“Obviously, we in Australia have been reluctant to take the same measure, even though it’s a lot easier for us to control our borders than it is for Turkey,” says Cachia, who works for a major Australian pathology firm but is speaking in a personal capacity.
True. Australia has banned arrivals from China and Iran. And on Monday, the federal Health Minister, Greg Hunt, and chief medical officer, Brendan Murphy, said that the government had escalated warnings to Australians against travel to Italy and South Korea. They also urged Australian health workers and aged care workers returning from Italy and South Korea to avoid their workplaces from 14 days on arrival in Australia, a measure to protect the most vulnerable from possible infection.
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But Australia has not banned arrivals from Italy and South Korea, even though the number of infections in those countries continues to burgeon. “This is a very serious misstep and a premature surrender of the natural advantage our island continent offers to slow this disease in Australia,” Cachia tells me. He thinks arrivals from Japan also should be halted.
On Sunday, the Home Affairs Minister, Peter Dutton, said that arrivals had been banned from Iran in particular – and not Italy or South Korea – because of doubts about the trustworthiness of Iran’s reporting. If this were the criterion, what about Indonesia? It continues to report zero cases. Its vice-president Ma’ruf Amin says that’s because of the power of Indonesian clerics’ prayers. Ma’ruf himself is a senior Muslim cleric.
Another possibility? Indonesia’s authorities are determined not to find any cases of coronavirus. Testing is strictly limited. As of Sunday, only 141 people had been tested. Out of a population of 270 million. Seek not and ye shall find not!
If the trustworthiness of reporting were the main criterion, Canberra would put immediate travel bans on not only China and Iran but also Indonesia and dozens of other nations.
Murphy gave a different answer on Monday when a reporter asked him for the medical advice to the government on whether to impose travel bans on Italy and South Korea: “It’s no longer possible to absolutely prevent new cases coming in, given the increasing changes in epidemiology around the country,” he said. “So in the case of Iran, there’s such a high risk that a travel ban is worth doing because it will slow down the number of cases. You cannot stop Australian citizens coming back. Some of the cases that came back from Iran with the disease are Australian citizens.
“At the moment, the medical advice was that the situation in Italy and South Korea, where they have large outbreaks but they’re confined and being localised, the risk – the proportionality – of putting in a travel ban wasn’t justified in terms of its benefit to the health protection of the Australian community.”
Cachia decodes this: “It implies that they may be resigned to a major outbreak in Australia.”
Murphy is telling us that there are two critical concepts being applied to Australia’s border policy. First is that it’s now all about slowing the spread of the virus – not preventing it. “Travel bans are – at this stage, when we have an outbreak in many countries – a way of delaying the burden of new cases coming in,” he said.
If we’re inevitably going to get a major outbreak, why is slowing the rate of infection so important? In Cachia’s explanation, the aim is to slow the rate to keep the number of severe cases below the “key resource constraint – the number of mechanical ventilators in Australia”.
Illustration: Andrew DysonCredit:
Standard treatment of severe cases is to put them on ventilators for a few days until the infection passes, he says. In effect, Australia is engaged in disease rationing to match ventilator supply.
But Cachia has an objection. He points up an inconsistency. Where people in Australia are found to have the virus, authorities are conducting “contact tracing” to find anyone they might have infected. “What’s the point of contact tracing while your borders from places that have declared states of emergency are still wide open?”
This brings us to Murphy’s second key concept. The word he used was the “proportionality” of applying a travel ban. Its proportionality was not “justified in terms of its benefit to health protection”. But a cost-benefit analysis weighs benefit against cost. What would be the cost of wider-ranging travel bans? This is where the consideration – unspoken – of economics comes in.
The travel ban on Chinese arrivals alone is imposing a major cost on Australia’s economy. The more countries listed, the greater the damage. With a widespread outbreak already inevitable, the net benefit of banning another country’s travellers is weighed against the net cost to the economy. The Australian economic modeller Warwick McKibbin estimated in a 2006 paper that a moderate to severe global flu pandemic with a mortality rate up to 1.2 per cent would cut the GDP growth of the world’s developed countries by up to 6 per cent. This would be a massive global contraction. To date, the mortality rate of the coronavirus worldwide – excluding China – is about 1.5 per cent, closely matching McKibbin’s assumptions.
So it’s no longer about preventing an Australian outbreak. Australia is now figuring out how to live with the COVID-19, rationing the virus to the capacity of the health system, preserving as much economic activity as reasonably possible in the process.
Adrian Cachia got his test results on Monday afternoon, by the way. He tested negative. He says he had mixed feelings. Relief, yes, but he says that it might be better to get infected now and develop immunity, giving his nerves some comfort. Which recalls the Cold War movie, Dr Strangelove. To adapt its subtitle, “How I learned to stop worrying and love the bomb”, Australia may be beginning to “Learn to stop worrying and love the virus”.
Peter Hartcher is international editor.
Peter Hartcher is political editor and international editor of The Sydney Morning Herald.
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