Mon, 27 Sep 2021

We are living simultaneously in two COVID worlds.

On the one hand we're talking about how life will be when 70% or 80% per cent of eligible people are fully vaccinated.

On the other, what we can call our third wave of COVID is spreading, hitting young people, infecting children, resisting efforts at suppression. Sydney is in dreadful shape, NSW regions are under threat (there's a lockdown in the Hunter), south east Queensland is shuttered, as is Victoria, and the rollout remains beset by difficulties.

We must, of course, have the conversation about exiting the pandemic. We need to consider issues including how a vaccination passport would work, when home quarantine can kick in, and much else around "opening up".

"Transition" and "campaign" plans abound - from national cabinet last week and rollout tsar Lieutenant General JJ Frewen this week.

All good but there's a pie-in-the-sky element about them when we're moving forward so slowly.

Unfortunately but perhaps inevitably Frewen, the logistics expert, this week found himself caught on the political fly paper, after Anthony Albanese made his populist call for everyone who's vaccinated by December 1 to receive $300.

Even in this age of the money tree, providing $6 billion not just to give the hesitant an incentive but also to reward those who need no encouragement would seem profligate.

The government, either worried the Labor proposal might catch on or because it wanted to pursue Albanese, launched a massive attack on on this "bubble without a thought".

Frewen was dragged in because he's canvassed various incentives. His position seems to be: possibly some cash, but not now. Both sides invoked his name in making their cases for and against the Labor proposal.

Morrison is using Frewen as a political shield, just as he once used former chief medical officer and now Health Department Secretary Brendan Murphy.

This has brought claims Frewen is being politicised, a perception the general needs to avoid, because it could make him less credible to the public, and is bad for the military.

It would have been better if Frewen had performed his role in civvies rather than in uniform, but Morrison no doubt likes the khaki. Certainly Frewen should guard against being drawn on political questions.

The Doherty Institute modelling presented publicly on Tuesday by professor Jodie McVernon showed how the rollout's limitations have undermined our fight against the Delta variant and will continue to do so.

The modelling's message was that the super spreaders are the younger adults, those between 20 and 40. As McVernon said, they infect both their children and their parents.

But they've been the worst catered for in the rollout. They were initially placed at the back of the queue, after the most vulnerable, key workers, and the middle aged. And Pfizer, the vaccine preferred for them - although they are now being urged to take AstraZeneca - has been in short supply.

Belatedly, vaccinations for them are being somewhat accelerated, but it is all ad hoc and unclear.

The politicians like to talk about the "learnings" (aka lessons) coming out of the experience of this pandemic. At some point, when we are much further down the exit road, there should be a comprehensive inquiry into how decisions were made and what went right and wrong, at both federal and state levels, particularly in the rollout but in other areas too.

In this context, Thursday's decision by the Administrative Appeals Tribunal that the national cabinet is not, as the federal government tried to claim, a cabinet committee and therefore not subject to cabinet confidentiality, is a welcome development.

We can perhaps understand - while still strongly criticising - how the federal government, not expecting the problems with AstraZeneca, failed to order enough Pfizer or to have sufficient alternatives.

But how come on Thursday, when people were being shouted at to get the jab, an inefficient booking system in NSW was hampering many doing that?

And why, way back when, did the government put so much weight on the doctors in delivering the early months of the rollout? The pharmacists have only recently been brought in. If they'd been involved from near the start, we would likely be in a lot better position, at least with the AstraZeneca coverage.

The question has to be asked: how much did doctors' lobbying influence the initial shape of the rollout? What clout did they have with senior health officials?

In February, the Australian Medical Association issued a statement headed "GPs, not pharmacists, best placed for vaccine rollout".

It said AMA president Omar Khorshid had written to Health Minister Greg Hunt to express the AMA's concerns.

The release went on: "Dr Khorshid told Sky News that the AMA would prefer that the rollout remained part of usual GP interactions.

"We do have significant reservations about the place of vaccination in pharmacy, [he said].

"In the very, very rare occurrence of a severe reaction like anaphylaxis to a vaccine, it's something that we really can't expect a pharmacist to be able to manage[...]

"But the main reason is that we think that vaccination is part of a primarily holistic care package where people have a healthcare home. They know to go and see their local GP for their healthcare needs."

In the AMA's defence, this was as the program was about to get underway and reaction to the vaccines had unknown elements. But the reference to the "main reason" is a giveaway. As is sometimes said, the AMA is the country's most powerful trade union. It fights doggedly to protect its turf.

When the Coalition came to power it launched a royal commission into the pink bats scheme. This was seen, and was, a political exercise. Nevertheless, it did identify faults in planning and administration.

The pink bats program and its problems pale against the importance of, and the inadequacies in, the rollout.

An inquiry into the handling of the pandemic should not be driven by political motives, but rather by the need to understand the reasons for the mistakes and how to be better prepared in future.

This isn't to diminish how well, comparatively, Australia did earlier in the pandemic. But the good side of the record shouldn't be an excuse to avoid rigorous scrutiny of the negatives.

You won't find provision for an inquiry in the government's exit plan. But it should be there, in stage four.

Author: Michelle Grattan - Professorial Fellow, University of Canberra The Conversation

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