Doctor and activist


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Author: Arthur Chesterfield-Evans

Tasmania Wants 90% of Adults Double Vaccinated before Opening the Border

30 September 2021

Here is a realistic assessment of how to stop an epidemic if you have the choice. Liberal Premier Peter Gutwein has some modelling coming. Bear in mind that 20% of the Tasmanian population are under 16 year of age, so if no kids are vaccinated the actual rate is still only 70%, not 90%. Even you assume that kids will not get sick, which is actually not a reasonable assumption, there are 30% who can spread COVID and 10%, the adults, who are quite vulnerable.

In reality, it is hard to get vaccination rates over 90%, though Blacktown LGA has 95% with first jabs, and presumably Tasmania would also being trying to vaccinate 12-15 year olds and younger if possible.

Meanwhile Morrison is stopping welfare payments to States when they get over 70%, which is actually starving people into unlocking. Even Conservative NSW Treasurer Perrottet is adding some welfare payments from the State budget.

www.abc.net.au/news/2021-09-29/tasmania-wont-reopen-covid-border-before-90pc-vaccination/100500844?sf249931972=1&fbclid=IwAR2NqGfeDQA9rGcnm7XQ6iLiDGK7XH1PNkRsjYs3uL15J31hP7qLbDsby88

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Motivation and Money

25 September 2021

Some years ago, I won a Public Service Fellowship to study workplace absence and had what the Americans call a boondoggle, with a world trip to look at why people attend or do not attend work.

One outcome from that was that I stopped using the word ‘Absenteeism’ as that is a valued judgement suggesting a worker disease, and used the term ‘workplace absence’ which, as the progressive journals at the time insisted meant that an employee considered that they had a better reason not to be at work.

Unsurprisingly people who had more interesting work or control over their work were less likely to be absent, while those in boring production lines were more likely.  The US car industry had absence rates of around 10% and handled this by simply rostering on excess people in the assumption that people were not going to turn up.  A union OHS academic there said that the rates of what we called RSI were very high, but I did not get to examine workers and naturally no figures were available.  

People who needed to be away from work also were more often absent, particularly women with families whose incomes were lower than their partners.  Later I looked at age groups and health as these were measureable and confirmed the general conclusion that health did not correlate with absence.  People who had a chronic illness were less likely to take sick days as they might need them later, whereas young healthy males wanted to go surfing. 

The Swedish car industry let workers have quite a lot of autonomy, but this had led to the workers trying to finish early and giving themselves RSI, but the Swedes were not keen to talk about this, as they had been studied by too many itinerants like me, (and one suspected that they did not like what we had found).

The Japanese worked very long hours, and had token payments systems which kept a peer pressure to gain this respect, but the last  part of their long working hours tended to be not very productive, because the peer pressure was merely not to be the first to leave.  Again, this insight came from US academics; not the Japanese.

One of sillier things that I noted in some management training that I had was that some still seem to think that the only thing that motivates people is money.  This seemed so simplistic to me as to almost absurd, but it was still taught.

So I was interested to see an article today by Malcolm Knox  in the SMH about the motivation of the Melbourne Storm Rugby League players, who are favoured to beat Penrith in the second preliminary final this afternoon.  Some of their players are paid much less than they would be if they changed clubs, but they stay there because of their respect for the coach, and for the fact that the team wins.  Young fullback Ryan Papenhausen is quoted as saying that he stays while Bellamy is coach because he thinks he will improve most while coached by this man.  So despite salary caps, which are designed to even up the quality of players between clubs, Melbourne have more than their share of stars.

I have not been a huge fan of Rugby League over the years as it seemed to merely have people bump into each other and lacked the subtlety  and variety of Rugby Union, particularly the innovative movements of the All Blacks.  But their variety and flair is improving, particularly with the work of Nathan Cleary at Penrith, which is now being watched and copied to the level that other teams have been beating them.

We can watch Melbourne Storm v. Penrith from 4pm, but I will also be thinking that if Melbourne wins, it will say something about motivation and money.

www.theage.com.au/sport/nrl/splitting-heirs-papenhuyzen-storm-s-regeneration-proves-the-cap-doesn-t-fit-anymore-20210924-p58ugx.html

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Victorian Government Bites the Bullet and Mandates Vaccination

22 September 2021

At last!  A government that does the sensible thing.  The Victorian government will only open up if people are vaccinated.  Thanks to NSW the Delta variant genie is out of the bottle and spreading nationwide.  Business wants to unlock, some with no care for anyone but themselves.

Victoria wants to unlock but minimise spread among those now having more interpersonal contacts.  The R (Reproduction) number is the number of cases each case infects.  If everyone is vaccinated, less people will get it and those who have it will get it to less people.

