23 March 2021
Prof John Dwyer has some relatively good news.
23 March 2021
Prof John Dwyer has some relatively good news.
21 February 2021
There are two quarantine stories extant, one short-term, one long-term:
The Sun Herald front page story is ‘State Debt Collectors eye hotel millions’. It is about how 5264 invoices covering 7214 travellers who stayed at quarantine hotels have not paid and thus have to be chased for the money. The fact that they had to stay at these very expensive hotels for 2 weeks to be allowed to come home seems irrelevant. The fact that they may have had to stay in hotels for 9 months overseas in lockdown situations, had to come home on very expensive flights and may have no money and no job is also not mentioned. What might have been thought of as repatriating citizens caught in a situation that was not of their making is now a routine debt like a speeding fine, to be chased by the NSW government’s privately contracted debt collectors.
Meanwhile down in Victoria in today’s Age there is talk of building a quarantine hotel at Avalon Airport. Avalon airport was ex-RAAF and is about 3 hours from Melbourne (as I discovered to my cost when taking a Jetstar fight to Melbourne without looking where it landed). It is now owned by Linfox Transport group, and the Wagner Corporation of Townsville was keen to build the quarantine facility. When asked by an interviewer what accommodation would cost, Mr Wagner replied that this was ‘commercial in confidence’. There was none of this nonsense about giving arriving travellers a ‘fair go’; presumably such assurances are not necessary to get the contracts these days.
The colonial-era Manly Quarantine Station, which was saved from developers some years ago and remains in the dangerous situation of being a historic site in NSW used to have 3 levels of accommodation, for the rich, middle class and poor. At least the financial reality was recognised then.
Presumably backpackers who needed to come home would be happy to stay in backpacker accommodation, whereas some business folk really cannot manage less than the Ritz. But the government ought to make provision for Australians who want to come home and returning travellers needing to be quarantined should have the right to return without having to pay whatever a privatised accommodation facility chooses to charge them, without the government’s contribution being to unleash the debt collectors.
Teflon Morrison has largely shifted the blame for the COVID deaths onto others, and has gained in popularity from the crisis. Here Elizabeth Minter looks a bit deeper.
The COVID vaccines were an international race. Many countries and companies competed. The Uni of Queensland one fell over because it made the AIDS test a false positive. There are now 5 principal ones in the media; Pfizer from Germany, Astra-Zeneca/Oxford from the UK, Moderna from the USA, Sputnik 5 from Russia, and Sinovac from China. Over here we ignore the two from Russia and China, for some reason. Do we not trust them, are we just racist, or do we want to support Big Pharma in ‘The West’?
I recently met with some medical sceptics, who said that there is no public proof that the vaccine works, i.e. published papers. I said that it was in the media that there had been a 43,000 person trial with not very many side effects. They conceded that this was correct, but pointed out that you could inject water into 43,000 people with few side effects, and that it was a question of how many of the 43,000 had been exposed to the virus, compared to a group of 43,000 in the same environment who had not been vaccinated. And you could not ask a volunteer who had just had the vaccine to cuddle up to a COVID case- that would be foolhardy. Their key point was that all the data was still in the drug companies’ hands and not publicly available. Presumably the regulatory authorities have it, and hopefully they are still being rigorous under the pressure. We have to assume the vaccines work as we need to open up the world economy.
Our government promised a fortune to these companies before they even had a product to sell, and all the bluster about having an equal world in terms of vaccine access does not seem to have dollars attached. At present there is not enough vaccine to go around, but it still matters where you start. Logically, vaccinating Australians where there is very little infection would likely save fewer lives than vaccinating people where the virus is rampant.
I have told the story before about Jonas Salk, who developed the polio vaccine with public funds and did not patent it so that the maximum amount of vaccine could be distributed to rid the world of polio. This was in sharp contrast to Glaxo, the drug company, which found that an old unpatented drug worked against AIDS, patented it and then insisted that the price of it be at least $US2 a day, although an Indian company said that they could produce it for 7 cents. The result was several million extra AIDS cases in Africa.
Sadly the Human Papilloma Virus (HPV) vaccine, Gardasil was a similar story. HPV was found to be the cause of cervical cancer. The vaccine was developed at Uni of Queensland by Prof Ian Frazer, and then marketed by CSL and Merck. Its roll out was considerably delayed by its cost, despite the fact that the Uni of Qld declined to insist on royalties from sales in developing countries. It is still $73 a shot in Australia (2 needed, 3 recommended), though our government makes it free to Australian schoolchildren.
