… Should we really learn to live with Covid?
That’s the headline and standfirst for my latest piece in Inside Story. It’s an expansion of my previous response to the kind of whataboutery offered by Gladys Berejklian, saying ““outside of a pandemic, we lose between 600 and 800 people every year to the flu.”
Read there, comment here.
John Quiggin 
Cannot agree more, also hate it when people use the straw-man argument that we can’t live forever and that you have to die from something
JQ said “Plenty of people will no doubt argue that this is all too burdensome”…
Not me.
Catherine Bennett says in this short paper. …
“Learning to live with COVID-19 in Australia: time for a new approach
Catherine M Bennett
Published 8 September 2021.
https://doi.org/10.17061/phrp3132110
Abstract
“The emergence of the Delta variant of SARS-CoV-2 has made Australia’s ‘COVID-zero’ strategy unviable. As signalled by the Australian Government’s National plan to transition Australia’s national COVID-19 response, we need to plan a pathway forward for life beyond lockdown. However, this plan must be guided by long overdue discussions on our tolerance for serious illness, and hospital and intensive care unit capacity. The modelling that informs the national transition plan remains relevant, even with increases in case numbers, but one crucial thing that does change if cases continue to escalate is the effectiveness of test, trace and isolate models. As we move into suppression mode with higher rates of the population fully vaccinated, we will no longer need to find every case. This is among the many shifts in approach that will shape our transition by early 2022 to living with – and controlling – the disease.”
https://www.phrp.com.au/issues/september-2021-volume-31-issue-3/learning-to-live-with-covid-19/
When Gladys Berejklian reportedly says “outside of a pandemic, we lose outside of a pandemic, we lose between 600 and 800 people every year to the flu. to the flu.“, is she saying that is an acceptable number?
If so, would that mean Gladys would accept losing between 600 and 800 people every year to COVID? If not, what number would she deem acceptable?
I think it’s time she elaborates to NSW residents what she (and the government she currently leads) thinks it would mean exactly to “live with COVID”, before we are all committed to it.
A video reminder from the Road Safety Commission titled Closer to home 60sec may outline what could be at stake:
As they say in philosophy, one’s modus ponens is another’s modus tollens
Ha! Good one.
The Premier of NSW is trying very hard to distract the media from her own failings. Using the deaths from flu is a desperate distraction from her inability to act decisively at the very beginning of June 2021. It also is an outcome affected by the past indecision that surrounded the Ruby Princess debacle. There too no one took the blame or lost their job. Having tolerated such gross incompetence back in March of 2020, there was no expectation of anything different out of the halls of power in Macquarie Street in 2021. For anyone who has forgotten that past dark episode, on March 19th, 2020 at least 2700 passengers from a cruise ship docked in Sydney Harbor were allowed to disembark before COVID test results were returned to NSW Health officials. This one act of incompetence resulted in 28 deaths and outbreaks of COVID19 in three states.The inquiry set up by the Premier of NSW came back with the finding that, and I quote:
“The failure to await test results on 19 March is a large factor in the commission’s findings as to the mistakes and misjudgements that caused the scattering of infected passengers.”
The commission particularly picked out NSW health officials who it found had made “inexcusable” and
“inexplicable” mistakes.
What was the response of the NSW Premier to such conclusive findings?
Four months later this article below appeared in the Australian Financial Review.
“Whenever governments make mistakes, none more so that cost lives, the public demands accountability, usually in the form of heads. Berejiklian refused to give them one.”
Aaron Patrick
Aaron Patrick
Senior correspondent AFR
Aug 17, 2020 – 2.37pm
Its telling passages are given below:
“Gladys Berejiklian, the NSW Premier, is really sorry. So too Kerry Chant, the NSW chief health officer. And Health Minister Brad Hazzard as well.
Despite the apologies, no one will lose their job or be publicly chastised for one of the most visible failures of the COVID-19 response”
This was when the Premier of NSW locked in incompetence into future management actions by NSW Health and set the bar high for public sector accountability.
No one should be surprised that less than a year later this all came back to haunt Sydney residents. Now in their fourth month of lock down, the residents of Sydney are expected to dig themselves out of the latest COVID19 outbreak.
I think Gladys is correct. We do need to live with the virus. This was the “Covid-sceptic” view a year ago which I rejected but now but things have now changed because of the possibility of vaccination. The costs and likelihood of being infected has fallen and the costs of endless lockdowns now loom large. Indeed the latter can no longer be expected to be as effective as there is widespread rejection of lockdown conditions – I see it in Melbourne – adherence to restrictions is largely a sham. The damage to psychological wellbeing and the costs of destroying business enterprise are now larger relative to the costs of the disease. Despite what some on the left say it is necessary to produce – the “no production” option with government filling the gap on the national credit card is not indefinitely sustainable. Moreover, we don’t want the state running our lives – freedom from government and bureaucratic management is important. Yes, we could adopt the Chinese model but who wants that.
