Wednesday, April 13, 2022

Dr Nick Coatsworth delivers a scathing verdict on Australia's Covid response - from the 'loud voices' who held us back to the worst restrictions

In a lengthy interview with Daily Mail Australia the 43-year-old describes what has worked best in the nation's response to the virus, what could have been done better and where we are heading.

He also slams the 'loud voices' he says are still scaring Australians who should by now be learning to live with Covid.

Coatsworth maintains restrictions should be removed as soon as they are not demonstrably necessary and will continue speaking out when an issue such as forcing children to wear masks at schools bothers him.

'My preference was always to look at the benefits and consequences of whatever restriction was brought in,' he says. 'I've thought in general that we were too slow to realise the negative consequences of most of the restrictions.'

At heart, unlike some of the fearmongers he has railed against, the Sydney-born, Perth-raised doctor and father-of-three is an optimist.

'I think we're in a good spot in the pandemic compared to other nations,' he says. 'It's difficult for people to see that because the Omicron BA.1 and BA.2 variants have actually caused a lot of disruption, but we've got short memories, I think.' Case numbers might be high but the fact intensive care units were coping was more significant.

'At the really pointy end, which I think is what we always have to bring it back to with the pandemic, is how much actual morbidity and mortality is this disease causing?' he says. 'It's really quite small compared to the number of cases that there are in the community.'

Coatsworth notes almost 95 per cent of the population are now double-vaccinated and an 'extraordinary number' of people have infection-induced immunity.

'I think that happening all at the same time will probably actually lead to a really big drop off in the cases,' he says. 'That's the most likely thing.

'You'll get these little spikes of cases but the trend over time will be downwards towards eventually just low levels of circulating cases in the community.'

Coatsworth was appointed one of three new deputy chief medical officers under Dr Brendan Murphy in March 2020 during the early days of the pandemic.

The consultant physician in infectious disease and respiratory medicine was seconded from Canberra Hospital where he was clinical director of medical services.

'People often wonder where I got the job from and it was partly being in Canberra - I knew all the players around the table,' he says.

Coatsworth had previously volunteered with Médecins Sans Frontières (Doctors Without Borders) in Congo-Brazzaville, Chad and the Darfur region of Sudan.

He had also served as executive director of the National Critical Care and Trauma Response Centre in Darwin and led an Australian Medical Assistance Team to The Philippines in the wake of Typhoon Haiyan in 2013.

Just as significantly, Coatsworth had recent experience as a frontline clinical physician.

It also helped that he knew Professor Paul Kelly, who later replaced Murphy as chief medical officer, through the Trauma Response Centre.

The first major government response to Covid was to shut international borders, which Coatsworth says bought valuable time to plan for the coming pandemic.

'I was confident that we were doing our best but I certainly wasn't confident about what would happen,' he says.

Early priorities were securing personal protective equipment, ensuring intensive care bed capacity, and procuring and making ventilators.

'It was all pretty united in the first six months,' Coatsworth says. 'I think national cabinet was working, the states and territories were doing things in a broadly consistent way.

'And then when it started to fracture and different states started doing different things it started getting quite confusing.'

Coatsworth's initial contract was for three months, later extended to six months, but he stayed on as a part-time adviser for another year.

He became a familiar face to most Australians from press conferences, television interviews and advertising campaigns but still thinks there was a lack of communication about where Covid was headed.

Coatsworth says it should have been made clearer that cases would eventually rise and there would be significant numbers of deaths but the health system could deliver care to those who needed it. 'That was the message that we needed to shift to in early 2021, to kind of prepare people,' he says.

'But unfortunately there was always a very loud group that thought Covid should be eliminated at all costs and I think that did hold us back a bit.' The 'inevitable' happened when the Delta strain hit.

'When the Delta wave came through it had the biggest impact on the people who had been eligible for AstraZeneca but had chosen not to get it,' he says. 'There were lives lost because of that anti AstraZeneca message. No question about it.'

Coatsworth says once the Pfizer vaccine became available residents of New South Wales and Victoria began getting the jab at an extraordinary rate. 'I still think that's the case that no other jurisdiction in the world did it as quickly.'

Coatsworth's philosophy is that no policy was necessarily wrong at the start and that most measures were worth trying.

'Most of us were pretty convinced that we needed the restrictions at the start,' he says. 'All the measures that we took were reasonable. 'But because they represented an infringement on human rights they needed almost a weekly reconsideration.'

Coatsworth says the 'default position' was to bring in restrictions first and worry later about civil liberties, when the reverse should have happened.

