COVID-19 Archives - thegoodwills.com

Adopt a duck in mental health week

It’s Mental Health Week, aptly coinciding with a self-diagnosed bout of post-viral depression. Those of you who suffer the ‘Black Dog’ will know that a flu or virus can tip you into a depressive cycle. She Who Also Gets It commonly says: “Don’t be depressed – it’s boring.” Fine for her to say if she’s OK.

(Read to the end then come back and watch this 43 second video by Bob)

As my Ma would have said (and maybe yours too), ‘misery loves company’. Statistically-speaking, about 40% of my readers will have suffered from some kind of mental health episode in their lifetime. The other 60% will probably let this FOMM go by (“Why doesn’t he write something nice and fluffy, grumble, grumble, or at least say what he thinks instead of quoting other people?”)

The latest data from the Australian Bureau of Statistics (ABS) tells us that more than 40% of Australians aged 16-85 years have experienced a mental disorder at some time in their life. One in five (21.4% or 4.2 million people), had a 12-month mental disorder. Anxiety was the most common group of 12-month mental disorders (16.8% or 3.3 million people). Young people were most at risk with 39.6% aged 16-24 years reporting a 12-month mental disorder.

Note: 12-month disorders are categorised as including anxiety, mood, impulse-control and substance use disorders.

The latest national study into mental health and well-being was released in July. Among its findings are that 3.4 million Australians aged 16-85 years (17.5%) saw a health professional for their mental health in 2020-2021. Of these, 57.4% had a 12-month mental disorder, 17.7% had experienced a mental disorder at some time in their life and 24.0% had no lifetime mental disorder. (To quote the quintessential Aussie singer-songwriter Kasey Chambers- ‘If you ain’t worried now, you’re not paying attention..’Ed)

That latter cohort (the 24%) are probably those referred to in this World Health Organisation (WHO) report. The WHO said that in the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by 25%.

“The information we have now about the impact of COVID-19 on the world’s mental health is just the tip of the iceberg,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their population’s mental health.”

The WHO’s Mental Health Atlas showed that in 2020, governments worldwide spent on average just over 2% of their health budgets on mental health. Many low-income countries reported having fewer than 1 mental health worker per 100,000 people.

Australia stands out from the crowd in terms of investment. Government spending on mental health-related services in 2019–20 was estimated to be around 7.6% of total government health expenditure.

The Australian Institute of Health and Welfare says $11 billion was spent on mental health-related services in 2019-2020. Of the $11.0 billion, State and Territory governments spent 60.0% ($6.6 billion). The Australian Government’s $3.8 billion contribution covered Medicare-subsidised mental health services and prescriptions.

Australian Government spending on prescriptions equates to about $22 per person. Anti-psychotics (48.1%) and antidepressants (32.5%) accounted for the majority of mental health-related subsidised prescriptions.

That may well be, but I pay something close to full price for mine, mainly because my doctor told me not to accept the generic version. On the other hand, I paid $6.90 for the antiviral meds prescribed when I tested positive to Covid-19. The full price on the packet was $1,130, Now you see why Australia is so lucky to have Medicare.

Ah Covid, that was almost a month ago. I still have a cough and after walking the dog on the river circuit, I have to take some Ventolin and lie down. Multiple research reports have emerged which discuss the serious implications of ‘long Covid’ and lingering symptoms such as lung problems, fatigue and ‘brain fog’. Clearly there is much work yet to be done to establish the long-term risks of having had Covid-19.

And yet the collective Australian government response to Covid seems to be aligned to President Joe Biden’s recent claim that the pandemic is ‘over’. We shall find out after today, which is when Australian State and Territory governments agreed we should no longer be required to quarantine after testing positive. My view of it is simplistic. As of today, 10.3 million Australians have had Covid and 15,399 died with Covid – more than people killed on the roads in 2020.

Perhaps it was coincidence that the US health administration also eased its quarantine recommendations. The Center (US spelling) for Disease Control and Prevention said in August it was no longer recommending that adults and children quarantine at home after having been exposed to Covid-19. The CDC instead recommends those exposed wear a mask for 10 days and take a test on day five. The CDC is, however, saying that Covid is ‘here to stay’, recommending that people who have tested positive to the virus isolate for five days.

Greta Massetti, chief of the CDC’s Field Epidemiology and Prevention Branch, said the changes reflected data indicating 95% of the population has some protection, either from infection or vaccination.

On September 29, Australia’s National cabinet unanimously agreed to scrap the mandatory Covid isolation requirement, with exemptions for those working in high-risk settings such as health or aged care.

Prime Minister Anthony Albanese said (in the same breath) that disaster payments for workers diagnosed with Covid would end, with the same exemptions for high-risk workplaces.

As The Guardian reported, all State Premiers and Chief Ministers agreed to the change, claiming it was “not sustainable” for governments to keep paying workers to stay home.

Predictably, the Australian Business Council and the Chamber of Commerce and Industry welcomed the decision.

I was taken by surprise, not expecting a Labor Government to make what is clearly an economic decision, rather than support measures that lower the risk of the virus spreading in the community.

Chief medical officer Professor Paul Kelly cautioned that quarantine measures may be re-introduced if pandemic conditions such as transmission rates dramatically changed. (Something reminds me about stable doors and horses bolting..Ed)

“We wanted to make sure that we have measures which are proportionate and that are targeted at the most vulnerable,” Mr Albanese said after the meeting. “We want to continue to promote vaccinations as being absolutely critical, including people getting booster shots.

“We want a policy that promotes resilience and capacity-building and reduces a reliance on government intervention.”

(Ed: Capacity building is ‘the improvement in an individual’s or organization’s facility to produce, perform or deploy’.

Mr Albanese was asked whether casual workers would now be forced to work while sick. His response was that the government could not keep paying for such financial supports, comparing the strategy to influenza.

“The flu has existed, and health issues have existed, for a long period of time, and the government hasn’t always stepped in to pay people’s wages while people have health concerns,” the Prime Minister said at a press conference.

While the advice here and in the US is (still) to wear a mask for 10 days after contracting or being exposed to Covid, the mask mandate for public transport was removed in all Australian jurisdictions last month. Apart from medical centres, hospitals and aged care centres, mask-wearing has become optional.

I wore mine while filming the short duck video (above). Avian flu – you can’t be too careful.

You’ve got a friend

friends-friendship — Friends photo by Annie Spratt, www.pixabay.com.au

While resting and recovering from Covid (honestly, the virus I had at Christmas seemed worse), I started reflecting on friends and friendship. At this moment in time, my definition of friends are the ones who bring you groceries, chocolate and Panadol, walk your dog and check on your well-being every day (thanks, Sandra, Kaz and Dee).

The deal with friendship is the unspoken agreement that one will reciprocate as and when appropriate. Research on this topic tells us that, unsurprisingly, the main reason friendships end is that one friend feels that the other is being selfish; it is a one-way relationship. Other reasons friendships fail come under the heading ‘loyalty/betrayal’. Or it could simply be that your friend moved to another town or city, took up with a new partner after a divorce or bereavement, or has developed opinions and beliefs that conflict with yours.

The latter clearly was the case when people who believed Covid was a real and present danger and lined up for vaccinations, came into conflict with those who denied it existed.

The advent of social media around 2004 has turned the traditional concept of a ‘friend’ on its head. In short, they hijacked the word.

A former colleague/friend whom I had not heard from in a while posted a message on Facebook on Sunday warning friends he had been hacked.

“Ignore any friend requests from me – I’ve got too many friends already LOL.”

Like all of us, I have far more email addresses and mobile numbers stored away than any one person could categorise as ‘friends’. Many of them date from my journalism career, where ‘contacts’ are the key to everything. Over time I reduced my phone contact list from 1100 to around 300.

Despite having a recent clean-out, I still have 400 Facebook friends.

