Tuesday 9 February 2021

Mismanagement of the highest order

Josh Gans's newsletter on Covid, testing, and vaccination continues to be excellent. 

Here's the latest from Josh, on failures in the Australian system that led to the most recent outbreak there.

However, let’s look at the testing. First of all, quarantined travellers are tested just twice (usually a few days after they arrive and a few days before they leave). Why aren’t they screened daily using rapid antigen screens? It costs very little and can ensure that cases are picked up quickly and extra precautions are put in place so the workers aren’t exposed.

Second, what about the employees? The workers are tested but not often. This one had symptoms before he got a test. From here the plot thickens. From WA Today:
Daily testing of hotel quarantine workers, which could have identified WA’s first community transmission case of COVID-19 in nearly 10 months several days earlier, was only rolled out on Friday, Premier Mark McGowan has revealed.

Following a National Cabinet meeting on January 8 all states and territories agreed to roll out daily tests of hotel quarantine workers after a Brisbane hotel worker was infected with the highly transmissible UK COVID-19 variant.

Victoria had already been doing daily saliva testing and Queensland enacted their testing regime three days later but Mr McGowan said on Sunday that WA had only just finished testing its new regime at the Novotel hotel last week.

“We put in place the saliva testing as quickly as we could using the health department and appropriate protocols, unfortunately, it didn’t start until late this week,” he said.

“It’s not easy, it is a big exercise to roll out.”
Well, that really cheeses me off. Yes, it is hard to get screening in place (I know it more than anyone). But it is not hard to do it in a rough and ready way while you work out best practices. So in WA’s case, they missed it by that much. But if this is your weakest link why did the Australian government wait until this year to decide to roll out daily testing? It boggles the mind. It is mismanagement of the highest order.
If it's mismanagement of the highest order that Australia only just recently started daily testing of workers in the border system, how should we describe a country that hasn't even considered implementing it yet?

Rapid antigen tests would be a fine addition, but the University of Illinois has had a saliva-based PCR solution in place for months, and it's at least as accurate as the nasal swab tests. 

It would be entirely feasible to add daily testing here for everyone in the border system, including those in MIQ. 

Back to Josh on Australia:
Nonetheless, this time around, you might be tempted to say, “it is what it is.” But it is February. A vaccine has been available since December. The Australian government has not rushed to procure vaccines. Nor should they necessarily do so as Australia is at Covid-Zero and doesn’t need mass vaccination as urgently as other places. However, Covid-Zero is a tough policy to maintain. You cannot tell me that it wouldn’t be possible to pay top dollar and procure vaccines for quarantine workers who, despite doing all you can, can still get infected and pass it through to the community. To be sure, if you have regular screening of everyone, there is a good chance leakages can be caught. But, there is a vaccine. The Australian government has sensibly placed these workers at the very front of the queue to get vaccines when they eventually arrive. But these workers and the country need them to have the best vaccines right now! The Australian government needs to be held to account for lockdowns and restrictions that occur that could have been mitigated by obvious, economically sensible actions.

Rather similar here.

New Zealand should have used advance market commitment orders to help secure an earlier spot in the queue while providing the funding that helps vaccine manufacturers scale up for everyone. But from where we are now, whatever your arguments around holding off on mass population vaccination in a spot where the virus is not prevalent, surely there should have been provision for enough early doses for workers in the border system. 

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