Brisbane airport covid-19 international arrivals
(Image: AAP/Dan Peled)

It has taken the potential criminalisation of Australians desperately trying to return home for the penny to finally drop. Australia’s policy of COVID-19 elimination is unworkable and grossly unfair. Elimination by definition requires borders to be shut, quarantine to be continued and extraordinarily expensive tracing, testing and lockdowns to be maintained.

To this point, it was widely believed that the majority of Australians supported our elimination stance. The resounding election victory of Mark McGowan in WA and the narrower success of Annastacia Palaszczuk in Queensland seemed to support this. But a Lowy Institute poll (taken before the India criminalisation threat) suggested that perhaps Australians aren’t quite so naive after all. Of the 2000 people surveyed, 58% supported vaccinated Australians being able to freely leave the country (18% of whom supported no entry or exit restrictions at all).

The question of opening borders is one which requires a full understanding of the risks. As soon as the borders open without quarantine, we will likely have a number of COVID-19 cases and inevitably some deaths. But once the genuinely “at risk” members of the community are vaccinated, the likely number of fatalities will be less than the seasonal flu (which in 2019 killed almost 1000 people).

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The key question then becomes: how many people need to be vaccinated to make that risk tolerable?

One of the most influential voices on risk levels is the Burnet Institute’s Brendan Crabb, for whom there seems to be no number of vaccinations that will be enough to ever open borders. Last week, Crabb suggested that unlike the flu, which kills hundreds of people every year, the community is “not going to tolerate severe disease and dying [and] in the absence of herd immunity … you will need some level of public health intervention, to run side by side vaccines. And probably for ever, as long as we have virus”.

Crabb has form. In December, he demanded a Sydney-wide lockdown, which never happened, and the outbreak was rapidly contained. He also criticised Singapore’s easing of restrictions in June last year — since then, Singapore has recorded a grand total of five COVID-related deaths.

Other health experts hold different views. The highly respected Peter Collignon and Greg Dore, for example, have both been far more measured on border closures and vaccine effectiveness. Dr Anthony Fauci last week suggested that for the US to return to relative normality, it would take daily COVID infections in the US to drop to about 10,000.

Real-life examples

While epidemiologists are often required to work under forecast model scenarios, we now have several real-life examples of the effectiveness of vaccines. Discounting the remarkable success of Israel (which used Pfizer), and the failure of Chile (China’s SinoVac), the best comparison for Australia is the UK (which mostly used AstraZeneca).

Despite less than 30% of UK residents being fully vaccinated with two doses, daily fatalities have dropped from 1250 per day to 15 per day. The UK, which was coming off a far higher base level of infection, showed that to reduce COVID-19’s lethality below flu levels, you merely need to vaccinate about a quarter of the population. In Australia, that will require about 13 million doses to be applied (or just over six million people vaccinated).

That means even with Australia’s horrifically slow vaccination rate, with just a minor improvement as mass-hubs become operational to 100,000 doses per day, we can reduce the risk of COVID death to less than the flu by mid-September. If we start vaccinating 200,000 people per day, we could get there by late July. (The rest of the developed world, specifically Europe and the US, will likely be completely open by June, tolerating a small number of deaths, like we do for hundreds of other illnesses.)

While a handful of epidemiologists may disagree, the UK evidence is clear.

Every year we happily tolerate appallingly high numbers of alcohol-related deaths, 15,000 tobacco deaths, and more than 1000 road deaths. We may just need to live with a thousand octogenarians dying from COVID each year too, if we want to stop treating citizens like criminals.

Adam Schwab is the co-founder of Luxury Escapes, a Melbourne-based travel company, a regular contributor to Crikey and a board member of Private Media, the publisher of Crikey.

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