Of course. we can continue with mask wearing, most social distancing and hand washing. That’s a better question to consider and spell out – how exactly might we all operate post lockdowns – rather than attributing putting motives of false logic to Gladys’ attempts to sell a new way of looking at things.
It is a goof summary and into the investigation that could follow in subsequent instalments of a cultural analysis of what drives idiocies like ‘presenteeism’, a mindset tending to descriptive of individuals within an Orwellianist mind set situation.
It is true that we could contemplate the psychotic wonders of microchips in vaccines perpetrated by those modern Big Brothers, Gates and Soros, but it would intrude on drinking times, vodka o’clock already!!?
We would need go no further as to investigations into the cultural backgrounding s of vaccine procurement foul ups, rorts and certain accompanying mischiefs, a deeper history of human processes and progress involving nature from an objective distance which can obviate narcissi8sm. homocentricity, lack of reflexivity and other negative traits clouding clarity of vision.
Certainly we would be not required to further consider the lives of billions living in Third World hovels, of course. Consider rather the responses of people like The NSW Premier and the PM even to local suffering.
Folk like Chris Kenny and Alan Tudge have (anxiously) reassured us, “nothing to see here” and pointed, “look over there, a bright shiny thing, Dictator Dan etc”) instead, as if they sought to divert us.
We now no longer need to worry about wholesale looting, environmental golden goose despoilage, callousness and indifference to suffering from the sort of folk mentioned by Quiggin, since it is all explained as nothing more than a commie plot by the neanderthals promulgating such “explanations”.
Thinking further, the writer finds it difficult recall a week thicker with nostrum pronouncement of the Tudge and Robert type, the inanities of Berejiklian and the zombie press and media and the covid vaccines nonsenses, all crowned by the Les Paterson crudity of the PM daring to mansplain violence to a woman’s conference.
I think Gladys and Scott are incorrect. We do NOT need to live with this virus. In fact, you do NOT live with this virus, you DIE from it. Given that we have permitted this virus to become endemic by a litany of unnecessary failures, which should stain Gladys’ and Scott’s political reputations for ever, it now means almost everyone who lives to a not so ripe old age, anymore, most likely WILL die from it, sooner or later.
Average life expectancy will most likely crater under the pressure of COVID-19. Or hasn’t anybody noticed how older people and people with medical preconditions STILL die regularly from COVID-19 even when double vaccinated? We have added this mortality (and morbidity) pressure to every other pressure. This will bite us in the ass big time.
Again, I ask, hasn’t anybody noticed that immune escape, vaccine escape, greater infectivity and potential greater dangers to younger people are being added to this virus’s repetoire on almost monthly basis by its ability to rapidly mutate? Hasn’t anybody noticed how high rates of reinfections, vaccine leak and long COVID are being found in the overseas data already?
The jabs are 12 gauge shotgun blasts at a massive, infuriated grizzly bear charging you at close range, Yes, the blasts might well stop the bear but would you absolutely trust them to stop grizzlies time after time, and even when you get old, decript and shakey? I sure as hell wouldn’t.
Yet, we blindly proceed on this re-opening madness. I keep saying it. I predict a public health disaster on a scale never seen by Australia before. And this disaster will run for years, if not decades. People are completely under-estimating this virus. It is like nothing we have ever seen before. It uses airbone transmission and the pulmonary access route but it is a very dangerous vascular disease which can hit any and every organ in the body. In less than two years, it has evolved to become the second most infectious disease known to science. It possesses the capability, as a coronavirus, to evolve to add the enteric route to its infection repertoire.
Even more profoundly, this virus is an example of punctuated equilibrium evolution. As a novel zoonotic disease it first entered and spread between humans in 2019. This means SARSCov2 and humans are right at the beginning of a deadly evolutionary process: an epidemiological front where this pathogen’s mutation and evolution is greatly accelerated compared to equilibria evolutionary periods. And an RNA virus of the coronavirus type is almost perfectly suited to take advantage of this situation.
But of course, neoliberal capitalsm knows better doesn’t it? It has already declared we don’t need an environment to run an economy. Now it has declared we don’t need people, more or less, unless they are perfect physial specimens and lucky enough to carry genes, mabe even mutations, that confer extra resistance to COVID-19. Of course, many people will survive COVID-19 in the long run. But it still may be fewer than people imagine. nd if you are over 60 the dice is already rolling for you. The disease burden, including long COVID-19 as well as deaths, will be immense and far more damaging to the economy than keeping pubs, clubs, bars, restaurants. sporting venues and tourist traps closed for while.
