Modest Expectations – Cheers Bar

Cheers Bar

The actual address of Cheers Bar was 112½A Beacon Street, Boston – in other words I have resorted to an approximation for this week’s blog.

One of my former partners, who was a very good mathematician, said that he always judged his peers by knowing whether they knew when to approximate. I have never been numerical, but I know you can vanish along the decimal value of π and end up in a different world where sanity evaporates in the pursuit of such accuracy in this relationship of circumference to diameter of a circle. Endless fun.

One of the matters that used to irritate me was when I was seeking certain data, I was told it was unavailable because 100 per cent of the data had not been collected. In other words, the data publication had been delayed by over-zealous statisticians when 95 per cent would have been adequate – if the distribution is normal then approximation of data around the mean of the distribution is mostly likely to be good enough for policy considerations.

But this wise mathematician also told me that when coming to conclusions make sure your assumptions are clear and transparent; something unfortunately becoming less and less evident in public policy. Then, your approximations could be assessed as to validity in the pursuit of making the particular decision.

The excellent Dr Paul Kelly, the Chief Health Officer, clearly outlined the government assumptions in his critique (let us not say criticism) of the government’s reasoning in invoking the provisions of the Biosecurity Act to keep Australians in India from returning. His was calm, measured, sensible advice, which the Government, now scrambling to save face, will follow. Within this prediction, it shall become clear how accurate is the approximation of 9,000 Australians in India who require repatriation.

And so it was, when the COVID-19 infected Dutton emerged in their midst, it was fortunate that Kelly was there to quell the Cabinet hysteria.

I do not know just how the Government have guessed, estimated, approximated and predicted the number of Australians who have visited our near neighbours. After all, the assumption is that each of the verbs in the previous sentences mean approximately the same thing, but with an ascending order of assuredness in their use in media releases.

With most of Asia plunged into pandemic considerations has Mr Coates, in that tattered remnant of his imperial cloak – the Olympic Games, issued an approximation of the number of athletes that will become infected during this festival. My assumption is that he will say “none”. Just an approximation after all!

The Divine Light of the Gods

One of the interesting aspects of the spread of COVID-19 in India is the reaction it has generated in those who, one way or another, are driven to comment. The threat to put Australian citizens in prison because they want to come home and escape the virus was hysterical. The fact that some of our best cricketers were caught up in this catastrophe only complicated the situation.

Now I am not one of those who believe that the Government’s immediate midnight reaction would have not been approved by a strong segment of the population. These have remained quiet while megaphones from both left and right have given Morrison a roasting, to coin a phrase. However, what has been most confronting here has been the sight of the funeral pyres night after night on television. As somebody said, it is a vision of hell.

In India, fire is a very important symbol. Yet India was associated with the flower generation where there was always some swami in some ashram somewhere in India where mostly privileged Europeans were drawn to seek “enlightenment”, and lotus flower symbolism was everywhere.

I first had the privilege of traveling the length and breadth of India when it was a secular state. Then the Nehru-Gandhi hegemony was strong.

With the ascension of the charismatic Modi, India has been converted into a Hindu state, despite the fact that India’s Muslim population is the World’s third largest, close behind two avowed Muslim nations, Indonesia and Pakistan. Hindu intolerance is confronting. I have entered a Kali temple, one of the few not prohibited to non-Hindu people. To me Kali was a black doll monster, at the centre of a dark incense-ridden foreign place where I was both fascinated and yet repelled.

Contrast that with the elephant head Ganesh, where the myth of his head being chopped off by an enraged Shiva and that of an elephant sown on to replace the human head is just one of tales which surround the religion. Yet we have a figure of Ganesh in our home. Ganesh is a symbol of good fortune; and it gives a clue as to how pervasive Indian culture becomes once you have been and seen.

The COVID-19 pandemic was never going to bypass India, because wherever you go in India there are crowds, pressing in upon one another. Modi loves the theatre of the large crowd and given that Varanasi is his electorate we are constantly confronted with the spectacle of the crowded river Ganges. When I was first exposed to this crush of humanity, it was as overwhelming as the smell of India, which never leaves you. There is an axiom which tests the strength of any union, association or whatever you call two foreigners abroad. “One watches the bags, while the other creates the space.” It always seemed to work no matter where we were in India – and crowds.

It is easy to ascribe a national identity to India, and there is no doubt the Hindu caste system has embedded in itself a sense of entitlement – at least with some. This is pronounced whenever you deal with Indians as at some stage a sense of entitlement will bob up.

Again, as an example, I remember giving a talk to a group of health professionals, predominantly doctors. There were both male and female doctors at this meeting in a town in the very South of India. My talk was given over dinner in which we ate our curry served on banana leaves. The whole atmosphere was so authentic – down to the separation of the male and female doctors onto separate tables, including my partner.

This often overbearing regard for the place of women was one of the problems I have encountered, not only in India but also with some Indian-trained doctors here. Yet Indian men have a great reverence for their parents, and one of the most obvious examples of this are reports of the number of older Indian women in wheelchairs at airports; sons are very concerned to ensure the mother does not have to walk from the plane, but they clearly show their wonderful ability to walk when greeted by family and leaping from the wheelchair to run to the family. This atavistic reverence is reflected in the number of stories of the Indian-born Australian now caught in India.

The other is the number of small children who seemingly have been lodged in India. It is very difficult to see an infant apparently helpless against the encroaching Virus and to not elicit the reaction for someone “to get them out of there”. What is the reason for this? Could it be that the couple working full-time in Australia want a safe haven for their child’s care, and grandparents are an obvious place to park the children, even if it means leaving them in India for extended periods. Up until now that practice has gone unnoticed or unsanctioned.

The Indian-born population in Australia amounts to 455,389 or 1.9 per cent of the Australian population. The affinity for the country of birth, especially when there are close relatives in India, remains strong. However, one of the prices of being a citizen is that you also accept that some of your personal risks clash with public policy considerations. However, if one knows the risk, then one must also accept the consequence if risk translates into liability for the wrong choice.

The fact is that the Australian government has not factored in the need for a more long term sustainable quarantine capacity will inevitably mean hardship will occur to those waiting to return from overseas. Just as it is trying to contain the Virus where up to 50 per cent of incoming travellers may be infected throws this policy stumble into letters writ large. Larger and more custom-made quarantine facilities, where it is an accepted fact that when coming from most places worldwide there will be an invariable 14-day hiatus during which everyone will quarantine and be tested multiple times, with designated exceptions such as New Zealand and the island dependencies of our two countries. The volume of people needing to come here will increase with an impatient tourist industry scratching at the Government’s door.

Politicians try to fill the vacuum of uncertainty with unsubstantiated optimism (remember the vacuous Trump assertions as America died), which in this case is trying to predict the future of a disease in which the vaccine remains unproven in its long term efficacy – and long term in this situation means “a year”.

Does that prediction alter when our young politicians realise that their contemporaries in both Brazil and India are dying from the mutant strains stealthily and rapidly causing them to die unpleasantly; and be under no illusions this chameleon virus can mutate at the drop of a tartan rug.

Australia has achieved an enviable record in quarantine, even though there are obvious blemishes. Parenthetically, rabbits were one example. Eradication has been so successful that rabbits are now a luxury item on the dinner table. Nowhere else in a major country except New Zealand has achieved suppression of the Covid-19 virus to the same extent we have. However, you can never relax, as shown by our pursuit of the rabbit plague.  (I consider Taiwan a special situation being more an armed camp than a nation.)

But after the Indian tide, the biggest test will be to see how the Government handles the anticipated 1,000 travellers returning from the Toyko Games, without assuming that any will become COVID-19 positive while out of Australia. Now where will be the holding pen? Even if the team members don’t all return at the same time, there will be a significant number to be managed at any one time in quarantine.

An expanded permanent human quarantine capacity that is not a “make do” in willing hotels clearly is essential. This sector will require staffing. That means more staffing and where does that staffing come from? I have worked in rural health encompassing inter alia assuring workforce for many years.  To achieve sustainability in the workforce in a country such as ours is very difficult, especially when the policy makers are blissfully ignorant of what works because there is no readily available corporate memory nor empirical evidence of what works – just opinion and opinionation.

Ganesh

Here we Go Again

I have worked in rural health policy for a considerable time and it sticks in the craw when a doctor reveals his ignorance by hailing the modest injection of a rural element into the Medicare benefit for eligible patients as if it is something new. Since there has been no rebuttal, this statement just confirms that the profession has no realisation of what has occurred in the past, what has worked and what has not.

Throwing money at medical workforce problems has never worked.

Repeatedly I have outlined the challenges that face the provision of rural health, and the problem is that the structural change I assisted in bringing in through the University Departments of Rural Heath, the Rural Clinical Schools and the Rural Intern Training Program in Victoria can easily disappear if there are no champions for its continuance. This requires advocacy, not lazy policy makers, who do not care a “tuppenny tart”, as long as they seem to be doing something, even if it is a discredited strategy.  This reminds me of that New York wit, Ida Downer, who wrote “Maybe some consultant provided advice at an appropriate price in order to maintain their expensive watch vice.

There are four challenges which should be addressed in the development of any rural health policy.

  • Social dislocation – by which I mean that the spouse does not want to go there or where you have to send the children away to school. The concept of a young graduate going to a rural location and staying there for his or her professional life is increasingly a myth. The sensible response to this challenge is to accept that five years is a reasonable stint in one place.
  • Isolation – this occurs in a variety of forms, but professional isolation is one danger, even with the myriad professional development programs including online options, coupled with the availability of registrars and other doctors employed in subsidised training schemes. The sole doctor risks burnout, and one of the aims of the programs I promoted was to reduce the possibility of professional isolation.
  • Community tolerance – in country towns, especially if you are the only one, you have no privacy. Therefore, there are two options – immerse yourself and your family in the life of the town or get away from the town at weekends which, in a single doctor town, leads to all sorts of antagonisms. In other words, the way the community views its medical workforce is critical for retention.
  • Succession planning – often the hardest, because there is a push me/pull me syndrome in many country doctors. When the media spotlight is focussed on the local doctor, then if the request is not for money it is a plea for more doctors. The doctor should be planning for succession, but how many do that? Often, when the doctor is offered a doctor to assist, then the resident doctor changes direction because the fear is of another doctor impairing the incumbent’s income, which is generally a nonsensical fear unless there is deeper pathology than just basic insecurity. The successful country practices involve succession planning so there is a gradual ageing of the workforce and a balanced practice with each doctor having the general skills to provide emergency treatment but having a special skill required in the practice, such as anaesthesia and obstetrics.

Money is always an important component and I was involved in a number of Inquiries in which the level of Medicare (and before that Medibank) patient benefits was the focus. One of the misunderstandings is that doctors’ fees are set by government; the Federal governments sets the level of the patient medical benefit and when I had direct involvement generally the benefit and actual fee charged by the doctor did not have a substantial gap. That does not hold any longer, except for general practitioners for whom different policies have been implemented, such as those that encourage bulk billing. The rural doctor, whether general practitioner or specialist, nevertheless have other sources of income to supplement the income derived from Medicare Benefits.

If I were conducting a review again of the rural workforce, flying from place to place as I did in the late 1990s, I would ask the same questions to find out what was happening in relation to those four challenges outlined above. You need to stay overnight as I did, and not fly in and fly out the same day. This overnight stay can reveal the tension and the stratagems of avoidance when the simple question of more money and more resources are not automatically accepted as incontrovertible fact.

As a person who engineered one solution to rural workforce and see it being trashed after you have “left the room”, it is very sad, but as someone once said about me, my epitaph should be “He tried!” 

A Woman Scorned

I never liked her father, Vice President under Bush Junior. Not that he was unintelligent. He was, but dangerously so.  I’m sure that I do not like her politics, but then Liz Cheney is a determined woman, who has a set of principles and Trump in his disregard of such principles should be challenged and defeated.

Liz Cheney

She is the sole representative from the State with the smallest population, Wyoming. It is the one State that has one representative in Congress and two in the Senate.

Wyoming is a rich State, and the inhabitants pay no State income taxes because this is fossil fuel territory – oil, gas, and coal. To see the kilometre long coal trains traversing the Wyoming prairie is a sight not easily forgotten. Cheyenne is the capital in the southern part of the State two hours from the Colorado border and one hour from Laramie, where the University of Wyoming is located. Both lie on this altoplano dry area, and travelling across the country just after the snow melts, it is easy to see how the vegetation struggles.

But six hours away in the northern part of the State is Jackson situated at the southern end of the Jackson Hole Valley. Here the scenery is some of the most spectacular, with the Tetons jaggedly thrusting their snow-capped peaks more than 4,000 metres in the cærulean sky. Jackson epitomises the tax haven for the ultra-rich, with an average annual income of the residents being US$16 million, a place with which her father was heavily identified.  One commentator has encapsulated the Jackson conundrum.

This form of “gilded green philanthropy,” widens even further the ugly socio-economic divide, hollowing out the community and making it harder for workers to live nearby. Unable to find affordable housing in town, they are pushed all the way into the neighbouring state of Idaho, on the other side of the treacherous and steep 8,431-foot-high Teton Pass. These workers told many a harrowing story about just making up — and then down — to work in the dead of Wyoming winter.

Close by to the Tetons is the Yellowstone Park with his surface covering the subterranean turbulence, which manifests itself in bubbling pools and geysers spreading across and into both Idaho and Montana. Some have said this is where the destruction of continental America will occur with a massive explosion.

In the meantime, there is Liz Cheney, at the prime of her working life being repudiated on voices by her Republican colleagues yet receiving a standing ovation at the end of her speech to the Caucus yesterday. The explosion which she is engineering under Trump will come, if death or gaol do not supervene. Trump who requires a cosmetic shield to conceal his vacuity, his seditious behaviour and mental deterioration must maintain his profile for another four years. During that time, his support among his own age group will winnow with inevitable death.

Liz Cheney’s march to leadership of the Republican Party is now unconstrained by any faux-loyalty. I shudder though if Wyoming becomes the model for USA. Ironically, Trump tried, but his criminal streak and his narcissism saw him come up short.

Liz Cheney may succeed. In the short term I applaud her unyielding opposition to Trump, but I also remember she is the daughter of Dick Cheney, who was de facto President for eight long years.

Mouse Whisper

There is an entrancing book published recently called “Entangled Life”. Before anyone thinks this is one of those morbid novels about self-discovery, may I interject and say it is a very entertaining exploration of the world of the fungi. One insight into the truffle makes one realise that its smell has to compete against “the olfactory racket of the forest”. As the author, Merlin Sheldrake, writes “every visual disadvantage that truffles face -being entombed in the soil, difficult to spot once unearthed and visually unappealing once spotted – they make up with their smell”.

Elsewhere in the book, Merlin (how appropriate for a mycologist) describes one of the truffle experts as having olfactory flashbacks how powerful is the memory aroma of the top truffles.  But even so he admits there is still so little known about the fungus, including Truffle Mice! Boy, can we smell!

Modest Expectations – Macmillan

I thought the letter in the Medical Journal of Australia from a group at the Royal Melbourne Hospital (RMH) noteworthy and hence promoted it to “top blog”. The letter suggests that 11 per cent of COVID-19 cases in Victoria were detected in health care workers, which is no different from the proportion within the State of such workers (which in itself is a percentage to wrestle with, i.e. one health care worker involved in the care of the other 88 per cent of the population).

Their data suggest that the community is a far more dangerous place to be exposed to the Virus than the work place.

The background is that the RMH established a clinic to test symptomatic staff from the RMH and nearby hospitals. By 6 April 1,160 symptomatic staff had been assessed and 11 were COVID-19 positive. Eight could be said to have had contact within the community, the others not determined – although thought to have had a low risk of contracting the virus in the hospital.

However, this letter was written in the very early days of the COVID-19 pandemic with tiny numbers, and it is very important to know if that trend continued given that the letter was not published until July. 

Went Phishing & Lost The Bait

I was scammed the other day – well let us say the attempt at scamming failed but it was an enlightening experience and shows how clever these people are. However, having said that, I presumably I was only one in a long line of potential targets and the spiel would have gone through many iterations.

The phone rang late one morning and there was a woman at the end of the line. The accent was foreign but recognisably Asian accented. The nature of the approach was courteous but one of the problems of old age is hearing what has been said. Foreign accents however modulated are difficult to understand at the best of times. This was a mature voice, if I could put it that way.

She purported to have rung from the Visa security unit and they had detected concerns about two of my recent transactions – one for $300 and one for $1,300 – and she was trying to stop the transactions.

However, I kept asking questions because I had did not have access to my current accounts. I was passed to her “Supervisor” – a male whose accent was more Bangalore then Bangkok. He was very smooth, and there is obviously an escalation plan (perhaps a male is thought more authoritative). He said that the Federal police had been notified and an officer had been assigned the case and I remember the name – Rodriquez – fictional, but an interesting choice. Then miraculously my man on the line had been able to reverse the smaller of the transactions. However, the bigger one was presenting a problem.

I then said “could I ring them back after I checked my account and could they leave a number to call them back”? Some of the scammers apparently do make that provision, but seemingly not in this case.

Thus the whole transaction was obviously not going well because the woman came back on the line and tried to increase the anxiety level by urgently asking for my account details.

That was enough entertainment for the morning. I hung up. They had made errors. However, because of the way scams are constructed, there is little time to think, especially when it is the first time such a sophisticated scam had been launched on oneself. They had switched from it being a Visa to a CBA account in a very seamless way, and even produced the BSB for a nearby branch (unfortunately for them, not one where my account is held).

