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Pandemics and public health

By Peter Curson - posted Tuesday, 15 September 2020

There is little doubt that maintaining our publics’ health requires a deft balancing act – of balancing the overall wellbeing of all Australians against the individual’s rights and freedoms. This is an exceedingly difficult task even at the best of times because there is often a basic conflict between the two.

In normal times when our society is not threatened by pandemics such as coronavirus, to achieve this balance still remains difficult. In times of crisis such as we have experienced over the last six or so months it often becomes almost impossible.

It is interesting how Australia still struggles with this basic dilemma – of how a country committed to the supremacy of civil liberties and rights and sensitive to discrimination, can reconcile the conflict between individual rights and the common good.


The coronavirus pandemic also illustrates how critical is the need for cooperation between all levels of government and how easy it is for states to simply shrug their shoulders and elect to go their own way. There is nothing new in this and our history is littered with examples of lack of cooperation, self-interest, over-reaction and outright antagonisms.

Why are we surprised as to how some states have reacted to protect themselves during the present coronavirus outbreak? Look back at our history. There are countless examples of how states rights and trade interests intersected with pandemics and epidemics, fostered state-commonwealth rivalries and made the overall achievement and maintenance of national public health a difficult if not impossible undertaking.

The 1908 Quarantine Act clearly gave the commonwealth power over internal quarantine in all states yet in the following year the federal government stated that it was not the commonwealth’s intention to make use of such powers when infectious disease broke out in any state.

Yet in 1913 when smallpox broke out in Sydney, Cumpston the new Federal Director of Quarantine unilaterally declared an area of 15 miles around Sydney’s GPO a formal quarantined area without any reference to the state government.

Somewhat like today this commonwealth decision produced a violent public reaction where people and the state government were highly critical of the commonwealth’s intervention.

The 1919 Flu pandemic provides another example of how when faced by a major pandemic the commonwealth and all states parted company and simply went their own way despite all states agreeing to a commonwealth plan in late 1918 whereby the commonwealth would assume total responsibility for the management of the pandemic if it reached Australia.


There is also little doubt how epidemics and pandemics can easily sweep away the façade we erect around our lives and reveal much about how we as individuals and our governments as over-lords regards death and disease and how we and they respond to such traumatic events.

Pandemics such as coronavirus reveal much about human reaction when confronted by life-threatening events. They also reveal much about how Government’s struggle to control and contain such outbreaks and in many ways fail to fully understand how ordinary people regard fear and risk in their lives.

As coronavirus demonstrates, pandemics consist of two major dimensions.

Firstly, an epidemiological dimension consisting of cases and deaths. Secondly, a psycho-social dimension involving human reaction and response.

Unfortunately our Governments tend to devote themselves to issues involving cases and deaths and show little concern or understanding for how people consider risk in their lives. Ironically, outpourings of fear, hysteria and panic can totally overwhelm the number of cases and deaths.

There is little doubt that the State and Commonwealth governments remain silent on how fear, hysteria and public panic might be managed. Our experience of SARS, smallpox, plague and influenza indicate to what extent such things can influence and disrupt normal life.

What we really need to fully understand is how ordinary people evaluate risk and handle fear in their lives and how many of the pandemic policies advanced by our governments regarding quarantine, lockdown, closures and travel restrictions actually serve to heighten our fear and anxiety.

All this encourages a deep scepticism among most of us as to whether we can have any confidence in our governments claim that they can actually protect us. Given this it is small wonder that public confidence in our government during times of pandemic crises remains at a low point.

Plague or pandemic fear may indeed be one of our most basic fears deeply entrenched in our psyche and representing an amalgamation of rational and irrational fears about contagion, infection, risk and exposure. It remains doubtful whether governments and their medical advisors fully appreciate this.

The media continues to play an important role in all of this as well. The desire to sensationalise and to play on ordinary people’s emotions often becomes overwhelming and undoubtedly influences how we see and respond to pandemic outbreaks.

 Public health is one of the basic props upon which Australia’s national security rests. Without a fearless, healthy and secure population Australia cannot prosper, expand its economy and maintain the health and wellbeing of all its citizens.

There seems little doubt that Australia will continue to experience major outbreaks of infectious disease over the next 25 years. Understanding and managing such outbreaks with specific reference to the psycho-social and behavioural side of such outbreaks would seem critical to implementing successful response and containment plans.

There is little doubt that people continue to harbour deep-seated fears about infectious disease and such fear is not related to science or empirical evidence but more shaped by personal attitudes and the way we see the world around us.

 It is clear that outbreaks of infectious disease can no longer be simply seen as the preserve of our government and their medical advisors. Pandemics of infectious disease involve all aspects of our lives and the sooner governments realise and plan for this the better off we will all be.

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About the Author

Peter Curson is Emeritus Professor of Population and Health in the Faculty of Medicine and Health Sciences at Macquarie University.

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