Modest Expectations – Geneva & Adelaide

The sight of our Prime Minister flailing around, without the wit and with deep-seated prejudices inherited in his childhood, reflects the fact that he is increasingly paralysed by the culture over which he presides. The problem with cultural change is that it takes time, and frequently depends on brutal decisions, not the least of which is to confront the problem head-on and cut away the diseased part.

Taking a medical analogy, once the doctor finds the abscess, it is drained. If the abscesses are miliary, then a general remedy is needed, and even then the disease may overwhelm the system.

All I know is the diseased process of our parliamentary government is not going to be solved by a laying on of hands or an outburst of political glossolalia.

The immediate response of sections of the Liberal Party is to introduce female quotas into the preselection process. Does the preselection procedures in the past give you reason to believe that this system will produce candidates that live within the Bell curve of normal women? And if you decide to select women who lie at least at the extremities of that curve are you sure that their idiosyncratic ways will benefit the community at large and not the tiny, skewed population that preselected them?

Extraordinary women may add colour and may play an important role, but the expectation for all women parliamentarians is that they will generally care and have an innate compassion and respect for other women. The current crop of female Liberal Party politicians (or for that matter National Party) in Canberra do not seem to have these qualities.

Catherine Cusack

There is one female politician in the Liberal Party who has seemed an exception. She is a NSW State politician, Catherine Cusack. She and her husband Chris Crawford represent that remnant of the Liberal Party that used to participate in the then Australian Institute of Political Science, in its latter glory days when it ran a summer school in Canberra and its Board had members from both major political parties. Gough Whitlam unveiled his Medibank initiative at one of the Summer schools, such was their influence. They were able to discuss policy in terms of the financial and social implications.  However, whenever Catherine Cusack has put forward genuinely liberal solutions, particularly in relation to conservation issues, she has been demoted, slapped down and unsupported by her colleagues, especially when attacked by the National Party.

Now she has called out the Prime Minister for his behaviour. Is this a single utterance of frustration and will she vanish back into the background of women who wear shapeless clothing, and have a bow in their hair to recognise their traditional inferiority at the time of the “rapture” – their role being in actually tending the hearth?

Cusack has issued herself with a challenge – that is to maintain her very important confrontational position. Otherwise, she will be dismissed as a remnant of a Liberal Party that, in the eyes of the current crop of her colleagues, never existed.

Meanwhile, Morrison recycles his bevy of outliers under the wing of Marise Payne, herself the invisible woman.

I was only 22

Rico Marley walked into a grocery store in midtown Atlanta on Wednesday afternoon carrying a guitar bag.

He headed for the men’s room, the authorities said, where he strapped on a bulletproof vest. He then donned a jacket, its pockets full of ammunition, and placed two loaded handguns in a left front pocket and two other loaded handguns in a right front pocket. In the guitar bag, he carried a 12-gauge shotgun, an AR-15 military-style rifle and a black ski mask.

Rico Marley’s weapons

Then he walked out into the store.

Police, tipped off by an alarmed shopper in the bathroom, soon stopped him. But the incident, just three miles from the site of one of the shootings last week that left eight people dead and coming two days after a man stormed a grocery store in Boulder, Colo, and killed 10, sent new waves of unease throughout greater Atlanta and also raised nationwide fears of copycat crimes.

It is stated that when the mass shooting season starts, then there is generally a series of massacres, and increasingly it seems that the supermarkets are the killing venues, whereas in the past it was schools.

This report in the NYT is unusual, instead of reporting a massacre, it provided details of the disturbed man before he could kill the innocents – his activities being seen by an observant guy who legitimately wanted to use the toilet; no, not a security guard, not a police officer, not anybody employed to guard the community. One can surmise that the alert was raised early in that the armed gunman was apprehended before he was able to effect mayhem.

In isolation, the 22 year old coloured, poorly educated gunman had a criminal record with relatively minor petty theft – a young man with a troubled mind.  It is only newsworthy in that the potential killer was apprehended before the shooting, given that in Georgia, one does not have to conceal one’s weapons. In other words, a casual passerby in a country inured to gun violence may have shrugged seeing a fellow men’s room user donning a flak jacket as just a “normal” incident. In fact, when the observer informed the store attendant of what he had seen, the attendant was initially indeed very casual, but fortunately the vital call for police was made.

