Like most countries, Australia, and more particularly the state of Victoria, is currently experiencing a second wave of COVID-19 cases with a predominance of community transmission. As of the 21st August 2020, Australia has had a total of 24, 602 cases (18, 029 in Victoria), 4,546 are current cases, and 485 deaths of which 302 were deaths in residential aged care facilities. These numbers are small in comparison to other countries but significant enough for the government to declare a “war on the virus.” Fortunately, the number of cases in Victoria is plateauing in response to stage 4 (metropolitan Melbourne) and stage 3 (regional Victoria) lockdowns.
COVID-19 is a great Leveler—no one is truly immune to it though the impact of the disease varies from person to person. The COVID-19 pandemic is also a great Revealer. It has stripped away the politics and laid bare the “broken systems” in Victoria, including generations of socio-economic inequities; the underfunded aged care sector; and the welfare sector involving those who are vulnerable, displaced, facing constant discrimination, and trapped in politically based policies that override human rights.
In Victoria, the second wave case numbers were highest in areas of low socio-economic demographics—the working poor, migrants, non-English speaking and culturally diverse people. In other words, those with poor social determinants of health[1]. One incident that rightly made headlines in the news and newspapers was the immediate “hard lockdown” of nine social housing towers where there were 102 cases of COVID-19 infections. The Victorian Premier’s intent was to contain the infection within the closely confined, overcrowded housing estates, each with shared facilities. The 3000 residents in these towers were poor, vulnerable and marginalized, comprising the elderly, migrants, refugees, culturally diverse, non-English speaking groups, some with histories of mental illness and post-traumatic stress disorders from past experiences with oppressive regimes. Domestic violence, drug and alcohol dependencies were common. Within a very short time of the announcement police and emergency services attended these housing estates. There was a lack of consultation with the local leaders and no communication with the residents, even with those who understood English. There were no evident strategies to manage communication, food, medications, and other necessities of life for the residents. Fortunately, the community, both local and afar, rallied with many volunteers including those from Catholic organisations, assisting and taking basic necessities to the residents where law enforcement officers would not, for valid reasons including fear of being infected. The intent to contain COVID-19 infections, whilst important, seem to have overridden basic human considerations in the immediate. Once again it is not so much what is done (immediate lockdown) but how it is done.
In October 2018 the Royal Commission into Aged Care Quality and Safety was established by the Australian Governor General following years of complaints of the lack of quality and safety in aged care. What the COVID-19 pandemic has done is to highlight further an aged care system that is wanting in its care for the elderly. Whilst the elderly are particularly vulnerable to COVID-19, the lack of quality and safety in several aged care facilities has resulted in even further deaths. Further complaints have been made to the Royal Commission on the poor care of the elderly witnessed by relatives prior to the death of their loved ones. Some of these facilities have now been taken over by the government.
The COVID-19 pandemic has also revealed our “true colours”. It has laid bare people’s values and how they live those values. There are those who value their “individual rights” and themselves, with no apparent sense of community or the common good. The pandemic has also forced governments to reveal their priorities. Fortunately, the Victorian state government seemed to have made choices reminiscent of some of the Catholic Social Teachings and have precariously and rightly chosen human life over a proposed healthy economy. The consequent socio-economic, health and education costs of lockdown have been very significant. There has been an ongoing review of policies and support attempting to offset some of the impact of lockdowns but not to pre-COVID-19 pandemic levels.
The daily updates from the Victorian Premier and his associates have included pleading with every citizen to do their bit by getting tested, wearing masks and isolating where necessary—”this is a war we can only win as a community.” The underlying message was for the common good. The promise of financial support was encouraging, but not for everyone. International students, casual workers, itinerant workers who took jobs Australian citizens would not do, missed out on financial support. Refugees and those trafficked were even more vulnerable. The impact of the lockdown on mental health, situations of domestic violence, the homeless were met with increased funding, seemingly not available prior to the pandemic.
Despite statements of an abundance of personal protective equipment in warehouses, health workers are having to provide for themselves. Caring for those who provide care and who put their lives on the line is an ethical obligation, and a value claimed to be held by the government, yet there is a lack of follow through in practice.
In the daily press conferences given by the Victorian Premier, there has been an insistence on not apportioning blame. He emphasised instead the poor choices made by those who continue to disobey health orders in this State of Emergency. He has endeavoured to seek the underlying reasons as to why those who live hand-to-mouth would still go to work instead of isolating whilst awaiting COVID-19 test results, and has remedied the situation with payments and pandemic leave.
Whilst lockdowns seem draconian to some, explaining why they are necessary and being transparent about them has engendered trust and cooperation. It has also helped focus and build on values that unite rather than divide. The Press have also played their part in holding the Victorian Premier accountable to his claims and promises of support.
These are small examples that highlight values that are central to being a human being and having as primary, the values of human life and dignity, and the common good. Issues of justice and equity, whilst improving, have a long way to go. The promises of further care to the vulnerable, marginalized, homeless and the addressing of social inequities have yet to be proven.
Australia’s health system has not yet been overloaded, though Victorian health workers are overstretched covering shifts of colleagues infected with COVID-19 or in isolation. If the system does overload it will challenge us further on our values and where we stand in terms of justice and equity, in caring for the sick. Ethical frameworks have been developed[2],[3] to help in decision-making. Stewardship involving accountability, inclusivity, transparency, reasonableness, and responsiveness would be important.[4]
The pandemic is a crisis—a turning point. It is an opportunity for transformation not just for governments but also for individuals. The lockdowns have in many ways forced us to re-evaluate our priorities and values, recognise the importance of relationships, the things and people we have taken for granted, and acknowledge that our pre-COVID-19 living has had a significant impact on our fragile ecology. For some, the recognition of personal responses to the lockdowns have led to an evolving awareness of who we are and what is essential for our everyday living. For others, personal reflections have led to decisions to let go of the culture of blame and move towards one of respect and human kindness. In many ways this pandemic has offered an opportunity to pause, to re-evaluate our values, and how we want to live more consciously our deeper human and Christian values, as individuals and as a church. These values are revealed in our actions and inactions, as we endeavour to live with greater moral integrity as leaders and members of a continually emerging Body of Christ.
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[1] see https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/determinants
[2] Dawson, A., Isaacs, D., Jansen, M., Jordens, C., Kerridge, I., & Kihlbom, U. (2020). An ethics framework for making resource allocation decisions within clinical care: Responding to COVID-19. Sydney Health Ethics.
[3] McDougall, R., Sheahan, L., Ko, D. (March 2020). Planning for and managing COVID-19: Ethical decision-making tool. University of Melbourne.
[4] Royal College of Physicians, (2020). Ethical dimensions of COVID-19 for frontline staff. Royal College of Physicians. https://www.rcplondon.ac.uk/file/20551/download