Coronavirus Government Global Briefing: April 27


Welcome to Coronavirus Government Global Briefing, Mandarin Premium’s morning update on everything in local and global government responses to the COVID-19 outbreak.

Downloads hit 1 million for COVIDSafe app

At 10.30pm last night, Health Minister Greg Hunt announced that one million people have downloaded and registered for the government’s new contact tracing app, ‘COVIDSafe’, just hours after registrations opened at 6pm.

The Health Department released the app, a Privacy Impact Assessment, and its response to the PIA yesterday afternoon, and while Australians may have plenty of reasons to distrust the app (think controversies around the anti-encryption Assistance and Access Bill 2018, Robodebt, MyHealthRecord, anti-metadata laws, etc), Hunt has pledged a series of protections:

  • only state and territory health agencies will have access to encrypted contact tracing data, which will be stored in Australia on Amazon servers;
  • anyone who accesses the data illegally faces up to five years in jail, under a new determination made under the Biosecurity Act;
  • the determination also explicitly prohibits pressuring anyone to download the app;
  • data stored on the phone will be deleted automatically after 21 days;
  • data stored at the server will be deleted at the users’ request and/or when the pandemic is over; and
  • agencies will be explicitly barred from accessing data under new legislation to be introduced mid-May.
Source: Department of Health via Apple.

Reactions to the announcement have varied wildly; a coalition of medical bodies, including the chief medical and nursing officers as well as the Australian Medical Association, have endorsed the platform, while an alliance of digital rights groups — including the Human Rights Law Centre, Digital Rights Watch, and the Australia Institute’s Centre for Responsible Technology — have outlined a series of requirements for the government to “earn the public’s trust”:

  • the government must publish the source code not only of the app, but for the entire system at the government’s end (both state and federal);
  • the government should provide for independent oversight and mandatory public reporting of all uses of the data; and
  • the government should, by legislation, eliminate the possibility of police and intelligence agencies using their anti-encryption powers, to use the app to access any information on a person’s phone.

The Law Council of Australia’s President Pauline Wright has also outlined a series of concerns:

  • The determination makes no provision on oversight and reporting on the app’s use;
  • ambiguities within the determination over when the obligation to delete data comes into effect (i.e. when is the pandemic “over?”);
  • an absence of ongoing obligations after the determination ceases to be in effect;
  • a potential ambiguity over other laws authorising the issuing of warrants could override the determination’s prohibition on access, without an express provision included in the determination stating that it prevails over all other laws; and
  • calls to legislative as soon as possible, considering the susceptibility of executive orders.

Finally, even allowing for some glitches as the fast-tracked app rolls out — see the app’s current 2.4/5 rating at the App Store, where early users complained it would not verify mobile numbers — it remains to be seen how effective the system, built off Singapore’s TraceTogether app, is at suppressing the virus, if at all.

On the dangers of “immunity passports”

As Australia continues to flatten the curve and prepares to loosen business and travel restrictions, there may be a strong temptation to hope that the creation of antibodies within pockets of the community — either from asymptomatic carriers or those who have recovered from serious infections — could help mitigate future outbreaks.

However, in a new scientific brief, the World Health Organisation outlines multiple issues with the concept of “immunity passports”, first and foremost that there is, as yet, no evidence that antibodies protect from a second infection.

Recovery does not equal antibodies, and antibodies do not equal immunity

As the WHO explains, bodies respond to the virus through a multi-step, 1-2 week process that first involves an innate response of macrophages, neutrophils, and dendritic cells slowing virus spread — and even preventing symptoms — and then:

  • producing antibodies that bind to and neutralise the virus; and/or
  • creating T-cells that recognise and eliminate infected cells, aka “cellular immunity”.

While most recovered patients serious symptoms display antibodies, researchers at Medrxiv.org have found that up to 30% of recovered patients people — overwhelmingly younger patients — develop low-to-undetectable levels of antibodies.

According to the WHO, this suggests that cellular immunity may also be critical for recovery; seemingly, this conclusion correlates with anecdotal reports of people testing positive after having already recovered from the virus.

“As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans.”

The brief lists a series of other challenges in accessing the accuracy and reliability of SARS-CoV-2 antibodies — for example, the fact some people who have recovered from the previous set of six coronaviruses (i.e. MERS, SARS, and four that cause the common cold) may produce antibodies that cross-react with those produced in response to infection with SARS-CoV-2.

