Month: May 2020

Modest Expectations – Barry Marshall & Obey

Pauline has parked her grandstand in the News Ltd car park, where she is advocating a High Court challenge to border closure. This is a normal Pauline stunt, unsurprising given that the Queensland elections are imminent -and there is nothing like a confected confrontation magnified by that shrill tone of hers.

One concession you have to give to this lady, she plays “victim” very well. One of the ploys when I used to be an official visitor to psychiatric hospitals in New South Wales was the way the inpatients could produce someone who had been “victimised” and ask me to help “save”, usually, a “her”.

My companion visitor was a wise woman, who unlike myself had long practical experience as a psychiatric nurse. She warned me not to be “sucked in’’, but listen to the complaint and investigate. However, she said – maintain rationality –don’t be get caught up emotionally as these people are very clever, since it was a practised scenario, and they try you out.

Whenever I watch Pauline, I am reminded of this advice, since whenever she is pushed into a corner the voice becomes quavery and the tears well up.

The one hand clap, Pauline.

But back to reality.

How much is this High Court challenge going to cost, Pauline? $300,00? More? For what, Pauline? A failed challenge? Of course, the victim.

However, who is going to pay? You, Pauline? No way. I’m afraid it is going to be us mug punters, of course; the real victims.

Telehealth – Look Mother! No hands

I was brought up as a medical student to believe that the essence of being a doctor was to take a full history from the patient and then to do a full examination.

That was a message. The face-to-face consultation was the basis of consultative medicine and the skill was to make the correct diagnosis – or if unsure, to provide a set of differential diagnoses based on what you had elicited as symptoms and signs of the patient’s condition.

However over the course of my medical career technology has intruded upon the “maestro” doctor able to diagnose the patient before he or she sat down. Observation to me remains a very important element as it was to Dr Arthur Conan Doyle, who invested his sleuth, Sherlock Holmes, with the same or enhanced degree of observation he had as a doctor.

The astonishing array of technology and increasing differentiation of care has been something I have witnessed through my long career. Sometimes I have watched and sometimes I have been closely involved, for example with the introduction of Magnetic Resonance Imaging (MRI) into the private sector and its recognition by Government – not always the most tranquil moment of my career.

There has always been agitation from the medical profession for reimbursement for non-face-to-face consultations. With the corporatisation of medicine, where the bottom line is everything, this agitation has not lessened. “Money for jam”, as the old saying goes, many jars of which will inevitably be transferred offshore.

Having watched telehealth progress through phone conversations to uncertain video links through to more reliable technologies such as Zoom has meant that technology has challenged traditional ways of medicine.

My only hope is that the government, which is increasingly strapped for cash, monitors it use.

I have used telehealth as a patient, and for a person with limited mobility it has been particularly beneficial. I have found that the doctors have been more punctual, but that anyway may be because of the lower volume. Telehealth acts as a screen. For the plastic surgeon, you can send a picture of the lesion, and get an opinion over the phone and in my case, yes it looked as though it needed to be removed; then a regular check up with the rheumatologist reviewing my pathology, a critical aspect in my ongoing chronic disease. More importantly in talking to my neurologist, he listened to my history, and said yes, it was important to see me, but I should have a cervical spine MRI first.

Two of the three telehealth consultations required subsequent face-to-face consultation. My general practitioners friend said that with the modern video technology, it is possible to diagnose simple conditions, such as a strained muscle, by observation and prescribe a treatment without seeing the patient in the rooms.

My appointments to see specialists could only be undertaken by face to face consultations – removal of a lesion from the face, assessment for cataract removal, neurological examination for the particular set of signs.

As someone who developed an auto-immune disease insidiously, after my diagnosis it was apparent that I needed not only a good general practitioner but also one who would provide continuity of care.

Being a doctor myself, I am in the worst category in regard to regularly seeing a doctor. I can do all that general practitioner stuff – but of course I cannot. It is impossible to have an objective view of yourself until, as I found out one night, I knew that I was dying. Hypochondria is one thing; a sense of impending death is another.

I survived the night, and because of the pain and stiffness and overall weakness, I went back to my orthopaedic surgeon whom I had consulted a dozen years earlier for my acute painful knee.

At this time, I had no regular general practitioner although most days I was surrounded by them at work. However, the orthopaedic surgeon knew what it was, but orthopaedic surgeons treat by operation and not by drugs and so he flicked me over to his trusted rheumatologist. Now rheumatologists are gentle ruminative folk, but have long lists of patients; so waiting for up to six weeks is not uncommon for an appointment.

Miraculously I saw the doctor that afternoon. He prescribed tests and drugs, but I was not to take the drugs until the test results came back.

The starting line could not have come sooner; within 24 hours after taking the first tablets, my condition improved dramatically.

Unfortunately dramatic improvement didn’t equate to immediate cure, but that’s another story.

What is interesting however, in a story about telehealth, is how do you diagnose this sort of disease. As one of my general practitioner colleagues said to me that this is a GP diagnosis – you ask: “Can you roll over in bed?”

This was very much after the fact. I had already been diagnosed and was being treated. However, I had not noticed it before; he was right, I could not roll over in bed.

Theoretically, if the doctor had been as astute as this Scot, who had seen cases before, a telehealth diagnosis might have been made.

But then again I still would have had to see him in a face-to-face consultation. Telehealth is not a panacea and I would caution government and suggest once the COVID-19 pandemic is controlled, to review its application closely, especially the biggest users and then ask why? As I know too well, governments are reluctant to wind back largesse for fear of vested interests squawking about compromising people’s health.

Telehealth is a bonanza for the corporate health business, where throughput is everything, and health care a by-product.

Nevertheless, far more insidious is the large health conglomerates where the owners are dependent on government payments to profit, inevitably providing donations to political parties to keep the tap turned on. Donations after all have a wonderful effect of assisting politicians to roll over – not necessarily in bed.

Hey, Pellegrini, whatcha doing with that test tube?

A new study shows coronavirus patients who took hydroxychloroquine to treat COVID-19 had a higher risk of death than those who weren’t given the drug.  

The study, published Friday in the medical journal The Lancet (22 May), also found that COVID-19 patients were more likely to develop serious heart arrhythmias if treated with hydroxychloroquine, or its closely related cousin chloroquine.  

Arrhythmias can lead to a sudden cardiac death, the report said, but researchers did not associate the study’s fatalities with adverse cardiac affects. 

Even though it’s only an observational study – not the gold standard double-blind, randomized, controlled trials – experts say the enormous sample size makes it compelling.

The study comprises of 96,000 coronavirus patients from six different countries who were hospitalized between Dec. 20, 2019 and April 14, 2020. Nearly 15,000 patients were treated with hydroxychloroquine or chloroquine alone or in combination with an antibiotic.

When I heard that the Walter & Eliza Hall Institute for Medical Research (WEHI) were about to embark on a trial to enlist 2200 health workers into a trial to test the efficacy of the drug being a preventative agent against the virus, I checked the date. No, it was not April 1st.

Professor Marc Pellegrini is employed at the WEHI with one of those expansive titles, which suggest he is important. On television, his justification for the trial is that the drug kills the virus in the test tube. So, I might add, does bleach.

I wondered how this experiment has come about.

This modern day Lancelot has given his project a grandiose title – COVID-19 Shield. Here I wonder whether you need a diploma in public relations rather than a science degree in this modern world purporting to be medical research.

I have not the seen the protocol except it seems to be a randomised controlled trial; but one important report I would like to see is that of WEHI Ethics Committee on the proposed study and the reasons for approval.

In the latest bulletin of WEHI, there is a coy mention of this trial without naming the drug and the brief comment that it is being funded by the Australian Government. There does not seem to have been the award of a peer-reviewed grant as one would expect for such a potentially dangerous activity.

The problem for the Australian government is that there is pressure coming from the non-medically qualified – especially from such a medical expert as Clive Palmer.

In response to the above Lancet article, the WHO is reported to have put on hold the hydoxychloroquine arm of review. However, the report has all the hallmarks of the WHO walking away (or should I say “crabbing” away), without losing face.

But WEHI seems defiant. At least Professor Pellegrini is. May I suggest it is time you retire the Shield, Sir Lancelot.

Finally, as The Washington Post noted – as I have – who says Trump has been taking the drug. Has anybody seen him take it? This person who lies, lies and lies. Why would his statement of putative self-administration be any different? In any event, he now says that he has stopped taking the drug. Come on, Donald, which is the lie?

The time I under-dosed with Chloroquine (Plaquenil)

It was about 30 years ago and we went on a tour of Africa. Among measures to be taken were the mandatory yellow fever vaccination and a prophylactic antimalarial, then hydroxychloroquine, which was marketed under the name plaquenil.

It was a wide-ranging trip, which excluded South Africa, then in the grip of the apartheid Afrikaans. However, in many ways it was defining as it led to us, especially my wife, returning almost yearly to the continent.

We had previously been to North Africa – Morocco and Tunisia – but this was a month long roam through Southern and Eastern Africa. The trip incorporated the island of Madagascar, the French Département of La Réunion and then finally the Seychelles. 

We spent some time in Madagascar, both in the jungle near Antananarivo, the capital, and the island of Nosy Bé looking for lemurs and indris. After leaving there, we flew to Saint-Denis, the capital of La Réunion, where the intention was to climb La Fournaise, the volcano at the end of the island. The year previously we had reached the summit of Yasur, on the island of Tanna in Vanuatu. This is one of the only active volcanoes in the world where you can stand and look down into its fiery cauldron. La Fournaise presented another opportunity to do so.

Le Piton de la Fournaise, Reunion Island

However, while having a drink at the bar of the hotel on arrival, I started to feel unwell. I went to bed, and then passed out. As described to me I began to get very hot, and my temperature was apparently swiftly rising, and as my wife said I became quickly delirious. She did not know quite what to do except keeping sponging me to try and reduce my temperature. She told me that her plan was to phone a public health physician acquaintance in Paris, in the event that I needed to be admitted to hospital because, as she said, her French wasn’t up to an emergency admission. However, about one in the morning, suddenly I was a bundle of sweat. I woke up; my temperature was dropping. My pyjamas were absolutely soaked with perspiration

How could this be; I was taking the plaquenil regularly, but then I reviewed my dosage – it was below the prophylactic dose. God knows even to this day how this happened, but it was obviously my mistake. Fortunately, my wife did not succumb. So even though I felt lousy and confused, I increased the dose to therapeutic. The worst residual symptom was a terrible headache behind the eyes. I have never had one like it before or since.

