Heterogeneity of the COVID-19 epidemic in Australia: What can we learn from it?

Abstract

\n It has been more than one year since the World Health Organization declared the pandemic of COVID-19. Countries around the world are still struggling to control their epidemics. Australia has shown its resilience in the fight against the epidemic by providing a comprehensive response involving the whole-of-government and whole-of-society. Despite the overall successful national response, the epidemic in Australia has been heterogeneous across states. We conducted a mixed-methods study to analyze the epidemic and explain the variable manifestation of the epidemic across states in Australia. Most of the COVID-19 cases and deaths were in Victoria and New South Wales states due to differences in governance of the epidemic and public health responses (quarantine and contact tracing) among states. Countries could learn not only from Australia’s overall successful response, through good governance, effective community participation, adequate public health and health system capacity and multisectoral actions, but also from the heterogeneity of the epidemic among states. Successful response to epidemics in countries with a decentralized administration requires multi-level governance with alignment and harmonization of the response.