The Coronavirus and the Perils of Expert-Driven Policy Salvatore Babones When the Australian Senate's Select Committee on COVID-19 held its first public hearings on April 23, 2020, the first witness it called to appear was, quite naturally, the country's Chief Medical Officer (CMO), Prof Brendan Murphy. As Australia's CMO and chair of the Australian Health Protection Principal Committee (AHPPC), Prof Murphy was the public face of the government's coronavirus response. Prof Murphy told the Senate's COVID-19 Committee that he 'first heard notification through the WHO [World Health Organization] on New Year's Day, on 1 January that there was a cluster of pneumonia of unknown aetiology in Wuhan'. For the next three weeks, Prof Murphy told the COVID-19 Committee, he and the AHPPC were in 'watching mode ... getting data out of the WHO, from our counterparts in other countries and from the CDC [the United States Centres for Disease Control]'.1 Prof Murphy said that on January 19, he and the AHPPC 'moved to a very different mode', issuing a travel advisory for Wuhan and notifying the Australian National Incident Room. What Prof Murphy actually told the public on Sunday, January 19 was: The situation warrants close attention and an evidence-based response and there is no cause for alarm in Australia. Australia has well established mechanisms to respond to ill travelers at points of entry. Under Australian legislation airlines must report passengers on board showing signs of an infectious disease, including fever, sweats or chills. Planes reporting ill travellers are met on arrival by biosecurity officers who make an assessment and take necessary actions, such as isolation and referral to hospital where required. The World Health Organization position does not currently recommend any travel advisory for China, or additional measures at airports beyond our established mechanisms. [...] Australia has processes in place to enhance border measures in relation to a communicable disease, if required, working through our established Health Protection system.2 [emphasis added] In other words, he confirmed business as usual. Preparations for a travel advisory for Wuhan weren't actually announced until Tuesday, January 21.3 In that January 21 message, Prof Murphy detailed the provisions that Australia would take at the border: All passengers on these direct flights will receive information about the virus on arrival requesting that they identify themselves to biosecurity officers at the airport if they are unwell. Once again, business as usual. That might not be surprising, except for the fact that on the previous day, Monday, January 20, China admitted that it had been lying to the world about the severity and infectiousness of the coronavirus, reporting 139 new cases of the coronavirus in Wuhan, Beijing, and Shenzhen.4 Cases were also reported in Japan, South Korea, and Thailand.5 Knowledge of the new cases may or may not have called for a more aggressive public health response, but knowledge of China's obfuscation should have raised alarm bells in the National Security Committee of Cabinet (NSC) that the AHPPC, acting primarily on advice from the WHO, might not have access to accurate and complete information about the evolving epidemic. 1 Returning to Prof Murphy's April appearance before the COVID-19 Committee, Senator James Paterson asked him 'what were the key, most important, decisions that the government made' in the early days of the crisis. In response, Prof Murphy answered that 'the most important early decisions were related to border measures'. He went on to explain that: China was clearly, in that early phase, the epicentre. It wasn't just Hubei province; it was spreading rapidly in other provinces of China. We knew that the greatest risk to uncontrolled transmission was in imported cases. As an island, we were in a position of perhaps doing border measures more effectively than other countries, so the unanimous health advice of the Health Protection Principal Committee was that we should do that. If only that were true, Australia might have entirely avoided the massive economic disruption causes by coronavirus shutdowns inside the country. In fact, Prof Murphy and the AHPPC repeatedly advised against more stringent border measures. On January 31, more than a week after China had locked down 50 million people in Wuhan and Hubei province, Prof Murphy said at a joint press conference with Health Minister Greg Hunt: The World Health Organization strongly recommends that country – nations do not ban flights from China because unless you lockdown exit from the country, banning flights, direct flights, doesn't stop people coming from China. [...] It seems likely that China is increasingly blocking export of its residents, so they are reducing tour groups coming out of China and if the outbreak in provinces other than Hubei, which is now completely locked down, increase, I believe they will stop exits from China which is a