That was it, except I felt lousy for over a week, but I did not have another crisis – nor have I had a recurrence since that day.

However, I always take Malarone, the current anti-malarial drug of choice whenever there is the prospect of contact with a malaria-bearing mosquito overseas.

But back to La Réunion, we did see around the island, including the Cirques, tropical remnant of extinct volcanoes but we never did climb La Fournaise.

No, I did not have a test to confirm – not malaria – confirm my anserine status.

But at least after that experience I can swear by hydroxychloroquine – for malaria!

Just a lurk

COVID-19 causes massive inflammation boosting cytokines, which increase the liver’s production of clotting factors, explains Beverley Hunt, medical director of Thrombosis UK and a practising clinician. For example, fibrinogen levels in a severely ill COVID-19 patient are 10-14 g/L, compared with 2-4 g/L normally and 5-6 g/L in a pregnant woman. “A COVID patient’s blood is enormously sticky,” she told The BMJ.

“All patients in critical care are at increased risk from clots because they are immobile, and when you are sick you have sticky blood,” says Hunt. Studies of venous thromboembolism rates among non-COVID patients in critical care show that rates of thrombosis can be as high as 28% if patients are not given any prophylaxis. Among patients given prophylaxis the rates are halved. So, we seem to be seeing significantly higher rates of thrombosis in COVID patients. 

“Thrombosis is definitely contributing to the high mortality rate from COVID,” says Hunt. “Not only can it lead to a pulmonary embolism, which can be fatal, but there are also higher rates of strokes and heart attacks.”

In this report in the British Medical Journal, a United Kingdom medical specialist is musing on COVID-19. Now at the outset one would have thought that the only experts interested (or consulted) would be emergency physicians, anaesthetists and respiratory specialists. However, this is a doctor expert in blood clotting which has arisen as a major COVID-19 complication, especially as the amount of anti-coagulant to be given seems to be unsettled. Moreover, there there are reports of late onset deep vein thrombosis. My Swedish correspondent mentioned COVID-19 toes, which appear to be a severe form of chilblains, pointing to this being the virus being an instigator of widespread disturbance in blood clotting.

What is further intriguing and indicates the widespread effect of the virus is loss of the sense of smell as an early sign. In humans, the olfactory cell location measures 9 cm2 and lies on the roof of the nasal cavity.

With the common cold when there is swelling of the nasal epithelium non-specifically, sense of smell is impaired. However there are reports that this COVID-19 virus infiltrates the sustentacular (supporting) cells which, together with olfactory cells, constitute the pseudocolumnar epithelium underpinning the nasal cilia and microvilli. Among other functions these cells have an effect on how odours are perceived by the olfactory cranial nerve.

It was interesting looking at the histology of the nasal lining, and its complexity. The olfactory nerve and its connections are one of the most neglected areas in medicine, because the sense of smell is more related to lifestyle rather than considered a major marker of disease. However, if it is indeed an early marker of COVID-19, attention should be paid to the way the nasal swab is taken to assist early detection, especially if the olfactory area of the nose is where the virus may lurk first.  This infiltration indicates how profound this virus may be in invading the body.

This virus is not going away soon and while Australia has, up until now, done an excellent job in suppression, “lurk” is probably the most concise way to describe it.

The Hungerford Games

We camped on the Queensland side of the fence, and after tea had a yarn with an old man who was minding a mixed flock of goats and sheep; and we asked him whether he thought Queensland was better than New South Wales, or the other way about. 

He scratched the back of his head, and thought awhile, and hesitated like a stranger who is going to do you a favour at some personal inconvenience. 

At last, with the bored air of a man who has gone through the same performance too often before, he stepped deliberately up to the fence and spat over it into New South Wales. After which he got leisurely through and spat back on Queensland.

Henry Lawson wrote thus about his experiences in Hungerford in 1893, when he had walked there with his swag from Bourke. The expectorating man’s name was Clancy, that familiar ‘loveable larrikin” character alienated from officialdom. Sorry, that is my ironic interpolation, and on the contrary Henry Lawson was not impressed by him.

There was no Pauline Hanson around in those days, and anyway she would not have been able to vote or stand for any of the colonial Parliaments in Australia at that time.

The Royal Flying Doctor Service (RFDS) periodically does medical clinics in Hungerford – this population speck, which straddles the border of New South Wales. This settlement is about a three hour drive along the Dowling Track from Bourke. I have always hankered to go there since I worked with the RFDS, for no other reason that it is there and like so much of western Queensland it epitomises my image of the laconic yet irreverent stoicism of the Outback.

We have years ago thought to drive there, but there had been heavy rains and the road beyond Bourke was impassable. The road is still unmade, but even though it is not the first place one would think to cross the border, my hankering is still strong. So I thought I would find out more.

The problem is that the Royal Mail Hotel is on the Queensland side of the Queensland-New South Wales border, which is defined by the wild dog fence. There is a border gate at Hungerford.

To get more intelligence on the current situation, I rang the publican at the Hotel. The news was grim. The gate is locked; the coppers have the key and even if I could he said it would inadvisable to try and climb over the gate. Anyway we would be aliens from New South Wales – waratah cockroaches invading the land of Cooktown orchid cane toads. So we could not stay at the inn.

So Premier Palazczuk, I promise I won’t make a High Court challenge if you open the Hungerford gate and allow us to stay in the pub. I’m not sure about the High Court challenge – however I believe there is a class action being mounted by a consortium of wild dogs to remove the fence between the two States. And it is only an unsubstantiated rumour that Clive Palmer is funding their challenge.

Muri Succursus

Mus Virgilis “destillat ab inguine virus”

We mouselings, as you know, pay homage to our celestial creator, Rodentia Nora. So we have knowledge of Latin – one of the greatest bard being one Mus Virgilis.

Given how much used the word “virus” is, we had a peep at its derivation.

“Virus” is a rare second declension neuter word for “poison” or “slime” and that attracted me to see if there was a plural form, “vira”. But the word has never been found in a plural form in Latin literature. Thus “viruses” is acceptable – even though the “es” suffix is generally associated with third or fifth declension Latin words.

And certainly do not say “viri”, which is Latin for “men”.

Modest Expectations – Kennedy

When I wrote about Sweden in my blog on 27 March, Australia was paralleling Sweden in numbers of COVID-19 cases – well sort of.

2,016 people have been reported infected with COVID-19 in Sweden (20 cases per 100,000 inhabitants). Nationally, 25 of the cases have died.

Australia had 3,047 cases with 14 deaths at the time (12 cases per 100,000 inhabitants). Of that total then, 300 infected were attributed to the Ruby Princess circus.

Reviewing the figures as of 20 May, the current Swedish figures are 31,523 cases (315 per 100,000 population and projected to be the highest per capita death rate in the world) with 3,831 deaths and 4,971 recovering. Australia by contrast has 7,081 (29 per 100,000 inhabitants) with 100 deaths.

My friend who is a senior radiologist, who once ran the department at the Karolinska Institute in Stockholm, has written to me last week (sic):

… In Sweden a large proportion of elderly who died from COVID-19 were not only old but in special care facilities …

Our experts seem to view yours and New Zealand’s very successful containment effort with scepticism, thinking that in the end, spreading is inevitable. However, the alternative that we are experiencing with many dead elderly is really also very painful indeed. Hopefully you will be better prepared when (if) the virus spreads again. We have had to put much of ordinary health care on hold and reports are that many who should seek care are not, ie transient ischaemic attacks (TIA,) coronary disease patients, symptomatic cancers.  

The much increased ICU capacity, fourfold increase, takes a toll on all other activity. 

… Life is not as normal as reported in international media, all shows and theatres are cancelled, very few travel by Metro compared to normal. Largely the restaurants are complying with rules of sparsely seated customers, with no waiting lines… However many are enjoying the outdoors and our small wood next door sees many visitors, keeping prescribed distances…

We are hoping for restrictions to ease so that we can at least visit Öland.

Lutheran church, Öland

Öland is an island four hours drive from Stockholm connected by a bridge across the Kalmar Sound and we had hoped to spend some part of the Northern summer there. Not now unfortunately.

My friend continued:

I have worked for some time, and noted the high proportion of pulmonary emboli in our COVID patients, as well as other interesting things with this baffling infection. Rashes, COVID toes, white lungs (usually associated with widespread asbestosis – Ed), cerebral complications, abdominal symptoms.  The list is endless.”

My friend mentioned a smorgasbord of diseases arising from COVID-19. This infection is neither the flu nor just a bad cold. And my friend does not even mention Kawasaki disease; there is much more in the COVID-19 malignant store to sample.

His comments were backed up in a report in the NY Times (May 16).

In essence, the report agreed that the Swedish mortality was very high among the elderly but unlike Italy where there was a high concentration of multi-generational families, Sweden lives in a far less cramped space with many more single person households.

The average Swede has less diabetes, obesity and heart disease than in the other countries with a high infection rate.

Even so the Swedish economy has not emerged unscathed –and a contraction of the GDP by seven to ten per cent is predicted by the Central Bank.

Therefore, for those idiot Australian Borises who want to open Australia tomorrow, think Sweden – and not as an Ikea panacea.

Thank God for our senior health people who said don’t go to see the “Sharkies” and hug each of the players in turn, but shut down Australia.

Sweden provides a salutary lesson as Australia re-opens its leisure activities.

Non dimentica

When you author a blog, you open yourself up to being wrong publicly. So I trawled back through my blogs to see when I first mentioned the coronavirus. It was late February, and at that time I was somewhat Thomasine, because a large group of our nationals had been airlifted back to Australia from Wuhan. None of them had tested positive before or after the quarantine.

Yet there was something I was unaware of at the time I wrote the piece and that was how many Chinese were working in sweatshops in Northern Italy. The Chicago Tribune as far back as 2009 reported … an estimated 30,000 Chinese are legal immigrants in this city (Prato) of 180,000. Another 30,000 illegal immigrants are also suspected to live here. Many among the Chinese work in small hidden factories for as long as 14 hours a day.

One of our informants recently confirmed that there have been regular flights from Wuhan to Milan, with up to 100,000 Chinese“guest workers”. making shoes there. Once out of the wild meat market, the virus thus had a saloon passage to the delights of Lombardy and Emilio-Romagna. There here were the crowded conditions both at work and domestically to spread the virus.

Despite there being no positive cases among the Wuhan evacuees, Australia had closed its borders to China and then selectively to other countries – but not to the United States, which we should have.