Last year in the USA there were about 20,000 gun-related murders and an almost equal number of individuals who committed suicide using a firearm. This was an increase overall, and the rise was attributed to being one endpoint of domestic violence.

On the other hand, mass shootings were absent, even though they constitute only about one per cent in most years. The reason for this is attributed to the COVID-19 pandemic. Schools were closed, there were fewer public gatherings.  The whole nation was plunged into collective misery so that those potentially homicidal aggrieved were absorbed into the wider community or, as stated above, violence was absorbed within domestic situations.

When the gun control advocates try to define solutions, they rely on the few small-scale attempts to ameliorate the situation, but unless Americans believe that their gun culture is unacceptable and women at all levels of society are considered equal in mutual respect, everything is for nought.

In other words, we are all powerless unless those who make the laws, makes the law. For me, if I were in power in Australia, I would limit the arms being made available to police forces. They are not a militia – not a paramilitary force. When did the police change from a “service” to a “force”? They do not need armoured vehicles and tear gas to protect the community. All police forces should be restricted in the colour they use, so they do not resemble a posh group of “bikies”. Try pink as the colour for their uniforms – why do they have to dress in black or midnight blue?  Get rid of the “aviators”. Be more selective in the range of ironmongery with which they adorn their uniforms. It would be such a change to see police showing compassion, on a regular basis, rather than presented as a novelty.

Another consideration would be to extend the principles of averment to all cases involving crimes of a sexual nature. I would turn the whole matter of proof over to the alleged assailant to prove he or she did not do it. Presumption of innocence in these cases does not work, first because of the trauma of the episode being cast out of the memory bank and then the unappetising prospect of ongoing harassment, being carried out in a court of law by an essentially misogynistic legal profession. Well, Gentlemen you only have to disprove that which has been so averred.

A consumer’s view of vaccination – albeit with the disadvantage of a medical degree

But infectious-disease experts are worried the pace needs to be faster to reach the high levels of immunity needed to slow the virus, especially as more transmissible variants spread throughout the country. To reach the level of protection needed, about 80 percent of the population has to be immunised, meaning that about 260 million people need to get vaccinated. That would require 3 million to 3.5 million shots being administered each day until April 30.

The Washington Post concludes an optimistic article about the efficacy of the Pfizer and Moderna vaccines in health workers with a muted warning. America has not embraced the Astra-Zeneca vaccine, which has been the subject of a number of caveats resulting in the temporary halt to its use in a number of countries. When these questions are answered and the world-wide juggernaut resumes, with the difficulties that entails to get momentum, another caveat is issued, currently surrounding some of the mutant strains of the virus and the ineffectiveness of that vaccine against these strains.

At the same time in Australia a great number of people who are not doctors are spruiking the virus vaccines, as if there were no doubt about their efficacy, their availability and the “Jab Program” being on time. As a result, there is the unedifying spectacle of political squabbling, and I as a customer has given up trying to make an appointment. The general practice phones are always busy; in fact, the general practitioners are not geared for mass vaccinations.

Again, I am told that the Pfizer vaccine needs to be stored at -70 degrees Centigrade, and given the shemozzle for a consumer, how can I be assured that the cold chain integrity has been assured? The questions then begin to flood out – for instance, how long will immunity last?

Clinical trials suggest that vaccine-induced protection should last a minimum of about three months. That does not mean protective immunity will expire after 90 days; it may last longer. However, that is still one unanswered question.

The other one, given the problems with the rollout, if I was able to secure a first dose, how long shall I have to wait for the second dose, and then more importantly, for the booster? It does not seem clear to me, whether (or more optimistically, when that will occur). That is why the J&J vaccine appeals to me more because it is single dose; but will it ever be registered in Australia? Questions, questions everywhere, but only opinions to imbibe. That is my reaction as an elderly consumer eligible for the injection. I am confused, and so will hold back. In the Australian climate it seems the best option is to wait and see.

I am very pro-vaccination, and unless it is caught up in this COVID mess I intend to get my inoculation against the flu as soon as possible My only worry is that the puerile political agendas will get in the way of the program, lending ammunition for the anti-vaxxers.