Given the inherent inadequacies eagerly demonstrated by various Govts and the range of nonsensical beliefs held by the electorate, it seems inevitable that we will have to learn to live with the bug.
We can only hope that the bug mutates itself into irrelevancy.
Yea, Ikon.
Exactly what Richard Dennis was saying in an article in the Grauniad:
https://www.theguardian.com/commentisfree/2021/sep/08/morrison-and-berejiklian-are-attempting-to-shift-the-blame-for-covid-on-to-us
btw, typo,, earlier comment.
“good” not “goof”.
Can I blame the keyboard layout?
I think Ikon said it well .This might be another Afghan war situation where in 10 years time everyone knows we did wrong ,no argument. If I had to bet either way I would bet on that .
Gladdys is finally starting to tell us what ‘live with it ‘ will really look like and no one likes it . Lots of surveillance .No vaccine mandate – but you wont be able to do anything without proof of vaccination. Distancing , tracing ,etc ,lockdowns likely – is the best case scenario for years ,who knows for how long. The AMA boss said ‘for the rest of our lives’. Who knows how bad the worst case scenario is – they wont say .Shame she didn’t tell us all this before they decided to give up on elimination and shoehorn us into ‘live with it’. How could this be better than no virus ? People in Perth and Tassie must think we are mad. We never had proper quarantine, now we have lockdown fatigue so its too late – they got their way .Hang on and good luck everyone.
The article makes a cogent point. We shouldn’t settle for less if we can conceive of a better way, and then if have the will, if we have the competence and if we have the money to implement it. Unfortunately that depends on quite a few ifs.
As for Gladys and her failures, as a Melburnian, I want to remind everyone that our Premier has enforced very long, harsh lockdowns, some aspects of which have no scientific basis, and Victoria has still recorded far more deaths than NSW. I think it’s too early to say whose strategy has been better. Although even comparing them is problematic because the success of a strategy depends on what its objectives are and whether they have been met.
The NSW Premier has taken dysfunction to a new (lower) level, the daily Covid briefings will now cease.
It seems fairly evident that the combination of twice failing to prioritise public health and corrupt actions by close associates are insoluble and will bring this govt down.
Kevin: – “…Victoria has still recorded far more deaths than NSW.”
I’d suggest that is because there hasn’t been any effective large-scale vaccine supply available for many Australians until about mid this year. Vaccinations have assisted in significantly reducing hospitalisation and death rates in the last few months:
https://www1.racgp.org.au/newsgp/clinical/covid-19-vaccines-work-but-their-efficacy-fades-st
If the Australian federal government had been anywhere near competent with establishing fit-for-purpose quarantine facilities early on (instead of continuing to abrogate their clear constitutional obligations, transferring it onto the states/territories with unfit-for-purpose hotels in high density population centres together with muddled infection control protocols) and sourcing adequate volumes of vaccines earlier (instead of failing to recognise the opportunities being offered by the likes of Pfizer), then I’d suggest Australia would not be in as big a mess.
I’d suggest Victoria would have had many more deaths if hard lockdowns had not been implemented. It seems to me you are apparently ungrateful for that, Kevin?
Geoff Miel, Your point was my point. The vaccines are effective at reducing the worst damages of this virus. That means that the cost/benefit case for lockdowns and for having our livers micro-managed by politicians and civil servants (an unambiguously hideous practice!) is now weaker than it was.
I think we are approaching the time where we can regain our freedoms and learn to live with this nasty virus. A few QALYs will be lost but the vast majority will be much better off.
It is urgent that the politicians and civil servants understand clearly that the emergency orders they dictated are a once off. We were good citizens and obeyed their instructions and listened to their horror stories – I did anyway. But enough is enough given the good performance of the vaccines.
Today Gladdys said something about how ‘ the reality of what living with Covid will look like ‘ could last 3 or 4 years . Kerry Chant even spoke of needing to keep in mind that there may be new variants which may complicate things – who would have thought !
I wonder what the $ cost of having 1 or 200 people in ICU for one year alone would be ,more than making a proper quarantine ? I don’t think we have had a leak from Howard Springs yet – the closest thing we have to a purpose built quarantine. Also I don’t think Vic has had a leak since our review of quarantine after the big lockdown last year .Then ,after the inquiry, they made hotel quarantine as good as it can be , proper PPE , proper training , negative air pressure etc. – Our outbreaks since then have been from interstate quarantine leaks.