more effective way. [...] So at the moment, our Health Protection Principal Committee does not recommend banning direct flights from China, as it's not a public health measure.6 [emphasis added] According to his Senate remarks, Prof Murphy woke up the very next morning, Saturday, February 1, to tell Health Minister Greg Hunt that an 'urgent convening' of the NSC was needed to ban non-residents from entering Australia directly from China. The story was further developed in The Age by Melbourne editor Jewel Topsfield7 and the Sydney Morning Herald by political editor Peter Hartcher.8 According to these two reports, on the morning of February 1, Prof Murphy sent Hunt the message that 'we now have sustained human-to- human transmission outside Wuhan; I think we are going to have to close the border to China'. Hunt called Prime Minister Scott Morrison, who ordered a meeting of the AHPPC. Hunt then set up a conference call with Murphy and Morrison. Murphy advised Morrison that 'there's a very strong risk of this spreading to Australia', which prompted Morrison to ask 'are you recommending that we close the border to China?' Murphy reportedly answered yes, prompting the NSC to act. Yet when the AHPPC did meet on the morning of February 1, what they actually decided was to 'expand the case definition for novel coronavirus infection from 1 February 2020 to apply to people from all of mainland China'.9 This, only after noting 'the increasing (but still relatively small) number of cases in provinces outside Hubei Province'. In other words, the AHPPC unanimously changed its opinion on travel from China, overnight, based on no new information or guidance from the WHO, which continued (and continues to this day) to recommend against restrictions on international travel. The NSC apparently considered the AHPPC's definitional change to be 'new and urgent information' and accordingly banned non- residents from entering Australia directly from China.10 2 Speaking at a press conference the next day, Sunday, February 2, Prof Murphy confirmed this account of the AHPPC's reasoning, that the sweeping travel ban resulted from nothing more than a definitional change. He explained that: Yesterday AHPPC came to the point where we believe that the spread of the virus outside of the Hubei Province in other provinces of China, while still relatively small numbers, represents evidence of sustained human to human transmission in those provinces. And we and other countries have now broadened our definition of the cases of potentially infected people to include anyone who has been in mainland China who has relevant symptoms. A corollary of that is, that extends to our travel warning and it also means that, given that we have undertaken a precautionary approach to quarantine people who had come back to infected areas; that used to apply to Hubei Province, but now it is applying to people who have come from mainland China from the 1st of February.11 [emphasis added] A much more likely explanation of the AHPPC's Saturday morning change of heart is the fact that the United States announced its own China travel ban on January 31, meaning that Australians awoke to the news on the morning of February 1. Prof Murphy seems to have overlooked this fact in his April Senate remarks, when he said that 'I think, in retrospect, our colleagues in ... the US regret that they didn't do the same' -- i.e., impose restrictions on travel from China. Of course, the US did impose restrictions. Australia followed suit within 24 hours. It seems unlikely (to say the least) that this was a mere coincidence, but that is the story we have been asked to believe, by Prof. Murphy, by Minister Hunt, and by the AHPPC. A more likely account Attempting to reconcile Prof Murphy's April remarks to the COVID-19 Committee to his public statements as the crisis unfolded, it is just possible that in early February, the AHPPC actually was keen to prevent the importation of coronavirus into Australia. But as the month wore on, it became more and more apparent that the AHPPC was in favor of relaxing border controls. On February 13, the AHPPC recommended that special exemptions to the China travel restrictions should be considered.12 On February 19, the AHPPC recommended that Year 11 and 12 students (i.e., teenagers) be allowed to travel from China to resume their studies in Australia, and that entry be considered for university students.13 On February 26, the AHPPC reiterated this advice, and began to build a case against restrictions on travel from Iran, Italy, and South Korea: 'extending travel bans to restrict travel from multiple countries is not likely to be feasible or effective in the medium term'.14 On February 29, the AHPPC flatly stated that: AHPPC believes that, in general, border measures can no longer prevent importation of COVID-19 and does not support the further widespread application of travel restrictions to an increasing number of countries that have community transmission.