Some restrictions including curfews, particularly those enforced in Victoria, served no useful purpose. 'Taping up the playgrounds was just bizarre,' Coatsworth says.

'The idea that being outdoors was ever any risk to anybody was an example of how we went too far with our restrictions.'

Coatsworth says vaccine mandates were 'very important early on' to drive uptake but have passed their usefulness. 'There's very few people who are likely to change their minds now because of the mandates,' he says.

Wearing masks was also important, 'when we didn't know much about the virus and may still be important if we have a more lethal variant.'

Lockdowns, because of their mental health consequences, 'probably caused more harm than good', Coatsworth says.

He also believes working from home now serves no purpose from a public health perspective.

'But I think for the people who are concerned about coming back to work we just need to reassure them.'

Internal border closures should have had an exemption process that allowed people with good reasons to travel the opportunity to do so.

'It's not enough to stand in front of a press conference and say "these decisions are heartbreaking" when you're stopping someone from seeing a loved pass away,' Coatsworth says. 'I find it hard to describe those decisions in polite terms. I mean, we're bloody Australians.'

Closing the nation's borders was the right thing to do at the time but caused the same unnecessary hardships as shutting off states.

'As an Australian citizen overseas, what on earth does citizenship mean if you can't get home?' Coatsworth says. 'I think the right decision at the start but it set us off on a path that left us closed for far too long.'

Coatsworth agrees with vaccinating children aged five to 12 but does not think there will be much difference in disease severity in a vaccinated person and an unvaccinated child.

'I have no problem that our child vaccination rates are sitting between 55 and 60 per cent,' he says. 'I don't think that's a major public health issue.'

Coatsworth reckons a fourth dose of vaccine is right for those with compromised immunity, and is probably worthwhile for those over 65. 'For people under 65 unless they've got some pretty severe condition I reckon three doses is fine,' he says.

Coatsworth's views are at odds with some more risk-averse commentators such as the ABC's Dr Norman Swan and former Australian Medical Association president Kerryn Phelps who favour restrictions.

'The problem is that group is loud and it's influential,' he says. 'It's a bit exhausting really. 'I thought it'd be all done and dusted by now - not the pandemic - but this bloody argument.

'It's bad for the punters as well. No one wants to see duelling experts, but then you have a choice. Do you shut up and let them run the narrative?'

The emergence of an unexpected Covid variant which was highly transmissible and lethal across age groups would be the worst future scenario but was 'very unlikely', Coatsworth says.

He does not like to use the terms winning or losing when it comes to Covid-19. 'Whilst I wouldn't say winning or losing I would say we've put ourselves in a better position that most other nations,' he says. 'That's how you've got to see it.

'It's a pandemic. We were never going to get through this with no deaths, no work force shortages, no supply chain disruptions. That's just magical thinking.'

Coatsworth says Australians should '100 per cent' be proud of how they have managed Covid-19. 'It was a joint effort between government, health care workers and the community. What it actually proves is Australia is not as polarised as everybody thinks it is.'

After his secondment to the Department of Health ended Coatsworth went back to Canberra Hospital as the executive director of clinical services.

He is now completing a PhD on health in foreign policy at Australian National University where he also lectures, and offering the occasional Covid commentary.

'I'm trying to do it less and less,' he says. 'I'm more and more conscious that I should be doing less and less. I'm not in government. I don't hold an official position.'

But it is hard to say nothing when someone with a loud voice says something with which he strongly disagrees. 'I suppose the best thing is to ignore them and just try to run a middle narrative, that's probably the best thing to do,' Coatsworth says.

'Sometimes my personality gets in the way. I get a bit fed up and have a crack.

'The one thing I just can't sort of let go of is the kids in masks thing. That's probably the only thing I'm going to stay very vocal about. I'm so convinced that that's the wrong policy.'


Student behaviour a rising problem in Victorian schools

Disruptive behaviour and poor wellbeing among students have emerged as bigger problems in Victorian schools this year than learning loss after two years of disrupted schooling.

Primary school principals say they are grappling with new behavioural issues among students, including new cases of school refusal, alarming social media activity and vaping on school grounds.

An ongoing survey of 12,000 students in 60 schools has also uncovered higher levels of distress about bullying among girls than boys during the first term of school this year.

The survey also found that more than 40 per cent of students have been experiencing problems with sleeping every week.

The worries about bullying, sleep and other wellbeing issues including homework are being tracked in a new check-in tool that more than 50 schools piloted last year, and which has since been expanded to 60 schools.

Boys have reported being less able to ask for help in the weekly surveys so far, both at primary and secondary levels, but girls have registered greater concerns about being bullied at school or online.

