COVID-19 and the Perils of Expert-Driven Policy

When the Australian Senate’s Select Committee on COVID-19 held its first public hearings on April 23, 2020, the first witness it called to appear was, quite naturally, the country’s Chief Medical Officer (CMO), Professor Brendan Murphy. As Australia’s CMO and chair of the Australian Health Protection Principal Committee (AHPPC), Professor Murphy was the public face of the government’s coronavirus response. He told the Senate’s COVID-19 Committee that he “first heard notification through the WHO [World Health Organisation] on New Year’s Day, on 1 January that there was a cluster of pneumonia of unknown aetiology in Wuhan”. For the next three weeks, he told the committee, he and the AHPPC were in “watching mode … getting data out of the WHO, from our counterparts in other countries and from the CDC [the United States Centers for Disease Control]”.[1] Murphy said that on January 19, he and the AHPPC “moved to a very different mode”, issuing a travel advisory for Wuhan and notifying the Australian National Incident Room.

What Professor Murphy actually told the public on Sunday, January 19, was:

The situation warrants close attention and an evidence-based response and there is no cause for alarm in Australia. Australia has well established mechanisms to respond to ill travellers at points of entry. Under Australian legislation airlines must report passengers on board showing signs of an infectious disease, including fever, sweats or chills. Planes reporting ill travellers are met on arrival by biosecurity officers who make an assessment and take necessary actions, such as isolation and referral to hospital where required. The World Health Organization position does not currently recommend any travel advisory for China, or additional measures at airports beyond our established mechanisms … Australia has processes in place to enhance border measures in relation to a communicable disease, if required, working through our established Health Protection system.[2] [emphasis added]

In other words, he confirmed business as usual. Preparations for a travel advisory for Wuhan weren’t actually announced until Tuesday, January 21.[3] In that January 21 message, Professor Murphy detailed the provisions that Australia would take at the border: “All passengers on these direct flights will receive information about the virus on arrival requesting that they identify themselves to biosecurity officers at the airport if they are unwell.”

Once again, business as usual. That might not be surprising, except for the fact that on the previous day, Monday, January 20, China admitted that it had been lying to the world about the severity and infectiousness of the coronavirus, reporting 139 new cases of the coronavirus in Wuhan, Beijing and Shenzhen.[4] Cases were also reported in Japan, South Korea and Thailand.[5] Knowledge of the new cases may or may not have called for a more aggressive public health response, but knowledge of China’s obfuscation should have raised alarm bells in the National Security Committee of Cabinet (NSC) that the AHPPC, acting primarily on advice from the WHO, might not have access to accurate and complete information about the evolving epidemic.

Returning to Murphy’s April appearance before the COVID-19 Committee, Senator James Paterson asked him “what were the key, most important, decisions that the government made” in the early days of the crisis. In response, Murphy answered that “the most important early decisions were related to border measures”. He went on to explain:

China was clearly, in that early phase, the epicentre. It wasn’t just Hubei province; it was spreading rapidly in other provinces of China. We knew that the greatest risk to uncontrolled transmission was in imported cases. As an island, we were in a position of perhaps doing border measures more effectively than other countries, so the unanimous health advice of the Health Protection Principal Committee was that we should do that.

If only that were true, Australia might have entirely avoided the massive economic disruption causes by coronavirus shutdowns inside the country. In fact, Murphy and the AHPPC repeatedly advised against more stringent border measures. On January 31, more than a week after China had locked down 50 million people in Wuhan and Hubei province, Murphy said at a joint press conference with Health Minister Greg Hunt:

The World Health Organization strongly recommends that … nations do not ban flights from China because unless you lock down exit from the country, banning flights, direct flights, doesn’t stop people coming from China … It seems likely that China is increasingly blocking export of its residents, so they are reducing tour groups coming out of China and if the outbreak in provinces other than Hubei, which is now completely locked down, increase, I believe they will stop exits from China which is a more effective way … So at the moment, our Health Protection Principal Committee does not recommend banning direct flights from China, as it’s not a public health measure.[6] [emphasis added]

According to his Senate remarks, Professor Murphy woke up the very next morning, Saturday, February 1, to tell Greg Hunt that an “urgent convening” of the NSC was needed to ban non-residents from entering Australia directly from China. The story was developed in the Age by Melbourne editor Jewel Topsfield[7] and the Sydney Morning Herald by political editor Peter Hartcher.[8] According to these two reports, on the morning of February 1, Murphy sent Hunt the message that “we now have sustained human-to-human transmission outside Wuhan; I think we are going to have to close the border to China”. Hunt called Prime Minister Scott Morrison, who ordered a meeting of the AHPPC. Hunt then set up a conference call with Murphy and Morrison. Murphy advised Morrison that “there’s a very strong risk of this spreading to Australia”, which prompted Morrison to ask, “Are you recommending that we close the border to China?” Murphy reportedly answered yes, prompting the NSC to act.

