In the twelve months that we have been forced to “live with” COVID-19, average life expectancy in Australia has fallen for the first time in generations. As of October, 8,832 people were counted as dying from COVID-19, and thousands more died “with” the virus. The Australian Bureau of Statistics estimates that, just like rents, fuel and electricity prices, deaths were up in 2022 by 17 percent—18,671 more than the recent average.

Social inequality is woven into these grim statistics. Aboriginal people are twice as likely to die from COVID-19 or end up in intensive care from the disease, while the lowest income earners are nearly three times more likely to die than the rich. 

The ruling-class offensive against public health unleashed in late 2021 has resulted in health outcomes going backwards, in real terms, for the first time in generations. Life expectancy increased almost inexorably throughout the twentieth century. Reducing the spread of infectious diseases like COVID-19 was key to enabling people to live longer. In the early 1920s, infectious diseases accounted for 15 percent of all deaths, according to the ABS; by the 1990s, that figure had fallen to less than 1 percent. Now, COVID-19 is the third leading cause of death in Australia, behind heart disease and dementia. By abandoning well-established, proven measures for preventing the spread of infectious diseases, Australia is ending 2022 with a health profile that belongs in the last century. 

Compare these figures to health outcomes in 2020. Public health restrictions such as lockdowns and mask mandates led not only to extremely low case numbers of COVID-19 in Australia, but to a drop in overall mortality. 

Government social support also dramatically reduced inequality and allowed workers to save money. In the second quarter of 2020, household deposits increased by $33.4 billion. For many surviving on Centrelink, the pandemic, grotesquely, provided a chance to pay for basic needs for the first time. Cassandra Goldie, CEO of the Australian Council of Social Services, noted at the time that the increase to JobSeeker allowed people to “access the essentials, like prescription glasses, a fridge and warm jumpers for their children to get through winter”. 

This didn’t mean lockdowns and social distancing measures were easy. They were trying, boring, stressful. They were arduous for essential workers such as teachers, thrown into an environment of online learning with no extra help or compensation. By and large, however, people supported the measures because, unlike the vocal minority of anti-vaxxers who argued that their individual rights trumped all broader social considerations, most people could see the point.

Collective discomfort served a greater good: stopping someone’s grandparents dying or the health system being wrecked. It was good to have avoided the scenes of overflowing morgues that emerged from Italy and the United States. It also showed that governments could find resources to shelter the homeless and pay for social support, if they wanted to.

Sections of Australia’s ruling class railed against these public health measures, in particular retailers and hospitality bosses. Keeping people alive required restricting economic activity: fewer people were spending money in their shops. Paul Broad, the chief executive of Snowy Hydro, expressed these political priorities when he told the Australian Financial Review: “The economy is hurting ... if consumption of electricity is any guide to what’s happening out there, activity is way down”. Gerry Harvey, interviewed for the same piece, said that the public health measures were “overkill, and the problem with doing overkill is you make a lot of people very angry”. 

State Labor governments, and in particular Victorian Premier Daniel Andrews, copped the ire of the mainstream media, small business organisations, fascists and the federal government for maintaining life-saving lockdowns. In late 2021, they caved. State and federal governments agreed to a roadmap for opening that involved gradually reducing and eliminating entirely a range of public health measures. The strategy was justified with reference to health pseudo-arguments. The transmissibility of the omicron variant rendered measures such as lockdowns futile, they said. There was nothing to be done to stop the spread. Initially, the roadmap was based on states meeting vaccination targets, creating the perception that Australia was simply adopting a new approach to handling the pandemic. 

In truth, opening up was about abandoning measures to contain the pandemic at all. Governments were led, not by objective science about the transmissibility of the virus, but by a political argument that business profits were more important than public health. As the year has progressed, even the most unobtrusive public health restrictions, such as compulsory mask-wearing on public transport and planes, have been scrapped. The most basic initiative to stop the spread of COVID-19, staying home if sick, has been attacked. First, payments for isolating workers were reduced, then abolished, preceding the lifting of mandatory isolation requirements for positive cases altogether. And the take-up of third and fourth doses of the vaccines—the initial pillar of opening up—has fallen precipitously. When the government has encouraged people not to take COVID-19 seriously, what would compel individuals to take the initiative to get vaccinated? 

Industry has hardly lifted a finger to strengthen public health—even measures that don’t require the lockdowns and social distancing they so despise, that wouldn’t stop people working or spending money. The pandemic centred attention on air filtration as a pillar of public health. Proper ventilation, installing air filters and C0₂ monitors, can help maintain clean air and reduce infection. But there are virtually no mandated indoor air quality standards, or even bodies to monitor indoor air quality as part of occupational health and safety. And no wonder: why would bosses spend money and time ensuring adequate ventilation if they aren’t required to? 

Daniel Andrews defended his government’s inaction against rising omicron cases in October, saying that “the era of COVID exceptionalism is over”. The statement encapsulates the extent of the ruling-class victory in trashing public health: people get sick and die from all sorts of things, so why should the government be expected to treat the pandemic as something special? 

