QED

Our COVID Response: Bordering on Incompetence

For the first time in history, the world has what might be called ‘Taiwan envy’. The tiny island territory that China claims as a province but whose president emphasises is an independent country —roughly three times the size of greater Sydney —is home to nearly 24 million people. That kind of population density should have made Taiwan a prime candidate for a coronavirus disaster. Instead, it has experienced fewer than 500 cases of the disease, roughly 80 per cent returning travelers.

Most international media accounts of Taiwan’s coronavirus success focus on its face-mask culture and universal health insurance. Others feature its high-tech, smartphone-based quarantine procedures. Public health experts, unsurprisingly, laud its highly centralised epidemic response system.

But the real reason for Taiwan’s coronavirus success was much simpler: strong border security. Taiwan treated the coronavirus as a border security challenge, instead of letting it in and fighting it as a public health threat.

Taiwan is the star of my paper The 12-Week Window: Coronavirus crisis Australia didn’t have to have. Other East Asian jurisdictions like Hong Kong and Singapore took a similarly tough approach to border security. Despite their high-risk status as major Asian transportation hubs, all three jurisdictions sustained the first shock of the coronavirus crisis remarkably well.

Consider that before the crisis hit, Taiwan’s capital, Taipei, had twelve weekly flights from the coronavirus epicentre in Wuhan; Hong Kong had at least eleven (plus high-speed rail connections); and Singapore had seven. That’s compared to three for Australia. Taipei, Hong Kong, and Singapore also form the nexus of an incredibly dense East Asian travel network. If the coronavirus was spreading anywhere in the region, they were bound to be hit.

It was proactive border security, not economy-wide lockdowns, that saved these densely populated jurisdictions from the worst of the coronavirus pandemic.

Immediately upon receiving the first report of an “undiagnosed pneumonia” in Wuhan pneumonia on Monday, December 30, Taiwan started to screen passengers arriving from Wuhan. It suspended the entry of all Wuhan residents on January 23. Singapore similarly cancelled all flights from Wuhan on January 23, with Hong Kong following suit on January 25. Australia suspended flights at the same time. The difference? The Asian jurisdictions actively screened passengers for illness and electronically recorded contact details in preparation for potential tracing. Australia greeted them with an information leaflet and the usual handwritten landing cards.

Taiwan’s China-wide travel ban actually came five days later than Australia’s. But after taking that big step, Taiwan continued to tighten travel restrictions throughout February, at a time when Australia was loosening them. By the end of the month, Taiwan had supervised quarantines in place for travelers from Hong Kong, Japan, and South Korea, with self-isolation for travelers from Iran, Italy, Singapore, and Thailand.

Hong Kong understandably took longer to ban travel from China, but in early March it started quarantining all passengers arriving from Iran, South Korea, Italy, Spain, and additional European coronavirus hot spots. Singapore similarly quarantined all arriving passengers beginning March 18. The quarantine measures implemented in East Asia differed from Australia’s March 20 travel ban in two important respects: they were supervised, and they allied to everyone, not just foreigners.

Australia didn’t start mandatory quarantines until March 27. When Australia did suddenly impose these sweeping new rules, chaos ensued. Taiwan and other Asian countries had been consistently ramping up quarantines throughout February and March, gaining valuable experience along the way. When Australia tried to go from zero to 100 overnight, it was too much, too late.

Nothing better illustrates the difference between Australia’s border complacency and Taiwan’s more aggressive stance than their approaches to cruise ships. Taiwan banned cruise ships on February 6, quarantining and testing all remaining cruise passengers after that date, whether or not any symptoms of coronavirus had been detected on their ships. Australia, of course, had the Ruby Princess fiasco — on March 19. That six-week gap tells the whole story.

Compared to Taiwan, Australia was slow to screen international travelers, lackadaisical in its self-isolation procedures, and inexplicably irresponsible in its management of the cruise industry. Once the coronavirus was allowed to enter the country, Australia’s public health response was excellent. But as Taiwan’s experience shows, a little more good sense at the border would have made it unnecessary.

Australia had twelve weeks to avert a coronavirus crisis. For the first six, its response was up there with the best. Then Australia took its eyes off the ball.

When the government failed to lock down the border, it was forced to down the country instead.