And a final question. Who was the bright spark who suggested “Jab”, with all the violent connotations of the word? It is more correctly “inoculation” or “vaccination” – injected into the muscle. “Jab” is variously to poke or thrust abruptly as jabbing a knife into a body; to stab or pierce as in jabbed the steak with a fork; or lastly to punch somebody with short straight blows.

I, the frightened old person, seeing a uniformed person with a syringe saying that “I am going to jab you – just a little jab – it won’t hurt you.” Violence follows me at the point of a needle.

I thus remain a watcher. There are just too many unknowns.

It may be raining here, but this just came from the Boston Globe

Workers at a Baltimore plant manufacturing two coronavirus vaccines accidentally conflated the vaccines’ ingredients several weeks ago, ruining about 15 million doses of Johnson & Johnson’s vaccine and forcing regulators to delay authorization of the plant’s production lines.

It does not affect Johnson & Johnson doses that are currently being delivered and used nationwide. All those doses were produced in the Netherlands, where operations have been fully approved by federal regulators.

But all further shipments of the Johnson & Johnson vaccine — projected to total tens of millions of doses in the next month — were supposed to come from the massive Baltimore plant.

Those shipments are now in question while the quality control issues are sorted out, according to people familiar with the matter.

Federal officials still expect to have enough doses to meet President Biden’s commitment to provide enough vaccine by the end of May to immunize every adult. The two other federally authorized manufacturers, Pfizer-BioNTech and Moderna, are continuing to deliver as expected.

Pfizer is shipping its doses ahead of schedule, and Moderna is on the verge of winning approval to deliver vials of vaccine packed with up to 15 doses instead of 10, further boosting the nation’s stock.

It is a pity Biden was not President a year earlier – when I was at my most skeptical – he seemed so ill equipped. But that is the nature of pontificatory error. It can be lost in the cushions of mea cathedra.  I shall wait until his Presidency reaches 100 days before deciding the nature of my humble pie.

Food and Drink for the Memory

This past week has been a time of eating out in Melbourne – almost the first indulgence as such since the Virus struck last year.

There were two occasions during the week, when I experienced two tastes that reminded me of a couple of meals – one about a decade ago in New York and one in Manaus in 2019.

The first was when I asked for a gin martini in this restaurant near the Jolimont station. The best martini I have ever drunk was in the Morgan Library and Museum on Madison Ave on the west side. We had ambled into this place, not knowing that it originally housed Pierpont Morgan’s and found that there was a restaurant situated in the middle of a library.

The ornate chamber was lined with bookcases and the filtered light gave us a gauze covering. Now I thought this is going to be one of those tea cake places with delicate cups of Assam tea and dainty neatly-shaved cucumber sandwiches. No way, the only cucumber was infused into the martini. Cucumber and martini when balanced is a superb drink. It is still my benchmark as the best martini I have ever tasted. It helps if you have a cucumber infused gin at the outset.

Some years ago I managed to corner the only remaining bottles of Gordon’s cucumber gin in the distinctive green-labelled bottles available in Australia. It seems that the only gin now available with a passing nuance of cucumber is the Scottish gin, Hendricks. So was I surprised when I ordered the martini last week, and the only gin I recognised was Hendricks, not being familiar with all these boutique gins popping up all over the place.

I was thus pleasantly surprised when the Hendrick’s martini was presented to me with a generous ribbon of cucumber in what could have passed for a sherry glass. Immediately I thought I was being short changed, and yet the martini was brilliantly balanced to highlight the cucumber infusion. There was one shortcoming, with which I confronted the martinista, and that was water in the martini. It is a bit of a conceit to pour you a gin straight from the freezer in the glass wetted with dry vermouth, in so doing limiting the water content and in a commercial world increasing the cost. The other problem is that gin watered down or inferior gin coming out of the freezer half frozen is not a good look for the martinista.

But back to the Morgan – we had the meal, but as we knew nothing about the place, we left without looking around this ornate building. It was just another place to have a feed. Pity we missed the Gutenberg Bible and the only remaining first edition of Paradise Lost. Mr Morgan had a great deal of money.

