Health Archives - thegoodwills.com

Concussion and the slow demise of contact sport

contact-sport-concussion — Image: John Hain, www.pixabay.com

As you might know, one of my unlikely ‘hobbies’ is watching rugby league games on television. It’s as exciting as things get around here, especially if your team is winning. Once or twice a year we go to a live game (at least $100 admission for two).

The technology used to televise contact sport has led to a level of live scrutiny the game has never known before. Back in the day you could tackle someone and give him a ‘facial” (mashing your forearm into his face), and if the referee didn’t see it, you got away with an unsporting, illegal ‘dog act’.

The advent of The Bunker (a small team of referees armed with the technology to forensically replay on-field incidents), has changed the game forever. There is only one referee, and he/she can’t be in all places at once. That is why the Bunker alerted the referee to an incident last week where Parramatta Eels forward Reagan Campbell-Gillard slid his knees into the back of Titans hooker Chris Randall (who was already on the ground). It didn’t look good and the player on the ground was in apparent agony.

Campbell-Gillard was sent to the ‘Sin Bin’ and later suspended for four weeks over a grade three dangerous contact charge.

Repeated replays of such incidents prompt mothers (and fathers) around Australia to say, ‘no son of mine is playing that brutal sport.’ Then they sign them up for under-12s soccer, even though 22% of injuries in the round ball game are concussions.

Australia can’t be too far away from a class action brought by former contact sport players for whom repeated head injuries have left a legacy. There have been a few individual cases brought in Australia. Former Newcastle Knights winger James McManus eventually settled out of court after suing the National Rugby League (NRL).

One does wonder how much longer contact sports like rugby league and rugby union can be justified when there is so much evidence to show what repeated head trauma can do to an individual.

Research published in the British Medical Journal canvassed the extent of head injuries/concussions and the risk of under-reporting. The research found that 17.2% of Australian rugby league players suffered a concussion in the previous two years and did not report it to the coaching team or medical staff. About 22% of NRL first grade players admitted to not reporting at least one concussion during the 2018 and 2019 seasons. The most common reason was the player ‘not wanting to be ruled out of the game or training session’ (57.7%) and ‘not wanting to let down the coaches or teammates’ (23.1%).

Rugby league has changed immeasurably since I first started watching the game in the 1980s. Many rule changes occurred, technology worked its way into the game and now, it seems, an entire game is played with player welfare a priority. Back in the day, players commonly used their shoulders to tackle an opponent, usually resulting in the foresaid opponent being concussed and having to leave the field. Players who led with their shoulders inevitably spent time off the field having shoulder reconstructions. Even now, when shoulders are much less utilised than they were, it is not unusual to find a player in his mid-20s who has had two or even three reconstructions.

The shoulder charge is not the only banned ‘tackle’. There is the crusher tackle, the hip drop, third man in and any tackle involving contact with the head. The latter usually ends with a player being sent to the ‘sin bin’. This means the team is a man down for 10 minutes. This commonly leads to the good teams putting on 10 or even 20 points in the period where they have a numerical advantage.

You’d have to ask why rugby league players persist with high contact tackles which sports administrators have agreed are dangerous. At times it seems malicious. True, you might get sent off for 10 minutes, but the bloke you tackled into oblivion is going off for an HIA (head injury assessment) and will not return to the field. The player in the sin bin, perversely, is allowed to return to the field.

Since the tightening of concussion rules in 2016 a few players have retired prematurely because of repeated concussions or ‘head knocks’ as they were once known.

Many instances of high contact are accidental, such as head clashes (at times with your own teammate’s head). Others come from fatigue – the opponent has already beaten you, but you instinctively throw your tired arms up and hit him around the throat, chin, and head.

The NRL, the professional body which administers the game, has in recent years initiated a range of measures designed to protect players from repeated head injuries.

Any contact with the head, be it an accidental head clash, a careless or deliberate high tackle or the unconscious player’s head hitting the ground is reviewed. The Bunker can intervene and order a player off the field to be assessed by an independent doctor.

Typically, the injured player goes off for a mandatory 15-minute HIA. The player may pass the test and return to the match, but more often if it is graded category two or three the game is over for that player. If the contact is deemed serious he may be banned from playing for several weeks.

Some players seem prone to head injuries and in recent years there have been plenty of premature retirements. In the UK, law firms are leading two court challenges, one against World Rugby and another against the promoters of rugby league in England. In all there are some 350 former players involved, all alleging that the sports’ governing bodies failed to protect them from concussion and non-concussion injuries. They allege that these injuries caused various disorders including early onset dementia, chronic traumatic encephalopathy, epilepsy, and Parkinson’s disease.

Despite an older study reporting that 23.2% of parents discouraged their children from playing rugby league, about 480,000 Australian adults, juniors and school children are engaged in the sport.

Speaking of school children (about 30,000 are involved in school programs every year), many will have reached adulthood thinking that sports betting is all part of the game. Sports betting has been legal in Australia since 1983. Lately there is much talk about placing constraints on the industry’s saturation advertising. So far the controversy has led to preposterous warnings after sports betting ads about the dangers of gambling addiction.

Gambling ads are a genuine issue given that NRL games were watched by 119 million viewers cumulatively over the 2022 season, an average of 620,000 viewers per game. The 53% increase in viewers on Channel Nine is reflected in a similar rise on Foxtel, with most games attracting 50,000 to 60,000 viewers.

The choice of betting types is large and varied. Punters can bet on the outcome of league games with novelty bets thrown in: first (and last) try scorer and in big games, man of the match, exact score, and exact winning margin. You cannot yet bet on which player will go off for an HIA, or which player will be sin binned, but never say never.

Australians have bet on stranger things.

More reading https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Sports-related-Head-Injury

From the archives (1) Bedside Manners

bedside-tables-manners — Bob’s bedside table (an example) Zoom in to see what he’s reading

So I’m visiting John in hospital and it’s just as well I didn’t come the day before, he says, because he was in a world of pain. Knee operations are like that. Hospital rooms evoke all kinds of memories, most of them not very pleasant, even a private room with a TV, telephone and a view of the painless world.

John was telling how his daughter phoned on his world of pain day to see how he was. The phone, on the bedside table, just out of reach, rang and rang. Somebody had moved the bedside table so they could set up the contraption that monitors one’s vitals.

There’s a small fortune to be made for someone who invents and promotes a bedside cabinet suited to the largely bed-ridden. It may well be that someone already owns the patents or has actually produced a prototype. They would go well in hospitals. The standard hospital brand tends to be a metal box on castors, usually with two (lockable) drawers and a cupboard to store your clothes, shoes and toiletries.

What is really needed, if you happen to be supine in bed and unable to roll over and reach out, is a bedside table that will come to you. I’m not an inventor, designer or cabinet maker, but I envisage the patient with a remote control pressing ‘turn left’ and with a barely perceptible whir, the bedside table obediently turns so it is facing the bed. The patient presses ‘rise” and the table rises, until the patient presses ‘stop’. ‘Open top drawer’, and the top drawer slides open, to offer an array of things one might need: reading glasses, hearing aids, wallet, mobile phone, private medical insurance card.

Those of you quick on the uptake will immediately see the broader commercial opportunities of such a user-friendly bedside table. The home model would have a built in power board for mobile phone, e-reader, MP3 player or whatever gadget you keep in the bedside cabinet that might require recharging. Ahem.

At this stage of musing it is important to note the debunking of the myth that one risks brain cancer by keeping a mobile phone next to the bed. The ABC’s Catalyst program is under attack for a program this week linking Wi-Fi and mobile phone use with brain cancer. According to the Australian government’s radiation safety agency ARPANSA, there is “no established evidence” that low levels of radiofrequency radiation from these devices cause health effects. The Conversation, an excellent source of analysis by academics and journalists, asked experts for their opinions.

