Numbers man

How good is Scott Morrison! Regardless of the facts on the ground, he’s always looking for a way to put a positive spin on Australia’s prospects in coping with COVID-19. Like Gladys Berejiklian, his solution to the current crisis is not to dwell on the disastrous effects of previous failures (or even current problems), but instead talk optimistically about the road ahead, when the country can open up again. It’s hard to fail when you’re talking about future plans, and it all feeds into his self-managed persona of an upbeat, solutions-oriented, practical leader. The problem, of course, is that it’s almost all spin. There is no agreed national plan, the Doherty Institute’s modelling in no way justifies opening up the country at a 70 per cent vaccination rate (to be clear: that’s 70 per cent of adults; 56 per cent of the total population), and the situation in NSW is set to get much worse if Morrison manages to convince the states to open up at this point. Thankfully, premiers and territory leaders outside of NSW realise the risks of opening up too early, and behind national cabinet doors they’re not going to support any rash “national” course of action. They will pay lip-service to the goal of opening up as soon as possible, but there is simply no way Queensland or Western Australia are going to open their borders to people from NSW while the virus is running rampant in that state, and nor will Victoria, the ACT, Tasmania or SA commit to any course of action that will obviously endanger their populations. But this is also part of the Morrison plan: he gets to be the guy who is fighting for everything to get back to normal, with Australians united; the premiers are the ones keeping Australians locked down and divided. He will keep talking about the Doherty modelling because it suits him. This morning he offered a nod towards being cautious, perhaps in anticipation of today’s national cabinet meeting, but the 70 per cent (or 80 per cent?) figure is still his favourite headline. The public needs to understand this: Morrison is being recklessly irresponsible in pushing for his interpretation of what’s possible. The Doherty modelling itself is seriously flawed, but even the most optimistic reading doesn’t support the conclusion that it will be safe to open up the country at 70 per cent adult vaccination levels. 

There are various caveats built into the Doherty Institute’s updated modelling, which allows for wriggle room in how it’s represented to the public. For example, it warns that further lockdowns could be necessary, and strong ongoing public-health measures will be required. And due to the difference in states’ capacity to provide health services and “TTIQ” capabilities (testing, tracing, isolation and quarantine), the Doherty report warns that “a precautionary approach is advised when defining a ‘national’ vaccine coverage threshold that would be applicable across small and large jurisdictions”. (To be clear: it is explicitly saying there should not be a one-size-fits-all national approach. Not that Morrison will incorporate this kind of talk into his national plan.) 

The report also states that 70 per cent vaccine coverage would only allow safe opening up “if optimal TTIQ can be maintained”. This is where the problems with this modelling become serious.

Any modelling based around “optimal” TTIQ should be regarded as irrelevant, for the simple reason that no Australian government has the capacity to maintain optimal tracking and tracing, nor quarantine or timely isolation, when cases get into the high hundreds or thousands. Take NSW as the obvious example: it has already ceased to list all exposure sites; it will no longer report the isolation status of new infections; and it has lost the ability to contact-trace even a majority of cases (yesterday there were 800 mystery cases out of roughly 1000). So the uses of isolation and quarantine are already severely compromised.

Yet even the scenario of “partial” TTIQ in the Doherty modelling is too optimistic. It doesn’t even model for declining efficacy of TTIQ under conditions such as NSW is experiencing: its “partial” TTIQ is a set value, and its baseline was based on the measures put in place during Melbourne’s second wave. Things are already worse, and more out of control, in NSW.

As Richard Denniss explains, “The Doherty modelling that the prime minister is relying on is literally built on the assumption that our TTIQ system is functioning well. While we hear a lot about the rollout of the vaccines, the Doherty modelling makes clear that without a highly functioning TTIQ system we have no chance of stopping our country’s ICUs from being overwhelmed” under the 70 per cent vaccinated scenario. The worst-case outcomes – and these are outlined in the Doherty modelling too – are simply catastrophic: tens of thousands of cases per day. Even at an 80 per cent scenario, the frequency of future lockdowns, number of infections and the likely number of deaths will be far higher than has been suggested, if the starting point is hundreds of cases. Modelling by academics and health experts at other universities and institutions reflects these concerns, with many arguing that a vaccination rate of 90 per cent of the total population is necessary to avoid mass casualties. Morrison has already rejected that assertion: “That’s not a realistic scenario and that’s not what is going to happen.” So there. Presumably he would reject this mountain of criticisms of the Doherty modelling too.

Vaccination figures reported by Fairfax yesterday told us that across the nation several of the most vulnerable cohorts, such as Indigenous people and NDIS participants, are actually among the least vaccinated, and there are still seem to be no plans for in-home aged-care patients. So, for all the optimistic relaying of figures about daily vaccination numbers, and news of young people becoming eligible and schools returning, and all the talk of the light at the end of the tunnel, too many people are at serious risk. 

The vaccine rollout is still too slow for comfort, and no amount of cheerleading will allow any return to “normal” unless numbers of infections are much lower and vaccination rates much higher, in all parts of the community.

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