Sunday, July 26, 2020

Melbourne intensive care nurse's blunt warning of big coronavirus risk to younger adults

This is contrary to all previous observations so requires explanation. 

The explanation probably lies in the origin of the current outbreak. It originated in big blocks of welfare housing. 

Many of the residents would be there because they had health challenges.  So they fit the usual observation that substantial co-morbidities normally are required for the virus to take hold.

So my hypothesis would be that the young patients came from welfare housing.  The virus normally hits the elderly most because most elderly do have substantial co-morbidities.

A senior Melbourne intensive care nurse says hospitals are preparing for the prospect of deaths among younger Victorians as authorities battle to rein in the state's coronavirus cases.

The head intensive care unit nurse at the Royal Melbourne Hospital, Michelle Spence, said there was a growing number of younger adults being hospitalised by the virus.

"What we are seeing now is young people who are going to die. There is no doubt about it," she said. "And these are people who are 30s, 40s, 50s, who have no past history."

She said deaths in Victoria had so far predominately been in older people, but that would change.

Yesterday, authorities revealed 20 per cent of people in Victorian hospitals with the virus were aged under 50, including four children.

The figures also showed a quarter of COVID-19 infections were being recorded in people aged in their 20s.

The Royal Melbourne Hospital has acquired a further 22 ventilators as the intensive care unit prepares for a surge in cases.

Ms Spence, who is the hospital's ICU nurse manager, said the hospital had patients ranging from their 30s to their 80s "and all of them are at varying degrees of their COVID journey".

"We're definitely not just seeing the elderly, that is not the case at all."  "It is definitely not an old person's disease," Ms Spence said.

She said a COVID patient's time in the intensive care unit was a long, slow process, where very ill people were separated from their families.

"Being in ICU is not a nice place to be," she said. "It is absolutely not a comfortable thing to do."

Ms Spence warned the process of recovery, even after patients leave ICU, could take a long time.

She urged Melburnians of all ages to follow the directive to wear a face mask when outside their homes, saying wearing a mask was "way more comfortable than being on a ventilator".


Managing Covid-19 without lockdowns

The fight against Covid-19 is a conundrum replete with knowns, known unknowns and unknown unknowns — as Donald Rumsfeld might have said — but policymakers don’t have the luxury of waiting for greater certainty and have to make choices here and now.

Some of the choices are reviewed in our analysis published online by the CIS this week, Policies against Covid-19: Reflections on the way in and the way out.

We conclude that ongoing or on-off reliance on heavy-handed lockdowns and shutdowns is unsustainably costly to jobs and living standards. It also produces downsides for other health outcomes, so the net impact on health over time is questionable.  Such policies deliver declining benefits, but rising costs, as shuttered business are driven past the point of no return.

Australia’s Covid objectives are now unclear. Having more than ‘flattened the curve’ of infections by mid-April below intensive care capacities that have been almost tripled, at least some state governments seem to have adopted an implicit objective of eliminating Covid — and this option is now being canvassed more openly.  But even if this could be achieved at all, it would be at an unsustainable economic and social cost.

The policies that worked best to reduce Australian infections to manageable levels were external border controls and quarantining of arrivals from overseas from early February, increasingly broadly and firmly applied through March. But as the situation in Victoria demonstrates, this policy has to be rigorously administered with no slip-ups.

With transmission from abroad shut down, keeping domestic transmission manageably low requires effective quarantine of the domestically-infected and isolation of their contacts. Contact tracing has to become speedier and interactive with testing to isolate new infections quickly.

Support for sensible social distancing has to be strengthened, relying on well-informed self-interest rather than heavy-handed proscription of business activity and customer restrictions. Providing growing evidence on the benefits of social distancing and the character of ‘superspreader’ events harnesses individuals’ self-interest and businesses’ entrepreneurship to sustain low-cost behaviour change and improve personal risk management.

This approach still involves costs. But they are lower relative to the benefits — and more sustainable than a continuation or return to the high-cost, low-benefit policies of business shut-downs and domestic lock-ins.


We need a Covid plan that is, dare I say it, sustainable

When Victorian Premier Daniel Andrews blamed his own population for spreading the coronavirus, accusing them of flouting self-isolation rules (actually, his health authorities had given them the wrong advice), he threatened an extension of the current lockdown. Quite aside from the ugly blame-shifting by a leader who is yet to account for his government’s mistakes, few people seemed to consider the crucial sustainability question.

Can Victoria really keep going into lockdown? At what point does the balance between public health, economic wellbeing, community needs and individual livelihoods, deserve realistic evaluation? If you keep locking down, there won’t be much to lock down.

The whole country locked down in March and the federal government budgeted an unfathomable $130bn to sustain people through the following six months. They got the numbers wrong in a $60bn mistake that surely would have cost the Treasurer his job if the error had been to the other side of the ledger.

The wage replacement scheme has been extended by six months and $20bn but unemployment is still expected to top 9 per cent.