If you search ‘bedside table’ you will find hundreds of designs (and prices) but nearly all follow the basic principle of a night-stand – a vertical cabinet with two or three drawers or two drawers and a cupboard. Once you’re in bed, only the top drawer is easily reachable and of course every time you lean over to look for something, there’s a risk you will knock something off the top (where many of us keep things like books, reading glasses, contact lenses, hearing aids, a glass of water, e-reader, wallet, and so on – not unlike the illustration above.

The smart bedside table would have a tissue dispenser built in to the side (also touch of a button) to free up space on the top of the cabinet. Bedside tables (the typical bedroom suite comes with two), are not designed with age groups in mind.

The 18-35 groups could get by with a wooden chair, on which to place current reading (e.g. Wild, by Cheryl Strayed, The Art of Asking by Amanda Palmer, On the Road by Jack Kerouac), and the essential accoutrements of the young and impulsive.

The 36-49 groups used to favour clock radios so they could get up with the lark listening to classic FM. These days it is likely to be a smart phone alarm and an MP3 player programmed to play your early morning playlist. Books may include: The Seven Habits of Highly Successful People by Stephen Povey or conversely, Summer on a Fat Pig Farm by Matthew Evans.

We elders need a lot of space on the table top. There’s the aforementioned hearing aids, a glass of water (to drink), a glass of water (for our teeth), one or even two of those Monday to Sunday prescription boxes so you don’t forget to take what the doctor ordered. There’s often a torch so those of us with cataracts don’t walk into walls or doors.

The over-65 top drawer is likely to contain a plastic folder with five or six prescriptions repeats, boxes of medications, tubes of ointment for various aches and pains and itches, several old watches, cufflinks (who wears cufflinks?), pebbles, feathers and shells collected from the last beach walk, a Swiss army knife, a pedometer with a flat battery, hearing aid batteries, a scattering of coins, a few buttons that ought to be in the button tin, the thumb splint from last time you had a bout of tendonitis, a well out of date asthma puffer, a well-thumbed copy of Meditations for Men Who Do Too Much, five bookmarks and a card with all your pins and passwords disguised as telephone numbers.

How are we doing so far?

The second drawer of your typical bedside table might be the place you keep bulkier objects like a wheat bag (put in microwave for 40 seconds and apply to aching body part), the leather writing compendium a well-meaning friend gave you for your 21^st birthday and which you cannot bear to throw away, even though it is a mid-20th^st century curio containing five old address books and a Valentine from 1974.

The bottom drawer is where you should keep a pouch containing important personal papers so you can grab it and run if there is a fire.

If your bedside table has a bottom drawer or a cupboard, you could try a psychological experiment: Every Sunday night, list everything that has happened in the news this week that you don’t want to think about and lock it away.

A year later you can read these 52 pages: Cardinal Pell. Who was he again? Oh, the asylum seeker babies. The Hague ruled on that, didn’t they? Anyway, they all went live in New Zealand.

A cluttered bedside table can be a trigger for allergens. At least once a month you should throw everything on the bed and give the cabinet a jolly good clean. Then put back less stuff. Go on, you can do it – who needs two watches that don’t work, an empty floss container or a tube of Dencorub with a 2009 use by date?

Some of you might wonder why I didn’t write about asylum seeker babies or Tim Minchin’s song about the cardinal, or that proposal by the Australian Chamber of Commerce and Industry – (journalist Paul Syvret called it a ‘brain fart’) – to turn age pension payments into a loan, repayable on the sale of the pensioners’ home.

As you can clearly see, especially if you zoom to 200% and examine the photo above, I had other things on my mind.

Physiotherapists in demand

phsyiotherapists-in-demand — Image by Matias Maiztegu, www.pixabay.com

Every day I walk anywhere, I silently thank the physiotherapists who got me back on my feet after a serious motorcycle accident in 1969. Too long ago and yet still traumatic to relate, so I’ll skip the detail of the accident and fast forward to the rehab centre.

Once out of plaster, able to use crutches and manage a flight of stairs, those with serious injuries were packed off to a rehabilitation centre. Those physios, I remember well, were relentless in the quest to restore flexibility and muscle strength to wasted limbs.

I’d fractured both kneecaps and had them removed, so on release from hospital had limited movement. My quads were so far gone I could hook an umbrella around my thigh.

Enter the first physio who introduced me to the pedal-driven lathe, on which we made wooden collection plates, cheese boards, wine goblets and other items that required hours of repetitious pushing up and down, first one foot then the other.

Then it was into the (heated) pool to developed further flexion through weight-bearing exercise. There were sessions with muscle-stimulating machines, weights and frequent massages to break up the scar tissue.

We were given three good meals a day and then sent off to bed at 8.30. One night we all sneaked out and found a pub down the road; discovering it was by no means an original idea.

My knees got better with time, although I still can’t squat down and kneeling is something I’ve learned to do as seldom as possible. If I get a flat tyre I call the RACQ.

I was musing about this on day three of the great rose garden refurbishment project, spending more time on my knees than I’m used to. Once the day warmed up, I’d shower and retire to the lounge to watch the Australian Open. I’m a fair-weather tennis fan and only get engrossed when we’re into the quarter finals.

He Who Was Deported for not Being Vaccinated is back again, and, despite a troublesome hamstring, seems destined to take home the AO trophy. As all the leading tennis pros do, he brought his own physio. He may even have brought two if you peruse this story.

No doubt you have all had dealings with a physio at one time or another. It doesn’t take much. Common complaints referred to physios include lower back problems, broken wrists, ankle sprains, knee injuries, shoulder conditions, achilles tendon and pectoral strains, tendinopathy, arthritis and the dreaded hamstring strain. Novak Djokovic has had a dodgy hamstring since he set foot in Australia but his physios are obviously skilled at keeping him on the court. He is in superb physical condition too, which helps.

Given the dominant form he displayed against Alex de Minaur (6-2 6-1 6-2), his hammies are just fine.

As Novak said early on: “It’s up to God, and my physio to help me. Let’s take it day by day, I hope I’ll be able to recover.”

The hamstrings are the muscles at the back of the thigh, attaching above the hip joint and below the knee joint. Adequate resilience of the hamstring muscles and their tendons, which attach the muscle to bone and are essential for movement, is essential and fostered by sport-specific exercise.

Retired ballet dancer Martin Collyer has just finished undergraduate studies at UQ for a degree in physiotherapy. One of his placements was at a former workplace, Queensland Ballet headquarters in West End. Like all elite athletes with a retirement age around 35, he made plans, initially working as a yoga teacher.

He said he chose to study physiotherapy despite some disappointing experiences with physios on the few occasions when he suffered injuries as a professional dancer. He related an anecdote from a group he was teaching about a long-term yoga teacher who was studying for a bachelor of physiotherapy. She chose to stop, after four years and much effort.

The reason cited was that physiotherapy was, “too focused on individual joints and muscles; too narrow,” leaving the individual feeling that yoga was a more ‘holistic’ approach. Martin was asked for an opinion.

“I said that while there are tremendous physios, the individual may matter more than the modality. There are great chiropractors working from the evidence base and using exercise as treatment, just as there are physios who may disregard the evidence base.

“Physio’s origins are in massage, but the profession has evolved a great deal over the years. Increasingly, the evidence supports exercise as best-practice management for a majority of musculo-skeletal conditions. This means that the training physios receive, with an emphasis on manual therapy and other passive techniques (e.g. ultrasound), may not adequately support them. While exercise was covered in my physio undergraduate degree, it was arguably insufficient.

