Opportunity Cost

Opportunity cost.  For those of you who have never studied economics you’re probably wondering what is opportunity cost?  And no, it is not some shopping styled reality game show.  Wikipedia defines it as “when an option is chosen from alternatives, the opportunity cost is the "cost" incurred by not enjoying the benefit associated with the best alternative choice.”  In terms of COVID 19, we have to ask what is the cost of this hard lockdown?

 It is a very hard question to answer as trying to predict what would have happened given different choices is like trying to predict the future, and the opportunity cost is far more than just an economic one.  I will list a few of the costs but this list is by no means exhaustive and if you feel like I missed something important, let me know in the comments.

The first cost is mental health.  Australia, and in particular Victoria, has had a massive cost of lockdown.  According to a report released by University of Sydney’s Brain and Mind Centre Australia will have a minimum increase in suicide rate of 13.7% for the next five years. But the problem will go far further than that.  We will also see a marked increase of the amount of people who will need to be treated for depression, anxiety and other mental health disorders and still it goes further.

 

People don’t talk much at the moment and not just because of the restrictions, there is nothing to talk about.  Everybody is bored and miserable and there is nothing to look forward to.  This will lead to in household conflict, family disfunction and domestic violence and the damage could take a generation to fix.

 

Secondly is simply just health.  Elective surgeries have been postponed indefinitely.  This may sound okay, but those elective surgeries aren’t going away and it’s not like the list of people needing surgery is simply going to stagnate.  It’s going to get bigger and people are simply going to have to wait longer and the wait isn’t like waiting for uber eats.  Many of these people will be in pain or discomfort, having to take medications just to get through the day.  It goes further than that too.  The longer people wait, the more chance a minor surgery will turn into a major surgery. 

 

People are also delaying seeing the doctor for minor ailments as well which could lead to big problems later.  For example, I recently went to the dermatologist because I had a mole I was concerned about (don’t worry, it was nothing) but whilst I was talking to the doctor I asked if she was busy at the moment.  The answer was no, not at all.  In fact, appointments were down about 30% with people waiting for lockdown to finish.  I found this concerning.  A mole can go for something easily treatable by a small procedure to something that will kill you in weeks, comfortably less than the lockdown period.  I also heard that some important hospital wards, including bone marrow transplant wards, were either closed down or working on diminished capacity.

 

Third is the sacrifices of life.  Right now, forget going on holiday if you live in Victoria.  You can’t even go out to the movies, for dinner or even see friends.  Personally, I haven’t seen my mother in eight months and that hurts.  Even the most introverted and cautious of us have a need for human interaction and an element of curiosity.  As humans it is built into our DNA and to deny it is retard our development and our progression through life.  

 

Forth, the economy.  For the first time in almost 30 years, Australia is in a recession.  Not just any recession, this recession is set to be one of the biggest in history and there is no way to sugar coat it.  It is going to hurt and that’s a fact, but how much is the question.  The longer we are in lockdown, the bigger the problem is going to be so there is a massive opportunity cost of lockdown.  The issue is we know what the cost of the virus is.  There is a very real cost in terms of sickness and death.  The economic cost is much harder to quantify.  The harder our economy is hit, the harder it will be to respond to other issues that may arise in the future.  We do not know what these issues will be but I can guarantee you, we will have them.  For example, it may impact our ability to respond to future bushfire crises or upscale aged care facilities to allow Australians a higher quality of living during their twilight years.  These issues will also cost lives but the number is impossible to quantify.

 

The economic opportunity cost also highlights by the massive disconnect in our political system.  Right now we have six state and two territory governments calling the shots and a federal government paying for it.  See the problem?  State governments are all about defeating the virus, consequences be damned.  On the other side we have a federal government worried about how the hell are we going to pay for it and how we are going to emerge from the backside of this pandemic.  No matter what, it is going to take us years to pay it back and no matter what the states do now I guarantee you it is not going to stop the states crying poor and ask the federal government for money in the future.  There is an easy answer to this.  100% responsibility and accountability lying with the federal government.  It is logical, pragmatic and cost effective.  Most importantly it is democratic.  Everyone in Australia has voted for the federal government, yet a state like Queensland is making decisions that effect the rest of Australia, yet the rest of Australia didn’t get a say in the Queensland government.  Annastacia Palaszczuk, your arrogant, politically narcissistic and self-absorbed behaviour would better serve Australia if you were on the dole.  Keeping your borders closed is crippling Australia for your own political gain.

