Reasons for pre-flight tests on China are now clear but home Covid strategies remain murky | Paul Karp

When is imposing a pre-flight Covid test requirement on travellers from China against medical advice not a breach of a commitment to follow that advice? When it’s done out of an “abundance of caution”, enough other countries are doing it and it might help squeeze China for more information about its Covid outbreak, apparently.

Those were the explanations the health minister, Mark Butler, offered throughout the week.

Although the requirement itself for a negative Covid test in the 48 hours prior to departure may not be onerous, it was still a surprise to see such a break from the “follow the medical advice” mantra of the first two years of the pandemic.

To understand how we got here, perhaps it’s best if we start with the government’s messaging last week, when the chief medical officer, Paul Kelly, publicly observed there was no need for pre-flight tests because Australia already had the variant circulating in China.

On Thursday 29 December, the prime minister, Anthony Albanese, told ABC News Breakfast the government would “take the appropriate advice from the health experts and follow that advice”.

It sounded pretty definitive, but he added: “Our priority is to keep Australians as safe as possible.”

Butler then announced on Sunday that Australia would impose pre-flight tests, leading some stakeholders, including Universities Australia and the Tourism and Transport Forum, to back the government, apparently on the assumption this is what advice recommended.In fact, in the advice written on 31 December and published after Butler’s press conference, Kelly said that he did “not believe that there is sufficient public health rationale” for any additional requirements, labelling any restriction on travel from China “disproportionate to the risk”.

Butler’s justification was that pre-flight tests were being imposed “out of an abundance of caution”, essentially arguing that it was above and beyond what was recommended.

The problem with Butler’s “abundance of caution” and Albanese’s keeping “as safe as possible” is that many public health experts, including Prof Julie Leask and the Australian Medical Association, noted we don’t seem to be taking the same approach with our own outbreak in Australia.

After two years of harsh policies including border closures and lockdowns gave Australia world-beating health results, 2022 was the deadliest year, with more than 14,000 Covid deaths.

The seven-day average for deaths per day is currently 21 and that’s mid-summer in Australia.

While almost nobody is calling for a return to the most restrictive policies, the AMA president, Steve Robson, called for a “comprehensive strategy” – which could include better ventilation and measures like mask-wearing on public transport – rather than what appears to be “a series of political responses”.

The pre-flight testing regime seemed to be full of political risks for the government, including criticism from the opposition for abandoning advice and imperilling the fragile relationship with China.

But the government has calculated that the risk is actually very low.

As one Labor MP told Guardian Australia, there’s more pressure from constituents “to screen Chinese travellers” than there is not to discriminate against China.

Australia was acting in step with the rest of the world, unlike Scott Morrison’s aggressive call for the World Health Organization to gain weapons-inspector-style powers to investigate the source of outbreaks.

And China itself requires pre-flight tests, so when it huffed and puffed about reciprocal countermeasures, Butler could honestly say Australia is asking no more of our arrivals than China does of theirs.

Outrage about the medical advice prompted the second Butler press conference, in which he praised his own transparency for having released it.

He continued to put a significant gloss on the advice by stating he had “accepted every positive recommendation” in it, measures to improve surveillance like wastewater testing.

Then, the real reason: “I’ve asked my department to reach out to their equivalents in China, to stress our view that it would be valuable for information to be shared more comprehensively by China not just with Australia but with the rest of the world.

“Real-time uploading of their genomic sequencing of Covid cases – this is what governments, including Australia, are calling for. This is why we’ve put in place these modest, sensible measures out of an abundance of caution.”

It’s good we now know why we’re testing travellers from China, but the government could be clearer on whether there’s any more we could be doing to deal with Covid at home.