Yes, I was skeptical – and the question remains in my mind why were there no positive cases detected in the people being flown out of Wuhan. If there were none, what was the major reason? I know, the plane air conditioning had been bolstered – what else? Social distancing? Masks? Hand washing? Repeated cleaning of the airplane toilets and no moving from the one seat unless going to the toilet? In the end no-one was infected – in 400 people out of Wuhan.

As for what I wrote, I think I overused the word “hysterical”, which I now regret. 

Abiden with me, fast falls the eventide …

… the New Yorker’s Adam Gopnik decided that this was the night that changed everything. “Not only, as we did not know then, was President Obama in the midst of the operation that would lead shortly to Osama bin Laden’s killing,” he wrote last fall, “it was also the night when, despite that preoccupation, the President took apart Donald Trump, plastic piece by orange part, and then refused to put him back together again.” Report in the Washington Post concerning the White House correspondents’ dinner in 2011.

It is about time that the Democratic Party in America prepares for its Peregrine moment. A Peregrine moment? Bob Hawke. The Labor party, which has always been gentle on its leaders up to that time, vanquished Bill Hayden and replaced him with a more formidable challenger to the then Australian Government – Bob Hawke. Not that Bill Hayden was any slouch and certainly in his long-term influence he has been much better than Joseph Robinette Biden Jnr.

In November this year, this man who served 35 years as a senator for Delaware will reach his 78th birthday and he is asking America to elect him to serve a period of time, which will see him leave office at 82 years of age, or perhaps at 86 years.

The most disturbing vision of Biden is his rear view – essentially that of an old doddering man. Then turn him around and there is that ever-engaging smile – as if he has a giant axon inside his skull that is connected to all the facial muscles, which make him smile on cue when somebody rings the metaphorical bell.

Biden is a plagiarist, discovery of which aborted his 1988 Presidential campaign. Plagiarism is a mixture of deceit and intellectual laziness – or underlying dumbness. This flaw resurfaced in certain dealings last year.

As I abhor hugging and extravagant shows of affection (one of the only positive outcomes from this virus), it is unfair to criticise his “touchy-feely” approach, unless it degenerates into the “creepy-gropey”.

Nevertheless, one positive sign that he is a good man is how he has handled grief and he has much to grieve about in his life.

Wilmington Railway Station

He seems popular, and although I did not see him on the railway platform of Wilmington, that city is an Afro-American with old patrician heritage veneer – it is this cultural gap that Biden has been able to span his whole professional life. After all, he has spent his life in politics with an early daub of lawyer on his escutcheon.

America is in a mess; no matter when the change is made there is a White House reduced to the political nursery of the Baby Trump, and there will need to be someone very focused to clear out the rattles, the dolls, the bucket and spade, and other geegaws fondled and thrown around in the past four years.

I fear Biden just doesn’t have the ability – no fire, only embers. My earlier comments about him have not changed, and my support for Bloomberg would still hold had it not been for this entry of Obama into the frame.

it struck me this week listening to Obama– is perhaps Biden only the shill? A cleverly-concocted shill for Obama. Maybe there is a residual something behind the Delaware smile.

There has not been a contested convention requiring multiple ballots since Eisenhower won the Republican nomination for President in 1952.

Only one President has served two non-consecutive terms – Grover Cleveland, a New York Democrat who was both the 22nd and 24th president.

Yet Obama may be the next to do so. After all, he is only 59 years of age and even another two terms would make him only 67, much younger than either Trump or Biden.

Will there be a contested Democrat convention? I would doubt it if Obama continues to surge. Biden probably may even nominate him.

Obama’s recent entry into the political debate is that of the man of stealth with disarming ruthlessness, just the needed antidote for Trump. Here was a man at a dinner, the master of the lampoon without any sign that at that same moment he was supervising the killing of Osama Bin Laden.

America is in a crisis, in a way that it has not been since the outbreak of the Civil War. Trump just has no sense of national leadership. His genius has been in dividing and ruling a circle of sycophants and chancers in a building on Pennsylvania Avenue and then darting off to rally to and sustain “his apprentices” – a hate-filled armed militia in the event that he does not get elected democratically.

Trump has a pathological fear of Obama – there is something deep in his twisted psyche, which no amount of ranting can exorcise. There is no doubt that if Obama wins and the Democrats get control of both the House of Representatives and the Senate, there would be no more the mister-nice-guy of his first term of 2008. Obama may very well push through an agenda not that much different from the one promoted by Elizabeth Warren. At the same time, he would be the focused commander in chief commissioned to slay the coronavirus by putting America on a war footing. Bringing order to chaos.

Nevertheless, I would speculate that one significant force who would not like to see Obama contest the election is his wife, Michelle. Why? Because as he exposes and humiliates Trump on the election trail with an increasingly unhinged Trump, then with all the fomented madness in America, Obama would be a prime target for assassination. That is the American way.

But as I have said often, what would I know? But then I cried when Kennedy died.

Just a Footnote – talking of Presidents

Once when a young doctor wanted to become a consultant physician, one pathway led to a year in the pathology department doing post mortems. Just as if one was training to be a surgeon, time in the anatomy department was one tried and tested way to that career.

One Friday morning, the Department boss came to me with his mischievous smile and said that he would like me to undertake an interesting task. The person on the slab had been born with Peutz-Jegher syndrome, which is an inherited disease where part of the syndrome involves multiple polyposis in the bowel. These polyps, usually benign, nevertheless could be very distressing and require multiple operative interventions.

In this case, they had been multiple with resultant adhesions all through the abdomen. The question of my boss when the post-mortem had been requested was to see if this particular person had had an undetected cancer in the large bowel.

It is a somewhat ironic situation that whereas I could do up to three postmortems in a morning then, post mortems even in the large hospitals today are rare. However, they are rampant on current television. Admittedly, there is still a swathe of forensic post mortems, and having been someone who was actively involved undertaking post-mortems it is sometimes hilarious to glimpse the portrayal on television.

When I was presented with this body, it was so scrunched up and distorted, it was hard to determine the age, but I do remember that there were remnant spots on his lips and face, which are part of the syndrome. The eyes were open and even after all the post mortems that I had undertaken, I had an immediate sense of pity – even in death the eyes showed the pain.

One of the ways I coped with post mortems was to put on a metaphorical mask for any emotions as I donned my apron and gown over what are now defined as scrubs (but then called boiler suit) and never take a memory of the post mortem away from the department.

Not in this case; I can still see this person in my mind’s eye. Of all the post mortems I have ever done, he did leave an impact, because he was the epitome of misfortune. Why had he been afflicted so – to live for what?

But you cannot have the luxury of thinking much about the meaning of life when you are doing post-mortems.

However, the task at hand was the congealed mass of intestine – seemingly an amorphous matted lump – and I had to open the bowel from duodenum to rectum without losing continuity in my dissection.

How the hell did he survive for so long? It was laborious work to dissect. The body had been stitched up and removed. All my colleagues had finished their post mortems and left. There I was; left on my own to dissect the bowel.

The complication was that I was supposed to be groomsman at a wedding at 6, and as the day progressed, I began looking at the clock. Eventually I finished, sometime around 5 o’clock. I had found no cancerous growth. However, I had finished and I knew I had done a good job.

I was fortunate that the mortuary attendants were still there and after having a shower, they helped me don my evening dress – white tie and tails which, when you are in a hurry, can be excruciatingly fiddly. An incongruous sight. In a hospital morgue.

Mortuary attendants are a genus of their own – in this case one was a large lump of a man with a funereal voice, who obviously enjoyed the work; the other a smaller man, whom I remember always swore by Cooper’s sheep dip as a great hair restorer. He used it daily. He had a thin wispy comb-over. The two of them were a somewhat quixotic pair.

Dressed, I dashed across the hospital car park and into my car. It was a short drive to the chapel where my friend was being married. I did not have time to see my wife, who on the previous Saturday had given birth to our second son, Marcus. In those days, life post-partum was a more leisurely affair, as Sister Fabian insisted that the mothers needed rest, but of course I could have my evening meal with my wife – just pop across the road after work, doctor.

But tonight was different and when I emerged from the hospital replete in white tie and tails, I remembered it was the day LBJ was coming to town and all the streets around where I was going would be blocked off.

Bugger! However, I was able to take a circuitous route and fortunately found a place to park – at least walking distance from my destination.

I took my umbrella because it was about to rain. There were numerous people along my route down Toorak Road. I really did not notice them as I was walking as fast as I could. I thought of running, but when you are like a stuffed white cockatoo, I thought it unwise.

So concentrated was I that it was not until it hovered directly over me that I looked up and saw the helicopter. Suddenly I felt I was the target. I stopped and waved gingerly. The helicopter crew having seen that it was only a strange young guy in fancy dress with a furled umbrella, rose and left me after a few whirring minutes.

At that moment, the big dark limousine whipped past. There they were – President Johnson with Prime Minister Holt – a brief glimpse of them through a bulletproof window.

Then they too had gone. I reached the chapel before the bride.

Quite a day.

Can I call you Belford?

Two mildly proptosed eyes peer through a crack in the closet door – then the perfumed polished head emerges looking around and then it is out – darting around the space – a twirling gossamer-haired Titania.

Then satisfied that the stable remains groomed, it retreats into the closet, more a cupboard where this remarkable beast has a number of instruments – the microphone, the megaphone, the semaphore flags, a euphonium, even a full set of drums. Here it changes into a different mode – no longer queen but king. And if we had penetrated the closet there would have been a number of jolly mates, who spent more time in the light, but in this cupboard they prove what religion is without devotees.

Belford, I am truly sorry about your departure. Such an ornament of darkness is irreplaceable because such perfection – a rugby coaching Titania, even if Balmain never benefited from your trail of tauric stardust.

However, away with sarcasm and irony; a lamentable trait which is stimulated by the very thought of you, Belford.

What a disheartening performance, Mr Albanese, your obsequies to Belford. Moreover, you are now the inheritor of the Labour tradition-the traditions of Curtain and Chifley.

What would they have said about this creature, who has said the vilest things about Jacinda Ardern and Julia Gillard? They are women. Belford seems to have a deep hatred of the successful woman – none are allowed into his closet wardrobe, no way.

So why on earth would you, Albanese, join Abbott and Howard (and predictably Morrison) in their obsequies? Do you intend joining them in losing your seat at the next election? I just happen to have a vote in your electorate as does my wife – and our friends. After all, you are not too young to remember that even Belford lost the safe Liberal seat of Eastwood at a by-election, never to be pre-selected again.

I believe that Belford has had a breakfast audience of 17 per cent. Perhaps we can ensure you get the same vote in the next Federal election – perhaps a few more per cent.