Reasonable medical opinion is that the risks of vaccine are massively less than the risks of getting COVID, so the case against vaccination is incredibly weak on medical grounds.  The ‘right not to have your body violated’ etc sounds very dramatic, and makes vaccination equivalent to rape in a semantic sense.   But in a practical sense the two concepts are as far apart as could be.  One is sensible medicine and the other is a crime.

Anyone who thinks that this does not matter should look at the graph of NSW cases that has peaked and is just starting to fall.  Anything that can flatten the curve or make it fall is good. Anything that makes it rise is creating deaths and misery.

I am a member of the Council for Civil Liberties and have spent years working against excess government power. But sometimes it is necessary to act for the common good.  I have no time for smokers’ rights or the right to spread disease.  The Morrison government is as usual missing in action when real leadership is needed.  ‘Let every workplace decide’, is a nightmare for retail business owners, offices and just about every other employer. Gladys is similarly missing.  Dan Andrews has stepped up, despite a motley crew in the streets spreading disease and demanding the right to continue to do so.

What of the Health System?  We are going the way of the Americans by stealth, and the fact that the public system is what has helped us survive is being glossed over, hidden  by subsidies to private hospitals. The Federal government has been quietly trying to kill public medicine for years. The Medicare rebate has fallen from 85% of the AMA rate to 45%, so for the same bulk-billing work doctors incomes have almost halved over 35 years, while subsidies to the inefficient Private Health Insurers continue.  Being a GP is now a little-sought speciality.  (I have a FB page- Fix Medicare that I spend too little time on).

The States have maintained the public hospitals at a minimal level, as all the lucrative work has been siphoned off by the private system basically doing the easy stuff.  There is No slack in the system, not that counting the number of ICU beds should factor.  All our efforts should be to keep people out of Hospital and ICU by prevention of infection. 

Have a look at this article on the anti-discrimination aspects of mandatory vaccination, and also look at the NSW cases, just turning down, but likely to rise if anything, like opening up from lockdown, tips the balance.

www.smh.com.au/national/victoria/here-s-why-no-jab-no-entry-is-not-discrimination-20210920-p58t2v.html?fbclid=IwAR2jrbfGJsq6fD-J-unnAn12j9UyWvdk-do5BpE23bI0z0gQ8kknq5nc39c

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An OECD Analysis of the Federal Government’s Policies

16 September 2021

This is a good and reasonably comprehensive article in The Guardian where the OECD looks at Australia with some interesting graphs and international comparisons. 

The OECD also wants to review the role of the Reserve Bank.  One might comment that the Reserve Bank might have more power in other countries and the OECD might either think it has more power here, or is pushing for it to have such. The RBA here had traditionally kept out of politics, finally made some very sensible comments and been roundly ignored.

www.theguardian.com/business/grogonomics/2021/sep/15/australias-climate-failures-are-costing-its-economy-and-scott-morrisons-government-is-being-blamed?CMP=Share_iOSApp_Other&fbclid=IwAR0HPjSa-z0Esu7GklbLRl3IrvAzJnjsBdMNX7VhWFbCcOsNbNBTYGpZO2U

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Uncontested Grants for NT Gas Exploration Despite Court Proceedings in Progress

15 September 2021

Federal Resources Minister Keith Pitt gave $20 million for gas exploration for fracking in the Betaloo Basin in an uncontested grant.  The grant was to Empire Energy that donates to both major parties, but seems to prefer the Liberals as they flew Energy Minister Angus Taylor and Liberal fundraiser, Ryan Arrold around the NT site (Guardian 20/8/21). 

The Betaloo Basin is in the centre of the Northern Territory, and the grant application was the subject of Court proceedings brought by the Environmental Centre (NT) and the Environmental Defenders Office.  It seems that undertakings were given not to give the grants, but they went ahead despite the assurances given to the Court.  The Australian Government Solicitor (AGS) said somewhat lamely that they can only do what their clients say.  The Resources Minister, Keith Pitt was criticised by the Federal Court judge, Justice John Griffiths, but it seems that this will make no difference either to the outcome or to the Minister’s career.  Presumably the idea that he would be charged with contempt of court is fantasy.

We seem to have reached the point of a third world country where the Government gives whatever it likes to its mates and due process is a distant memory.

Labor might be marginally better, but the benchmark has now been set very low.  Companies are becoming accustomed to governments bending to their will and will be reluctant to leave the ‘new norm’.  The only answer is a Swiss-style democracy with referenda as the main source of power and citizens able to overturn government decisions.  We need proportional representation and an end to the two-party duopoly so that all decisions are made on the floor of the parliament, not in back-room deals.  This will take a change to the Constitution, but this well overdue in any case, and we might as well do a thorough job of it.  The Swiss also have provisions to change their constitution without a fuss.

www.theguardian.com/australia-news/2021/sep/14/no-satisfactory-explanation-court-blasts-keith-pitt-over-grant-agreement-with-gas-company?fbclid=IwAR3v_4oGwTWFkiQ2xYp_l9Mjw2alDLARFN_St8hwoDbEp_MRup44fFbfXaU

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What Has Gone Wrong in Australia?