The other memory last week was when ordering kingfish ceviche at a Spanish restaurant in Richmond. It brought back memories of that morning in Manaus two years ago when I remembered the ceviche I had ordered. As background, we had arrived there around 2am after a five-hour flight from Rio de Janeiro and gone straight to bed.

In the mid morning, we had woken up to one of those overcast tropical humid days. It had been raining. Food was being served on the same level as our room in an open eating area overlooking the courtyard. It is somewhat disconcerting arriving into a city so far up the Amazon, knowing that we had to board the ship to take us up the river in a few hours, but not knowing quite when.

The only option was to have a meal, before being scheduled to be picked up. There was a tropical fruit collection to start. Ceviche was on the menu, in big white chunks marinated in a lemon marinade with red onions. The fish used in Manaus was tambaqui, an Amazon freshwater fish with a passing resemblance to the piranha; tambaqui has been overfished, and its future depends now on aquaculture.

It was a very memorable feast upon the ceviche. Nevertheless, we have moved on, as we do, even though this blog is somewhat wistful for a world that has gone.

Maundy Thursday – The Lavage of Feet

As I finish this blog in preparation for it being published, tomorrow is Good Friday. Now, it is the night that Judas Betrayed Jesus in the Garden of Gethsemane. When I was younger, attending a midnight vigil, where the whole church is draped in black, was one of my most compelling involvements. As a Christian, I was brought up with a belief that this was the one day of the year that we should collectively mourn with the day completely closed. However, this religious quirk has been the victim of multi-culturalism; it is no longer a national expression. However, for someone who was brought up to believe in the sanctity of this day, I cannot help being uncomfortable with this change.

Maundy Thursday as the name is thus described, is the day when Jesus after the Passover supper washed his disciples’ feet as a sign of his humility.  The British Monarchy has its own interpretation of acknowledgement of the poor. Rather than washing feet, the Queen hands out Maundy money, with the number of coin sets equal by gender; the actual number determined by the age of the monarch – in 2021, 94 sets for women and 94 sets for men.

1902 Maundy money

I have a 1902 Maundy money set featuring Edward VII – a silver one penny, twopenny, threepence and fourpence laid out on blue velvet in a small red box. Given the size of the coins, it literally is a miracle that this small box given to my mother, who had nursed this very widely-travelled lady who gave her these coins, has survived intact.  I remember seeing it first as a very small boy.

As my Cypriot doctor friend said: “Jesus is the reason for the season”. Especially appropriate comment, given I don’t remember any rabbits hopping around the Cross with baskets of eggs.

Mouse Whisper

President Biden pledged to have 200 million doses of COVID-19 vaccines administered by the end of his first 100 days in office. That’s double the goal he set in December and reached earlier this month before his 60th day in office. 

The mausmeister, who was so critical of Biden in the lead up to the election, grudgingly backing him to win, is holding back judgement, but has been pleasantly surprised. However, he was worried when the President stumbled three times on Air Force One stairs. He will have to realise rather than trying to appear decades younger by jauntily approaching the red carpet, that his behaviour will need to be modified. Fortunately, the last steps up to the plane entrance showed no evidence of a barked shin – no sign of limping. Good sign, but as my mausmeister found out, never be ashamed to use a cane – or hold onto the railing.

Modest Expectations – Round & Round

There was much hype surrounding the 20th anniversary of the Sydney Olympic Games with the spruiking by the ABC of their biopic, Freeman. Given the cloying, hagiographic way many of these biopics are constructed around sporting celebrities, one might have anticipated a certain predictability with a treacly voiceover. Therefore, I planned to give it a miss.

However, the television was tuned to the ABC during the Sunday night meal and it was just left on. I started watching with the eye of the sceptic prepared to switch it off. I did not. It was a fine depiction of an extraordinary woman.

I must say that at a time where the world is devoid of genuine heroes and heroines (if that word is still allowed) Cathy Freeman stands out. Running 400 metres faster than anybody else in the world was the centrepiece, but in relation to the woman herself it is, in the end, incidental.

Yet without this extraordinary talent, she would have been yet another unrecognised good person, one of those who form the spine that anchors this country. She is Indigenous. It marks her out. She provides that sense of grace that was so well emphasised by the beautiful unnamed Bangarra dancer, and as with Cathy Freeman, grace is so natural – more than just a physical attribute.

