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Health

Australia's public health messaging isn't hitting home like it used to. Here's why

WA Premier Mark McGowan watches on as Anthony Albanese speaks at a media conference in May. (ABC News: James Carmody)

It seems like no-one is speaking the same language anymore when it comes to dealing with COVID-19.

You may well have discussed the pandemic with friends or family and discovered you're no longer on the same page — in fact, you're reading from an entirely different book.

While some people are masking up in N95s, tracking daily case numbers and planning their lives around avoiding the virus, others are treating it as yesterday's news.

Australia's initial pandemic response was often cited as an exercise in messaging done right, with consensus at the governmental level and widespread willingness among the public to listen to scientific experts.

Now authorities are struggling to get people to adhere to the most basic of COVID restrictions, even in high-risk settings such as public transport.

So what went wrong?

The public health environment has become more complex

Dr Amalie Dyda is an infectious diseases epidemiologist at the University of Queensland's School of Public Health.

She says while Australia's public health messaging hasn't been perfect, it has been largely consistent on issues such as the value of masks and vaccines — even though it has had to adapt to some shifting science.

Dr Amalie Dyda says experts are doing their best to provide clear, consistent advice. (Amalie Dyda: Supplied)

But one of the key challenges has been communicating why governments make the decisions they do, sometimes seemingly against the spirit of health advice.

"As public health experts we provide advice from a public health perspective, but governments at the next level up have to weigh up other things," she says.

When COVID-zero was still within reach, the messaging was simple: Wear a mask in public. Isolate for two weeks if you test positive. Check the list of exposure sites. Sing from your balcony. If we stick together, we can beat this.

But when the Delta variant's rapid spread dashed Australia's hopes of eliminating the virus, even previously determined state governments were forced to admit defeat and change tack to "living with COVID".

Most states opened their borders to COVID hotspots in time for Christmas 2021. (AAP: Dave Hunt)

As higher vaccination rates were reached, policy goals shifted to include boosting economic activity by gradually reducing COVID restrictions, in the hope of doing so without overwhelming the hospital system.

This meant authorities occasionally straying from the language of individual health guidelines — "following these rules should keep you safe" — to sometimes encouraging people to take advantage of renewed freedoms and activities.

As cases inevitably rose, it also meant governments were faced with workforce shortages and supply chain issues, which they moved to address by reducing isolation periods, loosening the definition of close contacts and scrapping vaccine mandates.

Dr Dyda says Australia’s clear public health messaging on the dangers of COVID became less effective when people began paying attention to “high-level policy decisions" like removing mandates, which indicated a lower level of concern.

"From a public health perspective I think the messaging has been clear in terms of masks, vaccinations, not going out when you're sick," she says.

"[But] it's less about saying that; it's more about the mandates."

Actions are no longer matching words

Stephen Duckett says the politicisation of Australia's COVID response has resulted in a "waning of the social licence to regulate". (ABC News)

Professor Stephen Duckett, a former Health Department secretary and a fellow of the Australian Academy of Health and Medical Sciences, says the transition to "living with COVID" occurring in the lead-up to a federal election politicised the pandemic response.

Politicians who favoured looser restrictions were keen to adopt the rhetoric of personal responsibility, he says, while those who favoured continued intervention were reluctant to campaign on it — leading to a "waning of the social licence to regulate".

"Labor wouldn't talk about it, because the second they used the C word the Murdoch media would jump on them as 'the party of lockdowns'," Professor Duckett says.

"Since they've been elected it's hard for them to say 'We want to move on some of these [restrictions]'."

The situation is the same at the state level, he says, despite hospital staff being under pressure every day and being "really annoyed governments aren't doing anything to help them".

'We need inspired leadership': There are calls for a renewed COVID messaging push. July 20, 2022

Both the Queensland and Victorian governments recently issued pleas to parents for children to return to wearing masks at school — but made it clear the request did not signify a change in policy.

And ACT Chief Minister Andrew Barr last month said there were no interventions left that could conceivably stop the spread of COVID in the community.

"The chances of getting 20-year-olds to get any more vaccines is almost zero", he told The Canberra Times.

If masks are so important, why aren't they mandatory?

Professor Duckett says that at a time of record cases and overwhelmed hospital systems, the fact that restrictions are as loose as they've ever been since the start of the pandemic undermines the public health messaging, even as that messaging is becoming increasingly urgent.

"What we're seeing with our eyes and hearing with our ears is inconsistent," Professor Duckett says.

"Previously, we had messaging that masks are recommended. Now, they're 'strongly recommended'. Soon, we'll have 'strongly recommended with sugar on top'.

"We've gone up a level in the strength of the language, but there's been nothing to reinforce that."

He says governments need to show leadership in returning to tighter restrictions, even if the public is sick of them and it means taking a political hit.

"What we didn’t know 12 months ago is how quickly you can get reinfected — and every reinfection gives you a chance of long COVID," he says.

"Obviously when circumstances change, regulations must change."

Australians are no longer wearing masks to the extent they were during mandates. (AAP: Darren England)

Dr Dyda agrees that tightened restrictions and a reintroduction of certain mandates may be the only way for politicians to ensure their messaging is taken seriously.

"The literature suggests really one of the only things that works is mandates… not just in this pandemic context, but in other contexts," she says.

"From a public health perspective, we tend to shy away from mandates unless there's a strong argument for them, for the ethics of them.

"That balance may be shifting back again."

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