COVID-19 Response Inquiry

 

Overview

The Australian Government today released a large report on the Australian Government’s COVID-19 Pandemic Response from 2020.

The extensive report is focused on what happened in the pandemic of 2020-2022, but one of its key proposals for the future is that the Government will establish a permanent Australian Centre for Disease Control (CDC).

The Minister for Health and Aged Care, Mark Butler, this afternoon announced core details about the new CDC organisation, building on the interim entity within the Health Department that had been operating since the start of 2024. The Centre, to be based in Canberra, would aim to commence full operation on 1 January 2026.

We welcome the comprehensive report and the long-awaited announcement that an Australian CDC will be created.

It will be created by new governing legislation, setting out its independence advising the Minister directly, with the laws to be brought to Parliament during 2025.

$251 million would be allocated over the first four years to fund new operations.

There will be extensive debate on the report and its content in the weeks and months ahead. PHAA encourages members to write commentary pieces for our Intouch site on any aspect of the report, or on Australia’s public health needs for the future.

Expanding the CDC in the future to address chronic non-communicable disease

The Report recommends that expanding the scope and functions of the CDC should be staged to build on the work already commenced by the Interim CDC.
While not included in the seventh recommendation that directly relates to the establishment of the CDC, it anticipates a future stage where the CDC takes responsibility for preventing chronic diseases in Australia. The summary report clearly states that non‑communicable diseases should be included in its future functions:

“We support a phased approach to establishing the CDC, with the necessary upfront funding to address agreed priorities and commence the building of supporting interoperable systems. The Interim CDC is building the necessary technical and system capability to embed core functions. A phased approach also provides time for the CDC to build trust and credibility with key stakeholders and the Australian community.

An initial progress review of the CDC should be undertaken 12 to 18 months after the establishment and funding of the permanent entity, and after the first biennial report to National Cabinet and Parliament on Australia’s pandemic preparedness. This would assess its effectiveness in delivering on its core functions, and the biennial report will shape the work plan for its next phase. Based on performance outcomes, the CDC’s remit should be expanded in a staged way, including non‑communicable diseases so that the CDC has a complete health remit." (Summary of the Report, p.53)

The core functions recommended in the report include: 

  • Nationally interoperable data systems to drive optimal collection, synthesis and use of data and evidence, address data gaps and develop linkages to public health workforce capability data.
  • Surveillance systems to inform horizon scanning and early warning advice on emerging global issues.
  • Preparedness and scenario testing to assess national, whole‑of‑government preparedness and assess and make ready the full breadth of our public health expertise to be operationalised in a future emergency response.
  • Biennial pandemic readiness reporting to identify skills gaps and coordinate and resource training programs for system improvement.
  • Public communication both during a pandemic and as part of its business‑as‑usual activities providing a single place where the Australian public can find integrated information.
  • Behavioural insights to support public health responses and provide public health evidence to Australians in effective ways that encourage healthier choices.
  • Engagement with key academic and community partners to support knowledge exchange, identify research gaps and advise government on how these could be addressed.


The report also highlights the founding principles on which the CDC should be created:

  • Multi‑way cooperative relationships with the states and territories and non‑government organisations
  • Complementing and enhancing existing health and emergency governance architecture
  • Transparency, trust and independence
  • Certainty of funding for investment in world‑leading data‑sharing and surveillance systems
  • Building on the foundation established by the Interim CDC.



The report also recognises the population-level determinants of health and their relationship to pandemic management, and the consequences of pandemics.

“There is a strong link between pandemic preparedness and a healthy population with managed levels of non‑communicable disease. Pandemics also have a direct impact on the prevalence and management of chronic diseases. Given the clear synergies, the CDC’s pandemic response remit would benefit from a progressive expansion to include non‑communicable diseases, using the data infrastructure and data linkage established by the CDC in its initial phase. However, the argument for inclusion of non‑communicable diseases goes beyond this if we are to realise the CDC as a transformative national health asset: non‑communicable diseases impact more Australians, for more of their lives; contribute to more deaths; and drive greater health disparities. In order to deliver trusted advice on risk assessment, and provide a comprehensive approach to pandemic preparedness and response, the CDC should be expanded to encompass chronic and communicable diseases when it has progressed preparedness priorities, and support existing advice pathways to government and the Department of Health and Aged Care on policy priorities for non‑communicable diseases and the wider determinants of health.” (Summary of the Report, p.59)

Minimising harms

In the Minimising harm action section of the report, the Inquiry found that policies aimed at suppressing the virus in the initial wave were successful, resulting in many lives saved. The Australian health services system was protected from the waves of peak demand seen in other countries, with some minimisation of negative economic and social impacts.

However, the Inquiry also found that the initial responses’ “broader economic, social and mental health and human rights impacts were not always understood or considered”.

As the pandemic persisted, aspects of the initial urgent response policies were maintained over an extended time. The Report questions the proportionality of restrictive policies, suggesting instead that once more was understood about the virus threat, governments should have sought to be guided by a risk‑based approach grounded in evidence.

