This article is a synopsis of a Trans Tasman panel discussion on the topic of ‘Maintaining pandemic awareness over the coming years and preparing for an incremental resurgence of international travel’.
Dr. Pete Rive (host),
Senior Advisor, S23M
Chief Executive, Australian Healthcare and Hospitals Association
Bill Bowtell AO,
Adjunct Professor, University of New South Wales
Jorn Bettin (Q&A),
PR: I’d like to first begin by asking the panel about realistic scenarios for a resurgence of international travel the practical steps we need to make it safe.
AV: I don’t think international travel is on the agenda. I have packed my passport away in a filing cabinet. I’m saving my money and just buying good books instead.
VC: People are indicating to me that sometime towards end of next year is what they are planning for. And that’s really though for our businesses here who are global. It means that we do need to find new ways of conducting business. The brutal reality of people not being able to travel internationally for so long is quite intense in terms of the impact on our businesses, and on people in terms of mental health and wellness – traveling is a big part of what some people are doing.
PR: Bill, I was just wondering, if you can cast your mind back to the early days of HIV. You’ve had 30 years of experience of dealing with pandemic situations.
BB: The thing that transformed a very serious but manageable problem with HIV and AIDS into a global disaster that so far has taken the lives of 32 million people, was a very cynical set of political responses. And it has to be said that these responses came out of the United States of America at that time. It’s very similar to what has happened now with COVID-19.
We know how to deal with it, we know the behavioral things. Yet, here we are, not just with a public health problem and a viral problem, but with a cascading series of economic disasters, not least of which is in travel, which is 2% of world GDP. It’s really not been in the finest hour of international co-operation or common sense or science.
AV: We’ve also seen that there has been a loss of trust in Australia nationally, amongst the states and territories. We don’t see much transparency in decision making.
PR: Absolutely. Communication and education of the public is critical in this, because as you point out, the trust is hard won and easily lost.
VC: I think in New Zealand, comparatively, we’ve got leadership that is reasonably transparent, that fronts up constantly on it, communicates really, really well. This has built a lot of trust. The environment is slightly changing now, because we’re getting closer to an election, and it’s going to be really testing in terms of how we navigate through that.
AV: I think the really big issue in Australia, frankly, and it’s one which we weren’t really brave enough to tackle until things got too hard for us, was a very casualized workforce, particularly in residential aged care. Work had to be prioritized because of a need to survive. But at the same time, it put both healthcare workers, their patients, and their families, and community at risk.
There is no doubt, this has been an incredibly stressful time. And the other thing I would add, in terms of mental health, and that’s something we’re not really grappling with here, is that when people lose their jobs, when they lose their housing, when they don’t have food security, it’s very difficult to have optimal mental health.
BB: We have a whole generation in Australia, thankfully, who have no idea what a recession means, much less what we’re entering into, a cataclysmic destruction of businesses and whole sectors. And I think there’s a lot of denialism in Australia at the moment. There’s some belief that vaccine will come along. And there’s a lot of conflating of the idea that the vaccine is a cure. It’s just magical thinking really in terms of the economic crisis that we now deeply confront.
There are a million people unemployed in Australia and probably another million or two being kept going in underemployment. And there are vast sectors of the Australian economy that were dependent on effective international travel, which are just not coming back.
It’s clear that governments can borrow at zero interest rate to keep people going. And that’s what I think they ought to be doing. But they’re not. Eventually the problem with this is that the reality will bite, that things will not get better, that they will get worse. And to stop things from getting worse, you have to spend a great deal of money, immediately. And this does not to me, seem to have sunk in.
Getting international travel back together is a combination of three things:
- One is health. You’ve got to have a vaccine or treatment or something that reduces or eliminates the risk.
- Secondly, you’ve got the finance and economics. Nobody will go anywhere for tourism if they don’t have travel insurance at a reasonable rate.
- Thirdly there is the psychological aspect. Going on holiday is a fantasy. We like to go on a carefree holiday. I don’t go to sit in a dismal post-apocalyptic wreckage, having a mask on my face, outside in Brooklyn in the middle of winter.
In responding to the whole of the pandemic, we’ve just got to look at the way in which these three things come together. It’s a matter of getting that confidence, trust – feeling that we’ve got hope.
PR: A friend of mine recently sold their PR company to an Australian company, and he was chatting to the guy who bought the company in Australia. He said the Australian politicians just seemed committed to not listening to what’s happening in New Zealand, and I thought about that. This is not a game of rugby, we’re actually talking about lives. I was appalled. So, what are some of the practical suggestions to increase Trans Tasman multisolving and knowledge sharing for COVID-19 and beyond?
