LAUSR

The first phase of the response to COVID-19 in Australasia was relatively simple; pull up the drawbridge to prevent incursions at the border and use lockdowns to prevent spread when the border was breached. The relative success of that strategy is based on a combination of geographic isolation, climate and low population densities; our ability to borrow cheaply to cushion the impact on people’s livelihoods; the willingness of a fearful population to comply voluntarily with lockdown restrictions and, to some extent, the good fortune that few border breaches involved ‘super spreaders’. This is not a long-term strategy. Voluntary compliance becomes harder to sustain, cheap borrowing has a limit, luck eventually runs out and, at some stage, the drawbridge needs to be lowered in order to re-engage effectively with the world. We should not think that returning to normal means returning to our pre-COVID-19 position. We now know the tremendous cost in terms of lives and livelihoods of being poorly prepared for a pandemic. We need to invest in being much better prepared for the next one. At the same time, our health systems will face additional pressure from deferred demand (with less reliance on imported clinicians) and we will have to start restoring the borrowing capacity we rely on so heavily at times of stress. Being better prepared implies better pandemic planning and more disciplined border management, as well as improved testing, contact tracing and isolation measures required to support a proactive response, and so reduce reliance on lockdowns. As the response leans more heavily on vaccination and revaccination, we need to build and sustain the capability and capacity to deliver faster vaccine roll-out at the scale required to achieve and sustain herd immunity. The challenge for the next phase of our pandemic response is to move from a reactive isolationist response to one that we can sustain as we re-engage with the world, even after we have managed to vaccinate a large proportion of our people. This will be a world where COVID-19 will remain rampant in some countries for some time; in which mutated COVID-19 strains will emerge that are more infectious and may not be as vulnerable to existing vaccines; and where new pandemics are likely to become more frequent and could even be more dangerous.