Yet when the AHPPC did meet on the morning of February 1, what they actually decided was to “expand the case definition for novel coronavirus infection from 1 February 2020 to apply to people from all of mainland China”.[9] This, only after noting “the increasing (but still relatively small) number of cases in provinces outside Hubei Province”. In other words, the AHPPC unanimously changed its opinion on travel from China, overnight, based on no new information or guidance from the WHO, which continued (and continues to this day) to recommend against restrictions on international travel. The NSC apparently considered the AHPPC’s definitional change to be “new and urgent information” and accordingly banned non-residents from entering Australia directly from China.[10]

Speaking at a press conference the next day, Sunday, February 2, Murphy confirmed this account of the AHPPC’s reasoning, that the sweeping travel ban resulted from nothing more than a definitional change. He explained that:

Yesterday AHPPC came to the point where we believe that the spread of the virus outside of the Hubei Province in other provinces of China, while still relatively small numbers, represents evidence of sustained human-to-human transmission in those provinces. And we and other countries have now broadened our definition of the cases of potentially infected people to include anyone who has been in mainland China who has relevant symptoms. A corollary of that is, that extends to our travel warning and it also means that, given that we have undertaken a precautionary approach to quarantine people who had come back to infected areas; that used to apply to Hubei Province, but now it is applying to people who have come from mainland China from the 1st of February.[11] [emphasis added]

A much more likely explanation of the AHPPC’s Saturday morning change of heart is the fact that the United States announced its own China travel ban on January 31, meaning that Australians awoke to the news on the morning of February 1. Murphy seems to have overlooked this fact in his April Senate remarks, when he said, “I think, in retrospect, our colleagues in … the US regret that they didn’t do the same”—that is, impose restrictions on travel from China. Of course, the US did impose restrictions. Australia followed suit within twenty-four hours. It seems unlikely (to say the least) that this was a mere coincidence, but that is the story we have been asked to believe, by Murphy, by Hunt, and by the AHPPC.

 

A more likely account

Attempting to reconcile Professor Murphy’s April remarks to the COVID-19 Committee to his public statements as the crisis unfolded, it is just possible that in early February, the AHPPC actually was keen to prevent the importation of coronavirus into Australia. But as the month wore on, it became more and more apparent that the AHPPC was in favour of relaxing border controls. On February 13, the AHPPC recommended that special exemptions to the China travel restrictions should be considered.[12] On February 19, the AHPPC recommended that Year 11 and 12 students be allowed to travel from China to resume their studies in Australia, and that entry be considered for university students.[13] On February 26, the AHPPC reiterated this advice, and began to build a case against restrictions on travel from Iran, Italy and South Korea: “extending travel bans to restrict travel from multiple countries is not likely to be feasible or effective in the medium term”.[14] On February 29, the AHPPC flatly stated:

AHPPC believes that, in general, border measures can no longer prevent importation of COVID-19 and does not support the further widespread application of travel restrictions to an increasing number of countries that have community transmission … Whilst preventing entry to Australia for travellers from Iran … could be considered by government and would assist in compliance with self-isolation, AHPPC was concerned that further travel restrictions may set an unrealistic expectation that such measures are of ongoing value for further countries.[15] [emphasis added]

Ignoring the AHPPC’s advice, the NSC imposed a ban on travel from Iran the next day. On March 4, the AHPPC explicitly recommended against imposing a travel ban on South Korea.[16] The NSC imposed one anyway. One week later, the AHPPC didn’t even bother to issue a statement to guide the government’s March 11 decision to ban travel from Italy. On March 18, in advance of the government’s March 19 decision to impose a worldwide travel ban, the AHPPC actually argued that an open borders policy would be equally effective:

AHPPC noted that there is no longer a strong basis for having travel restrictions on only four countries and that Government should consider aligning these restrictions with the risk. This could involve consideration of lifting all travel restrictions, noting the imposition of universal quarantine and a decline in foreign nationals travel, or consideration of the imposition of restrictions on all countries, while small numbers of foreign nationals continue to arrive.[17] [emphasis added]

The picture that emerges from a detailed reading of the public statements made by Professor Murphy and the AHPPC throughout the first three months of the coronavirus crisis is of a health establishment that was committed to following WHO travel advice to fight the coronavirus in the community instead of stopping it at the border. The bizarre reported sequence of events on the morning of the February 1 China travel ban becomes much more intelligible if it is surmised that Murphy and the AHPPC in reality opposed travel restrictions, but were pressured into recommending them by the political leadership, who would have been shaken by the overnight news of America’s China travel ban. This would also make sense of Murphy’s extraordinarily sophistic explanation that the travel ban was merely the “corollary” of an overnight definitional change.

In the light of the AHPPC’s later pressure to loosen the China travel ban and resistance to further travel restrictions, Murphy’s claim to the Select Committee that he believed “the most important early decisions were related to border measures” beggars belief. He told the Senate that:

we put in border measures stopping all flights from China. We put in measures stopping people coming from Iran and the Republic of Korea. We then started some very enhanced border measures and progressively hyped up our recommendations to DFAT to increase the travel advisories. We have now really closed our borders.

All true, but little or none of this seems to have reflected his own advice at the time. Quite the contrary: it seems to have been the NSC that pushed for tighter border security measures.

The superior performance of the political leadership over the professional bureaucracy in this regard should not be surprising. In this crisis, good border security policy depended more on political judgment than on medical advice. In the internet age, the best medical knowledge and opinions are available to everyone who cares to access them. From mid-January, all of the information needed for the formulation of an effective border response to the coronavirus crisis was freely available on the internet. Australia was, as Murphy suggested in his Senate remarks, in the “position of perhaps doing border measures more effectively than other countries”. Had Australia acted more aggressively to limit and quarantine airport arrivals and followed Asia’s early lead in banning cruise ships, it might have saved hundreds of billions of dollars and avoided the self-quarantine of 25 million people.

 

Moral hazards in the formulation of border security advice

Decision-making in a crisis is a heavy responsibility, and it is much easier to criticise decisions in retrospect than to get them right at the time. Nevertheless, decision-makers should be able to rely on well-informed, unbiased, candid advice from experts. These experts have a responsibility, at a bare minimum, to take into proper account facts that are well known. In their advice on travel restrictions from mid-February through their final abrogation of responsibility on March 18, the AHPPC seems not to have met this most basic of expectations. Only a full investigation can reveal exactly why the AHPPC appeared so keen to follow WHO advice against imposing travel restrictions at a time when the seriousness of the threat posed by the coronavirus had already become well known—but one strong force that had the potential to bias the AHPPC’s travel advice is moral hazard.

Moral hazard is “the expectation that organisations (and their leaders) will reap the rewards of success but others will bear the burdens of failure”.[18] The AHPPC certainly faced serious moral hazards in all of its decision-making, since success in keeping Australia safe from the coronavirus would have meant honours for the members of the AHPPC but failure would impose costs on society at large. A focus on responding with internal public health measures instead of external border security measures would also have highlighted the importance of the AHPPC members’ own departments. As things have turned out, Professor Murphy and the AHPPC have in fact been widely lauded for their “fearless” advice to government.[19] The hundreds of billions of dollars that this advice has cost the country have been debited from other accounts.

In reality, whether in the spirit of collegiality with their colleagues at the WHO or for reasons of their own, Murphy and the members of the AHPPC seem to have resisted the imposition of travel bans until it became politically impossible for the government to continue to accept their advice. Even in the case of the momentous decision to close the border with China, the AHPPC held on to its anti-closure position until the last politically possible moment. In Murphy’s account, the Saturday morning decision to reverse course on the China travel ban was due to the fact that “sustained transmission” of the coronavirus was no longer occurring only in Wuhan, but in the rest of China as well. Yet just the day before, he had explained that Australia should keep its borders open, not because there was no sustained human-to-human transmission outside Wuhan, but because the AHPPC believed that it would be more effective to rely on China to impose exit restrictions. This was entirely consistent with WHO advice.