There has never been 8 billion people living a plane flight away from each other .There are 300 viruses in animals that are known to be able to jump to humans that haven’t done so yet . There is a further 2 – 300,000 that might be able to .Factory farming plus wilderness squeezed and intruded upon mean Covid 19 may just be a mild preview . Gathering viruses may be the future of humanity . The effects could be many and varied, as big as the imagination is. We still need proper quarantine .
This all reminds me of how Conservative elites have dealt with climate change .Pretend to do something ,ignore it ,lie ,divert attention , delay ,play it down , then one day – wham ! Its too late ,its too hard ,see we told you so – live with it.
The pandemic has taught us many lessons. The most interesting one is that in the face of a serious viral threat it is possible to eliminate it, and enough of the population cooperated with lockdown to achieve zero cases a few times – even though quarantine failed and let it back in. The other lesson is that government no longer has the ability to either effectively plan responses to future threats – (this pandemic was predictable), or implement plans in a timely fashion. We are led by politicians and bureaucrats who have limited skills and experience to do anything (or learn) but great expertise in BS and passing the buck.
It’s possible we could face something worse in the future, so it’s important to figure out how to improve infection control and support for the vulnerable. Many livelihoods have been damaged by the lockdowns, but they will also be damaged by having to unnecessarily “live” with a virus that could have been eliminated.
A. “The vaccines are effective at reducing the worst damages of this virus.”
Not always and not for everyone.
B. Liver micro-management versus a few QALYs lost.
The “right” to a venue drink (people can still drink at home with home delivery) outweighs another person’s few extra QALYs or indeed a perosn’s own??? The fact that I even have to point out the inconsistency and poor ethics of this is kinda sad.
C. The “good” performance of the vaccine.
It ain’t that good and it deteriorates month on month. We are only a few mutations away from a serious disaster, vaccines or not. But people who don’t understand epidemiology, vaccine escape, immune escape, the serious dangers of vaccine leak and the power of punctuated equilibrium evolution by a novel zoonotic virus, simply don’t understand what’s going on. They completely underestimate the dangers. Also, people who don’t understand that eradication “dominated”, in the economic jargon, rampant spread as a policy with or without a vaccine, don’t even appear to understand economics.
We HAD to eradicate. We may still HAVE to eradicate and lock down almost totally internationally with purpose built quarantine stations to bring Australians and residents home. We may also need seious ring-fencing internally. This virus may well prove completely unmanageable otherwise.
If a mutation started killing on a sliding scale of 10% of infants to 90% of over 90s and was well nigh unstoppable by vaccine would people agree to lock-downs to eradication I wonder? I suspect they would be screaming for it. So where on the scale from current reality to that possibility do we radically change our approach? We may well have to decide that because things are going to get much worse. 80% double vaccination of over 16s and some 12s to 16s is going to prove totally inadequate. That is my prediction.
Just heard (hearsay?) Berejiklian “does an Afghanistan” and “cuts and runs”, as to 11 am pressers?
Typical LNP, create an unholy mess and then run off, leaving someone else to clean up the mess.
Westmead Institute for Medical Research Clinical Professor Graeme Stewart was talking with Ray Hadley on Radio 2GB yesterday (Sep 9) morning. Professor Stewart suggests:
The podcast (duration 21:18) is available at: https://www.2gb.com/dont-listen-to-the-shock-jock-immunologists-remarkable-vaccination-insights/
I applaud Hadley for having Professor Stewart on his radio show. I’d suggest Hadley needs to have similar informative on-air conversations with climate scientists, like ANU Professor Will Steffen and CSIRO’s David Karoly, or perhaps with former Australian Chief Scientist Professor Penny Sackett, about the climate emergency; and with people like ANU Professor Andrew Blakers on reliable, affordable, low/zero GHG emissions energy solutions.
“NSW Premier Gladys Berejiklian cancels daily COVID press conference as state sets new infection record”
https://www.abc.net.au/news/2021-09-10/nsw-records-1542-covid-cases-and-nine-deaths/100450254
It is claimed that “NSW Health will publish daily videos outlining the latest information.”
This is a highly concerning development. The daily COVID press conferences should not be cancelled during an escalating crisis. This is not to say that the Premier needs to front every single day but the Premier should front at least once to twice a week. The daily press conferences should remain and the Deputy Premier, Health Miister or state Chief Health Officer could and should front the other briefings on a multiple or rotating basis. The crucial daily figures and serious health warnings need to be delivered in person every day and the Government needs to be held accountable and questioned every day in what is a serious national health crisis.