I deleted anyone I had never actually met, suspect accounts (where there appeared to be more than one) and people I’d had no contact with in the past 12 months.

Many of those ‘friended’ me because they read my weekly blogs or because they follow our music. One also tends to accumulate friends who use Facebook and Messenger to find people. The one-off reason for doing so comes and goes but the ‘friend’ remains on the list.

The irony is not lost on me that at least five of my oldest friends do not have a Facebook account and have no intention of starting one. Even when I share cat jokes. Prompted by the topic and these memories, I rang my old Kiwi school friend, who now lives in Sydney. He was his usual cheery self and I pictured his smile and that of his Dad, who he so resembles. This friend was best man at both my weddings, which is not something many people can say.

I told him we both had Covid and after commiserating he said he and his partner are still Covid-free. He attributes this to living something of a monastic life and wearing a mask when he does go places where people mingle.

We exchanged old war stories from school days. We were probably what people call ‘nerds’ now, before the term was invented. We were bookish and, even at a young age, interested in philosophy, psychology and comparative religions. We once got detention for riding a library trolley up and down the corridors (before school started), but that’s another story.

There’s been a lot of research done into the topic of friendship and how it is essential to our health and happiness. As we age, the number of friends in our physical address book dwindles. We lose people to cancer, heart disease and other illnesses. Others develop dementia and forget who we are.

Friends made when our children were growing up tend to fade away as the kids mature and move away to live their own lives. The vast size of the continent we live in contributes to the dissolution of friendships, as people move interstate for work or family reasons. I am probably fortunate to have kept in touch with a small group of men from school days. We are geographically scattered and to be honest do not have much in common these days.

Yet when we spend time together we are transported back to carefree teen years at the beach, drinking from tall necked beer bottles and daring each other to test the treacherous surf.

Clinical psychologist Anastasia Hronis writes that it is hard making new friends at any age, which is one of the reasons for our epidemic of loneliness. Writing in The Conversation, Dr Hronis, of Sydney’s University of Technology, says that for most adults, making new friends is hard work.

“In school, making friends can be as simple as going on the monkey bars together. But as adults, making, developing and maintaining friendships can be much more difficult.

“This matters, because we need friends. And while old friends are golden, nothing stays the same forever. Old friends move away, or have their time taken up by child-rearing or their careers. Without action, loneliness can quietly grow around you.”

The onset of the Covid pandemic produced the perfect storm of conditions for making friendships difficult to maintain.

Dr Hronis cites research that shows 54% of Australians reported a keen sense of loneliness. Before COVID, around a third of Australians reported feeling at least one episode of loneliness.

When researchers in a recent study interviewed adults about making friends,,the most important challenge cited was a lack of trust. People found it harder to put their trust in someone new compared to when they were younger.

If you are an older person starting out in a new town or city, you may find this research dispiriting. US researchers estimated it takes roughly 50 hours of shared contact to move from acquaintances to casual friends. Progressing the contact to close friends can take more than 200 hours.

Dr Hronis says there are many other barriers stopping us from having friendships, including an introverted personality, health barriers and personal insecurities.

“It’s entirely possible to overcome these barriers as adults and build meaningful, long-lasting friendships. We don’t have to accept loneliness as inevitable,” Dr Hronis said.

“If you put in ten minutes a day, you can maintain existing friendships and build new ones. Send a text, forward a meme, add to the group chat or give someone a quick call. Don’t get caught up on how much effort, energy and time goes into building friendships. Ten minutes a day may be all you need.”

Now you know why I got in touch this week! It wasn’t exactly intimations of mortality that brought me to it; the trouble with technology is, it is too easy to dash off a text or an email (that may or may not be read).

Sometimes what we all need most is to hear a familiar and friendly voice at the other end of the phone – with no risk of catching anything.

I’ll leave you with this performance of the best-known song about friendship. We were fortunate indeed to hear Carole King and James Taylor duet her song in 2010, when they performed in Brisbane. The 2010 world tour band included bass player Leland Sklar and drummer Russ Kunkel, both playing in this 1971 video.

Now there’s friendship for you.

Covid causing travel hesitancy

covid-travel-hesitancy — Overseas travellers 2012 to 2022 Source ABS

Some of my friends and family have decided to head off overseas (Covid be damned), and I’m just a tad jealous. Despite making plans to visit family in New Zealand in February next year, our last international adventures are now more than a decade ago. Anecdotes and photos have faded, alas.

It’s probably ‘normal’ for avid travellers to do less of it as they age, for financial and health reasons. In addition, as illustrated in this graph from the Australian Bureau of Statistics (ABS) website, the advent of Covid-19 and its aftermath certainly put paid to our collective travel ambitions.

A late 2021 study found that Australians were ‘lukewarm’ about travelling, ahead of international borders opening in February 2022.

The University of Queensland study found that only 51% of those surveyed were planning international travel, with New Zealand and Europe as key destinations. The research showed that 33% of respondents preferred to holiday in Australia, and 16% were going to stay home. Nevertheless, it has been five years since our last trip to New Zealand to visit whanua. There are new grandchildren – great-grandchildren, even. And my siblings are ageing, as am I.

As you will note from today’s chart, there has been a surge in overseas traveller numbers (inbound and outbound), but it’s a long way off the 2019 highs.

One outcome of the Covid pandemic and the lifting of travel bans is a dramatic shift in the way people plan overseas travel. A recent ABC segment found that hesitancy has changed the way Australians travel, with shorter lead times between bookings and departures. Pre-Covid, a large proportion of travellers made their own travel and accommodation bookings. But COVID-19 restrictions have led to a renewed interest in travel agencies.

Many people are nervous about what could happen should they catch Covid while travelling abroad. There are a couple of key flaws in Covid-tracking, and one is that sometimes people have Covid but don’t know it (asymptomatic). Then there are people (there would have to be some), that suspect they have Covid but keep on travelling regardless.

They might give it to a thousand other people, but as they might say in their own defence, our own chief health officer has said, it is “inevitable” most of us will catch Covid.

A friend who once swore she’d never visit Europe for all those reasons and more has just left for a six-week tour of the UK. In part, it is an organised tour and the rest independent travel. Our local friend, who we shall refer to as Zee, related a typical 2022 travel anecdote from the transit lounge in Vancouver.

“I never saw the person involved, but I gather he was a young man who had travelled via Alaska Airlines to Portland and then Air Canada to Vancouver. He had checked two bags with all his worldly possessions through to Korea. However, apparently, they never made it on to the Air Canada flight and nobody has any idea where they are. I know all this because he explained it in exhaustive detail several times to different people on a very long phone call. He was obviously distressed, and I felt very sorry for him. And I will never know if he ever got them back.”

Zee has since landed at Heathrow and boarded a tour bus bound for Oxford (Ed: The Perfect Comma Tour?). After seeing stories in the media about airline passengers losing luggage, Zee opted for carry-on only. I suspect UK charity shops will be the beneficiaries of that decision.

We have all heard about or seen media coverage of people trying in vain to find lost luggage, waiting for hours in queues or being repeatedly bumped off flights. During its 18-month hiatus, the airline industry, despite attempts to revisit glory days running decades-old commercials, appears to have serious organisational issues. It comes down to a shortage of staff and trying to make old bookings systems work in a post-Covid world. Not that we are anywhere near a post-Covid world.

It may surprise you to know there are 28 countries which are not open to international visitors. They include a few countries most of us would never have on our destination bucket list. A few have onerous travel restrictions which would probably deter most visitors. Hong Kong, for example, requires you to return a negative Covid test and then go into quarantine.

A useful website (Kayak) tells us there are 163 countries that are open to visitors, and which do not require Covid-testing or quarantining. Another 33 countries require Covid testing before they will let you in and three that also require you to go into quarantine. The 28 countries that are open only to returning citizens or those under ‘special circumstances’ include China, Taiwan and Russia.