BB: Now, you never want to declare victory or defeat in these things. But New Zealand did the right thing. As far as I can see, they did a behavioral intervention. They prevented the virus in its worst form, and they stuck at it. And half of Australia and New Zealand now lives in COVID free or zero local transmission environments and strategies, and the other half in Victoria and New South Wales don’t. Well, one way worked, and the other one hasn’t worked as far as I can see.
New Zealand’s lesson has been taken to heart by a lot of people. And we look forward to see how it’s managed in Auckland now, and to see what more has to be done with masks and even even better communication. New Zealand communication on this has been streets and galaxies ahead of the Australian response. So, we are learning slowly by the example set in New Zealand, and we should really, at every level, have so much more interaction and discussion with New Zealand, not just on this, but on what comes after, and how we rebuild.
PR: Vic, this is a huge issue. The world is never going to be the same really. The economists saying that we could be looking at 10 years before recovery. What do you what do you think in terms changing work patterns and things like telehealth. These are all opportunities.
VC: I’d like to connect it back to Allison’s point in terms of the pace of change that we’re asking from our people, which is severely stressful. We haven’t got all the data points yet, but in the United States online or e-commerce doubled in three months – it took 10 years to double before that. Part of the challenge, for both New Zealand and Australia, is that we were behind on digital adoption anyway, and so we weren’t necessarily well prepared to go into a more digital world. So that adds immense amounts of stress into the workplace because our workers are having to put in place new technical solutions, new ways of engaging with customers. That pace of change is not going to slow down. We’re going to permanently be changed.
Even without bushfires like in Australia, it’s been an intense couple of years. We’ve had lots of things going on here in New Zealand, so I do think there’s lots of opportunity, but I also think that generally people are in a quite stressed chaotic state because it’s a massive, massive adaptation to a different way of doing things.
So how we support our workforce is through that? And how do our leadership styles need to evolve to deliver that more emotional support that is really important as well?
PR: In October 2019 the Global Economic Forum concluded that globally we’re not prepared for a pandemic. They made the comment that there was a regular pattern, where in a crisis, we start start with a panic, then focus attention on the crisis, and then unfortunately fall back into complacency before the next panic. So how do you all think can we move beyond political election cycles to stay prepared? I am thinking of health risks beyond just diseases and pandemics, including issues such as global warming, which we just kick down the road.
AV: Just this week, the Australian government released its draft National Prevention Health Strategy consultation papers, and any right minded person would expect after the 9 to 10 months of experience we’ve had relating to bushfires and COVID-19, that there’d be some mention of those issues in a national preventive health strategy. But no, there wasn’t. These issues were completely absent, neither climate change nor the pandemic got a guernsey in this draft document, which is out for consultation, and supposedly will inform a 10 year strategy for us going forward.
Absolute absence of climate change or of the way that we might respond to pandemics, or the way we might deal with health equity issues in the social determinants, which are driving not only poor health outcomes for many of our communities in both Australia and New Zealand.
I don’t feel a whole lot of hope to be honest in that space. I don’t think we have actually realized that this isn’t going to just end when COVID ends. We actually have broader things to think about: How do we live in society? How do we, make sure our impact on the world is actually a little bit lighter, and our tread is a little bit softer than it has been for the last 30 or 40 years?
How do we recognize that with globalization came things like HIV, which spread very rapidly around the world, and now a pandemic, from a disease that started in a market somewhere in China in December, by January is in Iran, by February is in Italy, and by March is in Australia and New Zealand. If we don’t start thinking about the impacts of economic decisions of our industrial behaviours, frankly, we’re not going to be a very healthy society anywhere.
PR: Bill, you must see the repetition of this kind of lack of insight into ecological and environmental issues.
BB: Sure. The frustrating thing is that viruses are coming from nature is as old as history, since life on Earth began. And certainly in the last 30, 40 years, we saw what happened with HIV. Back then I was the advisor to the Health Minister in Australia. I know it sounds funny now, but we didn’t know for months what was causing HIV.
We invested massive resources in having people do the behavioral things necessary, to bring down the caseload. With prevention, like anything else, you get what you pay for. And there have been many countries in the world in relation to COVID who prepared, looked ahead, prepared, and invested in their public health structures.
