Early lessons from the COVID-19 pandemic in Australia

It is still early days of the pandemic in Australia and comprehensive post-outbreak reviews are many months (perhaps years) away, but important early lessons for future pandemic planning are clearly apparent. Some to start with are:

1. Act early in confronting outbreaks. Assume the worst could happen. Be prepared to act hard and fast.

2. Take all possible steps to convince the population of the seriousness of the threat to health posed by the pandemic. In the case of COVID-19 the reluctance to cancel the Australian F1 Grand Prix and ban travel from COVID-19-afflicted Italy sent the wrong signals. Likewise, the Prime Minister's statement he would be going to watch his favourite rugby league team the coming weekend a few moments after announcing intended social distancing regulations to come in on the following Monday. The flocking of thousands to Bondi Beach and back-packer parties flouting social distancing regulations are further examples of the 'seriousness' message not getting across.

3. Ensure communications by and between government and other key authorities are consistent. Avoid mixed messages. For example, whether or not to close schools during the pandemic has been a source of major public confusion. Parents listening to the Prime Minister on the one hand arguing schools are safe and should be kept open and, on the other hand, states pressing for closure have had every reason to be uncertain. Informing parents that schools were open, but that if possible children should be kept at home only added to this. At the other end of the age spectrum meanwhile, people aged 70+ have been left uncertain by both federal and state government pronouncements as to whether they had to stay within their homes or were just urged to do so.

4. The physical policing of social distancing should be uniform as far as possible/reasonable between jurisdictions and avoid any suggestions of pettiness or over-zealousness. Keeping the general public on side is critical when normally taken-for-granted civil liberties are suspended for lengthy periods.

5. An infectious disease outbreak of the magnitude of COVID-19 is obviously in many respects impossible to predict, but preparing as best possible is essential. This ranges from adequately funding biomedical teaching and research in our universities and other relevant institutions, to health workforce planning, to stockpiling adequate supplies of personal protective equipment (PPE) for front-line health workers, to having sufficient hospital intensive care resources, etc. Unfortunately we have been caught short in many of these areas in the current crisis. Politicians who have been involved in the emasculation of science/biomedical research funding in Australia over recent years should reflect on the consequences of that path.

6. Improve personal hygiene knowledge and behaviours in the general population (via schooling, media campaigns, etc). Such basics as regularly washing one's hands thoroughly, covering one's mouth when coughing, etc. are simply not adequately appreciated or practised by many people to the cost of both their own and other peoples' health. This may sound too obvious to need stating, but unfortunately many such basics are not observed.

7. Be open to opinions and advice from health experts outside the official government pandemic control/planning team. Not all expertise lies in one camp.

8. Mistakes/poor decisions will inevitably be made in the course of fighting any major epidemic. Learn from them. While potential legal culpability issues need to be covered, establishing how the mistake occurred and accepting responsibility for it so as to avoid a repeat occurring in the future is more productive than engaging in an endless buck passing blame game.

9. Be totally transparent regarding all data relating to the epidemic (e.g. modelling assumptions and results, quality, gaps, etc).

10. Make pandemic planning a central, on-going facet of wider population health planning.