But COVID-19 is exceptional. In August, fourteen people died from influenza, but at least 1,061 died from COVID-19. Comparing the two is like comparing an overflowing bath to a flood. 

The health impact of COVID-19 can’t be measured in lives lost alone. Long COVID is a tragedy. Researchers from the University of Tasmania suggest that half a million people will have long COVID symptoms by Christmas. Many have become disabled by it. Governments and businesses are not providing anywhere near the level of attention or resources this crisis demands. Australia is not even tracking cases of long COVID, as are many other countries of comparable size. For people suffering, accessing help is nightmarish because long COVID clinics are overrun or closing. 

In Sydney, the long COVID clinic at St Vincent’s Hospital has an eleven-month waiting list, while the Austin Hospital in Melbourne ran out of funding and completely stopped providing long COVID services. And more than one-third of Australian workers don’t receive sick pay. The inability of workers to take time off contributes to ill health by prolonging illnesses that could have been managed with rest and prevents people accessing the help they need.  

The most lasting impact of COVID-19 may prove to be the devastation it has wreaked upon Australia’s public health system. Every long-term weakness has been exposed and exacerbated by the pandemic. The president of the Australian Medical Association, Omar Khorshid, said in October: “Every part of the system is clogged with people who are waiting to be treated, from queuing ambulances outside the EDs, those waiting inside the EDs, to people waiting for elective surgery”. This year, almost every state experienced record high calls for emergency help, and record high levels of ambulance ramping. The overcrowding led to terrifying events, such as the Melbourne Royal Children’s Hospital turning away patients in December. Patients have died from preventable illnesses, with or without COVID-19, because the health system is in crisis. 

Record numbers of healthcare workers left the industry this year. In Victoria, they left at a rate of more than 200 per week, 20 percent higher than the year before. The federal secretary of the Australian Nursing and Midwifery Federation says there are double the number of vacant nursing jobs in 2022 than last year. Can you blame them? Imagine entering an industry with a desire to help people, and instead managing a pandemic the government is pretending no longer exists without the resources to adequately provide for those who need care. Nurses’ strikes in NSW and WA have highlighted the anger and resentment workers in the industry are feeling right now. 

There are no easy fixes to the crisis in public health. But if working conditions aren’t improved, it won’t be possible to stem the tide. There is a broader problem with Australia’s health system. Many presentations to hospitals could be prevented if the general standard of health was raised. This would rest not on hospitals, but on easier access to local health practitioners. Yet out-of-pocket costs for GPs are rising, and bulk-billing practices are usually overrun. The high cost of primary health care in Australia contributes to working-class and oppressed people having a poorer standard of general health and landing in hospital for illnesses that could have been prevented if health care was genuinely universal. 

At the very least, beginning to address the crisis in public health will require massive injections of funds: more beds, more staff, more equipment and better wages for workers. But in Prime Minister Anthony Albanese’s first budget, hospitals received $2.4 billion less funding than they had anticipated. Not only did federal and state governments decide to let more people get sick by letting COVID-19 rip; they also tightened the resources available for the public health system to look after them. 

COVID-19, then, is exceptional. Alongside the ransacking of public health, opening the economy has been a political and social assault. By relegating the virus to just another disease, the bosses have lifted the bar for how much pain, neglect and hardship workers are expected to accept. We are asked to take solace from the fact that “only” the vulnerable and elderly are dying from COVID-19. A few hundred deaths per month doesn’t sound too bad, if you don’t think of the faces behind those numbers.  

This debasing of social consciousness has broader implications than apathy towards illness and disability. It also undermines consciousness of the real causes of much ill health. It was right that, for a period, people demanded feats of ingenuity and an enormous, unusual allocation of funds to defend public health. If social resources were dedicated to making sure everybody was well looked after all the time—indeed, if the economy was organised on such a basis—there are myriad widespread and debilitating health problems that could be lessened, if not eradicated. 

If big companies were ordered to stop pumping sugar into every foodstuff and cramming junk down our throats, that would measurably reduce the rates of diabetes and heart disease. If unions could enforce safety standards to the letter, workplace deaths could be rapidly scaled down from the figure of almost one per day.

But as the ruling class has asserted again in 2022, the point of capitalism is profit for the few. That’s where resources go and what drives decisions. By allowing COVID-19 to spread throughout society, the ruling class has had a tremendous victory. Health care has returned to being an individual, rather than collective, responsibility, just like everything else is individualised: finding a way to eat, having a roof and bed, getting an education and so on. It should never be forgotten that the death and disability inflicted upon Australian workers were a choice. The bosses chose to do this to us, because it was good for their class and good for their system. 

There is no single policy that will solve the health crisis they have created. It will require an upheaval of social priorities, of the structure of the economy, of what guides political decision making. The bosses want us to think there was no alternative, and not to care about the victims of their cruelty. Instead, we should never forgive, or forget.