“Because of my prior experience in movement and movement coaching, I feel confident with this aspect of practice, but what about the individual who had little experience with sports and exercise prior to studying physiotherapy?”

Through four years of study, Martin said it dawned on him that the issues physios treat are public health problems.

“If more people were more physically active, far fewer people would suffer from musculo-skeletal complaints. The best sort of exercise is the sort you’ll keep showing up to.”

The popularity of physiotherapy as a study course appeals both to those who want to be practitioners and those who use it as an entrée to medical school.

The Australian Physiotherapist Association (APA) tabled recent data that showed there were 35,290 registered physiotherapists in Australia. Physiotherapy continues to be a female-dominated workforce (66%) and a Gen-Z profession with the majority of registrants aged 25–40.

The stumbling block for most people who are referred to a physiotherapist is the cost. Typical fees for a 30-minute or 60-minute session are between $80 and $120 per session. Your GP can issue a chronic condition treatment plan (subsidised) but this has limitations.

The Grattan Institute recently released a paper advocating a review of Medicare arrangements for allied health services.

Grattan Institute author Anika Stobart advocated scrapping the existing Medicare items for allied health and re-directing funding through local Primary Health Networks. These networks would contract providers to perform services with no (or very low) out-of-pocket fees for referred patients.

Stobart says that even though services are subsidised, they can still be very expensive.

“Last year, only 56 percent of allied health services were bulk billed, and patients paid on average $55 out-of-pocket per appointment.

Just this week there were news reports of a pending review of Medicare and its funding model. The Albanese government’s Strengthening Medicare Taskforce recommends moving from subsidising GP consultations alone to wrapping in care provided by nurses and paramedics.

Health minister Mark Butler said the current system is “no longer fit for purpose” and flagged changes in the May budget. Given that one in six GP presentations are for musculo-skeletal conditions, there’s a good case to review the Medicare treatment plan system.

I ran into the treatment plan limitations when seeing a physio for a rotator cuff (shoulder) injury some years ago. I quickly used up my “free” sessions but opted to keep going at around $70 a session. My physio claimed credit for the reduced inflammation and increased mobility over time. I said the symptoms eased once I started taking magnesium tablets. She politely but firmly disagreed.

Arthritis and the global business of hip replacements

arthritis-hip-replacements — Photo by www.pixabay.com

Who’d have known there were 2.150 million Australians who suffer from arthritis? It was one of the questions in the 2021 Census (asking about long-term health problems). I don’t recall answering the question, but don’t doubt that I ticked the top 3 boxes.

The three biggest long term health issues in Australia are: mental health, arthritis and asthma.

The 2021 Census was the first time the Australian Bureau of Statistics (ABS) asked about diagnosed long-term health conditions. Two million-plus people reported having at least one of the top three – mental health (2,231,543), arthritis (2,150,396) and asthma (2,068,020).

Of those who responded to the survey, 4.78 million reported having one of the 10 long-term health conditions; 1.49 million reported having two of the health conditions and 772,142 had three or more.

Let’s focus on health issue number two – arthritis. There’s a bit of it in my family and when the weather is cold or I have been playing guitar, typing or weeding, ‘Arthur’ reminds me he is king of my castle.

So far it is just swollen hand joints (thumb and pinkie) and occasional pain in the hip and femur. Despite having major surgery on both knees in 1969, I’ve ducked the serious inflammation that attacks hips and knees.

I once met the late jazz musician, Don Burroughs, who suffered with arthritis in later life. He told me he’d successfully taught himself different techniques for playing clarinet, flute and saxophone. Veteran guitarists will tell you similar stories of how to play, holding the instrument in different positions.

The Australian Institute of Health and Welfare shed some light on the subject in 2020 with a report that looked at an array of musculo-skeletal conditions that affect the bones, muscles and joints. These conditions include long-term (chronic) conditions such as osteoarthritis, rheumatoid arthritis, juvenile arthritis, back pain and problems, gout, and osteoporosis or osteopenia (low bone density).

The latter caught my attention as I recently checked in with the Bone Bus and had scans done of my hips, knees, spine and upper arms.

The Bone Bus is a travelling clinic with the sole purpose of measuring patients’ bone density. The scan is one of three procedures people over 70 can have that is wholly funded by Medicare. I had the pneumonia and shingles vaccines about 18 months ago. But ever since then, I was away travelling when the bone bus came to town.

According to John Hopkins Medicine, a bone density test is used mainly to diagnose osteopenia and osteoporosis. It is also used to determine your future fracture risk.

I have not seen a doctor about my scan yet (it can take a week to see a GP in this town – or any other for that matter), but I’m fairly relaxed about it. I’ve had a couple of tumbles in the garden and in the house in recent years and suffered only bruises of the flesh and ego.

Not so for some of my peers, who have either had a hip or knee replacement or fractured a hip after a fall.

Friends who broke a hip report a good rate of recovery. One friend was back driving six weeks later. Another was getting about town on a walking stick within a month.

The main issue when an older person falls and fractures a hip is the risk of death. The one-year mortality rate after hip fracture is 21%, once the fracture is surgically addressed. If not, the one-year mortality is about 70%.

This means 4 out of 5 older persons will survive the first year after a hip fracture. This mortality rate has remained unchanged since the 1980s.

The Conversation goes one step further, saying a hip fracture can often be a ‘death sentence’. The statistics around hip fractures in the elderly are alarming, notably that 27% of hip fractures occurred after a fall in an aged care facility.

Age is a key risk factor, with hip fractures more likely to occur in those aged 65 or older. They’re primarily a result of a fall, or when the hip collides with a solid object such as a kitchen bench. However, they can also occur when there has been little or no trauma.

Cognitive impairment such as dementia can increase the risk of falling. Frailty, poor vision, the use of a combination of medications, and trip hazards in the home also increase the likelihood of falls. Osteoporosis, a disease characterised by low bone mass and degradation of bone tissue, is another significant risk factor for hip fractures.

Data from the AIHW collated in 2017 found that 93% of new hip fractures were the result of a fall-related injury, of which 87% were minimal trauma (low-impact) falls. Nearly half (48%) occurred in the person’s private home, and, as mentioned, 27% occurred in an aged care facility.

Falls and fractures aside, if your hips are problematic, replacement surgery with advanced robotics and titanium prosthetics is the preferred option to waiting for the inevitable fall.

The hip replacement procedure has improved greatly since it started to become commonplace in the early 1990s. This YouTube video explains by animation how a compromised hip joint is replaced.

Osteoarthritis is usually the condition that leads to requiring a hip replacement. People with bad hips do have options (first line of treatment is anti-inflammatory drugs). Eventually, though, GPs are more likely to suggest a hip replacement than not. The technology for the procedure has improved to the point where the successful, pain-free recovery rate is above 95% and 90%-95% at the 10-year mark.

Surgeons have been able to replace worn-out or diseased hip joints since the 1960s, but it wasn’t until the late 1980s that people began actively seeking it out as an option.

About 44,000 Australians sign up for a hip replacement every year with more than 90% reporting a good outcome.

An article attributed to Fortune Business Insights shows that hip replacement surgery is a $US6.57 billion global business. Despite a 12.1% decline in turnover through 2020 (as Covid postponed elective surgeries), the business of replacing hips is huge.

Globe Newswire reported that the global market size is projected to hit US9.91 billion by 2028. The forecast growth is due to the “growing prevalence of osteoarthritis in the geriatric community”.

The market’s growth is also attributable to “favourable health reimbursement policies”.