I thought in retrospect that these scammers know how to press buttons. I have been robbed in the past, and it is an unpleasant experience. Therefore apparently concerned sympathetic voices on the end of a phone who have just enough information to sound legitimate and informing you of a robbery elicits an initial primal reaction. This has to be resisted, and in the end – as we keep being told – it comes down to never give callers your details unless you have initiated the call – as in booking a hotel stay. However, it is all so simple until it happens to you.

I understand now very clearly why the elderly are so vulnerable – some months before my mother-in-law had been targeted in a similar scam.

Yet is it still confronting when the ACCC puts out a report to say that $630m had been scammed in the past year. The problem is escalating in terms of money lost to the scammers. For my part, I am now very well aware of Scamwatch and the information provided is simply written and an excellent reminder that at times like this when so many are vulnerable, the Virus is not the only malady to avoid. 

Florida  Mosquitoes One day; Virus the Next

The Key West buoy

As I write, Florida has recorded 15,300 cases of COVID-19 in a single day (18,000 if equated to Australia’s population). What is that particular attitude on the part of the average Joe to hear it and yet then, masked, takes his children to Orlando Disneyland?

Modified from an earlier report from the New York Times:

To stop the spread of the virus from more heavily affected cities further north, the archipelago in southern Florida was blocked off since late March to June 1 to anyone who does not work or live there. Hotels were ordered closed, and passengers who flew in through the airport were screened and instructed to self-quarantine for two weeks. The isolation measures were among the strictest in the country. 

The actions worked: The Keys had just 100 COVID-19 cases and three deaths, according to data from the Florida Department of Health. The three counties to the north that make up South Florida — Miami-Dade, Broward and Palm Beach — have had a total of more than 25,000 cases and 1,000 deaths.

Yesterday, there were 74 infected in Key West, a significantly smaller percentage of the population to Florida as a whole.

I have been to Florida a number of times, but it seems now to be as dangerous as in the old days of pirates, swamps and caimans. It should be remembered that this now is the third most populous state in USA with over 21 million people whereas in 1900 it was about 500,000; Key West was the biggest city then.

Mosquito was king, distributing malaria or dengue among the population. However, mosquitoes are just the vector for the bug and even, despite a vast amount of money expended on discovering a vaccine against the plasmodium, none has emerged. Preventative measures have then been directed towards destroying the vector or shielding human contact by physical or pharmaceutical means. As I have related in an earlier blog, I have had malaria – only one attack luckily.

Dengue, on the other hand, is caused by a mosquito-borne virus and there is a vaccine limited to certain countries where the condition is endemic. It is available for those who have had the disease before and is delivered by three injections. It is not available in Florida although it is available in certain American territories, such as Puerto Rico.

Chronic disease, no matter the cause, is no joke; but until one catches it, as I did with malaria, then it remains one of the jokers in the pack of life. It seems that Florida is full of those jokers gradually, in the case of COVID-19, being extracted from the pack to over 250,000 recipients to be precise who have been extracted from the pack – as they say it is a joke or in the terms of the Head Joker a hoax –going to die laughing.

Key West is a settlement at the end of 44 stepping stone islands that lie between it and Miami. Miami may have the beach, but Key West has the sunset. However as one source said, “Without a doubt, there is dengue in Key West.” In fact Key West saw a dengue fever epidemic in 2009 and 2010, but it was suggested that it only affected five per cent of the population. This epidemic was mocked by a Dengue Night Fever Group, complete with wings and a John Travolta lookalike. The epidemic seemed to respond to the joke, and fizzled out.

Nevertheless there was a serious side, as one report put it: “At the Key West Cemetery, where the gravestone of B.P. ‘Pearl’ Roberts’ epitaph of ‘I told you I was sick’, has become world famous {and preceded Spike Milligan’s similar ‘I told you I was ill’ by 13 years}, dozens of “ovitraps” – black plastic cups laced with poison to kill female mosquitoes and their eggs – mingled among concrete urns and vases of water rife with squiggling larvae. Plans for next year include providing sterile male mosquitoes to prevent their mates from reproducing.”

Key West is the most southern settlement in the United States, 90 miles from Cuba as stated on the giant buoy. Over the horizon on this crimson sunset was the island we thought at the time impossible to visit from the USA, but 10 years later we were to be part of an American delegation to Havana.

When we were there in winter, Key West was a line of empty T-shirt shops with no visual means of support; it was the site of Harry Truman’s winter White House with the famous coffee table that, with the flip of a wrist, could be converted into a card table covered in green baize, and the Hemingway house with its trademark six-toed cats. Even though it was winter, there was a cheerful, devil-may-care population. Nobody mentioned dengue when we were there, but since at that time the last outbreak had been in 1934 – and we were there before the outbreak in 1991, there were no warnings about stagnant water or to wear insect repellent and sleep under mosquito nets.

After all, if you live in Key West it is not as though you reckon exposure to hurricanes and caimans is as bad as exposure to the neoliberal pirates from the North. After all there must be some compensation in living on the Oklahoma panhandle where the winds swirl in the sagebrush or the wilds of Homer on Kachemak Bay in Alaska where the snow-covered volcanoes threaten one from across the water. Places like Key West, the Oklahoma panhandle and Homer are remote enough to fend off the virus without too much central government assistance.

Of all public policy matters, population health and the accompanying science of epidemiology gets pushed down the agenda and attracts comparatively little government funding. To me one of the critical features of public policy in health is to have public health experts with clinical experience. Here there is a need to ensure a close relationship between the public health and infectious diseases disciplines.

More particularly, there is a need for policy nous, not the normal line up of university experts pushing their own barrows, nor general practitioners, whose knowledge of public health is so scanty. That is why on many occasions I have stressed the value of Paul Kelly and Nick Coatsworth to Australia. Michael Kidd, the other deputy medical officer as they say looks good in a suit but his work experience is not in public health. His value has been in his ability to chair meetings and have a soothing influence, which does have a subsidiary role in the often tense atmosphere surrounding this virus. Fortunately, he does not claim to be a public health expert and that he is certainly not.

However, at the apex of government there is responsiveness from the politicians, and it has been hard won from these people who probably thought of public health in terms of tips, drains and sewerage. For many years any public health emergency has been short-lived and more of an inconvenience – remember the cryptosporidium outbreak in Sydney in 1998?

In a fortunate way, so many of our governments are conservative and therefore make it difficult for the barbarians who are attempting in Victoria to drag down Andrews to replace him in Victoria with an effigy of Trump, complete with a neoliberal squawk of followers.

Florida is governed by such a Trump acolyte and thus ignorance, empty slogans and bluster are substituted for policy. No leadership, none. Just lachrymose self-pity. But those clowns, with their allegiance to those who put Trump in the White House, criticise Andrews for having 177 new COVID-19 cases on this particular day.

What was that number again in Florida, admittedly with four times the population of Victoria? 15,300. Their Governor just loves Trump.

However Key West, could still easily be closed down again, by taking a leaf from the Andrews folio. But leaves are so easily blown away.

Abattoirs & Meat Packing

Janine Sargeant – Guest Blogger

COVID-19 has exposed many cracks in society. The general level of personal hygiene and behaviour in social settings is one such ‘crack’ that has been variously addressed or papered over. However, the hygiene of abattoirs is one problem that needs to be fixed now.

Hygiene in animal slaughter and processing is crucial for food security. Unfortunately, abattoirs and meat packing plants have a mix of environmental and physical factors conducive for the spread of COVID-19. Meat workers stand close together, working long shifts, in cold and wet conditions. Production lines are structured so that the workers cannot physically distance – standing within 1.5 metres of another person for more than 15 minutes is deemed a COVID-19 risk. Further, workers may handle the same beast and that means the Virus can be spread so easily.

Tight-packed processing line

Clusters of COVID-19 cases have occurred in abattoirs and meat packing facilities around the world in Brazil, Canada, France, Germany, Ireland, Spain and the UK. More than 17,300 cases have been recorded in meat factory workers in the USA, with 91 COVID-19 related deaths. The latest outbreak in a German “meat processing factory” has infected 1,000 workers.

In Australia nearly 130 COVID-19 cases have so far been recorded in three abattoirs in Melbourne; one facility has been responsible for 111 cases.

Abattoirs and meat packing facilities can’t be closed down, if at all possible, for long periods so protection for the workers is essential to minimise or eliminate transmission. The meat industry has already been able to deal with Q fever, which is endemic in abattoirs, and brucellosis and TB in cattle – both diseases shared with humans. These have been contained.

Q fever presents a further problem because it often presents in a nondescript way. It is treatable in the early stages but both unrecognised and chronic Q fever cause symptoms that can last for months or years and may be fatal. There is a vaccine and by law all meat workers in Australia must be tested for and vaccinated against Q fever, their names added to an official register. The meat industry has been able to deal with these issues and now needs to apply itself in a similar way to urgently address the problem of COVID-19 transmission. Up to 2006 the cost of vaccination for Q fever was met by government. Now it has to be borne by the individual – somewhat of a disincentive, and a warning if a vaccine against COVID-19 is eventually discovered.

Operating with reduced staffing is nigh impossible in the meat processing production line. So the question for abattoirs and meat packing facilities is how to address the current problem as efficiently as possible. Physical protective equipment such as arm and hand protectors is already provided, so the provision of personal protective equipment (PPE) for all workers would not be unreasonable. Dealing with physical separation can be addressed with perspex dividers as have been installed between workers on production lines elsewhere, together with consideration of staggered rosters to reduce contact at the beginning and end of shifts, and on breaks.

In the short term these measures should at least reduce the opportunities for transmission while longer term solutions are explored.

There is no certainty about a vaccine for COVID-19 being available any time soon. Even the most optimistic research scientists – including the shameless self-promoters – admit that a vaccine before the end of 2021 is unlikely. The less optimistic admit that a vaccine may never eventuate, just as there is no vaccine for the common cold, also a coronavirus. Therefore society will have to live with this virus for some time to come and adjust the way business is conducted – industry by industry. Let us start with the abattoirs at a time when the rest of the world is in disarray. 

Oblivia – A short play with words 

In explanation

(a)     in accepting a challenge to write a short story in fewer than 400 words on a religious subject based on what I saw and then added a few brushstrokes

(b)     an appreciation of Lausanne cathedral

For her she had come for inspiration.

She, the lady in the crimson turban and gathered pleats threw up her arms and then prostrated herself before the altar. It was a small stage, there were no saints alive in the rose window above her. A rose window held true to its 13th century countenance as sketched by Villard de Honnecourt; as constructed by Pierre d’Arras. An Imago mundi which Oliver Cromwell would never have countenanced had he been allowed to get out of his Albion cage. So she thought.

A vague thought, but not “nouvelle”.

She did not see her companion fall down, striking his head on the stone – a fitting tableau. It was academic whether the fall preceded the fit.

She did not hear the head strike the marble.

She remained prostrate. Precisely on the stroke of the 120 “cat-and-dogs” mantra, she raised herself to a kneeling position and carefully flicked the crucifix from the pleats of her dress.

Her companion was bleeding from the right ear – unseeing eyes beneath increasingly blue-tinged eyelids – body quivering in the throes of grand mal epilepsy. Body askew on two levels. The head on the step – the body across the flag stones. Not particularly good for maintaining the airway.

The earplugs in her ears as she listened to the Tallis motet Spem in allium made communication difficult, especially as the videte miraculum had just commenced.

Her companion was dusky and his sounds were choked.

She crossed herself – an extravagant flourish considering the Calvinist surroundings – stood up only to genuflect – then plunged into a kneeling position, head upturned towards the Inspiration.

The workers fixing the heating system in the Grand Bay of the Cathedral had dropped their tools and run the length of the nave to the fallen person. One rolled her companion over; another then had run back to where the mobile phone had been left and was calling the ambulance. One worker was wrestling with the airway; could the colour be reversed? Another had fingers on the radial pulse. The fitting had stopped; the eyes remained without recognition. The light filtering down from the rose window elicited no response.

For him, he was left with no inspiration. 

Mouse Whisper

Well, if the mausmeister can come over all “authoric”, so can I.

In my wild erratic fancy visions come to me of Clancy

Gone a-droving “down the Cooper” where the Western drovers go;

As the stock are slowly stringing, Clancy rides behind them singing,

For the drover’s life has pleasures that the townsfolk never know.

 

Well, sounds to me as if it was an early Australian version of bull shift.

 

 

Modest Expectations – Natasha Nuora

Given what has been happening this week and I have been on the road in areas suggested as potential hotspots, I am starting this week’s blog with a few jottings. The radio has been the constant companion and television ever present in motel rooms, wherever you stop to socially distance.

I jotted down “self important politicians pontificating about how bad everything is – all on fat salaries and perks”.

I have never been a great fan of Tony Abbott, but when he was engaged as a firefighter or as surf lifesaver, he may have attracted some media attention, but unless it was all spin he continues to provide a real tangible service to the community.

So what of the current batch of politicians? What are they doing? Now in the time of the Virus where are all these well paid politicians and their side kicks – on the ground helping out rather than buried in spin – helping out with food deliveries – helping their constituents get through the crisis and not inflaming it.

For instance, those people in the high rise have two local parliamentary members – one Federal; one State. Both are Green.

Their names are Adam Bandt and Ellen Sandell. The photo-op outside the high rise apartments – of course. What else, running around picking up scraps of paper at the foot of the apartment blocks setting down the grievances of the locked down residents – and there is more – they are complaining to the government or in the political terms “ making representations”.

Now given that they represent comparatively small geographical areas, I would expect that these two would know what resources can be rapidly mobilised and instead of uselessly fluttering around be working to assure the “care element” for the tower residents.

Now if I were the local parliamentary member, given so many people have isolated in a series of high rise building, I would be seeking answers to questions of resident safety in the case of fire. Simple questions as to assure the smoke alarms in each of the flat are in working orders and nothing is blocking the emergency exits.

As I jot, in this fast moving scenario, comprehensive testing has  concentrated the Virus  in one of the towers. The Government has seemingly restored some order here.

I sympathise with Premier Andrews. He has the cattle he has been left with – often elected through branch stacking and factional deals. Obviously, a few able colleagues will have escaped the net of incompetence. One of these is Richard Wynne, who is the Housing Minister and the State member for Richmond who is very much acquainted with public high rise towers and what’s more effective.

The Victoria Opposition? I’m sorry I suffer from coulrophobia, which makes me having difficulty commenting further.

However, there is one person who overcomes my coulrophobia, and that is Premier Gladys. Obviously the spectre of the Ruby and Newmarch keeps her awake at night.

As soon as the pandemic flared up, she was into border lockdown without any contingency plans. Then a COVID-19 positive teenager turns up in Merimbula -after all, if the spread is going to happen, school holidays is a perfect time as Victorians flee winter.

However, had she anticipated border lockdown and was there a contingency plan? Well, apparently no. However, next day, she is encouraging NSW border townspeople not to travel and may have to lock down that area.

I bet there is no contingency plan in place to withdraw her troops in the face of the advancing Virus to the Murrumbidgee River, and yet she stigmatises her NSW border constituents and reinforces what has been said for years – that the NSW border should be reset at the Murrumbidgee River, so little the NSW government is concerned about its Riverina population welfare.

Day 1 of border closure – 6.00am – 4 degrees C

Data, Gladys, data – 10 cases across Albury-Wodonga and not one for 92 days until a couple of Melburnians were caught escaping Melbourne. The Victorians have locked down metropolitan Melbourne – that should be sufficient in any case.

It also raises the question of why isn’t the Government coming down hard on the appalling behaviour in Sydney, where social distancing appears to be reduced to about 30 cms if you’re one of the massive pack of people lining up to enter a hotel in Double Bay. Callers to ABC’s breakfast program discussed strategies for avoiding unwanted hugs – there seems to be a pandemic of short memories about how to avoid catching COVID-19 if that discussion is anything to go by.

Then Gladys’ nightmare continued, JetStar slipped a plane through the NSW cordon, emphasising the inherent fragility of policy being as strong as the weakest link.

Now two of the 48 passengers refused to be COVID-19 tested. If that one percentage of “refuseniks” is considered representative of those who are probably the same cohort as the anti-vaxxers, then there is a need for quarantine space not being a plush hotel to accommodate them.

No doubt, NSW has done an excellent job in relation to hotel quarantine, but that does not diminished the argument for designated quarantine facilities. The new and immediate challenge is a government intent on providing a refuge for an unspecified number of Hong Kongers at the same time as the States are showing hotel fatigue by pleading for fewer overseas flights.

Then, there must be a plan to cater for expanding travel given that for a long period into the future, the world will have reverted to the nineteenth century quarantine situation given the differential effect of the Virus on nations – and not wanting to completely stifle international travel yet not wanting travellers to be isolated for quaranta giorni, the basis for the word “Quarantine”.

The Greater Green Triangle

I have spent a lot of time in the Greater Green Triangle over the years. From the time I was responsible for some community health projects in Western Victoria and more recently when I was Director of Medical Services at Edenhope Hospital for a couple of years. If you asked 100 people in Victoria or in South Australia (outside the GGT) where is Edenhope, I would guess the number who knew where it was in each State would run into single digit figures.

However, Edenhope exemplifies a border town and the interdependence of border settlements with one another. Their ability to accommodate to different governments with different legislation is one of the qualities that I love about such towns. I have worked in many.

The problem is that being at the extremes of the State, unless in Queensland where the border is close to the capital, the border residents tend to be forgotten. And this is so, even in Queensland! At the Post Office Hotel in Camooweal on the Queensland-Northern Territory border, you can get the best steak sandwich in Australia – but who would know.

