On 25 January, the first case of COVID-19 was confirmed in Australia, with three further cases confirmed later that day. By 30 January, this had increased to nine cases, with the World Health Organisation (WHO) reporting 7818 total confirmed cases worldwide, including 82 cases reported in 18 countries outside of China.
On 2 March, Australia saw its first community transmission of COVID-19, bringing the total number of confirmed cases to 33.
Australia's cumulative total cases hit triple digits on 10 March, with a daily increase in reported cases of 13. From that point, the total number of cases rose rapidly until 28 March, when the daily increase in reported cases peaked at 464 and the cumulative total hit 3626.
Prior to 27 February, the Australian Government's (government) main focus appeared to be on border control measures in the hope of containing the virus and preventing widespread community transmission in Australia.
However, between 27 February and mid-March, it became increasingly clear that containment strategies alone would not be sufficient in preventing the spread of COVID-19 in Australia. Specific strategies would be required to 'flatten the curve', improve contact tracing, and build up the National Medical Stockpile (NMS) in an attempt to save lives.
This chapter examines the government's response to community transmission of the virus, including:
the overarching national health strategy;
issues concerning transparency of key medical decisions;
securing access to a successful vaccine candidate for Australians; and
the need for an Australian Centre for Disease Control.
The overarching health strategy
Box 3.1: Interim finding
The Australian Government's overarching strategy to deal with COVID-19 was not explained clearly to the public until late July—more than four months after strict sanctions were placed on the way Australians lived their lives.
The lack of a clear strategy on how to respond to COVID-19 in Australia affected early decision making by the Australian Government, which ultimately saw the states and territories, in particular New South Wales and Victoria, take charge and force the national lockdown on 30 March.
Clarity in the strategy being pursued by National Cabinet
During the early stages of the pandemic, the overarching health strategy pursued by the government was unclear and appears not to have been settled until some months into the management of COVID-19.
The Grattan Institute noted that '[t]he lack of a clear overarching strategy to respond to the crisis has resulted in a reactive policy approach', leading to 'mixed and confusing messages'. Another submission observed:
Australia's health approach from the beginning has appeared to be reactive rather than proactive, piecemeal rather than clearly defined, and above all, to people in the community who understand science, the planning appeared opaque.
In his first press conference about the virus on 23 January, the Prime Minister sought to reassure the public that the government was taking 'evidence based, proportionate, additional measures' and that the majority of Australians could go about their 'normal course of business'. No mention of a strategy was made during this press conference.
On 27 February, when asked about the establishment of particular clinics and the powers to quarantine people, the Prime Minister said:
…in the event of a pandemic... the goal is to slow its spread if it gets to Australia, but with the number of countries that are now affected, we have to be realistic about the likelihood of containment strategies into the weeks ahead.
Statements released only a week later by the Australian Health Protection Principal Committee (AHPPC) recommended a focus on 'domestic containment and preparedness', but fell short of clearly articulating any overarching strategy.
On 11 March there was a noticeable shift in language with a focus on 'sustained community transmission'. In a press conference, the Chief Medical Officer (CMO) stated:
If we develop sustained community transmission, then the models can predict how long it might take to develop a peak. And again, those models depend on how well you contain during the development of the sustained community transmission. So there are a variety of potential models, but a pandemic or an epidemic in Australia could last as short as 8 weeks, or as long as 14 to 16 weeks.
On 16 March, the then Deputy CMO, Professor Paul Kelly, pointed to modelling from New South Wales (NSW) Health and Germany indicating that between 20 per cent and 60 per cent of Australians could become infected, with a mortality rate of 1 per cent.
Modelling released by the Department of Health (DoH) in April 2020 and undertaken by the Doherty Institute additionally predicted an infection rate of between 11.6 per cent and 89.1 per cent, depending on what mitigation strategies were imposed.
Based on these comments it appears that up until mid-March the government was preparing for significant levels of community transmission within Australia.
Amid increasing public debate on what strategy should be pursued, the
Prime Minister announced in April that 'Australia will continue to progress a successful suppression/elimination strategy'. The announcement may have been intended to clarify the government's strategy but caused more confusion as it merged two distinct strategies.
At its first public hearing on 23 April, the Chair of the Senate Select Committee on COVID-19 (committee), Senator Katy Gallagher, asked DoH what strategy the government was pursuing—herd immunity, containment, suppression or elimination. Ms Caroline Edwards, then Acting Secretary of DoH confirmed that they were 'trying to reduce the number of infections', but did not specify any particular strategy.