We are fortunate in Australia that such procedures are paid for by Medicare, albeit after a lengthy waiting period. A hip replacement can cost between $19,439 and $42,007 (median $26,350). You probably know people who have had both hips done. Three cheers for free medical care (introduced by Gough Whitlam in 1974 and further enhanced by Medicare in 1984).

Meanwhile I should, I know I should, go back to the aged person’s gym that focuses on stretching and flexing, working on the all-important core strength which helps us keep our balance.

As for knees, which are more problematic, I already wrote about that.

FOMM back pages

B Positive – not just a blood group

blood-donor-positive — Image: Ahmad Ardity, Pixabay.com

That cute but corny aphorism came to mind as my friend Mr Shiraz misinterpreted my recent trip to Brisbane as a blood donor emergency. He wanted to know why we were braving extreme weather and I texted (flippantly) “Appointment with Dracula.”

What I meant was we had tickets to Dracula, a production by Queensland Ballet. Dracula aside (one of that company’s best IMHO), you may have noticed there is a bit of a blood donor drive happening in Australia.

The Australian Red Cross (Lifeblood) and individual State health departments are assisting in the drive to replenish blood stocks, as demand reaches a 10-year high. As a recent Facebook post by Queensland Health noted, the shortage is of the greatest importance when it comes to rare blood groups. The post encouraged people with A negative blood to “roll up their sleeves and give generously”.

Such exhortations make my skin crawl, bringing back memories of a daily blood test over a lengthy stay in hospital. My blood group is not that rare, and, despite my life being saved by a blood transfusion in 1969, I have never donated my blood to anyone. Dad, on the other hand, had such rare blood he was on a list to donate in an emergency.

It didn’t happen often, but he would at times get a call (typically at 2.30am): “Mr Wilson, we’re sending a taxi…”

Lifeblood, the donor agency of Red Cross, is on a mission to replenish its blood supplies. It appears that through the pandemic, blood donor numbers had dropped off.

As lockdowns lift in Victoria, New South Wales and ACT, elective surgeries will start again and meanwhile we are just weeks away from holidaymakers taking to the roads, with the inevitable spate of accidents.

The impact of Covid-19 has been felt among blood agencies around the world. A study published by the US Library of Medicine noted the rise of concerns, confusion, and misleading rumours with regards to blood donation during the pandemic period.

“Additionally, due to the government’s interventions such as home sheltering, mass lockdown, and curtailment strategies towards public gatherings amid the COVID-19 outbreak, the arrangement of the voluntary blood donation drives has been debarred. Likewise, there has been a general reluctance of the public to come to the blood centres to donate blood.”

Lifeblood Executive Director of Donor Services Cath Stone said half of all blood donation appointments in Australia were not being attended, while hospital demand was at its highest point in a decade.

“Our donors have shown us incredible support over the last two years; however, as life moves to COVID-normal, it’s important that people continue to donate to help ensure hospitals can continue to treat patients.”

Lifeblood’s reserves of O Negative blood are being challenged, with the number of O Negative donors falling during the pandemic, despite increased hospital demand. O Negative is a universal blood type and can be given to anyone in an emergency.

“Only 9% of Australians have O Negative blood, but it makes up 16% of orders from hospitals because it saves lives in emergencies.”

While Australians are being persuaded to donate, here’s the status of blood supplies around the world.

It is comforting to learn that 97.5% of the global population is covered by organised collecting. Almost 120 million units of blood are donated every year, but as the World Health Organisation data shows, donation rates differ wildly. Some high-income countries see seven times more donations than in low-income countries.

If you have ever been involved in a motor vehicle accident, a brawl or a workplace mishap, you will know that sometimes victims lose too much blood. Transfusions are needed for health conditions including anaemia, complications during pregnancy and childbirth, severe trauma (accidents) and surgical procedures and transplants. Transfusions are also used regularly for patients with conditions such as sickle cell disease.

The WHO and Lifeblood are vigilant about screening donations for HIV and Hepatitis A B and C, to name a few diseases.

A survey in 2018 found that 72 % of countries had a national blood policy. Overall, 64% of reporting countries, or 110 out of 171, have specific legislation covering the safety and quality of blood transfusion. National blood policies are most prevalent in high and moderate-income countries.

There are great variations between countries in terms of age distribution of transfused patients. For example, in high-income countries, the over-60 transfused patient group accounts for up to 75% of all transfusions. In low-income countries, up to 54% of transfusions are for children under the age of 5 years.

In high income countries, transfusion is most often used for supportive care in cardiovascular surgery, transplant surgery, massive trauma, and cancer therapy. In low and middle income countries, it is used more often to manage pregnancy-related complications and severe childhood anaemia.

The WHO has been campaigning to persuade countries which allow blood donors to be paid to switch to a voluntary system. In countries including the US, Austria, Germany and some Canadian provinces, individuals can earn about $50 a time for donating blood. The collecting and warehousing of plasma has become a multi-million dollar business. The main commercial advantage is that plasma can be frozen and kept for up to a year.

Blood is usually separated into three major components: Red blood, plasma and platelets. Red blood has a life span of 42 days and is used for emergency transfusions. Plasma is the colourless liquid separated from blood. It is most often used to treat burn victims and those with bleeding disorders. The main function of platelets is to stick to the blood linings and prevent bleeding. Platelets have a shelf life of five days and are most often used for organ transplants and surgeries.

Musician Mal Webb has been a blood donor for “at least two decades”.

“I recently switched to donating platelets, which means I can do it more often.”

Sometimes even when you want to donate blood, the tight regulations around blood quality can rule you out, as a friend who used to give blood found out.

“Unfortunately, they changed the rules some years ago so if you had been in England for any length of time you might have Mad Cow disease and so couldn’t donate.

“I was disappointed as I felt good giving blood, knowing I was helping other people.”*

There are examples of physicians experimenting with blood transfusion on animals as far back as 1668. The current system can be traced back to the early 19th century, In 1918, British obstetrician Dr. James Blundell performed the first successful transfusion of human blood to treat postpartum haemorrhage.

Lifeblood and State health departments face an uphill battle trying to convince Aussies to give blood. Although one in three Australians will need a blood donation in their lifetime, only one in 30 give blood every year. It seems it was always thus, though. An article in the Sydney Morning Herald in September 1949 spoke of a ‘blood donor crisis’. The article quoted a NSW Red Cross spokesman.

“Our most urgent need is to make members of the public realise that their blood is worth bottling,” the spokesman said, hijacking a WWI term more often used as the ultimate compliment on a job well done.

If you haven’t donated blood for a while or had never even considered it, here’s a handy link: https://www.lifeblood.com.au/blood

Tell them FOMM sent you.

*People who lived in the UK for more than six months between 1980 and 1996 are ineligible to give blood due to Mad Cow disease.

A Free Education – the Whitlam Legacy

free-education-whitlam — Students protesting about abolition of free education Image courtesy of www.solidarity.org

I will be forever grateful to the late Gough Whitlam for allowing me an opportunity to pursue a free education. I was 30 at the time with no qualifications and a chequered work history. My future lot in life was looking like casual labourer/dish pig. Not that there’s anything wrong with good honest sweat of the brow. But my undoubtedly sharp mind was frustrated by menial work and I was at a roadblock.

At the time unemployment was high and I was struggling to find any kind of work. I’d left school at 15 and had been in constant employment ever since, most of it unsuitable, apart from a three-year stint as a trainee psychiatric nurse.