Kayak, an on-line travel agency, maintains a web page which keeps track of where you can go and what restrictions there are (if any). Despite Australia requiring all people travelling to and from the country to be double vaccinated, some countries (like Ireland) have an open-door policy. I would caution anyone with travel plans to check and double-check the entry (and exit) requirements as they change all the time.

The Kayak web page is also a one-stop place to check out how other countries are going with their vaccination rates. They range from Samoa (100%), Singapore (92%) and Germany (75%) to scarily low numbers in countries like Somalia (16%) and PNG (3.4%).

Our research into travel to New Zealand in six months’ time has thus far revealed it will be costly for comprehensive insurance. This is more to do with being 70+ than any other factor. Even though it is six months’ away, hire car companies seem to be short of vehicles. Of more pressing concern is planning ahead to avoid catching Covid and giving it to other people, namely elderly family members. We are fortunate to have an extended family in NZ who would find ways of accommodating us should we need to go into isolation (a bach at the beach, Cuz?). But it is best to make sure you factor another $1000 or so into your travel budget to cover contingencies.

As readers may have gathered over the eight years we have been communing on Fridays, I’ve done a fair bit of travelling in my youth. We also had some adventures later in life – in 2004 exchanging houses for six months with an English couple who lived in Godalming (Surrey). That was a great way to see Greece, France, Belgium, Italy, Scotland, Wales and other places, three weeks at a time then back to base to live the suburban life for a while. We visited relatives in Canada on the way over and re-visited Canada in 2010 for a family reunion. This seems to be the year for the Canadians to visit us. Brother Jon was here in May, making the most of the wet winter. Cousin Glen and his wife will be here in our Spring. They intended to travel in 2020 but we all know how that went down. There’s talk of a cousins’ reunion (probably in Seattle) in 2023. .

As readers may recall from recent essays about our trip to Tasmania, we found there’s a fair difference between taking on a 10km bush walk at 64 and 10 years on. .

Let’s see how we pull up after a month in New Zealand.

FOMM flashback

Covid- it’s everywhere

covid-masks-pandemic — Washing line 2022 Willfried Wende – www.pixabay

On a quick shopping trip this week, it seemed that every second person was wearing a Covid mask, even though there is no legal obligation to do so. Friends, relatives, neighbours and friends of friends are either in isolation because of a positive RAT test or actually have Covid-19. There’s been a nasty flu getting around South-East Queensland at the same time. The only way to tell one from the other is to take a Rapid Antigen Test.

The statistics are a bit scary. The only saving grace is that the Omicron variants are said to be ‘milder’ than the Delta strain which was rampant in 2020.

As of this morning, Queensland reported 45, 824 active cases, including 6,366 new cases in the previous 24 hours. There were 907 hospitalisations and 14 patients in Intensive Care Units. There have been 73 deaths (people who died with Covid) this week alone.

There are many unanswered questions about this third wave of the Omicron variant. Like, how come we haven’t had it? Knock on wood. Or why do some people get “long Covid’’ where symptoms persist for months?

If you look at the historical charts, you have to wonder why governments decided to take their collective feet off the pedals of the crowd control machine.

On December 16, 2021, Queensland had 17 cases (a weekly average of 9). Then we opened the borders, relaxed the mask mandate and other rules like contact tracing which had thus far kept the virus out of Queensland.

By January 17, 2022, new cases had spiked to 31,056. While numbers have since fallen away, the State reported 32, 355 new cases (between July 11 and 15), with hospitalisation rates between 800 and 900.

Cumulatively, Queensland has now recorded 1.63 million cases (equates to 32% of the population) and 1,388 deaths. So much for Omicron being more infectious but less serious than Delta.

Queensland’s chief health officer John Gerrard has been quoted that catching Covid is “inevitable”. Ironically former chief health officer Jeanette Young, now Governor of Queensland, was also taken down by the virus.

Did you know that the entire Queensland Maroons rugby league team held a fan day in Warwick last week? The visit started with a sold-out dinner on Tuesday night with guest speakers including Maroons coach Billy Slater. Next day there was a street parade, breakfast in the park, coaching clinics for children and then the Maroons had a training session at the local footie oval. A few days later, two members of the team, Cameron Munster and Murray Taulagi tested positive for Covid and were unable to play in the decider on Wednesday.

I did notice that team members wore masks as they mingled with the thousands of fans who turned out to meet and greet.

Which brings me back to people wearing masks – in the street, in cafes, shopping centres and pharmacies. The latter used to insist on customers wearing a mask, but without the muscle of a state-mandated instruction, they can only make polite suggestions.

Remember the days of close contacts and contact tracing? The border closures, closed-down cafes and bars? Apart from hospitals, organisations with a Covid policy and employers, it seems you don’t have to prove you are double vaccinated. Hardly anyone checks to see the green tick on your phone. I was only asked to do so twice on a three-week trip to Tasmania in April. We did find you had to wear masks on public transport in Victoria and Tasmania (as you do in Queensland, although many do not wear masks).

An approved style of mask is your first line of defence to avoid being infected by Covid-laced aerial droplets. Second line is to stay home as much as possible.

The people I feel for are those who cannot avoid being in close quarters with other people (aged care homes, prisons, detention centres etc). It is now well known that residents in aged care are vulnerable; not only because of their living circumstances, but also because most are 75 and over and in the high-risk category.

Nationally there have been 2,881 deaths in aged care homes since the pandemic began in early 2020 and 2,580 residential aged care facilities have had an outbreak during that time. It’s probably misleading to include those two facts in the same sentence because the mind goes: ‘Hey, that’s an average of one death for each facility.’
The Guardian reported yesterday that 100 aged care residents are dying with Covid each week, with more than 700 current outbreaks. The industry fears that two-thirds of aged care homes across Australia may be grappling with outbreaks over the next six weeks.

Amid reports of a Covid outbreak on a cruise ship anchored in the Brisbane River, I went looking for places in the world where the virus had been contained. Unhappily, the virus has caught up with some of the 10 or so island countries which, until the end of 2021, had managed to stay safe. They included Nauru, which went from zero cases in late 2021 to 40% of the population being infected. Nauru, as you may or may not know, is ‘home’ to 129 asylum seekers, most of whom have been on the island since 2012.

The World Health Organisation confirms that there are currently 121 new cases in Nauru and a cumulative 6,237 cases (and one death) since January 2022.

Citing global numbers, the WHO says that as of July 11 there have been 552.5 million confirmed cases of COVID-19 and 6.34 million deaths. As of 2 July 2022, a total of 12.03 billion vaccine doses had been administered. As for the United States, 87 million cases have been recorded since early 2020 and 1.02 million deaths. Donald Trump, we’re looking at you.

Compare that with Australia – 10,515 deaths since the first cases were seen in February 2020.

This takes me back to an early report from Seattle, the US city that gave the world the TV soap opera ‘Grey’s Anatomy’. A community choir had met for a rehearsal in the early days of Covid when nobody knew what we were dealing with.

As Live Science recalls, 52 people were unknowingly infected with Corona virus at a choir practice in Mount Vernon, Washington. The event led to the deaths of two people.

The practice happened on March 10, roughly two weeks before Washington Governor Jay Inslee issued a ‘stay home stay healthy’ executive order, barring social gatherings and non-essential travel.

That story shocked Australian choral singers. Most community choir directors I knew decided to cancel rehearsals for the foreseeable future. We mucked around on Zoom for a while and had a few tentative practices outside, but it just wasn’t the same. Eventually in 2021, as case numbers began to fall, choirs and orchestras started rehearsing again under controlled circumstances.