What if states are still locking down in a year? What if the virus is running rampant so that tourism and hospitality businesses cannot function 18 months from now? Would it be sustainable for wage replacement schemes, additional unemployment benefits and special industry stimulus packages to continue?

Scott Morrison, Treasurer Frydenberg and Health Minister Greg Hunt deserve enormous credit for putting Australia in this position; if an effective vaccine is readily available worldwide within a year, their response will rank as one of the world’s best.

But even if the current Victorian outbreak is suppressed and our national economy can operate relatively freely behind sealed international borders, how will we be placed in a year if the virus continues to run rampant across the world? How long can we continue to close ourselves off from overseas students, tourists and immigrants?

Would we simply be delaying the eventual spread of the virus across our nation? Would all our most drastic and costly measures have been in vain?

What we have done so far has our COVID-19 death rate per million people sitting at less than six, whereas the US is over 400, and in Britain and Spain it is more than 600. How long can we afford the policies that have delivered this staggering success?

We should thank our lucky stars that upwards of 98 per cent of infected people suffer minor symptoms only and the young are virtually impervious to the virus (compared to the Spanish flu which killed infants and healthy young people in their millions). We need ways of dealing with outbreaks that fall well short of closing businesses, crushing livelihoods and banning human interactions.

This is where widespread mask-wearing, social distancing and hygiene, coupled with protections for the vulnerable, offer vastly more sustainable options. We eventually might have to learn to live with the disease.

The economic sustainability of hard borders restricting interstate travel is highly questionable, especially for tourism and hospitality. And these measures hurt socially; communities like Albury-Wodonga and Coolangatta-Tweed Heads are being torn apart; families are being kept from each other.

Our politicians have been too eager to outsource decision-making to medical experts who have a singular focus on preventing infections, which we know can be stopped dead if we cease all human interaction.

This represents the “collapse of government legitimacy”, according to the Manhattan ­Institute’s Heather MacDonald, who has written about this phenomenon in the US.

“For three months, public officials abdicated their responsibility to balance the costs and benefits of any given policy,” she says. “They put the future of hundreds of millions of Americans in the hands of a narrow set of experts who lack all awareness of the workings of economic and social systems, and whose science was built on the ever-shifting sand of speculative models and on extreme risk aversion regarding only one kind of risk.”

MacDonald said the experts were “deaf to the pleas of law-abiding business owners who saw their life’s efforts snuffed out” as these decisions destroyed wealth through arbitrary decision making. This tragic summary sounds gut-wrenchingly familiar.

Secure in their permanent tenure, bureaucrats and publicly funded broadcasters have barracked for ever more draconian measures while the price has been paid by the unemployed and small business owners who have seen their hard-won assets eviscerated. As always, it is for politicians to carefully weigh-up costs and benefits.

Consider how the coronavirus measures have all but eradicated influenza infections this year and, according to the statistics, saved more lives than we have lost to COVID-19. Yet would we suggest imposing these lockdown measures every year, at these costs, to save 150 lives or so from flu? ­Obviously not, or else we would have done it ages ago.

Our leaders have changed their pandemic objectives on us without saying so explicitly. We were told initially that we were locking down to give authorities time to expand capacity within our health system so the pandemic would not overwhelm us.

Authorities tripled the availability of critical care beds nationally from just over 2000 to more than 7500 but, so far, the pandemic has not required more than 100 on any given day and fewer than 50 are being used now. We have ample surge capacity.

According to the original rationale, we ought to be more relaxed about higher levels of infection without shutting down society. So long as our hospitals are not overwhelmed, this might be more sustainable than lockdowns, especially if it is inevitable that we end up in this situation eventually anyway.

Instead, state politicians seem to be taking every infection case within their borders as a political blow. There is an absence of national policy as states ignore urgings from Canberra and shut borders and cities.

State governments seem able to shut down anything, except protests. And they are prepared to implement every pandemic ­response, so long as the federal government funds it.

This is the devolution of the federation; we are not all in this together, each state is in it for ­itself. It is not sustainable.


Academic freedom bows at the altar of social media

The university was too canny to challenge Peter Ridd on his climate skepticism.  Instead they got him on a perverted legal technicality

It’s out with philosophers John Stuart Mill, John Locke and Isaiah Berlin and it’s in with “the internet, social media and trolling”. According to the majority judgment of the Federal Court of Australia in James Cook University v Ridd handed down on Wednesday, that is.

Peter Ridd was employed by James Cook University for 27 years before his employment was terminated in May 2018 for serious misconduct. At the time Ridd was a physics professor. However, he was not dismissed on any academic or teaching grounds.

Rather, Ridd went down because JCU maintained that he had failed to act “in the collegial and academic spirit” required and had denigrated a fellow staff member by failing to act “with respect and courtesy”. Oh yes, Ridd had also denigrated JCU, the Australian Research Council Centre of Excellence for Coral Reef Studies and the Great Barrier Reef Marine Park Authority.