It is disgraceful that the NSW Govt. has run for the hills in this manner. They have also been progressively hiding or selectively non-reporting key figures. This is just a further regression in this process. First the data is progressively disappeared and then the representatives disappear themselves as well. How much longer before daily case numbers, daily hospitalization numbers, daily ICU numbers, intubation numbers and deaths are all hidden or the data obscured in some way by redefinitiona and so on? How can anyone have confidence in this NSW government and our Federal government to tell the truth about this crisis? The clear movement is to obscuring and hiding how bad this crisis is getting. If Gladys Berejiklian does not want to even try or appear to manages this crisis of her making she should resign immediately. She is imperiling the whole of Australia.
I hope the press are on to this. If these LNP governments have their way they will obscure all objective data as to what is really happening. They are going to try to disappear the pandemic outcomes in classic “1984” style. I hate to imagine what comes next. If the people don’t destroy the neoliberals at the next relevant ballots, then Australia is truly lost.
The very fact that G.B. is disappearing as much as she can indicates a LOT more bad news is on the way. No modern politician fails to front early and often when they have good news to boast about. But when the facts and figures are so bad not even the masters of spin can spin them… Hoo-boy you know the news is bad.
So far, all predictions of disaster in this matter have been spot on. I expect this to be the case for a long time to come. I am talking about years, not months. And to think, early eradication and effective national quarantine could have saved all this trouble at one hundredth of the human and economic cost.
Most of the world doesn’t get a choice not to live and die with Covid. Gordon Brown https://www.theguardian.com/commentisfree/2021/sep/09/west-vaccine-doses-covid-production
“Soon, the ten-billionth Covid vaccine will roll off the production lines. By January, according to a recent report from the data research agency Airfinity, a tipping point will be reached when there will be enough vaccine doses for every adult on every continent. By June the number of doses will reach 27bn, enough to fully immunise the world’s population twice over. But despite this manufacturing triumph, we are losing badly in the arms race to actually inject every adult in every country. Next summer, on current trends, more than half the world will remain unvaccinated.[…..] Even though the G7 nations promised Covax in June that they would share 870m doses with the poorest countries, just 100m have been released to them..”
It looks as if maligned BIg Pharma is delivering on vaccine production The failure, and it is immense, has been by the governments of rich counties. With an assist from the government of poor ones: vaccines are pretty cheap and waiting for Covax cargo is not an adequate response to a major public health crisis.
Airfinity report here with data by vaccine: https://assets.ctfassets.net/poihmvxzgivq/7a5YY7FOvQuGUKdHcSGIqn/20184b777a59602afc4eba1172ca4c4f/Airfinity_Vaccine_Prepared_for_IFPMA_media_brief_FINAL.pdf
It is a shame Berejiklian has run off, and an even bigger shame on the MSM going silent on it.
MSM has become even more gutless than the politicians.
Only Anne Davies at the Guardian bothered to offer a comment piece.
James Wimberley writes above that “Most of the world doesn’t get a choice not to live and die with Covid.” This is true at this point in time. However, there are three aspects to this which we need to unpack. These aspects have to do with time, exponential growth and endemism (from “endemic”).
When highly inimical things or processes have the potential to grow exponentially then they have to be “nipped in the bud”. This is true of a skin cancer like melanoma. It has to be excised promptly or it will spread rapidly and even likely metastasize through the body. The exponential growth of the cancer at sites throughout the body is what kills the patient. The appearance of SARSCoV2 is of like nature in the collective body (as bodies) of the human race. If it had been excised early by eradication it would not have virally metastasized, as it were, in human bodies all over the world. Once we had reached the condition of endemism, it is in a sense like the condition of metastasization.
Thus, the first huge mistake made by the rich, neoliberal nations in particular was to let SARSCoV2 spread in the first place. It was eminently predictable that letting SARSCoV2 spread would be a disaster. The susceptibility of modern, interconnected global civilization to a pandemic has been predicted over and over again since at least the 1960s or 1970s. I mean predicted both by science and in popular culture as science fiction and dystopian fiction.
In movie versions of the fiction, we can note “The Andromeda Strain”, “Planet of the Apes” (new version at least), “Outbreak” with Dustin Hoffman, “I am Legend” (new version) with Will Smith and “Contagion” with Matt Damon. In such dystopian fiction, the source of the pandemic is often extra-terrestrial or it is a result of “mad science”. Only in “Outbreak” and “Contagion” is it presented as a result of natural evolution and zoonotic transfer to humans.