This artistic portrayal, far from complicating the vision of Freeman winning and thus being a source of distraction, made me realise that this was more than just an expression of the filmmaker’s sensitivity, it demonstrated something rare in the Australian psyche – a genuine unsentimental view of what grace under pressure is all about.

Freeman engendered on that night a sense of optimism in a country which wallows in its veneration of failure – Burke and Wills, Gallipoli and Fromelles immediately springing to mind.

Now, two decades on, she has remained the same determined person dedicated to doing good without constantly reminding us of it – that was one message that I took from this biopic.

Thick as a Plantain

Queensland is a different world, to a point. When I was first exposed to the public service in Queensland, I was amazed to see and feel how centralised the system is. It so closely approximated attitudes in the Victorian public service, which I experienced when I had worked there, that I felt quite at home.

The authoritarian personality dominates the centralised mentality of Queensland public servants. It was almost to a level that paper clip distribution in a Camooweal government office depends on the signature of the Departmental head in Brisbane.

When the authoritarian personality is combined with a healthy dose of xenophobia and lack of intellectual integrity it perfectly describes Pauline Hansen. Yet such a perception of her underpins a preparedness of Queenslanders to elect her – time and again.

Her tearful retreat whenever she is under political fire relies on a cynical appeal to an undercurrent of paternalism. If she were a man, she could not hide behind a veil of crocodile tears. The extraordinary performance of the Queensland Premier last week accusing the Prime Minister of bullying when he was making a perfectly reasonable request shows that in Queensland the Hansen playbook is very adaptable – in this case by the Premier herself.

Then there is her chief health officer, Dr Jeanette Young who, according to the Premier, apparently is running the State – at least in health and in border exemption. She does not have any public health qualifications despite having been in the job for 15 years.

This is the same Jeanette Young who, during the swine flu scare of 2009, advocated for Queenslanders to stock up on food – in essence stirring up panic buying. Well, Queenslanders, there has been another outbreak of swine flu in China, which has been kept quiet. China has just banned pork imports from Germany because also has been the emergence of swine flu there.

Dr Young is unyielding – to a point.

The Premier and her minions may want to blame Peter Dutton for everything, and the Hanks imbroglio allows the State government to spread some of the topsoil, but Dutton cannot be blamed for allowing the polo-playing McLachlan with his flock from descending on Queensland (and a variety of other well-shod Victorians) to serve out their quarantine in the comfort of a resort. If the Premier is to be believed, this is the handiwork of Jeanette Young, who makes the decisions to allow special access. However, in so allowing it, this seems to contravene everything the resolute Jeanette Young says she stands for.

Yet Jeanette Young is not averse to the quavering voice when under media scrutiny. After all the health plausibility of many of her decisions is inversely related to the political expediency. At least with Daniel Andrews, he has now learned that public health considerations must have a scientific basis; and is following a course. He is in for the long term. Sounds familiar. Perhaps he has observed the Chinese devotion to the long term solution at close quarters.

Dr Young has recently acquired a deputy, Dr Sonya Bennett, who has worked in the Royal Australian Navy before joining the Queensland Department of Health to oversee public health three years ago. Given the propensity of professionals in the armed forces to collect post-graduate certificates and diplomas, Dr Bennett has acquired appropriate public health qualifications. She has the credibility of sitting on a government committee to oversee communicable diseases, and presumably is assisting in the flow of exemptions.

However, in the end Queensland with in all its authoritarian rigidity has to find a way out of its completely illogical stance of border closure that demands a rate of community transmission that is absurdly low before the drawbridge is lowered. In a population of 8.129 million, NSW is reporting around five cases a day – that’s 1 per 1,625,800. Maybe the election will do the trick – one way or the other, if Australia can wait that long.

But, Jeanette, batten down the hatches, swine flu may be coming again and Australia needs a unified strategy to deal with a new swine flu outbreak – apart from advocacy of panic buying. Time to start behaving like a country.

But, you know, it is Queensland and do they know how to bend a banana!

The little sparrow 

Having discussed Cathy Freeman, this vignette of another inspiring woman may help ease reaction to the writings immediately above. Sarah L. was a young English doctor when she met me in the corridor of the hospital. She looked so small; even childlike and yet when I met her at Doomadgee, I soon found out her resilience belied her appearance.

