Australia's chief medical officer has warned the pandemic is not over and more peaks in COVID infections are likely, as national cabinet responded to a dip in virus transmissions by lifting mandatory isolation requirements.
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Professor Paul Kelly called for an end to "COVID exceptionalism" and flagged the emergency response phase of the pandemic had ended.
Public health experts were split on the national cabinet decision to end mandatory isolation from October 14, while business groups swiftly applauded the move.
Advocates for people with disabilities and the elderly warned the relaxation of mandatory isolation rules heightened the risk of infection for people at risk of severe illness from COVID.
Pandemic leave payments will also end from October 14 except for casual workers in high risk settings including aged care, disability care, Aboriginal healthcare and hospitals.
Prime Minister Anthony Albanese on Friday said the national cabinet decision was proportionate to the public health risk of COVID, and was targeted at protecting the most vulnerable.
"We want to continue to promote vaccination as being absolutely critical, including people getting booster shots, and we want a policy that promotes resilience and capacity building and reduces our reliance on government intervention," he said.
Professor Kelly said the decision to end the five-day mandatory isolation period recognised community transmission of the virus was low. He advised national cabinet that removing the isolation period was a "reasonable course of action from the public health point of view".
"It does not in any way suggest the pandemic is finished. We will almost certainly see future peaks of the virus into the future as we've seen earlier in this year," he said after the national cabinet meeting.
"It's a time though now to consider that we have other things that we can do to protect those most vulnerable people and that is absolutely our key aim."
Professor Kelly said the role and necessity of mandatory isolation needed to be considered alongside high vaccination rates, the availability of treatments and vaccines, and other measures to protect vulnerable people.
"It's time to move away from COVID exceptionalism in my view, and we should be thinking about what we do to protect people from any respiratory disease."
Some state and territory leaders, such as NSW premier Dominic Perrottet, had urged an end to mandatory isolation periods ahead of national cabinet.
'A balancing act' or 'sheer madness'?
Epidemiologists said the national cabinet decision involved a balancing act but reflected the change in levels of COVID infections and deaths. However they said workers should protect vulnerable people by isolating if they were infected.
Deakin University epidemiologist Catherine Bennett said it was important to preserve measures including mandatory isolation in case they were needed if transmission levels spiked again.
Australian National University public health expert Peter Collignon said it was important that people took responsibility by isolating voluntarily when they were sick with COVID.
Professor Collignon said previous government decisions to reduce mandatory isolation periods had not brought on major spikes in infections.
"It's a balancing act. I don't think anybody knows the right answer. But so far, whenever they've done this, it hasn't been catastrophically bad," he said.
Deakin University associate professor in epidemiology, Hassan Vally, said the national cabinet decision reflected a fundamental change in the risk calculus when it came to the threat that COVID posed in the general population.
"This shift has occurred because of the high level of immunity in the population, which is a result of a combination of vaccination and infection," he said.
However University of South Australia epidemiologist Adrian Esterman blasted the national cabinet decision to end mandatory isolation, saying it was "clearly a political decision" and "sheer madness".
"The government have told the population it's all over and people should get on with their lives. And now it's acting on its own propaganda," Professor Esterman said.
"Unfortunately, it's not over. We're still getting 40,000 cases a week and over 200 deaths."
He said many people were afraid to leave the house due to the risk of serious illness from COVID.
"The majority of people who catch COVID-19 won't get seriously ill, but they still stand a reasonable chance of getting long-term health problems, i.e. long COVID. But anyone who's over 16 who catches it can get seriously ill."
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Before the national cabinet meeting Australian Medical Association president Steve Robson said removing isolation periods was putting the public at risk, and was being pushed by people who were "not scientifically literate".
"If you think the flu is COVID, you're living in fantasy land. COVID is a long-term infectious [disease], we're already seeing a massive effect of long COVID on the workforce and the community. You don't have it with long flu or long cold. It's fantasy," he said.
Other countries were already seeing a large increase in COVID cases again, Professor Robson said.
"It's coming into holiday season when people would be travelling around the world. We think it's a period of significant risk and we're urging caution because we need to protect the health system and we need to protect vulnerable people like those in aged care and people with a disability," he said.
The COVID isolation period was cut from seven days down to five at the national cabinet meeting last month.
'World just grew smaller'
Advocates for people with disabilities and for the elderly warned the latest national cabinet decision could lead to greater infection numbers among people vulnerable to severe illness.
Head of policy at Advocacy for Inclusion, Craig Wallace, said the decision meant people vulnerable to severe illness would be questioning whether anyone they came into contact with were asymptomatic carriers of COVID.
"That means that the world just grew a lot smaller for people who are already pretty isolated three years into this, and are feeling the effects of that maybe in terms of social isolation, and a lack of connection to community and the ability to do the things they need to do and to source the things that they need," he said.
Council on the Ageing chief executive Ian Yates said while he understood the practical reasons behind the national cabinet decision, there was a risk to vulnerable people if it led to an increase in infections.
"We will be certainly hoping that people who know they're unwell keep clear of other people, particularly older people," he said.
Professor Kelly said outbreaks of COVID had fallen in aged care facilities since Australia's last peak in infections.
"Things have changed a lot since that time, and that has included a month where we decreased from seven days to five days not in aged care but in the broader community," he said.