As Australian and US states lift lockdowns, one expert says 4 key differences helped Australia manage its outbreak while the US is fumbling its response

A surfer walks to the water through a designated walkway at Bondi beach after the 7am reopening on April 28, 2020 in Sydney, Australia. Mark Kolbe/Getty Images
  • After months of lockdown, countries around the world are beginning to ease the lockdown restrictions put in place to curb the coronavirus’ spread.
  • Some Australian states and territories have begun to loosen their coronavirus restrictions, which were implemented early on in the country’s outbreak. The country’s overall number of coronavirus cases per day has been largely decreasing since early April.
  • The US is also eager to reopen its economy, and several US states have begun to loosen lockdown measures. But as a whole, the country is still seeing huge spikes in its number of cases, and experts say some states are yet to reach their peak.
  • Dr. Lesley Russell, who advised both the US and Australian governments on health policy, told Insider how Australia managed to get ahead of the virus while the US continues to lag behind.
  • Visit Business Insider’s homepage for more stories.

After months of lockdown, countries around the world are beginning to ease the lockdown restrictions put in place to curb the coronavirus spread.

Several countries in Europe have recently begun to reopen, including Germany, Denmark, Norway, the Czech Republic, and Poland, though many have warned that the process will be slow and closely monitored.

Australia is among the countries beginning to ease its lockdown, though each of its six states and two territories has its own social distancing rules in place. Australia has a population of about 25 million and has recorded 7,045 cases and 98 deaths as of May 17. Its number of coronavirus cases per day has been largely decreasing since early April and has seen less than 50 new cases per day since April 17.

On May 5, Australian Prime Minister Scott Morrison met with state and territory leaders and agreed that the country would begin to lift lockdown restrictions in stages with the goal of establishing “a sustainable COVID-19 safe economy in July 2020,” though he stressed that each state would be able to move at its own pace.

Each Australian state and territory is coordinating its reopening with the federal government, but easing its restrictions based on the situation locally. For example, the Northern Territory, which has only recorded 29 cases and zero deaths, began reopening national parks and allowing outdoor activities on May 1. The state of Victoria, on the other hand, has reported over 1,500 cases and 18 deaths and began gently easing its restrictions on May 13.

Seeing the successes of other countries in stemming the virus, the US is also eager to jumpstart its economy, and several states are set to reopen in the coming weeks. As of May 15, Georgia, South Carolina, and Montana have lifted restrictions, and others including Texas, Maine, and Illinois have partially reopened. Several states, including Arkansas, Iowa, and Nebraska, never issued statewide stay-at-home orders.

But experts have warned that reopening too quickly could see a resurgence of the virus in a second wave, a particular concern for the US which has seen over 1.4 million coronavirus cases and more than 89,000 deaths across its 50 states. The number of new US daily cases remains in the tens of thousands, and recent projections indicate that some states have not yet passed their peak.

While Australia and the US are both looking toward the future, one leading health policy expert told Business Insider that Australia has taken a drastically different approach to fighting the pandemic, which puts Australia at an advantage to fight off a potential second wave of infection.

Dr. Lesley Russell is an Adjunct Associate Professor at the Menzies Centre for Health Policy and a non-resident fellow at the United States Studies Centre in Sydney Australia. She previously served as a senior adviser to the US Surgeon General in the Department of Health and Human Services under the Obama administration, and also as a health policy adviser to the Australian Labour Party.

She broke down four major differences between the Australian and the US coronavirus responses:

1. Preparation: Australian leadership empowered its health agencies while the Trump administration has taken a ‘just in time’ approach.


Russell said one of the major differences between the US and Australian responses to the coronavirus outbreak was how both countries prepared in advance.

According to Russell, in recent years Australia has boosted finances and personnel for its agencies responsible for monitoring indicators of infectious disease, including the Australian Health Protection Principal Committee – a subcommittee of the Australian Health Ministers’ Advisory Council (AHMAC), part of the Council of Australian Governments (COAG) – which coordinates efforts between federal and state governments.

“Australia had done a fair amount of preparation and had the mechanisms in place,” she said, including regular updating and testing of its national pandemic action plans.

She continued: “In Australia, the state and the federal governments are not known for their cooperation. But when it’s crunch time, facing a coronavirus pandemic, they have really all stepped up and the level of cooperation.”

Russell said that comparatively, US public health agencies were less prepared for a pandemic, despite early warnings.