Further, “Outbreak” and “Contagion” do give at least a nod to the fact that such outbreaks can be causally related, at least in part, to criminal or foolish human actions and even to human political and economic systems. War, biological weapons research and wildlife smuggling featured in “Outbreak”. There was no direct imputation that civil war in Africa helped spread the disease there but that implication is available to actively draw out of the movie in the process of movie criticism. Wildlife smuggling was shown as a direct causal chain to the outbreak in the US. In “Contagion”, encroachment on the wilds is shown or strongly implied. Bulldozers knock down (more native?) palm trees in the near environs of a poorly maintained piggery. Bats are disturbed and bat-chewed palm nuts fall where a pig can eat them (shown in flashback). Later, a cook who has been preparing a raw pig in a Hong Kong restaurant, merely wipes his hands on his chef’s apron (no hand washing) before shaking hands with a restaurant customer (the wife of the character of Matt Damon).
Neither of these movies (Outbreak or Contagion) fully pursue any real critique of late stage global, and capitalist, food production chains. That would be anything from too obstructive of a good story, to too tendentious and even too radical. When narrative criticism of the real system gets too close to real problems it has to draw back for commercial and even ideological reasons. The fact that our modern production systems and travel systems cause us to be wide open to pandemic outbreaks is clear and it was predictable and predicted both in fiction and in science.
Scientists have long been worried about another flu pandemic the size and scope of the 1918 Flu Pandemic. This is well and truly on the record. They were also concerned about the appearances of emergent zoonotic diseases which accelerated in the 1980s, 1990s and 2000s. I do not need to rehearse the names of all these diseases. Naming HIV, Ebola, SARS1, MERS and Zika should do, along with mentioning the new more virulent and drug resistant variants of “traditional” diseases like Malaria and TB. As I have said before, the book “The Coming Plague : Newly Emerging Diseases in a World out of Balance” – by Laurie Garret, published in 1994, provided ample warning. The capitalist system or the globalized system, whatever you like to call it, ignored all the warnings and here we are.
On the scientific side it was also predictable, to a high degree of certainty, that SARSCoV2 (“COVID-19) being already contagious by aerosol or at least droplet and being a mutable RNA virus would rapidly evolve into more dangerous, more contagious and more virulent variants. Really, the odds were London to a brick for this, so why weren’t we told the truth from the start that these were real possibilities? Worst of all the emergence of SARSCoV2 was going to be a clear case punctuated equilibrium evolution which means in practice accelerated high speed evolution. I have covered this before.
Instead the public was faced with a snow job of myths about “herd immunity”, “flattening the curve” and “living with the virus”. [2] Why was the public not told the truth about these real, quite probable and highly dangerous possibilities. At the risk of sounding like the Khaleesi’s handmaidens, I have to say, “It was known”. I mean known by the scientists in the know. Even in the first few months of the pandemic, by late Feb 2020, IIRC, I was an advocate of eradication of SARSCov2. However, I did not then fully appreciate that “herd immunity”, “flattening the curve” and “living with the virus” were all going to prove such dreadful myths with respect to the disease. As a layperson it took me more months of research to fully appreciate what dangerous myths such cliches were in respect of the disease in question. However, the most advanced virologists and epidemiologists already knew the dangers were high and that these cliche-myths were, to a high degree of certainty, going to be proven myths. Why were they not listened to? Why did the myths get airplay and the advanced science not? The answer is easy in a sense: neoliberal capitalism.
I also want to take issue with the construction that “maligned BIg Pharma is delivering on vaccine production” if that is intended as advocacy for corporate capitalism. Big Pharma only delivered because they were given massive R&D funds by Big Government. Then they were permitted to exercise monopoly control of production to garner massive profits from this exercise. Their monopolies are one of the main reasons that other technology capable countries are not being given the patents and permitted to make these vaccines for the public good allover the world.
Globalist and capitaliast production systems and production chains are exactly the reason were are having this ongoing cluster**** of a disaster. I mean has anyone noticed that the hybrid socialist/state capitalist system of China has MASSIVELY outperformed the West in suppressing this virus? And this is without good vaccines so they have done it mostly with NPIs. Their vaccines are not great it is true and this perhaps is almost the last arena where their technology lags the West. They will make this up in about three years and they won’t give two shi*s about patents and IP. Our system is being comprehensively defeated by socialism and state capitalism. It’s about time we woke up. Of course, we should implement democratic socialism, not the Chinese or Russian authoritarian models. Only by inoculating ourselves with our own form of democratic socialism can we avoid falling to the much more efficient but also much less humane authoritarian socialism or more likely to its reactionary opposite, namely populist, neofascist capitalism.
He is/was a clever writer, Robin Cook, wrote a whole series of better than average airport speculative fiction books back in the eighties and nineties to do with medical propositions and ranks with the likes of Grisham as a person trained in the field in which his books have been set.
But the publishers probably wanted stuff a bit one dimensional; not too complex for the oiks and definitely nothing too critical of the system. I think reasonably sincere, Cook, but curtailed by factors outside of his control like most writers.