In May, DoH clarified that the National Cabinet had endorsed a strategy of suppression with the potential for elimination. Further information was provided on 24 July when the AHPPC announced that 'the goal for Australia is to have no community transmission of COVID-19, strengthening the current suppression strategy'.
The clearest statement on Australia's strategy from the Prime Minister wasn't made until 4 September, some eight months after the first cases in Australia, when he announced that, 'National Cabinet has agreed to a suppression strategy for COVID-19 with the goal of no community transmission'.
On 26 June, Senator Gallagher asked a question on notice about the Victorian Health Minister's public comment that 'National Cabinet agreed to a suppression strategy not an elimination strategy'. However, the DoH refused to provide any information in relation to:
when that decision had been adopted by National Cabinet;
if the decision was made based on AHPPC advice; and
what materials were relied on in making that decision.
In light of this refusal to provide information, there is no evidence that the strategy articulated by the Prime Minister on 4 September was the same strategy adopted early on by the government.
The government's strategy to respond to community transmission was not clear until at least July. It appears, based on public statements by Ministers and officials, that the government had initially considered a different strategy at the onset of the pandemic that would have resulted in a much higher number of infection rates, prior to the National Cabinet deciding to adopt strict social distancing measures in late March 2020.
The committee is concerned that a clear strategy was not put in place until some months into the pandemic. The lack of a clear COVID-19 strategy would have affected early decision making and partially explains the constantly changing, confusing and chaotic days in early March of ever-tightening social restrictions culminating with the states and territories and, in particular,
NSW and Victoria, forcing a national lockdown at the National Cabinet meeting on 29 March.
Adoption of social distancing measures
Throughout March, the Prime Minister gave mixed messages on the role and importance of social distancing in reducing community transmission and, at times, appeared to cast doubt on the need for such measures.
On 3 March, amid escalating public concern and increasing COVID-19 infections in Australia, the Prime Minister declared that people could 'go about their daily business' and that he was 'looking forward to going to places of mass gatherings such as the football'.
Dr Norman Swan gave evidence to the committee that this was 'the dominant message from governments, particularly the Federal Government' prior to 16 March. Dr Swan suggested:
They seemed to be obsessed with not panicking the community, because they said, '80 per cent of people have a mild disease; it's only a small number of people who do have [the] disease.'
On 13 March the Prime Minister announced the first restrictions on mass gatherings in response to an AHPPC recommendation. However, he declared that he still intended to go to the football the next day, despite growing criticism. He only reversed this once a senior Minister, Peter Dutton MP, tested positive for COVID-19 following a trip to the United States and had attended cabinet meetings with the Prime Minister.
On 18 March, Dr Brendan Murphy was asked his views on a two to four-week shutdown on society. He stated that this action was not recommended and that '[i]t does not achieve anything'.
Dr Murphy's views aligned closely with comments from the Prime Minister on the same day that 'there is no two-week answer to what we're confronting'.
Increasingly stricter social distancing restrictions on non-essential gatherings, and on businesses listed as 'non-essential', were adopted by National Cabinet on 18 March, 23 March and 25 March.
During this period there was confusion over constantly changing information and inconsistent messages from the Prime Minister about the rules for 'essential' and 'non-essential' activities.
For example, questions arose as to why hairdressers were permitted to remain open but beauty salons, some of which also operated hairdressing salons, were required to close. While barbers and hairdressers were allowed to remain open, the government placed a 30-minute limit per customer, which was then changed the following day due to concerns that the time limit was not workable.
At times, the Prime Minister's attempts to explain the situation only added to the confusion. On 18 March he listed certain 'essential' activities and explained 'everything else is non-essential'. However, on 24 March, in response to questions over the meaning of an 'essential worker', he unhelpfully suggested that 'everyone who has a job in this economy is an essential worker'. This was in direct conflict with state leaders' requests for non-essential workers to work from home if possible.
The increasing restrictions between 18 March and 25 March were followed by the decision from National Cabinet on 30 March to place a two-person limit on indoor and outdoor gatherings. Australians were encouraged to stay home and only permitted to leave the house for an 'essential' purpose.
Based on the public comments of the Prime Minister, ministers and the Commonwealth CMOs, it is clear that in March government representatives were reluctant to pursue stricter social distancing measures which might result in a wide-scale national lockdown.