Experts told us that singing in a closed room was a sure-fire way to catch the virus – 20 or 30 people spraying droplets everywhere. Nobody said anything about 52,000 people in a footie stadium shouting and screaming for 80 minutes. Yes, it was an open-air event, but even so, those patrons walked in and out of the venue, used the public toilets and struggled back and forth along packed aisles, spilling beer and spreading potentially lethal aerial droplets around. Because Queensland won the State of Origin series, there was lots of hugging, kissing and selfie-posing. Then they all got on trains and buses, noisily singing the team song on the way home.

Don’t get me started. (Yes, but ‘we’ won – wasn’t it sweet? Ed)

FOMM Back Pages

Much ado about Djokovic

Djokovic-tennis-Covid-19 — Image: Rod Laver Arena, Melbourne Leau Smith/pixabay.com

Some journalism traditions die hard and fortunately, the one that persists in quality publications is to separate news from opinion. The labels “Opinion” or “Comment” ought to accompany any writing which draws on facts but allows the writer to comment and interpret. (Ed: Like FOMM).

Outspoken Australian journalist and commentator Van Badham was introduced this way in the New York Times on Sunday.

“Opinion – guest essay by Van Badham.”

The headline (which tradition decrees is always written by someone else), said: Novak Djokovic got the boot. Australians are thrilled.

The headline set the tone, in part by using Aussie parlance and then with the partially substantiated claim “Australians are thrilled”.

This was drawn from a poll cited by Badham that 83% of 60,000 respondents were in favour of Djokovic being booted. (FOMM opinion – But wait, that means 10,200 were not in favour…Oh right, it’s an opinion piece).

The labelling of opinion pieces is an industry practice that cuts both ways. It gives readers a first-up warning that what they are about to read is just that – somebody’s opinion. At the same time, the disclaimer allows Badham freedom to use the acrimony around Novak Djokovic’s visa cancellation to highlight the government’s (mis)handling of Covid-19.

“There’s a familiar pattern of government miscommunication and ineptitude unfolding around Djokovic that sadly reminds us of our brief and squandered advantage over the virus,” Badham wrote.

Not to be outdone, The Age also latched on to the term ‘the boot’ which is Aussie for being fired, kicked out of a pub or sent to sleep it off in the spare room. Writer Peter Schmigel ‘put in the boot’, which is Aussie for kicking a man when he’s down.

In a rare departure from form, Sky News said the Novak Djokovic saga had “damaged the government’s reputation”. Sky News host Rita Panahi said Djokovic had essentially been deported for “thought crimes”. In her Behind the News programme (a review of headlines on the topic), Panahi said the government “cynically made this decision with an eye on the polls”. What was that about my enemy’s enemy?

These obvious comment pieces reminded me that a reader suggested I write about ‘proper’ journalism. How do you separate well-researched, balanced news reporting from the bias of commentators of the right and the left, he asked? OK, done that.

The Djokovic story was hard to ignore. The media swarmed on it like wild bees drawn to a hole in a weatherboard house. January is usually a fallow field for the skeleton crews left in newsrooms, Many people are on holidays, including those who feed stories to the media on a daily basis. Suddenly, though, there was drama on the central court – a rare Sunday sitting of the full bench of the Federal Court involving the world’s Number 1 tennis player. Ask people who have been waiting two years for a court hearing what they think about that.

Journalists rostered to work on Sundays rarely have such a prize on their shift. As usual, radio and television news had the best of it.

There is rarely anything left for the Monday papers, except for targeted news released by organisations fond of exploiting the vacant space.

For example, the Queensland Government’s spin doctors tabled new research that demonstrated the disproportionate risk of remaining unvaccinated.

Independent news portal ‘InQueensland’ summed it up in one, 33-word lead paragraph.

“An unvaccinated person who contracts Covid-19 is 24 times more likely to end up fighting for their life in intensive care than someone who has had all three jabs, Queensland Health data shows.”

This introductory paragraph tells the reader in one sentence what the story is about. No need to read any more. Just retire to the water cooler and tell others. You can see the deft hand of old-school journos behind this opening para, wordy though it may be.

Health Minister Yvette D’Ath used this data to urge older Queenslanders to get their booster shot.

(Ed: we had ours on Wednesday).

The Australian Consumer and Competition Commission (ACCC) and other such organisations often release statements to the media on a Sunday for publication on Monday. It’s the slowest news day, so journalists hungry for a fresh angle can never resist. As the story usually relies on an official statement, it is difficult (on a Sunday evening) to track down someone to represent the other side.

John McCarthy, writing in On-line news publication ‘InQueensland’, reported on Monday that the ACCC had received 1800 complaints of retailers over-charging for rapid antigen tests. McCarthy cited a Chamber of Commerce and Industry survey, which showed that the lack of test kits as well as staff shortages were critical factors in the crippling of the supply chain..

This type of story will be ‘broken’ in the Monday newspapers and pounced upon by news-hungry radio and TV producers. Those breaking the story will have little opportunity to follow up, which becomes the role of radio news. While the ‘claims’ referred to are yet to be proven, they highlight the issue of price gouging over RAT’s (rapid antigen tests that can be done at home- for those unfamiliar with this Aussie acronym) and put a number on instances of (alleged) profiteering. I heard ACCC chairman Rod Sims expanding on this story later in the day on ABC news radio.

Sims said the level of pricing was “clearly outrageous”, citing media reports of as much as $500 for two tests (we paid $56 including postage for our pack of five kits, which is top of the wholesale price range).

The ACCC said there was an increase in the amount of RAT selling through service stations and convenience stores. They had become the source of many of the complaints it was receiving.

By publishing these claims, ‘InQueensland’ did radio and TV journalists a favour by pointing them to a couple of outlets (named in the report).

We sometimes describe this kind of story as “bees in a bottle” – give the jar a good shake and see what sort of noise they make.

It’s no wonder the more experienced journalists turn to commentary or analysis. The basic practice of news reporting can be quite tedious. It involves spending hours on the phone ‘doing the rounds’ and waiting, waiting for people to ring you back. In my day, the editor would probably not run your story if you did not have the other side. All too often now, the 24/7 news cycle forces media outlets to publish now and update later.

When reading news, it’s not a bad idea to separate hard news (two men died in a head on collision), from news like the ACCC report, that could become harder news once it progresses to prosecutions and hefty fines.

As for the label ‘Opinion’ or ‘Comment’, if it’s not there, write to the publisher and say that it ought to be.

In the case of writer Peter Schmigel’s ‘open letter’ rant about Novak Djokovic, the ‘Opinion’ label also allows news editors to deal with blow-back. “Don’t shoot the messenger,” they will tell irate tennis fans. They have reason to be irate – Schmigel (writing in Melbourne’s No 1 newspaper), agrees with the blokes down the pub – Novak’s a ‘boofhead’.

“The forms, mate, the forms. It would have been nice if you could have just filled in the forms right. You didn’t. Double fault. Maybe you should fire somebody – whether it’s the lawyers, the coaches, the agents, the masseurs, or your Dad, who tried to start World War Three on behalf of your backhand.

Or, maybe, just maybe, take some responsibility.”

(I particularly liked it when someone described Djokovic’s statement (that his staff member had filled in the paperwork incorrectly) as ‘the dog ate my homework’ excuse. Ed)

FROMM back pages

Buying masks for a masked ball

masks-masked-ball — Image: People queuing to buy face masks, San Francisco 1918. Wikipedia CC

I was cruising the supermarket aisles in search of Rapid Antigen Tests and P2 masks when a young woman opposite did that eye flash thing (above her mask). I was astonished – this last happened, what, in 1996? It’s quite a feat to demonstrate interest in the opposite sex with eye movement alone. Usually the mouth is used too, with either a shy smile or a naughty smirk.

The woman in question moved past, to her partner who had been behind me all the while. They moved on to the nappy aisle.

Time to take my temperature again, although this week I’m decidedly better. Before we get into a discussion about masks and how strange it is to see almost everyone wearing one, a small correction. Last week in my fevered state, I added an extra digit to the Covid cases numbers for Tasmania. It was 3,665.

