on those adhering to restrictions, particularly as it is extended to 9pm.

The decision of when to ease restrictions is likely to be one of the most challenging and complex decisions ever made.

Correction: An earlier version of this article incorrectly stated that more suicides had occurred in 2020 compared to 2019. There has not been such an increase. Apologies.

ABOUT THE AUTHOR

Michael Tanner

Michael Tanner

Michael Tanner is completing a Doctor of Medicine/Doctor of Philosophy. His writing explores the intersection of economics, the media and public health. His writing has also been published in The Age. Michael’s Twitter handle is @MichaelTanner_

21 Comments

  1. Avatar

    I think the number of people not wanting to get tested will largely be a factor of whether people believe the virus is real as much as the people that want everything open today. Neither will ever get a test unless forced. Majority of people want to do the right thing. If we continue on current rate in Vic I think we are also likely to meet the 5 cases/day over 14 days but maybe a week or 2 later. I think a big part of the reason for 5/day over 14 days is people will relax and we are likely to see a spike 2 weeks after the stage is met. More movement guarantees more cases. Mystery cases is probably the most important metric to get down to zero before opening up. We should also make it a requirement that to start work again after opening up is allowed you have to be tested and report negative for covid. This will ensure testing is still high enough to catch cases.

  2. Avatar

    On the politics of this: I think the term ‘polarisation’ is both overused and a mischaracterisation. It implies two equally opposed forces equidistant from a perceived centre. The problem is that in both the American and Victorian example, the conflict is invariably initiated by the Right moving to its own pole and abandoning the centre, whilst the ‘left’ remains rooted to the centre acting on medical advice and some political pragmatism. The Right is also vastly stronger, having the backing (implicitly or explicitly) of the MSM and business elite, and the whirlpool of conspiracies on social media.

    It is certainly good that this is not a mischaracterisation to be found in the article, but the use of the term, especially in a headlines, gives a wrong impression of the situation. I think a more appropriate term would be ‘toxicity’ or ‘division.’ The author is correct that disagreement is necessary in a functioning democracy, but the described circumstances go beyond that, as one side disavows reason or morality, preferring nihilistic theatrics.

  3. Avatar

    What are the benefts of the B& R policy for Victoria ?
    Why didn;’t Victoria learn from Qld, NSW ,SA. ACT and WA on how to control aged care . Was it because he knew better than the evidence of the other States? . He made a blunder it would be good for all if he admitted it. We now have an irrational blame game going on .

    • Avatar

      The fact is that aged care is the responsibility of the federal government, has been since Howard privitised it. Now, nursing homes in Victoria ARE the responsibilty of the state and they have a set ratio of accredited nurses per a set number of patients, which is not the case in federal aged care, and there have been very few cases or deaths in these Victorian nursing homes.

      • Avatar

        Daibhin why do you ignore the facts of the other States managed it better and how Victoria did on this . You also ignore the B& R question . Have they been advising Dan on his policy it seems very similar to Wuhan

      • Avatar

        Similar B&R agreements have been signed by other states and the Federal government. This is a beat-up. The Victorian agreement is only an agreement to have a discussion. It’s actually worthless.

        The other states didn’t ‘manage’ aged care better – NSW had a shocking death toll in the first wave, and as aged care is controlled by Federal government, the Victorian government had to ask permission to intervene, which took some time before permission was granted. For example, they wanted to move some residents into private hospitals, but that wasn’t approved immediately – the Feds had kept all aged care residents in NSW – Covid positive or not – in their aged care facility – and wanted to do the same in Victoria.

        Until we get welded into our homes, you can’t say that our lockdown is similar to Wuhan.

      • Avatar

        Well said, Anne. It’s so annoying that some people continue to spruik the Fed Gov line without tsking time to do their own research.

      • Avatar

        Anne a little light on facts . NSW had about 45 , Victoria close to 600 .Tasmania did well as well .Movement into hospitals was under State control not federal .Victoria is clearly worse then all the other States combined .
        Why won’t Dan release the B & R document ? Perhaps then one can see and evaluate but that may not be possible in Victoria

      • Avatar

        Why do you ignore the facts about the many deaths in NSW aged care? Really, just following along with what the feds and MSM spill out in order to get evety state to become Liberal ones and the power that would hand to the current leader, Morrison, which is as plain as day if you take time to look. Please do not respond, I just can’t be bothered with pointless discussions with persons who can’t see past their noses.

  4. Avatar

    I am not a Labor supporter, but have a great deal of admiration for how Dan has handled the virus.

  5. Avatar

    “The road map has flaws. The criteria for loosening restrictions should
    not be based solely on case numbers. This disincentivises testing when
    people only have mild symptoms. The proportion of tests returning
    positive should play a major role in deciding when to ease restrictions”
    I appreciate your suggestion at an alternative criteria for easing the restrictions, however, your suggestion has the same issue as the current criterion, there can’t be a high number of positive tests if people just don’t get tested.

    • Avatar

      As an example, if we only tested people hospitalised with pneumonia, the vast majority of tests would come back positive, but case numbers would remain low as we do not pick up people with mild infections. On the flip side, if we tested the entire population, the proportion of tests returning positive would be miniscule, but case numbers would be higher, as we pick up mild/asymptomatic cases. This is why both factors should be counted. If people “just don’t get tested”, only those sick enough to require medical attention will be tested, and thus the proportion of tests returning positive will be higher.

  6. Avatar

    There has not been an increase in suicide – that was mere speculation, encouraged by anyone who wanted to end restrictions for financial or political reasons. An article in The Age within the last month gave the year to date figures for 2020 and the same period in 2019 – in fact, 2020 had two fewer suicides.

    People may have lost jobs, but many have not had to commute, are often getting more exercise (the daily walk), many are cooking instead of buying unhealthy takeaway, and increased support payments have taken the edge off unemployment and underemployment.

    We may actually find at the end of the year that there has been a reduction in stress-related diseases such as heart attacks and strokes, as well as fewer car accidents. Just be careful doing home repairs and renovations – ladders and power tools are dangerous!

    • Avatar

      Re suicide impact, the recent Grattan report Go For Zero cites (p 20) Foa et al. (2020): “the pandemic and spread of COVID-19 has a clear negative impact on mental health in the UK, but the introduction of restrictions and controls was associated with a rebound in mental wellbeing. The analysis was extended and the findings held in Australia, New Zealand, Ireland, the US, Canada, India, and South Africa.”

  7. Avatar

    Thanks all for comments – apologies re suicide data, the report I referenced was for 2019. The article has been corrected.

  8. Avatar

    The Liberal Party and it’s media stooges (or is it media and Liberal Party stooges) have succeeded in making a public health issue into a political issue. We can see the polarisation on political lines in the commentary below.

    This suits both, because those who advocate for wealth and privilege are already bored with Job Seeker in particular. Originally a payment for those who are unemployed “through no fault of their own”, are soon to be reclassified as dole bludgers on Newstart. Pressure is building to open borders and ease restrictions because those with influence want to go back to making money. Sickness and death being but collateral damage.

  9. Avatar

    745 deaths in Victoria 87 elsewhere in Australia . What did D Dan do correctly ? The evidence suggests very little.
    Should Victoria be paying for it overseas residents that arrive in other States who are Victorians and are supported elsewhere or is D Dan exempt ?

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