Russell said that in recent years, the Trump administration has “undermined the ability” of the Centres for Disease Control and Prevention (CDC) – the US federal public health agency which has been at the helm of managing information related to the coronavirus outbreak in the country.

“[The CDC] has been neutered by a shortage of resources, both dollars and personnel,” Russell said.

Trump has repeatedly tried to cut the CDC’s budget, including his administration’s proposal to slash $US700 million, or nearly 9% of its budget, even as the coronavirus spread in the US. Congress has not enacted those cuts.

The US has made several recent cuts to the public health sector under Trump: In 2018, the Trump administration disbanded a pandemic response team established under President Obama’s National Security Council in order to cut costs, and never replaced them. The White House also slashed a CDC position in China meant to detect disease outbreaks in the months leading up to the US coronavirus outbreak.

According to Russell, the Trump administration has favoured taking a “just in time” approach to handling the crisis.

Trump has come under scrutiny for his administration’s slow response to the coronavirus crisis, with reports indicating US intelligence warned Trump in January and February about the likelihood of a pandemic.

“Trump got a lot of information from the various arms of government – from the military to security councils, to the CDC – that there was a threat of a pandemic,” she said, “And it was ignored.”

Russell said that investing in agencies that deal with disease preparedness and prevention is crucial, though funding is easily cut as the threat of disease is not always apparent.

“Diseases and viruses prevented, don’t show up on anybody’s radar screen,” Russell said. These outcomes are hard to measure.”

2. Leadership: Australia’s prime minister is taking a backseat to scientists while Trump turned his briefings into campaign events.


Another key difference between the US and Australian coronavirus response is how leadership has delivered vital coronavirus updates to the public.

In Australia, Russell said, “we don’t have Trump and America does, and that makes an enormous amount of difference.”

According to Russell, Australian Prime Minister Scott Morrison has allowed health experts to take the lead in delivering messages to the nation.

“For a period of time, there was a bit of a conflict between Morrison wanting to speak up versus what the experts, like the Chief Medical Officer of Australia Brendan Murphy, was saying,” Russell said. “But Morrison has since stepped back.”

She said the prime minister has shifted his focus to “being the general cheerleader” and discussing the economic aspects of the coronavirus pandemic.

“In Australia, messages [about the virus] haven’t been politicized,” she said.

But President Trump has taken a different approach to his near-daily coronavirus press briefings, which he recently scaled back on, following backlash over his statements suggesting that disinfectant could be injected into the human body to kill the coronavirus.

According to Business Insider’s Kayla Epstein, the “marathon-long briefings” would begin smoothly but devolve into chaos as journalists “pressed Trump on his previous comments, tweets, and claims.” The president would also use the briefings as an opportunity to berate reporters, contradict his top medical experts, and deliver inaccurate information about the US coronavirus response.

“Trump has undermined the authority of expertise, in particular of scientific expertise,” Russell said. “And that’s really quite problematic in terms of what the general population thinks and their willingness to believe things that don’t make sense scientifically.”

Russell said that Trump has treated his press briefings like “campaign events,” instead of delivering crucial and apolitical information about the virus to the American public.

“They’re not briefings, they’re campaign events,” Russell said.

3. Testing and contact tracing: Australia has developed a nationwide tracing app and has a surplus of test kits. The US experienced major issues with testing early on.


Experts have repeatedly said that testing and contact tracing are two crucial capacities that every government needs to have in place in order to safely lift coronavirus restrictions. Robust testing systems and comprehensive contact tracing allow governments to see where the coronavirus is going, who has it, and whether the population is gaining immunity.

“You can’t see what the problem is unless you do testing,” Russell said.

Making testing quick, accurate, and widely available has been an issue for most countries, according to Russell, though she said that testing has “really become a disaster in the United States.”

Test kit shortages and potentially faulty kits stalled US health authorities’ abilities to monitor the number of infections during the initial stages of the outbreak. But though the US has significantly ramped up its capacities in recent weeks, the testing process remains slow and limited, and the US has been left trying to play “catch up” from its early mistakes.

And although Trump has claimed that the US leads the world in coronavirus testing, data indicates that the US still lags behind Italy, Canada, and the UK in the rate of testing done per capita.

While some states have expanded their testing capabilities and certain cities have allowed testing for all, other states have actively discouraged anyone who isn’t showing symptoms from getting tested.