However, let’s return to the Greater Green Triangle. The Victorian-South Australian border was set in 1836 to run along the 141st meridian. Although there is some discrepancy between the then and now measurement, what distinguishes the area east and west of the line is the limestone South Australian coast and hinterland; and this is reflected in the buildings. Mount Gambier stone is a distinctive limestone. One of the ways community in rural Australia has traditionally defined itself is through its football leagues. In this area traditionally there has been a strong Australian Rules tradition; all the border leagues are organised around perceived communities, and these do not seem to recognise borders as a barrier.

The Greater Green Triangle has its base along the coast from Apollo Bay in Victoria to Kingston in South Australia, and as it goes north, where the major population centres are Horsham and Keith, before it runs against the Mallee, an area that also crosses the border.

The point is, as I found out when I assisted in the establishment of the cross-border Greater Green Triangle University Department of Rural Health, that it proved a viable size to deliver an area where medical students could gain enough clinical experience. It showed that the region had both the intellectual capital to provide tertiary education for the population locally and also a population to support clinical training. Both Flinders and Deakin University have had a significant investment in this putative region.

Working at Edenhope demonstrated how clearly important Naracoorte (known locally as Nazza) was to those living on the other side of the South Australian border. This was emphasised by the 2011 floods, which closed the road between Edenhope and Horsham. This meant that services in South Australia were crucial.

Look at the data. Regional Victoria has been virtually free of the Virus for a long time. Therefore, the case is clear for a more sensible approach to border closure in the south-west of Victoria and the south-east of South Australia.

The recent cross-border exemption of 50 kilometres recognises the importance of Mount Gambier and Naracoorte to Western Victoria. However, it dose not recognise the importance of Portland, Hamilton, Warrnambool and even Horsham to South Australians living along the border. As I write this, there is apparently a substantial backlog of people seeking to gain the requisite permits to cross the border

Recognition of the Greater Green Triangle – a long-established and recognised area by three governments – is now being undermined under the current COVID-19 restrictions. The tri-governmental decision to close the Victorian border with NSW fails to recognise that this economic, educational, health and community zone should not be undermined during the COVID-19 pandemic.

East of Eden

The Victorian border south of Eden suddenly looms as a small notice and a bigger notice further on announces the East Gippsland Shire. There is one mobile neon sign saying that those from some undefined hotspots are not allowed into NSW. The cars that whiz past, including several towing caravans – all with Victorian number plates. There is no sign of any active policing of the border.

However, that was before the NSW decision to close the border from Tuesday midnight.

There is no doubt that this border crossing will present a logistics problem. It is going to be interesting to see how the NSW police will arrange their supervision of the Princes Highway border for an extended period, given that it very sparsely populated in an area of bush regeneration, with lots of tracks and not much population until Eden 50 kilometres up the Highway. The ADF may be very useful here. Presumably for completeness, the NSW water police or the Navy will be patrolling the 31 nautical miles between Mallacoota and Eden.

This past weekend we decamped to Merimbula. We were curious to see how the devastated region, after the ghastly summer bushfires, was regenerating. We had watched, as did so much of Australia, with horror and helplessness the destruction being wrought. We contributed to the bushfire relief, but it seemed a pittance. We were then ashamed at the politicians’ response, many of who were overseas, even though there was forewarning of the disaster afoot, much in the same way this border closure has been handled. Many warning signs; then the white stick panic.

Our visit coincided with the weekend of the Eden-Monaro by-election, and although some equated the electorate with the bushfire, the actual area of the electorate burnt was comparatively small and unpopulated. However, that statement is little comfort to hamlets like Cobargo or Mogo where the devastation was numbing. In Australia loss of property is like losing your mind – your memory.

Yet in Merimbula there are few signs of the bushfire. The trees grow tall in the gullies and onto the rises of this hilly settlement with its glorious views of the water stretching out into the Pacific Ocean. Here is a world of the best rock oysters and great fish cuisine. And that emblem of middle class – the golf course – that has been unaffected. The trees are majestic and the fairways green.

Here is the remnant temperate rain forest, which stretches out onto the slopes of the Great Dividing Range. Yet here is an electorate, where a climate denier whose only bush fire policy seems to be fuel reduction, nearly got elected. I would like to see how she would go about man-contrived bush fuel reduction on Brown Mountain. Fortunately, she received a huge thumping by the Merimbula voters.

South of Eden where the devastation was so pronounced there is a very small population – tiny settlements such Kiah are littered with the graveyards of houses, although the local store stoutly displays a “bottle shop” sign.

 

Princes Highway, south of Eden

I remember the reports from Eden, which saw people congregating at the wharf. The flames across Twofold Bay must have been a terrifying sight.

The sturdiness of the bush has been shown by the way the new green leafy growth has been shinnying up the black trunks – to announce its new arrival. However, death is beige, trees whose beige foliage hangs forlornly. The trademark colour of emerging wattle is noticeably absent. Yet there are banksia and grevillea in flower – small numbers but as with the grass, and the ferns and wildflowers, exhibiting regeneration. Nature does not wait for government assistance. Will the thousands of eucalypts across NSW and Victoria that now have epicormic growth gradually recover? Time will tell, but the intensity of the fires was such that we are unlikely to see recovery any time soon, if ever.

There are areas of clear felling and trees scorched beyond immediate redemption. There are no sounds – no bird sounds, no evidence of wildlife, no animals skittled on the roadway. It is not yet Spring but this is a silent world, apart from diminishing noise of the highway.

Yet the two government bush fire inquiries are meandering down bureaucratic gravel roads. The NSW Inquiry finished its community consultation in May, and the Federal Inquiry is due to finish on August 31. When will there be recommendations; when will there be action?

The governmental inertia is appalling and, as has been shown by the Berejiklian approach to government, it gives no idea of whether she knows what she’s doing – apart from kicking the can down the highway and trying to find it in a white stick panic. The NSW bushfire report is due “before the next fire season” (policy by length of the string principle) and presented to her (policy by ceremonial burial)

However, get ready for her response in 2021 when the remaining South Coast bush may have been subject to fuel reduction, but not in the way she meant – only it was not her fault. Nature had just misinterpreted her message.

Stabilising our “Arc of Instability”

Neil Baird – Guest blogger

Celebrated American travel writer Paul Theroux describes his impressions of our neighbouring Pacific islands in “The Happy Isles of Oceania”. It is an ironic title for a book that others have described as “The Arc of Instability” – the chain of islands extending from the Cook Islands in the east to Indonesia in the west.

Cook Islands

While the latter epithet was originally applied to geological instability, it now much more accurately applies to geopolitical instability. The Chinese “dragon” has awakened and is blowing its hot, corrosive and corrupting breath in the direction of our archipelagic neighbours.

That makes it high time that Australia and New Zealand wake up to the threat that accompanies China’s interest. We should be doing much more to counter that threat while we still can. Instead of our benign neglect of the region during the past 75 years Australia and New Zealand need to become very proactive and pragmatic. It is far too late for idealism – the light on the hill burns low. 

Anyone sceptical of the danger that the Xi Jinping-led China presents to Australia should be reminded that his approach shares the hallmarks of a number of pre-World War 2 dictators.

Inter alia, Winston Churchill’s “The Gathering Storm” and Willard Price’s “Japan’s Islands of Mystery” and “Japan Rides the Tiger” very perceptively and accurately predicted the likely outcomes arising from the behaviour of such “Imperialist” dictators.

Willard Price’s books are most relevant to Australia’s current situation with respect to our neighbouring archipelagic nations. His description of the Japanese strategy and actions in regard its League of Nations Mandate of the Micronesian territories north of the Equator are particularly apposite in our current situation. President Xi’s China is closely following General Tojo’s playbook, albeit a little less brutally; so far.

Xi Jinping has demonstrated his imperialist credentials in the South China Sea. They have since spread rapidly with his “Belt and Road Initiative” which, as well as many Pacific and Indian Ocean states, now even encompasses the satirically characterised “Democratic Socialist Republic of Victoria”.

A serious and rapidly worsening problem in Australia’s immediate neighbourhood has emerged. While many of our neighbouring nations have been described as “failed states”, it is probably more accurate to class them as “unviable states”. In hindsight, it would have been better if they had formed a federation giving them some critical mass when they gained independence from their former colonisers.

They are, apart from Indonesia and Papua New Guinea, mostly too small, in terms of land area and population, let alone resources, to be economically viable individual nations. All are, to be bluntly honest, seriously deficient administratively. That makes them unusually mendicant and, therefore, vulnerable to external influences.

This reality must be allowed for in any approaches Australia makes to our neighbouring nations in an effort to counter the influence of the Chinese government. These countries need help and, to preserve its own future, Australia needs to help them.

However, to effectively help protect our neighbours from Chinese hegemony, Australia must be much more realistic and practical in its approach than has been the in the past. The paternalistic, diffident approach of Australia has created a vacuum that China is rapidly filling.

Australia must help protect these “Pacific paradises” from the detrimental effects of Chinese “colonisation”. This will require a very different diplomatic approach that to challenge the capabilities of both Australian and New Zealand bureaucrats – be they diplomats, trade representatives or “aid” consultants. They will need to be very incorrect politically.

That will require a much more culturally sensitive and realistic approach than has ever been demonstrated by current employees of Australia’s Department of Foreign Affairs and Trade and flies in the face of their education and departmental acculturation.

The simple fact is, as any senior island nation bureaucrat will privately confirm, their biggest problem is “political interference”. Read “corruption” from elected representatives from ministers downwards. The Chinese government panders to this. Australia does not. This policy puts us at a great disadvantage. Australia must learn to work around and overcome that distasteful reality.

With that reality firmly in mind, Australia needs to much better plan its approach to those tiny nation states. We have to accept that they are not really “democracies” in the way that most Australians and New Zealanders understand that word.

Apart from brown paper bags of cash, diplomacy has a long tradition of purchasing influence. Scholarships, similar to those offered by the successful Australian Indigenous Education Foundation, provided to the bright – they’re always bright – children of politicians would be a start.

So would appropriate venture capital funding for business start-ups. “Educational” tours for politicians are always popular. There are numerous examples of what could be done in that line without having to go so far as the old German trick of “limitless” credit cards.

Australia could do much more in the areas of health, education, transport, agricultural, forestry and fisheries development, disaster relief and even defence. Australia could provide these island nations with safe, efficient and comfortable Australian designed and built ferries for inter-island transport. Importantly, Australia should train them to operate and maintain those ferries safely.

In contrast Australia should not be:

(a) building “Taj Mahal” financially unviable convention centres, or

(b) providing fleets of fancy cars to transport the delegates to non-existent conferences.

Above all, unlike our Chinese rivals, Australia should not be pushing debt onto the islanders, which only serves to reinforce their mendicant status.

The aid provided should be practical, sensible, conspicuous and culturally sensitive. There is no point in providing aid in any circumstances where someone else gets the credit for our generosity. Importantly, rather than handing over cash that inevitably would be spent on Toyotas, Yamahas, Hyundais or Maseratis, Australia should promote purchase of Australian goods or services.

We have plenty of desirable home grown goodies to offer,” as one reliable source said to me.

Not To Know What Happened Before One Was Born Is Always To Be A Child

I once had dinner with the essayist, author and sometime editor of Harper’s, Lewis Lapham, in New York. It was very cordial, entertaining dinner. I was trying to entice him to Australia to give a talk, but somewhere, sometime he slipped out of the net and did not come.

Later he did come to Australia and Bob Carr hosted him. The meeting of those minds is not surprising because although Lapham was a gifted essayist with a very astute mind, he could not resist writing such words: “I first met him at a New York dinner party in 1962, among the company then traveling in the entourage of President John Kennedy, and over the next half century I ran across him at least once or twice a year – in a Broadway theater, on a lawn an Newport, Rhode Island, in the Century Club dining room, on the stage of an university auditorium.” However, he carried his self-importance more easily than Carr, probably because he was a true intellectual.

In any case he was talking about Arthur Schlesinger. Schlesinger was a historian, a very good historian, who saw the world in which he lived, as Lapham recalls, as a place “to construe history as a means rather than the end, the constant making and remaking of the past intended to revise the present to better imagine the future.”

Schlesinger, although he died in 2007 at the age of 89, had witnessed the growth of the information revolution, without watching it explode. He noted that it was associated with “an attitude of mind which accommodated the floating world of the timeless fantasy, impatient and easily bored, less at ease with a stable storyline than with the flow of brand names images in which nothing necessarily follows from anything else”.

The problem with eloquence is that those mentioned above are listening to a different beat and hence the comment is lost in that floating world. Further, eloquence may mask thoughts that may be too personal, too generalised or just too loquacious.

“The problem is if the population do not recognise that history captures the past then the populace may be presented with solutions where there is no link between cause and effect. To be told what is right without any evidence, without the benefit of history is to caught up in the whirlwind of fake news, fascist politics and quack religions.”

Schlesinger was talking about Bush The Younger’s legacy in dumbing down American educational standards. Such a statement retains its relevance 13 years later, when the barbarian is no longer at the gate – he is within the gate. Now educational standards are reduced to slogans and chants of invective repeated.

Lapham compares Schlesinger’s analysis of history with that of a man who “forged the strength of Roman history into a weapon”. According to Lapham, both this man and Schlesinger recognised history was not a nursery rhyme. The name of the Roman was Cicero.

Marcus Tullius Cicero

Cicero paid a mortal price for his defence of the integrity of the republic against vanities of would be Emperors; and by the way, the quote at the head of this article was written by Cicero; how prescient a description of the current American President.

Mouse Whisper Primo

Overheard in the executive office of an unnamed casino: “Of course we have bought a vat of sanitiser – how else are going to launder all the money we are getting?

Mouse Whisper Secondo

Premier Gladys, my whisper from the floor, may I give you a tip about salt and pepper shakers – use them first, then hand sanitise. Then everybody can share or else wipe the shakers down before you use them.

Modest Expectations – Macquarie Island

“Australian state and federal police routinely carry firearms. While on duty, most officers’ duty belts consist of a handgun, Taser, expandable baton, pepper spray, a set of handcuffs, ammunition magazines, gloves, torch, and a two-way radio.”

When the Queensland police were bailing up people at the Queensland border checking on their status, there was not the slightest indication that they were observing any of the rules explicitly set down to minimise the spread of the virus – no gloves, no masks, leaning on car doors, no evidence of hand sanitiser as they handed the documentation and pen to the driver … and as for keeping the requisite distance from their fellow officers, what a joke.

The police are so used to walking virtually hand in hand, nobody has seemed to have told them that just because they are a member of the police force, the virus will not quail at all the ironmongery jangling from their belts. It is far more likely that the belt and the attached items will attract the virus especially as unwashed hands fiddle with them. Where, Madam Commissioner Carroll are your COVID-19 virus protocols and where did you gather your officers together to be briefed on the importance of following the guidelines before they were let loose on the motorists?

It is salutary to remind the Australian police forces that 500 members of New York police force are COVID-19 positive, and there have been a number of deaths. Thus, at the very least each police officer should have a bottle of hand sanitiser placed between the gun and the Taser – and use it.

As for the air conditioning in these lock-down hotels, it is as important for the guards to be especially conscious of the health guidelines and not congregate, as police tend to do. Most of the air conditioning in the hotels is not hospital grade, and therefore there is no guarantee that the virus will not spread.

The last thing the hapless NSW Premier wants is police officer(s) or for that matter an army staff member testing positive in the next two weeks.

Her performance and that of the even more hapless Dr Chant is shaped by their failure – even up until 28 March – to quarantine the arrivals at Sydney International Airport. The Garuda flights where it was reported to ABC radio by a passenger that there were coughing and spluttering passengers allowed to pass through the country’s borders without any checking. If true, this just adds another entry into the charge sheet.

But back to the police – the incongruity of the social distancing in relation to the police force is shown in the images of their patrolling. Presumably the police are now ordering paddy wagons, which provide each recalcitrant with 4 square metres of space.

However jokes aside, the most impressive figure this past week in NSW has been the police commissioner, Mick Fuller – firm, decisive but compassionate – and incorruptible. He was prepared to take the community into his confidence by indicating he had a 90-day supervision delegation from the government to continue to do what the police were doing.

The images are now changing of some of the police force now with gloves and masks. But viruses ride on gloves and there is no evidence that they are being changed regularly. I still could not see the bottle of sanitiser at hand, so to speak.

By the way, where has the NSW Health Minister been? He was last seen coughing a week ago but popped up again on Sunday still looking congested. I hope he has not being doing a Boris, and got impatient with isolation.

The strange case of the Premier and the Fourth Saturday in Lent

One has to give it to the Queensland Premier Palaszczuk. She has a compliant Chief Health Officer, who is not a public health physician. She has closed the borders and at the same time allowed local government elections to proceed, even though they could have been deferred. The images of the voters not “socially distanced” and effectively gathered in large groups could not be reconciled with the health warnings currently agreed by the National Cabinet, of which she is a member. It is even reported that the electoral staff walked out of one voting place stating that they felt at risk.

However, by this questionable activity, the government could cover up the two by-elections being held to replace to members. One was in Bundamba, held previously by one who had said that the Queensland Treasurer was a four-letter word as she resigned. That is true, she is Treasurer Trad, but I am not sure whether this disaffected female member meant that word.

The second case was the long-standing LNP member for Currumbin, who had the temerity to vote for the abortion bill and was hounded by the trolls that seem so part of the LNP right wing so that she resigned. She was replaced by someone who had been a member of the LNP for a month and once appeared on a show featuring ‘”Australia’s Worst Drivers” – a trait among the politician class, yearning to be the centre of attention. The electorate seemed unimpressed, but that person seems heading for a narrow win – just a normal day in the politics of the Sunshine State.