This article says that the Coronavirus vaccines will worsen inequalities. This is true, because not only will poorer countries not be able to afford the vaccine, they will also have more people die and have higher health costs as they will have to treat the cases. It will also have a bigger impact on their economies. The fine rhetoric about sharing world knowledge will certainly be tested. It might be noted that the Chinese released the draft genome of the Coronavirus to the world in January 2020 (Sciencemag.org) in the interest of stopping the outbreak, which was a credit to China and gives credence to their vaccine. On the other hand, I seem to recall that Pfizer declined to be involved in information sharing, but have been unable to find the reference for this.
Pfizer did not get public funding but their development partner, BioNTech, did. The question is how much profit will there be in all this, and how much will the price stop poorer countries getting the vaccine.
The fact that governments no longer fund the research directly and go into ‘private-public partnerships’ gives rise to the feeling that governments put in the funds but the private partners both determine the priorities in research with a bias towards research that can make a profit and then make that profit. The governments then either largely fund the profit, or leave their populations unable to benefit from the research that they as taxpayers funded.
I have two relevant articles on this, one below, and one coming shortly.
We hear a lot about 3 COVID vaccines; the Pfizer one being rolled out in the UK last week and in the US from tomorrow, the Oxford Astra-Zeneca one that is imminent, cheaper and has less problems with refrigeration, and the Moderna one, which is US based and does not yet seem to have a launch date.
There are two other vaccines in the news, the Russian Sputnik V one being rolled out there and in Eastern Europe, and the Chinese Sinopharm one that is going into Indonesia, India and elsewhere. But it seems that no one is considering bringing these two into the Western world. We might ask, ‘Why not?’
Is it racist? Do we think their scientists are no good and would fake the results? Are we simply in the thrall of Western pharmaceutical companies with captive regulators? Perish the thought, would their vaccines be cheaper? China has 1.3 billion people to protect and have goes to a lot of trouble to do so. They had scientists working with the US until the fuss started. They had a head start in the vaccine race. If the vaccine did not work they would have wasted a lot of time and effort vaccinating their own country and would suffer a huge loss of face. It seems unlikely that their vaccine does not work. So again, why no evaluation here? If Australia asked the Chinese to give us the data on their vaccine to evaluate it for licence here, it would be a nice peace gesture in the needless spat that was created when Morrison accused the Chinese of hiding the origins of the COVID epidemic.
It seems that some scientists in Britain and Russia have suggested cooperation between the Oxford and the Russian Sputnik V vaccine. This story is from RT- Russia Today. Will this actually happen?
People are asking me if they should get vaccinated. It shows how trust in our institutions has been eroded. A few years ago no one would have questioned it.
The side effects are far less than the death rates from COVID, particularly in older age groups or those with other health conditions. COVID also seems to have a considerable amount of long-term after-effects in a significant percentage of people; note the difference between the infection rate and the recovered rate in the statistics. (Of course some may have just been lost to follow-up).
Children seem to have few symptoms, but if they are not infected and grow older without immunity, it would be ironic if they are then badly affected later. Mumps is like that- relatively trivial in youth, but can cause pancreatitis, encephalitis and sterility later. Years ago in the pre-vaccination days, if a child had chicken pox or measles, the mothers would all bring their children to be deliberately infected at a ‘Pox Party’, though these are now discouraged. This sort of immunity may well be spreading and giving herd immunity in countries that have COVID now endemic, but it would be unwise to do it here as it would spread it to more vulnerable demographics.
Chicken pox can cause herpes zoster (shingles) in older folk, which is very painful, and now has a vaccine (Zostavax) that is very expensive but free after age 70.
This article is about the Oxford-Astrazeneca vaccine, which is not the Pfizer one that is currently being rolled out in the UK. It seems that the Oxford one is the first to publish the results of a Phase 3 trial, and though a lot of people have been vaccinated, not many people have been infected, which means that the numbers on which the conclusions are drawn are still not large. There is an embedded link in the article that gives a good summary of the trial procedures. It seems that the Oxford vaccine will have the advantages that it is easier to store, and transport and is cheaper. Presumably as this article is now published, its roll out is imminent also.
From an Australian perspective, there is now a huge rollout of the Pfizer vaccine in the UK, so we will know exactly how well it works by the time it gets here.
It is sad that the Qld Uni vaccine has been abandoned as it gives a false positive for the HIV/Aids Antibody test. Presumably it would have worked, and perhaps an alternative HIV/Aids test might have distinguished the two apart.