As the majority of us are wearing face masks for the foreseeable future, what are the best masks and how should one go about preserving their integrity? When, dare I ask, is some entrepreneur going to launch a 2022 version of the 18^th century masked ball? These lavish social events were popular in Europe (Venice) and later in the UK (where the decadence got dialled down to a cup of tea and a biscuit level). You could drink standing up, too.

You’d have to adapt the costumes, though. In those days the preferred mask left the mouth uncovered (all the better for conversation and naughty smirking). One of the more common masks employed at these events was a sequinned eye mask mounted on a stick, so the damsel could hide behind it (if flirting), or maybe avoid the attentions of a rancid squire.

This could be a good time to observe that for nearly all masked comic book superheroes, the mouth is always visible. Most superheroes wear eye masks (with no visible pupils.) This, and the skin-tight costume (first popularised by Lee Falk’s The Phantom in 1936), are the popular hallmarks of superheroes.

Batman and Robin supposedly wear masks to hide their true identity, so even observant people will never see wealthy philanthropist Bruce Wayne in the street and go “Omigosh – it’s Batman.”

Back in the real world, circa January 14, 2022, you can walk past someone you know quite well, not recognising them behind the ubiquitous face mask.

“Crikey! Is that you, Barry?”

“Mhww fwhff gruff.”

The challenges facing two or more people trying to have a conversation while wearing a face mask has resulted in the Chinunder, a word I made up, which is what it implies.

Many women, it seems, prefer the little black face mask. Men in general and as usual, have no sense of fashion or flair. Some make their own masks (I did see someone with a hanky tied across his nose and mouth, like a baddie about to hold up the stagecoach).
While medicos will tell you a plain surgical mask is preferable to a bandanna or a mask with an exhaust vent, it (was) OK to make your own. You just need two or three layers of cloth, an adjustable bridge (for those who wear glasses), and elastic to hold the mask close to your face. A timely ABC report this week, however, has experts saying the cloth mask is worse than useless and instead we should wear N95/P2 masks.

This is despite the N95 masks I bought from a hardware store (for $4 per packet), clearly states ‘not for medical use’.

More information on cloth masks is available through the Infection Control Expert Group

Whatever. If you wear hearing aids, take great care when removing your mask as there is a 50/50 chance one of your hearing aids will go ‘ping’ into the nearest hedge or shrubbery.

If you don’t make your own, what kind of mask should you buy? The benefit of N95/P2 masks is they can be bought at hardware stores or chemists and can be re-used.

But even the simple job of shopping around for an appropriate mask carries risks. Chanteuse, an avid FOMMer, commented on an ABC interview with an epidemiologist, who was asked what you should put in your ‘someone in our house has COVID’ prep kit.

The answer included disinfectant, gloves etc plus two RATs per inhabitant, a thermometer and a pulse oximeter.

“I reckon you’d get COVID in the hours and hours you’d spend traipsing from shop to shop trying to get your hands on the last three,” Chanteuse said. Traipsing, now there’s a word.

Corona virus, as we know, can spread through droplets and particles released into the air by speaking, singing, coughing or sneezing.

A survey by the Melbourne Institute found that nearly 90% of Australians support the use of masks in public places to reduce the spread of COVID-19. Approval was also high (93%) for the 14-day quarantine period for people diagnosed with Covid.

According to a team of academics from Bangor University writing in The Conversation, mandated mask-wearing is not just something prompted by Covid-19. During the Spanish Flu in 1918, the Blitz in Britain in 1941, and the smog outbreaks in the UK from the 1930s to the 1960s, mask wearing was promoted as a patriotic act.

“However, the media’s scope in the first half of the 20th century was mainly limited to government-approved posters and newsprint in the 1910s. By contrast, today’s media landscape – especially social media – allows for individual and personalised voices to be heard to an extent unthinkable in earlier decades.”

Now, of course, we have Freedom rallies, people campaigning against lock-downs and mandates, scribbling slogans on footpaths… It’s nothing new – see Anti Mask League of San Francisco 1918.

If you see someone in public who is not wearing a mask, resist the temptation to try and change their mind. Avoid them like the plague, if you will, on the assumption that they are also un-vaccinated.

Which leads me to speculate about those masked superheroes who do such amazing things (while doubtless spreading viruses everywhere). Comic artists of the day must have decided that a black eye mask conveyed the necessary gravitas. Lips are drawn to look kissable.

Comics were banned from our house when I was a child – Blyton good, Phan-tom bad. I could never figure out why this ban was in force since our daily newspaper (which was in the house), commonly ran three or four comic strips including Andy Capp, Dagwood, The Phantom and Mandrake the Magician.

Despite the household ban, I was a big fan of Phantom, Ghost Who Walks, Man Who Never Dies. He’s still going in 2022. But The Phantom does not have superpowers – it’s a multi-generational story which has fed the myth of immortality. As the story goes, phantom babies are born in the Skull Cave in Bangall* and raised by wolves (and their mother, Diana Palmer). Devil and Hero stand by, not the least perturbed by the change in the pecking order.

“Diana! Not another girl!”

Successive Phantoms always seem to be gym fit and fearless, which means they have avoided jungle diseases like dengue, yellow fever and African trypanosomiasis (sleeping sickness). Perhaps Mr and Mrs Phan-tom take the kids to the clinic in town for vaccinations?

As they say of the 21^st Phantom (disguised as Mr Walker, wearing a hat, sunglasses and heavy overcoat (on a humid night in darkest Africa):

“The Phantom can be at many places at once” (old jungle saying).

*Fictitious African country.

And a joke for the ladies: Masks are like bras- they’re uncomfortable, you take them off as soon as you get home and if you see someone without one, you notice it. Ed

A garden of viruses

Dear reader, please wear a mask and don rubber gloves before reading this none-too-subtle discourse about viruses and how little medical science knows about the common garden variety.

Since I tested negative to Coronavirus, after sitting in the car for two hours on December 28, alas, I still feel like shit. Excuse the language but there is no more apt description. Those lacking in empathy might dismiss it with “Oh it’s just a cold – build a bridge and get over it.”

Not that simple, sorry. There are more than 200 different cold viruses, and despite medical science’s skills in almost every other department, we don’t have a cure for any of them. The common cold virus lasts six to 10 days and the best advice is to stay in bed, or at least stay home until you feel better. There are many remedies which arguably speed the healing process and they include plenty of sleep, plenty of fluids, exercise (which seems counter-intuitive), and other more desperate measures like eating a raw onion and listening to jazz for 30 minutes.

I felt great on Christmas Eve, cooked pizzas for the family, tried to find something intelligent to watch on TV and failed. Went to bed early.

Christmas Day I woke with that post nasal drip thing – you know the one? Within hours my nose was running and I was going ‘ah-choo f***’, spreading germs around the house. I participated in Christmas lunch, feeling gradually worse as time went by. Boxing Day was bad.

“Perhaps you’d better go and get tested,” advised my sister-in-law, the nurse.

I did so on my return home, knowing I’d have a shorter wait than people were experiencing in Brisbane, where we spent Christmas.

While this was going on, reports were dribbling in that our Christmas lunch guest were succumbing to ‘#ahchoof***’. I got a negative test result within 24 hours so that was a relief. Or was it really?

I still felt like shit and Christmas lunch guests, including SWAGACF, were feeling equally miserable.

Cousin Alice rang to say she’s sorry she missed Christmas lunch (in isolation awaiting a Covid test), which proved to be negative. My brother-in-law started referring to me as ‘the East Coast distributor’.

As many people found out, there was something ‘going round’ at Christmas.

I chatted online to a friend who was dreading catching whatever was going through his tribe of grandchildren. Later he texted:

“I’ve got the wog – about to get a RAT test. Result in a bit. Timer on. And…Negative.”
“You were on the spot by proxy at this historic event.”