Under cover of the local council elections, it is postulated the Palaszczuk government wanted to test the waters before the State elections due later in the year. If that postulate is correct, and in the 93 member unicameral Queensland parliament the ALP would have retained power whatever the outcome, it seems reprehensible to have held these by-elections at this time. But this is Queensland, the home of progressive health policy and One Nation (which incidentally polled very well in Bundamba). As if to highlight stuff-up, the Electoral Commission stumbled badly and most of the results were still unclear on Sunday afternoon. As will be the long term consequences of this essentially political preservation action by the Palaszczuk Government.

Obviously the Premier has not given up political machinations for Lent.

Cone of silence

The Diamond Princess caused much mayhem in Japan.

The Ruby Princess has since caused much mayhem in Australia. At least ten per cent of Australians infected with COVID-19 as of this week came from that one cruise ship.

Are the media asleep? Can nobody join the dots?

Why have there being no interviews with Ann Sherry, the Executive Chair of the Carnival Shipping Lines, asking how this all occurred. Why was the Ruby Princess allowed to berth? Why were the passengers herded off without even a passport check? Look, you gullible NSW voters, no hands! Surely no political pressure – beggar the thought.

But then the media, over the years, has performed a series of gushing tributes to this former bureaucrat and adviser to the Federal Government.

After the Diamond Princess fiasco in Yokohama, the CEO of Carnival Cruises, Arnold Roberts, was quoted as saying

We have hundreds of cruise ships, very few had cases on them. The one that had the most cases was very early on when no one understood hardly anything. With 20/20 hindsight, could everyone had done something sooner? Perhaps. But it was an evolving, learning situation.”

Not soon enough for the Ruby Princess obviously.

Now Mr Roberts made his first fortune playing blackjack on cruise ships by counting the cards it would seem and used this astuteness to run both weedkiller and sweetener enterprises. He was brought to the Arison owned shipping lines in 2014 because as was quoted:

It’s been a rough two years for the company. First, its Costa Concordia sank off the coast of Italy, killing 32 passengers. Then an engine-room fire on its Carnival Triumph left the ship without power. For five days, passengers lacked air conditioning, hot food and use of most toilets. Cable news was fixated, dubbing it the “poop cruise.” 

Training for a pandemic?

Now, Ann Sherry, what have you got to say about all this and especially in regard to the Ruby Princess and it berthing in Sydney with infection on board?

As for Dr Chant, Chief Medical Officer of NSW, you read this about the Carnival ships and especially look at the dates and tell us “mug NSW punters” why you should still be in your job:

Shared swimming pools, compact and enclosed spaces and quarters, frequently touched surfaces from handrails to slot machines, and meals shared with hundreds create an “increased risk of infection of COVID-19 in a cruise ship environment,” according to a warning issued by the Centres for Disease Control and Prevention (CDC) on 8 March.

(At time of publication)There have been at least eight cruise ships with confirmed coronavirus cases across the entire industry, including the Diamond Princess, Grand Princess, A Sara, MSC Meraviglia, Costa Luminosa, MS Braemar, Silver Shadow, and the Silver Explorer.

Carnival and other major cruise companies, halted all travel only after the State Department advised Americans not to travel on cruise ships and the CDC published a no-sail order of March 13.”  

The Ruby Princess berthed in Sydney on March 19 – without any quarantine intervention from you Dr Chant. Turn off the light as you leave.

A message from Princess Cruises

The Danger of the Hospital

I was asked whether I wanted to help out in Queensland. There were no immediate problems, which arose at the time of the first request. Then came the escalating restrictions and the changing job description.

Having to negotiate the border and being accosted by a police force, which were exhibiting doubtful levels of hygiene, especially in the transfer of documentation was the first problem.

The second was that the first job indicated it would be restricted to providing COVID-19 and public health telephone advice only, and then as I have been used to in any jobs relating to Queensland, the job description changed to one of face-to-face contact. As I am of the age where the government have suggested strongly I be confined at home, which I take to be a domestic situation, telephone advice was feasible and something that, as a public health physician, felt I should undertake.

The one particularly important thing that Australia has done, undoubtedly having Paul Kelly and Nic Coatsworth with their extensive knowledge of public health to back up Brendan Murphy, has helped establish the testing regime. The messaging has come a long way since the time early in March when a member of my family resisted the determined attempt to turn him away from Box Hill Hospital and insisted on being tested despite then having to wait one and half hours, despite there being no-one else there.

Coupled with closing the borders with China the testing regime has probably saved Australia. Early testing means that fewer people have had to go into hospitals. Testing has improved with a faster turnaround time for results. I for one, if tested positive, would have stayed at home as long as possible as opposed to hospital admission.

If you read the list of health workers dying in Italy it is reminiscent of reciting war casualties. The headline in the Italian newspaper early this week read “Coronavirus, morti altri dieci medici. Dall’inizio dell’epidemia sono 51.” You do not have to be fluent in Italian to know that 10 doctors died on one day earlier this week, bringing the total to 51. This number has continued to rise.

Despite the shroud waving led by the ubiquitous Professor Talley in the MJA and the intensivist petitioner Dr Greg Kelly and his collection of medical jeremiahs, Australia is not tracking Italy. I have already expressed my disgust at the NSW Department of Health in regard to the cruise liners, and there should be appropriate retribution at an appropriate time.

If you read the Johns Hopkins Centre for Systems Science & Engineering (JHCSSE) modeling this week, according to JHCSSE’s modeling when there were 3640 cases (about right) in Australia, we had 460 deaths; the modeling is based on Italy given this prediction of 460 deaths would be close if the case and death rate was similar to what has happened in Italy,

So much for modeling; and I wish that everybody would stop printing these hypothetical figures, which may as well have been got by reading the tea leaves. The problem with the media is that, over the years except for a very few people like Norman Swan, it is totally gullible in relation to health, reporting every bit of public relations fluff that is put out about so-called medical “breakthroughs”. That is particularly dangerous when there is a pandemic and the hucksters are abroad.

However, this does not mean even at my vulnerable age, that I would want to be admitted to hospital if I developed a fever and a tell-tale cough. I would hope to tough it out; but then again I hope I won’t have to make that decision.

Now that is an ordeal

We have been seeing a flood of returning passengers from ill-fated travels, many of whom commenced these travels at the wrong time when the portents were there of gathering clouds – 16,000 left Australia after 18 March when the Government’s Level 3 travel advisory was issued (Reconsider your need to travel because there are serious and potentially life threatening risks).

Those who have been able to return should count themselves lucky. Complaining about their situation in five star hotels reminds me of a time, of my father’s generation and of a place called Singapore. Here were a number of involuntary travellers called soldiers who were deserted by their leaders, with their braid and red banded caps called generals and brigadiers. The soldiers were confined, not for two weeks but for three years – if they survived – as guests of the Japanese. Their first place of confinement was known as Changi.

Therefore the younger members of the currently 5,000 in confinement in Sydney hotels, would never have been contact with some of those soldiers, who eventually returned. I was taught by some of these men – they never had a sense of entitlement; they had not been locked up in a hotel room for two weeks with three meals a day, phones, internet, television and new towels every day. They had a slightly different experience over three years.

They never moaned; very few wrote about it. Very few ever talked about it. Some of my generation – people I knew – never knew their fathers – today a word lost in the slush of that term “loved one”.

There was no TV series called “Survivor” with inane presenters and faux battles. Maybe after you are released there will a scramble for a media contract to tell all.

In contrast, in my youth I remember there was the man who always dined alone on Christmas Day away from his family because that was the day his mate left his quarters for the last time, not to the streets of Sydney but to an unmarked destination.

So take a powder, you lot, turn off your Skype; stop making yourselves look totally selfish on Facebook, and just deal with it.

As for the media giving these people oxygen, what about the Biloela Four locked up on Christmas Island – a sort of Changi without the cherry blossom. Forgotten them?

Skiing in a time of coronavirus

Janine Sargeant – Guest Blogger

The media have been reporting on the now infamous Aspen 9 who are reported to have brought more than a ski tan back from their recent trip to Aspen in Colorado.

Burnished with schadenfreude the reports have followed members of this group through birthday parties in Melbourne and Noosa and a visit by one couple to their beach shack at Portsea; the reports have included tallies of the number of confirmed cases among the ski party and those apparently directly attributable to the two birthday parties. The Noosa party resulted in many positives among guests, but also among the restaurant staff. There is talk of legal action. The 14-day mandatory self-isolation for overseas arrivals was introduced the day after the ski party returned.

More broadly the Aspen 9 saga raises the question of what plans there are for the Australian ski season, which normally opens on the long weekend in June. The skiing might be out in the fresh air two ski poles apart, but the ski lift transport, aprés ski scene and accommodation is not.

Having spent quite a bit of time on the skifields, skiing, running a ski shop and working a bar at a lodge – my version of a well-spent youth – I still remember a case of tonsillitis that sent everyone into a spin because the close-living environment of ski lodges was so conducive to the spread of illness. However, if even the well-heeled in their plush accommodation are catching COVID-19 in record numbers, then there’s really a problem. Without knowing the denominator (how many there were in the Aspen group) there’s no way of knowing what the incidence of infection was, but there are enough cases to raise alarm.

One of the highest COVID-19 infection rates per capita in the USA has been reported by “The Washington Post” as being in Idaho’s Wood River Valley – 192 cases in a county of only 22,000 residents; there have been two deaths so far. Why is this? Idaho has some of the best skiing in the US and is a well known conference destination. Skiers fly in from around the country and around the world and no doubt have brought in COVID-19.

The source of the infection in Blaine Co, home of Wood River Valley and Sun Valley, was almost certainly skiers from Seattle, from which there are direct flights. Washington State had the first confirmed positive case in the US and up to mid-March, had the highest absolute number of confirmed cases and the highest number per capita of any state in the country. That has now changed with the epicentre shifting to New York.

However the counties surrounding Vail and Crested Butte in Colorado and Park City in Utah – all skiing hotspots – are now also COVID-19 positive hotspots.

Wood River Valley’s small hospital has been partially shut down because four of its seven emergency doctors were quarantined. The fire department that also operates the ambulance is relying on volunteers. One of the doctors who has tested positive said he thought he had caught the virus because of close contact on ski lifts.

All State Governments in Australia have effectively banned recreational travel within the State, and absolutely banned travel between states except where a permit is in place or a resident is returning home – but 14 days of self-isolation are required. Everyone is supposed to stay home, but for how long? The June long weekend is eight weeks away.

Faced with the experience of the US, which has spilled over into Australia with the Aspen group and around 50 positive cases, presumably NSW and Victoria should be putting skiing on hold for 2020 – and without any intervention from Master Barilaro, the local member, especially after the Ruby Princess fiasco.

Mouse Whisper

Paul Barry brought this to my attention as I was gnawing my way through my late night supper 

What is this constant mention of Petri Dish in relation to coronavirus?

Viruses need living cells to propagate, not Petri Dishes containing blood agar, upon which bacteria and fungi party.

Fortunately, my relatives are less exploited now as a medium in which to grow viruses, but embryonated eggs have always been a favourite culture medium. However, now most viruses are grown in cell culture.

Nothing to do with Petri Dishes. Today’s tip for the journalists, if you want to sound knowledgeable at least check the details; a Petri Dish isn’t something from “My Kitchen Rules”. So drop the Petri Dish metaphor. Even a simple mouse like me knows it has nothing to do with viruses.

Modest expectations – J.J. Lyons

The problem is that, over the years, the community has become inured to the laughing mother in the advertisement with a gaggle of inanely smiling children showing how some disinfectant or other has rid the kitchen countertop of 99 per cent of germs.

If we lived in a sterile world devoid of all viruses and bacteria then like them we would all be dead.

Therefore we have to be reasonable, but when we have a media fuelling the hysteria that is not easy. There is a talk about the “surge” in infection and highlighting the number of deaths from the “killer virus”, rather than highlighting those who have recovered. The basic fact is that in a population of 25 million there have been less than 200 reported cases – i.e. as of today, an infinitesimal percentage of the population. The number is small, and it is important to maintain perspective. This is a prime function of government in the face of the irrational community response. Such a reaction dwarfs the other responsible response, which is building an evidence base as to what this coronavirus actually does.

Thus currently the rate of increase has hardly been a “surge” despite its attraction as a media headline – or even the milder use of “tide”. And if you use “surge” as a faux-dramatic metaphor then eventually the metaphor will “abate” as a tide will ebb.

Take Dr Higgins: how is the contact tracing going? It would useful if we were told how many of the people, including patients, with whom he came in contact have returned a positive test. However what we have is some State Health Minister attacking him and the AMA responding, rather than getting together and using this case to obtain useful information about the spread or otherwise of COVID-19.

Dr Higgins was on a United Airlines flight from San Francisco. I know somebody who was on the same flight who has the “sniffles”, all very mild. However, when my acquaintance’s partner became ill with a fever, an attempt to see the local general practitioner, resulted in an immediately referral to the relevant Hot Line which, having established my acquaintance as a resident of that State, then referred my acquaintance back to the general practitioner.

So much for consulting your local general practitioner as the front line defence, as the AMA have been telling the community. My acquaintance went off to a newly-designated centre for coronavirus testing. It was so new that the staff provided a good imitation of not knowing what to do. Waiting, my acquaintance and partner were alone, but it took an hour and a half for my acquaintance to be seen.

Despite my acquaintance’s history, the hospital-based centre was reluctant to undertake a test. Initially, the triage nurse wanted to send them away. Eventually my acquaintance was tested, but not the partner because at that time there was no proven contact with a confirmed virus carrier.

Ultimately they both tested positive and my acquaintance’s partner’s substantial workplace has been locked down for a week. They have children at school and university. The children tested negative.

It should be appreciated that the coronavirus tests for virus RNA being excreted at the time of the tests. There is no serology test to tell whether the person has had the coronavirus. Young people clear their system very quickly because in the main their immune response is very strong, a fact having being confirmed elsewhere. So it is quite possible that the children had been infected but have been asymptomatic and were no longer excreting the virus.

My acquaintance and partner no longer have to fight for attention. They have their own personal doctor contact available and visiting nurses. That is fine when there are so few cases, but this is a government that tends towards engendering fear rather than soothing concerns, when the number of cases are primed to increase.

Already the reluctant-to-test-centre of a week or so ago has a queue of the mostly worried well.

When winter comes is everybody going to receive such personal service? The answer is in the ability of general practice to develop a more hygienic environment this winter – not having waiting rooms filled with coughing adults and children would be a good start.

And what about the United Airlines flight? My acquaintance wasn’t sitting anywhere near Dr Higgins. So what is the evidence basis for the “same row plus two rows in front and two rows behind” exclusion zone? Almost everybody goes into the bathroom on a long flight, and from observation the level of hygiene in the bathroom is generally appalling. Tissues everywhere, an unclean basin and taps, water left in the bowl, used hand towels poking out of the waste bin, handrail and door locks not cleaned between usage.

In the meantime the United Airlines flight had been merrily going everywhere presumably continuing on with the scant hygiene measures which have been characteristic of  airlines.

It may well be that America may prove to be the biggest problem and the irrational behaviour of the President, most recently in a blanket ban on flights coming from “Europe” (senza the UK) and at the same time a reluctance to be tested himself, does not help.  Will America be added to the Australian exclusion list? After all, viruses do not respond to ideology.

I suspect that this scenario which is going on all over America with an unprepared and totally under-resourced public health system. As I’ve just said, Trump’s measures are irrational, and hard to follow, but that is nothing new.

Yet here, summer has been and gone; summer is not conducive for coronavirus spread and a containment strategy based on excluding nationals from an ever expanding list of other countries is in place. So currently it is a good time to be in Australia, and if the medium term strategy is based on a belief that with summer in the Northern Hemisphere the coronavirus epidemic will abate, then the current strategy has a modicum of sense.

The underlying problem is whether the political declamations are actually being carried out. Some of the state governments websites giving advice are very good, but why not consolidate this information into one web site – this is where the federal Government should be the single voice.

One of the problems highlighted by the 1918-1920 influenza pandemic was the destructive effect of the lack of public health co-ordination between States. Ostensibly, the Commonwealth is in control, but with each State seemingly disseminating its own information, it calls into question what is the actual level of coordination.

However, the tipping point is to know how far the government’s policies can go to effectively close the country down before wrecking the whole societal fabric and not just the economy. Having everyone in two-week isolation is ultimately unsustainable.

So a greater number of people who have to work will ignore the ban or not be tested; or the government will relax the ban. The evidence is that the older population are disproportionately affected, not school children or young adults. So why close the schools? We don’t do that if children catch the common cold, a coronavirus relative.

Look at the mixed messages. No wonder the community is perplexed.

Mixed message one: There are the media appearances of politicians elbow bumping and contorting themselves. However, what does the Prime Minister do in a forum where the spread of coronavirus is being discussed? He shakes hands with the guy who introduced him, does not use any hand sanitiser and goes to a lectern where there is no indication that it is to be cleaned between speakers. As far as we could see it certainly was not cleaned in this case.

Mixed Message two: There is a full house at the women’s cricket final – so much for the empty stadium scare that some of the muppets in the football codes seem to be mouthing.

Mixed Message three: There is the spectacle of the women cricketers jumping all other one another, high-fiving, potentially contaminating one another.

Mixed Message four: The Victorian Premier is threatening to close down the education system while at the same time giving an exemption to Ferrari for the Formula One exercise in air and noise pollution. No crowds, Mr Premier, after all it is school but of a different sort.

It was wonderful to see the publicity-shy Dr Mukesh Haikerwal in his medical practice car park collecting specimens for testing in a strapped pathology system. Presumably he continued to do this once the cameras stopped and continued to flood the local pathology laboratories with specimens. But what was his protocol for offering testing? Close contact with a person with who was confirmed positive? Or the worried well? Not clear. But the next day, having put on the show for the TV, his clinic was overwhelmed.

