COVID-19 inquiry: a sub-standard response?

The federal government has appointed an independent panel to conduct an inquiry into Australia’s response to the COVID-19 pandemic to help better prepare and protect our country for the future.

The inquiry, to be led by economist Angela Jackson, epidemiologist Catherine Bennett and public administration specialist Robyn Kruk, will review what worked well and what we can do better to improve Australia’s preparedness for future pandemics.

It will consider Commonwealth responses to the pandemic, including the provision of vaccinations, treatments and key medical supplies to Australians, mental health support for those impacted by COVID-19 and lockdowns, financial support for individuals and business, and assistance for Australians abroad.

The inquiry will also consider the role of the federal government in responding to future pandemics, including the coordination of a national Cabinet.

Legal and human rights

Dr Christopher Rudge, a Lecturer for Sydney Health Law at the School of Law at The University of Sydney, said, “While several important legal and human rights arguments for and against the imposition of coercive and conditional mandates must be considered by the inquiry, I believe that, on balance, and from a legal and bioethical perspective, the general orders of coercion were legally and morally justified as a late and last resort.

“Having said that, the right to refuse medical treatment, freedom of thought, conscience and opinion, and the right to bodily integrity are important precepts that deserve serious consideration in any inquiry into COVID-19 governance. And in many cases, alternatives to coercion are preferable.

“In light of these considerations, the inquiry should pay particular attention to: the exercise of powers under public health legislation in each state, and what conditions are placed on that exercise; the process by which vaccines and other therapeutic goods (such as donations of hydroxychloroquine entered into the national stockpile) are selected for government investment; and the use of private consultancy firms to architect public health policy during emergencies and the problems associated with ‘business case’ analysis for vaccine investment,” Rudge said.

Choices and planning

Professor Adrian Esterman, Chair of Biostatistics at the University of South Australia, said the inquiry is timely. “There are many things that the federal government did well, like the quick closure of international borders, the establishment of a national Cabinet and a joint committee of chief medical officers.”

However, there are also many things that the federal government did poorly — one of the worst being leaving most of the responsibility for responding to the pandemic to the states and territories, Esterman said.

“Poor choices by our governments included the use of hotels as quarantine accommodation, a questionable choice of vaccines, very poor messaging (that still continues), inconsistent border closures, and inconsistent data collection and definitions (that also still continues). There must be a hard look at lockdowns — were they necessary? How long should they have continued? Should we have shut schools down? Was the use of mandates for vaccination and mask wearing necessary? And finally, how good was the government’s economic response to the pandemic?

“It would be nice (but don’t get your hopes up) if this didn’t turn into a political bun fight. Certainly, there should be many lessons learned — one of which would be the need for Australia to become much more independent in the manufacture of vaccines, PPE etc. The role of the new Australian CDC also needs to be discussed. The best outcome will be an Australia better prepared for the future.”

A sub-standard response?

The Institute of Public Affairs (IPA) called “the COVID inquiry farce a breach of trust with Australians”.

“It has become clear, since the Prime Minister’s announcement of the COVID-19 inquiry, that Australians can have no confidence in its process, its leadership or that it will provide the answers they deserve about the mismanagement and controls imposed on them during the pandemic,” said Morgan Begg, Director of Research, IPA. 

For example, said the IPA in a statement, “The terms of reference specifically exclude from the scope of the inquiry ‘actions taken unilaterally by state and territory governments’ including the imposition of arbitrary lockdowns and other public health restrictions; the inquiry will not have Royal Commission powers; the inquiry will be led by an independent panel of three people, two of which were supporters of Victoria’s hard lockdowns: Dr Angela Jackson and Professor Catherine Bennett.”

“Our research demonstrated the need for a full royal commission by state and federal governments to investigate the unprecedented adoption of emergency public health powers. The federal government’s response is sub-standard and is a breach of trust with Australians,” Begg said.

“When in opposition, the Prime Minister promised a royal commission into the COVID response. Instead, we are getting a sham inquiry that will do little more than provide protection to government officials who engaged in draconian overreach.

“Australians deserve a proper royal commission to look at all levels of government, to learn the hard lessons of lockdowns and ensure they never happen again,” Begg said.

Health economics

Associate Professor Haitham Tuffaha, Interim Director, Centre for the Business and Economics of Health at The University of Queensland, said that given the urgency of the situation, our response to the pandemic involved immediate actions that were not thoroughly evaluated for effectiveness, costs and value for money.

“The Australian Government has invested a total of over $18 billion in Australia’s vaccine and COVID-19 treatment supply as part of the COVID-19 health response. As COVID-19 transitions into an endemic phase, the role of health economics in decision-making will be increasingly required to evaluate the cost-effectiveness of various prevention, testing and management modalities of COVID-19, which will inform a more effective and efficient response to future pandemics. Importantly, long COVID (defined as >12 weeks) affects around 10% of COVID-19 cases in Australia. Long COVID has significant health and economic impacts on Australia and we need to find cost-effective ways to detect, treat and control long COVID, infections and their long-haul consequences.”

The ongoing impact

Professor Tissa Wijeratne OAM, a researcher at RMIT University and Co-Chair of Public Awareness for the World Federation of Neurology, said the ongoing impact of COVID-19 as a leading cause of death and disability worldwide is a significant concern.

“In 2020, it became evident that a substantial portion of COVID-19 infections resulted in what was described as Post-COVID-19 Neurological Syndrome, affecting approximately one in four individuals, potentially impacting over 200 million people globally,” Wijeratne said.

“Research into the disease has provided valuable insights into its mechanisms. It has been established that persistent maladapted immune system changes play a critical role in the post-COVID-19 phase. Additionally, there is growing evidence of energy system dysfunction at the cellular level, which contributes to the complexity of the condition.

“Furthermore, clinical observations have highlighted the utility of simple bedside tests, such as assessing hand-eye coordination, in detecting and predicting which patients are more likely to develop Post-COVID-19 Neurological Syndrome and post-COVID condition, both of which have significant neurological manifestations. These insights underscore the importance of early detection and intervention.

“The urgent need for action is clear. Clinical trials are essential to develop effective treatments and interventions for those experiencing Post-COVID-19 Neurological Syndrome and related conditions. Equally important is providing peer support and resources to affected individuals and their communities as they navigate the challenges of these conditions.

“In conclusion, it is indeed time to take action. The global community must come together to support research, clinical trials and initiatives aimed at better understanding, preventing and treating the neurological consequences of COVID-19. By doing so, we can provide much-needed relief and hope to millions of people affected by these conditions.”

Image credit: iStockphoto.com/mihailomilovanovic