Amanda Bickerstaff, chief executive of Pivot Professional Learning, which operates the online tool, said students’ responses also indicated that many children do not know how to ask for help or feel like they have a trusted adult to turn to.

“There is a general understanding from educators that wellbeing has been deeply impacted,” Bickerstaff said.

“We saw that about half of students were either neutral or struggling with their wellbeing every week at the end of last year ... when we start our check-ins in term two we fully expect that we will see some students that need support because it’s been a very difficult start to the year after a very difficult two years.”

Students’ social skills are also rusty, principals say.

Philip Cachia, who heads St Francis Xavier Primary, said students at the Montmorency school had to relearn how to play together. “They were home for so long and suddenly they needed to co-operate with each other and share,” he said.

“We almost had to re-teach them those skills, that you can’t always be first and you can’t always win and you can’t always get what you want, which is maybe what they were used to when they were at home.”

Henry Grossek, principal at Berwick Lodge Primary, said that student behaviour was now a bigger issue than learning loss as schools resumed normal practice after the two years of disrupted learning.

Thousands of tutors have been deployed to schools to help students catch up on lost learning last year and this year, but Grossek said schools were less well resourced when it came to managing students’ emotional wellbeing.

“Social and emotional loss is the big issue and we are all chasing our tails to catch up on that,” he said.

Simply coming to school each day had been “therapeutic” for most students, whose behaviour improved over the course of term one, but a handful have developed serious mental and behavioural issues, Grossek said.

“A few are finding it difficult coming back to school,” he said. “They are almost school refusers; they are anxious and worried about coming back to school even though they haven’t had big troubles in the school.”

Steven Kolber, a teacher at Brunswick Secondary College, said his class of year 7 students were not as socially adept as previous cohorts, but also had an enhanced appreciation for school.

“The students are approaching school with more maturity, as though school is in some respects a luxury, rather than something they are forced to do,” he said.


Parliament must be able to have the final say on an Aboriginal voice

Put simply, there is only one question you need to ask about the proposal to recognise an Indigenous voice to parliament in our Constitution. Under the model to be put to the people, can parliament abolish the voice or not?

Use whatever euphemism you want – abolish, terminate, remove or defenestrate – Australians will clearly understand the issue if you put it before them honestly and clearly. Yet even now, with the urgent call from Indigenous leaders that a referendum be held on May 27 next year or January 27, 2024, some of them are deliberately ignoring the point, perhaps trying to slide a radical model past the population by stealth.

Some voice advocates, especially in the media, are too overcome by emotion to deal rationally or analytically with the issue. Could it be possible that most simply don’t understand the significance of the point?

Let’s skip the dissembling, the fudging and the occasional downright dishonesty. Who is boss – parliament or the voice? Can the voice give parliament the proverbial finger, meaning that no matter how badly behaved, how corrupt, inefficient or downright unnecessary the voice might become, parliament will have no power to abolish it?

The dividing line between yes and no answers is the dividing line between an acceptable, sensible constitutional recognition of Indigenous people and a radical and indefensible attempt to remake our Constitution on racially divided lines.

While the voice debate has, to date, seen all manner of urgers trying to dragoon popular opinion into their camp, it will not be until this question is answered that we will learn what Australians really think about the voice.

However, my guess is most Australians are ready to enact constitutional reform to facilitate the establishment of a voice provided it is properly supervised by and subject to parliament in the same way as every other advisory body in our national life is.

So for example, if you will pardon my amateur legislative drafting, a new provision in our Constitution could say: “There shall be a voice whose members, rights, powers, privileges and other features shall be determined by laws passed by the parliament. Parliament may at any time by law change any of those features and for the avoidance of doubt may abolish the voice with or without a replacement.” This might lead to more Australians saying yes at a referendum to establish a voice.

Such a provision provides simple and powerful constitutional recognition that does not override parliamentary sovereignty or put a racially constituted body beyond the triennial judgment of the electorate.

Sadly, what the radicals among voice activists want – although they frequently try to hide this agenda – is precisely that. To put the voice beyond the reach of parliament. To quote professors Marcia Langton and Tom Calma from the foreword to the Indigenous Voice Co-Design final report: “We were not surprised by the growing support for constitutional enshrinement (of the voice) … for many practical and principled reasons … including that it would be the best way to protect an Indigenous voice against abolition.” This fear stems from the 2004 abolition of the Aboriginal and Torres Strait Islander Commission, a little lamented body whose maladminis­tration and ineptitude led to its abolition with bipartisan support.