Now pop-up clinics; I suggest the government consider using the expertise of Dr Haikerwal with his car park technique to ensure that the Health Minister’s promise of the having all these clinics popped up by the end of May can be met. After all, he looks good in a suit.

Then as Australia enters the winter unless there is reliable health surveillance, it may be expected the pop up clinics are going to be inundated by people with that other coronavirus, the common cold, or those who are suffering influenza.

It is always disappointing that the first thought of governments is the authoritarian solution. Australia has always been quick to press that button. Such a solution resulted in the misguided lock hospitals of the past on Dorre and Bernier Islands in Sharkes Bay. Aboriginal men and women suffering from venereal disease were sent there. Australia has a dark history of isolation of people with disease and community panic attacks.

It seems at this time the greatest risk group is the elderly. However, they are not all congregated in nursing homes. On the other hand, they are not, by and large, in the workforce. Many roam in the freedom of being child-free and comparatively well off. One has to know where the mobile “grey nomads” will congregate in the coming months, and where they will roam in remote Australia. Perhaps that is why there is a run on toilet paper and disinfectant.

For the sedentary aged care population and their housing, just assure hygiene and that someone is checking on them to ensure they have supplies. Places for the aged should conform to the level of hospital hygiene. After all, we are the vulnerable group, and let me say that this raises very strong questions about the workforce’s ability to communicate with an increasingly deaf population and with its significant demented cohort.

In the end, China may be able to impose Draconian provisions in the short term but will it effect the cultural changes vital to prevent this sort of disease outbreak happening again? And the experts still don’t know whether this infection confers life long immunity. The common cold recurs and it is contained in a set of coronaviruses.

As somebody very wise said to me, the aim of all the actions taken in the public and private sector should be directed to creating a new appreciation and behaviour in relationship to personal and community hygiene. Conceivably then we may be able to blunt the inevitable winter season coming up where we are beset with the common cold and influenza, as well as this COVID-19.

We are already seeing this with the proliferation of hand sanitiser stations in public places, offices, banks and shops. I hope it continues to grow so, for instance, washing your hands before eating which I was taught to do as a child, becomes the accepted norm again.

Rollin’, rollin’ rollin’ – Raw Hide

The problem with toilet paper is that, while it is considered an essential, it is a topic we normally do not discuss.

The picture of three ladies wrestling over toilet paper in the Chullora Woolworths may be appalling for the pious commentators, but there would be a sizeable populace who found the spectacle as mildly diverting as watching mud wrestling.

This toilet paper imbroglio reminded me that a number of celebrities including Magda Szubanski, Merv Hughes and Ita Buttrose, all making fun of themselves, have appeared in toilet paper commercials. However, the prize paper seller was Lleyton Hewitt in his memorable commercials.

Perhaps Government could use these toilet paper spruikers to use their talents in calming the hysteria induced by a country afraid of being quarantined with dirty bottoms.

By the way, when we were young, there were always squares of newspaper hanging on the hook beside the dunny door. Even then we favoured the Daily Telegraph as the paper most worthy of use because we knew that it had been pre-tested.

Nevertheless, we did a trial this week – 15 minutes in tap water at ambient temperature (a) toilet paper, (b) ordinary tissue, (c) paper towel and (d) newspaper of same size – at this time that water agitated to simulate flush. The result, toilet paper and tissue disintegrated, the paper towel dehisced and the newspaper was unchanged and still readable; so much for newspaper and paper towels.

Mount Quilton, a new Tasmanian landmark

Leprosy

Leprosy is endemic in the Kimberley. When I first went to the Kimberley in the 1970s there were obvious signs of past leprosy in elderly aboriginal people, particularly men. This was characterised by loss and deformity of both fingers and toes, and the leprous discolouration of the skin.

Randy Spargo, whom I have mentioned in a previous blog, has also commented on the destruction of cheek bones and the nasal septum as a characteristic Randy remembered – the so-called “lion face”.

The Aboriginals in the early days of the 20th century who were found to have leprosy were rounded up in an appalling manner, put in chains, taken away and confined. Originally there was a leprosarium at Cossack, now a ghost town near Roebourne which, when the patients were moved to the new Derby facility in 1935, was burnt to the ground as a public health measure – such was the fear of the disease.

Bungurun

The was managed by an Irish order, St John of God nuns from the mid 1930s, and the conditions improved so much so that the leprosarium had outlived its usefulness by the time I visited Derby. In the 1940s a treatment had been found, and the public health measures of contact tracing for those with the disease was well in place. I remember one of the nurses saying that they had only one whitefella on their list; all the others were Aboriginals allowed to move around – but their movements were traceable, which was no mean feat.

I met some of the last nuns. They were caring, admirable women who had worked much of their life bringing a more humane way of caring for lepers. Soon the leprosarium would be closed. Contact tracing was maintaining oversight and facilitating care for a diminishing population of lepers.

The Kimberley is strongly Roman Catholic and there were tales of the then Bishop of Broome, John Jobst, who was reputed to have been a panzer commander in World War 2, terrifying everybody with his fierce approach to flying – tales of Aboriginals scattering as he unexpectedly would come into land.

However, the 1970s in the Kimberley was a time of great change there. Its Wild West characteristics as described above began to fade.

For those suffering from leprosy thankfully change had started earlier.

However, there are lessons to be learned. The mere mention of the word “leprosy” incites fear in the average person. Leprosy is a mycobacteria like tuberculosis. Both are contagious diseases.

Tuberculosis was particularly common before antibiotics became available, but in the Western world it was realised that there was a “herd immunity” – in other words we, as a white race, had a better immune response than other people, such as Aboriginals.

The first response of the community is to isolate the infectious ones, these days in more humane ways than in the past. However, a person is isolated, how long is the sentence – and when these poor people try to break out from their isolation our first reaction is to punish them.

Punitive powers exist under current State legislation, but true to form when you have a government such as ours that tends to prey on community fear it’s not unexpected to turn public health into incarceration. After all, the other name for this is “border control”.

We don’t want to end up with armed police patrolling the street to stop people coming out of their houses – and why not a curfew for good measure?

Before the Attorney General, who seems to be a reasonable character, goes further into this murky Duttonian world, he should see what his West Australian forbears did to the Aboriginal population in the name of public health.

After all, recommending 14 days in isolation from an indeterminate starting point when the coronavirus infection possibly occurred is just an informed guess. Why not 40 days as the Bible exhorts, Mr Morrison.

And why this stupid term “self-isolate”? In those days before the Age of Fear” I just stayed away from work when I had the flu and thought it inconsiderate to go out while coughing and presumably infective. Why not retitle the play “Self-isolating for Godot”?

Mouse Whisper

When Marie Curie visited the United States in 1921, interest in radium surged as reported some years ago in one of those journals hoarded by mausmeister. “Americans were flocking in their thousands to buy bottles of radioactive water, believing it would cure their aches and pains.”

Never fear, there is a spa in an old uranium mining area on the border of Germany and the Czech Republic, which advertises the anti-inflammatory effects of radon-infused water. How many, Topollino wonders, are fruitlessly flocking to this spa to escape the virus?

Radium Palace

Modest Expectations – The Two Noble Kinsmen

Leigh Sales, what planet are you on? Take your statement last week about those poor tradies who need to drive Uber at the weekend for extra cash. It was put into perspective a few nights later when – that “uber tradesman” Scott Cam was revealing as “chiselling” the Government out of a six-figure sum for his part time services. For his part-time activity he was not behind a steering wheel. He is the Wheel!

Ms Sales, “tradies” as you call them are doing very well, by and large. Probably given you are upwardly mobile, it is just conceivable that you employ a “tradie” or two. I like the word “tradie”; it fits into all forms of the alphabet a-gender

From personal experience, one of my “tradies” owns a hotel and the other has so much work, the last thing he requires is the wheel of car in the evening other than to go home. I suggest that Ms Sales profiles the Uber driver. I know anecdotally my Turkish-born taxi driver who has been driving me for years and who has had a network of drivers from the pre-Uber days, now drives for Uber in addition to his own clientele. However, I suspect that you will find a great many Uber drivers, who are first generation arrivals in this country.

One of the interesting aspects of taxi travel, of which I once did a great deal, always riding in the front seat, I learnt a lot about the outside world; it was the front seat to an ethnic collation.

However, the racial profile of taxi drivers has changed. I always remember a young Greek doctor who, when he first arrived in Melbourne in the mid 90s, could not believe the number of Greek taxi drivers here. Now there are less Greeks. Taxi driving is an indicator of a less established community. For instance, you may find that an increasing number of Sikhs, newly displaced from the Punjab, are a major taxi or Uber population. But freed from the bureaucratic entanglement of the old taxi cartel, Uber driving attracts the retrenched older person and the student out to make a quid – particularly overseas students. I do not deny that there is a poor postilion under-class, but it ain’t “tradies”.

Nevertheless, it made me think about the proposition of the under-utilised “tradie” workforce, if indeed there is such a thing.

Given that it is a local council responsibility to provide a home maintenance and modification service in addition to hospital adjustment to daily living (ADL) for patients returning home, I would have thought that if there were these Sales’ “tradies” out there looking for twilight cash, then they should be easily absorbed more usefully into an Australia-wide home maintenance and modification service co-ordinated as it is locally. It is difficult to gauge how prevalent these schemes are; I remember when I was running a community health program nearly 40 years ago, some of the more progressive local governments had begun to set them up, but in those days there was a bureaucratic separation between health and housing.

Michael Portillo has recently fronted a documentary on the UK public housing situation acting unfortunately as an apologist for (rather than he once was an acolyte of) Margaret Thatcher. She was guilty of poor decision making when she sold off the social housing stock for a pittance without any strategy for its replacement. Portillo himself tried to absolve her of the social vandalism.

The whole question remains of who pays for social housing but more importantly prevents the purchase for its speculative purchase to drive up prices and hence to conceal the underlying inflation in the economy. At the same time the tacit pact between big business and government suppresses the earning power of those who should be able to afford such housing, either by renting or purchase.

In any event, it is just another area for you to explore, Ms Sales, especially with all this talkfest going about us aged across Australia, rather than indulge in the mythology of the “poor tradie”.

Albanese and the Coal Scuttle

The Adani Coal Mine is a private mine. It’s been approved. It is going ahead. It’s not a Government mine… Finance has been the issue with the Adani mine, but it’s had its environmental approvals. I support the jobs that will be created by any project, any project in Queensland or anywhere else for that matter. What Government needs to do is to set in place strict environmental guidelines. When those guidelines are approved, then you have projects which go ahead if they receive private sector support. 

The first reaction to this Albanese mouthing is that the weasel should be removed as a protected species irrespective of the Albanese predilection to cuddle the animal.

Let us make an early prediction. Albo will have difficulty retaining his seat if he does not do a better job of explaining whether he will be emulating the Prime Minister and going into the House brandishing a lump of coal – Balmain coal – or not. After all, his electorate boasted a coalmine, and my late neighbour remembered as a boy running around the corner to pick up some lumps of coal for the family stove. The air was full of coal dust, pit ponies were still being lowered every day into the mine and there were several major accidents when men were killed. However, the coal was convenient to keep the stove going and the fire alight; ensuring the skies were grey.

It is written in the wind as far as you are concerned Mr Albanese. Go on a trip to Queensland, hug a replica of the Balcaldine tree, and desert a Sydney where the pall of brown smoke foreshadows summers of the future, where blue skies are an increasingly distant memory, as they were when coal was mined.

I have lived in the electorate long enough (although we were only recently redistributed to Albo) – long enough to have seen it desert its working class legacy to that of wall to wall cafés. I can remember the whistle signalling that work had commenced on Cockatoo Island across the Parramatta River. I can remember the odours from the soap factories, which had saponified the river for years. I had walked up the hill and been shown the entry to the Birthday and Jubilee mine shafts that had been sunk when Queen Victoria was in her venerable years. The area was a wasteland of weeds, but you could still see the access points to the mineshafts. The soil is thin and poor in Balmain and as you stir it you wonder how much of the contamination of the past is floating into the atmosphere. And the working class had to endure it, while the tycoons flourished.

Balmain coal mine

In Balmain, one of Paul Keating’s achievements in decontamination was the development of the old Ballast Point Caltex site into a magnificent public park; so much of the harbour waterfront was lined by industrial sites, now gradually renovated, although not necessarily reflected in the growth of liveable space. The working class has become educated, but the same tycoon-types still exist, now complicit with a rising rent seeker class, a.k.a. politicians.

Now, Albanese of Grayndler goes off to circulate in central Queensland, unfamiliar territory for a Sydneysider well versed in the rent seeker class who inhabit Sussex Street but will the Camperdown boy be seen at the end of the street in Moranbah? How much can a fleeting visit do for the Queenslander’s view of you, a Mexican arrayed in RM Williams clobber, your sombrero at a rakish angle to display your winning countenance.

Then that statement you made of: “if we don’t mine it, somebody else will.” A variant of “if we don’t kill our grandchildren than somebody else will”. How well you demonstrate the Hollow Man.

When you come back to your ex- coal mining electorate of Sydney, I’m sure you’ll get a rapturous welcome with us all waving soot laden miner’s lamps to welcome your return.

Oh, by the way, when you are hob-nobbing with the Adanis, tell them we exported coal from Sydney to India in 1799. It will inform how important your electorate has been in defining the genesis of Coal as an invaluable Export -and you as a reaper in the Carbon field, its representative.

Anti-Vaxxer – Prosecute for Genocide Part 2

According to a 2018 report by Complementary Medicines Australia, the country’s complementary medicines industry made $4.9b in revenue last year — including $2.77b in vitamin and dietary supplements — and is expected to grow by another $2b over the next five years.

Just a casual comment to indicate how much porcaria Australians are pouring into their bodies every year. What I find disgusting are the advertisements which show the happy family images loading up their shopping baskets with this stuff – as though a healthy young family needs it – and some of these naturopathic fanatics have the hide to fill their children up with these drugs while at the time perniciously undermining of the community’s health status, trying to claim that vaccination is harmful. Anti-vaxxers have been allowed to roam in this community.

We should take a leaf out of the Samoan legislative book, and prosecute and jail those who would willfully promote ant-vaccination messages and promote rubbish substitutes. To kick this matter along a letter will be sent to each politician in Australia, asking the simple question of whether they support vaccination or not. It will made very clear that a non-response will be taken as a “no”; and the results will then be published, so that at the next elections these enemies of the welfare of our children can be identified and dealt with at the ballot box – at least in the first instance. Legislation will follow.

Telling it how it is

Below is a note received from my private health fund. It is clear and needs to be read against the outpourings of the Grattan Institute.

I read the comment of one journalist the other day, who describes herself as “senior”. She reckons that she does not need all that private health insurance stuff – you know cataract, hip surgery and that unfamiliar set of lesions called “grab bag”. She boasts that she is fit and into marathon running. The association between long-distance running and knee and hip injury is still in dispute.

The problem is that the attitude being promoted by such comments constitutes an attack on community rating. Once community rating is destroyed, then life is a lottery as you enter the realms of catastrophic insurance and you being rated on your individual profile. You are laid bare – no community rating to protect you; warts and all, literally.

The other factor, which has had a disastrous effect on the health system, are all the cost shifting antics of the States, to which the health fund attests below. And even more outrageous, the diversion of money destined under the Commonwealth-State funding agreements being diverted to uses other than the health portfolio.

Anyway, in the meantime, read what is said by a health fund, which is not set up to make obscene profits to be repatriated offshore, but one where the membership is put first. Surprising, you say, but it does occur.

It can be a distressing time when you are admitted to a public hospital emergency department due to an accident or unexpected illness. 

Together with seeking medical care, you will be faced with another decision – do I use my private health insurance policy or Medicare to cover my admission?

What does it mean to be a private patient in a public hospital? 

To be privately covered in a public hospital means your private health insurance policy with us is covering your admission, rather than Medicare.  The admission costs can include your accommodation, theatre and medical fees. 

There are genuine and appropriate reasons to receive treatment as a private patient in a public hospital. However, its increasing prevalence in recent years has raised concern around the reliance of public hospital funding on private health insurance, and the impact this is having on premiums.

You may be approached by administrative hospital staff. Roles have developed within public hospitals and these staff, called patient or client liaisons, are responsible for signing up private patient’s health funds. There has been recent criticism made of the tactics used by these staff, so it is important you have the facts to make your own choice if you are approached: 

There is no obligation to use your private health insurance 

If you are eligible for Medicare benefits, you can choose to be covered as a public patient and all medically necessary inpatient costs will be covered by Medicare. You have a right to be a public patient, even if you have private health insurance, and this should not affect the level of clinical care you receive. 

The hospital may offer additional ‘perks’ if you choose to be a private patient.

Public hospitals are known to offer additional benefits to patients who choose to use their private health insurance, including free Wi-Fi, food vouchers or parking discounts. Information about being a private patient in a public hospital can be hard to find and varies between hospitals; particularly in regards to more important benefits such as guaranteeing choice of doctor, access to single rooms and specialised follow-up care. It is important to ensure you are receiving the right benefits by using your private health insurance. 

You could have out-of-pocket costs if you use your private health insurance. Your policy with us will apply to your admission if you choose to be a private patient in a public hospital. This means, you may be required to pay any excess, and the doctor who treats you may charge a gap for their services, above what Medicare and the health fund will cover. It is important to remember that if you are covered by our basic policy, no matter how it is promoted, any exclusions or restrictions of your policy will apply, so you may not be covered for the services you require.