The WHO, in the highly-publicised report of the second meeting of its Emergency Committee on January 30, had already admitted that “human-to-human transmission has occurred outside Wuhan and outside China”, though without using the qualifier “sustained”.[20] By January 31 Australia time, it had already been widely reported in the world’s media that the coronavirus had spread to every region of China, and at least four provinces outside Wuhan had more than 1000 confirmed cases.[21] At the time, it was also already well known among infectious disease experts that the “confirmed” cases constituted only a fraction of the total cases in China.[22] Guangdong province alone, hosting over a thousand coronavirus cases (including at least two Australians), sent 77,787 passengers to Australia in January 2020.[23] On January 31, no one reading the news could have been unaware of the sustained human-to-human transmission of the coronavirus outside Wuhan and Hubei province—and the risk this posed to Australia.

The exact relationships among the CMO, the broader AHPPC, and the NSC necessarily remain opaque, but it seems clear from a close reading of AHPPC statements and Murphy’s public comments that:

• The AHPPC shared the WHO’s strong predisposition to oppose travel restrictions
• The inclination to impose a China-wide travel ban did not originate with the CMO or the AHPPC
• The AHPPC, following the WHO’s reasoning, consistently advised the government to rely on China itself to contain the coronavirus within its borders

In addition to the AHPPC’s incentives to align with the advice coming from the WHO, Australian governments (including state governments, which are represented on the AHPPC) faced strong incentives not to embarrass China with a travel ban. China was well known to vehemently oppose travel bans. Australia has a contentious diplomatic relationship with China, despite the fact that corporate Australia relies heavily on China as an export destination, investment source and business partner.[24] This tension is reflected in Australia’s state-level economic diplomacy relationships with China, with states like Victoria[25] and Western Australia[26] pursuing closer relationships with China in recent years despite federal pressure to be more cautious. Australian governments thus also faced moral hazards in their coronavirus response emanating from their political relationships with China. The extent to which this may have affected policy advice and policy-making is, of course, unknown.

There were also strong economic arguments not to ban travel from China. The strongest of these came from the international education sector, including its most powerful component, the universities. Australian airlines, by comparison, were not very dependent on China: out of a quarter of a million seats available on non-stop flights from China to Australia in January, only 5.7 per cent were on Qantas, and none on Virgin Australia.[27] Tourism operators were generally small companies lacking political power, and in any case tourism from China was collapsing even without travel restrictions. The only large, powerful organisations that expected customers to travel from China regardless of the coronavirus epidemic were Australia’s universities, in particular its influential Group of Eight universities. That these universities were all public institutions only added to their influence.

As the universities and their industry bodies warned at the time, the China travel ban has cost Australian higher education dearly. The Mitchell Institute of Victoria University in Melbourne estimates the likely lost revenues due to coronavirus at $19 billion spread over three years.[28] Of course, most of these losses would have been realised anyway, as the coronavirus would have cut off most international educational travel by the end of March 2020, whether or not Australia had imposed its February 1 China travel ban. The crucial counterfactual is that Australian universities would have retained many Chinese students for the first semester of 2020, had the travel ban taken effect just a few weeks later. Nonetheless, in February the Centre for Independent Studies estimated the likely first-semester revenue losses to all Australian educational institutions due to the China travel ban at between $2.8 billion and 3.8 billion—still a very substantial sum.[29]

These potential losses seem almost certain to have been the primary consideration behind the AHPPC’s arguments starting in mid-February that the China travel ban should be relaxed. In its statements over that period, the AHPPC repeatedly floated the prospect of relaxing travel bans for students, and students only. It never so much as mentioned relaxing restrictions for business people, investors or extended family, to say nothing of tourists. The one time that the travel ban actually was relaxed, in late February, the only group allowed in were Year 11 and 12 students (and their guardians), an action specifically cited by the AHPPC as a prelude to admitting tertiary students.[30] Standing next to the federal authorities at the press conference convened to announce the partial travel opening was the Victorian education minister, James Merlino.[31] Australia’s top universities may or may not have lobbied the government in private for a relaxation of China travel restrictions, but their financial dependence on China was well known. An August 2019 paper from the Centre for Independent Studies characterised it as “extreme”.[32]

The tragedy of moral hazard is that to avoid upsetting a major trading partner or to save a few billion dollars in international student revenue, the Australian government came very close to inviting more than 100,000 Chinese students to fly to Australia at the height of China’s nationwide coronavirus outbreak. In the end, the Australian government avoided this outcome, but only because the advice of the AHPPC was disregarded, not because its advice was followed. Prime ministerial pronouncements that national policy would be “guided by the expert medical advice of the Australian Health Protection Principal Committee” must be taken with a grain of salt.[33] When it came to imposing and maintaining Australia’s travel bans, the NSC repeatedly acted against the spirit (if not the letter) of the AHPPC’s expert medical advice. The country is lucky that it did.