Without access to key documents, the committee speculates that this reluctance was due to either: concerns over the economic consequences of such restrictions being put in place; or, a failure to fully recognise the extent of the risk that COVID-19 posed to Australians' health.
As discussed earlier in this chapter, comments by the Deputy CMO anticipating infection levels of between 20 to 60 per cent suggests the goal of 'no community transmission' eventually adopted by National Cabinet was not part of the government's initial plans at the onset of the pandemic.
In a hearing with key medical experts, Dr Raina MacIntyre, the head of the biosecurity program at the University of New South Wales, told the committee she thought NSW and Victoria had 'led the charge for a national shutdown':
I think, yes, that the two chief health officers in New South Wales and Victoria, particularly, were very strong in leading us out of that.
It had also been reported during the lead up to National Cabinet's decision on 30 March that Victoria and NSW were calling on the government to announce stronger restrictions.
In an episode of the ABC program Four Corners aired in April, the Premier of Victoria, the Hon Daniel Andrews MP and the Premier of NSW,
the Hon Gladys Berejiklian MP, both made comments confirming that they had been working together on such an approach. Premier Andrews stated:
I made a judgement, and, Gladys made a judgement as well, that this thing needed a big jolt. We needed to take a big step.
While Premier Berejiklian made the following comment:
Premier Andrews and I did talk and both of us had similar concerns representing the two largest States. We felt we had to act quickly and strongly and I'm glad we did.
Several submitters including the Grattan Institute also commented on the different approaches adopted by the Commonwealth and states and territories:
The Commonwealth continued to take a more cautious and risk-tolerant approach to the introduction of widespread infection control measures. The states and territories, particularly NSW and Victoria, were more risk-averse and enacted more comprehensive measures such as school closures to prevent spread of infection and to reduce the prospect that public hospitals, the responsibility of states, would be overwhelmed.
The committee accepts that the decision for a stage 3 lockdown was an important one which has, without doubt, saved lives, prevented the spread and reduced the community transmission of COVID-19 across Australia.
This critical meeting on 30 March and the decisions that followed are a clear example of the federal system of governance in Australia working in the national interest.
Lack of transparency behind key medical decisions
The committee recommends that the Australian Government publish all previous and future minutes of the Australian Health Protection Principal Committee to provide the public with access to the medical advice behind all decisions affecting the community's safety, livelihoods and personal freedoms.
The AHPPC has been the key body advising governments on the public health response to COVID-19 in Australia.
The AHPPC is chaired by the CMO and is comprised of all state and territory Chief Health Officers.
Although the AHPPC pre-dates the COVID-19 pandemic, in response to the pandemic it instituted daily meetings from 30 January 2020 and was appointed a subcommittee of the National Cabinet on 17 March.
The decision to make the AHPPC a subcommittee of the National Cabinet automatically resulted in its advice not being available to the public unless specifically authorised by the National Cabinet.
As a result, the advice provided to National Cabinet by the AHPPC is unnecessarily secretive. AHPPC statements are only released after being approved by the National Cabinet members and no minutes of meetings have been made publicly available since 26 February.
There is no public record for the majority of meetings of the AHPPC. Despite holding several hundred meetings in the first eight months of the pandemic, only 65 statements have been released to the public.
As discussed later in Chapter 8, the government has used National Cabinet's status as part of the Federal Cabinet to refuse committee requests for important information including:
minutes of all AHPPC meetings;
the date National Cabinet first agreed to a suppression strategy; and
the DoH's position on internal border measures.
Without public access to AHPPC minutes, there is no way for the public to understand what issues the AHPPC was considering and what decisions were made when. It also means there is no reassurance that the government has followed the best medical advice when making critically important decisions affecting every Australian.
In the committee's first hearing on 23 April, the Chair asked DoH whether all recommendations of the AHPPC related to COVID-19 have been adopted. DoH didn't answer the question, instead responding with:
The AHPPC has regularly put forward advice on Australia's health response to COVID-19 for consideration by all Australian Governments. AHPPC statements are publicly available at this link…
Expert witnesses presented compelling evidence to the committee that AHPPC advice should be publicly available. For example, Mr William Bowtell AO stated:
In relation to public health matters, the default position should be that all of these considerations and deliberations are made public…. When there is so much information coming in and the decisions are so critical and people pay with their lives when the decisions are not so good, we need the widest possible input...