Using your private health insurance can affect premiums. It has been reported that growth in private patient admissions in public hospitals has contributed to approximately 0.5% per annum increase to premiums over the past five years. This means, private health insurance premiums can be contributing to services that could be receiving public funding paid through taxes.

It is important to remember you have a choice when deciding how you will be covered for services in any private or public hospital.  

Be informed, be equipped with the right questions, and know your rights as a patient.

Amen.

Mouse Whisper

Some years ago, when Aleppo was still a beautiful place, an Australian senator was reported in The Weekend Australian as saying

“Syria is a country that has been a bastard state for nearly forty years.” However it should have read: “Syria has been a Baathist state for nearly forty years. The Australian regrets any embarrassment caused by the error.”

Sadly, no need to correct the statement these days.

Souk of Aleppo

Modest expectations – Temperature

There has been a great amount of strategic mucking around in the Northern Atlantic and the question of whether climate change had made the north-west passage navigable for most of the year has been troubling among others the Canadian security boffins. After all, there are many competing claims for the Arctic.

The Canadians … and the Danes claiming Hans Island

However, one of the most bizarre events was when the Canadians sent a helicopter to a speck called Hans Island, which lies in the stretch of water between Ellesmere Island and Greenland separating the Arctic Ocean from Baffin Bay. Canada disputes ownership of the rock with Denmark and after the Danes had raised their flag on the rock in 2002, the Canadians came back in 2005 and planted a windproof Canadian flag which promptly fell over. However the Danish flag was removed and returned to the Danish ambassador in Ottawa. There was Danish outrage, and immediate consideration was given to the dispatch of a destroyer, complete with not only the Danish flag but also a bottle or two of Danish schnapps.

The dispute is still raging with the Canadians retaliating with Canadian rye whiskey to complement the Canadian flag. The issue of course is definition of fishing and sea floor mining rights.

It is understood that the puffins, being very clever birds, have difficulty leaving the island now that they have learnt to open the bottles.

But as the Chinese have shown, you do not want to leave your rocks unattended and then complain about any unexpected consequence.

Confucius was a very wise man

It is somewhat ironic to see the SMH headlines screaming about Chinese infiltration when snugly lying within the paper was “China Watch”. It is like finding a copy of “Watchtower” in the Book of Common Prayer.

I glanced through the contents, and there was a piece about one of the many minorities. In this case it was about the sea gypsies or Tanka people who were resettled on the Fujian coast in Southern China. I always shudder at the word “resettlement” and who was the architect of the resettlement? It was none other that Xi Jinping, then the deputy secretary of the Communist Party in Fujian where he honed his political skills with minority groups over 17 years, as instanced by moving the Tanka people onshore. Much better for their life style onshore, rather than honour the centuries of tradition living on the sea. Sound familiar?

This was probably done for a strategic reason. Fujian is a sub-tropical province lying opposite Taiwan. Cleanse the water and give a clear line of sight to the rebellious “’province”. Yet Fujian itself is underdeveloped and quaint, the birthplace of oolong tea, soya sauce and a fermented fish sauce called kê-tsiap, which over the centuries with the addition of tomatoes became an Anglo-American national delicacy called ketchup with no residual relationship to its Chinese antecedent.

However, as I flicked through this insert, what attracted me as well was the announcement that the Sea Dragon 2, China’s new ice breaker was making its maiden voyage to the Antarctic base at Zhongsan, which is close to Australia Davis Station on the continental Antarctic mass; and also to Chang-cheng (“Great Wall”) located near the Chilean station on otherwise uninhabited King George Island in the South Shetlands. The crew complement was announced as containing scientists and support staff. Built in Shanghai, the vessel is 122.5 metres long and capable of sailing 37,000 kilometres in a single voyage. Moreover, China is already building a third.

Australia is building its new icebreaker in Romania named “Nyuna” (the Tasmanian aboriginal word for “Southern Lights”) due for delayed delivery next year. This icebreaker is longer, wider, and has twice the displacement of the Chinese vessel. It is supposed to have a life of 30 years. One wonders incidentally what ice sheets will be like in that time.

However, it was clear from incidents in 2013 when both the first generation Chinese and Australian icebreakers had difficulties in accessing a Russian ship stuck in the Antarctic ice that they needed vessels with improved capabilities.

Most of icebreaker activity has been confined to the Arctic region. After years of indecision, the U.S. government has issued a contract for the U.S. Coast Guard’s three new heavy icebreaker in decades, the first be delivered in 2024. As one source commented, “These ships are absolutely critical to the United States’ continued ability to conduct operations in ice-filled waters, especially in the increasingly strategic Arctic region.”

There was no mention of the Antarctic region because in the 60th year of the Antarctic treaty, the sacrosanctity of the Antarctic remains in place where everybody makes no territorial claims while agreeing to work together in spheres of scientific influence. This situation is in place until 2048 – neither mining nor militarization, even if contemplated, being allowed until that year.

However, like Japanese whaling for ostensibly research purposes and the self-regulated tourist pollution, the fact that the Chinese are already planning a third icebreaker, which will give them a distinct tactical advantage in navigating the Antarctic, the word “research” can be used to cover any number of deceptions.

Given the Chinese activities in the South Chinese Sea, there are many uninhabited places in the Southern Ocean, some of which come under the Antarctic treaty and some not. However, it will only take one nation to throw a rock into the Southern Ocean – and whether it will be noticed in the storms that rack that part of the world, who knows.

Not to put too fine a point on it, the Russians have 41 icebreakers and have just launched the first of three combination icebreaker warships complete with cruise missiles and of course a landing area for helicopters. The Arctic has no treaty to protect it and much jostling for sovereignty over the resources, especially now the waterways are more accessible because of climate change.

The Chinese I’m sure will be watching. They are always in for the long haul. The “China Watch” provides a useful insight into the thinking, even if we Australian readers may think it a bit of Sino-“puff”, remember “puff” is followed by the dragon – the magic dragon.

The new plague – the online anti-vax ‘influencer’

Guest blogger: Janine Sargeant#

A new plague is sweeping the world and we seem powerless to stop it. This is the epidemic of online anti-vaxxer ‘influencers’ whose commentary influences people to not protect their children from preventable disease; these ‘influencers’ should hang their heads in shame.

At a time when Samoa is struggling to deal with a shocking measles epidemic, this hasn’t stopped those who peddle nonsensical cures for measles from spruiking their wares. As of today, more than 60 have died, over 50 of these are children aged less than four. There have been more than 4,000 measles cases in Samoa’s population of around 200,000 since the outbreak began about seven weeks ago.

Measles is the most infectious disease and it has spread through much of the developed world this year. In developed countries there has been comparatively little loss of human life; New Zealand recently suffered its worst epidemic of measles in 20 years – 2,000 people were infected, but there were no deaths.

However, Samoa has been another story. Measles travelled from New Zealand to Samoa where the population had very low vaccination rates; WHO estimated Samoa’s total population immunity to be as low as 30-40%. Samoa’s health service was not equipped to deal with an epidemic.

In response to nursing error that resulted in two deaths in 2018, (the guilty nurses now serving five year prison terms) the immunisation program was shut down for months and was slow to recommence, and the anti-vaxxers leveraged off this medical error. Samoa’s vaccination rate plummeted.

A perfect storm – the Samoan population had no chance to resist and those who paid the price were the youngest and most vulnerable of the population who had no say in whether they should be vaccinated or not.

Anti-vaxxer advocates were proposing vitamins and alkaline water cures instead of the vaccine; but the prize goes to Samoan-Australian online influencer, Taylor Winterstein, who is reported as “liken(ing) the new mandatory vaccination regime (in Samoa to combat the outbreak) to Nazi Germany.” There’s been plenty of angry responders in the Australian media to that fatuous comment.

Winterstein’s husband is a Samoan-born rugby league player, who after stints with Manly and Penrith is now in France – not back to his native country to apologise for his wife’s behaviour. 

But back to Mrs Winterstein … let’s look a little further into this person’s medical and public health qualifications: well, she has none. However, as a self-described “Integrative Nutrition Health Coach” she is unqualified but adept in self-promotion and encouraging her “followers” to part with money to hear about the dangers of vaccinating children. 

Mrs Winterstein is quoted as saying: “The amount of NRL players and their partners who consciously choose NOT to vaccinate would seriously surprise you”. Well, she does mention the name of the pregnant wife of a Titans player – nobody else, but perhaps she should name names.

For my part I would strongly encourage all NRL players and their wives to publicly support vaccinating their and our community’s children from an entirely preventable disease that has caused so many deaths and continues to do so.

And let’s not forget those who suffer terrible long-term post-measles conditions such as subacute sclerosing panencephalitis (SSPE) – one for Mrs Winterstein and her ilk to look up. This causes a terrible, lingering death, brain gradually reduced to “porridge”.  

Mrs Winterstein, my anger is palpable. Perhaps if young parents see what happens to their children with this post-measles neurological complication, they may think again and defy your “influence” and head for the clinic. 

What are “influencers” in the online psyche? They are individuals with the power to affect purchase decisions because of their authority, knowledge, position or relationship with their audience. They drive traffic and sales to a product or service based on their recommendations. All very commercial; time to remind these “influencers” that this authority and power comes with very real responsibility and if you stray into public health and medicine, just remember that you should also do no harm. 

What is her solution? Black rice, which can be bought at the supermarket and which she sells at a substantial price premium.

Mrs Winterstein, you intended to go to Samoa with a pocketful of rice to give a workshop when there was one family in Samoa – their three very small children were all taken by this measles outbreak. Did they heed your advice? 

The Samoan Government has now arrested a “traditional healer” who has been telling people to not vaccinate their children.  His “traditional healing” that involved the use of somewhat non-traditional bottled vitamins, was facilitated by Mrs Winterstein’s “influencing”.  A recent post by Mrs Winterstein now says her family is coming under attack from media outlets around the world and she’s the target of a witch hunt – well that might just be the problem of being in the business of promoting eye of newt, toe of frog … and charms of powerful trouble*.

And Shannelle, the wife of the Titans player, you would have given birth by now – get your child vaccinated, please.

*with thanks to Mr Shakespeare from many ages ago.

#Among other things, Janine Sargeant is a Master of Public Health

How much are we paying these jokers?

In such circumstances, monetary policy needs to be accommodative. Low interest rates are acting to support borrowing and spending. While the recent changes to some lending rates for housing will reduce this support slightly, overall conditions are still quite accommodative. Credit growth has increased a little over recent months, with credit provided by intermediaries to businesses picking up. Growth in lending to investors in the housing market has eased. Supervisory measures are helping to contain risks that may arise from the housing market. 

There are further signs of a turnaround in established housing markets. This is especially so in Sydney and Melbourne, but prices in some other markets have also increased recently. In contrast, new dwelling activity is still declining and growth in housing credit remains low. Demand for credit by investors is subdued and credit conditions, especially for small and medium-sized businesses, remain tight. Mortgage rates are at record lows and there is strong competition for borrowers of high credit quality.

The easing of monetary policy this year is supporting employment and income growth in Australia and a return of inflation to the medium-term target range. The lower cash rate has put downward pressure on the exchange rate, which is supporting activity across a range of industries. It has also boosted asset prices, which in time should lead to increased spending, including on residential construction. Lower mortgage rates are also boosting aggregate household disposable income which, in time, will boost household spending.

The pace of growth in dwelling prices has moderated in Melbourne and Sydney over recent months and has remained mostly subdued in other cities. In other asset markets, prices for commercial property have been supported by lower long-term interest rates, while equity prices have moved in parallel with developments in global markets. The Australian dollar is adjusting to the significant declines in key commodity prices. 

Such are the public releases from the Reserve Bank Board. Two of the above paragraphs are from the latest report; and two from a report from 2015 when now Emeritus Sheriff Stevens was in the saddle. Then to give it extra emphasis I have mixed them up so each two-paragraph excerpt has one from Sheriff Lowe and the other the benefit of Emeritus Sheriff Stevens’ wisdom.

I asked someone wise in the world of finance what he thought of the following quote:

The genius of the recent administrations has been to transfer inflation to the stock market – that is to the prices of stocks and bonds instead of to the price of labour and production. Real wages are lower than they were in 1964 (written in 2005). 

He missed the bracketed attribution, and thought the quote referred to the current situation, whereas it was a prescient comment made in 2005 before the GFC. He agreed with the sentiment. Nothing has changed, he admitted.

As the excerpts from the RBA writing show, there is not much new thinking going on there, but what would one expect of a Board, with the Governor, the Deputy Governor, and Secretary of the Treasury being committed public servants that inhabit the Morrison self-described bubble; another who has lived in that curious chimera of public servant and multiple company directorships, three representatives of big business, a highly placed investment banker, and an academic with close links to the Anglican Church, which has been described as big business on its knees.

The problem with this economic and morally stagnant Australia is that the people making decisions enjoy the benefits of that stagnation. Neither political party dares to throw a stone into the fen where the water has stopped flowing and the fragrant algae of our political system, which thrives on stagnation, is hiding the poison that is killing Australia. Soon the beautiful fen with its wondrous fauna and flora will become an irreversible cesspool full of the tailings of illusionary productivity.

Which of the current Board would suggest that a wealth tax, a large increase in funding providing for education and health care systems and climate change proofing action, should get an airing rather than just allow this country to sink into an algae infested sink hole. From the sidelines one could imagine all the myriad rent seekers and mercantilists scrambling to get out of the hole while the ordinary Australian drowns in debt.

What is needed is to build the new political movement, which defines ‘the honest toiler” centre, which looks after the wellbeing of the nation rather just that of self-absorbed politicians. Development of this concept is just the shorthand for a series of future blogs, to assist in stirring the pool, clearing the algae and starting the water flowing.

After all, I do not want my grandchildren growing up in an increasingly uninhabitable planet.

Mouse Whisper

Talking of Danish schnapps or its other Scandinavian name aquavit, Finns are known for their taciturnity. So when a Swede and a Finn sat down to a glass of aquavit, the Swede said “Skol” the Finn said nothing, and they drank the philtre. This ritual was repeated five times the Swede said “Skol” on each occasion and the Finn said nothing. So they drank on, refilling their glasses on the way.

Aquavit for two

However, on the seventh occasion the Swede again said “Skol” and this time the Finn burst out, “The trouble with you Swedes you talk too much,” and drained his glass.

They say alcohol loosens the tongue.

Modest Expectations – Adelaide

I used to listen to his Letters from America – clever oral essays – the British gentleman reflecting on the mores of the day from his study in America. The author was Alistair Cooke, a remarkable figure in his adopted country, who wrote his observations in his weekly epistle until just before his death in 2004.

He had been in America since the early 1930s as a correspondent, but at the heart he was a film critic, and moreover mixing with the “stars”. One of the films he wrote about accepted the doomsday hypothesis of the last survivors of planetary nuclear war. The film was Stanley Kramer’s “On the Beach” adapted from an eponymous novel by a British expatriate who went under the non-de-plume, Neville Shute.

Melbourne was the chosen site for the film, and I remember being in the school quadrangle when Gregory Peck turned up with his son, presumably to enrol in the school while he made the film. I was struck by how much presence Gregory Peck had, without creating any fuss – just dad taking his son to school which, in 1958 was somewhat unusual, but I suppose my dad took me to school on my first day. In fact on reflection he did, found me being bullied by a future archdeacon and had me learn to box as a consequence.

Ava Gardner’s comment on Melbourne was cutting – she thought it a perfect place to make a film about the end of the world. After all, Melbourne pubs closed at six o’clock begetting the six o’clock swill where large glasses called “pots” were lined up to be consumed in the half-hour of grace before the doors were locked. Restaurants were sparse, and any place where you could drink required that alcohol to be bought in a brown paper bag and taken off the table if not drunk by nine o’clock. Men drank beer; women were segregated in the hotel lounge and God, it was not done to have a woman in the front bar. Women of refinement drank sherry; and Scotch whisky was the drink of the “top end of town”. Then, wine was consumed by the bohemian fringe of this apocalyptic maledom, as Ava Gardner viewed it.

In his review of the film, published in the Guardian 17 December 1959, about which Cooke is positive – “a story…as clean and unsentimental as a skull.” However, on the imagery reflecting on the future, Cooke is pessimistic. He quotes the collective wisdom of three think tanks to write:

They agree in approximate terms that nuclear war in the next decade is more likely than not. They warn us that the military decline of the United States in the short span of fifteen years has left it open to a devastating attack; that the disarmament at the United Nations and Geneva may blind the United States to the possibility that the Soviet union with a clear superiority in the arms’ race will use it to blackmail or attack its major opponent without warning. 

Neville Shute, the author, subscribed to the mutual annihilation theory rather than the above, (which seemed in accord with that of Cooke) since it mirrored the mindset of the late 1950s and 60s before the Vietnam War monopolised the headlines.

However, when Khrushchev engineered the Cuban missile crisis and failed, that was it – one episode of blackmail and the Russians withdrew to its reality. Competition with the United States in hindsight was illusory once the Americans got serious. However, it was not until Reagan called the Russians’ bluff and thus three decades later the Russian empire was in ruin.

Now we have Putin, the arch illusionist, at it again. Russia has divested itself of land, but they have been mindful that maintaining a number of satraps is important. Garrisoning countries is a costly exercise for a country with a GDP not much bigger than Australia’s. This time he wields his power by bullying his neighbours, which provides occupational therapy for his armed forces whether they be in the Ukraine or the Caucasus. Up to this time he has not manufactured a reason to march across Lithuania so that that exclave of Kaliningrad can be re-united with Mother Russia; but if he thought he could get away with it, who knows.

However, this illusion of the powerful strutting дуче also depends on his manipulation of Trump. Maybe I am only dazzled by the illusion of an image of a marionette with golden hair, on a wire, being paraded before a worldwide audience.

