Australia’s COVID-19 response frayed after early successes, damaging the public’s trust and making it unlikely that lockdowns or other harsh restrictions will be tolerated again, a federal government review has found.

The review hailed “courageous decisions” taken by leaders early in the pandemic, without which it concluded the pandemic death toll would have been several times larger, but said cracks started to emerge as the pandemic wore on and communication was often poor, undermining public confidence.

“Trust has also been eroded, and many of the measures taken during COVID-19 are unlikely to be accepted by the population again,” the reviewers said.

Recommendations focused on better preparedness and co-ordination between levels of government, to improve readiness for future pandemics. Studies of the impact on children and on population-wide mental health were also recommended.

But the reviewers – senior public servant Robyn Kruk, epidemiologist Professor Catherine Bennett and economist Dr Angela Jackson – also offered wider commentary on the effectiveness of border closures, lockdowns, school closures, vaccine mandates and aged care strategies.

While they did not draw conclusions about the appropriateness of those measures, they did find that decision-makers often failed to give enough weight to the human rights implications of their decisions, and to communicate the evidence behind their decisions to the public.

“Governments could legitimately restrict certain human rights in implementing their response to COVID-19 … [But] some restrictions were poorly justified in extent and/or duration, disproportionate to the risk and inconsistently applied across the country,” they said.

‘We know there will be a next pandemic’

Health Minister Mark Butler welcomed the review, which he said did not seek to “scapegoat” any individuals but also “did not pull any punches”.

“It is very human … to want to move on, and to avoid raking over what was a very distressing time for our community,” Mr Butler said.

“But we have a responsibility … to build a high-level playbook for the next pandemic, because we know there will be a next pandemic.

He said cabinet had agreed on Monday to task the public service to consider how to action the recommendations.

He added the government would seek to have a new Centre for Disease Control, a national public health body which was a key Labor election promise, operational by January 2026.

‘Building the plane while it was flying’

The reviewers said Australia was “recognised globally” for elements of its public health response and that its rates of infection, hospitalisation and death were among the world’s lowest in the first 18 months of the pandemic.

“We lost too many lives, but we also saved thousands, and this needs to be understood as we reflect.”

But it found Australia’s preparedness wanting, pointing in particular to a lack of prior collaboration across the federation to agree how a pandemic would be handled.

Setting those roles for next time — including responsibility for quarantine, medical stockpiling and border decisions — was a key recommendation.

So too was a better series of action plans, especially for vulnerable populations. Reviewers pointed to the new Centre for Disease Control as the place to co-ordinate these plans.

“One of the most common phrases we heard during the Inquiry was ‘building the plane while it was flying,'” the reviewers said.

“There was little clarity as to roles and responsibilities, particularly between the Commonwealth and state and territory governments … [This] caused significant distress, delays and increased risk of harm in key areas of the pandemic response.”

‘Courageous’ to close border

The reviewers praised Australia’s initial response, including the swift international border closure and then-prime minister Scott Morrison’s decision to set up a national cabinet with state and territory leaders.

They “strongly endorsed” the federal government’s decisiveness and the “visible and significant leadership role” taken on by Mr Morrison.

The reviewers said the “decisive leadership [and] agile implementation” of national cabinet in those early months, including the nationwide lockdown and the JobKeeper payment, fostered public trust and a community enthusiasm to “do the right thing,” creating a sense of national purpose or “Team Australia.”

But even at this stage they identified missteps, saying the federal health minister’s national emergency declaration was made without sufficient evaluation of human rights and exemptions to the international border closure were poorly managed.

The reviewers called the border closure a “brave yet challenging decision” with a “patchwork” implementation.

“[This] led to frustration, confusion and stress for returning and travelling Australians who were trying to navigate the chaos.”

The review heard there were “high levels of distress and anger” from Australians caught up in international border closures and that some were denied travel exemptions to see dying family members or attend funerals.

It was also critical of the handling of privacy concerns over the COVIDsafe contract tracing app, which it said was ultimately unsuccessful.

Quarantine rushed

The reviewers said National Cabinet’s “Team Australia spirit” unravelled over time, and that eventual public splits between leaders damaged public trust.

“One of the greatest challenges to trust in science was when jurisdictions took different approaches in similar situations while telling the public they were listening to the science,” they said.

They said national cabinet was poorly prepared for hotel quarantine and that it was still unclear whose responsibility it should have been.

“Complex logistics had to be put in place within 72 hours… There was little consideration about an appropriate workforce, and minimal time for planning.”

Issues included poor ventilation and poor infection control practices, both hampered by the lack of nationally-consistent guidelines.

The authors said quarantine should not be implemented the same way again and said with hindsight governments could have made better use of home self-isolation.

“The assumption that Australians returning from home would not adequately quarantine [was] without good evidence… [and] based on the premise that citizens could not be trusted.

“This no doubt reinforced the feelings of oppression voiced by people in quarantine.”

Lockdowns lost ‘credibility’

They made similar criticism of state lockdowns and mask mandates, saying these were not often guided by rigorous evidence and real-time evaluation.

“Effectiveness was inferred from overall reported case numbers, but this is a very limited approach to evaluation and did not reveal which [restrictions] were effective and whether the stringency setting were right.”

Reviewers also noted governments were not collecting real-time information on the mental health impacts of lockdowns or the impact on children of school closures.

“There was no ongoing monitoring of proportionality of responses… Interventions such as lockdowns should only be used as a last resort, not as a frontline disease control measure.”

The reviewers said lockdowns eroded public trust and had “lost credibility with the Australian public.”

“In future, Australians will only have an appetite for short, sharp lockdowns, if any at all, and there would probably be decreased public compliance.”

The reviewers noted there was a perception some restrictions, especially curfews and movement restrictions, were more about facilitating policing than supporting the health response.

And they accused state governments of a “smoke and mirrors” communication strategy about the need for restrictions, especially by failing to admit when restrictions were motivated by concern about hospital capacity.

“It does not pay to underestimate that media’s and public’s ability to see through [this],” they said.

The reviewers added the impact of restrictions on children and population-wide mental health were “likely to be felt for some time,” and that children’s rights and rights of people in aged care were “deprioritised” to support the public health response.

‘Care’ needed on vaccine mandates

The reviewers also noted the erosion of trust caused by vaccine mandates, which it linked to present-day “vaccine fatigue” and the lack of ongoing COVID immunisation.

They said any future mandates would need to be “carefully balanced” against consideration of social licence.

They also criticised vaccine procurement delays, saying this was one of many areas in which the Department of Health was stretched beyond its capability.

And it called for further research into the prevalence, effects and treatment of long COVID, noting that while newer variants appeared less likely to lead to long COVID the phenomenon was still poorly understood.

“Overall, we believe that people should be proud of what we achieved during the pandemic … Australia was one of the most successful countries in its pandemic response,” they said.

“This inquiry aims to use the benefit of hindsight to guide future actions: not to ‘fix’ the actions taken during the last pandemic, or deride the decisions that were made…

“While the type and timing of the next pandemic remains uncertain, we can be assured that it is likely to occur within our lifetime.”