I know that in Australia, Victoria, over 20 years, they cut the public health budget to derisory amounts, about 0.6 billion. Whereas the other states and territories, Queensland, New South Wales, put a lot more effort and time into funding it, and therefore were much better placed when the emergency came to activating the people and the resources that they had built up.
I also know Asia of course, with very co-ordinated public health structures, very well integrated, very collectivized. How a country like Vietnam has dealt with COVID is quite remarkable. It’s not just a function of the highly developed and rich countries of the world. Vietnam dealt with it extremely well. So, there are models for success, at least in dealing with COVID. For very strange reasons there are countries in the world that we would not look at to learn what was being done to prepare, to mitigate the problem, and to keep it down to a manageable level.
The countries that stripped away the public health structures, that defunded public health, that marketised and privatized it, and and just dispensed with it – not surprisingly, I’m thinking of the UK, the US – they have done appallingly badly and they don’t really have a way, even now, out of it.
So, if we want it, we’ve got to pay for it and invest in the structures. We need to prevent little problems from becoming big ones: COVID, climate change, etc. you could do the list.
AV: One of the things I noticed very early on in the pandemic was that New Zealand’s bureaucratic communications were a lot more consumer friendly. Even on the government’s Ministry of Health website, compared with the Australian government Department of Health website, the ability to find resources is very much greater than it was in Australia.
One of the other communication challenges we’ve had in Australia is inappropriate translations or inaccurate translations into community languages or lack of translation.
Another area which has been highlighted to me is problematic, is that there’s very little systematic way of thinking about interpreting in healthcare facilities in Australia. So in matters relating to PPE for example, interpreters weren’t included in the thinking around PPE. People just thought, it would be easy, and that they can just interpret via telephone or video. But a lot of interpreting actually requires watching body language and facial expression, and it requires the ability to listen to a group of 5 or 6 people talking about an issue, and then being able to translate that into a meaningful way to the healthcare provider. We just haven’t got that right in Australia.
I think in Australia one area where we have done reasonably well actually is in remote and and rural Aboriginal and Torres Strait Islander communities, because very early on in the piece, Aboriginal community controlled health organizations received funding and essentially were empowered to take very localized and regional leadership in the response. For example, in the Northern Territory and in Western Australia, there have been facilitated boarder controls, keeping COVID out of very high risk population groups.
Conversely, the challenge has been Aboriginal and Torres Strait Islander people living in a city like Melbourne, where there has been a substantial outbreak, were actually very much in that marginalized population group, and they’ve not fared so well there.
PR: If we looked at the crystal ball, what do you all think might international travel look like in five years, and what level of travel in terms of old style economic activity will be possible?
BB: I wish I could predict five years. Five months I think is the problem. A vaccine is not going to resurrect international travel, particularly tourist travel. You might get better treatments of one sort or another, a bit prophylactic treatments, a bit like taking prep for HIV, or some days people take for malaria, so that you might get an elevated degree of protection if you don’t have the virus if you’re going to travel to somewhere where the virus is a problem.
But you can see that that’s only going to come very gradually and incrementally. Tourism is going to be very difficult. Unless Victoria comes back to New Zealand outcomes, it seems to me to be very hard to accept that there would be any real serious increase in travel between Sydney, Melbourne, and Auckland. I don’t see that possible, really.
We’ve got to bring down the risk by going for zero community transmission in the Australian states and New Zealand and maintaining that for some while, and then move to see if we can increase slowly the travel between Australia and New Zealand.
JB: There are certain words that sometimes get used by politicians to be perceived as realistic, that may in the longer term be unhelpful. For example, when the war metaphor is used, along the lines of the war on COVID, it conjures up the wrong kind of image and the wrong kind of expectation that somehow we can get this over with and then it’s done. Beyond the war metaphor the talk about normality is concerning. The climate crisis isn’t going away anytime soon, yet we see politicians talking about things like recovery and the new normal. I think those words are setting expectations that may be very, very hard to meet.
AV: You have a look at what’s happened in Europe in the last couple of months as Europeans like to travel during July and August. We’ve seen significant outbreaks and resurgence of COVID as a result of that. I think just observing what has happened in Europe, around travel in particular, we would have to acknowledge in island states like Australia and New Zealand, that adopting a model where you could basically go wherever you want, is not actually a very sensible thing for us to do.
The real challenge, I think, for New Zealand vis-a-vis Australia is, it’s fine for people maybe to come from New Zealand to Tasmania where there’s not much incidence of COVID or even to the lovely city of Canberra where I live where there hasn’t been a COVID case for nearly two months.