However, Prince Andrew was not the only person to be seen in the company of Mr Epstein – a figure who, in death, increasingly resembles The Tar Baby.

I wonder what Mr Cooke would have thought of this scenario which, in another context from the film “On the Beach”, could end up in mutual annihilation.

Another Alister – Another Time

There was another Alister, whom I admired greatly. His name was Alister Brass. “Alister” has a protean number of ways of being spelled.

Alister was the editor of the Medical Journal of Australia for a period in the mid 1980s – not only a doctor, a journalist, a war correspondent, but also a man of great innovation and integrity. He was lost prematurely to AIDS.

He did not have to adorn his ego with citations and references to his own achievements. He did not have the basic insecurity that often accompanies this display, and not to put a fine point on it, he viewed being editor as a full-time occupation, not a part-time bauble.

The Nobel laureate, Dr Barry Marshall wrote a telling piece about how Alister Brass helped him, reporting on self-administration of Helicobacter pylori to himself as part of fulfilling Koch’s postulates to prove that the bacillus caused peptic ulcer. Alister Brass had seen the original paper that Barry Marshall and Robin Warren had published in 1984 in The Lancet. Brass had encouraged Marshall to write an article for the MJA, which was duly submitted to “scrupulous referees” (Marshall’s words), who demanded a re-write and the final published article in 1985 became very influential in the recognition of Marshall and Warren’s work by a sceptical worldwide audience.

Marshall could not have been more clear about the value of Alister Brass’ role, as all great editors have, in ensuring the work, which eventually brought Marshall and Warren the Nobel Prize, was scrupulously refereed and then published. As Marshall himself concluded years later Re-reading that paper every few years, I am impressed by how far the MJA Editor was ‘sticking his neck out’ in allowing me to publish a hypothesis as to the cause of peptic ulcer. It was a further 5 years before journals allowed the word ‘cure’ to appear in articles about duodenal ulcer, and almost a decade before mainstream United States journals could accept it as proven.

Be that as it may, the point should be clearly made that two people who were outside the conventional medical establishment at that time (they were in Perth during the period of the research), Marshall and Warren, were nowhere near the major beneficiaries of medical research funding – Victoria or NSW.

The rush to citations as a sign of pumping out research papers has recently been criticised by the Chief Scientist, Alan Finkel. He mentions the “salami-slicing techniques” whereby, why have one paper when you could have three out of one piece of research? Then there is the multiple authorship where those who seem to be at the top-end of frequent flyer points appear on an article to which their input is negligible. I believe the citations record tallies over 5,000 authors. The emergence of a plethora of non peer-reviewed journals offering to publish articles in return for money, has just added to the proposition that “citations” are being discredited as a valid measurement of scientific worth.

Marshall and Warren were a temporary antidote to the accusation that so much of this form of research is trivial. The question remains: should the community reward funding submissions that emphasise process (of which parading a wealth of citations is one criterion and that insidious “proven track record” is another) rather than an outcome bestowing a tangible benefit on the community?

It is a pity that Alister Brass’s life was cut short, because we would not have to be reminded of the Journal’s worth by some obscure measurement. It would have been self-evident. He would clearly have made the above question irrelevant through the way he extracted the very best from authors and researchers in the same way Ingelfinger and Relman as Editors defined The New England Journal of Medicine.

A load of old cobblers

I sit and cobble at slippers and shoon, From the rise of sun to the set of moon; Cobble and cobble as best I may, Cobble all night and cobble all day.

In 1982 I invited David Owen, then at the height of his political powers, to give the address at the 50th anniversary of the Australian Institute of Political Science*.  Named in his honour, Sir Norman Cowper attended this inaugural Oration. Sir Norman had been among the founders of the Institute, although that is another story.  Dr Owen charged the Institute nothing. I was able to wrangle a first-class airfare London to Sydney return out of Qantas (in the days before business class and Irish parsimony).

These days politicians, after their retirements, have a habit of charging large amounts of money to perform while they garner a luscious pension for which we all pay. The current Treasurer, Minister Frydenberg, now aged 48, will in all probability be no exception. No need to retrain good ol’ Josh after the age of 60, except to identify the location of the amenities cabinet in whichever ambassadorship he has been awarded and later on retrained on how he stores his cash when there will be no banks left we can trust.

Politicians advocating this course for the elderly should not do so unless they are also serious about being role models, insisting on retiring on modest pensions and seeking retraining. Otherwise they could be subject to ridicule with a restive population calling for the re-introduction of the pillory.

Perhaps Abbot could resume his religious calling and be retrained as a Pentecostal minister; my favourite rent-seeker, Christopher Pyne because of his fixer obsession being retrained on reaching 60 as a paper hanger. However I jest – but if you think about it further, why not? Also, perhaps the word for this breed is “train” rather than “retrain”.

At my 70th birthday I was chirpy enough for people to exclaim that 70 was the new 50. It is seductive to believe that aphorism. However, when Frydenberg exhorts the elderly to retrain the answer is for what – and what time will be required for this mythical retraining and then, assuming anyone, anywhere would consider hiring this retrained person, one may only be able literally to work for a few years. Even though the average living age may have crept up to over 80, this increase in quantity cannot be necessarily equated to quality and ergo capacity to work.

Susan Ryan, Age Discrimination Commissioner from 2011-2016, used to bemoan the fact that there was age discrimination in Australia. Well, thank you for borrowing my pocket watch and telling me what I already know – if you’re over 40 and wanting a job, good luck. What did she do in her five years there? But then she was followed by another “retrained politician”, Dr Kay Paterson – and there is silence broken only by the chirping of crickets when the question is asked, what have you actually done to solve the problem of age discrimination for older Australians looking for work?

So what is the Frydenburg retraining all about? I worked until I was 75 years, and the only retraining I needed was to cope with my disease over my last 15 months, when I was deprived of independent living. However, with a carer for whom no government assistance was sought, I was enabled to ease into retirement. I had a few part-time “hangovers” from my previous jobs, which provided employment for another 18 months. Thus I was well into my 77th year when I finally finished.

Therefore it may be more about convincing employers of the worth of retaining the employees on, say, a contract for three to five years. On the other hand, I do not believe that the economy should be burdened with unproductive ageing staff. I can say that because – in the terms of the Italian calibration of age – I am about to pass from vecchio to anziano. 

Jokes aside, “working” and “ageing” provide a complex situation. I have had to deal with people who should have long since retired, and increasingly they had presented a hazard. It becomes a very difficult situation especially if they have accolades from their careers, which suddenly become more important to them when their livelihood and relevance are threatened.

I have one advantage. I have my marbles and I can look back over the past 20 years during which Treasury has put out a number of papers on this matter of ageing and the workforce – for what effect?

Just giving more benefits for a relatively small but vocal segment of the ageing population without the bother of setting up retraining scenarios, with only a marginal chance of success.

The “Golden Age” index is touted as a benchmark, but the index age range is 55-64. Fifty-five is a ludicrous age to retire, but was the basis of many public service plans with penalties imposed for working beyond that age. As a result, there has been the growth of so-called consultant work – doing what you were doing before, but at a higher rate of remuneration to top up that indexed pension, and stimulating the rise of the rent-seeker class.

Minister Frydenberg, can I hand you the last?

The Victorian TAFE sector says it takes a year to train to become a cobbler aka shoemaker. Another way of being the life and sole of the party when and if you get to 70!

*Now the Australian Institute of Policy and Science

Jesus the Leader

Now a rather sad case of a man when a post-graduate student who, when he was a student at the US Army War College, wrote a dissertation on Jesus Christ the Leader.

He described the Jesus model of leadership as love. His first criterion was that leaders traditionally sat at the top of the pile and issued orders, while Jesus “inverted the pyramid” and “he got down in the trenches and served the troops”. The rest of the “Jesus the Leader” dissertation proceeded from this statement.

Fast-forward 15 years and now Major General Gregg Martin faces his Jesus moment when as,

“The president of the National Defense University stepped down from his post last week following reports of an ongoing investigation into a poor command climate at the Defense Department-operated institution.

Maj. Gen. Gregg Martin officially relinquished the job last Monday…the move was approved by Chairman of the Joint Chiefs of Staff Gen. Martin Dempsey… Gen. Martin said he believed this was the right time for a new leader to guide the institution as NDU continued to prepare leaders for the challenges facing the U.S. Military.  

Martin was reported as having unilaterally ordered a series of sweeping structural changes at NDU without consulting its tenured faculty and other academic leaders, and that he threatened to fire anyone who challenged his plans. Martin responded that he was indeed seeking “transformational” change within the university, but that his comments were misinterpreted.”

Hardly a sign of mutual affection, but as Martin had written in his dissertation, “Jesus religiously took time away by himself, plug into his eternal power source – God’s Word – and recharge his battery. When things get extremely hectic, it may be time to consider taking an afternoon to play golf.”

Jesus thanks you for that advice. Some people may define the golf links as a wilderness but I think,

General, you are advising the wrong chap.

Jesus is the Palestinian chap on the right hand side.

In turn, Martin has languished in his own Pentagon wilderness for the past five years.

Mouse Whisper

Chevron ran an advertisement bemoaning the fact the United States reserves of natural gas were small compared to Russia, Iran and Qatar. In fact the United States and Turkmenistan vie for fourth place. This ranking has not interfered with the fact that the United States is the largest producer of natural gas ahead of Russia.

On contemplating this Chevron advertisement where ostensibly the message is that the USA has a smaller supply of one commodity than “shock horror” Russia and Iran, it struck my murine mind that how it was playing upon the fragile ego of the American people. Trump has also exploited the same fragility in his “Make America Great” mantra. Augmenting it with red dew drops of “Russia with Love” has led Trump supporters to wear T-shirts which say “I’d rather be Russian than Democrat”. You mean better be Stalin than Roosevelt?   I am really now mus confusus. People so insecure in themselves that they would compromise their country’s security. Maybe they should have a portrait of Benedict Arnold on their T-shirt as well.

Benedict Arnold

 

 

 

 

 

What Trump supporters are wearing this Fall.

Modest Expectations Skat

“The problem with the drought is that it is predominantly affecting National Party electorates and as the Prime Minister charges round these electorates all he succeeds in doing is emphasising the impotency of government, while making the National Party look like drongos. Then enter off right, the Belgian fixative who does a deal with Hansen who knows when to throw a tantrum. Obviously her colleague in Tasmania has viewed this Flemish reflex, which has been adapted from Pavlov’s observation on canine behaviour. Frankly, I am sick of Keating’s unrepresentative swill being given a disproportionate voice while I struggle to pay my mortgage and make ends meet, all because of the manipulation by a Flem.”

Unfair; of course. But that is one example of how Australia is perceived as being governed. Maximising the influence of a few to the detriment of the majority. Just the frustration of being a young urban graduate, and collectively primed to burst forth, when the articulate leader of reform – perhaps a numerate “Whitlam” would help – emerges in the next three years, a person who puts the interests of the country first. Or do we reach a Chilean tipping point where the rules become radically different.

Some weeks ago, I recounted briefly that I had just come back from Chile where I made a point of visiting the Museum of Memories and Human Rights. At the time I said that the museum was “the brainchild of President Michelle Bachelet, to ensure that one memory sticks in the mind of the Chilean people. On a wall on the first floor are myriad photographs of Chileans murdered by the Pinochet regime – 130,000, probably more.”

Recently, she has visited Australia in her role as the UN Commissioner on Human Rights to deliver the Whitlam Lecture, which was booked out by the time I got round to it. But from snippets, I got the gist.

I had also seen an enticing advertisement for a house nestled in a valley between Santiago and Valparaiso – separate terraced complex houses a sauna, Jacuzzi and hot tub, and two bathrooms. The property also includes a one-bedroom guesthouse, a covered parking area for four cars and organic orchards with 750 avocado trees and other fruit trees with “income-producing potential”; on 17 acres handy to both Santiago and Valparaiso. The price? About AUD2m. All this under the headline: “Following a tax hike and a steep drop in sales, prices are rebounding thanks to a stable economy and new infrastructure projects.”

Yes, when we had been in Santiago in late August, it had seemed very quiet; well run city, taxi driver even praised the cops as the only honest police force in South America. However, that contrasted with a comment in The Economist about the current President, Sebastián Piñera, which concerned the social conflicts with students that had bedevilled his first term. In order to reinforce the point, The Economist alleged police had tried to cover up their murder of a member of the Mapuche, an indigenous people.

The Economist added, “That followed a string of scandals – ranging from planting evidence to corruption – in the Carabineros, the once-revered police force. The army is no better. Some officers have been found to have stolen public money; others have sold arms to drug-traffickers.

Somewhat different perspective from that of our driver as we drove through quiet suburban streets to the Museum …

Sure, when we later went on the road to Valparaiso, the slums stretched along it for miles inducing a feeling of unease.

On the way, stopping for a wine tasting in the Casablanca Valley, it was just what you would expect from a wine tasting vineyard in Australia – impeccable surroundings both inside and out, a fire to warm this predominantly young stylish crowd from the winter cold. I was reassured there that Chile was an exemplar of middle class respectability.

Then off to Valparaiso, where the poor in barrios cling onto the sides of the steep hills, yet all with a stunning view of the ocean. Here the streets plunge down these steep slopes – a variation on the big dipper. Barrios did not exude stark poverty but the people in the doorways or struggling up the streets with their provisions did not look happy.

It’s not that long since Valparaiso was almost destroyed in a massive earthquake, and the city has a shabbiness that belies the fact that it is a tourist centre and the politicians meet here in the National Congress building. The city had a sullen feeling, despite it being one of those places where there is so much intrinsic beauty, at least to my eye, despite its vulnerability to earthquakes.

Now two months on, the cities are aflame, the streets are crowded with a rioting populace, the army has been called out. The 130,000 dead on Bachelet’s Memorial wall have had a few added.

The cause? A seemingly minor increase in subway fares has proved the tipping point. The people have had enough. The country’s prosperity revealed has been heavily weighted to a small fraction of the community who can afford to buy the property described earlier.

The currency is devaluing, the inequity in everything from wages to health care lies revealed. The hatred of politicians has boiled over; despite conciliatory gestures. People lie in the streets, dead or injured. Tear gas lingers; property estimated to be worth $2 billion Australian dollars has been destroyed in the rioting, and the number arrested harks back to Pinochet’s times. The military are on the streets, their punitive powers on show. Piñera has cancelled two international conferences presumably not to show the World his intention to return to a military dictatorship.

After all, he has an approval rating of 14 per cent, presumably by all those hiding within gated communities. Piñera is reputed to be the wealthiest man in Chile, having introduced credit cards into that country and, as a badge of his mercantilist mind, he has manipulated stock such that he faced court more than once. He is the sort of person, who fits in with the definition of “politician”. He is a man well versed in fraud who has tried to shuffle his Ministers, but the protests have increased. Shuffling or sleight of hand generally also means taking money from someone else’s pocket.

Those in the streets are not fooled. They can see what awaits them on the horizon. All they have to do is go in the Museum and see the filmed images the morning Chilean democracy last died on 11 September 1973.

Bubble Australia

The Congress in Valparaiso has been invaded, and while the major excuse given for the increasing development of Parliament House into an impregnable Bubble Australia, thought must have been given to a popular invasion to construct it in such a manner. Presumably Bubble Australia has food and cocktails in store to last for six months in the event of a siege.

When people hate politicians enough, the tipping point will be reached. We are not immune from a Chilean-like situation – the only difference is that Australia has yet to have experienced a Pinochet. Yet we have a number of very good would-be impersonators.

I think Chile needs you back, Michelle. As for Australia, the space is unfilled – as yet. But then one of the characteristics of these new movements, apart from their youth is the difficulty in finding the leader to be carted off to gaol, effectively decapitating the rebellion. The Extinction crowd is on the streets, but they do not have the same mentality as the police force in its armour plate; and one has to hope wearily not to have a rerun of Queensland brutality à la Springbok tour or ageing commentators of both genders mimicking Askin’s admonition to drive over curly-headed young Sri Lankans – metaphorically of course.

However, if a society is unequal in its rewards system, and in their Morrisonian Bubble the beneficiaries try to insulate themselves, eventually someone will prick the Bubble or let the air be exhausted from the Bubble. It may take time, but there will come a time if there is no remedial action, we could end up like Chile or, for that matter, Hong Kong or Beirut.

Another Play with Words

Guest Blogger – Chris Brook*

The NSW government has announced that it is moving away from activity based funding in health care, to an outcomes-based funding approach. More recently the Australian Treasurer has declared that he wants Australia to do likewise to a quality care approach and eliminate low value and unnecessary care.

Both reflect the adoption of a new approach to measurement of value.

This announcement presages the latest fashion in health care economics and organisational design in the United States, which is value-based health care.

It is growing into a huge industry reaping enormous fees for consultants. As with any scheme, it gains keen audiences for its promoters because of its purported benefits and simplicity.

Basically the theory is simple – along the lines of:

(a) value, never quite defined but clearly related to outcomes and

(b) value, again never quite defined but including elimination of low value or unnecessary care resulting in:

  • integrated care
  • improved efficiency at all levels
  • team based care
  • patient-focussed care
  • higher quality care
  • better outcomes
  • improved prevention of ill heath and
  • lower cost

How could anyone object to such a set of targets?

And this all happens, apparently, through tweaking of economic signals along with better IT, better data capture and use, incentives for provider re-organisation and a value focus by patients. No wonder funders love the idea, or at least the components they choose to understand. However, like all things that sound too good to be true, it is too good to be true.