Doomadgee is mainly an Aboriginal settlement in the Queensland Gulf country and has had its moments with a police station under siege and Aboriginal riots. The problem with this settlement is that it is the meeting place of various mobs, and in such clusters, there are always underlying tensions, even when there is no violence between rival mobs.

When she greeted me, she apologised for saying she was a little tired. The previous evening, she had been called out to triage a serious vehicle roll-over, and given that nobody wears seat belts, there was a variety of serious injuries. She had to work out the priority in treatment and who needed to be evacuated to Mount Isa or to the coast. They had all survived.

She also wanted to set up an evidence-based treatment for scabies, which was endemic in the community. Scabies is caused by mites (Sarcoptes scabiei), which burrow into folds of skin, are found in children’s hair – and often, in the severest form, the scabies lesions are inter alia infected by streptococcus pyogenes. Scabies spread by contact and older people tend to be “super-spreaders”. There are a number of treatments that work, but they require compliance. She wanted to test ivermectin, which can be administered orally and used topically.

Scabies

Ivermectin’s parent drug was discovered in Japan in the 1970s and was first used in1981. It is the essential agent for two global disease elimination campaigns that will hopefully rid the world of both onchocerciasis and filariasis. These diseases affect the lives of many millions of poor and disadvantaged throughout the tropics. Ivermectin is also effective against mite (scabies) and lice (crabs or pubic lice) infestation. It has a very wide use against parasitic infestation, but for the use proposed by this young doctor there were still unknown elements.

The attack on scabies means ridding the home of the mites and, for instance, the habit of sleeping with dogs, which occurs in Aboriginal communities, can facilitate the spread. The young doctor, who had paediatric training, wanted to clear the children in the community of scabies.

I was impressed by her enthusiasm, and her approach reflected my ideal public health physician – able to have clinical expertise and yet wanting to set up a trial to see what would best suit her community.

This week, I tracked her down to see what happened. Yes, she successfully eradicated scabies, but that was so long ago.

She was pregnant at the time I met her in Doomadgee, and subsequently she had a second child. They all moved to the Coast. Her professional career was interrupted by a couple of major car accidents – one on Magnetic Island and one in Townsville – after she left Doomadgee. She took a long time to recover, and has been left with residual loss of vision in her left eye. She is now practising at Townsville Aboriginal Health Service.

To me, she was an exemplar of a doctor working in a remote community who was able to cope with emergencies but yet with the curiosity and determination of the public health physician. She epitomised the very best of medical practice, but her experience also demonstrated the lack of sustainability of a health system built on the individual worth without there being succession planning. That is a major problem that has bedevilled medical practice, particularly in rural and remote areas.

Before I made contact with her this week, while reflecting on Doomadgee, it reminded me of looking out of the train window and seeing two women tending a colourful beautiful garden alongside the train platform. Then the train moved on, and I did not have a return ticket.

However, on this occasion, I knew the name of the woman and when she rang me back, the voice was still so familiar. It was still the bright, breezy Sarah.

Letter from Victoria

I was talking to a friend of mine in Victoria. He is a consultant geriatrician, one of the best. He is also a member of a nursing home board.

In this State of unmitigated residential care disaster, in this nursing home there have been no cases of the coronavirus, in either residents or staff. He prefaces his comments by saying that luck is always a factor. Nevertheless, what they did from the outset was to ban visitors, allow only essential trades people into the facility and ensured that on arrival the staff had a temperature check and were quizzed on whether there was any sign of COVID-19 disease. Then, all staff appropriately attired themselves, and strict protocols were observed.

I asked how the residents coped with this degree of lock up – and he said they hated it, one saying she preferred to be dead rather than endure such conditions. So it is not just a case of expressions of pious statements about “loved ones” whenever a person in their nineties dies, but perhaps in the eyes of the departed, death was a joyous event. The problem is that it is one technology we have not mastered, that of polling the dead.

Apropos, I asked about Zoom and other means of distanced face-to-face communication. His view was that for the elderly it was no substitute for physical contact.

He made a further comment that it seems that in these institutionalised care environments, aerosol rather droplet spread is the major means of transmission. He cited a case where a particular residential facility was coronavirus free in the morning and by the evening two-thirds of the people were coronavirus positive.

