On Tuesday, Professor Nigel McMillan predicted that COVID-19 will be the leading cause of death in Australia by the end of the year.

Such a declaration would have, not so long ago, made the front page, so to speak.

Professor McMillan, an infectious disease expert with the Menzies Health Institute Queensland, told ABC Radio that one in 110 Queenslanders were infected with the coronavirus – and yet people weren’t taking COVID-19 seriously enough.

He urged governments to find a middle ground in managing public backlash against mandated measures, and taking the pressure off hospitals.

By way of example, he called for masks to be mandated at large events, such as the upcoming Royal Queensland Show.

“People basically don’t like being told what to do and people really are mentally exhausted from all this, but the reality is right now today, one in every 110 Queenslanders have COVID,” he said.

A day later, Victoria’s acting chief health officer Ben Cowie “strongly recommended” that employers and universities, where practical, encourage work and study at home until the end of August.

He’d previously recommended that masks be required in public indoor settings, such as schools, early learning, shops and bars, clubs and restaurants.

People are reluctant to undergo the same COVID restrictions again. Photo: AAP

The Australian Medical Association backed these measures – and why not?

The coronavirus – in its new variants – has never been more infectious. Hospital numbers are uncomfortably high. Booster rates are uncomfortably low.

However, mandates are enacted by governments – and none, state or federal, are willing to go down that path again.

Victoria’s new Health Minister Mary-Anne Thomas gave the thumbs down to Professor Cowie’s recommendations for expanded mask mandates.

At the same time, however, she noted that according to her expert advice, wearing masks in indoor settings was strongly recommended.

A bit confusing? Ms Thomas explained that mandates weren’t the most effective way to promote mask wearing.

Instead, the minister went the route of many a social media influencer and talked about Victorians being empowered to make their own choice.

Is this just a political copout?

Why are politicians resisting mandates against expert opinion?

Is it because elections are looming?

Is it because research shows that people are less likely to adhere to mandates today because of ‘restriction fatigue’?

Or is it because mandates require enforcement – and that takes away police resourcing from more important tasks?

Dr Chris Moy, chair of the Ethics and Medico-legal Committee of the Australian Medical Association, said: “Probably yes to all three. It’s a legitimate conclusion.”

But it may not just be a simple case of bum-covering or cowardice.

The public’s tolerance of mandates has significantly waned and simply may not be worth the drama.

Paul Strangio is a professor of politics at Monash University.

In an email, Professor Strangio told The New Daily:

“I certainly think that politically it would be extraordinarily difficult for the Andrews government to introduce mandates at this time with an election impending. However, it is not only the Victorian government that is adverse to reintroducing mandates: This is the case across the nation with governments of all stripes regardless of the timing of elections.

“In a nutshell, I think a return to the kind of restrictions that were imposed during 2020 and 2021 would be practically ineffective and politically untenable. In these circumstances, the strategy of providing information to the public and relying on people to make wise choices (about things like mask wearing, working from home) is the only feasible position.”

The public is being urged to make wise choices, such as working from home. Photo: Getty

Professor Strangio said that initially the public was remarkably compliant with mandates (and nowhere more so than in Victoria, where restrictions were the harshest), but by 2021 it became evident that tolerance was wearing out.

“Not only did compliance decline (revealed in data about population movement) but the restrictions incited growing hostility,” he said.

“Therefore governments have calculated that a reintroduction of restrictions would not be practically effective; indeed, may well be counterproductive.”

So empowerment is the way to go?

Holly Seale is an associate professor and social scientist at the School of Population Health, UNSW Sydney.

Last week she published a piece at The Conversation: ‘Mask mandates – will we only act on public health advice if someone makes us?’

Reading the piece, you’re likely to come away thinking, well, yeah, probably.

However, in an interview, she made the point of not saying whether she supported mandates or not.

“I’m not answering that,” she said with a light chuckle.

The reasons for Dr Seale’s coyness was a desire that people should read the piece for themselves and weigh up the evidence.

However, she was direct in saying the idea of empowerment was on the nose.

“People hate the word ’empowered’ – there’s a real backlash,” she said.

“The idea that if you give people the tools and the information, they’ll go away and do what you want them to do – that hasn’t always worked very well.”

In her piece she writes:

“Community empowerment refers to the process of enabling communities to increase control over their lives. But that doesn’t mean everyone will feel empowered to do the safest thing.”

She said that ‘empowerment’ refers “to the process by which people gain control over the factors and decisions that shape their lives. It can prompt innovation in health messaging and engagement”.

The Omicron variant has played havoc with case numbers and hospitalisations. Photo: Getty

But in times of uncertainty, such as a pandemic which doesn’t yet appear to be nearing its end and with new subvariants emerging, “the simple act of not wearing a mask may give people a feeling of control over an unfamiliar situation”.

Or, of course, empowerment can mean giving people permission to do whatever the hell they want.

What happened in January?

This is what happened in January when the federal government, and then the NSW government, put the decision for mask wearing and social distancing in the hands of the people.

COVID-19 ceased to be an issue for many if not most people, despite the Omicron variant playing havoc in infection numbers – and Australia started seeing 1000 deaths a month.

Since then, the disconnect between social attitudes and public health reality has only grown. If there’s been a wake-up call, it came about with the cancellation of COVID-19 support payments.

Suddenly, we were seeing young people on TV weeping their hearts out, putting pressure on a new federal government (one that inherited a trillion dollars in debt) to reinstate those support payments.

Although Dr Seale cautions against conflating support for ill people and broader public health policy, Dr Moy says it’s a matter of “reciprocity”.

He feels that if the government is called upon to protect people who don’t have sick leave, then maybe the wider population has a responsibility to play a more active role in preventing the spread of the coronavirus.

The government is under pressure to provide support for casual workers who catch COVID to stay home. Photo: Getty

Dr Seale agrees with political scientist Paul Strangio: Without mandates, the answer lies in effective messaging.

As Chris Wallace, a professor at the Faculty of Business, Government and Law at the University of Canberra, told the ABC, the answer to mandates is “a big, fat, persuasive ad campaign so no one misses the message”.

Yup. Marketing might save us by gently nudging compliance.

But Dr Seale cautions that mask mandates may return: “However we also need to be realistic given the point we are in the pandemic. These nudges may not be enough and if there are any other shifts in severe COVID cases due to new variants, it is important to prime the community that mandates may be needed again.”