Then came the concept of a mature-age tertiary degree or the prospect of studying screen-writing at the Australian Film & Television School. The latter proved a hard nut to crack, so I opted for a three-year course in journalism and media studies. What a journey. There were four school terms in a year at the time, so I figured by Easter of the first year I’d know if I could cut it or not. My results were mostly A’s and B’s so I knuckled down to full-time study, hammering out assignments on an ancient Olympus typewriter picked up at a police auction.

My student colleagues wasted no time explaining the privilege of a free university education. In 1974 it had been ushered in as one of the first in an astonishing array of social policy reforms by one Edward Gough Whitlam, without doubt our most controversial politician.

Yesterday was Remembrance Day but also the 46th^t anniversary of The Dismissal, the fateful day in 1975 when the Queen’s representative in Australia, John Kerr, sacked a sitting Prime Minister. Gough Whitlam came to power in 1972 with the memorable campaign ‘It’s Time’. And it most certainly was. In a few short years Whitlam and his government dragged Australia out of a 1950s mindset into the era of afros, paisley shirts and flared jeans.

Most people under 50 are unlikely to know this story unless they studied law, politics or social policy at university. On Labor’s election, Whitlam and his deputy, Lance Barnard, formed a duumvirate (a two-man cabinet). They then spent two weeks working on a massive amount of draft legislation. If you are of my generation, I suppose your life experience will dictate what you think is the crowning achievement of these social reforms.

For me it was a free tertiary education. For women (or men) going through an ugly divorce, it was the single-parent pension.

Regardless of a ‘free’ education, the life of full-time student was a pauper’s existence, devoting most of our time to qualifying for a job-related degree. I recall doing a deal with the university bookshop and my local dentist to pay off my debts in instalments. Meanwhile, I played guitar in a bush band, worked as a free-lance journalist and took casual jobs when I could.

It is now 32 years since free tertiary education was scrapped by Bob Hawke’s neo liberal Labor government, to be replaced with the Higher Education Contribution Scheme (HECS). While Whitlam’s nemesis, Malcolm Fraser, tried ending free education in 1976 and again in 1982, it was Hawke who killed it off in 1986 by introducing a first-ever student fee. The Hawke government abolished free education by stealth, first with the $250 admission fee when students enrolled, then a fee system for international students before progressing to HECS in 1989.

The scheme began modestly, charging students a ‘proportion’ of the cost of their education. This morphed into open slather in 1994 when Labor allowed universities to ‘charge what the market would bear’, for tertiary courses.

As Tom Fiebig wrote in the socialist newsletter, Solidarity, a typical university student today will graduate with a $20,303 debt. Some 150,000 students now have more than $50,000 in debt.

Under HECS, students were given interest-free student loans, most predicated on not being due for repayment until one’s income reached a certain level.

So that was just one little thing that Whitlam and Barnard did, not nearly as universally acclaimed as the Medicare model. There was so much more: they abolished conscription, ended capital punishment, introduced no-fault divorce and a single-parent pension and started talks on Aboriginal land rights. There was equal pay for women, Legal Aid, the Federal Schools Commission, major subsidies for the arts and the National Sewerage Scheme, which put an end to Australia’s night cart collection system. While we are still today debating the need for an appropriate anthem, Gough got things started in 1972, giving God Save the Queen the flick and opting for Advance Australia Fair.

Whitlam finished our involvement in the Vietnam War, bringing the Australian Army Training Team home. Most troops, including conscripts, had already been withdrawn by his predecessor, Billy McMahon. What is not so well known is that when abolishing conscription, Whitlam arranged for the release of seven men who were in jail for refusing to go to war.

As one might expect when a new leader is stirring up a stagnant system, Gough Whitlam had his critics. He was hardly to blame for the 1970s global oil crisis, rampant inflation, lengthy recession and massive unemployment. But those disruptive events made Whitlam an easy target for those who successfully branded his government as poor economic managers.

I have chronicled many of these events in a song, ‘When Whitlam took his turn at the wheel’, which we posted on Bandcamp yesterday.

I did not have room for a verse about the ‘Blue Poles’ incident. Whitlam had opened the National Gallery, which wanted to purchase a modernist painting by Jackson Pollack. The asking price was $1.3 million (at the time a third of the gallery’s annual budget). The gallery director needed the PM’s personal approval. Although he did not need to make the purchase price public, Whitlam did so, creating a political and media scandal. Alternatively, it symbolised his foresight and vision (or his profligate spending). In 2016 there was a fresh furore when Victorian Senator James Paterson urged the government to sell Blue Poles (citing an insured value of $350 million), to reduce debt.

A fine orator and debater and a compelling public figure, Gough Whitlam went well on the international stage. He was the first PM to visit China, but as the song says – ‘today nobody knows’.

(Satire)

Here’s a short transcript from an interview with a sympathetic community radio station.

Natasha: Welcome, Comrade. So what made you think about writing this song, Bob?

Bob: Well, Natasha, I read a few stories recently which observed that it was the 7^th anniversary of Whitlam’s death. I started thinking about the legacy that he’d left and how today’s generation is probably blissfully unaware of his achievements”.

Natasha: You have written in a previous episode of FOMM that you met Gough one time and that it did not go well?

Bob: I made the mistake of handing him my card from the Courier-Mail where I was employed as a business journalist. He looked at the card, made a scathing comment about the newspaper’s campaign against historian Manning Clark, gave my card back, turned and walked away.

Natasha: You don’t mention that in the song, although you do take a swipe at Gough’s vanity?

Bob: Yes, he probably would have thought the song was about him.

Natasha: Thanks, Bob Wilson. This is Socialist Songs Hour and here is that song, When Whitlam took his turn at the wheel.

You can listen to the song on our Bandcamp page https://thegoodwills.bandcamp.com/ and if you like, add it to your digital music collection. Share with your friends.

Country of origin labelling under review

counhtry-of-origin-labelling — Image: An example of what some might like to see in revised country of origin labelling: source The Conversation

I discovered only in the last year or so that up to 70% of ham and bacon sold in Australia is imported from Europe or the US. Your regular supermarket no doubt helps out by labelling pork products so you know what you are buying.

For example, ham off the bone is almost always produced in Australia. Cheaper cuts and processed ham and smallgoods may contain up to 70% of imported pork. Australian Pork Limited recently found that 10% of shoppers admitted they failed to check or were unaware of country-of-origin labelling.The survey was carried out to support an awareness campaign in South Australia.

While all fresh pork sourced and sold in Australia is locally grown, Australian Pork Limited CEO Margo Andrae urged shoppers to identify Australian ham and bacon products.

“Consumers should check the bar chart on the country-of-origin label, located under the green and gold kangaroo. The bar chart must be almost full or have a percentage of at least 90% Australian ingredients, to guarantee the pork is Australian.” Australian Pork Limited is one of many organisations which has made submissions to a review in 2020 of the country of origin labelling regime. The Department of Industry, Science, Energy and Resources was aiming to complete its report by July 2021, but so far it has not been publicly released.

Labelling laws were introduced in July 2018, after a furore surrounding a case in 2015 where consumers contracted Hepatitis A from frozen berries imported from China and Chile.

Country of origin (CoOL) labelling requires the food product to contain a label with information stating the percentage (by weight) which is (or is not) Australian made.

For example, a label might read : “Made in Australia from less than 25% Australian ingredients.” The ideal, for those who believe our food is best, are declarations like “made in Australia from 100% Australian ingredients” or “Grown in Australia”.

Consumer organisation Choice, which campaigned for CoOL labelling as early as 2015, also made a submission to the review, voicing concerns aired by subscribers.