Here is an article about the US Health system and its response to COVID. Basically it seems that the US government is subsidising COVID treatments so that they are more lucrative than treatment of other diseases, so the private operators are filling their hospitals with COVID patients whether they need to be admitted or not, and non-COVID patients are excluded.
The other thing that is interesting is that there has been a huge growth in administrators since the 1970s. It has to be understood why private health systems are so inefficient. They have to keep individual insurance databases to keep track of premiums and churn as people change funds. When someone is treated they have to account for every band aid, visit, procedure or investigation, bill the patient and pay the practitioner. They have to market their product, compete for staff, and then figure out ways to avoid paying if possible.
Universal systems have everyone eligible, so do not need to worry about who is getting treated. No need to market the system, maintain many different churning databases, compete for doctors, keep accounts for every details of every treatment and bill and pay for them individually.
In terms of better health care there is no problem of adapting to whatever disease needs the most attention as the staff are motivated to do the most effective treatments, and there is no distortion of priorities to maximise profits.
The US health system is the least effective in the developed world in terms of delivering health care. but it is the most effective at its primary object- turning sickness into money.
No one has looked too closely at why the Australian system has been able to respond. Basically our public health system is State-based hospitals, which are still largely public and have doctors who could be re-directed to testing and vaccination. They can also change to do COVID if needed, and treat disease on their merit.
The private hospitals did very well out of the government subsidies here because they were emptied ready for a COVID influx that never came and they just pocketed the cash without much publicity for this from either themselves or the Government.
Australia has continued on its previous course, which is to starve Medicare and help the private system move towards a US system by stealth, and the COVID pandemic has so far not brought this to light. What is left of the public system has done well, helped by the fact that we are an island nation, so had some warning and could act to quarantine ourselves. The government was happy to take advice from the medical professionals because it had made such a mess of not taking advice from the firefighting professionals. But Medicare is still being quietly destroyed and we are moving to a US system of private medicine.
The government saves money on Medicare doing this, even though the system is much less efficient and much less equitable. But the key reason is not the savings on Medicare, it is the money to the Party coffers from the Private Health Industry (PHI), which is now much stronger with the changes John Howard did to the Aged Care system in 1997, which made it effectively a for-profit system, and the NDIS also a for-profit system, subsidised by the taxpayer through the Medicare levee, which was ironically not being used for health. (The discussion of the Aged Care system was in one of my posts last week).
The key thing to understand in the destruction of Medicare is that the rebate to doctors which was set at 85% of the AMA fee, so as to replace private medicine, has risen at half the inflation rate for 35 years and is now 46% of the AMA rate. Doctors are paid half what they were, so specialists mostly will not use it, and GPs who still bulk bill just do shorter visits.
Here is the article on the US response to COVID. Their prevention is also hopeless, as with such a poor welfare system the people cannot afford to stop work, and the story that it was a hoax was also promoted by President Trump. The obsession with ‘individual rights’ sits uneasily with the idea of staying home for the common good, and makes disinformation campaigns easier. People wanted to believe it was a hoax, because they could not afford to stop work anyway.
Doctors tend to assume that everyone knows certain things, particularly because everyone they meet usually does. They also tend to think that everyone knows the order of importance of what they know.
Many years ago as I started to campaign against tobacco, Henry Mayer, the first Professor of Political Economy in Sydney, who had a regular column in the SMH told me that the health people were invisible in the media on the tobacco issue. I said that this was ridiculous, it was the most studied subject in the history of medicine, with over 60,000 papers and growing daily. He pointed to a person called Tollison, who wrote in the non-medical media that was read by the business sector. There were no medical responses there. The mainstream also media had relatively little on tobacco, as tobacco advertising was one of the major sources of revenue.
So the harm of tobacco was known, but ignored, like the fact that you are going to die one day.
It came home to me, when I amputated the leg of a smoker for vascular disease. He had bad lungs and a bad heart. I said, ‘Look mate, if you keep smoking, you will lose the other leg.’
To my amazement he replied, ‘Look, all you doctors go on about smoking, but if it was as bad as you say it is, the government would do something about it’.
He had internalised the government’s non-action as being mute testimony to it not being a problem. Doctors are, after all a subculture that claims to have expertise in a certain area, as do engineers, educators, weather forecasters and many other groups. In tobacco, the Tobacco Industry, the Australian Hotels Association, Clubs and Pubs and the advertisers and sponsorship recipients fought like tigers to stop reasonable public health policy. They are probably still retarding it- there has not been a Quit campaign in Australia for over a decade.