Some of the issues emerging are:

  • it is a North American solution to a North American problem
  • it assumes complete market flexibility, both patient and provider
  • it does not define outcome (clinical, functional, meeting expectations – actual against expected) and
  • it does not define value (whose or which value particularly)

Nonetheless some very interesting tools are being developed, such as much better prediction software which may dramatically alter future risk rating down as far as the individual level (with all the accompanying risks that entails).

To give the topic due attention needs at least a podcast discussion, with more than one opinion to assess.

This is but a teaser – an opening shot.

It does remind me that the world thought it had the solution to health care back in the 1930s, with the establishment of health maintenance organisations with uncannily similar promises – and promise!

As a very smart man once said to me looking into the mirror: “Chris, health maintenance organisations are a great idea and always will be.”

*Chris Brook PSM FRACP is a medical practitioner with 30 years senior management experience in the Australian health system

Tiempo, damas y cabelleros por favor

I came across the 29 May 2009 issue of Time which listed the 100 most influential people in the World. These lists are just one form of vanity press, a filler where high profile people are paid to write about other perceived high profile people who, unlike the writers, have attained the “magic” hundred.

The first one listed was Teddy Kennedy, who promptly died before the end of the year – and his legacy was his work in advocating for still unfinished health care reform. The second one listed was Gordon Brown, his paean written sympathetically by J.K. Rowling. He is long gone from the influential hundred; although he is probably behind the scenes within the Scottish resistance to Brexit.

However, in the 100 influential figures listed, both Boris Johnson and Elizabeth Warren get prominent space. A young Boris Johnson with boyish face and laughing eyes is eulogised by Conrad Black. One might say that it takes one to know one, but Black, ten years on pardoned by Trump for his malfeasance, was right in saying that Boris was a man to watch.

For her part, Elizabeth Warren is there for her expert knowledge of bankruptcy through all its shades, and her take on the financial services industry; she is “characteristically unfazed by the criticism.”

Surprisingly Putin and unsurprisingly Trump are not listed, and Xi Jinping is reduced to a narrow column on page 28. After being described in his role then as the Chinese vice-premier as “best known to many Chinese for his singing wife”, the writer goes on to pen that Xi lost his patience at a meeting in Mexico. He is quoted as saying, “Some foreigners can’t seem to mind their own business and sit around complaining about China.” But as the writer went on “He carefully flavoured the complaint as a joke, which took some of the pressure out. The politician’s instinct, it seems, is always at the ready.”

And as the writer said earlier in his piece: “the running joke in Beijing is that anytime there is a potentially nasty task, Xi gets it.”

First, Xi may joke, but he is no joke, and secondly I am not sure how he would describe Trump, but he obviously has a great deal of experience in such matters.

As for the rest, well there are those in elected office, those blazing a trail as “influential” and in the end there is mostly a Warholian outcome – maybe a tick over 15 minutes.

All shook up …

Guest Blogger:  Janine Sargeant*

Hard to believe, but there apparently are “Elvis Loathers” – designated by areas of calm cobalt blue on a demographic map of the USA. The “Elvis Lovers” are bright red and shake up much of the eastern half of the US.

Like him or loathe him, Elvis is everywhere

This map appeared in the August 1993 issue of American Demographics. Prepared by a Texas market research firm, using demographic data and addresses of members of Elvis fan clubs, it purports to show the depth and breadth of Elvis fandom. The most “Elvis-friendly” places apparently are small towns dominated by mills, farms and main street retailers, but also the newer blue-collar baby boomer suburbs on the edges of cities like Atlanta, Miami, Austin, Kansas City and San Diego.

Bob Lunn, then president of Direct Image Concepts Inc., said he launched the Elvis survey for a client wanting to sell Elvis memorabilia. While the client went bankrupt, Lunn’s company enjoyed plenty of publicity by making the survey available to the media. The 7,000 responses to his questionnaires came from Elvis fan club members. He used the responses to develop a composite of the then typical Elvis fan: a conservative, blue-collar, white woman in her 40s or 50s who votes Republican, has a high school education or less, is married with children, watches sitcoms and the Home Shopping Network and reads Bride’s Magazine and the National Enquirer. The typical fan also drives American sedans or pickup trucks, swims in above-ground pools, smokes menthol cigarettes, drinks malt liquor, and eats white bread, canned meats and Velveeta – all of which probably had a place on Elvis’s pantry shelves.

The Elvis map showed the clear divides that commonly exist in the US between east and west and north and south, although in this instance the north eastern states (with the exception of New York and Boston) certainly carried the flag for Elvis.

However, the map demonstrates how data can mislead. Based on Lunn’s methodology Alaska, with the exception of Anchorage, apparently is full of Elvis Loathers. Problem is, not much population in Alaska to move that state into the red zone (or perhaps it is just that the moose prefered Little Richard). Look more closely at the blue zones (except perhaps Blue Hawaii) and to a large degree the problem is a lack of individuals to sign up with an Elvis fan club.

What would the map show if it were redone now? Probably a lot more of “Elvis Who?” in beige, although it would likely now be called “Elvis? Meh.”

Exercises like these are an amusing diversion, but perhaps not to be relied on, as Lunn’s client discovered.

Janine Sargeant runs a medical association in the not-for-profit sector.

Mouse Whisper

Funny coincidence but my mouse trainer’s thirty-second wedding anniversary has fallen in the week of the thirty-second Modest Expectation blog. A coincidence, but in the world of gifts even for such an anniversary, ebony is the go.

Ebony mouse whispering

Modest expectations – Westphalia

I understand le canard Trump was instrumental in securing the treaty of Westphalia in 1648. That statement is about as idiotic as his justification for welshing on the Kurds because they did not help in Operation Overlord.

It reminds me of the bon mots uttered by Marshall Green, the shadowy US Ambassador to Australia, who was implicated in the Whitlam dismissal.

“When he heard there may be Turkish troops posted to the Vietnam War, Green is reputed to have said: “I have always wanted to see Kurds in Hue.”

There is no mention of Miss Muffet or the tuffet upon which she was sitting.

Upon which Miss Muffet sat …

Diversion to Lithuania

I have been reading a book written by David Smiedt about being a Lithuanian Jew. I have always admired the Lithuanian Bund – a collective of Jewish socialists with their Polish and Russian brothers and sisters who provided a bulwark of social idealism and democratic spirit in an area that was rife with anti-semitism and authoritarian politics. They were a reservoir of Yiddish speaking Jews and were opposed to the Zionist element of Judaism, at the time when an independent Jewish state in Palestine was very much debated.

Many of the Bund came to Australia, and I remember a former Yiddish school in Carlton being rented by a group of young parents including myself as a day nursery. It was surplus to their needs, but we inherited an elderly Lithuanian, Joseph Giligich, who was very much the “hands-on landlord”, and even though his constituency had moved from Carlton south of the Yarra, he was always buzzing around.

He was not the only Lithuanian to attract my attention, for very many of the refugees from the Baltic countries after World War 11, whom I met, were Latvian. However there was one in my year of medicine, who introduced himself as “Casey”, which sounded Irish, and then uttered his surname that, like Icelandic surnames, tend to be long and trail away into the distance. The scribe politely asked how it was spelt and he started “Z…d…” The rest was lost in the mirth of the class. He was Lithuanian born.

It was some years before I had the opportunity with a friend to visit Lithuania – and yet it was not a Jewish Lithuania that I saw. It was very much a Roman Catholic Lithuania.

It is a long drive from Riga to the capital, Vilnius. So we have an intermission. We stop off at the Hill of Crosses near the town of Siauliai (pronounced “Sharlie”). As I mentioned earlier in my Jiminy blog, this Hill is an extraordinary sight to behold as we near it. “Behold” is the right word, as it is a religious experience – thousands of crosses and crucifixes of all dimensions piled together on this hill and around its base As they are mostly composed of untreated wood, they are grey and slowly rotting. Some are pasted with chips of golden amber but the sun has gone and they too merge into a cheerless greyness. It is a vision of Golgotha seen though the eyes of Mervyn Peake.

For Lithuanians this is a sacred spot, and despite it being pulled down during the Russian rule, the Lithuanians have ensured that it has sprung up again. The various notes in various languages strewn on and among the crosses indicate the Hill is not restricted to the locals. I gaze out on the adjacent lush meadow bordered by a clear stream. The forget-me-nots nestling among the crosses under the cypress trees provide a dash of nature to this oppression of crosses and crucifixes. I would have thought that this scene would provide a degree of tranquillity. But it does not. The Hill has a stench of death.

However, for most who come this is a sacred spot for pilgrimage. For them, placing a cross or crucifix among the many others may seem a fulfilment – an apologia for the journey. Lithuanians are Roman Catholics and as a country they have a natural affinity with Poles, who, like them, are Catholic. Small Polish flags are seen poking through the adornment of crosses testifying that it is a place of pilgrimage. For me, despite the gloomy appearance, the Hill is the second most arresting sight in Lithuania that I have seen until Vilnius.

The weather that has been threatening suddenly bursts open on my way back to the car park, which is about half a kilometre away. While our driver has been able to drop us near the Hill to let us out, he has to retreat to the car park. I get drenched.

It is still raining when we get to Vilnius. Our experience was somewhat different from the author of the Lithuanian odyssey, who explored the underbelly of the city.

The square outside our hotel has a number of intersecting lanes and streets lanes adding to its central importance. The square is lined by shops, amid which is the church of St Casimir. Nearby to the hotel is the National Philharmonic Hall, where we venture to hear the works of a Lithuanian composer, Osvaldas Balakauskas. The building reflects the Russian stucco socialist realism of the time. It was built in the 1940s. The music of a modern Lithuanian composer is challenging and we don’t have the energy to interpret all his nuances – we leave at the interval.

The weather has started to warm up on our second day, so we have the option of sitting out on the pavement or inside. We sit outside, quietly sipping a pre-lunch ale, when suddenly they descended. A line of cars and motor cyclists – men in red berets and army uniforms –men in dark suits with those radio earpieces dangling from their ears, seamlessly alighting in feathery concert from the cars – a fluid movement as though it had been a learnt art at bodyguard school.

Even the car doors are closed quietly. However, this is an exercise in hanging about until the centre of attention, who seems to have the rank of Lieutenant General arrives, has a brief kerbside conference with his staff and disappears inside. Amid all this activity we are not disturbed, not asked to leave, not frogmarched away.

The minders are all very relaxed but alert. They tell us who is coming, the name sounding like Gaubys. There is no self-importance in these men, apart from the number required to protect this dignitary. They chat to us. The Lithuanian army is supposed to be a reasonable fighting force. We are not very far from the Belarus border, and if we were allowed we could have had gone to Minsk and back for lunch -that is if you prefer Belorussian cuisine. However, the iron curtain still clanks at the border of these two countries.

Instead, being in the centre of town there are convenient cafés. One named California across the street takes its clue from its title and serves food with an American brio. I have the clam chowder and not the hamburgers. The café across the other lane is the Café Montmartre where the food has a very French flavour – the familiar eponymous onion soup, snails, even frogs’ legs are available. This shielded us from what is very endemic in all Baltic cookery. No matter how tricked up it is, it all comes down to meat and vegetables – with some fish. The grilled sea bream at the Café Montmartre is probably the best fish I had on this journey.

Lithuania is known for its glassblowing – stikliai – and there are many shops, which put this Lithuanian art on display. From one of these shops, I buy a simple small glass robin as a memento.

It is also known probably more widely for its amber, as is Latvia.

The Vilnius Cathedral has a neoclassical colonnaded façade and the building is topped by three statues, the central one – St Stanislaus, the patron saint of this country, carries a cross.

The cathedral has a high vaulted Gothic nave adorned by paintings and frescoes. They are again nothing remarkable. I light a candle for my close friend since it is nearing the tenth anniversary of his death. I stop for a moment before the basilicaform chancel and sanctuary. It is a strange place to remember him. I cross myself.

Close by there is the 13th century tiered tower, once part of the city defences but since the 19th century, the cathedral belltower. The bells ring out at 5pm but we are here in the morning.

Outside is a Dominican friar, who is speaking Russian animatedly to his companion. It is an example of the unexpected. I could see this as the opening scene in a John le Carré scripted film (or am I thinking of Dan Brown?) – a Russian-speaking “supposed” Dominican monk up to something. (This poor innocent man here in the portico becomes the subject of a vivid imagination).

Then an unforgettable moment occurs. My eye catches a small child being slowly rotated by his mother on a small patch of pavement. We wander over to see what the child is doing. They leave. This is the square within the Square where the last or first person stood when, as mentioned earlier, two million Lithuanians, Latvians and Estonians held hands to celebrate the three countries released from Russian rule. It is just a single marker of a symbol of a solidarity, which is missing in all the other relationships between the three countries.

Stebuklas Miracle Tile, Cathedral Square, Vilnius

Standing on this marker because of its simplicity and yet its significance as a currency of communication is my trip highlight. Having duly rotated on the spot as a symbol of good fortune, I walk with my companion away across the square to the gardens where the trees shield us from the increasing warmth of the day.

I cannot forget the mother with her child standing on the marker – he looking down, she gently turning him around. I hope the child enters a world where “sekmes, veiksmi , edumay guide him on through this turbulent World – and each a word in a different language but meaning much the same – good luck.

But first don’t let Trump know of this country that has seen so much pain since its Grand Duchy days between the 13th and the end of the 18th centuries, and of the three Baltic countries has the smallest Russian population. Yet it borders the Russian Baltic exclave of Kaliningrad and its neighbour Belarus may as well be Russian.

The last part of our walk through the University of Vilnius is somewhat of an anticlimax – up a hill, curving narrow street, no shade, weather now hot, little green space to rest. I buy a Lithuanian flag at the university bookshop. Now I have the three flags of the Baltic countries and, as with everything else, they could not be more different. But remember these people did once hold hands across all their borders in 1989, 30 years ago, on August 23 – and they have not forgotten.

As David Smiedt, who works as a comedian, concluded following his far more extensive exploration of Lithuania than mine, admitting that he views the world through a Jewish lens:

“I envy their self-assuredness, which I originally mistook for aloofness or suspicion. Lithuania, like its inhabitants will hold your gaze.”

Amen. 

The Case of Gladys Liu

Lodged in the Prime Minister’s unintentionally leaked “talking points” between Northern Syria and Infrastructure are three dot points about the member for Chisholm (sic):

  •  Ms Liu has spent a considerable amount of time over the last three weeks reviewing her association with all community organisations. With nearly 1,000 Chinese organisations in Victoria alone it has been a lengthy task.
  •  Ms Liu has very clearly stated that she does not wish to be a member of any organisation that has not received her explicit consent. She has asked that she be removed from all organisations that have not received her consent.
  •  Ms Liu is confident that she is not linked to any organisations that may have inappropriate associations.

“Now go away and stop bothering me” is the subtext.

However, the first talking point implies our member for Chisholm is so disconnected with what she has been doing that she had to go through 1000 Chinese organisational names. I don’t know about you Prime Minister, but I know which organisations that I am linked to – and I do not have to go through the telephone book.

The weasel, not quite out of the burrow …

Next point, the weasel is out of the burrow – explicit consent. What does that mean? Now she has asked that she be removed from all organisations that do not have her “explicit consent”. Now, Prime Minister, given she has combed through 1000 organisations, how many would that be?

Final point – she is confident – but are you? And then the weasel attacks again “inappropriate associations”.

The fact the Intelligence Community warned Malcolm Turnbull about Gladys Liu should not be ignored; what has changed that has now prompted your Assistant Minister to use the word ‘smear’ in relation to the questioning of Ms Liu? If logic is used, then does the Intelligence Community with their advice to your predecessor form part of the smear.

For my part, what if she believes in the Chinese system of government, I do not see that as a crime. However, if anybody is a member of a proscribed organisation or has committed offences under the broad brush of ‘espionage’ then it becomes a different matter. The Prime Minister has obviously made the assumption that this is not the case.

However, she is now a Member of Parliament and what she says will be carefully watched not only by the Opposition but also by her erstwhile colleagues. However, just as we will have American apologists there is no reason for there not to be Chinese apologists in Parliament.

Ultimately, the ballot box will tell whether the case of Mrs Liu results in her being re-elected or not.

She made a very eloquent maiden speech, which implies that she has a literary grasp of the English language. However, if she becomes a Chinese apologist manquée, then she will not only have the ballot box to deal with. I suspect Beijing will be watching also.

However, if the Prime Minister does wish to show his trust in Ms Liu, he should ensure for instance that she is made a member of the Parliamentary Joint Committee on Intelligence and Security.

Ms Liu is not the first Chinese-born member of parliament to to be questioned over a Chinese-based organisation connection. Only last year, Mr Pierre Yang, an upper house Western Australian Labor member of parliament apologised for not disclosing membership of two associations allegedly linked to the Chinese communist party from which he has since resigned. Given the problems the NSW branch of  Labor Party are having with their association with Chinese benefactors, this is yet another challenge which our European exclave called Australia is facing, lying as we do geographically at the end of the Dragon’s tail.

Mouse Whisper

Topolino is indebted to David Smeidt for this sample of Yiddish humour:

One day Shlomo and Moshe are talking about holidays. Shlomo says, “I think I am just about ready to book my winter holidays again, but I’m going to do it differently this time. In the past, I have always taken your advice about where to go. Three years ago you said to go to Eilat. I went to Eilat and my wife Ruth got pregnant. Then two years ago, you told me to go to Bermuda and Ruth got pregnant again. Last year you suggested the Canary Isles and, as you know, Ruth got pregnant yet again.”

Moshe asks, “So what are you are going to do different this year, Shlomo?”

“This year,” replies Shlomo, “I’m taking Ruth with me.”

Eilat