“Consumers want to identify whether a product is local or not. However, if a product is not local or has overseas ingredients, consumers want to know the origin of these ingredients. Highlighting the proportion of Australian ingredients does not satisfy the statement ‘country of origin’ nor does it meet consumers’ expectations of food labels. For example, claims such as ‘Made in Australia from at least 25% Australian ingredients’ still leaves consumers in the dark as to where the remaining ingredients come from.”

Other improvements sought by those lobbying the department are to extend labelling to ‘non-priority foods’ which includes biscuits and snack food, confectionery, energy drinks, soft drinks, tea and coffee and bottled water. As you might expect, almost all of the 20,000 Choice subscribers surveyed for this submission said that knowing where the food and drink they buy comes from is important.

More than 90% of respondents use country of origin labelling to make decisions when buying food at the supermarket. About half said they use the labels “frequently” and 40% use it “every time”.

The CoOL scheme is administered by the Australian Consumer and Competition Commission (ACCC).

When you delve into this topic a little, it does not take long to find that imported foods take up a lot of shelf space in our supermarkets. This is particularly so for the Indian and Asian food shelves and the pasta and sauces section.

For example, when you wheel the trolley (with two wheels veering in opposite directions) into the fish aisle, here’s your dilemma.

Australia dropped out of the canned tuna business a decade ago, finding it too hard to compete with product from South East Asian countries. Countries like Thailand, where most of our canned tuna comes from, have geographical advantages over Australia and a low-cost processing and production chain.

As for canned salmon, sardines and the like, we go top shelf. We may have fallen for the advertising (bears fishing for salmon in fast-flowing Canadian rivers), but we figure the only difference between the pink or red salmon consumed in the wild by bears is that ours comes in a can (and our feet don’t get wet).

According to the Department of Agriculture, 70% of edible fish consumed in Australia is imported from Asia or New Zealand. This may sound arse-about, but Australia exports about half of its annual fisheries and aquaculture production by value ($1.5 billion in 2019-2020). A report by ABARES describes our export trade as “specialising in high unit value products for the growing Asian market”.

“Australia’s reputation as a reliable and high-quality supplier of high unit value fisheries products, and its proximity to Asia’s fast-growing seafood market, generally insulates Australia’s trade in fisheries products from longer-term shocks. The pandemic has caused some disruption to Australia’s usual trade, particularly for products that are highly export oriented, such as rock lobster and abalone.”

The Buy Australian Made campaign has its adherents, most subscribing to the philosophy that it creates and sustains local jobs. A friend became quite incensed recently on discovering that the can of evaporated milk she had bought was imported from Mexico. Irate, she rang the parent company to complain.

“Why can’t we make it here?” she said (to me).”

She has a point, when you consider that condensed milk is just dairy milk with the water removed and sugar added.

It wasn’t too hard to find out that we did indeed make both evaporated and condensed milk at a factory in Victoria. The owner, Nestle, announced the phased closure of the factory in August 2019, with the loss of 106 jobs.

General Manager Andrew McIver, reflecting on the decision to close and move production to Nestle’s overseas factories, said: “People just don’t buy tinned milk like they used to, and cheaper imports have eroded our business further.”

Dairy Australia says imported milk comprises about 2% of Australia’s dairy imports, mostly specialty cheeses from New Zealand and Europe.

Should we really care too much about where food comes from? Some years ago, I bought a packet of frozen peas from a supermarket, not even looking or thinking about country origin. I got the bag home and read “Produce of Poland” on the label. Then I checked the map and found that Poland is just 709 kms from Chernobyl, the site of a nuclear plant meltdown in 1986.

Said packet of peas came in handy when I injured my knee (against the corner of my desk), but eventually I threw it away.

There have been enough high profile incidents of food recalls over the years to raise our levels of awareness about the risk of contamination.

Food Standards Australia and New Zealand (FSANZ) says that food recalls averaged 76 a year between 2011 and 2020. While we are all aware of cases where recalled food was contaminated by salmonella, listeria and e coli, these are in the minority.

Almost half of the recalls in 2020 were foods with ‘undeclared allergens’ (e.g. milk, eggs, peanut). Of these recalls, just over half were imported food products. Anyone can sign up to FSANZ to receive food recall alerts

Should you be unfortunate enough to buy a recalled food products before it it removed from the shelf, the advice is to return it to the retailer for a full refund.

Or, like the peas from Poland, you could just chuck it out.

The joys of gardening

joys-gardening-company — (Photo: SWPAG (aka Laurel Wilson, suitably attired for gardening – the T-Shirt quote says ‘Economic Rationalism Isn’t’)

This week, determined to write something without uttering the C word, I decided on a blow-by-blow description of our efforts to establish a garden. Great minds do think alike, apparently, as The Conversation published a timely piece on Monday. “It’s a great time to try – a vegetable patch.” The Conversation’s thrust is that we (the people) have more reason now than at any other time in recent history, to grow our own food. If you take heed of the dire warnings from the International Monetary Fund, by the time the global recession really kicks in, it will be harvest time!

My thumbs have definitely greened over years of associating with She Who Plants and Grows (SWPAG). In the early days, keen to be seen as doing my bit, I weeded down the narrow but sunny side of the house. Alas, the two weedy-looking plants I ripped from the ground were tamarillos, planted by SWPAG. There was a degree of cold shoulder for a while. Mollified, I tried a parody – “I’m sorry I killed your tamarillos, every night I’ve been hugging my pillow”.

You had to be there.

We always planned to build small vegie gardens in the relatively small back yard of our new abode on the Southern Downs. We went down to the Big Green Shed and spent the equivalent of a months’ worth of fruit and vegie supplies on above-ground garden beds, compost, manure, cane mulch and assorted seedlings.

Then we set about building the first of the timber, no-dig garden beds. After a considerable amount of finessing and swearing, we concluded that the metre-square pre-cut garden beds were not at all precise.

By trial and error we put the first one together, using a battery-powered screwdriver and a hand-held Phillips head screwdriver to finish the job.

The swearing started with repeated attempts to get the box level.

“Next time let’s get the ground level first,” I suggested.

There’s a recipe to follow when making a no-dig garden bed. First you build a layer of small twigs and branches for drainage, then a layer of cardboard. Next a layer of cane mulch, then a bag of manure, another layer of cane mulch, a layer of our very own compost, husbanded (and I use the word correctly), from our own vegetable and fruit scraps, lawn clippings and anything compostable that wasn’t a weed. Then more layers – cane mulch, manure, compost and then more cane mulch. Finally, SWPAG said: “That’s enough.”

We stopped for a cup of tea and a biscuit, which turned into an hour-long bout of stooging about the house complaining about various aches and pains and watching last week’s Gardening Australia.

Later, we watered the new garden and let it sit. Magpies appeared from nowhere and started foraging around the edges where we’d stirred up all kinds of magpie food.

That was Friday. Night fell and we watched the latest edition of Gardening Australia. This truly national show has something for everyone, no matter where you live, even this peculiar temperate/arid zone where 100mm of rain in a day leads news bulletins.

On Saturday we decided to spice up the day with a trip to the dump. The fellow at the boom gate (1.5 metres away), said “Not another load of garden waste!”. (It’s the new excursion in these ‘iso’ times. Ed)

We got up early on Monday morning and set our minds to building the other two garden beds. Now that we knew what we were doing (Ed; LOL), in no time at all we had three above-ground garden beds. The magpies were ecstatic and the dog christened all of them.

Our fledgling herb garden, established a few months ago, was contained elsewhere in a dozen pots of various sizes. Curiously (I thought), SWPAG tasked me to move the 12 pots, strategically positioning them inside the second above-ground garden bed.

“So we didn’t really need the second bed?” I ventured, without a trace of criticism or sarcasm.

“Yes we did – it looks tidy that way”.