 

Lastly, I believe that the lockdown is sacrificing our values.  It is unaustralian to lock ourselves away and not help.  States like Queensland have simply closed their borders as if to say “Bugger off the rest of you, we’re okay and the rest of you can suffer.  Oh and whilst we’re at it we’ll steel your grand final and pretend we’re doing you a favour.”  Annastacia Palaszczuk, you might say you’re here to help and you’ll do what you can and you feel for Victoria but we’re not buying your political rhetoric.  

 

On a micro scale we have also been forced to sacrifice our values.  Last week Victoria was hit with gale force winds. Many suburbs were left without power and water for days, including my in-laws.  My in-laws are also old school so they do not have internet or a mobile phone.  They were isolated and we could not go and check on them because they were outside of our 5km exclusion zone.  We had a choice, do what is right and go and help or obey the rules and let them fend for themselves all alone.  The problem was sorted out eventually and I’m not going to tell you how.  

 

I’ll also give you a macro example.  California is currently experiencing bush fires and they have asked Australia for help.  All the states have been very limited in their response citing COVID19 as the reason.  Victoria is not sending anyone.  Sure, there is an added danger and complication but is that a reason to sacrifice our values?  Are we going to turn our back on helping just because we’re scared of COVID?  The firemen we would send would be fit and healthy individuals who would be at a minimal risk of COVID and each of them would know the risks and have the right to say no.  But, I guarantee you that they wouldn’t because unlike government that can turn there back on Australian values, individual Australians wouldn’t, it’s simply not in our nature.  Sending people to California would also have no impact on our own COVID response and people that went would simply need to quarantine when they got home.  To compromise our values is akin to selling our soul to the devil.

 

Until next time,

 

Stay well

Border Issues

Let me start by saying this.  In terms of pandemic management, geographical segmentation is a really smart idea.  Preventing people from moving from area to area is a really smart idea in controlling the spread.  This means that any outbreaks are contained to a specific area and therefore are much easier to control and also keep people outside the area safe.

Australia has done this but we have not done it well.  Our primary form of geographical segmentation is the states.  In this post I’ll go on to explain why this is a bad idea and potentially even dangerous but first, to give some context, a little history lesson.  Why did the states set up the way they did?  

Originally, there was one colony, Sydney, and this had jurisdiction over all of Australia which back then was known as New South Wales.  Over time, new colonies were set up and given the distance between them and the fact that even any meaningful communication between all of them could take days, each colony was given it’s own jurisdiction.  Way back in the 1800’s it was essentially a huge land grab by each colony to control as much land as possible and long and the short of it was the state boundaries were born with each area being responsible for its own governance.  In all the research I have done for this I not once found anything that has said that the state borders need to be set up with pandemic management in mind.  As a result, it is a really bad idea.

First, the states are too big.  I’ll use Victoria for the example.  At the start of the second wave, all of Victoria were under the same restriction and the only closed borders were on the borders of Victoria.  Melbourne had the outbreak. The fact that Melbournians were aloud to travel to rural Victoria spread the virus around the whole state.  If the border had been placed around Melbourne from the start, rural Victoria would have been able to safely go about their business with only minimal restrictions and those close to state borders would have been able to travel to other states too.  This would have also allowed us to keep more of the Australian economy open and keep our communication links unincumbered which at this moment would be critical.

Secondly, the borders where they lie have caused an absolute nightmare for many border towns.  Essentially, communities such as Albury-Wodonga or Tweed Heads-Coolangatta have been split down the middle cutting people off from family, friends and essential services.  These towns sprung into existence on the border because there was a strategic economic advantage to do so but, they have evolved into single communities.  Dividing them like we have makes about as much sense as drawing a boundary down the middle of other country towns like Ballarat or Dubbo.  The only reason we accept it is because they lie on state borders but the virus doesn’t give a hoot about state borders so neither can we.

Lastly, also in regards to border towns, there are two reasons that the borders are actually unsafe.  First, in order for the border towns to be able to function correctly all they allow local traffic.  This means that the virus would be allowed to gradually spread up to the border town, the local traffic takes it across and away it goes.  Secondly having the borders right through the middle of these towns means there are far more roads to police and far more traffic to monitor.  So much so, that the border towns do not have the manpower to manage the border crossings on their own so they have to bring in police from other areas.  The busy border then becomes much more than a barrier to the virus, it becomes a genuine potential hazard point and the police bought in from other areas of Australia could be infected and inadvertently end up taking the virus back to their home towns.

There is an answer to this.  What we need is a federal response to this crisis, not a state by state response.  If this was the case we could make boundaries where they would be most effective for managing the pandemic.  After all, the virus does not care about our borders, the only thing it cares about is spreading and existing.  It is not discriminatory and it is not sentimental which means we can’t be either.