 

“Proformalist” reasoning at the border — the malady of believing your own platitudes

If the advice on border security offered by Australia’s health authorities was potentially coloured by moral hazards, the actions taken were even more compromised by the malady of “proformalist” reasoning. Proformalism is the practice of treating stylised facts as if they were actual facts. It is characterised by “box-ticking the letter of the law while completely ignoring its intentions”.[34] If Australia had a narrow escape from moral hazard in its coronavirus border security response, it fell prey instead to proformalism of its isolation and quarantine procedures.

In its travel-related coronavirus statements throughout the crucial period of February and early March, the AHPPC consistently endorsed “self-isolation” or “self-quarantine” at home as the proper response for travellers returning from coronavirus hotspots. It described such unmonitored self-isolation as “a highly precautionary approach”[35] that constituted a “strict quarantine requirement”[36], despite being self-enforced and relying entirely on voluntary compliance, with no official follow-up. As one colourful account described the procedure:

Our plane was held at the gate while a customs official moved through handing out bits of paper explaining the self-isolation rules: a single A4 sheet that most passengers around us folded up and stuffed in a bag. In the everything proceeded as normal, until we spotted a tiny sign directing those who had been in China, Korea, Iran or Italy in the last 14 days to move to a separate area for “enhanced screening” […] One of those gowned medical staff came and took our temperature and asked if we had any symptoms of coronavirus. We said we didn’t, and so were pointed back in the direction of the general immigration area.[37]

This account from travel writer Ben Groundwater describes events that took place at the end of March, though they mirror exactly the procedures announced by Professor Murphy at the end of January for arrivals from Wuhan.[38] These procedures could only be characterised as “highly precautionary” on the pro forma assumption that all passengers would correctly identify for advanced screening, the pro forma assumption that all passengers would appropriately self-isolate, and the pro forma assumption that no passengers were infectious while in transit, whether or not they were symptomatic. Violate any of these pro forma assumptions, and airport arrivals halls had the potential to turn into a massive cauldrons of coronavirus transmission.

With the exception of the Wuhan evacuees quarantined in Christmas Island in early February, Australia didn’t impose supervised quarantines on arriving passengers until March 29, long after the futility of self-isolation should have been clear.[39] It shouldn’t have taken press reports of coronavirus-infected returnees shopping, eating out and playing golf to alert Australia’s chief health officers to the fact that handing out fliers on arrival at the airport did not ensure effective case isolation.[40] When Australia did start imposing real quarantines, they applied to all travellers, from risky or safe areas, infected or not. Yet by this time, most of the coronavirus cases that would enter Australia from overseas had already entered. The horse had already bolted.

The Ruby Princess fiasco further illustrates the dangers of proformalist reasoning. Following the closure of Asian ports in mid-February, cruise operators were permitted to redirect capacity to Australia. Ships like the Ruby Princess were also allowed to sail between Australia and New Zealand because both were categorised as “low risk” countries. This pro forma approach to risk did not incorporate the lessons that should have been learned from the Diamond Princess, on which a single initial coronavirus case spawned 634 infections.[41] That was known nearly three weeks before the Ruby Princess even set sail. The Ruby Princess was allowed to operate because pro forma it represented a low risk of departing with a case or picking one up in New Zealand. But if even one of its 2647 passengers did have coronavirus—or, more to the point, any one of the thousands of passengers on any of the dozens of cruise ships that were allowed to sail from Australia in February and March—Australia would have another Diamond Princess on its hands.