The thing about gardening, it has to be regarded as a hobby, because financially (the wooden boxes alone cost $147), it makes no sense at all. But it’s great for your mental and physical health, gives a sense of accomplishment and creates convivial times spent outdoors. Best of all, you have something to show for your labours.

I mentioned Gardening Australia – despite the obvious expertise of the presenters, it baffles me how few of them wear gloves or dust masks when handling compost, gypsum, dynamic lifter and a host of other elements added to the soil.

The harmful bacteria and fungi in potting mix have been known to cause lung ailments such as Legionnaires’ disease or Histoplasmosis (the latter a fungus that lives in parts of the US, Central and South America, Africa, Asia, and Australia).

The risk is accentuated if you store bags of potting mix in a moist and warm environment where fungi can multiply. This article in The Conversation qualifies the warning by adding that the risk of contracting lung disease from using potting mix is slim. Nevertheless, I wear a dust mask when using potting mix, cane mulch or any soil additive that gives off dust. SWPAG takes it one step further and wears a respirator.

Sometimes, breathing noisily, she complains in a muffled voice (like Dark Helmet in the 1987 Mel Brooks spoof, Spaceballs):

“I can’t breathe in this thing.”

Wearing gloves is a sensible protective measure. If you are a guitarist (or a person who likes to cultivate long nails) it will protect them from damage. If you have any tiny cuts or abrasions, gloves will guard against picking up infection, or worse, tetanus. There is a vaccination one should have to guard against the latter, a serious bacterial infection that causes muscle spasms.

Even Good Housekeeping magazine got in on the gardening hazards topic, warning gardeners against everything from Lyme disease (we don’t have this in Australia, or so it is said), heat stroke and poisonous plants to a stern warning about harmful chemicals used in lawn and garden care products.

Robyn Francis of Permaculture College Australia, on the other hand, says people should get their hands dirty and soak up the serotonin in the soil. She cites research that “dirt-deficiency in childhood is implicated in contributing to quite a spectrum of illnesses including allergies, asthma and mental disorders.”

No need to be more paranoid than we already are, folks. Be like Bob – wear a hat, mask and gloves and stay 1.5 metres away from potentially hazardous substances.

Which reminds me of the time a friend was staying with us in Maleny and helped SWPAG plant an edible fruit tree down the back of our half-acre block. Just as they neared the bottom of the hole they’d prepared, a large hairy spider jumped out, rearing up and showing fearsome fangs. To this day they ae not sure if it was a deadly Funnel Web or the less harmful but no less scary Trapdoor Spider.

Risks aside, you could do worse, in this strange time we Australians have abbreviated to ‘Iso’, than to establish a small vegetable and/or herb garden. If, like so many city folk these days, your back yard is small, fear not. Josh from Gardening Australia has (almost) the last word.

FOMM back pages:

Splendid isolation in the time of COVID-19

Isolation-COVID-19 — Two wallabies practising social distancing (in Wodonga, Victoria)

As we drove 1,200kms in haste from Albury NSW to the Southern Downs, trying to escape Queensland border chaos, I was grateful for readers’ insights into COVID-19 and isolation. First of all we should credit Sandy W with the witty caption for this week’s photo.

Realising I’d be spending three days driving home before resigning ourselves to self-isolation, I asked FOMM readers for their thoughts on this health crisis. I was overwhelmed with responses, so will keep some back for next week’s quarantine episode.

Two readers sent me the same meme which essentially says:

“Your grandparents fought in a world war. All you’re being asked to do is sit on the couch. Don’t fuck this up.”

The meme memo was a bit too late for the hapless authorities who allowed 2,700 people to disembark from the Ruby Princess and mingle amongst the crowds in Sydney’s streets, shops and nightclubs; 130 passengers have since tested positive to COVID-19.

Yesterday we began 14 days’ voluntary home detention, mindful that we have been travelling through rural NSW in recent weeks.

King Richard of The Village said self-isolation is ‘great’.

“I’m enjoying the time to do all those jobs at home that I put aside for another day. We visit the IGA late in the evening when we need to and keep in touch with friends by phone. It’s a bit like my childhood memories of World War II and self-sufficiency.”

I asked our musician friend Silas Palmer how his gigs were going: “Six major festivals and a lot of small events, all cancelled but we’re in the same position as everybody else.”

“But we’re practicing a lot,” he added gleefully.

Katie Bee self-deprecatingly said: “So far the trickiest thing for me is that with so many things I CAN do, and so much time to do them in, my procrastination knows no bounds!

“But I’m finding myself a little more often on FB, and keeping in touch with friends by phone or email, and am gradually doing jobs that normally never enter my consciousness, after which I reward myself with some Netflix.”

Superchip from Calgary said that having been raised on a remote prairie farm in southern Alberta, isolation was not something that caused him great angst.

“I do not consider my formative years as being spent in social isolation, but I did spend a lot of time alone. I learned how to make my own fun. I learned how to just sit and try to take in my surroundings. I enjoy the company of other people, but I don’t need it on a constant basis. Given the state of the world at present, I feel I am one of the lucky ones. Getting past the pandemic will not be a mental challenge for me.”

Anne and John are self-isolating, which means missing out of physical contact with grandchildren.

“We are missing our music session, our book clubs and exercise classes,” Ann said. “Our little granddaughter (supposed to be keeping to her school routine at home), Zoomed us this morning and tried to teach us some origami to keep us occupied…..argh!”

Barbara is coming to terms with strict tests and limits in her home, the Independent Living Unit section of an Aged Care Facility.

“The impact of the virus has radically changed our lives in the past couple of weeks, but particularly in the past couple of days. All entrances other than the main one to our Residential Care Facility were closed last week; entrance restricted to two only visitors at a time (who have their temperature taken and are then asked to use hand sanitiser). This test has now been extended to delivery drivers visiting the facility.

Despite the constraints, she does not feel out of touch with the world.

“My IPhone is in full use. I can have uke jam sessions with friends; enjoy the light hearted Facebook posts and many, many things to keep my day full.”

A few of my readers appear to belong to the introvert club (we are apparently supposed to teach extroverts how to handle this).

Roger Ilott has been a professional musician and sound engineer for more than 30 years and is not fazed at all.

“As the ultimate stay-at-home, this is fulfilling a lifelong ambition of mine – I’ll never have to go out again!

“I actually always just wanted to be a session musician and did quite a bit of that in the 1970s and 1980s. Since Penny (Davies) and I started our own folk music label back in 1982, I’ve been able to do loads of session work as well as performing. I’m happy all my days sitting in the studio recording (and in cricket season, streaming the Sheffield Shield while I record!).”

After eight days in isolation, Ruth realised this was very similar to how her life has been for the past eight years, caring for her husband who had a serious stroke.

“I have come to this realisation after speaking to family and friends on the phone, some of whom are expressing angst and frustration. On listening, I realise I don’t feel like this at all. I am actually loving it. Loads of time in the garden( work and pleasure), heaps of time for photo sorting and sending, enjoyment in doing things I NEVER do, eg, cleaned all our windows inside & out the other day!”

Choir enthusiast First Soprano said that self-isolating for a couple of weeks would be easy as long as you prepared appropriately.

“Social isolation, as we know, is not a healthy situation (and unfortunately, unlike the Italians, we don’t live in high-rise flats; Italian city folk have been able to continue “socialising” from their balconies, which actually looks like lots of fun and would certainly keep spirits up), but happily in this day and age we have Skype and FaceTime so we can still easily keep in touch with family and friends.”

Jim from Albuquerque said life in the time of Corona had made a difference in his working class neighbourhood.

