Prepare for a change in the COVID blame game

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The COVID-19 policy in Australia has been largely characterized by a culture of blame.

Who to blame for the hotel quarantine violations? Who to blame for contact tracing failures, border restrictions, stranded Australians and botched vaccine rollout? Who to blame for epidemics and blockages in elderly care?

The policy of COVID-19 in Australia has been largely characterized by a culture of blame, such as around epidemics in the care of the elderly. Image: Getty Images

On a personal level, anger and blame are bad for your health and bad for recovery from illness.

Avoiding blame and its political consequences has also proven to be a major headache for state and federal governments looking to navigate their way through a volatile and fractured public mood.

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While governments naturally claim credit for things that go well, they are never willing to accept blame for things that go wrong and are very happy to blame others whenever possible.

So while Prime Minister Scott Morrison’s announcement this week of a 4-phase pandemic exit strategy has been well received, comments from cabinet members, state prime ministers and health ministers signal a new phase in the level of responsibility they plan to accept for COVID-19 outbreaks in the future. Hint: not much.

The language of life with COVID heralds a transition that could ultimately see the blame for cases, disease, death and economic damage shift squarely from government to, guess who?

You.

That should sound the alarm bells, here’s why.

Public health is concerned with the way societies are organized, resourced, and the levels of health and / or disease that they consequently generate. For this reason, sickness and illness rates differ between countries or jurisdictions that are otherwise similar.

Making COVID-19 a matter of personal responsibility is the path the UK is taking now. Australian Prime Minister Scott Morrison (pictured left) with UK Prime Minister Boris John outside 10 Downing Street, June 2021. Photo: Getty Images

Public health outcomes are inseparable from public resources, social organization and government priorities.

This means that when something goes wrong with public health, like an epidemic, it is most likely the fault of governments that it happened in the first place (whether it was the result of poor surveillance or ‘bad regulation) and also the responsibility of governments to repair because individuals do not control the levers powerful enough to intervene on a large scale.

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Now compare that with medicine. Medicine is concerned with services, treatment, disease management, individual patient care and risks. Beyond access issues, these functions are largely separated from government policies.

If a person develops an illness as a result of their behavior (which can include smoking, drinking, or poor hygiene), they are unlikely to directly blame the prime minister or prime minister. If they do, the government will simply dismiss them from their responsibilities as people seeing traffic trauma.

By distinguishing public health issues from medical issues, then, it’s easy to see what kind of issue governments would prefer COVID-19 to be an individual issue.

Making COVID-19 about personal responsibility, risk assessment, and common sense largely absolves them of any liability and potential blame. This is the path the United States and the United Kingdom are taking right now.

For example, despite the skyrocketing number of cases expected to hit 50,000 per day in two to three weeks, the UK is quickly shifting to a personal accountability model for its so-called Freedom Day on July 19. , where all public health decrees like mask wearing and social distancing requirements will be removed.

As Australia suffers ongoing instant lockdowns, discussion is shifting to living with COVID now that the national plan has been tabled. Image: Getty Images

If the freedom offered on this day is for the citizens, then it is also for the government which will finally be released from all responsibility and blame for the tragic mismanagement of this country’s COVID-19 public health response as the number of deaths is approaching 130,000.

However, with vaccination rates approaching 50%, Prime Minister Johnson and Health Secretary Sajid Javid are working to stress that any future infection, illness and death will not be due to their failure to succeeded in protecting public health, it will be because individuals did not protect themselves. .

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Here in Australia, things are not so bad. Yet as we endure instant lockdowns on-going, the discussion is once again shifting to living with COVID now that the national plan is tabled. However, getting from here to there is a huge step forward as a large piece of the puzzle is missing.

On Friday, July 2, Prime Minister Morrison announced that Phase 2 of Australia’s plan would be triggered when a scientific per capita vaccine count is reached (currently modeled by the Peter Doherty Institute for Infection and Immunity). He reiterated that this number would not be driven by political considerations, but by science.

Yet this ideal of reaching a scientific objective number is impossible because, as described above, public health outcomes are generated by the organization of societies, which are guided by government priorities. The argument is therefore circular.

Second, the discussion that dominates the number of mystery vaccinations seems to assume that we are aiming for a herd immunity based on the Delta strain which should achieve coverage above 80-85%, or perhaps less with continued use of the mask, the contact tracing and social distancing policies.

Achieving equitable access to immunizations leaves large groups vulnerable and is unlikely to ever be truly equitable. Image: Getty Images

But then again, should collective immunity really be the goal and how does that fit in living with COVID?

Some sections of the community and industry have already suggested a preference for achieving a level of vaccination that produces an acceptable level of death and disease without achieving herd immunity (flattening the curve), but they are hesitant to suggest what should be that level.

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Going further, Victoria Premier Daniel Andrews even launched the idea that vaccination rates are less important than the rates of people who have had equitable access to vaccinations.

After which, its bad luck, you are alone. But who can scientifically define equitable access? And even if we agree on this, then should we blame the people who were not convinced by our sad campaigns to get vaccinated for getting sick and / or dying?

So the point at which we reach phase two is much trickier, less scientific, and more subjective than it sounds.

Achieving collective immunity sounds good in theory, but it may not even be possible without additional and ongoing non-pharmaceutical measures like masks of the kind the UK rejects.

Falling short of herd immunity and simply flattening the curve, COVID-19 will become endemic with the continued threat of new strains and breakthrough infections that can lead to further restrictions and a return to lockdowns.

And achieving equitable access leaves large groups vulnerable and is unlikely to ever be truly equitable. In equitable access scenarios, who gets sick and who suffers?

Falling short of herd immunity and simply flattening the curve, COVID-19 will become endemic with the continued threat of new strains and breakthrough infections. Image: Getty Images

The answer is likely to be the most vulnerable, the poorest, the least educated usual suspects.

These are the people whose health is already worse and government and public health practitioners will continue to have the responsibility to protect.

We still have some way to go, but unless governments are also prepared to relinquish their power and responsibilities as the organizers of society, they cannot yet escape all the blame.

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