8 September 2021

John Quiggin gives a good, insightful summary in The Monthly.

www.themonthly.com.au/issue/2021/september/1630418400/john-quiggin/dismembering-government?utm_medium=email&utm_campaign=The Monthly Today – Wednesday 8 September 2021&utm_content=The Monthly Today – Wednesday 8 September 2021+CID_77319af0620e0ea97965a0e5af6e7e60&utm_source=EDM&utm_term=The Monthly#mtr

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Please Sign the Petition to stop the COVID Lockdown Ending Prematurely

4 September 2021

The Governments, Federal and NSW State, seem hell bent on ending the COVID lockdown.

Morrison stuffed up the vaccine and Gladys stuffed up the lock-down.

Now Morrison is talking about ‘Freedom’ and ‘One Australia’ showing that patriotism is the last refuge of a scoundrel.  Gladys is talking about the need for more deaths as if it is an inevitable consequence of the Delta strain and that nothing can be done to mitigate the situation . She is talking about bed numbers and trying to conjure ICU nurses out of thin air.  The fact that the State public hospital system is always at full capacity with beds in corridors in ED is well known to any health professional who has any dealings with the system and is about to bite us big time.

So what should be done?  The lockdown can only buy time to improve the vaccine rollout, but this is still very much worth doing.  Figures from NSW that I posted last week suggested that vaccination reduced the chance of being in ICU by about 97%. Vaccinated people can still get and transmit COVID as it seems that the antibodies are not in secretions, so it is not until the virus invades that the body starts to fight it.  But as the disease is milder, vaccinated people will cough less, spread  the virus for less time and be less sick themselves.

NSW has given about 7.2 million doses to a population of 8.2 million people.  For everyone in NSW to have 2 doses it would take about 16 million doses.  If we assume that about 4% of people are anti-vaxxers and want to take their chances, and 16% are children under 12 for whom the vaccines are not approved,  then 80% of the total population should be vaccinated, which will take about 13 million doses.  At the current rate of a million doses a week, that should take about 6 weeks from now.

The government already has a huge debt and will avoid a lot of future costs by prevention rather than ‘cure’.  A support package for those who cannot work is naturally needed also. There was a full page ad in the SMH last week with a number of businesses urging the Government to stick to the opening up timetable of the Doherty Report.  Given that the Doherty Report recommendations were based on a far lower number of cases and it was assumed that what cases there were could be traced and were not Delta variants, the report needs to be reconsidered. Perhaps because it is from a reputable research organisation and that it is a long read it has not been seriously challenged, The Government has used it to try to justify the early opening.

One of the disappointing things in my life has been the revelation that some people really do not care a fig about anyone as long as they are personally OK.  I was initially shocked to find that the Tobacco industry really did not care how many people died as long as they could make money.  I found that the asbestos industry was the same, and then that most businesses skimp on safety on the principle that ‘we take the money, you take the risk’  There has also been the worrying trend, which I still link to Harvard management theory  in the 1980s that managers can manage anything, and just need to buy any expertise that they do not have.  Often that do not even know what they do not know, so they neglect to ask, do not know who or what to ask, or find the advice inconvenient.    And sometimes they put ads in the paper.

We also cannot assume that those in Government know or care or that their primary concern will be for the welfare of their constituents.  Presumably their unlikely re-election is what they are focused on.

So please sign the petition to stop the early opening- it currently all we can do.

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Corruption at Many Levels- the ripping off of Meat workers

1 September 2021

An article in the SMH on 31/8/21 said that there was a lot of bribery and corruption in the recruitment of Chinese to work in Australian abattoirs.

Abattoir work is physically hard and unpleasant, so rather than pay Australians more to do it, workers are recruited from overseas, like fruit pickers.  The government, perhaps because of political donations is happy to make special 457 visas for this, rather than insist that the jobs go to Australian residents. This is the case for both Liberal and Labor. (Marx said that people were more loyal to their class than to their country, but we won’t mention this now).

So the recruitment process has been corrupted as some foreign people will pay a lot to get into Australia and after working here for 2 years on totally exploited wages they hope to get a residency visa.  Recruitment agents may take whatever money they can get, and whatever other little sweeteners.  Fake CVs were used to claim that Chinese had good English skills and had worked in abattoirs, which is presumably unlikely as Chinese abattoir workers would not have the money to pay the recruiters.  This farce came to light naturally from a whistle-blower who was in on the deal rather than any regulatory agency, the Home Affairs Dept or the Meat Industry National Training Council (MINTRAC).  The Union was not mentioned in the story. 