The electorate just has to find its Zali Steggall – willing to challenge your antediluvian views – the electorate has a bit of time to find someone, Mr Albanese, someone who can continually provide a reminder for your praise of Belford, the misogynist.

And remember, Mr Albanese, Belford was in all probability shafted by the Melbourne establishment. Your potential nemesis, Mr Albanese, is Victorian. I am unsure but perhaps then you would get more than 17 per cent of the caucus vote once your praise of Belford sinks into your colleagues.

The Sutherland Reds and Campsie Green factional mates of yore may have excused this behavior but they are almost extinct – and your hero, Belford is about to fall off the wall – enclosed in his own green bottle.

And as you may realise, although he was a good unionist and a Sydney boy, Ted Grayndler is buried in Melbourne – admittedly not “by”.

Mouse Whisper

A colleague of my mausmeister, Professor Leeder, has suggested that a uniformed public health service should be created here as in the United States. There is some value in this idea as it would make public health much more easily identifiable as part of the emergency response team. While it has blended in so well at present, being a uniformed service would provide both a discipline and continuity. However like all uniformed services there is always the danger of attracting the characters, who prefer vestments and braid to activity.

Nevertheless, my mausmeister thought that the comment below (as reported by The Economist) of a current Prior of a Camaldoli order was very relevant. This order is a Tuscan offshoot of the Benedictines, who have an excellent tradition of teaching yet within the monastery are encouraged to keep their own company, in prayer and reflection – without loquacity.

“Still, liberalism has its limits. The liturgy, the scripture, the ritual, the tradition, is the container that holds this life together. You start losing that, it’s a free-for-all.”

Think about it. Wise words. It has a relevance in all sorts of way at the current time, not just to public health, or to a putative uniformed service, and also not only to Christianity.

Benedictine monastery, Tuscany

Modest Expectations – Rat

Australia has a good health system, not perfect but resilient, with some tough informed public health medical practitioners. After an uncertain start it has put in place a comprehensive contact tracing system and a comprehensive testing program while shutting borders.

Thus Australia has built a robust defence, unlike the USA where the hapless Dr Fauci is like the little boy with his finger in the Trump dyke. Give a new twist to a Faucian bargain. His bargain is that he can keep his finger in the hole when the dyke has disappeared, that is if he does not succumb. After all, he is 79.

For the dyke is crumbling because successive American governments have done next to nothing to maintain the public health system – instead seeing health care as just another commodity like golf buggies and casinos upon which you can gamble in a betting ring called the New York Stock Exchange.

The concept that the public health measures are hindering return to normalcy is delusional. For what is normalcy? The good old days are gone, like the Edwardian shooting party with the First World War.

However in this world there seems to be this retro-accelerator stuck in some political vehicle driven by those wanting to return to last February and the good old days of unfettered neoliberalism. For all the talk about its healing balm, the ideal of neoliberalism is a country built on cheap labour fuelled by high immigration from poorer countries. In the US it is these poor – the modern day slaves that the unions have abandoned by and large– whose ranks are being thinned by the virus.

Once, in Australia there was a booming educational market fuelled by temporary immigration, where a profitable equilibrium has turned universities into paper mills churning out certification so their Vice-Chancellors can pocket a million dollars a year and then one at least smugly leave the country with a series of High Anglican platitudes. Wait on though, the borders are closed because the virus has been spreading so rapidly – a crown of thorns killing and maiming in its wake, laying bare the vulnerability of our so-called civilised, neoliberal, sophisticated world.

Now in 2020, the level of hygiene worldwide has been insufficient to stem the viral spread without the current measures. Australian forces, despite some early missteps have, for the time being, repelled these invaders.

The chattering classes are at once relieved but also restless. The Sunday morning in the sun denied; the chatter grows louder – the limited aperture to the café society. The muted resentment as represented by “The common cold is mild;it’s a corona virus; nobody dies from the common cold.”

“The influenza virus?” There is a vaccine – so why worry. Lots of people who we do not know die each year but we do not close down the country.”

“Anyway the COVID-19 virus is worse in the elderly so why should I as an upwardly mobile young person worry?”

And most importantly: “It doesn’t seem to be here in the Southern highlands where the megaphones of denial are suddenly muted, but the spaces are large and the people are few on these estates of the privileged.”

At this point it should be noted that the incidence of respiratory infection has declined as a result of the anti-COVID-19 measures, although this is ignored by those feverishly crying for the accelerator to be pushed through the floor, propelling us back to the past. But unlike the war, this is only months back – grasping distance. The cry goes up: let’s get back to where it all began!

After all, the brawny shock jocks say the virus is a pussy – overblown – let’s throw open the economy, open the borders, let the virus overrun the planes, forget about all those lessons in public health hygiene.

Continued patience is needed. One of prime advantages the human race has is its ability to learn, adapt and innovate. That has happened up until now in Australia and that is why Australia is so well placed.

You see overall, the gung-ho people say the virus has not infected me. But then I was here in Australia and not on the Ruby Princess. Back to square one, but even if you can’t see these viral waves, unlike the Goths and the Huns. There will be successive different pandemics if the world remains unprepared. Yet I hope a better world will emerge after 2020, one that is able to cope with these invaders so that my grandchildren will grow up in another better world as I did after the Second War, which was won –to open  a world far different and far better from that of my father where the rants were there, but not on twitter.

Therefore, while our borders hold out against the viral invader so Australia can have time to reset – just like wartime – and spend our money on essential work rather than the fripperies of the Colosseum or the Hippodrome.

Colosseum

Australia should concentrate not only on traditional defence and biosecurity but also on water and littoral security – and social housing. Dismiss the monuments to political vanity, such as stadia, war mauseolea and unnecessary relocations of little used “icons”. (God what an overused word to justify boondoggles).

The days of the irrelevant, for example, the event planner and the conference concierge, should be numbered. We can’t stop the gambling, but we can tax it heavily and spend it on the necessities rather than The Everest. Australia needs to have a time to see how unimportant yet destructive such misplaced use of resources is to the plan for this national “reset”.

Perhaps we should know how Governor Cuomo, who is the middle of his Battle for Coronavirus, lists his priorities: “When restrictions are lifted the state’s least-affected central counties will go first and each economic sector will be phased in slowly: construction and factory jobs first, and retail establishments that can deliver goods curbside. Next: banks, insurance, law firms and other professions. Then restaurants and hotels, and finally entertainment, sports and schools.” 

Somewhat at odds with our priorities, but then he sees it all from a warzone perspective.

As a postscript, Australia needs to have a clinical dissection of the maul of staffers, rent seekers, lobbyists and superfluous bureaucracy which seem to be excessively paid and which circulate like the rings of the planet Saturn around the various parliaments -nine in all now very much outlined by their extravagant rings.

Drifting towards Analogy

While World War 11 was raging, there were a number of neutral countries that avoided or suppressed the combatants within their borders, while building their financial position (or not) on the back of devastation elsewhere. Some were at the heart of the conflict but with secure borders (Switzerland and Sweden able to benefit); others were far way (South America, but somewhat weakened by internecine conflict); but there were others too weak to sustain a long-term financial benefit; some recovering from serious warfare (Spain and Ireland) and others (Portugal and Turkey). For warfare – read pandemic; for neutrality – read freedom from serious pandemic.

As an example, is Australia supplying iron ore while Brazil remains heavily at war with the virus, akin to Sweden able to maintain iron ore production during the World War 2 without fear of destruction of its supply chain?

I suppose the message is that we should aggressively maintain our “neutrality” for our benefit until the rest of the world gets its health care back in place.

Australia should stop Pyning

Neil Baird – highly regarded commentator on all matters maritime; previous guest blogger.

 Obviously we are very slow learners in this country. Since before the First World War, Australian governments have interfered relentlessly in the free market for building ships. That interference has resulted in ongoing political embarrassment for its perpetrators and enormous waste of taxpayer money.

Essentially, government-owned ship builders have been encouraged several times in Australia and elsewhere and have always failed.

Government shipbuilding has never worked and will never work in Australia because there always seems to be another Canberra political opportunist who manages to convince his parliamentary colleagues into “having another go“. There is old axiom here – seemingly ignored – if it doesn’t work, don’t do it again. 

You don’t have to delve far back in history to find other, equally wasteful examples such as the Williamstown Dockyard in Melbourne and the Newcastle State Dockyard. Cockatoo Island, prior to its takeover by Vickers, an English public company, was another. Every one of them has managed to burn massive amounts of taxpayer money in the search for the holy grail of Australian warship building “independence”.

Recently, there has been considerable bitter controversy around the ever-increasing cost estimates for Australia’s future “Attack Class” submarines. Most of the debate fails to get anywhere near the reality of the problem. And, of course, it’s not just the submarines; we also have a substantial order in for frigates, which faces similar difficulties.

The ASC (Australian Submarine Corp) is just another in a long line of uncompetitive attempts at achieving the impossible. No matter how good the foreign partner, ASC has always ruined the project. Why would it be any different in the future? 

For the latest iteration of submarines and frigates in the pipeline, much of the blame can be sheeted home to three former leading Liberal politicians, Messrs Pyne, Abbott and Turnbull. Together, they have lumbered this country with the wrong warships that will be delivered too late and at ridiculously high prices. And at the root of it all – the wrong company – the ASC. Wrong place; wrong decade.

Even without Abbott, the Turnbull Government tried to bribe South Australia to vote for the Turnbull government in the 2016 federal election – a massively unsuccessful ploy.  

Apart from the proven incompetence of the chosen builder, Australia has yet again chosen warships that are inappropriate for the task and which will be obsolete by the time they are commissioned. They will also be many times more expensive than need be.

For example, Defence “gurus” may have tried a little harder with our “nuships”, as they so quaintly call them. But, no, and indeed, Defence CAPEX is, and mostly has been, a disaster area.

On the basis that every cloud has a silver lining, the economic disruption arising from the COVID-19 pandemic offers us a wonderful opportunity to extricate ourselves from this current naval ship building folly. The pandemic will cost Australia untold billions. So Australia should be taking every opportunity to eliminate any wasteful government expenditure. The Department of Defence is an obvious area in which waste can readily be cut at no cost to effectiveness or readiness. 

In the case of the submarines and frigates, Australia should grasp this opportunity to break both contracts, even if that necessitates paying substantial penalties. The reason: Australia simply cannot afford these Defence toys. Paradoxically, this “first loss” would be our “best loss” and, easily, our “least loss”.

And the solution?