In fact, Ridd disagreed on scientific grounds with the views of some fellow academics and some influential organisations about the long-term viability of the Great Barrier Reef.

He maintains that sections of the Great Barrier Reef are in good shape and that coral dies and is reborn as part of the reef’s life. This is inconsistent with the scientific orthodoxy preached by JCU and like-minded organisations.

Announcing the termination in May 2018, Iain Gordon, then JCU’s deputy vice-chancellor, referred not to the quality of Ridd’s teaching and research but to his “manner” and “disrespect”. You see, he had been charged with having “trivialised, satirised or parodied” JCU’s disciplinary processes. Why, Ridd had even sent a private email to a friend dealing with JCU that was headed “for your amusement”. How shocking is that?

It is a long time since there was genuine academic and intellectual freedom in the groves of academe — if this ever existed. The ideals pronounced by John Henry Newman’s 1875 The Idea of a University are essentially utopian. What’s new about the current JCU case is that the curtailment of academic freedom that once prevailed in the social sciences has extended into the physical sciences.

Take Australia, for example. The two big cases of academic freedom in the past half-century involve philosopher Frank Knopfelmacher (1923-95) and physicist Ridd. In 1965 Knopfelmacher, who was a lecturer at the University of Melbourne, was appointed to the position of senior lecturer in philosophy at the University of Sydney. The appointment was overturned by the university’s professional board.

Knopfelmacher’s appointment was strongly supported by David Armstrong, one of Australia’s finest philosophers.

Like Ridd, Knopfelmacher went down because of his irreverent manner and a tendency to criticise colleagues in addition to his unfashionable views. An articulate and well-informed anti-communist, Knopfelmacher upset the leftist fashions of the time with his vehement criticism of the communist regimes in central and eastern Europe (East Germany, the Soviet Union) and Asia (North Korea, China, North Vietnam), and their supporters in the West.

In 1964 Knopfelmacher wrote an article in Twentieth Century magazine criticising the leftist ideology that prevailed in many of Melbourne University’s social science departments. He claimed that left-wing academics discriminated against non-leftists and exercised significant veto powers “in matters of academic preferments and sinecures”.

This accurate comment was used against Knopfelmacher by his opponents on Sydney University’s professional board.

In the half-century since the Knopfelmacher affair, the attack on academic and intellectual freedom has moved into universities as a whole, including the physical sciences. That is Ridd’s problem. JCU appears to have a view that the Great Barrier Reef is dying fast and anyone who disagrees with this orthodoxy, no matter how well qualified, does not have a right to be heard, especially if they are irreverent and outspoken.

In one sense, the Federal Court’s decision in JCU v Ridd turns on the interpretation of the enterprise agreement under which the respondent was employed.

In September last year the Federal Circuit Court (Judge Angelo Vasta presiding) found that JCU had contravened section 50 of the Fair Work Act by making findings against Ridd, giving him directions with respect to confidentiality and speech along with a “no satire” instruction. All this, the court found, had led to an improper employment termination.

However, the current case is more important than mere industrial relations. The majority — justices John Griffiths and Sarah Derrington — essentially dismissed “historical concepts of academic freedom”.

So the thoughts of Mill, Locke and Berlin are out of date. Griffiths and Derrington instead cited the work of American philosopher Jennifer Lackey concerning the internet and social media. They quoted favourably from the Illinois academic, who has written that the concept of academic freedom has been challenged not only by no-platforming but also by student demands for “content warnings and safe spaces” that “leave us in uncharted territory”.

Newman, originally an Anglican who became a cardinal in the Catholic Church, was a deeply religious man who saw a role for an essentially secular university bestowed with intellectual freedom. But many a modern campus has become an institution that acts in accordance with the notion that “error has no rights”.

This was once the teaching of extreme religious sects. Now it is being put into effect by censorious administrators, academics and students who believe that those with whom they disagree have no right to be heard.

In his dissent, Justice Darryl Rangiah placed much more emphasis on Ridd’s right to intellectual freedom. Rangiah agreed with the majority that the decision of the primary judge contained material errors on industrial law.

However, he said that while the appeal should be allowed, the proceedings should not be dismissed but remitted for a further hearing. Rangiah did not support the majority view that some aspects of Ridd’s conduct cannot be characterised as an exercise in intellectual freedom.

While JCU v Ridd turns primarily on industrial law, it is likely to have the unintended consequence of discouraging academics who are at odds with prevailing fashions in the social and physical sciences from speaking out.

Australian universities need more Knopfelmachers and Ridds — not fewer.


 Posted by John J. Ray (M.A.; Ph.D.).    For a daily critique of Leftist activities,  see DISSECTING LEFTISM.  To keep up with attacks on free speech see Tongue Tied. Also, don't forget your daily roundup  of pro-environment but anti-Greenie  news and commentary at GREENIE WATCH .  Email me  here

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