Again, the Report indicates that the focus on maintaining low COVID rates came with inadequate consideration of broader health, economic and societal impacts.

Examples of these impacts in the Report include:

  • The vaccine mandates role in increasing rates of vaccine reluctance in Australia
  • Social isolation increasing poor mental health, risk of family, domestic and sexual violence
  • Pandemic disruptions on care for chronic conditions
  • Reduced access to screening services (in particular cancer screening)
  • Reduced access to education, disability supports and secure housing.
  • Ongoing social and emotional development impacts (such as school attendance) on children who experienced school lockdowns
  • Over stimulating the economy with excessive fiscal and monetary stimulus and contributing to the post pandemic inflationary period.

Positive impacts from government policies included increasing social security payments and eviction and rent rise moratoriums (reducing housing stress for these populations, thus reducing risk). Noting that once these temporary securities were lowered or removed, many people were in the same position as before the pandemic.

The Report outlines immediate actions for the Government to take now to address ongoing issues from the COVID-19 Pandemic, such as “a COVID catch-up strategy in response to a decline in the delivery of key health prevention measures”.

The Report also outlines key actions that will ensure the Government has future decision-making capabilities that are risk‑based and grounded in evidence, such as establishing structures to ensure that impacts on children are considered in future pandemic preparedness activities and responses.

Trust
At the beginning of the COVID‑19 pandemic, Australians were largely compliant with public health orders that significantly restricted their movements and freedoms, reflecting a high level of trust in government, together with a general fear of personal harm, and a willingness to make individual sacrifices for the collective good.

However, the Report concluded that a significant erosion of public trust in the Australian Government occurred throughout the COVID-19 pandemic. The report emphasises the need to rebuild and maintain trust between government and the community, including by considering impacts on human rights.

The Inquiry’s public consultation indicated that public trust was negatively impacted throughout the course of the pandemic by the mandating of public health restrictions, particularly vaccination.

“The combination of mandatory measures and the perception people had that they were unable to criticise or question government decisions and policies has contributed to non‑mandated vaccination rates now falling to dangerously low levels,” states the Report.
The Inquiry also found that different approaches taken across the states and territories, and a lack of communication about why decisions were being taken, also led to distrust.

Equity

The COVID‑19 pandemic confirmed that while everyone faces risks and negative impacts during a major health emergency, certain groups of people will experience a disproportionate level of risk and impacts. This may be due to pre‑existing health issues, socioeconomic inequities, employment circumstances, or geographic location.

Early in the pandemic, the heightened risks that the COVID‑19 virus posed to Aboriginal and Torres Strait Islander people were a key focus of the Government’s response. This recognition was underpinned by the knowledge of the widespread health inequities and socio‑economic disadvantage experienced by many Aboriginal and Torres Strait Islander populations as an enduring impact of colonisation, and the risks for those living in remote communities.  In partnership with communities, Aboriginal Community Controlled Health Services and local governing bodies, governments implemented response measures that reflected local priorities and needs.

The Australian Government’s response had a significant impact on how different populations experienced the pandemic. For some groups, the actions of the Australian Government during the COVID‑19 pandemic compounded the negative effect on their health and wellbeing.

For example, the Inquiry found that the additional risks faced by culturally and linguistically diverse (CALD) communities were not sufficiently anticipated, understood or addressed through much of the response. Throughout the pandemic in Australia, CALD people, particularly those born overseas, experienced substantially higher COVID‑19 death rates than the general population.

The decision to exclude international students and other temporary visa holders from certain supports, including income support measures, reflected the continuation of prior policy settings but was not appropriate for a pandemic.

The Report recommends that pandemic support measures include all residents, regardless of visa status, prioritise cohorts at greater risk, and include them in the design and delivery.

Communications

The Report recommends building and maintaining coordinated national public health emergency communication mechanisms to deliver timely, tailored and effective communications, utilising strong regional, local and community connections.

While there were positive aspects to the Government’s early communications approach, they did not achieve a nationally cohesive approach, and communications did not meet the expectations of the public, community sector or industry.

A key contributing factor was the perceived inconsistencies in the approach to the development and implementation of pandemic response measures across jurisdictions. National communications did not adequately address or explain why these inconsistencies were occurring, allowing confusion and mistrust to develop.

The speed that information was communicated was also an issue, as evidence and public health orders changed rapidly. Vaccine communication was one area where significant confusion and mistrust developed in the absence of clear communication from the government.

In addition, communications generally took on a universal approach, and as a result not simple, accessible or meaningful for some specific audiences.

Widespread social media use facilitated the rapid spread of misinformation and disinformation throughout the pandemic, which exacerbated issues such as vaccine hesitancy and people taking ineffective treatments not backed by science.
Initiatives to address misinformation and disinformation through literacy building, proactive communications, and regulatory approaches, as well as important longer‑term initiatives to build societal resilience, are important.