Race to 80: how we can reopen borders and end lockdowns

We all know vaccines are the route to “living with” rather than “being overwhelmed by” COVID-19. With Australia’s rollout lagging dismally behind other advanced nations, we need a plan with meat on the bones that commits governments to targets, ensures supply promises are met, improves logistics and messaging, and announces the sequence for reopening borders.

First, set targets. The government should nominate a population-wide vaccination target that ensures we can start to relax border restrictions and commit to no major public health measures such as lockdowns.

Grattan Institute’s modelling suggests that after 80 per cent of the population is vaccinated, including 95 per cent of over-70-year-olds, living with COVID-19 in the community will be manageable. Serious cases are not likely to overwhelm the health system.

Even if the delta variant turns out to be more infectious than we expect, the health outcomes will be only a bit worse than a bad flu season. If transmissibility is in line with expectations, fewer people will die from COVID-19 than from the flu.

But abandoning the “zero COVID” strategy at lower levels of vaccine coverage is a different matter. Even at 75 per cent, there are plausible scenarios where case numbers grow too quickly, intensive care capacity is exceeded, and death numbers are high.

Such an approach risks sending us back into long lockdowns; 80 per cent delivers much greater confidence in reopening. Overseas evidence suggests it is achievable.

Running a weekly $10 million lottery through the crucial month of November and into December could shift more into the vaccine camp.

Second, fix supply and logistics. An 80 per cent vaccination level can be reached by the end of year if a vaccine is approved for children under 12. Otherwise, we should aim for March 2022, by vaccinating a higher share of adults.

Due to confused messaging around the AstraZeneca vaccine, supply of Pfizer has been the limiting constraint on the rollout to date. But substantially more Pfizer is on its way. By the end of the year, there will be enough to fully vaccinate 20 million Australians.

Logistics will be crucial to successfully ramp-up. This means not just reverting to a “GP first” strategy but delivering vaccines en masse via state-run vaccination hubs, pharmacists, schools and workplaces, and through pop-up clinics at major public transport stations and sporting events.

Regional centres and rural towns must not be overlooked. This ramp-up must planned and co-ordinated now.

Third, actively confront hesitancy. The overwhelming majority of Australians are willing to be vaccinated. Genuine anti-vaxxers are loud but few – surveys suggest only about 10 per cent of Australians are strongly opposed to getting a COVID-19 vaccine.

Governments should focus on the moveable middle – the next 30 per cent, who are open to getting a vaccine but say they are waiting. Once supply arrives and everyone is eligible, we need campaigns that focus on the hesitant and harder-to-reach groups, including women, young people, and those from culturally and linguistically diverse communities. Designing and testing the messages with these groups needs to be happening now.

We should also roll out a national lottery, to provide an additional incentive. Running a weekly $10 million lottery through the crucial month of November and into December could shift more into the vaccine camp, and will be more than worth the price tag, given the costs of keeping borders closed and the ever-present risk of lockdowns.

Fourth, put in place a ramp-up strategy. If by November we aren’t tracking to meet the 80 per cent target by the first quarter of 2022, governments should impose more coercive measures, such as vaccine passports for international and domestic air travel, hospitality, and entertainment venues.

We should also require mandatory vaccination for people dealing with vulnerable populations or in high-risk settings, including aged care workers, hospital staff, disability care workers, prison workers, and teachers.

Finally, reopening should be sequenced. At 80 per cent, we should allow Australians who are fully vaccinated and those from low-risk “bubble” countries to come without quarantine. By the time we reach 85 per cent, we should move to quarantine-free entry for anyone who is fully vaccinated.

The government’s first, second, and third priority this year must be to vaccinate the nation. The costs of lagging are enormous. The national cabinet should agree on Friday to a plan to reach more than 80 per cent vaccine coverage, and then throw everything, including the kitchen sink, at getting there.

There is nothing more urgent and important.