If COVID-19 is here to stay, how can we best protect people’s health?

RAT tests have sold out across the nation.

The current COVID-19 wave, triggered by the Omicron variant, has given rise to daily case numbers in the 10,000s and hospitals are struggling to cope. Given daily cases had not surpassed 3000 until mid-December and politicians had two years to prepare for this likely scenario, public anger at government failings is justifiable.

This anger has been further fuelled by moves in New South Wales and Victoria to continue apace with reopening after months of lockdown, as most other states lifted border restrictions, allowing COVID-19 in.

Some lay blame for the current outbreak on the federal and NSW Coalition governments. In reality, these measures are in line with the reopening plan agreed at National Cabinet by federal, state and territory governments — both Coalition and Labor — and represent the continuation of a two-year long bipartisan plan for dealing with COVID-19. 

Having benefited from being an isolated island nation and the delayed arrival of the virus, federal and state governments found themselves in an enviable position to suppress the first wave.

Since then they have sought to keep case numbers as low as possible, primarily by closing international borders — including for many citizens — and imposing lockdown measures whose health, social and economic impacts were most keenly felt by working people, until agreed vaccination targets were met. 

At the same time, governments refused to boost healthcare funding and ensured economic support measures were temporary so that they, and employers, bore as little ongoing cost as possible.

With COVID-19 widely circulating in the community, the challenge for progressives is to work out how best to organise public anger towards fighting for measures that can offer lasting protections.

Reverse course?

Faced with rapidly escalating Omicron case numbers, many progressives said the best way forward was to reverse course and reintroduce previous measures — albeit partially.

In mid-December, petitions called on the NSW government to restore indoor mask-wearing mandates, QR codes, density limits in hospitality venues and vaccination passports. Within two weeks, the NSW government did just that (with the exception of vaccination passports).

Yet, cases continue to soar and states that kept such measures are not faring much better.

In late December, the focus shifted to calling on the federal government to reverse decisions such as reduced isolation periods and the promotion of user-pays rapid antigen tests (RATs) over government-funded PCR tests. 

But these decisions had been agreed to by all governments, Coalition and Labor. More importantly, simply reversing such measures is problematic.

When it comes to isolation periods, the new rules reduce the time frame for those who test positive or are deemed close contacts from 14 to 7 days, as long as they are asymptomatic or test negative, in the case of close contacts, at the end of this period.

The shift is a reflection of the changing reality. Previously, it made sense to extend quarantine to 14 days, despite most onward transmission taking place within a 5–7 day period, as only a small number of people needed to isolate and the extra time provided additional certainty that onward transmission would not occur.

But, at much higher case numbers new factors enter the equation.

First, is the ability to maintain essential services, such as food distribution (there are already empty shelves in supermarkets) and hospital care (where beds are available but staff are not).

The Centre for Future Work’s Jim Stanford, who estimates that one-third of NSW workers could be in isolation over the coming weeks,  such levels of worker absenteeism could lead to a “life-threatening catastrophe”. This is why some state governments have already been forced to further curtail isolation requirements for certain essential workers.

Compliance is another issue: it becomes impossible at such high case numbers. Expecting people will stay home — even if asymptomatic and losing income — rather than asking them to isolate for the critical infectious period means the danger of people not getting tested starts to outweigh the risk that some who may still be infectious leave isolation too early.

As for RAT and PCR tests, the former should be free and accessible to all and the capacity of the latter expanded. But given 40–45% of transmission is asymptomatic, increasing our reliance on RATs makes sense to minimise transmission. RATs could be an invaluable tool for schools, hospitals and other essential workplaces.

Looking forward

Overall, simply calling to (partially) restore previous measures does not deal with the present reality.

That almost no-one is calling for a return to harsher lockdown measures indicates most see going back to zero cases as impossible. This is because the lockdown measures required would have to be even more draconian and a highly vaccinated population is unlikely to accept this.

Governments are wagering that the current anger will wane into acceptance and resignation. 

However, acknowledging that we are now living with COVID-19 should not mean giving up on the fight for measures that can help drive cases down and protect working people. 

We need to continue demanding governments, state and federal, implement measures that can have real and lasting impacts.

Central to this is the fight for global vaccine equality, as no one will be safe until everyone is safe. 

For a start, the federal government should renationalise the Commonwealth Serum Laboratories, reverse its decision to wind back AstraZeneca production and ramp up vaccine supplies to neighbouring countries.

Greater public spending on healthcare is also crucial, and not just for hospitals. Increasing staff numbers requires pay rises and free education as incentives for more people to join, rather than leave, the industry.

The impact of the pandemic on global supply chains shows the need to start producing more medical goods at home. We have to be able to ensure supplies of goods, such as testing kits, masks and other personal protective equipment (PPE).

Ensuring safe schools and workplaces, through improving ventilation and ensuring adequate, free distribution of PPE and RATs, could be made a priority through government programs that involve workplace safety representatives, trade unions and parents and citizens associations.

Establishing a system of guaranteed 14 days paid sick leave for all, regardless of employment or visa status, would remove any dilemma about losing income for workers getting tested or close contacts needing to isolate. In addition, the JobSeeker coronavirus supplement should be reinstated and made permanent.

To stop employers abusing the reduced isolation period, there should be a ban on sacking any worker who refuses to return to work after seven days. A negative RAT test, paid for by employers, should be a requirement for those returning to a workplace, while those who can work from home should do so for the second 7-day period, even if asymptomatic.

It is also past time for the public to be able to scrutinise the advice and modelling provided to government. introduced during the previous phase of the pandemic, should be repealed.