The Government should immediately liquidate ASC Pty Ltd (formerly the Australian Submarine Corporation) and I use the word “liquidate” advisedly. It should definitely not be sold off to some “spiv” private equity outfit with guarantees of future business after which any assets would be stripped. That would just make matters worse. ASC has no hope of ever being anything but a drain on the public purse. The only realistic solution is to kill it off completely, once and for all.

The perfect patrol boat?                                                       Photo courtesy Southerly Designs/Dongara Marine

Australia should proceed with offshore patrol boats (OPBs), especially those being built by Austal (Australian based, but because of an inability to recruit employees here, it is building more of its ships in Asia). But all larger warships, unless very near completion, should be cancelled immediately. 

The only way we can hope to purchase warships at sensible prices and have them delivered on time is to buy them

(a) complete from foreign builders – as we do with aircraft (and even here with F-35 fighter there have been disastrous choices) – or, preferably,

(b) from our highly competent and globally competitive local commercial ship builders. We have several of those. They are world class but Canberra appears to be completely ignorant of them. Probably, that is because those shipbuilders have better things to do than waste time in navigating the Canberra labyrinth.

If manned submarines are really needed, Australia should buy nuclear, reducing the number to six and buy them completely constructed and fitted out in France.

Australia, as mentioned above, has neither sufficient time nor money to build or fit them out here. An added problem is the apparent inability to sensibly and inexpensively choose between the competing offerings from the electronics and weaponry suppliers. One other area to be investigated is the new, small and comparatively cheap, unmanned submarines that Boeing is building – a fully autonomous extra large unmanned undersea vehicle (XLUUV) class.

Does Australia really need and can we afford to wait for new frigates? Unlikely. Again, they will most probably be obsolete before delivery. There are plenty of alternative “submarine killers” available.

Instead of always blindly following our American protector, Australia should very carefully examine what China is doing. The Chinese, 20 or so years ago, started with a “clean slate”. The principle of their long range, hypersonic “carrier killer” aircraft, missiles and missile launching assault craft is well worth close inspection. Ironically, those assault craft were designed in Sydney. So, too, is their very cost effective “maritime militia” concept.

That is something Australia could well emulate, keeping costs down and putting our “naval eggs in many more baskets”. The admirals would hate the idea as it would return us to what they would see as too great a reliance on reserve personnel. They have a strange antipathy toward such a move. However, Naval reserves worked well in wars past and they seem to be working well in the Chinese military forces.

Australia should be looking closely at lower cost enemy ship detection technology using drones and commercial “off-the-shelf” electronics. To destroy those enemy ships and subs, let’s consider the feasibility of truck mounted anti-ship missile launchers that could quickly be moved to appropriate places around the coast? Then there is the modernisation of mine warfare methods. In other words, what gives “the biggest bang for the buck”; a notion in these times which should be more fashionable in Australia.

I would put forward a further question. Why not encourage our world competitive aluminium shipbuilders instead of actively discouraging them? Try to do things their effective and very competitive way, rather than call on inferior overseas sources. They also could easily adapt to steel. It is simpler to weld than aluminium.

And, given that “war should never be left to the generals” (read “admirals” here) we should appoint an advisory and enquiry committee. Perhaps counter-intuitively, that committee could be “balanced” by appointing as its chairman a uniquely qualified and experienced retired admiral, John Lord. As well as being a former maritime commander, Lord has many years of commercial management experience including of purchasing ships. He has vast experience of the perils of dealing with recalcitrant politicians and with the Chinese, having been Chairman of Huawei Australia for a decade.

Committee members should be recruited on the basis of their ability, not because they are mates of existing politicians, admirals or senior bureaucrats. Such a committee should be asked what Australia really requires for: (a) effective maritime defence, both short and long term as well as for (b) both forward and homeland defence. It should be strongly guided to think only of warfare and most certainly not to prop up the current boondoggle in South Australia.

The result of the above task should be done much better, more swiftly and overall much more cost effectively. Thus, Australia should take the “opportunity” that the COVID pandemic offers to sort out our naval purchasing disaster once and for all.

It is getting to be a Long March

There is a group of modellers in Germany who suggest that by prolonging lockdown here for another few weeks, we could really suppress virus circulation to a considerable degree – bringing the reproduction number below 0.2. I tend to support them but I haven’t completely made up my mind. The reproduction number is just an average, an indication. It doesn’t tell you about pockets of high prevalence such as senior citizens’ homes, where it will take longer to eradicate the disease, and from where we could see a rapid resurgence even if lockdown were extended. 

In a thoughtful question and answer session as reported in The Guardian, Christian Drosten, who had been involved in the original characterisation of the SARS virus in 2003, discussed the current pandemic with a reporter from The Guardian.

His comments on the nursing home makes sense; and here there is a need for a detailed plan to close the gap between health care and nursing home care as though there should any difference.

When her opinion was sought on the removal of the residents from Newmarch House, the NSW Chief Health Officer, Dr Kerry Chant, inanely remarked that they may not have wanted to be moved, as though all are in a suitable state to be consulted in some languid case conference.

Dr Chant, if the nursing home is on fire, then you move the residents – no questions asked. The immediate aim is to remove people from danger, to put out the fire with the least damage and not ask the staff (metaphorically clad in t-shirt, shorts and thongs) to do so. We call in the professionals immediately. That is what they did in Tasmania, where the bureaucratic lines were put on hold. The residents were moved and AusMat came in and cleaned the infected area.

In the interim, it gives time to clean up the mess, give Anglicare a boot up the backside, have education and safety protocols with somebody clearly qualified and responsible for the staff anticipating that there will be a high turnover, and provide the requisite gear to counter any “spot fire” emerging. This plan should be generalised and as it is a health matter it should come under the surveillance of the NSW Department of Health, irrespective of where the funding comes from.

And as for the Commonwealth-based Aged Care and Quality Commission, they seem to be the same sort of quango inhabitants which are bred in some public service hatchery for such jobs with seemingly little hands on experience. Maybe wrong, but tell me if that is so. Anyway I don’t see them with disinfectant and mops in hand cleaning Newmarch House.

I sent an email to someone who has some influence about two weeks ago. Inter alia, I emailed:

There is an uncontrolled outbreak of COVID-19 in Penrith…

This Newmarch House disaster has all the hallmarks of another Ruby Princess. The NSW Department of Health have gone missing… There is an increasing degree of frustration going on among the relatives. The nursing home lockdown is the only defence, and increasingly flimsy.

Penrith is at risk and joining up the dots and we end up with the Penrith Panthers, with one of their players already breaching the guidelines…  

The italicised comments of Dr Drosten at the head of this piece seem to be on the same page as these. 

A fascinating interview

I had watched a fascinating interview of Denis Richardson by an obvious old mate in Barrie Cassidy, when she looked at me with some surprise. Now as this someone asked, why would I write about an old bureaucrat who’ll soon be forgotten? Maybe the name may be lost on the tip of the tongue; but these people leave an important legacy.

Listening to the interview with Denis Richardson, I thought maybe somebody would have said that about Cardinal Richelieu – my mother’s charcoal portrait of whom has always hung in my office.

Richardson comes from a long line of such confidantes to the powerful, having come far from his origins in Kempsey. He does not give the impression that he is a Burnt Bridge Road boy.

Cassidy in a very insightful interview meandered through the upward spiral of this highly intelligent yet controlled man who has kept his obvious sense of the ridiculous in check during his career.

As one who resisted the blandishments of certain ASIO operatives to join when I was President of the Melbourne University Student Representative Council and who shared a study with Brigadier Spry’s son, it was interesting to the modern iteration of the “spook boss”.

His obvious attachment to the American alliance was deftly handled as if the positioning of Casey to Washington in 1940 was purely a prescient sign of the pact between USA and Australia. He did not mention how the ANZUS pact actually occurred despite the opposition of the State Department when a serendipitous meeting occurred between the then Australian Ambassador to the US, Percy Spender, and Harry Truman in 1951. But what would I, an outsider know. These are minor quibbles in an interview, which should be required viewing by those wanting to enter the public service – and especially Foreign Affairs.

I shall certainly get my grandkids to watch – a real-how-I-saw the world without moving my lips. Seriously, excellent viewing – and if you read this as you may – I too have been to every State in the USA plus Puerto Rico. However, Richardson’s peripatetic nature was probably only following one of five Ambassadorial dicta: “see politicians when they are out of office and in their home states, away from Washington, which also means travelling.”

There was only one slightly disconcerting feature, for such an impressive bear of a man. He has an extraordinary giggle. But the unexpected is one expected in such a complex person.

Bloody good interview, Cassidy.

Mouse Whisper

As a reaction to Cardinal Pell?

The Vatican Synod of Bishops ruled Monday that perjury is not a mortal sin, downgrading the sin to venal. “God and The Mother Church will be more than satisfied with a penance of 20 rosaries for any act of perjury,” Cardinal Angelo Sodano said. “Any earthly prohibition against lying in a court of law has no relevance to the holy teachings of The Bible.” The proclamation comes on the heels of last Friday’s doctrinal clarification that adultery only occurs when both participants are adults.

Do you smell a rat? Yes, this comes an American publication called The Onion. It was published in 2002.

No, it has nothing to do with Georgie. However, somewhat telling do you not think?

Modest Expectations – Pike’s Peak or Bust

The Cook / Covid-19 comparison highlights a problem with a cohort of young doctors who go into public health medicine. Generally they are very intelligent, but some, unlike Sue Morey or Nick Coatsworth for example, have lived a professional life in cotton wool. Among them, you get a few smartarses, where the ready availability of Twitter and one more glass of red than should be imbibed leads to a misstep. The higher up the career ladder, the more the misstep becomes obvious. If the misstepper ends up on the ground, the question arises whether the person is mortally injured or will just bear a stigma on his or her professional life.

There are no real excuses for such a puerile tweet, where superficially it may be seen as a clever expression of a belief. However, despite the predictable blustering from the Liberal political cognoscenti pazzi, they should rest assured that the good doctor would have been given a verbal flogging by the Premier.

Yet he would recognise that she is a hard worker in a stressful position, and one who would definitely be against premature opening up Victoria and having to combat the “joy boys”, jocks and the Murdoch publications braying for sport to be reintroduced for solely financial benefits with a slight simpering regard for the community health.

Andrews learnt a lesson at the last minute, pulling back from the Grand Prix. With the potential of a cohort of infected Europeans mingling with the crowd, Australia may well have been plunged into a crisis. It has been bad enough with the antics of the NSW government in regard to the Ruby Princess. I do not underestimate the involvement of this good doctor given the reckless behaviour in the neighbouring State with Victoria not locking its borders against NSW.