I spent much of the past week in and out of bed, binge-watching Succession and marvelling at the acumen of Shakespearean actor Brian Cox as the amoral, ruthless media baron. I also spent time wondering how I got this thing. Didn’t I wear a mask when going anywhere? Didn’t I wash my hands assiduously?

The best advice to avoid the common cold is just that – wash your hands after any contact with anyone or anything. Avoid contact with people who have the common cold. Ah, the tricky one. How do we know they have the common cold? They could be asymptomatic, as I was on Christmas Eve.

Through almost two years of dealing with a potentially deadly pandemic, it’s fair to say that the media, and medical science to a lesser degree, has been less focused on other viruses.

Having said that, researchers did note the sharp drop-off in influenza numbers in 2021. This phenomenon may well have been due to the general population taking Covid precautions.

In the August edition of the Australian general practitioners magazine, ‘newsGP’, it was noted that a year had passed with not one single death due to influenza.

Professor Ian Barr was frank when asked if he ever imagined the current situation; just 435 notified cases (to August 2021) and no hospital admissions.
Barr, who is Deputy Director of the World Health Organisation Collaborating Centre for Reference and Research on Influenza at the Doherty Institute, said: “No. It’s amazing. Never.”

Professor Barr says the absence of influenza is a positive, although he also points to a number of other respiratory illnesses beyond the rising number of COVID-19 cases.

“I think fighting one virus at a time is quite enough for the general public. I don’t think we should get too complacent. There are other viruses circulating and depending on which State you’re in, those viruses are circulating at different levels.”

For context, in Australia there were 21,005 notifications of laboratory-confirmed influenza by August 2020 and 35 deaths. In 2019 there had been 214,377 and 486 deaths. (One explanation I read for this situation is that many deaths from influenza happen in Aged Care homes – the increasing emphasis on hygiene resulting from the Covid epidemic has had the effect of reducing the number of influenza deaths.Ed)

On January 6, 2022, Australia had 330,289 active Covid cases including 32,312 in Queensland. Before Christmas we had bugger-all.

I’m spending a lot of sick-bed time consulting Dr Google. If you want to minimise the chances of getting Covid, head to Tasmania. The Apple Isle and the Northern Territory have the lowest cases numbers in Australia, although at this time of year the climate is more attractive in Tassie than in the NT.

There were only 785 cases in Tasmania on Monday, increasing to 3,653 yesterday but well below the 268,787 cases in NSW and Victoria, the States you drive through to get to Tassie.

As an island State, though, one can fly directly to Tasmania, with only one border check. In WA, closed borders explains its low tally of 74 cases. The prosecution rests.

It fell to me then, viruses aside, to go on an emergency shopping expedition. I rationalised it thus: past the contagious stage, wearing a mask, washing my hands. What could go wrong?

On my last quick trip to buy juice, tissues and toilet paper, I witnessed an exchange between two customers (who apparently knew each other well enough to drop their masks under their chins).

“It’s all a bit much, eh?”

“Yeh, this flu’ll get us all eventually.”

One old bloke tendered a limp-looking ten dollar note. The (masked) checkout person picked it up in the manner of someone removing a gecko from a windowpane.

Then I went home and Dr Googled some more, finding along the way a study done in Germany which says listening to music can help heal the common cold.

Dance music, soft rock and jazz were genres most favoured to increase the levels of antibodies in the bodies of those listening to such music. (The jazz will drive me out of the room, thus achieving the aim of isolation. Ed.)

Research by the Max Planck Institute in Germany concluded that certain types of music boost the immune system and help to decrease the level of the stress hormone cortisol. Enthused by this research from 2008, latched on to by radio DJs and pop culture writers, I put together an appropriate playlist.

Our music advisor Franky’s Dad listened to the playlist and replied:

“This playlist gives an insight into the way a virus can addle the brain.”

“I see that you’ve been guided by the theme of illness & medicine,

“It’s a bewildering mix of genres though!”

FD (who also has the wog) contributed If I Could Talk I’d Tell You. Anyway, we agree – avoid listening to your favourites when unwell.

This eclectic playlist of 25 tracks – not all about feeling poorly – includes a pithy little ditty from our album, The Last Waterhole. I recommend Don’t Crash the Ambulance, not for the image it conjures, but as a piece of political history, with George W Snr advising the next president: “Watch and learn, Junior. Watch and learn.”

Germ Boy’s Mix

Covid triggering depression and anxiety

covid-depression-black-dog — Image: The author and black dog, moving day 2019 (before Covid-19)

It’s the lead news story you’d probably never see on prime time TV, a focus on depression and anxiety and how Covid-19 and the control response has seen more of us succumb to the Black Dog.

Newsreader: “Researchers have published new data that show the incidence of depression and anxiety among travellers stranded in Queensland has soared in recent months.

“70% of those who reported acute anxiety or depression over the past six months were people from New South Wales and Victoria who find themselves exiled in Queensland.”

(Cross-over to interview)

Interviewer: Julianna and husband Dario* have been stranded in Queensland since a road trip north in June turned into five months in exile. Our correspondent caught up with them at Sapphire, after the couple had spent a fruitless week fossicking for opals.

Julianna: “It was fun until it wasn’t fun. I mean, how many times can you go to the Qantas Museum? I miss my grandkids and I miss Victoria, the markets and all the good foods you can’t buy in outback Queensland.

Dario: “Yeh, Julianna’s right And, you know, a 20-foot caravan might seem big until you have to live in it for months on end. It always smells like fried eggs.”

Interviewer: So you have both slipped into a state of anxiety and depression as a result of not being able to go home?

Julianna: “Yeh, well it’s not logical – I mean the sun’s shining and the birds are singing and every day we feel safe because there’s hardly any cases in Queensland. But I’ve been feeling increasingly sad and apathetic.”

Dario: “And I’ve been drinking more than I usually do…

Julianna: “You reckon?”

Satire it may be, but it’s no laughing matter, this dark mood which can inexplicably darken the sunniest Queensland day. The symptoms are not hard to read: feeling tired all the time, not going out much, feeling miserable, feeling that nothing good ever happens, relying on alcohol…

Sunday is World Mental Health Day, although why we only get one day a year is something to ponder.

Multiple studies have been carried out that link the increased incidence of anxiety and depression to the global pandemic and the response by authorities to control the virus.

Professor Richard Bryant from UNSW’s School of Psychology says people find it harder to cope as time goes by.

“We are having a longer and later lockdown experience than the rest of the world, due to the lack of people who are vaccinated and the Delta strain of COVID.

“What we tend to see is that people get anxious at the start, then when the effects of social isolation wear on, it becomes a depressive reaction: people’s coping resources get eroded over time.”

Prof Bryant said the Delta strain and the effect of younger people dying has elevated anxieties among that cohort because they thought COVID was mainly a risk for older persons.(Apparently not taking into account the possibility of their catching Covid and passing it on to older people, such as their parents. Ed)

He says we can learn about the trajectories of mental health in Australia by looking at countries that are somewhat ahead of us.

“For example, one study in the UK sampled people at varying points during the pandemic. This study found that two months into lockdown, which is approximately where much of Australia is positioned now, the rate of people’s anxiety had decreased marginally relative to earlier periods during the pandemic.

However, at that stage more than half of the people participating in the study were still reporting anxiety.”

Three months after lockdowns started in the UK and restrictions were beginning to ease, half of the respondents still reported being worried about the pandemic.

As always, those most vulnerable to mental health problems were young adults, the unemployed, single parents, and people with long-term health conditions.

A recent webinar hosted by Monash Business School explored the impact that deteriorating mental health is having on the Australian economy (estimated at between $40 million and $70 million a year). Covid-19 has driven a rise in the prevalence of depression and anxiety disorders, and is linked to an overall decline in women’s mental health.