Proformalism was similarly implicated in the decision to allow the Ruby Princess to dock at Sydney’s Circular Quay with no additional health precautions. Because it had only travelled to New Zealand, and New Zealand was a low-risk country, pro forma the ship posed a low risk of coronavirus infection. The same was true of every individual ship that was allowed to dock without checks. Of course, it was tragically not true of the cruise ship industry as a whole. Whatever the result of the criminal investigation into the legal responsibility for the decision to allow the Ruby Princess to offload without precautions, the intellectual fault at the centre of the fiasco is clear. Proformalist reasoning at all points made the Ruby Princess disaster possible, and a disaster like it almost inevitable. In allowing the cruise industry to operate (and, indeed, expand) throughout March, Australia’s health authorities considered only the pro forma criteria that were already in place before the coronavirus crisis began. They abjectly failed to learn from the real-world events that the rest of the world was following live on television.

 

The crisis Australia didn’t have to have

The coronavirus has turned into a truly global pandemic, but Australia’s coronavirus-prompted economic “hibernation” (to use the Prime Minister’s word for it) could have been averted by simple good sense. As the experience of Taiwan has demonstrated, the coronavirus battle could and should have been fought at the border. All that was needed for Australia to dodge the coronavirus bullet (and save hundreds of billions of dollars) was for the country to have:

• Imposed travel restrictions on countries at the point when the coronavirus became endemic in those countries
• Enforced monitored quarantine on Australian residents returning home from those countries
• Suspended cruise ship sailings in February

The first action simply seems like good old common sense—although it was not a sense common to the WHO or the Australian public health community. The second should have followed on from the quarantine restrictions imposed on the Wuhan evacuees; it is a mystery why Australia’s public health authorities felt that February returnees from Wuhan required such extreme isolation, while later returnees from coronavirus hotspots like Iran, South Korea, Italy and the United States could be trusted to self-isolate at home on their own recognisance. Finally, it is incredible that the cruise industry was allowed to continue to operate (and even expand its operations) in Australia as ship after ship around the world fell prey to coronavirus outbreaks.

When Professor Murphy appeared before the Select Committee on COVID-19 on April 23, he told Senator Paterson that throughout the coronavirus crisis, “government decisions, both federal and state, have at all times been advised by the consolidated national advice from the AHPPC”. In a strictly pro forma sense, that statement probably is true. But this kind of proformalist thinking is what introduced the coronavirus into Australia in the first place. Had the NSC discounted the advice of Murphy and the AHPPC, discounted the China-influenced advice of the WHO, and relied on their own good judgment about border security, Australia likely would have avoided a crisis altogether. As the rollout of the useless and unused COVIDSafe app has shown, if you have a hammer, every problem is a nail. For Murphy and the AHPPC, their hammer was a public health response involving hospital preparations and self-isolation for the entire country. Border security was not really their remit. Border security is the responsibility of the NSC. By relying too heavily on public health advice, the NSC let down its guard, and let in the coronavirus.

*****

Salvatore Babones is The Philistine. A footnoted version of this article has been submitted to the Australian Senate’s Select Committee on COVID-19.

[1] Unsigned, “Australian Government’s response to the COVID-19 pandemic” Senate Select Committee on COVID-19, April 23, 2020: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;db=COMMITTEES;id=committees%2Fcommsen%2F75585d2b-2ea4-429c-bc62-d82fe6ee120d%2F0001;query=Id%3A%22committees%2Fcommsen%2F75585d2b-2ea4-429c-bc62-d82fe6ee120d%2F0000%22

[2] Brendan Murphy, “Chief Medical Officer’s statement on novel coronavirus”, Australian Government, Department of Health, January 19, 2020: https://www.health.gov.au/news/chief-medical-officers-statement-on-novel-coronavirus

[3] Brendan Murphy, “Novel coronavirus update”, Australian Government, Department of Health, January 21, 2020: https://www.health.gov.au/news/novel-coronavirus-update

[4] Unsigned, “Update information on the novel coronavirus”, World Health Organization, January 20, 2020: https://www.who.int/thailand/news/detail/20-01-2020-update-information-on-the-novel-coronavirus

[5] Dawn Liu, Eric Baculinao, and Isobel van Hagen, “China’s coronavirus: Cases surge into the hundreds as the virus spreads around Asia”, NBC News, January 21, 2020: https://7news.com.au/news/public-health/coronavirus-cases-surge-into-the-hundreds-in-china-as-the-virus-spread-around-asia-c-656871

[6] Greg Hunt, “Press conference at Parliament House about novel coronavirus”, Australian Government, Department of Health, January 31, 2020: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/press-conference-at-parliament-house-about-novel-coronavirus-0