The AHPPC's published statements fall short of the standard set by the
United Kingdom's Scientific Advisory Group for Emergencies which publishes its minutes of meetings and supporting documentation.
Given the profound impact of the advice provided by the AHPPC and the decisions of National Cabinet, the committee agrees that advice provided by the AHPPC should be publicly available. The committee suggests that publishing the minutes of the AHPPC would be analogous to the publication of the Reserve Bank of Australia's (RBA) board meeting minutes; with these minutes providing the Australian public with transparency, accountability and information regarding the decisions the RBA is making.
The shifting messaging around social distancing in early March, school attendance and mask use are examples where greater transparency around the reasoning behind AHPPC decisions would be useful.
In relation to mask use, at a press conference on 5 March, Dr Murphy stated that 'there is no reason to put a mask on when you're walking around the shops'. This message continued to be reiterated, with the Prime Minister making the following statement on 24 April:
National Cabinet noted the AHPPC advice that wearing of face masks by the general population is not currently recommended. Should significant community transmission in Australia occur, mask wearing in public is an available option.
However, on 25 June Dr MacIntyre, who has conducted 'the largest body of clinical research on face masks and respirators in the world', told the committee that the use of face masks as a tool to reduce the transmission of COVID-19 was 'cheap, effective and low risk', as well as 'a no brainer'.
Dr Norman Swan told the committee he had reviewed statements made by National Cabinet but was still unable to understand why they were not recommending the use of face masks in public. Dr Swan posited that National Cabinet's advice was not consistent with the review in the medical journal, The Lancet, and commented that 'we deserve to know' the evidence underpinning the National Cabinet's advice.
The committee agrees with the view expressed by key expert witnesses that information provided by the AHPPC should be made publicly available, similar to other countries, to assist in understanding decisions, allow greater transparency and ensure public cooperation with health measures.
Box 3.2: Interim finding
The $5.24 million COVIDSafe app has significantly under-delivered on the Prime Minister's promise that the app would enable an opening up of the economy in a COVID safe manner.
The app was launched with significant performance issues and has only been of limited effectiveness in its primary function of contact-tracing.
The committee recommends that the Australian Government commission an independent review into expenditure on, and design of, the COVIDSafe app.
On 1 May, the National Cabinet released advice from the AHPPC setting out the key metrics which would inform decision-making on the relaxation of restrictions. The advice included the use of a 'COVIDSafe App' as one of the 15 precedent conditions. A three-step plan to gradually re-open Australia, announced on 8 May, also noted the importance of downloading COVIDSafe.
Since its launch on 26 April, the Prime Minister has marketed the COVIDSafe app to the Australian community as a vital tool to enable the country to ease out of restrictions. In a press conference on 29 April, he said:
I would liken it to the fact that if you want to go outside when the sun is shining, you have got to put sunscreen on. This is the same thing.
…This is the ticket to ensuring that we can have eased restrictions and Australians can go back to the lifestyle and the many things that they previously were able to do and this is important.
Soon after its launch, the Prime Minister confirmed that at least 40 per cent of the population would need to download the app for it to work as intended. However, by 24 August the number of COVIDSafe registrations had only reached about seven million, still short of the 40 per cent (10 million) registrations that the government had been aiming for.
Mr Randall Brugeaud, Chief Executive Officer of the Digital Transformation Agency (DTA), advised the committee that as of May 2020 the government had spent $1.5 million on developing the app. By 29 October, Mr Brugeaud advised the Senate that in total $5.24 million had been spent on development, professional services and operational costs. It is not clear how much has been spent in total on the app, but media reports indicate that a proportion of the $64 million advertising spend under the government's CovidSafe Strategy was also allocated to promoting take-up of the app in addition to the $5.24 million in development and operational costs.
Despite more than $5 million spent so far and the Prime Minister's repeated promises on the capacity for the COVIDSafe app to reopen the economy safely, it has delivered extremely limited tangible results to date.
As of 26 October, the app had identified only 17 close contacts with COVID-19 who would not have otherwise been captured by manual contact tracing.
Not only has the COVIDSafe app under-delivered in terms of its effectiveness with contact tracing, it has also experienced issues with its performance. In answers to questions on notice, the DTA provided Bluetooth testing results which indicated that, as at 26 April, communication between two locked iPhones was 'poor'; the app only picked up between 0 per cent and 25 per cent of all Bluetooth pings.