Just a word of advice to you Dr Van Diemen, if you want to say what you like publicly, wait until you get to my age, and then it does not matter. You will recover from this glitch and hopefully have a successful career. But ditch Twitter and leave your wisecracks to spaces where the walls are not listening. Everybody in stressful positions needs to sound off occasionally, but go find a few like-minded galahs to share your frustrations. I mean the fluffy grey and pink ones.

A little known encounter of Jimmy Cook

Since everybody is getting into Cook, I thought reviving a relevant part of my novel “Sheep of Erromanga” would enliven the discussion about of the impact of this Yorkshireman on one small island in the South Seas. The story centres around a young Australian called Philip Morey who spent two years on the then New Hebrides island of Erromanga in the1930s, and this describes the end of a trek across the island.

At last, Philip had emerged from the dark jungle through the line of giant tamanu trees. Through the foliage he was met with a vista of huts along the water’s edge. To his left, the dancing silvery shards of the river Ounpontdi made him stop. 

So this was Potnarvin, lying under the lee of a mountain called Traitor’s Head. He shaded his eyes as he looked upwards. The mountain appeared to rise to what he estimated to be about 3000 feet. Its height was hard to gauge as clouds obscured the peak. As Philip was to find out over the three days of his stay, Traitor’s Head was almost perpetually covered in cloud. The clouds concealed the fact that Traitor’s Head was a volcano. It had not erupted for nearly two hundred years, but had done so twenty-five years after Captain Cook had been there on an exploratory voyage. 

The mountain had received its name from Cook who, on landing on the beach, wondered why such apparently friendly people were armed to the teeth. One of Cook’s muskets had misfired and the friendliness had vanished in an instant. A battle had followed and, before Cook was able to get back to the ship, one of his sailors had been mortally wounded and at least two of the Erromangans lay dead. Philip thought the “Traitor” was an odd choice by Cook, given that he had a meticulous way of naming his discoveries. The Captain was probably just annoyed. “Traitor” did not seem to be the right word, although the incident was certainly prescient of Cook’s future.

The villagers, unlike their ancestors, had welcomed Philip. They seemed to appreciate the quiet tall young white man, who came out onto the beach stopping to look around and unbuckle his rucksack.

Cook’s response was predictable – confrontation with bloodshed. At the time of Cook’s visit, the Erromangans were cannibals, with a strict etiquette concerning where the white man could move around on the beaches where they landed. These rules were transgressed as they were later with the arrival of Presbyterian missionaries. When they crossed this line they were killed. In addition the natives developed quite a taste for Scottish missionaries – haggis?

Purchase a copy of The Sheep of Erromanga! Email enquiry to: SheepofErromanga@gmail.com

The recidivist Carnival

On February 27 this year, a cheery ABC reporter noted:

… the effects of swine flu in the grip of the 2009 pandemic was confronting. This disease affected people who don’t often get the flu, afflicting young adults whose previously healthy lungs became white and cloudy with pneumonia. While most recovered, many did not. By the end of 2009, more than 37,000 Australians had been diagnosed with swine flu. 

More than 190 people were dead. 

Worldwide, the US Centres for Disease Control estimate swine flu killed as many as 575,000 people. Eighty per cent of them were under 65. 

Let’s contrast the swine flu epidemic with the spread of the novel coronavirus — or COVID-19 as it is now known.

The new virus is sweeping through parts of China and infecting small numbers all over the world…

I will not detail some of the learned academic predictions that were criticising our draconian measures e.g. close our borders to China. Their expert advice was just wrong.

Now just what was being reported in the media in the autumn of 2009?

As suspected swine flu cases in the Hunter New England health area jumped to 72 yesterday, a Hunter family quarantined at home after a cruise on virus ship Pacific Dawn slammed the handling of the outbreak. 

The Exxxxxxo family of Thornton was ordered into quarantine on Tuesday, a day after they arrived home from a 10-day cruise on the Pacific Dawn, and only after Mrs Chris Exxxxxxo contacted health authorities.

“There were 2000 or so passengers wandering around who had no idea that they should be avoiding contact with other people.” Mrs Exxxxxxo contacted NSW Health who confirmed the family should be quarantined and was later contacted by P&O Cruises.

As the flu emergency escalates, the Federal Government has ordered enough doses of swine flu vaccine for 10 million Australians. The Exxxxxxo family has spent the past week in lockdown in their home and will not be allowed out until they receive the all-clear on Sunday… 

…When the Pacific Dawn cruise ship docks in Brisbane today, after cutting short its cruise because of the flu threat, the Queensland Government will invoke tough quarantine powers to stop interstate passengers disembarking. Three crew members have tested positive to the virus, but have recovered with treatment. Five passengers await test results. Health officials will screen the ship’s 2000 passengers and 700 crew. Only Queensland residents will be allowed to disembark and will be asked to quarantine themselves for seven days.    

“We are being extremely cautious in our testing arrangements for anybody who presents themselves with flu-like symptoms” Carnival Australia chief executive Ann Sherry said.

Of course, that is what you would say, Ms Sherry, with your winning smile. It is however understood that people with swine flu contracted on Carnival ships may not have agreed.

And then about the same time there was another media release…

Minister for Health, John Della Bosca, today announced NSW would upgrade its Swine Flu protocols for cruise liners who arrived in NSW waters. 

The NSW approach to arriving cruise ships has been developed in consultation with the Commonwealth. 

“When the Pacific Dawn arrived this week, its passengers had not been to any jurisdiction where Swine Flu was present and it was considered unlikely the virus was on the ship,” Mr Della Bosca said. 

“The two children from the Pacific Dawn who have since tested positive for Swine Flu had not travelled overseas before boarding the ship, had no contact with affected countries, and were not considered to be at risk. 

“An additional 16 people from the ship have since been confirmed to have Swine Flu. Six of these people are currently in Queensland. 

“These people have been assessed by public health staff and placed into isolation. 

“Further public health assessment of contacts of these passengers is now underway.”

Similar pattern. Let them all off the boat – she’ll be “jake”. The NSW Chief Health Officer then – the incomparable Kerry Chant.

Unlike COVID-19, a vaccine was rapidly developed for swine flu, (the existing influenza vaccine was partially effective) which then helped contain the viral spread. Nevertheless, on a population basis Australia had the third highest number of cases worldwide. The virus affected the elderly, young children and pregnant women particularly, and spread so rapidly that contact tracing was well nigh impossible. Fortunately, it was not as deadly as initially believed, unlike COVID-19.

In the case of Victoria, it was bought there by a well-to-do Australian family returning from the USA by air. Their children spread it in the two well-known private schools they attended and the spread was accelerated by a “social” dance. Later, its spread was tracked along certain tramlines passing through Bolli-wood a.k.a. Toorak.

It is interesting that although it was first berthed in Victoria, the cruise ship made sure it spread the virus to NSW where the normal laissez-faire attitude (see Chant) predominated. However, in Queensland the Pacific Dawn was refused permission to berth, and the following may be apocryphal but nevertheless it is a good story. A highly-placed Queensland official threatened to order gunboats, a.k.a. whatever Dutton inherited, into the Brisbane River to make sure it did not happen – bit of a wimp the current Premier – only closing the borders.

The Office – viruses thrive on randomness

Some time ago, as I reported previously, well before the COVID-19 outbreak, I was sitting in the foyer of the Alfred Hospital in Melbourne where there was a hand sanitiser predominantly displayed. Virtually everybody entering and leaving the hospital ignored the instructions to clean their hands.

Last week I was waiting in the foyer of Cabrini Hospital in Malvern and next to where I was sitting, near the hospital exit, there was a hand sanitiser. Despite the hospital foyer having all the trappings of virus prevention, this sanitiser was mostly ignored. Yet on the other side of the foyer not five metres away all the preventative measures were in place – maintaining a safe distance in defined queues, temperature and verbal screening, hand sanitiser use being required.

The difference – one side of the foyer was supervised; on the other, no supervision.

The problem with any loosening of the COVID-19 chains is that the new concepts of hygiene are yet to be embedded in the nation. As I have said, the standard of public toilets gives a clue as to how seriously hygiene has been embraced by this country. Driving between the two capital cities this past week for medical appointments, I observed that the toilets along the Hume Highway are just as bad or as average as they have always been. There has been no change except toilet paper has disappeared for various reasons from some of the dispensers.

Having issued this caveat, there is no doubt the underlying strength of the Australian health system has been shown even given some of the dills, often influential, who have tried to disrupt the public health protocols, because that is what they are – dills with a deep-seated sense of entitlement and self-importance – the essence of “Do you know who I am?”

As I wrote last week, there is a good case for the re-opening of schools, and paradoxically Premier Andrews being so hardline means that the other politicians have to be more measured.

Viruses love disorder

The more that you contain the natural community Brownian movement into more laminar flow then the more order you bring to contain the enemy. However, at the same time it must be recognised that open plan and activity-based work spaces designed 20 years ago to maximise the number of occupants were also designed to maximise “random” contact between staff members who were moving around in the workspace. The post-COVID-19 office has to contend with minimising disorder while dealing with now-outdated office planning that maximised apparent randomness.

While the concept of working from home has seemed to solve the problem of halting the viral spread, the evidence of long term efficacy of working from home is mixed. Some may praise its “flexibility” and claim that efficiency has improved, while others use the word “chaos”.

In my mind’s eye I have a hospital operating theatre. Here people are gathered together for hours on end to perform operations and in so doing assuring the patient does not acquire an infection attributable to the operation. The air conditioning must be maintained at such a standard that the air circulating is pure enough for the most complex operation – such as a joint replacement – to be undertaken with the least risk.

In the end, the assumption must be that the post-virus office must be big enough to provide sufficient space for people to congregate while maintaining a certain distance from one another without shouting. Street clothing does not seem to be a major factor in viral spread, but the operating theatre staff do not go into an operating theatre in their street clothes as the nineteenth century surgeons did. They change into their green or blue scrubs, their head covered and mask at hand. And at the operation a further gowning with all the appropriate obedience to the rules takes place, and this ritual is repeated for each patient.

Professor Lindsay Grayson

Professor Lindsay Grayson, the Australian doyen of hand hygiene succinctly summarised the national hand hygiene study after eight years observation in 2017 – The National Hand Hygiene Initiative (NHH) has been associated with significant sustained improvement in hand hygiene compliance and a decline in the incidence of staphylococcus aureus bacteremia (HA-SAB). Key features include sustained central coordination of a standardised approach and incorporation into hospital accreditation standards. The NHHI could be emulated in other national culture-change programmes.”

