If we face a new pandemic will our government protect us?

With more than 80,000 cases confirmed around the world and possibly many thousands of cases undiagnosed or unreported the coronavirus that emerged in China some months ago is now spreading to countries around the world. Already cases have appeared in parts of Europe as well as South Korea and Japan.

As well, cases continue to appear at an alarming rate in China.

Because the data so far released by China cannot be trusted we simply wait for the virus to continue its spread. If this virus goes global are we looking at a rerun of a disease like influenza which currently causes between 3 and 5 million cases a year or perhaps we are to be confronted by a pandemic such as the influenza one in 1918-19 which caused well over 50 million deaths.

With respect to this outbreak we seem to be confronted by three possibilities.

Firstly, that the virus will eventually burn itself out and gradually disappear. Secondly, our so-called control approach, involving quarantine, isolation, travel restrictions, isolation and avoidance, testing and spraying and cleansing as well as the development of new anti-viral drugs and vaccines could possibly cause the coronavirus to come under our control. Finally, the disease continues to spread rapidly around our world and mutates to spread directly from human to human creating a new worldwide pandemic.

But are we facing a possible pandemic?

 So far, the WHO states that the infection has not exhibited uncontained global spread and that we are not yet witnessing a large number of deaths. But it may simply be a matter of time as the virus threatens to spread further afield. Already people believe that large parts of Africa are at risk. Africa has so many close links with China that it is hard to believe that the disease has not yet arrived.

Regardless of this there is little doubt that we are currently suffering the beginnings of a so-called pandemic of reaction characterised by sharp falls in stock markets around the world, restrictions on travel, quarantine and closure of schools, large scale development of special isolation buildings, cancellation of sporting events a general reluctance of people to leave the safety of their homes and the spread of fear. Add all this to major programs of isolation, cleansing, spraying and regular checking of individuals for signs of the virus.

In China sports fields, schools, hotels and government buildings have been transformed into Quarantine Stations for infected people. Already there are hints of the same happening in Australia if cases of the disease begin to emerge.

If this happened could we take refuge in the belief that our Government would protect us? Would the States and the Federal Government cooperate in a standard policy of quarantine?  

Unfortunately, history suggests otherwise. Dealing with major epidemics and pandemics calls for cooperation between the various levels of government – local, state and commonwealth. Despite current confidence such things cannot be taken for granted. Australia’s history is littered with examples of lack of cooperation, of self-interest, ignorance, over-reaction and antagonism.

The 1919 flu pandemic in Australia is a case in point. In 1918 faced by an influenza pandemic on its doorstep the Commonwealth Government issued instructions to quarantine all ships arriving in Australia where cases of influenza have occurred on the voyage. It also convened an Influenza Planning Conference for all States and Territories to agree on a national plan of action to confront a possible pandemic.

All States and Territories agreed to immediately notify the Commonwealth the moment influenza broke out within their borders and that the Commonwealth would have absolute authority for quarantine and restricting inter-state movements. Once influenza cases began to appear in 1919 all this fell completely apart, and each State and Territory went is own way.

Some States delayed or refused to inform the Commonwealth and other States that influenza had broken out within their borders and instituted their own border controls ultimately forcing the Commonwealth to abandon its plans. Each State developed its own set of quarantine and border protection policies and took over racecourses, schools, church halls, kindergartens and other buildings for temporary hospitals.

Fear and panic raged through city streets and people avoided public transport, declined to go to the pub or to sporting events and avoided walking city streets as well as avoiding contact with neighbours. Fear and panic raged through the workforce and impacted heavily on business and Government services.

The 1919 influenza pandemic ranks as Australia’s greatest social and health disasters during which more than 15,000 people died and hundreds of thousands caught the disease.  Epidemics and pandemics are also as much psycho-social events as they are epidemiological ones. Regrettably Governments have tended to overlook this.

One of the consistent themes in Australia’s history of infectious disease is a failure to appreciate the dissonance between how “experts” and ordinary people perceive risk, infection and contagion.

Risk to our “experts” is a definable, measurable phenomenon. For most of us, however, risk is shaped by personal attitudes and the way we view the world around us. It is a social phenomenon, socially constructed, largely intuitive and emotional. Unfortunately, Governments tend to not understand this.

In the final analysis is our past any guide to the future? If coronavirus breaks out in Australia, our Government will surely fall back on the same measures advanced against the influenza pandemic. Given our experience I wonder how successful this might be and whether we could have any confidence in our Government’s ability to protect us.