Further testing showed some improvement as at 26 May but issues remained, with two locked iPhones picking up between 25 per cent to 50 per cent of Bluetooth pings.
Technology experts noted that the design of COVIDSafe relies on using Bluetooth in a way that it was not designed to be used, that is, to connect to any untrusted device that happens to be in range. The committee received submissions suggesting that the COVIDSafe app should be migrated to an interface developed by Apple and Google, arguing that these are more consistent with a 'privacy by design' approach, and can run reliably in the background of devices.
The government is yet to make a compelling case for the value that the app has actually delivered. The government has spent a considerable amount of public money and adopted a very optimistic stance on the benefits of the app—which the Prime Minister suggested would become second nature to Australians ('like sunscreen') and play an integral role in protecting the community.
Access to a successful vaccine candidate
Box 3.3: Interim finding
The Australian Government has lagged in securing vaccine deals and needs to do more to catch up. It also overstated its progress towards securing access to a vaccine in August when it prematurely announced a deal with the pharmaceutical company AstraZeneca.
There is little doubt that our best hope against COVID-19 is a vaccine. As
Dr Murphy told the committee on 14 August, 'the only way we'll be able to gain full protection is if we have a successful and safe vaccine which is available to all'.
There are currently over 42 COVID-19 vaccine candidates undergoing clinical evaluation. However, given that only 20 per cent of vaccines that reach clinical trials succeed, the government will need to secure as many deals as possible to ensure timely and large-scale access to a successful candidate.
It is also important to account for the fact that even successful vaccine candidates may not be enough to eradicate the virus. As Dr MacIntyre told the committee on 25 June:
It's in our national interest to diversify vaccine procurement and encourage domestic manufacturing, because one vaccine candidate may be safer or more effective than another. And, if we put all our eggs in one basket, there will be a risk.
Australia was relatively slow off the mark to secure any vaccine deals. On 14 August, the committee asked why Australia was lagging behind 12 other countries which had signed 27 agreements to get access to a potential vaccine. Dr Murphy responded:
We are in active, commercial-in-confidence, discussions and negotiations with a very large number of vaccine providers.
On 19 August—five days after the committee hearing on vaccines—the Prime Minister announced that:
Australians will be among the first in the world to receive a COVID-19 vaccine, if it proves successful, through an agreement between the Australian Government and UK-based drug company AstraZeneca.
Under the deal, every single Australian will be able to receive the University of Oxford COVID-19 vaccine for free, should trials prove successful, safe and effective.
However, a statement from AstraZeneca made on the same day clarified that it had only signed a 'Letter of Intent' with the government and that further steps remained including other contractual agreements and arrangements with a selected manufacturer who can produce the vaccine locally.
On 7 September—almost three weeks after announcing a deal had already been struck—the government announced it had secured production and supply agreements with the University of Oxford/AstraZeneca and the University of Queensland/CSL vaccine candidates.
For most Australians access to the 84.8 million doses covered by these deals will be delayed, with only 3.8 million doses (enough for 1.9 million people) available from January and February 2021. This may be a direct result of Australia waiting to sign a deal until after the United States, India, and Europe had already secured 1.7 billion doses of AstraZeneca.
On 5 November, Health Minister, the Hon Greg Hunt MP, announced new vaccine deals with Novavax (40 million doses) and Pfizer/BioNTech (10 million doses).
Minister Hunt noted that, unlike Australia's other three vaccine candidates, the Pfizer/BioNTech vaccine is a messenger ribonucleic acid (mRNA) type vaccine and provides an important degree of diversification in our vaccine strategy. On 10 November, Pfizer announced that its phase three clinical trial indicated the vaccine candidate was more than 90 per cent effective in preventing COVID-19, leading to media reports characterising it as a 'frontrunner'.
However, Australia does not have the domestic manufacturing capability to produce mRNA-type vaccines like the Pfizer/Biotech candidate at scale, nor can we store and distribute mRNA vaccines at the required temperatures (which can be up to negative 80 degrees Celsius). Additionally, at only 10 million doses Australia's agreement with Pfizer would be nowhere near sufficient to cover the full population, as any vaccine would require 2 doses per individual.