“Both friends and neighbours with either high or low paying jobs are on furlough or worse. Some better compensated than others in time-off but all paddling the same boat. Neighbourly relations are conducted at a safe remove but with a higher content of cordiality: Hey, howya doin’?; Feelin’ OK?; Need anything? Toilet paper?”

“Mercifully, no one is sick.”

Jon from Vancouver Island says there is always plenty to do on his little farm in what is often regarded as Canada’s Riviera.

“Spring has just arrived, which means preparing the garden for the upcoming season. Like many, I shudder when reviewing my market stocks but this brings with it a modicum of patience, realizing that fixing this up effectively is beyond me.”

Ms Proodreader, who lives alone, said she is enjoying the interaction with virtual choirs and musicians sharing online.

“I’m mostly staying upbeat but I’m prone to little bursts of panic. I’m very much keeping away from all media….. especially social media…… as there is so much misinformation and I just need to know the basics not the analyses and the what ifs.”

Yeh I’m with Proodie on that one. There is a lot of misguided and possibly inaccurate information being spread on social media by people who should know better. The mainstream media is completely obsessed and helplessly looking for any new angle.

As for the free papers left in the letterbox – wash your hands after reading.

Postscript: You might enjoy Erin Sulman’s Apocalypse Playlist. If you do have a listen, track 30 is Warren Zevon’s Splendid Isolation. It was recorded live in Brisbane in 1992 – you can probably hear us and Prince Richard of the Village cheering.

Last drinks at the Paradise Motel

alcohol-last-drinks — Image: Michael Jarmoluk, Pixabay.com

As I gave up drinking alcohol some 36 years ago, it was probably not surprising I forgot the essential ingredient for a house-warming party.

“Um,” said She Who Trusted Me with the Catering, “What about the ice – for those who are bringing something to drink?”

Off I went on a mercy dash to buy a bag of ice. The first guest had arrived before I returned and showed me the best way to prepare ice for an esky (drop it on the concrete driveway).

There was quite a bit of wine left over at the end, which suggested our guests were moderate drinkers (or intended that wine be left for mine hosts). In all, it was an enjoyable christening of the Paradise Motel (named after one of my more fanciful songs).

My mind turned to this subject with a timely new report from the Australian Institute of Health and Welfare about the effect of drugs and alcohol on the health of the general public.

This intersected nicely with an observation made by an emergency medicine veteran. His view was that if everyone gave up drinking alcohol and taking illicit drugs, Emergency Department staff would then have ample time to care for people who are genuinely sick.

The National Hospital Morbidity Database showed that in 2017-2018, there were 136,000 same day or overnight hospital admissions for a drug-related principal diagnosis. On its own, alcohol accounted for 53% of these admissions. No prizes for speculating about the other 47%.

Ah, you are thinking, the wowser’s view: “all health problems caused by drugs and alcohol are self-inflicted.”

Perhaps the ER veteran’s views would also include people whose health has deteriorated over time as a result of smoking tobacco.

The AIHW report confirms a noticeable decline in the use of tobacco in the 14 and over age group (from 24.3% in 1991 to 12.2% in 2016). Despite this impressive statistic, smoking is still the leading cause of cancer in Australia (22% of the cancer burden).

Alcohol abuse, however, is a far more worrying problem. The World Health Organisation found that 3 million deaths result every year from harmful use of alcohol (5.3 % of all deaths). The harmful use of alcohol is a factor in more than 200 disease and injury conditions.

It is generally accepted that (excessive) alcohol consumption and its aftermath contributes to more than 6000 deaths in Australia every year.

You’d never know it, but sometimes in the privacy of our own lounge room, we watch the reality TV show, RBT (the ex-probation officer and the (sober) ex-journalist relishing the opportunity to make snide comments). We did sympathise to a degree with the young chap who freely admitted to using cannabis every day (‘but I don’t drink alcohol at all’). Nevertheless the law finds that he is still driving under the influence and he thereby paid a price.

A month or so ago I had to drive to Toowoomba for the day and was stopped by a roadside breath test crew. Did I say this was at 9.10am on a weekday? She Who Still Enjoys a Drink or Two observed that such roadside blitzes often catch people who are still over the blood alcohol level limit after a night of partying.

The AIHW report found that while the majority of Australians drink alcohol, the overall daily intake is on a downward trend. The proportion of people drinking in excess of lifetime risk guidelines continues to decline.

The apparent consumption of alcohol in 2017-2018 was equivalent to an average of 2.72 standard drinks per day per consumer of alcohol aged 15 and over.

That is a fair way below the binge drinking and ‘pre-loading’ that goes on among the must-get-drunk-to-socialise cohort.

Almost 40% of Australians aged 18 and over exceeded the single occasion risk guidelines by consuming more than four standard drinks in one sitting. About 1 in 6 (17.4%) Australians aged 14 and over put themselves or others at risk of harm while under the influence of alcohol in the last 12 months.

I guess these are the people the RBT teams are out to catch.

Alcohol consumption inevitably increases on festive occasions like Christmas, New Year and public holidays like Australia Day. Special birthday and anniversaries are also vulnerable times for those who find it difficult to stop after two or three.

So how much is too much? The Australian Bureau of Statistics defines binge drinking as more than 7 drinks a night for men, and more than 5 for women. The NHMRC Australian Alcohol Guidelines defines excessive drinking as more than 4 standard drinks per night.

So how did we all go after those festive season parties? Many start at home and stay there. Others start with a few at-home drinks (sometimes known as pre-loading), before partygoers wisely catch taxis to the next venue, where the drinking continues.

Drink-driving laws have done much to help drinkers self-regulate. Many of the people stopped by officers on RBT were consciously monitoring their drinking.

But not everyone is as keen to avoid losing their drivers’ licence. In my court reporting days for a daily newspaper, I recall cases where the defendant was found to have a blood alcohol level of (extreme example) 0.34 – quite a long way beyond the Australian limit of 0.05). Quite often people with this level of blood alcohol have been found asleep at the wheel of a stationary vehicle (and a jolly good thing too).

Not that it should fall to me to make such withering observations, but I sometimes wonder how the evening ended for three young women, so much under 18 and under the influence after the footy (about 10pm) that they took off their high heeled shoes and wobbled down Milton Road.

“Are we going clubbing?” I heard one of them ask a less-than sober friend. “Do you reckon we should we catch a cab to Valley or walk?”

Given that a round of four beers at the footie will set you back $40 or so, this type of drinker is unlikely to belong to the ‘average’ household that drinks $32 worth of alcohol per week. Did you notice that the NIHW report implicates adolescents as young as 14? In a country where the legal drinking age is 18, this implies that older friends (or family) are buying alcohol for the under-agers.

The AIHW report found that 9.1% of adolescent males and 6.8% of females aged 12-17 exceed the adult guidelines for single occasion risk.

Young people are arguably more likely to be influenced by alcohol advertising at major sports events, prompting targeted opposition from alcohol education lobbyists.

You might have heard tennis ace Nick Kyrgios say to John McEnroe after Tuesday’s night’s Australian Open win – ‘he’s had too many beers’ – a response to a spectator who yelled out something incomprehensible.

The National Alliance for Action on Alcohol is taking on the Australian Open, urging organisers to consider the role of advertising in youth drinking. An e-petition to this effect has so far gathered 151 signatures.

Another critic observed: “…exposure to alcohol advertising places children at greater risk of drinking earlier and at more dangerous levels than they otherwise would.”

This is a long way from my youth in 1960s rugby-mad New Zealand, where drinking beer to excess was considered to be a badge of manhood. It’s not, but I guess the statistics in 2020 show that more of us realise that now.