With the likes of Trump, Johnson, Morrison , Harvey Norman and the Murdochs, of course, reality assumes the role usually reserved for fiction. Thinking on it, the Grenfell Towers disaster also follows this pattern of life imitating art.
Iko said “In movie versions of the fiction”.
Whoa. Too much.
Search Results for : “spanish flu”
All Movies (337)TV Shows (7)
https://www.rottentomatoes.com/search?search=spanish%20flu
I want to recommend the excellent ABC website article:
“NSW marches ahead on its COVID roadmap to freedom, leaving all other states in its wake” – Laura Tingle.
https://www.abc.net.au/news/2021-09-11/covid-nsw-roadmap-to-freedom-amid-growing-crisis/100452012
Although the title should have been:
“NSW marches ahead on its COVID roadmap to freedom, leaving wreckage in its wake”.
The other ABC Analysis “The weapon Queensland has in its COVID-19 arsenal that locked-down states have run out of: LUCK!” is also worth reading. We have been lucky. Our Premier has been lucky. “Give me lucky generals,” Napoleon Bonaparte is supposed to have said, preferring them to talented ones. Queensland so far has had a lucky Premier, given that she has gotten away several times already with delaying lock-downs until after big footy matches. She seems inordinately accommodating to the maor sports lobbies. But I think our luck is about to run out. At the rate NSW is sending Delta incursions across our border, we probably have 50% chance each week of an incursion that leads to a full blown breakout. How long can we last? NSW is forcing us to “toss the coin” every week.
Victoria also has fallen to the shock troops of COVID-19. All the virions are shock-troops and they don’t even need a general, being an autonomous swarm. Nevertheless, they have two Quisling human generals operating for them, Berejiklian and Morrison, traitors both to the cause of Australian public health.
Barilaro.
The article should have been headed,
‘The downward spiral to hell via a sack cart’
Too true.
The road to hell is paved with bad intentions.
It is not difficult to imagine the more responsible members of the press gallery pulling their hair out by the roots lately.
Send in the clowns..
So will the PBAC be instructed to lift its willingness to pay threshold for new medicines to be listed,on the PBS (cost per qaly) for all other non-covid diseases to a least the Australian governments revealed preferences under Covid or at least match that of ATAGI, which indicated that Australians were willing to pay directly and indirectly billions to avoid a single death from the AZ vaccine?
Andrew,
Explain your reasoning with elaborations, quotes, data, calculations and deductions. How did ATAGI indicate that Australians were willing to pay directly and indirectly billions to avoid a single death from the AZ vaccine?
That was a consequence of the advice. In fact one of the reason that they erred was lacking a dynamic model of covid that considered various economic scenarios and setting their base case (which ultimately got communicated) as levels of virus that reflected the locked-in scenario. Ie borders shut.
I don’t need to quote the PBAC. Review their Public Summary Documents and literature
The PBAC typically regard a medicine at the price offered by a company to be acceptably cost-effective if modelling suggests that the incremental cost effectiveness ratio of adopting the therapy is between 45k-80k per qaly gained ( depending on other factors such as existence of alternative therapies and disease severity). That basically translates to around 100kper life year saved (back of the envelop and removing the QoL weighting in QALY)
This low willingness to pay translates into significant delays to access to medicines in Australia (two or more years is not uncommon)
Question: do you really think that the vaccination procurement debacle was a one off. I am afraid it reflected the general attitude towards doing business with drug companies and an arrogance within the Department of Health.
Maybe look at some of the submissions from patients and companies to the recent House of Reps inquiry on this
Andrew,
I know little about the technical side of this issue. That’s why I asked. I had a vague awareness that certain new medicines and proprietary non-generic medicines took a long time to be approved before use in Australia. One theory could be the intransigence of the PBAC and/or ATAGI (not sure of the overall split of their roles). Another theory could be the greed of the big Pharmas with their monopolies/oligopolies and their sky-high prices. A further theory would be how those two factors then interact complexly.
Your suggestion that it’s all interconnected certainly fits the general observation one can make about complex, interacting systems, whether they be real systems, administrative systems or political-economic and finance systems. There is also the general issue that neoliberalism also tries to do everything related to social expenditures on the cheap so that the neoliberals can direct maximum profits to their corporate allies and levy the lowest possible (or no) taxes on them.
I resolutely avoid taking medicines and nostrums of all types but that only works while one has the luxury of no serious conditions. As soon as a serious condition hits, or threatens, one usually has to take the relevant medicines and the relevant vaccines. Thus, one can then become hostage to the prices of Big Pharma.