The briefing, which WHO will update as new evidence becomes available, concludes that while the body supports governments testing for antibodies — both at the population level and amongst specific groups such as health workers, close contacts of known cases, or within households — most are only designed to provide data on the percentage of people with detectable antibodies, not to determine whether those people are immune to secondary infections:

“At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an ‘immunity passport’ or ‘risk-free certificate.’ People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission. “

WHO unveils advice for adjusting public health and social measures

The warning against “immunity passports” builds directly off the WHO’s technical guidance, ‘Considerations in adjusting public health and social measures in the context of COVID-19‘, released 16 April. Amongst other data concerning risk-assessment indicators and long-term scenario projections — the most plausible of which “involves recurring epidemic waves interspersed with periods of low-level transmission” — the reports outlines six recommendations for adjusting suppression measures and the risk of a resurgence, which, in brief, include:

  1. COVID-19 transmission is controlled to a level of sporadic cases and clusters of cases, all from known contacts or importations; at a minimum, new cases would be reduced to a level that the health system can manage based on health care capacity.
  2. Sufficient public health workforce and health system capacities are in place to enable the major shift from detecting and treating mainly serious cases to detecting and isolating all cases, irrespective of severity and whether there is local transmission or an importation.
  3. Outbreak risks in high-vulnerability settings are minimised, which requires all major drivers or amplifiers of COVID-19 transmission to have been identified, with appropriate measures in place to maximise physical distancing and minimise the risk of new outbreaks.
  4. Preventive measures are established in workplaces, including the appropriate directives and capacities to promote and enable standard COVID-19 prevention measures in terms of physical distancing, hand washing, respiratory etiquette and, potentially, thermal monitoring. Teleworking, staggered shifts, and other practices should also be encouraged to reduce crowding.
  5. Manage the risk of exporting and importing cases from communities with high risks of transmission. This can be done through an analysis of the likely origin and routes of importations, the epidemiological situation of areas of origin and destination, and measures in place to rapidly detect and manage suspected cases among travellers both at departure and at destination.
  6. Communities are fully engaged and understand that the transition away from large-scale movement restrictions and PHSM, from detecting and treating serious cases to detecting and isolating all cases, is a ‘new normal’ in which prevention measures would be maintained, and that all people have key roles in preventing a resurgence in case numbers.

In other updates, the WHO announced a new initiative Friday to strengthen collaboration across world governments, manufacturers, and the private sector to ensure equitable access to diagnostics, therapeutics and vaccines. The briefing was attended by leaders including French President Emmanuel Macron, European Commission President Ursula von der Leyen and German Chancellor Angela Merkel, who committed to ensuring all tools will be made available to the public when they are available.

Finally, ahead of the start of World Immunisation Week, WHO has also called for countries to maintain immunisation services during COVID-19 and released new modelling analysis of a tight timeframe to minimise disruptions in malaria prevention and treatment in sub-Saharan Africa.

State wrap: WA & QLD restrictions to ease, NSW’s school report, and packages forever

With Australia’s curve flattening to a seven day period of below 25 new daily cases, two states have announced plans to ease restrictions either from today or throughout the week.

Australia recorded just 16 new cases yesterday, following a daily record of 460 in late March. Source: Department of Health.

From today, Western Australia has lifted its two-person rule to indoor and outdoor gatherings of 10, including for weddings, outdoor personal training, and open house or display village inspections.

Queensland Premier Annastacia Palaszczuk announced that, from 11.59pm this Friday 1 May, stay-at-home restrictions will ease and — while maintaining social distancing and hygiene practices — residents will be allowed within 50km of their house for recreation and non-essential shopping with members of their household or one friend.

Environment Minister Leeanne Enoch also announced the partial re-opening of some national parks.

“But can I say, this is a very small step that we need the public to 100 per cent co-operate with because if we do see mass gatherings, I will not hesitate to clamp back down,” Palaszczuk said.

Conversely, Victoria’s Chief Health Officer Brett Sutton reiterated that the state will not wind back stay-at-home measures until at least 11 May, The Age reports, when the current state of emergency ends.

Report: COVID-19 in schools – the experience in NSW

Yesterday, the National Centre for Immunisation Research and Surveillance released ‘COVID-19 in schools – the experience in NSW‘, a study of 15 NSW schools that recorded confirmed COVID-19 cases from March to 21 April.