Salvatore Babones is an Adjunct Scholar at the Centre for Independent Studies

19 comments
  • ianl

    Thank you Salvatore. I’ve made a persistence of this issue so I appreciate your article immensely.

    It is also true, however, that Aus did not so much as “take its’ eye of the ball [of international border closure]” as delay it at the panicked request of the universities, trying to gather as many fee-paying students from overseas as possible. Despicably selfish behaviour from the most pampered groups of our self-appointed “elite”.

    And this behaviour was condoned, played down, hidden, shoved into the memory hole, by the MSM and our other heroes.

  • pgang

    If someone could let me know when the Wuhan virus becomes a serious threat to any nation, I’d appreciate it.
    With respect to the elderly and infirm, the fact is that a few of them becoming ill and dying does not constitute a national or moral crisis.
    Especially when practising doctors are able to provide simple treatments to prevent symptoms from escalating into emergencies. If health authorities and medical unions in Australia have decided to ban these treatments, then that’s on their shoulders.

  • Davidovich

    When the next pandemic arrives, and it will, Australia won’t be able to shut down the economy again as it will just be unaffordable. Our political leaders and bureaucrats bungled the border closures and must learn the lesson that prompt and firm action on borders must be applied as soon as knowledge of the virus is gained. That, of course, also means taking no notice of the WHO and its assurances.

  • lloveday

    Indonesia, like Taiwan has a “face-mask culture”, albeit to a lesser extent, and has made wearing a mask outside of a residence compulsory.
    .
    I was surprised to hear an Indonesian medical expert explain what I’ve been going on about when solving the world’s problems over a beer or 10 – the dangers of wearing a mask, particularly while exercising and especially if one has underlying respiratory or cardiac problems (and the older you are the less healthy your heart and lungs surely are) due to lack of oxygen and more than usual CO2. Two 14yos collapsed and died recently in China wearing masks during a running time trial.
    .
    I measure my blood pressure daily. Before the world-wide lockdown and exercise restrictions it was typically 130-135/70-80 and is now 145-150/80-90.
    .
    Maybe if I had a home gym, swimming pool, spacious back yard, chauffeured car, huge government salary……like so many of the effective dictators imposing the lockdowns it would not have risen so dramatically.

  • Farnswort

    An important piece – thank you Salvatore.

    The Morrison Government was far too slow to enact the appropriate border security measures during the early stages of the coronavirus pandemic. Canberra allowed people to keep streaming into the country by the jumbo load without screening or quarantines. Even its ‘ban’ on incoming passengers from China was riddled with holes like Swiss cheese. For instance, the Morrison Government quietly allowed over 30,000 Chinese students to subsequently enter Australia via third countries – a move designed to placate the greedy universities.

  • Peter Marriott

    I agree with pgang. It’s an influenza, i.e. an influence, i.e. an epidemic like all the other influenza’s and we shouldn’t have had to shut down the entire country in fear of it. Age is not the issue going by my reading of it all, it’s chest morbidities, regardless of age just like many of the standard influenza strains I think. Even on the Diamond Princess I read more than half the 79 year olds who tested positive actually had no symptoms at all and almost half the 89 year olds were the same, which doesn’t sound like the standard flu to me where there appear to always be symptoms of some kind, and when comparing statistics with the annual standard influenza season it’s necessary to use a big multiplier I think, because millions do get vaccinated for the standard flu, whereas of course no one has had any for this Wuhan one.

  • Farnswort

    No Peter, it is not an influenza virus. It’s a completely different virus type. It is also a novel virus.

  • Salome

    Taiwan was a standout success. If Australia failed in not being just like Taiwan, so did the rest of the world.

  • March

    The response to this virus has been the worst example of risk management in human history. It is a genuine danger to the very old but to the rest poses as much of a threat as the seasonal flu. A proportionate response would have had us look after the most vulnerable instead governments around the world lost the capacity of reason and were sucked in by highly flawed models that exaggerated the threat and we collectively blew our brains out. To add insult now our politicians parade around like they have saved the world and sadly it seems a large part of the population also sucked in hook line and sinker seem to agree.

  • Peter Marriott

    Farnswort, thanks for that. I was using the historical definition of influenza, based on the mediaeval Latin ‘influentia’ which was commonly used to describe a visitation of any epidemic disease. Age per se though does not seem to be a major factor, it’s more the existing morbidities ; a fit and healthy 80 year old with no chest morbidities seems to be in less danger than an obese 30 year old with bronchitis and or asthma.