The committee supports the government's efforts so far to secure access to a potential vaccine, but remains concerned that the government's efforts to date are not enough. On 5 November, Dr MacIntyre suggested that 'we should diversify further', and reiterated that until vaccines are rolled out, 'we won't know which ones are the safest and most efficacious'.
While the committee hopes that one of Australia's four vaccine deals pays off, it is also unclear if we will be ready to distribute the tens of millions of vaccines required to immunise the population. On 5 November, Minister Hunt conceded that 'the roll-out of a potential COVID-19 vaccine is a significant logistical challenge', and indicated that the government was in the process of inviting suppliers to participate in a limited tender process.
With the first vaccines potentially ready to be rolled out in January, it is deeply concerning that the government is only now starting to take action to address the logistical challenges involved in distribution. There is also a lack of transparency around how the limited number of early access vaccines would be allocated across the health and aged care workforces, as well as high-risk populations including elderly Australians and people with pre-existing chronic conditions.
The government is also yet to articulate a clear plan for the event that a vaccine is unable to fully eradicate COVID-19. Britain's Chief Scientist,
Sir Patrick Vallance warned in October this year that there was a need to provide the public with a 'realistic picture' about the potential efficacy of any successful vaccine, and that even if a vaccine became available in early 2021 COVID-19 could become endemic. To date, there has been little discussion of this reality with the Australian community.
An Australian Centre for Disease Control
The committee recommends that the Australian Government establish an Australian Centre for Disease Control to improve Australia's pandemic preparedness, operational response capacity and communication across different levels of government.
Australia is the only member of the Organisation for Economic Cooperation and Development to not have a Centre for Disease Control (CDC) or equivalent body. According to the Australian Medical Association (AMA), since the United States first established its CDC in the aftermath of
World War II, the CDC model 'has become the benchmark for disease control and prevention and provides world-wide resources, surveillance and research'.
In 2012−13, the House of Representatives Standing Committee on Health and Ageing found that a CDC 'could assist in encouraging more uniformity, improved efficiency and better coordination between public health departments'. In March 2013, it recommended that the government commission an independent review to assess the case for a CDC. The government rejected this recommendation in August 2018.
In a hearing on 25 June, the committee heard from Dr MacIntyre that Australia had been disadvantaged by not having a CDC, 'mainly because the operational response capacity—the bums on seats, the people who can get up, go into the field and investigate an outbreak—is in the states and territories'.
Dr Peter Collignon also agreed there were benefits of a CDC, although he noted that his preference would be for the European model, which does not have laboratories and instead focuses on 'having a coordinating centre that's there for getting and disseminating information in a timely fashion'.
In its opening statement to the committee, the AMA argued:
Many leading experts agree with the AMA that an Australian Centre for Disease Control would offer advantages in being prepared for and responding to infectious diseases and pandemics.
There have been at times a lack of consistent public health COVID-19 advice from governments, particularly in the early stages of this pandemic. This caused communication challenges for the community as a whole.
The Australian Nursing and Midwifery Federation supported the AMA's call for an Australian CDC, noting that 'it could go some way to alleviating a number of the concerns that our members have had around PPE [personal protective equipment]'. They also gave evidence that 'our planning for a future pandemic wasn't what we thought it was' and that a CDC could have provided clearer guidelines on the use of personal protective equipment (PPE).
As this report shows, Australia's response to COVID-19 has been undermined by tragic failures in aged care, a lack of pandemic preparedness and deficiencies in the NMS. There have also been issues with secrecy over the medical advice to governments and mixed messages from national leaders on social distancing, school closures and state border measures.
As the AMA explained to the committee, an Australian CDC could address some of these concerns:
It would be permanently resourced at a sufficient level during non-pandemic periods to be ready for the next pandemic when it occurs.
It would research, manage and provide rapid risk assessment of communicable diseases and provide scientific briefings, surveillance reports, policy advice and public education about potential disease threats and prevention measures.
It would oversee stockpile sufficiency of PPE and medicines, and manage escalation plans to ensure stockpile sufficiency during pandemic outbreaks.
With regards to Dr MacIntyre's point about the decentralised nature of Australia's operational response capacity, a CDC could also be well-placed to improve surge workforce capacity, which has been overstretched in the aged care sector, as well as in quarantine facilities.
Given the submissions from the AMA and other key stakeholders and experts, there is a strong case that the government should establish an Australian Centre for Disease Control, with a model to be determined in close consultation with key stakeholders including in the aged care sector and the states and territories.