The challenge to community cleanliness is to accept the challenge for its offices as set down by Professor Grayson.

The new office order

The elements of the new order now are being tested everywhere, have they penetrated into every individual’s brain … at least not yet.

The elements include:

  • Social distancing and limiting the time spent in face-to-fact contact or in a closed space with others
  • Lift etiquette and disinfecting
  • Masks (understanding how and when they should be worn and by whom)
  • Air conditioning
  • Hand hygiene and not touching the face
  • Temperature checks
  • Responsibility for the regular cleaning of one’s designated work area, including equipment such as computer keyboards and phones
  • Regular cleaning of the office, reception, kitchen areas and the toilets
  • Quarantining anybody who shows the slightest sign of a respiratory infection
  • Viral testing
  • Being able to plug into a internal form of contact tracing to identify if employees are not generally within their designated areas (that is, for the purposes of maximum numbers to ensure social distancing)
  • Food outlets
  • Making provision for workers who are at a higher risk

This is part of the equation – the other major element is how to get employees to and from work safely when public transport is designed around maximising the number of passengers and when work hours are not staggered, but that is a future blog.

One of the theoretical advantages has been the advance in communication over the past decade. This has meant that isolated people can see one another – good reliable images of the people. How far that improvement in this distant communication can supplant actual face-to-face contact will give researchers a great deal of time to seek answers. Online meeting platforms will be an essential part of the response to this pandemic.

It is up to those who head the large firms to enforce social distancing – not sitting huge distances away, although appropriate spacing of work areas will be important, but being careful of exchanges – the hand shake, the hug, the kiss on the cheek, borrowing somebody’s pen. It is these social gestures, essentially random, upon which the virus thrives.

There must be an etiquette in the use of lifts, as is occurring in hospitals already, with the maximum number of people prominently displayed. Again this demands discipline.

The meeting room should contain a round table of appropriate size, and the air conditioning should be such that a joint replacement could be performed on the table with little chance of airborne infection. Time spent in closed meeting rooms should be minimised.

This leads to the discussion about planning an office to be open plan or not. As the NYT reported this week: “Some companies have begun mentioning a return to one of history’s more derided office-design concepts: the cubicle. There is talk also of the cubicle’s see-through cousin, known as the sneeze guard.

“Cough and Sneeze Protection Screens,” is how they are being marketed…

Earlier in the article “Soon, there may be a new must-have perk: the sneeze guard. This plexiglass barrier that can be mounted on a desk is one of many ideas being mulled by employers as they contemplate a return to the workplace after coronavirus lockdowns. Their post-pandemic makeovers may include hand sanitizers built into desks that are positioned at 90-degree angles or that are enclosed by translucent plastic partitions; air filters that push air down and not up; outdoor gathering space to allow collaboration without viral transmission; and windows that actually open, for freer air flow. 

All very good, and some of these changes are evident in our hospitals and retail outlets, but it is imperative that offices have a structure to ensure that all the changes are effected. In other words there is a team of enforcers, from the time the person enters the office area initially to use the hand sanitiser to the odd time he or she may use the toilet. You see that sign in the aeroplane toilets to respect the next user by cleaning up after yourself. One can believe that some who use the toilet are blind. After a few hours in the air the said toilet can become unclean because of lax enforcement. The new office will ensure that cleanliness is maintained

Then there is consideration of the material that you use to outfit the office anew. In a NEJM article and combined with another source, it was shown that the virus persisted up to four hours on copper, eight hours on aluminum, 24 hours on cardboard and two to three days on plastic and stainless steel. Elsewhere it has been shown that on glass or wood surfaces, the virus will remain present for up to 4 days.

Reassuringly it has been shown that Covid-19 can be eradicated within one minute by disinfecting surfaces with alcohol, 0.5% hydrogen peroxide, or bleach containing 0.1% sodium hypochlorite.

Watching the thermographic camera in operation while I waited at Cabrini Hospital was an impressive demonstration of its capability, and the question is the number needed and their positioning. Having temperature taken manually is probably more consuming of staff time. Nevertheless the receptionist or however he or she is described must be someone who understands the basic requirements of public health, and it should not be too difficult to arrange an instruction in this. After all, the responsibility extends to ensuring clean toilets, that there is form of “contact tracing” of anybody in the building, with the current chunky badges of identification need to be reviewed.

One of the other matters which follows is how food and drink is dispensed. Bringing your own coffee cup and lunch is an obvious solution. Trialing take-away has been happening in the community, and therefore how the workers obtain their coffee and lunch needs to be mapped. When food and drink is raised, then the spectre of alcohol is also raised. I have some doubt that those affected by drink respect social distance. Then what does the office do with those who smoke, coffee in hand outside the building. As I walked around the outskirts of the Royal Melbourne Hospital last week, even there were numerous staff members in their scrubs outside smoking in corners away from the elements.

Thus in the end someone in the office must be the arbiter deciding who needs to be tested or sent home. There is a certain unrealistic optimism about a vaccine, and clearly the anti-viral drugs do not work on coronavirus. If they did, the cure for the common cold would have been had long ago. As for hydroxychloroquine … be careful Palmer, what is your pitch when the first person dies using that drug rather than killing the virus – go green rather yellow?

Those in business must take a pessimistic view and not believe the vaccine is just around the corner. However, in equal measure they must take an optimist view that careful planning and implementation of a rearranged COVID-19 office space will support both the reopening of business in 2020, but also recognise this will be the “new norm” for the foreseeable future.

As for masks, they may be obligatory in the operating theatres where the operating team are kitted up with sterile gowns and gloves, however in the community I have this image of the Italian smoking, his mask limp around his chin. Masks are ideal to irritate, to touch – as are gloves when the gloved hands are moving from one potentially infected surface to another. Masks thus can be a definition of false security as are latex gloves – only as clean as the last touch.

In the end, the broader community has to come to an understanding of what is needed to provide a safe working environment because the changes that are needed cannot be achieved without everyone giving up some personal “freedoms”. At the same time reliance on pre-COVID-19 legislation to direct the ways things were done won’t cut it any more. Governments have to review all their relevant legislation to make sure they don’t allow sloppy hygiene to continue.

This is whither I have arrived – a personal exercise calling on what seems to be a reasonable allotment of information in turn to provide a reasonable allotment of advice.

Mouse Whisper

I was self-isolating outside my mousehole when I looked up at my mausmeister’s television and saw a man called Nev who turned up on the screen. He seems to reflect this economic imperative, which is taking over from the lingering pandemic, as his mates are getting restless. Doctors should stick to the hospitals was the secondary unvoiced agenda.

Pardon my meek mousiness by addressing you as Nev. I thought I heard it correctly that you said there will not be another pandemic – you will make sure it does not happen again? (see above). Hope the viruses are listening.

You know Nev, you, the bloke who maybe can’t see the trees for the Forrest.

Danse Macabre

Modest Expectations – Giuseppe Conte

Kristina Keneally last Sunday was almost hysterically defensive in trying to shield the NSW Department of Health from blame for the Ruby Princess affair. It is noted that she, among others, enjoyed the largesse of Carnival, as reported in The Australian Financial Review in 2009. And the media does not report all her contacts; therefore it is inconceivable that this dinner was the only contact she has had with what are described as the “queens of the sea”.

They were dubbed the queens of the sea and the seaboard triumvirate as Carnival Australia chief Ann Sherry and chairman Katie Lahey and Governor-General Quentin Bryce put on a massive party for the launch of P&O Cruises’ new liner, the Pacific Jewel, at Sydney’s overseas passenger terminal on Saturday night.

More than 900 diplomatic, tourism and naval brass plus some serious business heavies hit the deck in the balmy summer weather to watch Bryce do the honours in the traditional naming ceremony.

Among the guests were GPT Group chief Michael Cameron, Deutsche Bank chief Chum Darvall, NSW Premier Kristina Keneally, UBS chief Matthew Grounds, Unicef Australia chief Carolyn Hardy, Telstra chairman Catherine Livingstone, David Jones chairman Bob Savage and head of apparel Colette Garnsey, Garvan Research Foundation director Lyn Gearing and navy fleet commander Rear Admiral Steve Gilmore. Also on board were the liner’s celebrity chef Luke Mangan and designer Alex Perry, who dressed Sherry (unfortunate juxtaposition -ed) and R.M. Williams’ chief Hamish Turner.

From all accounts it was a big night, with an on-deck circus and Australian Idols Stan Walker and Wes Carr. Funds raised went to the Leukaemia Foundation and Special Olympics Australia. And this time – unlike in May, when Sherry and her posse were quarantined on board – there was no swine flu to worry about.

Quite a quarantine force above, Ms Sherry! And this time in 2020 you made sure you were not on board when the virus hit.

Dear Chattie

This is a very personal note which others may find eye glazing. One of my cousins, Carol, put together the letters between the soldier and his sweetheart. They were her grandparents; Charlotte Egan was my aunt.

Andy Campbell, a young farmer, went into battle at Armentières almost as soon as he arrived in France in 1917. The family soon received the news “missing in action, believed killed”.

However,

                                                  Military Hospital

                                                  Tankerton

                                                  29/3/1917

My loving girl,

I suppose you will be wondering how I am getting along. I sent a cable home so they would let you know I’m progressing slowly … I wrote to you from Boulogne in France. I came over here on the 26th and it is a pleasure to see the good old English soil again. France is a rotten hole of a place.

I was in Armentières in the trenches.
Miss C. Egan

Austin Hospital Heidelberg

Dear Madam

Re: Pte A Campbell No 2033 38th Battalion

… He is stated to have been admitted on the 12th March to the 13th to the General Hospital suffering multiple gunshot wounds and dangerously ill.

… admitted to Military Hospital Tankerton in Kent.

… suffering from a shrapnel wound of back, left arm, right hip and buttock. He has a compound fracture of the left ulna and radius. He has an injury to his left lung. General condition is severe but is progressing satisfactorily.

Well my darling I hope you are not worrying. I know you will be anxious. I haven’t lost any limbs thank goodness. But I’ve got some shrapnel in my chest somewhere. It went in my back. The other wounds are healing fast.

…This a great place for oysters. The boats go out every morning and the boys here call them the Australian fleet

…I often dream of my loving girl and home
                                                                              Goodbye lovely.

Andy Campbell was returned to Australia, hospitalised in Caulfield Hospital and was discharged from the hospital and the Army in 1918, a year after being wounded.