[7] Jewel Topsfield, “Brendan Murphy: The public face of Australia’s fight against COVID-19”, The Age, March 20, 2020: https://www.theage.com.au/national/brendan-murphy-the-public-face-of-australia-s-fight-against-covid-19-20200320-p54c87.html

[8] Peter Hartcher, “”Three decisions and a two-point plan”: How Australia got on top of COVID-19”, Sydney Morning Herald, March 9, 2020: https://www.smh.com.au/national/three-decisions-and-a-two-point-plan-how-australia-got-on-top-of-covid-19-20200508-p54rag.html

[9] AHPPC, “Australian Health Protection Principal Committee (AHPPC) novel coronavirus statement on 1 February 2020”, Australian Government, Department of Health, February 1, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-novel-coronavirus-statement-on-1-february-2020-0

[10] Scott Morrison, “Updated travel advice to protect Australians from the novel coronavirus”, Prime Minister of Australia, February 1, 2020: https://www.pm.gov.au/media/updated-travel-advice-protect-australians-novel-coronavirus

[11] Unsigned, “Press conference at Parliament House about novel coronavirus”, Australian Government, Department of Health, February 2, 2020: https://www.health.gov.au/news/press-conference-at-parliament-house-about-novel-coronavirus

[12] AHPPC, “Australian Health Protection Principal Committee (AHPPC) resolution on travel restrictions and coronavirus (COVID-19) 13 February 2020”, Australian Government, Department of Health, February 13, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-resolution-on-travel-restrictions-and-coronavirus-covid-19-13-february-2020

[13] AHPPC, “Australian Health Protection Principal Committee (AHPPC) recommendation on travel restrictions and coronavirus (COVID-19) 19 February 2020, Australian Government, Department of Health, February 19, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-recommendation-on-travel-restrictions-and-coronavirus-covid-19-19-february-2020

[14] AHPPC, “Australian Health Protection Principal Committee (AHPPC) statement on coronavirus (COVID-19) 26 February 2020”, Australian Government, Department of Health, February 26, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-statement-on-coronavirus-covid-19-26-february-2020

[15] AHPPC, “Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 29 February 2020”, Australian Government, Department of Health, February 29, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-coronavirus-covid-19-statement-on-29-february-2020-0

[16] AHPPC, “Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 4 March 2020”, Australian Government, Department of Health, March 4, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-coronavirus-covid-19-statement-on-4-march-2020-0

[17] AHPPC, “Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement regarding travel restrictions on 18 March 2020”, Australian Government, Department of Health, March 18, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-coronavirus-covid-19-statement-regarding-travel-restrictions-on-18-march-2020-0

[18] Salvatore Babones, “Australia’s Export Exposure to China’s Coronavirus Epidemic”, Centre for Independent Studies, February 18, 2020: https://www.cis.org.au/publications/analysis-papers/australias-export-exposure-to-chinas-coronavirus-epidemic/

[19] Jill Margo, “The two phone calls that ignited Australia’s pandemic response”, Australian Financial Review, May 25, 2020: https://www.afr.com/policy/health-and-education/the-two-phone-calls-that-ignited-australia-s-pandemic-response-20200521-p54v8z

[20] Unsigned, “Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)”, World Health Organization, January 30, 2020: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)

[21] Bill Chappell, “Coronavirus Has Now Spread To All Regions Of Mainland China”, NPR News, January 30, 2020: https://www.npr.org/sections/goatsandsoda/2020/01/30/801142924/coronavirus-has-now-spread-to-all-regions-of-mainland-china

[22] Helen Branswell, “Limited data may be skewing assumptions about severity of coronavirus outbreak, experts say”, Stat, January 30, 2020: https://www.statnews.com/2020/01/30/limited-data-may-skew-assumptions-severity-coronavirus-outbreak/

[23] Unsigned, “International airline activity – monthly publications”, Australian Government, BITRE, May 1, 2020: https://www.bitre.gov.au/publications/ongoing/international_airline_activity-monthly_publications

[24] David Uren, “Australia’s booming trade with China will shape strategic policy”, ASPI Strategist, September 3, 2019: https://www.aspistrategist.org.au/australias-booming-trade-with-china-will-shape-strategic-policy/

