Tue Apr 12

Did the Morrison government really prevent 40,000 COVID deaths? A health economist checks claims against facts

Written by: Simon Eckermann, Professor of Health Economics, University of Wollongong

As an opening gambit to his re-election campaign, Prime Minister Scott Morrison claimed his handling of the pandemic had saved 40,000 lives ^[1]. This figure compares Australia over 2020 and 2021 with an average derived across higher-risk predominantly northern hemisphere countries ^[2].

He made similar comparisons to much higher-risk countries two years ago, at a press conference ^[3] on April 7 2020. Morrison and Chief Medical Officer Brendan Murphy pointed to COVID graphs comparing Australian cases with modelling.

“We have so far avoided the many thousands, if not tens of thousands, of cases that may have otherwise occurred by this point across the Australian community — and indeed the many more fatalities that could also have occurred by this point,” he said then, urging Australians to “hold the course. We must lock in these gains.”

But a comparison with equivalent countries tells a very different story about the claim to have saved 40,000 lives ^[4].

The wrong comparison

Given Australia’s very different environment as an island in the Oceania region and strong evidence transmission of initial COVID strains were highly seasonal and temperature dependant, the comparison with OECD countries in the northern hemisphere doesn’t hold.

Australian-led research ^[6] as early as February 2020 showed there were significant reductions in rates of COVID transmission associated with temperature. Higher average temperature was strongly associated with lower cases.

Those findings were confirmed by global research comparing ^[7] 117 countries with more than 100 cases up to April 10 2020. That showed there was an average 5.4% reduction in case transmission for each degree increase in temperature above 0 centigrade and explained 72% of variation.

During 2020 this was reflected ^[8] in rapidly increasing cases during European and North American winters. Numbers then tailed off in summer as temperatures rose while the South American winter saw case rates increase.

Family members remember loved ones lost to COVID on the National Covid Memorial wall in London. AP Photo/Alastair Grant ^[9]

Comparing within our region

As an island in the Oceania region, Australia’s 2020 outbreaks were largely restricted to those imported by air and sea travel, flourishing in the colder environments of meatworks ^[10], until temperatures dropped with winter and outbreaks started to emerge in Tasmanian hospitals and in Melbourne – the coldest, high-density urban population centre in Australia.

Robust comparison for Australia over 2020 are with Oceania region countries facing the same environmental risks with original variants. At December 21 2020, Australia had the highest COVID case rates (1,101 per million) or death rate (35 per million) of all Oceania countries ^[11], other than French Polynesia which opened up to cruise ships in August 2020.

However, Oceania’s climatic cloak of protection in 2020 would not last.

New variants brought greater risks

The Delta variant was much more transmissible ^[12] than the original COVID strains and able to transmit at higher temperatures ^[13]. This was clear from the catastrophic spread that occurred at the height of the Indian summer ^[14] in April and May of 2021.

When the Delta outbreak emerged in Sydney in June 2021 from an unvaccinated limousine driver, less than 4% of the Australian population ^[15] was double-dose vaccinated. The percentage in NSW was lower still, an at-risk population of sitting ducks ^[16].

Yet right up until June 26 2021 Morrison claimed ^[17] no lockdown was required to address the Delta outbreak, despite the absence of broad vaccine protection.

The low vaccination rate was attributable to reliance on one vaccine and the contracting out ^[18] of many aspects of the rollout to a range of for-profit companies. Each aspect of the process proved poor value ^[19], including vaccine rollout strategies and planning, vaccine distribution, delivery of vaccination programs in aged care, and systems meant to monitor these activities.

Bottom line: the relevant comparison is to New Zealand

The federal government’s claims of success show it did not learn the importance of the precautionary principle ^[20] – a decision-making approach used in public health and environmental fields that urges caution when the science and risks are still uncertain – and wasted the luck Australia had in 2020.

To say there has been a saving of 40,000 lives relies on a comparison to the northern hemisphere at the beginning of the pandemic when Australia had a climatic cloak of protection and a safe distance from which to learn from overseas evidence.

New Zealand provides a more useful comparison if we’re to judge the success of the Morrison government’s pandemic handling. Our neighbour faced the closest set of climate and wider conditions to us and had similarly high levels of PCR testing (at least until Omicron overwhelmed testing in late 2021). On this comparison, Australia did not do well.

By September 15 2021, COVID case rates ^[21] in Australia were almost four-fold that of NZ (3,038 versus 796 cases per million) with more than eight times the death rate (43 versus 5 five per million) – further puncturing the Morrison government’s 40,000 lives boast.

In November 2021, the federal government claimed it was well prepared ^[22] for Omicron, but 70% of all COVID deaths in Australia ^[23] (4,579 out of 6,569 as of April 11) have occurred after that date ^[24]. The majority of those were in 2022 ^[25] and are therefore not been accounted for in the 2020 and 2021 comparison underlying the 40,000 lives saved claim.