8
Sep
2020

Victoria’s COVID roadmap and the 5 stages of grief

by Stephen Duckett


Published in The Age, 8 September 2020

American psychiatrist Elisabeth Kubler-Ross famously described five stages of grief: denial, anger, bargaining, depression, and acceptance. We see all of these in responses to Premier Dan Andrews’ COVID-19 road map announced on Sunday.

Some people are in denial – this road map cannot be right; the modelling must be wrong

Prime Minister Scott Morrison is in the anger stage. The Premier, he rails, is going too slowly.

Others have entered the bargaining stage – why can’t we have a different arrangement for northern Victoria, where the number of cases is so low that it would already meet the step three criteria?

Still others are exhibiting signs of depression. Mental health consultations with general practitioners are up, and the social isolation consequences of lockdowns are very real indeed.

And still others are reluctantly accepting where we are, and are just knuckling down and hoping that soon we will all be able to forget what a terrible year 2020 was.

Behavioural economics also helps to explain some of the reactions to the Andrews’ road map.

Business leaders seem to exhibit optimism bias – they naively assume that if we lift lockdowns now there is no real prospect of having to go back into lockdown sometime in the future. The reality is, of course, that while the virus circulates there will always be a chance that there will be a “super-spreader” event where one person infects 60 people, then they infect another 60, and so we will be back in lockdown again. Does business really want to take that risk?

The modelling shows that it is better – both for our economy and for our health – to continue restrictions for a longer period now than to take the populist path of prematurely lifting restrictions.

NSW is being held up as the shining example. Better contact tracing, fewer restrictions, fewer new cases too: goes the “gold standard” argument. But NSW is playing with loaded dice. Each new day, NSW is one super-spreader event away from a larger outbreak and a return to lockdowns. NSW should not be smug: it should adopt more restrictions, including mandatory mask wearing, rather than basking in the glow of being lauded as a risky role model.

My take on the Victorian road map is that it is mostly right but partly wrong. The Premier is right to keep us focused on zero active-transmissions as the goal – it is the right goal for health, and right for the economy. He is right to have explicit criteria for lifting restrictions.

Unfortunately the criteria are way too complex – a fortnightly moving average, but only relevant after some future date and depending what the source of infections is.

It could hardly be more opaque unless the Premier incorporated the cycles of the moon, the star signs of the key players, and whether the wind was blowing from the east.

Some of the restrictions are irritating – why keep the curfew? It doesn’t appear to be evidence-based, and it gives the Prime Minister yet another opportunity to display his antagonism to Victoria and Victorians. Why not different criteria for northern Victoria? Why not open primary schools, given that the evidence shows the risk of transmission is low among young students?

If you walk down any high street in Melbourne you see the effects of the restrictions – businesses are shut, the streets are empty. The restrictions are indeed hard. But they are, in the long run, for the better.

Perhaps, come September 13 – the road map’s first step – the Premier should issue a revised plan having consulted more widely. Victorians’ grief might ease if that revised plan is clearer and more evidence-based but still keeps us protected and aims for zero.