[25] Richard Willingham and Bill Birtles, “Victoria deepens engagement with Beijing’s controversial Belt and Road initiative”, ABC News, October 24, 2019: https://www.abc.net.au/news/2019-10-24/victoria-deepens-links-with-china-controversial-belt-and-road/11636704

[26] Eliza Borrello, “Australia’s states are growing closer to China as the federal relationship remains strained”, ABC News, November 10, 2019: https://www.abc.net.au/news/2019-11-10/the-iron-ties-that-bind-australia-states-to-china/11664730

[27] Unsigned, “International airlines operated flights and seats”, Australian Government, BITRE, May 1, 2020: https://www.bitre.gov.au/publications/ongoing/international_airlines-operated_flights_seats

[28] Peter Hurley, “Australian universities could lose $19 billion in the next 3 years. Our economy will suffer with them”, The Conversation, April 17, 2020: https://theconversation.com/australian-universities-could-lose-19-billion-in-the-next-3-years-our-economy-will-suffer-with-them-136251

[29] Salvatore Babones, “Australia’s export exposure to China’s coronavirus epidemic”, Centre for Independent Studies, February 18, 2020: https://www.cis.org.au/publications/analysis-papers/australias-export-exposure-to-chinas-coronavirus-epidemic/

[30] AHPPC, “Australian Health Protection Principal Committee (AHPPC) recommendation on travel restrictions and coronavirus (COVID-19) 19 February 2020 “, Australian Government, Department of Health, February 19, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-recommendation-on-travel-restrictions-and-coronavirus-covid-19-19-february-2020

[31] Greg Hunt, “Facilitating Chinese-based students to attend Year 11 and 12”, Australian Government, Department of Health, February 22, 2020: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/facilitating-chinese-based-students-to-attend-year-11-and-12

[32] Salvatore Babones, “The China student boom and the risks it poses to Australian universities”, Centre for Independent Studies, August 20, 2019: https://www.cis.org.au/publications/analysis-papers/the-china-student-boom-and-the-risks-it-poses-to-australian-universities/

[33] Scott Morrison, “Continuing travel ban to protect Australians from the coronavirus”, Prime Minister of Australia, February 20, 2020: https://www.pm.gov.au/media/continuing-travel-ban-protect-australians-coronavirus

[34] Salvatore Babones, “Salvatore Babones Newsletter #049 — Proformalism: The Australian disease”, Salvatore Babones Newsletter, March 21, 2020: https://us12.campaign-archive.com/?u=90977cf4d83d5376e1443fd2c&id=b45acf1bdf

[35] AHPPC, “Australian Health Protection Principal Committee (AHPPC) statement on novel coronavirus on 29 January 2020”, Australian Government, Department of Health, January 29, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-statement-on-novel-coronavirus-on-29-january-2020-0

[36] AHPPC, “Australian Health Protection Principal Committee (AHPPC) statement on coronavirus (COVID-19) 26 February 2020”, Australian Government, Department of Health, February 26, 2020: https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-statement-on-coronavirus-covid-19-26-february-2020

[37] Ben Groundwater, “Coronavirus in Australia: I just flew in from Italy and Australia isn’t doing enough”, Traveller, March 18, 2020: https://www.traveller.com.au/coronavirus-in-australia-i-just-flew-in-from-italy-and-australia-isnt-doing-enough-h1mlne

[38] Brendan Murphy, “Novel coronavirus update”, Australian Government, Department of Health, January 21, 2020: https://www.health.gov.au/news/novel-coronavirus-update

[39] Lily Mayers, Sarah Thomas, and Kevin Nguyen, “First mandatory coronavirus quarantine passengers arrive at Sydney Airport”, ABC News, March 29, 2020: https://www.abc.net.au/news/2020-03-29/first-airport-passengers-face-mandatory-quarantine-arrive-sydney/12099734

[40] Cameron Houston, “Wealthy couple return from skiing with coronavirus then do not self-isolate”, The Age, March 25, 2020: https://www.theage.com.au/national/victoria/wealthy-couple-return-from-skiing-with-coronavirus-then-do-not-self-isolate-20200325-p54du5.html

[41] Rhea Mahbubani, “More than half of all coronavirus cases outside China are from the Diamond Princess, but the cruise ship is already planning to set sail again in April”, Business Insider, February 12, 2020: https://www.businessinsider.com.au/diamond-princess-sail-again-april-coronavirus-outbreak-2020-2?r=US&IR=T