Until next time,

Stay well :)

   

We're all in this Together!

 We’re all in this together!  We’re all in this together.  We’re all in this together?  Are we?  Being from Victoria I have two ways of thinking about this.  First, if I listen to my friends and family both in Victoria and interstate.  Everyone has been extremely understanding, compassionate and sympathetic and from that point of view I really feel that we are in this together.  This was compounded by a wonderful 30 second filler piece I saw on ABC news that played a string of messages from people all over the country giving beautiful words of encouragement and support.  In this respect, I absolutely feel like we are all in this together.  It gives me energy in this second lockdown.  I feel empowered like I am doing this for the good of the country and the safety of everyone.

Unfortunately, I start to feel very differently when I continue to watch ABC news.  Now don’t get me wrong.  I don’t blame ABC news.  I believe they are the most rational and unbiased news network in the country, but in bringing us the news they also televise all politicians press conferences, press releases, behaviors etc…  And this is where it all breaks down.  Many of the politicians (not all) have made us feel extremely isolated and alone.  Especially being Victorian, I and many of my friends and family feel extremely disconnected from the rest of Australia.

 

Let me start right at the top.  Our Prime Minister Scott Morrison who has said countless times that we are all in this together.  And he said it at the start of Victoria’s second lockdown, moments before he went home, picked up his family and went on to enjoy a couple of nice cold beers at the footy.  As we are all in this together I know exactly how he felt as I went home picked up my family and went off to the MCG.  Accept for the fact that we didn’t go to the MCG, we didn’t watch the football and we didn’t enjoy a couple of beers because we were in lockdown.  Now I don’t begrudge my fellow Australians going to the footy when I can’t because management of the pandemic needs to concentrate on the hotspots.  Some people have said they don’t begrudge the PM having a bit of time out to watch the footy as he has an extremely difficult job at the moment.  I disagree though.  It is a difficult job for a variety of reasons.  One of the main reasons is to represent the Australian people which includes enjoying the good times but also empathising with the bad times which sometimes means sacrifice.  Sacrificing your trip to the footy so you can stand side by side with Victorians in their time of suffering.  But I guess you have set a precedent here by sodding off on a Fijian holiday during the bushfire crisis.

 

Well, it wouldn’t be COVID blog focusing on Australia if I didn’t mention supreme Victorian leader, Dan Andrews.  Again, a leader that has used the line “we are all in this together” in abundance.  In his defence though, at least he hasn’t been to the footy and from an advertising standpoint the Victorian government has a great slogan “staying apart keeps us together”.  He has also fronted up to the media everyday which can’t always be easy, or is it easy for him?  It could be argued that he actually likes the attention and the power that comes from having Victoria in a state of emergency.  I personally don’t think this is the case but his rhetoric has felt dictatorial.  Especially at the start of lockdown the premier kept telling us that we needed to understand how serious the pandemic was.  Well, I’d like to ask him if he knew how serious the pandemic was when he trusted hotel quarantine to private security or when cracks in our contact tracing and COVID testing became apparent?  Instead we were forced into Victoria’s one and only weapon against COVID, lockdown. And as he did it we were made to feel like it was our fault, that we were to blame and we were the all the ones who had let Victoria down and were the shame of Australia.  He also made us very much aware of all the restriction we would face, that they would be enforced by the police and what the punishment would be.  Newsflash people, it was not our fault.  It was the fault of the Victorian government and even though he has taken responsibility he has not accepted the blame or apologised for it.  As a result, the messages from the premier have been mixed which makes us feel alone and that does not make us feel together.

 

Finally, I’m going to focus on the other state premiers and chief ministers with particular attention on my least favourite politician in the world right now, (and that’s a pretty low bar) Annastacia Palaszczuk.  Not only is her name insufferably difficult to spell her demeanour has been smug and arrogant and I for one feel like she thinks she is better than the rest of Australia.  She constantly says she has to put Queenslanders first and when you say that you divide the country.  In this case Queensland is above the rest of the country with Victoria being left right down the bottom nestle uncomfortably beneath fifty feet of your political garbage.  With lines like “Victoria, don’t come here” you’ve made us feel like we come from a diseased, rancid leper colony that deserves the contempt and disdain of the rest of Australia.

