Public health and its role in Victoria’s pandemic stimulus election

Victoria’s upcoming election provides an opportunity to reflect on and learn from the state’s response to the COVID-19 pandemic, inform public health policy and improve our resilience to agents emerging pathogens over the next four years.

Australia’s response to the pandemic has been characterized by a clear recognition of the importance of states and territories as leaders in the public health response.

States have become the primary decision-makers in determining the need for lockdowns and a wide range of other public health restrictions.

Overall, Australia has had a relatively successful response in terms of controlling the virus, but has also endured long periods of lockdown in pursuit of this aggressive strategy.


Read more COVID-19 lockdown in Victoria: getting ahead of the spread


Victoria was at the forefront of this process, as the state government embraced the COVID-zero strategy. This elimination approach required several extended periods of lockdown, but allowed restrictions to be lifted once transmission had fallen to zero, with long periods of relative normalcy between outbreaks as the pandemic raged abroad.

These decisions were made in the context of an emergency response to a generational threat, but as COVID shifts to endemic transmission and emerging infections pose a lingering threat, we can now consider more sustainable policies.

Highlights of our pandemic response

The adaptation of our academic sector, our laboratory resources and our world-class staff to the response to the pandemic has been a major asset; As a state, we have contributed substantially to the national response through our innovative genomics, modeling, engineering, evidence synthesis, therapeutic trial expertise and vaccine development.

This helped drive the pandemic response in real time and kept us at the forefront of the national and international fight against COVID-19. As data, technology and evidence were developed, they were quickly incorporated into our local public health response.

…and weaknesses

Given the lightning-fast time scale of the pandemic, Victoria was initially reliant on its pre-existing public health and healthcare infrastructure. Victoria’s public health system suffered from a lack of consistent resources and an overly centralized system in Melbourne.

This exposed key weaknesses early in the pandemic, including inadequate public health staffing and outdated disease surveillance and management systems, such as a paper-based contact tracing system.

More decentralized systems, such as those in New South Wales and Queensland, have provided greater local public health capacity.

Additionally, Victoria’s centralized systems have contributed to delayed or ineffective communication with many Victorian communities, particularly during the first few weeks of our second wave in 2020.

Building on strengths

Continued investment in high quality research capacity could maintain Victoria as a world leader in infectious disease control.

The recently announced Victorian mRNA Hub, a collaboration between Monash University and the University of Melbourne, has been supported by the state government, while the major philanthropic grant given to the University of Melbourne to establish the Cumming Global Center for Pandemic Therapeutics was likely facilitated by Victoria’s outstanding medical research experience.

These major global research centers will have positive spin-offs for Victoria, as they will become hubs to attract more researchers and PhD students, and stimulate developments in technology and industry, creating jobs in Victoria.

As the Commonwealth government seeks to deliver on its election promise of a national CDC, Victoria can remain at the forefront of this process.

Remedy weaknesses

Victoria has taken important first steps to revitalize its public health and response capacity, including through the development of Local Public Health Units (LPHUs) at the end of 2020.

These health units are helping to decentralize the public health system, integrating the response within local health departments and communities, while maintaining close links with Victoria’s Department of Health.

LPHUs can have many important local roles, including:

  • contact tracing
  • disease surveillance
  • operationalization of intervention programs
  • communicate with local communities.

The local knowledge, community connections, and value that LPHUs provide are critical components of future pandemic preparedness.

The next parliament should prioritize consistent funding for LPHUs and ensure that links to primary care and community services continue to be developed. The expansion of the public health system also has the benefit of supporting the career progression of public health professionals.

Social cohesion and investment in public institutions

COVID-19 has clearly demonstrated that we need to develop a more robust health and societal system which is the greatest asset to support our response.

This should go beyond investing in newer and larger hospitals to cover the full spectrum of the health system, including community and primary health care, care for the elderly, public health and research. .

The social determinants of health, such as living and working conditions, education and social support, have long been recognized as upstream drivers of broader health outcomes.

The COVID-19 pandemic has been no exception, with socially vulnerable individuals and groups suffering the greatest impact and poorest outcomes in Australia.

Equity should be a fundamental tenet of our response to future pandemics, but it is difficult to achieve overnight as we strive to tackle the latest emerging pathogen.

Despite the often divisive discussions leading up to this state election, the next state legislature is expected to focus on building community cohesion.

For public health decisions, public trust is essential to ensure that control strategies are optimally effective against infectious threats, and is our most important defense against future pandemics. However, the process of building such trust goes well beyond health policy and requires a whole-of-government approach.

This article was first published on Monash Lens. Read the original article.

With

James Trauer
associate professor (research); Head of Epidemiological Modeling Unit, School of Public Health and Preventive Medicine, Monash University

Angus Hughes
Epidemiologist, Epidemiological Modeling Unit, School of Public Health and Preventive Medicine, Monash University


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