Professor Jayashri Kulkami, Head of the Department of Psychiatry at Monash Central Clinical School, uncovered some striking findings from an online survey conducted by her research team looking at ‘Women, COVID-19 and Isolation’.

Professor Jayashri points out that the concept of quarantine is not new, and that isolation is intended to keep people safe. Paradoxically, for some women and children, being isolated at home is doing the opposite.

“The negative consequences include the risk of losing jobs, greater economic vulnerabilities, and psychological health issues resulting from isolation, loneliness and uncertainty.”

Statistics collated by Beyond Blue, one of the many support services people can turn to, show that:

l One in seven Australians will experience a depressive illness in their lifetime;
l One in 16 Australians is currently experiencing depression.
l One quarter of Australians will experience an anxiety condition in their lifetime.
l One in seven Australians is currently experiencing an anxiety condition.
l One in six Australians is currently experiencing depression or anxiety or both.

Fortunately, support-seeking appears to be growing at a rapid rate, with around half of all people with a condition now getting treatment.

Against those long-term stats, an Australian Bureau of Statistics survey published in July found that one in five Australians are reporting high or very high levels of psychological distress linked to the COVID-19 pandemic.

Lockdowns bring unexpected positives

The New Daily’s John Elder set out to find the hidden silver lining beneath this gloomy diagnosis. He examined a survey of 3,000 people by psychologists from the University of Strathclyde in Glasgow.

The May 2020 survey found that more than half reported positive changes in their lives since COVID-19 took hold. In particular, 87% of people were more appreciative of things usually taken for granted. Respondents reported having more time to do enjoyable things, spend more time in nature, pay more attention to personal health and pursue physical activities. (Our garden has never looked so good. Ed)

These changes in behaviour were still in train for half the participants who had reported positive effects.

A December 2020 study from the University of Sydney found that 70% of its 1,000 participants experienced at least one positive effect of the pandemic.

“The top three positive effects were having the opportunity to spend more time with family; having greater flexibility in working arrangements; and appreciating having a less busy life.”

The University of Bath and the University of Lisbon surveyed mothers with one or two children (in the UK and Portugal). Many of them were working at home on reduced wages, while 93% of their children were learning from home via remote learning.

“Nearly 90% of the women found that the hardships caused by the pandemic had provided valuable opportunities. More time with the family, rediscovering small pleasures – but also time to think about their one and only life, and its meaning.”

As Elder found, and you don’t know until you go looking, the Covid pandemic has been responsible for “post-traumatic growth”. This is a formal label for what happens when people undergo a transformation after suffering adversity.

“Many people say they have found meaning in their lives – or at least have begin to ponder more deeply about these big questions that are answered more by feeling, than thinking.”

Things to ponder on Sunday, when we reflect on the 300 million people who struggle with or just simply live with depression.

As we often say around here, when the sun is shining and the birds are singing, “Well, at least we don’t live in Afghanistan.”

*not their real names

FOMM back pages

Time for advance care directives

advanced-care-directive — A Covid worker taking a break. Image by Mario Hagen, pixabay.com

Today I thought it wise to mostly bypass the relentless onslaught of negative news about Covid-19. Instead, let’s talk about Advance Care Directives, Do Not Resuscitate (DNR) orders and organ donation.

I can’t imagine anyone under 50 who has given these topics a moment’s thought, but read on. Twenty years from now you’ll say to your partner – ‘Remember that piece Bob wrote about DNRs? Maybe the time has come?’

The topic arose as the Covid-19 death toll in New South Wales reached 132, including 80 since early June. The Australia-wide death toll since 2020 is now 989.

Although we have wills and have given each other enduring power of attorney, there’s something about DNRs and Advance Care Directives that sounds, well, permanent.

I came to this topic after counselling someone whose two life-long friends are simultaneously succumbing to terminal illnesses. As we age we start to experience more episodes of friends and relatives dying or being inflicted with infirmity through strokes or dementia.

The advanced care directive gives individuals the power to state what should happen to them should they be in a comatose state.

How many times have you heard someone say ‘if that happens to me, take me out the back and shoot me?’ It’s a fine philosophy. But unless you stipulate in a legal document what you want to happen if you are incapacitated but still breathing, you will remain hooked up to machines that keep you alive.

A common law Advance Care Directive allows you to specify your wishes about future health care and medical treatment. A Directive can only be followed when a person no longer has the capacity to make decisions and the direction relates to the medical treatment or health care situation that has arisen.

DNR orders have been around since the 1970s, but problems remain communicating the wishes of loved ones. For example, a resident of an aged care home is found unresponsive and not breathing. The carer believes the resident has a DNR order in place, but it’s not documented. So they have to decide whether to leave the resident while look for the correct documentation, or stay with the resident and begin CPR (cardiopulmonary resuscitation)

This example, cited in a National Seniors magazine article, describes it as a medical and ethical problem dogging the aged care sector. While a documented DNR is legally binding, it has to be found before it can be acted upon.

“Nurses report residents being resuscitated even when a DNR order is in place, and the family and the resident (after he survived) came away angry and disappointed he was put through such heroic measures”.

The problem arising from the example cited is that CPR can injure people, especially the frail or old. Worse though, if the person’s heart has stopped beating for a long enough period it can lead to brain damage and a lingering and undignified end of life.

So we all know this; we have all heard similar stories. Yet here we are in our early 70s, still procrastinating about what we want to happen should we be found unresponsive and not breathing.

Those who follow any number of religions may choose to bypass the choice to have a say in what happens in their dying days. While my mother sought such treatment as there was for cancer in the 1960s, she firmly believed the outcome would be “God’s will”.

When you do get around to making a Directive, you may also wish to donate your organs, or those organs which are still in good enough shape to give away.

This is where younger people come into the picture. If you had a bad car accident and died of head injuries, what would you want to happen to your perfectly healthy heart and lungs?

Too dark for a sunny Friday afternoon? Songwriter Loudon Wainwright III put it all in droll perspective in a two and a half minute song, Donations.

“In case of an accident, who could they notify – would it be alright if they notified you?” he begins.

After discussing his lonely life as an ‘unmarried orphan’ he envisages someone fishing out his wallet and looking for a donor card:

“As for my corneas, I don’t care who gets them, but all other organs and parts are for you.”

But Bob, you’re saying, spluttering into your cappuccino or your first cocktail – this is no laughing matter.

No, it isn’t, but neither is lying in a coma, intubated and kept alive by a machine when a signed and witnessed document could save everyone a lot of heartache.

There’s a global debate around the ethics of dealing with DNR orders during a pandemic, where ventilators are in short supply.

The journal Frontiers in Public Health says DNR was only discussed amid the H1N1 influenza pandemic in 2009, with clear global recommendations.

“The unprecedented condition of the COVID-19 pandemic leaves healthcare systems worldwide confronting tough decisions. DNR has been implemented in some countries where the healthcare system is limited in capacity to admit, and thus intubating and resuscitating patients when needed is jeopardized”.

Most of the 988 Australians who have died of Covid-19 were in the 70-90+ age groups. In the absence of local research, here’s an example from the US that sheds some light on the prevalence of DNRs among older people.

Of 1270 patients (median age 66), admitted to two New Jersey hospitals over three months in 2020, 640 died with death certificates attributing COVID-19. Of these, 570 (89.1%) had DNR orders.

The proportions were similar in a study carried out by Sheffield University in the UK. We could also have a debate about whether the term ‘resuscitate’ applies in Covid. Intubation is often used not to resuscitate but to keep the patient oxygenated and reduce respiratory distress.