I and many other Victorians also take umbrage to your request to host the AFL grand final because Queensland as you put it has done most of the “heavy lifting”.  You might call it “heavy lifting”, I call it cashing in on Melbourne’s misfortune.  The AFL relocation has been a massive boon for your economy with many teams having to pay to house and maintain their players, staff and family in your state as well as the economic benefits of hosting the games.  Could you please use this topic to show a little respect and humility as hosting the AFL is not a burden but a privilege and an economic cash cow in this time of COVID recession.

 

I have to say that although I have singled out Annastacia Palaszczuk she is not the only one as no premier has an argument for total vindication.  However, one of the failing is not just in our political leaders but in our system.  How can we possibly all feel like we are all in this together when we have six state and two territory governments, as well as the federal government, splitting up jurisdictions based on region and responsibility.  We are 25 million people with 9 different governments.  If we were controlled by just one government, regional lockdown would be far easier to deal with and I believe our response would have been far more effective.

 

Until next time,

 

Stay well

Hope for the Best, Prepare for the Best?

In my last post, I gave Daniel Andrews and the Victorian government a scathing rebuke of their handling of hotel quarantine.  Honestly, it was justified but I could have forgiven them for that if that was where the mistakes ended.  I mean, the NSW government led by Premier Gladys Berejiklian, severely bungled the Ruby Princess cruise ship outbreak but since then I believe their response to the pandemic has been the best in the country as they have managed small outbreaks effectively whilst keeping the economy open.  In stark contrast, the Victorian government kept making mistakes which only exacerbated the problem.

In this post I will outline what I believe is the biggest mistake made so far and relates to the heading, “Hope for the Best, Prepare for the Best?”  I know, everyone knows the saying is hope for the best but prepare for the worst but that is not what we did.  Before we went into the first lockdown Australia got lucky.  We knew what was going on in China but we were not sure how it was going to go spreading to other countries.  Australia could have easily got stung by this as we have direct flights to and from China and if we had been the first country to get badly hit we would be facing huge repercussions.  But, the virus chose Italy and Spain and we had the benefit of going into our first lockdown whilst the problem was relatively small.

And from there we enjoyed what seemed like the governments one and only weapon against COVID 19.  Lockdown.  For the best part of 3 months we stayed home, binged on Netflix and got fat whilst COVID cases diminished and we awaited freedom.  Doing what the Victorian government had instructed.  Little did we know, the Victorian government was leading by example and also doing nothing.

The government had three months to prepare for the worst and I actually got to experience first hand how badly they had failed.  Back in May, I personally knew two people who had been tested for COVID19.  Both results came back negative, within 24 hours.  Fast forward a month and Victoria is suddenly faced with the second wave.  Testing is ramped up and the government is congratulating itself on how many tests are getting done.  There is just one problem.  It took far longer than 24 hours to get the results back.

Now, how did I manage to experience this first hand?  Well, back in June one of my sons teachers had been tested for COVID19 and that test had come back positive.  My son was a close contact.  I do not know when the teacher was tested so I do not know how long he had to wait for his results.  What I do know is that my sons contact with the teacher happened on a Thursday.  We understand the school was informed on a Monday.  The school informed us via email that night but we didn’t read the email until Tuesday and we were not informed by the authorities until Wednesday.  If the school had not informed us we could have been letting my son interact with society for six whole days whilst being infected.  48 of these hours were since the teacher was confirmed positive.

Anyway, my son seemed remarkably nonplussed which was good but I was frantic.  What if he was positive?  What if he’s infected others? What if the rest of the family get it?  What if… What if… What if…  I had hundreds of questions and I had to wait over a day to get answers.  I also started trying to contact trace my sons whereabouts.  In the four days he had before notification, he had hung out with friends both in and out of school.  He had seen his grandparents and aunt and uncle.  I had taken him to have his hair cut and taken him for a hot chocolate and we also went to the supermarket.  If you think about it, that is only just more than one thing a day and if I remove his school friends from the equation that could be as many as 30 close contacts.  Anyway, I cannot say how long the gears were turning before our notification but I do know that the official contact tracing took two days.  This is way to long.  It needed to be the same day but this is not where the story ends.  

As soon as we find out that was son was a close contact we took him to get tested.  That happened on the Tuesday.  As he was a close contact we were told his result would be prioritised.  We got his “priority” results five days later.  Five days of worry.  Five days of concern.  Five days his close contacts could be running around the state unknowingly spreading the virus.  Luckily, the test came back negative.

One month later, I developed a sore throat.  Normally I’d think nothing of it but given the pandemic and the instructions from the authorities I went and got tested.  When I got there they simply told me that the results would take five days.  In five days my result came back negative.