The major preliminary findings include:

  • In NSW, from March to mid-April 2020, 18 individuals (9 students and 9 staff) from 15 schools were confirmed as COVID-19 cases; all of these individuals had an opportunity to transmit the COVID-19 virus (SARS-CoV-2) to others in their schools.
  • 735 students and 128 staff were close contacts of these initial 18 cases.
  • One child from a primary school and one child from a high school may have contracted COVID-19 from the initial cases at their schools.
  • No teacher or staff member contracted COVID-19 from any of the initial school cases.

The NSW government welcomed the report and author and director of the NCIRS Professor Kristine Macartney said, although the investigation is ongoing, their “findings build on emerging data from overseas that suggest very little spread of COVID-19 between children or from children to adults”.

Local council package! Arts package! Transport package! Packages forever!

Capping off another bumper weekend for relief funding, the NSW government announced a $395 million stimulus package yesterday aimed at council jobs, services and infrastructure, to include:

  • a $250 million increase in low-cost loans for eligible councils through the state’s borrowing facility provided by TCorp to kick-start community infrastructure projects, bringing the facility’s total to $1.35 billion
    • TCorp will also be offering principal and interest payments deferrals on existing council loans upon request for the next six months
  • up to $112.5 million from the NSW Government’s ‘Jobs for NSW’ Fund to support a Council Job Retention Allowance of $1,500 per fortnight per employee to limit job losses in the NSW local government sector
    • The allowance will be paid for up to three months to qualifying staff working in the NSW local government sector;
  • $32.8 million to assist councils meet the cost of the FY2020/21 increase in the Emergency Services Levy

Elsewhere, the Victorian government yesterday announced a $16.8 million creative industries survival package including:

  • a $13 million Strategic Investment Fund to be shared by almost 100 non-government arts and cultural organisations including festivals, performing arts companies, museums and galleries
    • beneficiaries include venues La Mama Theatre and Heide Museum of Modern Art, festivals such as the Melbourne International Comedy Festival and the Melbourne Fringe, regional events like the Ballarat International Foto Biennale and Clunes Booktown Festival and First Peoples organisations Ilbijerri Theatre and Kaiela Arts.
  • a $2.2 million Sustaining Creative Workers fund to offer quick response grants for Victorian-based independent creatives and micro-organisations with at least five years of professional experience
    • grants of $5,000 will be available for individuals, and $10,000 for micro-organisations and businesses
    • an additional $2,500 in access funding will be available for creatives with a disability, and disability-led organisations
  • almost $1.6 million to be invested directly into the sector over the next three weeks through the VicArts Grants, Music Works, and Innovation in Marketing programs
    • details of the latest grant recipients will be available at creative.vic.gov.au from midday today, Monday, 27 April

Finally, the Queensland government announced a $54.5 million transport package on Saturday targeting regional air, bus and ferry services:

  • regional aviation
    • support for QantasLink, Regional Express (Rex), Skytrans and Hinterland Aviation to continue running air services on reduced schedules to regional and remote communities, to complement Federal grant funding, which will contribute to rebuilding to a more frequent timetable
  • regional buses
    • support for bus operators to continue running services in Cairns, Innisfail, Townsville and Magnetic Island, Bowen, Whitsundays, Mackay, Yeppoon, Mt Morgan and Gracemere, Rockhampton, Gladstone, Bundaberg and Elliott Heads, Maryborough and Hervey Bay, Gympie, Maleny, Kilcoy and Woodford, Minjerribah, Toowoomba and Warwick.
  • regional ferries
    • support for ferry operators to keep running services on a reduced schedule to Thursday Island, Magnetic Island, Minjerribah (North Stradbroke Island), Southern Moreton Bay Islands and Coochiemudlo Island.
  • personalised transport industry
    • extending existing booked hire/taxi driver authorisations and taxi/limousine licences for six months
    • a further waiver of the annual Taxi Industry Security Levy in 2019/20
    • extending all existing booking entity authorisations for six months
    • extending the refund policy for holders of booked hire service licences so they can receive a pro-rata refund if they choose to surrender their licence
    • waiving fees for operators to de-register and re-register their vehicles.
  • heavy vehicles
    • continuing the existing registration freeze by a year
    • removing de-registration and re-registration fees.
  • licence and registration fees
    • fees to cancel licence or vehicle registration waived
    • learner drivers won’t have to pay costs to renew learner licences renewed until they can book a practical driving test.

For health department updates: Federal, NSW, Victoria, QueenslandACTSouth AustraliaTasmaniaNorthern Territory and Western Australia.

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