Trump’s denial of the significance of COVID19 must have struck a chord with those who knew that in the absence of decent welfare system a lockdown would send them broke. They needed to believe that they could carry on, and he and his denial were their salvation. A lot of business interests supported them- they would go broke too.
So it was interesting that the health facts became politicised, and wearing a mask was as much a political statement as a medical one. Politics was not, and will not be in future a good basis for personal preventive heath decisions. So controlling the COVID epidemic in the US will be harder than here, where mainly apathy and complacency are in the way.
The figures that only 4% of people in the US changed their view on the dangers of COVID goes some way to explaining why Biden did not have a landslide. For many people, COVID was not an issue, Trump’s rhetoric was plausible if you did not fact-check, and the economy had been going OK prior to the epidemic.
Virus neglect didn’t infect Trump vote
Since the first person was diagnosed with COVID-19 in the US, more than 10 million cases have been confirmed and nearly a quarter of a million people with the virus have died.
Watching from afar, in a country where the coronavirus has been significantly less lethal, it is surprising the incumbent president did as well as he did.
While the pandemic probably did cost him votes, surveys we have run over the course of the year showed there are strong partisan effects on attitudes towards COVID-19, with supporters of Donald Trump mostly unconcerned about the risks from the virus, and getting less worried as the year went on.
These surveys were run in May and September. Both surveys consisted of responses from more than 1000 Americans.
In May, approximately 40 per cent of all Americans were very or extremely worried about the possibility they or a family member might catch the virus. Almost the exact same number were only a little or not at all worried. According to our data, this level of concern actually declined slightly between May and September.
This was largely a partisan affair. Respondents who said they were going to vote for Joe Biden retained a similar level of concern during this period, with 48 per cent very or extremely worried in May, and 50 per cent in September.
However, respondents who said they would vote for Trump were not very concerned about COVID-19 in May – about 19 per cent reported they were worried about it in the first survey and just 11 per cent of Trump voters reported this level of concern in the second survey.
The partisan differences, and the declining trend in Republican concern about COVID-19, are largely the product of the extremely polarised media and political environment in the US.
Trump voters are less trusting of information on COVID-19 from medical experts than Biden supporters, and between May and September a quarter of Republican voters became less likely to trust information from these experts.
This difference may, in part, stem from the media through which they obtain information. Those with the lowest levels of trust tended to rely upon more conservative cable and online news like Breitbart and Fox News, for instance, which have played down the risk posed by the pandemic.
Republicans who rely more on these conservative media outlets were more likely to have lower levels of trust in medical experts, even after controlling for demographic differences between Democrats and Republicans. They were also as likely to trust Donald Trump as medical experts for information on the coronavirus.
In this polarised environment, very few voters abandoned Trump between May and September (only about 4 per cent in our data), and hardly any shifted to support Biden.
Trump supporters tended to align their position on the coronavirus with their political allegiance. Relying more on media that downplayed the significance of the coronavirus, and taking cues from Republican leaders, they decided the pandemic was not a significant threat.
Our data indicates Biden was able to win over a small number of voters who supported neither candidate at the start of the year. It was enough to win in the end, but not enough to deliver the predicted landslide.
Shaun Ratcliff is a lecturer in political science at the United States Study Centre, University of Sydney.
Europe is trying to get out of lockdown, but did not have the COVID19 epidemic under control, so the numbers are rising quite steeply, and look likely to be more than the first wave. I tried to put some graphs together, but it has proved beyond my computer management competence, so I can only refer readers to the Worldometers COVID home page and ask you to click on the individual countries and scroll down to the ‘New Infections’ graph if you want to check what I am saying.
The UK, Ireland, France, Belgium, the Netherlands, Portugal, Poland, Czechia, Austria, Denmark are all rising. Spain was following the same pattern, but has just started a new lockdown. Germany is ticking up, somewhat more modified, as is Norway. Sweden continues to have cases, but there is some doubt now about how they collect their figures.
The lesson for Australia is clear. We have to be conservative and go for elimination. Suppression will not work. There is danger that NSW has people no longer getting tested, presumably because admitting that an infection is possible means you have to self-quarantine for 2 weeks and have a nasty thing stuck up your nose, when you might just have a cold.
Daniel Andrews has taken the flak, but implemented a policy that has probably saved Australia. No thanks to Morrison, whose advice has been frankly mischievous.
Stephen Duckett, one of the architects of Medicare, tells it like it is.