In my teens I had a fair interest in philosophy and comparative religious studies, which probably explains why I am out here today on the agnostic high wire. I remember someone using a word which I misheard as ‘Youth in Asia”. These were the days when research was done in a library using an index card system. Eventually I discovered that euthanasia had nothing to do with rebellious teens in Asia. Fifty years or more later, the notion of assisted dying, or aid-in-dying as it is called in the US, is strongly resisted in many countries. The degree of resistance is usually linked to how devout the population is and the strictures of dogma.

Nevertheless, when faced with a terminal illness diagnosis, many people take whatever treatment or palliative care that is on offer. Towards the end, this is typically morphine and its derivatives or, where it is legal, medicinal marijuana.

Palliative care, which has been in use since the 1960s, skirts between aid-in-dying and palliative sedation.

The boundary is “fuzzy, gray and conflated,” according to David Grube, of the advocacy group Compassion and Choices.

“In both cases, the goal is to relieve suffering”.

Thomas Strouse, a psychiatrist and specialist in palliative care medicine at the UCLA Medical Centre, believes there is a difference.

“The goal of aid-in-dying is to be dead; that is the patient’s goal. The goal in palliative sedation is to manage intractable symptoms, maybe through reduction of consciousness or complete unconsciousness.”

Be that as it may, you are less likely to get what you want without an advance care directive.

More reading;

(NB: Herman Wouk, who is mentioned here. died on May 17, 2019 aged 103)

Angst in the time of Covid

polio-cholera-covid — Image: A young girl is given oral polio vaccine – Wikimedia CC

Amid reports of doubters who (still) believe Covid is fake news, this week we examine the history of public protest and vaccine hesitancy in times of contagion.

Those 3,000 or so people who mingled on Sydney’s streets a while back, protesting against the Covid lockdown, protesting about vaccines – it’s nothing new.

In the early 19^th century, Joe Public was getting riled up by the spread of cholera and the seemingly poor response by doctors and authorities. There was similar dissent shown when the UK government sought to make the smallpox vaccine compulsory in 1854. There was an ‘anti-mask’ movement during the Spanish Flu and much stigmatisation of polio victims in the first half of the 20^th century.

While the threat of cholera has been eradicated in countries with good drinking water and sanitation, there’s still a lot of it about in parts of Africa and Asia.

Cholera is a severe diarrhoeal disease which, if left untreated, can kill within hours. It is commonly transmitted via food or untreated water, particularly in countries with poor sanitation. Even now if you are travelling to Asia or Africa, your GP will advise getting vaccinated.

And here, dear reader, is where the great divide starts; the inevitable chasm between the majority who accept the science and medical advice and those who don’t. There are those who think the Covid vaccine is a plot to de-populate the planet or a conspiracy to control our minds by implanting microchips. Mine has already succumbed, as you can tell.

The first cholera epidemic (1831) emerged in Russia then somehow moved to Scotland, causing considerable angst and consternation. Just absorb this snippet from Wikipedia and put it in the context of Sydney’s Covid lockdown (and protests).

“A major riot took place in Aberdeen on 26 December 1831, when a dog dug up a dead body in the city. Some 20,000 Aberdonians (two-thirds of the city’s population, although this number has been criticised as an exaggeration), protested against the medical establishment, who they believed were using the epidemic as a body-snatching scheme similar to the Burke and Hare murders of 1828”.

In the summer of 1832, a series of cholera riots occurred in various towns and cities throughout Britain, frequently directed against the authorities, doctors, or both. Of the 72 cholera riots in the British Isles that year, 14 made reference to body-snatchers (“Burkers”).

Burkers were people who believed that medical authorities were acting in co-ordination with the State to purposefully kill and reduce the population (weeding out the poor and weak). Sounds outlandish now, eh?

Despite oral vaccinations being in widespread use, the World Health Organisation (WHO) recorded 499,447 cases of cholera and 2.990 deaths in 2018, spread across 34 countries. About 75% of cholera cases were attributed to Yemen. As the WHO observes, cholera is most likely to re-emerge and spread in countries affected by war and civil unrest and/or where infrastructure has been damaged by natural disasters.

If you roll back 102 years to the Spanish Flu pandemic, it is not hard to uncover instances of public unrest. They ranged from people stigmatising those who had the virus to complaining about having to wear a mask in public.

Historian Humphrey McQueen says mask wearing was strenuously enforced in New South Wales.

“The demand for masks was so extensive that to prevent profiteering, the Commonwealth Government declared butter muslin and gauze to be `necessary commodities’ within proclaimed areas.”

Opponents of mask wearing saw them as breeding grounds for infection or as sapping the community’s ‘vital force’. A ‘Bovril’ advertisement alleged that anti-influenza masks were ‘like using barbed wire fences to shut out flies’.

McQueen said there was widespread support for inoculation throughout the country. By the end of 1919, 25% of people in in New South Wales had received two inoculations against Spanish Flu.

“Melbourne’s socialites reputedly arranged `inoculation parties’ where the guests ‘got the needle’ in turn to slow music and a prize was awarded to the shapeliest arm.”

Vaccine hesitancy is no surprise to David Isaacs, Professor of Paediatric Infectious Diseases, University of Sydney.

Writing in The Conversation, he explored the topic from smallpox through to the Covid vaccine.

“In 1853, concerned by pockets of poor uptake of smallpox vaccine, the British parliament introduced the Vaccination Act, making infant smallpox vaccination compulsory.

“Mandatory vaccination fomented opposition, something we should remember if considering making a modern vaccine mandatory.”
Protests quickly emerged, with more than 80,000 vaccine dissenters marching through Leicester carrying banners, a child’s coffin and an effigy of Jenner.

Eventually, the success of Jenner’s smallpox vaccine silenced the anti-smallpox vaccination movement.

I sometimes look at the smallpox scar on my arm (1955) and wonder why people were so scared of something that could spare you from a disease more contagious than Covid-19, with a 30% mortality rate.

In the first half of the 20th century, the ‘silent killer’, polio (infantile paralysis) swept quickly through the US and other countries.
The US was desperate for a polio vaccine and it got one, but not without an early setback. Virologists Albert Sabin and Jonas Salk, competed to develop the first polio vaccine.
Salk’s vaccine, made from killed polio viruses, was ready for a large clinical trial in 1954.

Five companies applied to mass produce the Salk vaccine, four major pharmaceutical firms and one Californian family firm called Cutter Laboratories. The trial results proved the vaccine worked, so vaccination began in 1955.

But within two weeks, children who received the Cutter vaccine (but not the vaccines made by the four other companies), started to develop paralysis. Of the 200,000 children given the Cutter vaccine, 40,000 developed polio, 200 were paralysed and 10 died.

“The polio vaccination program stalled due to the ‘Cutter Incident’, but the fear of catching polio was so great the public was soon reassured the other vaccines had not caused polio,” Prof Isaacs wrote.

I don’t remember being told this story as a child in the 1950s, lining up in a New Zealand schoolyard for the polio needle. New Zealand was as badly affected as Australia, with five polio epidemics from 1914 to 1954, resulting in many deaths and people my age being left with a lingering legacy.

Polio Australia says there are 400,000 Australian survivors of the childhood polio epidemic. At its peak between 1944 and 1954, the virus killed 1000. The highly contagious virus, spread via faeces and nasal mucous, resulted in poor people and those living in overcrowded situations being stigmatised. Then as now, outbreaks were dealt with by closing schools, borders and public facilities like swimming pools. Victims were quarantined and newspapers published a daily tally of polio cases and deaths.

Prof Isaacs compares these stories with the public concern which arose in 2020 about the Covid vaccines, primarily because of the risk of blood clots. He concludes with the ‘greater good’ argument.

“In Australia, a concentration on individual risk at a single point in time ignores the benefits to the community of widespread vaccine uptake.

“History tells us the public can tolerate risk of harm from vaccines when the severity of the disease warrants the risk.”

I don’t know about you, but my second AZ shot is due tomorrow. I’ll run the risk.

More reading:

The Cutter incident