Andy married Charlotte Egan in 1920 in Redbank in Central Victoria.

In the end, they had four children. They moved around country Victoria, he working for the State Government in the Soldiers Settlement Scheme, finally ending up in the small town of Beaufort.

Charlotte Egan became one of the earliest members of the CWA and as well as raising a family worked as a volunteer for the Red Cross and other charities for all her married life. She was known for her cottage garden. “Stalwart” she was in every sense of the word.

Andy, who never regained the use of his left arm, died suddenly in 1953 and Aunt Chattie, as I knew her, outlived Andy by almost 50 years, dying at 101.

As my cousin wrote about her father and his sisters growing up during the Great Depression “They lived the country life-style with wood burning stoves, home baked bread, roast dinner, a cow to milk and butter to churn.”

In 1992, I was asked by the Victorian Department of Health to review a number of small country hospitals including the one where my Aunt Chattie resided; one where she had spent a considerable time on its Auxiliary. When I was there I went to see her; she was then 100. She turned to me and with these direct words of quiet reproach, said: “You have not come here to close the hospital I hope, Johnnie.”

It was the same Aunt Chattie, who reproached little Johnnie for throwing a scone 45 years before at Great Aunt Mildred.

The hospital remains open today.

Edenhope War Memorial

Andy Campbell’s name is on the War Memorial in Edenhope as it is with those of his brothers also on the one in Harrow. These are small towns near the South Australian border where Andy Campbell grew up and later worked.

One Anzac morning I happened to be in Edenhope. I was alone standing in front of the War Memorial. It was a cold morning with clear skies streaked with red. It was a strange sensation that I, a person who abhors war and thinks Anzac Day commemoration is overblown, should be standing at dawn to honour Uncle Andy on that day in April.

But then Uncle Andy did not think war was much chop either. 

The Day My Belt Broke – an Australian at the Antiques Roadshow 

The hardy BBC perennial show has been yet another casualty of the Covid-19 pandemic. It has been cancelled in 2020.

I am an antique Antiques Roadshow tragic. Fiona Bruce has been the presenter since 2008. She exudes charm; how she handles the gormless, how she handles tragic situations – all are confronted with a degree of appropriate equanimity and sympathy.

Antiques Roadshow, Benedictine Abbey, Buckfast, Devon

The TV show has been brilliantly devised because so many of the long time presenters are so idiosyncratic and of course the locations for the shows are carefully selected. I happened to be looking at the program early in 2018, and saw that the last Antiques Roadshow would be at Buckfast in Devon in the grounds of the Benedictine Abbey. Buckfastleigh, the adjoining “ancient woollen town” was where I could trace my maternal line back seven generations.

Too good an opportunity to pass up! Since I was going to be in the town for the Roadshow I decided I would pose two modest questions about my submitted items: was that New Zealand silver on the 19th century greenstone boot hook and was that Australian gold decorating the carnelian brooch?

However, the program organisers seemed not interested.

On impulse I decided to present a spurtle to Fiona Bruce – something Australian. So, given her Scottish name, I bought it, a Scottish porridge stirrer, made on the west Coast of Tasmania from Huon pine – a quirky gesture.

We arrived around 10 in the morning – there were already long queues. We were assigned to the “Miscellaneous” queue. For TV, queues are shown as an interactive experience, with Fiona often moving along the line. The reality is that you just shuffle along for three hours, although it must be said that the Poms are unfailingly cheerful at this event.

Eventually, we were diverted to Hillary Kay with our 1912 diorama of Canberra because as a naturalised Australian she knows “us colonials”. The less charming expert to whom we were initially sent was very offhand and uninterested in our offerings, but at least she did send us over to Hillary.

The first thing Hillary said was that I looked “reasonably respectable” and could I mind her handbag. Then she disappeared for 20 minutes. When she came back, she was just as she appears on screen – charming, frank, informative, with a sharp-edged smile.

She admitted she had no clue about either the value of this long scroll or its purpose, but believed it was a significant piece of Australiana. Australiana mostly had little market in the United Kingdom. We had a pleasant conversation even though probably I could have met her in Sydney if I had bothered to work out where or if she consulted there.

As for Fiona Bruce, just after we had arrived in the morning we had been directed to the producer for a possible spurtle handover. “Yes Fiona would be delighted to meet and receive the spurtle”, with the addendum that it would be “off camera”. But drat – the spurtle was left in the car – and the moment was lost. “Yes we could come back later” – “yes around 1 to 2- Fiona tends to leave about 4”, but as the day wears on then everybody becomes consumed with the unexpected and then your request becomes an irritation … when I later enquired of the producer I was told “no time soon”. The moment passed and I penned a note and left the spurtle with the BBC.

However, at that point any lingering thought of staying on the off chance of meeting Ms Bruce was dashed when my belt broke – and now I was truly disabled. Trying to keep one’s trousers up when one is walking uphill with two canes takes one to new level of disability.

So there we were – missed out on meeting Fiona Bruce – but then one of the great disappointments of my life was not meeting Zhou-En-lai either in Beijing in 1973, but that is another story.

Give me Land, lots of Land…

Hundreds of cases are believed to have emanated from an après-ski restaurant and bar in Ischgl, a resort town in Austria. You can see a video of the carousing at the alleged establishment, where there’s nothing but close quarters boisterousness and singing. 

Why is singing significant? One 2019 study published in Nature’s Scientific Reports found that “the rate of particle emission during normal human speech is positively correlated with the loudness (amplitude) of vocalization.” It also found that “a small fraction of individuals behaves as ‘speech superemitters,’ consistently releasing an order of magnitude more particles than their peers.” In its review of the literature, it also offered wild facts like this: Saying “aah” for 30 seconds releases more micron-scale particles than does 30 seconds of coughing. That may be why weddings and funerals and birthday parties and church services of all sorts have been central to outbreak anecdotes. As for drinking establishments, a quiet pub with a bit of space between customers probably isn’t going to see a lot of people infected at once. But a rowdy spot in the Alps? A lot of infections. Shared vocalization is a magical thing in normal times, but these are coronavirus times. Even a cough-along is looking safer than a sing-along. 

Aspen après ski

This quote is comes from a recent issue of Vanity Fair, and is timely for proponents of opening up the snow fields.

What the virus has taught us is that space is important, but is this not an absolute. Snowfields provide space, but not the lodges, which are not necessarily built for spacious relaxation.

While the upper crust ski set might enjoy spacious accommodation, much of the rest of the skiing experience is crowded bars, lift lines and chairs. Combine that with close contact with the ski slopes workers who live in very close quarters, and a highly contagious virus has an ideal setting in which to spread.

In Victoria Mr Virus No 13 was one of the early ones to be infected by the virus on his way through the United States. He infected his wife who was a teacher, and in turn one of her colleagues who shared an office with her contracted the virus. There was one other case at the school, a boy who had recently returned from China, with whom she had no contact. The school online chatroom was full of thrashing about – no one knowing what to do. Their three children were not positive on testing – two being pupils where she taught.

The instinctive reaction is to flee home, lock the doors and turn it into a fortress to defend Olivia and Christian from the risk of contracting the disease. Home schooling is rapidly constructed. Then TV arrives and we have pictures of the domestic Elysian Fields where Olivia and Christian are seen hard at work on their own personal laptops carefully spaced around the island bench in the kitchen, and home is portrayed as a uniformly happy environment.

If long-term home schooling were the answer why have schools? What is emerging in Australia is a frayed attitude to schools.

For those whose parents have employment then the school becomes a de facto childcare centre. Is that what schooling is about? What about the family in the working class area where both parents are unemployed and the children are at home. Do they go to school as part of a welfare system to escape the threat of domestic violence, ever present at home?

The problem with selective schooling is the loss of the objective –universal education. Because as shown in those parts of USA where education is rudimentary, one of the pillars of civilisation is severely loosened.

In Australia the school situation provides the basis of an observational trial. Inevitably political fingers cannot be kept to themselves and thus any data collected will be contaminated.

Three States are opening the schools up; two are opening up cautiously; and three are favouring keeping children away except for exceptional circumstances.

Given that the major factor in spreading the virus in schools is probably the teacher staff room, I can understand why the health authorities are cautiously supporting fully opening the school. Children seemingly develop a mild form of the disease, but it was not so when I lived through a polio epidemic. So educational strategies where widespread disease threatens must be robust but flexible.

Shroud-waving teachers stigmatise their profession by saying that they cannot convert the current situation into a new routine. Dream on, the world and everyone in it will have to live with the virus, a vaccine is not coming soon, and thus society must develop the ability to work in a different space with scrupulous hand hygiene and regularly cleaning of the classrooms and making sure the school toilets are maintained and not pig sties covered in disgusting graffiti.

The toilet is literally the seat of good hygiene, where it is imperative to maintain the soap/sanitiser and have a working drier. The traditional paper hand towel should be banished. Schools will need to employ people to ensure that an even standard of hygiene is maintained as well as the cleanliness of the ablution block, whether it be the poshest or the most working class of schools.

This approach to hygiene has to be embedded in the school culture and in the teaching profession, rather than complaining that the virus is not one’s personal responsibility. Nobody should be allowed in the school with any signs of respiratory disease. If by chance they are, all school should have a school nurse, someone able to be kitted up and quarantine both the sick child and teachers until they are able to go home or to a health care centre.

When it is expressed in this way, it means not letting children go back to school and leave it that – it means a wholesale change in the physical school arrangements over time. There would be nothing more worthwhile in the life of a medical or nursing student than to spend a few weeks in a school assuring cleanliness even if it meant that they had to clean out and maintain the cleanliness of the latrine. This would provide some useful understanding of basic practical public health.

This pandemic is not a casual event; the World has been fortunate to have dodged the contagion for so long, given how many epidemics have threatened.

A country that trashes education, a country that trashes health and hygiene is a barbaric State. Just ask Donald Trump.

Mouse whisper

An H5N1 strain of bird flu influenza virus emerged in Southern China in 2006 (where else?). While it appeared in chickens, the super-spreaders were shown to be ducks. The one that initiated it all was Donald, the greatest super-spreader the world has ever known. It was seen quacking all over Southern China – rose gardens, high golden towers – everywhere, its distinctive vermillion tail twitching – a sight to see.

And then it vanished. Nobody knew where it went. But they say it was a dangerous virus Donald carried, capable of doing anything, even being able to convert its carrier into a different species. The most powerful and destructive virus ever isolated in modern civilisation it is said, but then nothing as a result has ever been greater than Donald the Quack.