Prime Minister Scott Morrison was smugly distancing Australia from the riots in the USA over the George Floyd public murder, but voices were quick to point out that there had been 432 deaths in custody in Australia since 1991, despite Royal Commissions and their findings, which were not implemented.
The demonstration was planned as everyone here knows the COVID19 lockdown is gradually being eased as there are now few community-acquired cases in Australia.
But the Police applied to the Supreme Court and got them to declare the rally and march illegal under the COVID19 restrictions. I had been going to miss the march on health grounds, but the Police rather than the public health authorities wanting it declared illegal made me want to attend.
As I have written before, Police intolerance of any sort of dissent was clearly brought home to me when I wore a sign that said, ‘Respect the Dead by working for Peace’ at the ANZAC service in Hyde Park in 2019, where the police sergeant said that he would arrest me if I did not move 50 metres away.
John Howard initiated the needless Australian invasion of the Middle East against the wishes of 74% of the population who marched in 2004. The creation of a terror threat due to that folly, the handling of that threat by increasing surveillance, decreasing civil liberties and increasing Police power without supervision is a trend of our time. The other trend, the increase in social inequality has put pressure on Police, as the enforcers of the norms of a social system that excludes an increasing percentage of the population.
But the Police inability to handle mental illness or drunkenness and conflict has not been sufficient. There are too many deaths in custody, which principally affect Aboriginal people and too many Police shootings, which principally affect the mentally ill.
So I was not willing to sit at home because the Police did not want a demonstration that asked that they be called to account and change their ways.
Interestingly some of my son’s friends who are overseas students did not dare to go lest their visas be cancelled.
The Supreme Court’s ban on the rally and march was overturned on appeal in the morning, but my opinion was that most people going to the 3pm event were unaware of this and, like myself had decided to go anyway.
The city had prepared for the event by stopping the trams from Circular Quay, (could they have run from Central to Randwick?), and by the trains not stopping at Town Hall. So we walked from Circular Quay and the demonstration went back almost the full length of the Queen Victoria building in George St. It later went back further than this. Protesters were socially distancing and about two thirds were wearing masks. People were walking among the protesters issuing masks and hand sanitiser, and soon more than 90% were wearing masks. There was a wide spread of ages and racial origins.
The protest speakers were on the Town Hall steps, but could not be heard at all for a fair percentage of the crowd as the PA system which is on the traffic lights was not in use by the speakers. After about half an hour, at about 3.30pm the speeches stopped, and everyone assumed that the March would start. It did not. It was not clear what was happening, whether the rally was allowed and the march not. There was quite a lot of chanting of ‘Black Lives Matter’ and also activist shouting, ‘Too Many Coppers’ with the reply ‘Not enough Justice’.
There were Police amongst the protesters. They did not look comfortable, and I noted Glock pistols in their holsters. Glock pistols have no safety catches, so the only thing stopping them or someone else grabbing them was the flap and press stud on the top of the holsters.
We kept thinking that we were about to march, as we went forward in little bursts. But looking a long way ahead we could see that the placards were not moving. All that was happening was that the social distancing was being taken up. This and the chanting would have increased the infection danger somewhat, so one could only wonder at the reason for the delay. The rally and march had been scheduled from 3pm to 5pm with a break at 4.32pm when we were all to kneel for 1 minute to remember the 432 people who had died.
The March started a bit before 4pm and wound to Belmore Park near Central station with the stop and kneeling at 4.32pm an impressive moment. Belmore Park was totally packed, with social distancing quite undermined, so we took a photo and left. Apparently there were some minor scuffles between Police and people who stayed after 5pm.
It was interesting that the public, who have been very compliant and responsible throughout the COVID19 epidemic, were willing to defy the Supreme Court ban on the rally and march. The large Police presence suggested that they were willing to suppress the event, but there were a very large number of protesters, 17,000 seems a reasonable estimate. I do not think that the crowd would have tolerated not having the rally and not marching, so it might have escalated with lines of Police, riot shields, water cannon and tear gas. Fortunately sense prevailed.
It was a victory for the people in the sense that they stated in large numbers their attitude to Black Deaths in custody, and the limits to which they are willing to tolerate the Police, the government and the Supreme Court telling them what they may and may not do. The relatively poor uptake of the COVID19 tracking app is a similar indicator of the trust of government. No, we do not want COVID19, but we do not trust the government either.
As I get older, I trust people more and government and institutions less, and work for the power to go to those who legitimately own it, the people. This was a good day. Hopefully no COVID19 cases will result.