That will potentially challenge the airline industry to start to think about the hub and spoke model for air travel that it has used in dispersed countries like Australia.
I actually think business travel potentially will reduce, possibly more significantly even than tourism, because we’ve all learned during this year that we can conduct a lot of our business without actually having to go and sit in the same room as people. I think just trying to go back and back to what we used to have is not what we ought to be aiming for.
BB: I think the point about using these metaphors, like war is completely right. It’s a useless concept. The virus is not at war with anything. The virus is just an expression of physics, and chemistry and biology. It does its work, it transmits; and at the moment, if you’re going to use the metaphor or war, it’s winning.
We saw a terrible way that worked out in Victoria where after the first lockdown around Australia, there was a great deal of agitation there about so-called Freedom Day, that they had won a victory over the virus and that they were celebrating Freedom Day, like the end of a war. And they would come out of their homes, and would resume normal life as it used to be.
This was a cataclysmic mistake, because the people of Victoria somehow deluded themselves into believing that they had won. And at that moment when they dropped their guard, when the social distancing collapsed, when the government didn’t recommend the use of masks, when people were congratulating themselves on how wonderfully they handled it and had virtually no community transmission. Of course, that’s when the virus started its work. It was a misuse of words that deluded the population into believing that the worst was beyond them, in their desire to go back to the normal.
The world we started the year with has gone. It’s gone, and the economics of that world have been smashed into a million pieces. So, we have to build up something better and we have to really understand the mistakes we have made to get into this mess, and we do have to come up with a new language of hope and opportunity that we can do this. I mean, we can recover from this. But we’re not going to go back to what it was before.
There is a great degree of denialism, and the longer we’re in denial, the more it gets in the way of the rebuild, I think.
JB: Our collaboration and communication is increasingly facilitated on mediated by technology, and in many ways the technology dictates to us the ways in which we can interact and engage with one another. The question is, to what extent do we want that to remain in the hands of the corporations that provide us with the tools, and to what extent we actually need to be empowered to create ways of collaboration and communication that reflect our personnel or team based styles that work for our particular context?
VC: Just speaking from New Zealand example and what’s happening over here, I think I agree with the points that have been made in terms of the significant impact, and really taking us right back to the bottom of Maslow’s hierarchy of needs and what we value in our lives.
I do think that there are some opportunities that are rays of hope here. There’s a lot more valuing of your whānau or your family, and people are really appreciating spending more time at home, organizations have learned that we can be highly productive over this technology.
In our organization we were way more productive when we were fully locked down and distributed. And you can see some of the technology companies, like Zoom, and even Google are starting to consider that in their roadmaps and bring in new ways for us to communicate. So, I think that will continue.
The challenge that I see there is that with male dominated technology companies there will be limitations on how far they can go, because there isn’t enough diversity in there to design for a much broader range of society. Hopefully it can accelerate through some of that diversity coming in. Or we could see completely new companies setting up that really do understand the dynamics of how you create, maintain, and grow relationships over these mechanisms.
And I so agree with you Bill, we’re never going back to what we had. And so talking about that is the wrong thing. We don’t know where we’re going, and that is part of the challenge. And so we’re just taking steps until we can get more clarity on it, and we can come together as a public and private sector.
And I don’t think solely government’s responsibility to get us out of this. The relationships need to be strengthened between the public and the private sector, which means government needs to bring new models of how it works with the private sector. That is really, really critical. And then the private sector need to give government a break, so when they do try new things, don’t slam them. Because otherwise, you’ll halt them forever, and lock them into this risk averse position of never wanting to try anything, because no matter what they try, if they get it a little bit wrong, someone’s going to slam them. We need to develop some new ways of working in some new tolerances between us.
We talked about the the major, major agitations around climate change, how we’ve grown our, our wealth economically, etcetera. If we don’t live our lives and the way that we did, how does it help the planet? Even in the city, in Auckland, people are saying, oh my God, the level of life around unbelievable.
People are really starting to think about, actually, do I really want to live that? And that trend has been happening for 3 or 4 years. I hope, somewhere, someone is really starting to look at all this data and say, OK, well, we wanted a world where we weren’t destroying the climate so fast, where we weren’t being so consumer focused and materialistic. We really need to learn from some of those data points that are emerging as we speak.
BB: The very least the CBD offices can get start to get transformed into low-income housing. That’s what we should start looking at.
Facilitated by S23M in association with