My question is during the first lockdown we had three months to prepare.  Three months to streamline contact tracing protocols.  Three months to ramp up testing so why do our capabilities seem almost exactly the same on day one of the pandemic as they do now? In the absence of a vaccine or any effective medical treatment quick, accurate testing and fast, effective contact tracing should be our first weapon against the virus.  Instead it seems to be a strict lockdown that attacks our economy, our freedom and our civil rights that is our only effective measure against COVID19 in Victoria.

You might say though that staying ahead of the contact tracing is too difficult.  I’ll grant you, it is hard.  Even with 24 hour turnaround on testing contact tracers seem to always be chasing their tail but it is possible.  NSW have been effectively managing a small number of cases for weeks without letting it get out of control.  If the most populous state with the largest city can do it then why can’t Victoria?

Until next time, stay well :)

Ps.  Why does testing even need to be 24 hours?  Why can’t we get a test done in an hour or less?  How much easier would that make it for contact tracers?  As it happens, the Hunter Medical Research Institute are close to just that so why aren’t governments supporting it?  I will talk about this more when I give you my thought on the COVID19 vaccine.

So, Why is it so?

In my last post I stated that here in Australia we like to conduct "redo" not "research".  If you didn't read it I suggest you do by clicking this link.  The question remains why we do this?  In case you are expecting me to give you reasons why it all makes sense that we do it this way, I apologise.  These are not reasons that work for the greater good or are in the best interests of patients or the community at large.  They either serve a minority or make no sense.  I have four reasons:-

• First is a reason my friend and reader of my blog, aminfla, alluded to in a comment on my last post.  Big pharma.  Big pharmaceutical companies like one kind of research and one kind only. The research that leads to them making a profit.  The latest and greatest wonder drug that they can pedal to the masses for millions.  Don't get me wrong some of these drugs that have been developed over the years have changed the face of modern medicine.  But sadly, when research is available that has the potential to do the opposite to their bottom line it is seen as a threat.  So they protect their interest by pushing their own research on specific charities that specialise in funding medical research (which is quite successful as they donate quite heavily to these charities) or finding ways to discredit the other research.  Is it illegal?  I don't know, you'll have to ask a lawyer.  Is it unethical?  Absolutely.  I'm not saying that these companies should fall on their sword and support the other research, but they should certainly not actively try to hinder it.

• Politics.  Research is about knowledge, expanding our understanding and making new discoveries.  Politics should be about the successful running of a country or state but it's not.  Politics is about winning.  Therefore, whoever is the current government they don't want research, they want wins and unfortunately research involves a lot of failure or from a political perspective, losses.  As Thomas Edison said, "I haven't failed, I've just found 10,000 ways that won't work".  Politicians don't want to fund the 10,000 ways, they just want the victory, the one and in order to make sure that happens they just fund redo.  However, being politicians they do not admit to this.  No that would be political suicide.  Instead they point to my third reason...

• Thalidomide.  Most of us have heard of this drug.  If you haven't, here is a quick recap.  Thalidomide was developed in West Germany for a variety of conditions and was also deemed to be a safe drug in the treatment of morning sickness.  It was then marketed in a varieties of other countries without receiving proper scrutiny.  Only after that all happened it was realised that the drug caused severe deformities in the unborn babies.  Since then strict regimens have been in place for all research done outside Australia.  Now, I do understand that this was a horrible tragedy.  Many babies died before they even had a chance at life and those that lived had to live with severe disability.  BUT, should that mean we have to redo every single piece of overseas research?  I don't think so.  Firstly, the mistake that was made in West Germany could have been made anywhere.  Germany is actually quite strict, rational and regimented about its medical research (disclaimer: I have no idea what it was like back in the 1950's and 60's) and it is somewhat arrogant to think that we as Australians (or any other nation) are incapable of making the same mistake.  We are.  After all, money hungry pharmaceutical companies that like the idea of fast tracking their chemicals to market reside in every corner of the globe.  Lastly, there has to be better ways of safeguarding people against such problems, but more of that later.

• Lastly, the medical fraternity.  Have you ever been treated by a doctor that displayed some degree of arrogance?  There are plenty of them out there and many of them are simply too arrogant to admit they are wrong.  Doctors can formulate an opinion based on little evidence and once that has happened it is almost impossible to convince them otherwise.  Or maybe they are told that the best solution lies in a different field of medicine and they are 'no longer requires'.  Ego kicks in and hey presto!  They suddenly don't like the new idea.  There are plenty of examples.

Anyway, they are the reasons I have come up with.  If you have any more I'd be happy to hear them.  Especially if you disagree and believe you have that "all makes sense" reason.  I'd love to hear it.  Until next time, stay well:)