Kam was told in August 2020 that his 92-year-old mother had contracted Covid and was very sick.

They didn't know where she was.

After calling nearby hospitals, he discovered that his mother had been admitted to the hospital. She died at 9pm on the 30th.

As the virus swept through aged care homes, staff and residents became sick, management struggled to create makeshift Covid wards, and hospitals were full of elderly patients.

Kam Atkins at his mother Norma Atkins’ grave at Brighton cemetery

Kam Atkins at his mother Norma Atkins’ grave at Brighton cemetery. Norma died of Covid aged 92. Photograph: Ellen Smith/The Guardian

There was no treatment or vaccine. Basic care in aged care homes was neglected because of a lack of staff.

As the stress from the health system spread, so did the family's nightmare.

Norma Atkins

Norma Atkins died at 92 after getting Covid-19 at the Menarock aged care facility in Rosehill. Photograph: Kam Atkins

The staff at the crematorium worked until 4am to take care of the bodies that came in.

She lost her body. It wasn't until three weeks later that I received a call saying "We found her." She was taken to the wrong crematorium after she was released from the hospital.

One of about 900 deaths from Covid-19 in Australia in 2020 was that of a woman who loved painting her nails, listening to country music and watching tv with her friends.

The country is close to 10,000 Covid deaths. There have been more deaths in 2022 than in 2020 and 2021 combined, yet the confusion and fear of the early months of the epidemic have largely subsided.

The reopening of borders and the lifting of public health restrictions caused the deaths to increase. The lessons of the Pandemic are still coming into focus two years after the event.

Lives cut short

Australians have been hit with a lot of numbers during the Pandemic.

State governments still publish this data and the media occasionally reports it, but the numbers no longer determine whether a person will be locked down, out of work or separated from family and friends. Ten thousand new cases or ten thousand deaths is not the same.

The Australian population is one of the most vaccined in the world. A sudden influx of residents from aged care facilities has stopped for healthcare systems. The heart and lungs of the most vulnerable people were more likely to die before vaccinations and treatments.

Deaths affect vulnerable and disadvantaged people in a different way. The people who are most likely to die are those who are unvaccinated, have not had their booster, or have significant co-morbidities.

The severely unwell may stay in hospital longer or die a short time later due to the health conditions that Covid worsened. It's not easy to determine whether someone died with Covid or not, but that doesn't make up for the loss of a loved one.

When he celebrated his mother's 92nd birthday with her, the day before her nursing home went into lock down and just days before she contracted Covid, he said, "We'll be celebrating your 100th one day."

People want to get back out there as life moves on. Our losses haven't been as bad as those in other countries. The death toll in Australia is still terrible.

There are thousands of people. Even with the development of vaccines and treatments, there are still questions and pain for the family of those people.

Moving beyond the numbers

Some deaths in Australia may have been preventable if early treatments that prevent Covid from becoming severe were more accessible and more investment was put into the health system.

Many health workers who worked through the Pandemic say the numbers need to be put into the context of the global experience.

The head of Royal Melbourne hospital's department of respiratory and sleep medicine remembers watching with alarm the high number of deaths among health workers abroad.

No staff members have died from Covid. A list of all the respiratory physicians who died from Covid was given to the US Thoracic Society at an international meeting last year. It was really sad. The healthcare workers here are tired but they have more support than those overseas.

Prof Jodie McVernon says reaching 10,000 deaths highlights the success of the strategy to delay reopening borders and keep restrictions in place.

Deaths are rising in countries that reopened before vaccines were widely used. Over one million Covid deaths have been recorded in the United States. Young and previously healthy people are dying at an alarming rate due to low rates of vaccinations and booster shots.

If we learn anything from our 10,000, it's the advantage of our strategy, which has been essential for reducing the impact and burden of death. The deaths are tragic, but we are seeing very different scenarios in countries that did not have the same strategy.