After talking to him, I re-read the Newmarch Report, which shows that if you bring in a competent team that knows what it is doing then you get to the same situation that my friend describes. But it is far from a perfect situation.

I wonder whether the central agencies or the private operators have worked out how much it would cost to comply with the 20 recommendations of that Report.

The Commonwealth government, with an incompetent Minister, is still relying on the private sector, with its record of putting profit before care increasingly being shown to be scandalous. The fact that some Victorian aged care facilities delayed the release of dozens of deaths which were then added to the daily tallies has not been adequately explained, but hopefully the answer is not deceit .

My friend said that government-run and not-for-profit facilities were better in his view. Yet Newmarch is operated by Anglicare, an offshoot of the Anglican Church, and seems to have belied that generalisation as does the apparent gouging of the contaminated St Basil’s Home in Fawkner, a northern suburb of Melbourne, by the Greek Orthodox Diocese.

However, mimicking the home environment but being able to maintain infection control at a level where the coronavirus will be repelled at the door remains a challenge, organisationally and financially.

I know that if and when the time came for me to go into a nursing home, it will be a one-way street. Thus I want to go into a place where my family at least has the choice of visiting me. I do not want to go into an institution, which is kitted out as an intensive care unit, so that I become a delayed statistic dying in a labyrinth of tubes, with a card on my big toe labelled “a loved one”. “Loved One” is becoming the modern day substitute for the black rimmed Hallmark bereavement card.

Coronavirus is an accelerant, and if you are old and contract the Virus, but survive the buggery of being on a ventilator in an actual intensive care unit, you can then become a photo opportunity for the evening news, before dying unnoticed a few weeks later. Is that what I would want – is it anything anybody wants?

Federally-Operated Quarantine Facilities

The comment has been made to me that government building a series of quarantine facilities would very expensive. The problem is that there is no evidence of long term thinking beyond the immediate combat with the current coronavirus. We have the spectacle of the President of the United States denying climate change, a feeling echoed by members of the Australian Government. There is a suggestion that swine flu outbreaks are now reappearing in China and Germany complicating the world disease profile.

Coronavirus infections are out of control in many places throughout the world, where incidence and number of deaths are the indices to measure spread and severity. Yet, unexpressed is the level of morbidity, which at present can be classified at short to medium term. I have yet to see whether the impact of morbidity on the world economy and burden of disease has been assessed. Probably, it could be argued that we are only seeing six-month data.

Our ancestors recognised the need for quarantine facilities but often located them in harsh settings. However, being in a necessarily isolated environment need not be harsh.

It seems that both the Northern Territory and Kristina Keneally among an increasing number of others, myself included, are advocating for discrete quarantine facilities. However the Australian government, with its attachment to private enterprise, appears to prefer to maintain the fiction that hotel quarantine can work in the long term. Frankly as the economy improves and the hotels are required, planning for these facilities should occur now rather than in the usual ad hoc manner. More importantly, we need to get quarantine out of the major population centres, and we need to find an affordable quarantine solution if Australia is to re-enter the international community and not completely destroy tourism for the foreseeable future, particularly if a successful vaccine is not found in the next 12 months.

Howard Springs quarantine facility

In relation to a particular operational Northern Territory facility, the comment is that to get to it “…drive south-east from Darwin Airport for 30 minutes and you will arrive at an old mining camp – the Manigurr-ma Village for fly-in, fly-out natural gas workers. Until recently, this complex was abandoned. Today, it is perhaps the most popular travel destination for Melbourne escapees.”

In other words, facilities do already exist, and it seems a tolerable spot to spend 14 days, especially if the facility is airconditioned. In my last blog, I suggested the Northern Territory as the site for quarantine and singled out Katherine. Creating a so-called bubble around Katherine would allow the possibility of visits to Katherine Gorge, increasing the tolerance levels for incarceration. However, creativity is never a recognised expertise of public service.

Now the Northern Territory First Minister has been re-elected, he can act with more freedom, notwithstanding section 49 of the Northern Territory Self Government Act. This mirrors terms of Section 92 of the Constitution in protecting movement across border. As one constitutional expert has said: “It means the NT is in the same position as a state.” However, the Northern Territory exists under law enacted by the Australian parliament, and is not recognised in the Constitution as a State.