Migration agents are a poorly controlled profession at the best of times, with many dodgy operators exploiting desperate people.

Australia should spread its wealth by paying people to do jobs like abattoirs and fruit picking, and if these products are more expensive in consequence, we need encouragement to Buy Australian produce. Of course ‘free trade’ treaties favour cheap imports, but if we are going to have the social harmony that comes from a reasonably equitable society, we have to spread the nation’s wealth.  Cheap meat should not just lead to a conga line of corruption and exploitation as a by-product.

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Irresponsible COVID Policies will Destroy the Federal and NSW Liberals

29 August 2021

Ok. I am making a prediction.  The totally irresponsible Liberal COVID policies will destroy both the Morrison government and the NSW Liberals.

Why?  The strategy of unlocking with only 70% of over 16 adults vaccinated is totally irresponsible.  It is true that less children will get a bad infection and die, but some will- perhaps 1 in 100,000.  But if a few million children go back to school, that is still a significant number.  The unvaccinated children will also get infected and go home to their families and infect them. Every parent who has had kids start at day-care knows how many more colds they got that year. 

As far as the adults are concerned, if there are still 30% of them unvaccinated, that is a huge number to make an epidemic.  The hospitals always manage with very slim margins of capacity.  How many beds are in corridors and how many trolleys in ED normally? Quite a few. Now they are stopping non-urgent surgery, but these cases are not trivial, and cancer patients may well die of their delays.

But they key point is that the hospital system will be overwhelmed by cases and that those cases  would not be necessary if the government held its nerve and  continued the lockdown until all those who wanted the vaccine had it- upwards of 95% perhaps.  If NSW is vaccinating a million people a week and has 8 million people needing 2 doses each, that is 16 weeks, less the fact that almost half the adult doses has been given.  12 weeks might be a realistic estimate, better if the vaccine can be hurried further.  As far as the children are concerned, I recall in the 1950s when polio vaccine came- we were simply lined up in the school corridor at lunch time and everyone was done.

The cost of vaccination compared to the cost of hospitalisations does not bear thinking about. It is also probably that the cost of the hospitalisations and time lost will exceed the cost of a decent home support system- but Morrison will not even consider this, still talking about tax cuts before the election, as the national debt balloons to record levels.  Do the rich really need this?

Morrison also wants to force states that have almost no COVID to open up. Qld and WA, having isolated themselves, controlled COVID and given themselves quite a remarkably normal quality of life do not want to be forced to open to NSW and Victoria, where COVID is frankly out of control.  Morrison needs Qld seats to get re-elected.  If he forces Qld to open and the pandemic spreads there as it will, his chances of re-election is nil.

Gladys Berejeklian is now talking about vaccinations, trying to distract attention from the number of cases and is systematically getting us used to the idea that since we now can never get to zero cases, we have to open up, and might as well do it now as later.  This is not true, if now we are not vaccinated, and later we will be.  She is blamed for the Delta virus escape as she did not mandate vaccination for limo drivers who ferried people from the airport to the quarantine hotels and then was slow to lock down Bondi when the infection escaped in June. So now to say it is all inevitable and unlock with what amounts to a very low vaccination rate is likely to lead to very big epidemic, the health system being overwhelmed, a lot of unnecessary deaths and yes, Gladys losing the election.

And Gladys does not like Morrison either, so she had better throw him under a bus before he does it to her.

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COVID Vaccine Works!

29 August 2021

An anti-vaxxer who keeps posting on my Facebook page also keeps demanding proof that the vaccine does more harm than good.  I told her to do her own research as it is really too obvious.

I looked at the figures for NSW today and they made the point very clearly.  There are 126 people in ICU of whom 13 have had one dose of vaccine and 1 has had 2 doses. The percentage of NSW people over 16yo unvaccinated are 37.3%, one vaccination jab 29% and two vaccinations 33.8%.

If vaccine did not work, the percentage of people in ICU would be the same in all 3 groups. This would mean unvaccinated would be 47 (37.2% of 126), one vaccine jab 37 (29% of 126) and two vaccine jabs 43 (33.8% of 126).  But the numbers are: unvaccinated 113, one jab 12, two jabs 1.

So those with 2 jabs have only I person in ICU instead of 43, and those with one jab have 12 instead of 37.  So the chance of being in ICU has been reduced by 42/43 (97.7%) with 2 jabs, and 25/37 (67.6%) with one jab.  This is just a one day sample (yesterday in NSW), but the results are very significant. The data is from NSW Health via Juliette O’Brien’s website.

And the chance of dying due to vaccine is about 1 in a million.

www.covid19data.com.au/hospitalisations-icu

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