And in terms of contact tracing, the US government has not come forward with a comprehensive plan that would work across all states, though tech giants Apple and Google announced that they would be teaming up to create a smartphone system that they say will be available in May.

“In rather typical fashion, [US contact tracing] is being left to the private sector,” Russell said.

Comparatively, Australia invested in widespread testing early on and has mechanisms in place to monitor contact tracing.

Australia has recently expanded its testing policy to allow anyone with respiratory symptoms to be screened for the virus. The government also recently received a surplus of millions of testing kits, which the federal government says will allow the country to significantly boost its COVID-19 testing.

The Australian government also released a contact tracing app that millions of residents have already downloaded, which the prime minister has said is the country’s “ticket” to easing restrictions.

“Australia has really started good contact tracing,” she added. “It remains to be seen whether Australia’s app will work or not, but at least there is a national thought process about it in a way that there just isn’t in the United States.”

4. Gaps in the healthcare system: Australia’s universal healthcare and mandatory paid leave grants Australians the freedom to get medical help without entering financial hardship. Many Americans remain worried about the economic costs of getting sick.


Lastly, Russell pointed out that the US and Australian healthcare systems are vastly different, and are institutionally set up to handle public health crises in distinct ways.

Australia’s healthcare system is divided into the public and private sectors ⁠- its public-funded universal health care insurance scheme called Medicare provides partial or full coverage of most primary health care services to all Australians free of cost, while several companies also offer private health insurance funded by a combination of government and private entities that allow for expanded coverage and broader choice.

In brief, Russell said, “Australia’s Medicare system means that people can seek help when they need it without fear of financial repercussion.”

And while the US spends more on healthcare than most other countries, it does not have a universal healthcare system in place. Instead, most Americans rely on their employers to provide them with health benefits, and millions of others have no health insurance at all.

These gaps in healthcare coverage are pronounced among minority groups in America, who are more likely to be uninsured throughout adulthood.

“It’s important to have health literacy,” she said. “It’s not great in some parts of Australia, but I think it’s better overall in Australia than they are in the United States.”

For some Americans, getting sick can lead to excessive healthcare costs and even bankruptcy.

“It isn’t just a matter of addressing the healthcare issues associated with coronavirus,” Russell said. “It’s also a matter of addressing the economic issues associated with it.”

Russell said that Americans on the lower socio-economic spectrum may delay getting tested for fear of the economic risks associated with becoming infected.

“A lot of poorer people are nervous because [if they get sick] who pays for their healthcare costs?” Russell said. “Can this person afford medication? Can they take time off to isolate?”

Paid sick leave policies also differ greatly between the US and Australia.

In the US, employers are not mandated to offer paid sick leave or personal leave. In Australia, all full and part-time employees of any industry are entitled to four weeks of paid annual leave and 10 days of paid sick leave. In April, Australians were also given two weeks of unpaid pandemic leave, should they need to access it in case of emergency.

According to Russell, these benefits grant Australians greater freedom to ensure they can take time off of work if necessary, and limit the spread of disease without invoking financial hardship.

Overall, Russell said that Australia has had a combination of ‘good luck, good management, and good timing’ in handling its outbreak.


Russell credits Australia’s proportionally smaller coronavirus outbreak to “a combination of good luck, good management, and good timing.”

“Things worked really well in Australia in a way that just hasn’t happened in the US,” she said.

She said that Australia hasn’t seen the types of protests against lockdown measures that have become more frequent in the US, and added that Australians are “pretty compliant people in a way that perhaps some Americans aren’t.” She said that for some Americans, who have supported Trump and pinned hope on his promise of a booming economy, they’re “really suffering” under US coronavirus restrictions.

“Trump’s real clout going into the upcoming election was going to be the economy and the economy has tanked,” she said. “And people are really, really suffering. That makes people very fearful and makes them do things that are not civil.”

Russell did note that Australia’s smaller population size relative to the US – which has a population of 328 million – has made it easier, in part, to enforce lockdown restrictions.

And Australia’s geographic location – being an island continent in the middle of the Pacific – has also allowed the country to remain relatively isolated as the number of cases has exploded across other continents.

Despite the differences between the two countries, Russell said the virus has exposed social and institutional inequalities that exist in both societies, in addition to challenging each country’s public health response.

“The virus has the potential to tear apart the social cohesion,” she said. “We have to keep behaving sensibly.”