  • Stephen Due

    Massive economic destruction – such as we have seen inflicted on Australia by our governments during the pandemic – is neither rational nor morally justifiable. It has been made even worse by the restrictions on our democratic liberties, including the suspension of our parliaments, and stay-at-home laws, The comparison of this novel virus with influenza is valid epidemiology, regardless of certain differences in its behaviour. In view of that comparison, the course of action chosen by Australian politicians is utterly reprehensible in my view. No attempt was ever made to balance the supposed benefits of this shocking policy against its downside. There was no rational risk assessment process whatsoever. That only medical experts were given the microphone to influence public opinion, and the seat at the political table to guide government policy, shows how incompetent the management was. No rational person would have embarked on such an economically and socially destructive program without proper assessment of the risks. This was an exercise in media-driven mass hysteria and political grandstanding of the worst kind in my view. A disgraceful period in Australia’s history that ought to be remembered with shame. Hopefully – though it is a faint hope – lessons will be learned and limits placed on the use of emergency powers during pandemics in future.

  • DG

    March, you are right on the failure of risk management. While people insist on reducing it to a matrix of coloured squares we will continue to see similar failures, I’m sure. Rather than failure mode analysis, rigorous consequence analysis, perhaps using scenarios, and articulated sensitivity analysis of models, if not the full blown Monte Carlo analysis, we are in risk management pre-school.

  • Peter Marriott

    I agree Stephen. One other thing I’d like to add ; in my view the reaction in some quarters I’ve read about, if it’s true, that anyone disagreeing with the total lockdown and restrictions in some way might not care about peoples lives would be beneath contempt, and would smack of a debating position that was weak and plain wrong, simply trying to shut up anyone who disagrees. There have been serious illnesses in the past that did warrant targeted drastic quarantine measures like, cholera, typhoid, small pox, bubonic plague with death rates in excess of 30% I believe, but this Wuhan virus is definitely not one of them.

  • Simon

    When the next pandemic strikes, as it most assuredly will, I doubt anyone will be crazy enough to go down this razed earth path.

    There is reason the lockdown is unprecedented – nobody in their right minds would have thought of imprisoning people in their own homes for months on end, denying international as well local travel and closing down business and industry – for a virus!

    The wild imaginings of CMO’s have always exaggerated the menace of these things – it’s only for this virus that the politicians seem to swallowed it all hook, line and sinker. Even Kevin Rudd, to give him his due, didn’t listen to the alarmists for the 2009/10 Swine Flu pandemic.

    Taiwan may be an example to us, but I personally doubt we need to have even gone as far as it did. That is because the virus mainly affected older people and especially in those in care homes, most of whom had co-morbidities.

    What we should have done is protect them as best we could, practiced social distancing, increased hygiene and spent a lot more time outdoors to get the sun.

    Incidentally, the Lancet had to withdraw its’ risible article on the ‘dangers of hydroxychloroquine’ and I am sure that drug would have saved many lives. The irrational took over once it was commended by Trump.

  • ianl

    Salome

    >”If Australia failed in not being just like Taiwan, so did the rest of the world.”

    It’s not as if the Taiwanese method was a complete surprise to the everyone else. The Taiwanese developed this from their SARS-1 experience and constantly shared it as they updated it.
    Our own bureaucratic heroes (our Nanny State) were in the loop, attending the same international conferences, on the same distribution list for published papers, being kept abreast of the research from the world’s viral labs, including the CSIRO …
    3rd rate complacency, then combined with the most egregious of deliberate double standards, has destroyed much of people’s individual, independent economic efforts and opened the populace to agreeing to some variation of collectivism tacitly supported by timid governments.

  • Elizabeth Beare

    Reliance on highly flawed models that exaggerate the threat and therefore blowing our economy up? Sounds like Climate Change to me there so we can only hope that people notice the similarities with COVID19 and get more critical of the CO2 madness.