The experience with the repatriation of Australians from Wuhan should have given the few long term planners in government a clue of how to handle quarantine. The Northern Territory is an ideal place. Over time, flight schedules can accommodate the need for incoming quarantine.

The other destination for the Wuhan evacuees, Christmas Island, is to Australia what French Guiana is to France – a place to send people to be forgotten at a great cost, but inconvenient for large scale quarantine.

Kristina Keneally took a direct stance recently when she suggested that the Federal government could provide a set of quarantine resources if they are establish any form of international tourism. Repatriating the clamouring Australians provides a pool of people to test how best to allow people coming from COVID-19 endemic areas to return – or come to Australia.

The model exists in the successful evacuation from Wuhan.

Build or adapt facilities in Northern Australia to enable people to be quarantined for 14 days.

Gradually close down hotel quarantine, as international restrictions are eased but, in the light of the Government’s announcement this week that incoming passenger numbers will be increased, those states and territories that have taken a back seat in hosting quarantine can take some of the load – the ACT is a case in point, with its newly-constructed international airport; there are suitable sites in the ACT – much land around the Fairbairn RAAF base.

However, long term it is undesirable to use hotel facilities, which are not dedicated health facilities, for such a purpose. Thus there is a reason to establish a health-tourism forum so that people in each sector are brought together to develop a common language.

As with any facility designed to attract tourists to this country, each person presenting at a border should have the equivalent of the yellow card – when we needed to show evidence of smallpox vaccination, inoculation against typhoid, cholera – and still yellow fever.

Remember that yellow, even in this world of digital communication, remains the colour of the letter Q – hence quarantine. Data should provide evidence of the time of testing, a temperature check at departure and arrival and a checklist of symptomatology. As a parenthetic comment, the ability to test olfaction may become an important additional marker.

The longer there are no organised quarantine facilities the more policy will be at the mercy of ad hoc arrangements. Quarantine facilities that are recognised and organised with appropriate staff will provide a Security Blanket for the politicians, who are increasingly terrified of opening their borders – and in general Australia.

When we wanted to deal with those poor benighted asylum seekers, we were not at a loss for ingenious methods of inflicting as much misery on them without descending into actual torture. Also, can anybody realise how much hilarity and champagne cork popping there was in the Cambodian government when we wanted to “rehome” some of these asylum seekers.

However, the asylum seekers were at the end of a line of misery, and despite the compassionate cohort of advocates their plight means little to the vast majority of Australians.

By contrast, quarantine, well organised with a border force replete with replacement masks of compassion and a health work force working in conjunction with the tourist industry in all its manifestations would seem to be a simple concept to put an end to the ad hoc actions and the unmitigated xenophobia that some of our governments have developed.

Well, let’s see!

O Panda Alaranjado

I don’t see how we get through to the January 20, 2021 inauguration day without bloodshed.  Ever since James Adams succeeded George Washington in 1797, there has been a peaceful transition of power in this country from one president to the next. I fear that after 223 years we are about to tarnish that record.

So has been written to me by an American lawmaker.

Everybody has been setting out a scenario that this increasingly unhinged person with his band of acolytes could inflict on the USA if he loses.

The following is one is taken from the playbook of the Bavarian house painter, he could contrive to see the White House burnt down, and then invoke the Insurrection Act of 1807. “In all cases of insurrection, or obstruction to the laws, either of the United States, or of any individual state or territory, where it is lawful for the President of the United States to call forth the militia for the purpose of suppressing such insurrection, or of causing the laws to be duly executed, it shall be lawful for him to employ, for the same purposes, such part of the land or naval force of the United States, as shall be judged necessary, having first observed all the pre-requisites of the law in all respect.”

Burning the White House, 1814

Not that it was an insurrection but British troops did burn down the White House in 1814. So there is a precedent, if not a president.

Mouse whisper

One Australian politician who answers to Julian the Lesser has made a statement that more Australian have seen Berlin than Bundaberg. Bundaberg has 93,000 people.

Is Julian the Lesser suggesting that:

  • people who live in Bundaberg are blind
  • there are more people than that to take our breath away.

All in all, a rum statement.

Out of breath