Concerns for Australia include the availability of early treatments that prevent vulnerable people from becoming severely unwell and the potential for long-term effects on those who have had Covid.

Covid is appropriately moving from centre stage to backdrop
Jodie McVernon, epidemiologist

McVernon says deaths and case data are more complicated to analyze. It was easy to identify what Covid was doing to the body and to determine if someone died from or with the virus in the early days of the Pandemic. Researchers have a better idea of how the virus behaved when nearly all infections are being captured. The data was more useful.

It is harder and harder to know what causes what, and what is linked to what, as the number of cases increases.

She wants to know what is known about the people who died. What were their conditions? What number of vaccinations did they have? What treatments did they offer? It's important to understand the current burden of disease and plan for the future.

McVernon gave the federal government modelling to plan its response to the swine flu, and is now working on models to see where population immunity is headed in Australia.

She asked about the impact of the variant on the hybrid immunity. What are we going to do about that? We are trying to think in a different way. We are training people around the world to ask these questions and prepare them. Evidence is being taken and turned into knowledge to guide infectious disease policies.

She doesn't think the move away from daily reporting of deaths is bad.

Covid is moving from one place to another.

Aaron Deane

Nurse Aaron Deane: ‘My body started to collapse because I wasn’t coping mentally and emotionally.’ Photograph: Jessica Hromas/The Guardian

Many other challenges and conditions need to be responded to. We have changed our procedures for controlling infections. Delivery of other health services has been affected by this. How can we use what we have learned during Covid to respond to the other challenges?

I think we are standing back and looking at the bigger picture. It is the right time for that.

‘Don’t minimise the trauma’

Hearing about deaths and Covid numbers has become too much for Deane. He stopped receiving Covid news notifications. Deane traveled to Victoria to help nursing homes deal with Covid outbreak in 2020.

I went back to Sydney and people were not wearing masks at all ... it was just like the most surreal feeling
Aaron Deane, nurse

Deane was angry when he read that politicians said those who died from Covid were old.

I just wanted to have some respect.

Don't minimize the toll, don't minimize the trauma of deaths, and everything everyone went through at the same time as those deaths. It was really bad.

In Victoria Deane saw elderly people with wounds that had not been treated for days. While wearing heavy PPE for hours at a time, he and other staff struggled to provide the care they knew residents deserved.

Deane said that she could barely afford her rent.

He remembers that it was difficult to keep the uninfecting residents away from the infections.

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There was a lady with dementia who didn't have Covid but she was confused and distressed and I was trying to keep her out of the infectious areas of the home. She liked to listen to music. I used to distract her by playing music and dancing to stop her from wandering.

He would go back to his hotel after a long day of work.

He worked with outreach teams at the St.Vincent's hospital in Australia to find homeless and vulnerable people.

It was so traumatising because I was in that hotel by myself in Melbourne to deal with what I was seeing at work, and everyone there had masks on and were only allowed to leave during the day.

It was like a completely different world when I returned to Sydney and people were not wearing masks at all, walking around in groups. Covid spread in other places as well.

Deane is having a hard time moving on. He is going to work for a pharmaceutical company.

He said he couldn't do it anymore. My body collapsed because I wasn't taking care of myself. I wasn't able to bounce back because I was still facing the demons of what I had gone through.

There is more than one Deane. The results of a survey of healthcare workers were published in June. There were 258 workers who reported frequent thoughts of suicide or self- harm in the preceding two weeks.

The death toll from Covid in Australia is not as bad as in other countries.

Many of the people leaving the health system are traumatised by it.

There are more preventable deaths without investment in healthcare.

While not wishing to diminish the number of deaths, a vaccine nurse who worked during the peak of the Pandemic said that they should not be the focus.

Everyone is sick to death of reading about Covid numbers and people are just desperate to do some normal activities. We need to move on from the numbers now.

We need to ask hard questions about what we are doing to invest into our health systems, invest in prevention, and invest into aged care so that we can stop preventable deaths, no matter the cause.