    In the early stages of a new disease all epidemiology is likely to be flawed due to assumptions made that turn out to be inapplicable; and too many epidemiologists rely on very simplistic models (cf climate modellers in this regard). We still don’t completely understand COVID19 as an illness. There are some indications that it is actually a vascular illness which expresses itself in loss of respiratory and cardiac functioning, in some cases meaning that ventilators might even be counter-productive in treatment. People with high blood pressure and coronary artery disease are over-represented in those with COVID19, which suggests people with some malfunctioning in the angiotensin hormonal system may be at risk, because the virus attaches to the ACE2 receptors, proteins on the ACE2 cells which are the point of infection for the Cov2 virus. Some blood pressure drugs increase the number of these receptors, hence the concern, although it may yet be a beat up. There are studies ongoing as to whether iatrogenic (medically caused) factors might be involved via pressure-lowering medication which interferes with this system via Angiotensin Converting Engyme Inhibitors (ACE Inhibitors) or Angiotensin Receptor Blockers. The use of these drugs, especially the ARB’s, seems to increase the levels of ACE2 protein available on the cell walls of blood vessels and most likely also in the heart itself, predisposing to infectivity.

    GP’s have been alerted to this research but told so far to hold off changing any medications, due to the likely deleterious effects of doing this with some patients under complex treatments for severe vascular and coronary artery disease. Panic responses could only cause further problems for some under treatment.

    In discussion with my GP, I have stopped taking my ARB’s and moved to a Calcium Channel Blocker for my only moderately high BP. I preferred the ARB’s as they had no side effects, unlike the CCB’s which take a month to get used to but at 78 years old next month, I considered it a wise decision to change medication if medically advised it was OK to do so. My husband, ten years younger than me, is on both types of medication (Antiotensin ARBs and Calcium Channel Blockers) due to a heart stent and his cardiologist wants to keep it that way. So no easy answers for all re this vascular side of COVID19.

    Thus – we don’t know all there is to know yet about COVID19 as a disease. It is not just influenza, although it presents in a similar manner initially and stays that way for many – a bit of a cough and a sore throat at the worst. Whatever it is, we have as a society to get used to living with it. Most people who get it will get over it, including many older people. I have always taken the view that due caution is a good idea, but ceasing to engage in life by limiting too much of what is normal and enjoyable is too much caution for me. Others may be less sanguine, and often with good reason.

    On the issue of quarantine at the borders, obviously it is a good idea for some at all times, and for all during the height of an epidemic curve. Many people would voluntarily quarantine if requested, as we did flying into Sydney from Los Angeles on 25th March, but being handed a bit of paper with a website URL on it was insufficient information. During a pandemic I think offering all incoming airline passengers, and others heading straight home to stay, a small ‘comfort’ package of tea, coffee, milk, biscuits and muesli bars would be helpful, as would a telephone list of emergency food delivery suppliers, paid or unpaid. Better than arriving home unable to access an online supermarket delivery for days and nothing to eat or drink after that first sleep. We were lucky we had family to leave stuff on our doorstep immediately. And anything is better than 14 days in a stale aircon hotel room.

    EB

  • Elizabeth Beare

    Agree about risk-management pre-school in all of this.
    And public health pre-school too.
    Lessons should be learned from it all.
    The main one: it is easy to petrify people but far harder to admit you were wrong.

  • nilsm

    Taiwan anticipated the Wuhan virus. They did not know when, but they knew in advance that new viruses would emerge from China sooner or later. Ever since SARS killed eighty Taiwanese in 2003, and even more so after the Airbus deal in which France built a high level virus research lab for the Chinese military, Taiwan has known that more new viruses would emerge from China. Taiwan prepared its epidemic defences years in advance, performing regular government-wide epidemic response exercises at least annually. Taiwan’s national response was well rehearsed because they were aware of China’s ongoing threat as a source of viruses.

    Taiwan never had or needed any lockdown. Bustling crowds continued to pack cinemas, schools, night markets, restaurants, department stores, buses, trains, businesses and everything. In April the Taiwan government was considering reducing the maximum number of people permitted into amusement parks. (Taipei Times, p3, 9 April 2020 https://www.taipeitimes.com/News/taiwan/archives/2020/04/09/2003734282).

    Taiwan’s economy throve on because epidemiologists defined the national response, free of political contamination.

  • Farnswort

    Peter Marriott, I apologise for jumping to conclusions. Sadly, too many people still seem to hold the belief that the COVID-19 virus is a member of the Orthomyxoviridae family. I’ve become a bit fed up with seeing these claims repeated time and again.

    When dealing with a novel virus of unknown parameters, it is vital to adopt the precautionary principle to mitigate the potential pandemic risk.

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