US neoliberalism and Australian neoliberalism have different perspectives on drug prices. High drug prices suit US neoliberalism. Big Pharma shareholders get rich, political parties get big donations and the poor, who can’t afford the medicines, can crawl off, suffer and die. The US ruling elites don’t care. The poor are completely expendable, they have no voice and they often don’t vote.
In Australia, we have significant remnants of a social security system and a public health system. The latter is much more efficient and cost-effective than the privatized US system. One pressure on our system is the high pricing of new medicines from Big Pharma. Our bodies, like PBAC, are, I assume, trying to maintain cost-effectiveness and avoid capitulating too much to exorbitant Big Pharma pricing. That’s a laudable objective. Whether they do that well and flexibly or poorly and inflexibly is another question. No doubt they are also constrained by continuous, neoliberal penny-pinching here and no doubt also heavy behind-the-scenes pressure from the US to just accept the US Big Pharma pricing system.
Andrew said “That basically translates to around 100kper life year saved (back of the envelop and removing the QoL weighting in QALY)”.
And maybe, instead if looking at parliamentary enquiries, look at the fundamental underlying data, assumptions and techniques used to generate outcomes.
Aren’t QALY’s the “ability to quantify tradeoffs and opportunity costs from the patient and societal perspective make it a critical tool for equitably allocating resources.” … “and that its use may restrict patients with disabilities from accessing treatment”.
Wikipedia.
Can you Andrew, or any one else please, point to datasets used to generate QALY’s? Do used data sets show inclusion / exclusion of noisy pademics data? Is data dumped or smoothed or massaged so as to make sets more decision /tradeoff / opp cost / allocations friendly in ‘normal’ times?
Or, is one persons dead, another persons life year vs income?
And what about VSL?
“Don’t shoot the messenger — on the value of human life”
https://marginalrevolution.com/marginalrevolution/2021/08/dont-shoot-the-messenger-on-the-value-of-human-life.html
Tyler Cowan was also unable, at this time, to clarify datasets cur offs. I asked.
****
“Death” and the Valuation of Health-Related Quality of Life
…
“Conclusions and Results.
Data showed that there is a small group of individuals who, when given the option, choose to place relatively high value on the state “dead” compared with other health states. This did not appear to be due to artifact. Evidence also suggested that the usual assumptions underlying the transformation of health state values, for which the distance between full health and “dead” is used to define the denominator, may not hold for these individuals and may distort aggregate preference structures. The authors stress the need for more systematic inquiry in this field.”
https://journals.lww.com/lww-medicalcare/Abstract/2001/03000/_Death__and_the_Valuation_of_Health_Related.3.aspx
*****
● Perhaps our host has an answer -JQ. I’d appreciate a comment from Ernestine too please. I am probably ignorant. Hapoy to be corrected.
“Equity weights in the allocation of health care: the rank-dependent QALY model”
Authors
Han Bleichrodt 1, Enrico Diecidue, John Quiggin
PMID: 15154692DOI: 10.1016/j.jhealeco.2003.08.002
*
“Characterizing QALYs under a General Rank Dependent Utility Model
HAN BLEICHRODT Erasmus University, Rotterdam, The Netherlands
JOHN QUIGGIN Department ofEconomics, James Cook University, Townsville, Australia
…” In many public policy decision contexts no good market data exist to value health outcomes. In these circumstances, most studies have relied on surveys to derive values for health outcomes (for an overview see Viscusi (1993)). The commonly used methodology in surveys has been to ask members of a representative sample how much they are willing to pay for reductions in the risk of contracting a particular disease. This methodology is referred to as “contingent valuation.” Over the past decade, there has been an increasing awareness of potential problems with the contingent valuation approach (e.g. Hausman (1993)). As a result of these problems, several studies have suggested to use utility based measures of health outcomes (Viscusi et al. (1991), Krupnick and Cropper (1992), JonesLee et al. (1995), Magat et al. (1996)). The theoretical relationship between the contingent valuation method and utility based measures is straightforward (Viscusi et al., 1991), but empirical evidence suggests that the latter are more reliable. The utility based approach to the valuation of health has been frequently applied in
allocative decisions in health care (Torrance (1986)). The most important utility model in health decision making is a simple additive model:”…
Abstract
This paper provides a characterization of QALYs, the most important outcome measure in medical decision making, in the context of a general rank dependent utility model. We show that both for chronic and for nonchronic health states the characterization of QALYs depends on intuitive conditions. This facilitates the assessment of the validity of QALYs in rank dependent non-expected utility theories and a comparison with other utility based measures of health.”
Key words: utility theory, choice under uncertainty, value of life JEL Classification: D8, I10
Click to access jru1997b.pdf