Not only does the ATSIC experience give a powerful example of why any voice should be capable of being abolished, there are compelling reasons of principle why parliament needs to have power to abolish the voice.

To demand that the voice be protected forever is the ultimate act of defeatism, an abject surrender to helplessness. We should be aspiring to lift Indigenous Australians up to the point where they need no special treatment, no special voice. Saying Indigenous Australians will always need a special voice is ultimately insulting. It assumes they will always need special treatment over and above their non-Indigenous fellow citizens.

There are pros and cons to affirmative action but even the most fervent advocates of it will usually admit affirmative action measures must be time limited. As Justice Sandra Day O’Connor said in the landmark US Supreme Court Grutter v Bollinger decision, which approved limited and targeted use of racial preference in US college admissions processes, “Race-conscious admissions policies must be limited in time.” She went on: “The court expects that 25 years from now the use of racial preferences will no longer be necessary to further the interest approved today.”

Of course, there are radicals who say the point of the voice is not to address disadvantage but to recognise inherent rights stemming from prior occupation. Australians will find this a hard sell – helping those who are disadvantaged and giving them special access to parliament is one thing. If we arrive at the highly desirable point where living standards of Indigenous Australians are the same as non-Indigenous Australians, why should skin colour or genealogy confer special rights?

A voice that is permanently entrenched by the Constitution, co-equal with parliament and unable to be abolished by parliament, should be offensive to all Australians, regardless of skin colour, as patronising and infantilising. It is, however, much more. It would destroy a constitutional principle – that of parliamentary sovereignty – because the voice could flip the bird at parliament if parliament thought it was no longer necessary or appropriate. It also would enact a perman­ent gerrymander. Indigenous Australians would get two votes in our democracy – one for the voice and one for parliament – whereas the rest of us get only one.

To do all this on racial grounds, to permanently divide Australians by race, is not something we should tolerate.

During this election and beyond, we can expect urgent demands for a voice referendum to be followed by claims that it is nonsense to suggest a constitutionally entrenched voice will become a third chamber of parliament. Vigilant, rational and persistent testing of those claims means we must demand an answer to this single question: “On your proposed model, will parliament have the power to abolish the voice?”

If the answer is no (or some formulation of weasel words that really mean no) there is nothing further to ask. This model should be unacceptable to all Australians who value our system of parliamentary sovereignty.


Australia presses Solomons to disallow Chinese warships docking

Pacific Minister Zed Seselja has broken off election campaigning to fly to the Solomon Islands for urgent talks over its controversial security pact that has alarmed countries in the Pacific.

Senator Seselja’s two day mission comes as Prime Minister Scott Morrison said Australia was lobbying Honiara to prevent Chinese warships docking there.

Mr Morrison acknowledged Solomon Islands’ leader Manasseh Sogavare had made clear the security agreement would not allow a military base but concerns still remained.

“We are continuing to press on the issue of rotation,” Mr Morrison said while campaigning in western Sydney. “Possible rotation of vessels or others that might seek to go to the Solomon Islands. And that is a serious issue that we will continue to press.”

Australia was “always respectful” of the fact that the Solomon Islands is a sovereign country, Mr Morrison added. “They’re not a state of Australia,” he said.

“They’re not under Australia’s control or direction. And my approach to the Pacific, as the Foreign Minister will attest, has been to always respect the sovereignty of our neighbours and particularly in the Pacific.”

Mr Morrison said gone were the days that Australia treated the Pacific as a “bit of an extension of our own country”. “They didn’t like being treated like that and nor should they,” he said. “And I’ve never treated my Pacific family like that.”

Senator Seselja, who is facing a high-profile challenge by independents to his ACT seat, said his talks would include the proposed Solomon Islands-China security agreement, following recent dialogue at the officials’ level

“We look forward to ongoing engagement with Solomon Islands, and with our Pacific family members, on these very important issues,” Senator Seselja said.

“Our view remains that the Pacific family will continue to meet the security needs of our region.”

Before the announcement of Senator Seselja’s visit, Opposition Leader Anthony Albanese accused the government of responding too slowly to the risk posed by the security agreement.

Draft details leaked last month of the security agreement show it would enable the stationing of Chinese armed police and military as well as “other law enforcement and armed forces” in the Solomons.

But intelligence officials fear it could pave the way for the establishment of a Chinese naval base less than 2000 kilometres from the Australian mainland.

Mr Sogavare has denied that. He said the agreement, which is close to being finalised, was necessary after anti-government riots last year targeted Honiara’s Chinatown and infrastructure funded by Beijing.




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