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Yeah, and it's having adults around who aren't f*ckwits.

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And a lot of people don't have that.

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Hi, welcome back.

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Berger and I had a chat the other day about the ostrich phase of the pandemic that we're

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in now, which is the one where we're on a public health and government level, just sort

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of trying to ignore it and hope that it goes away.

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Bertrand Russell, the famous philosopher said that we have to deal with the facts as they

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are and not as we wish them to be.

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And much as we may wish that there's not much COVID around and that it's no longer evolving

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and that people are not dying from it or getting long COVID from it, those things just aren't

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the facts.

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It's a strange schism to be dealing in a world where you understand that and yet you have

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to get on with a life surrounded by people who don't understand it.

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So it's important that we keep drawing attention to the truth and also support one another

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through what is a very difficult phase.

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Over time, the evidence becomes undeniable.

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But in communities that are not vaccinated and are very young and not doing things like

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monitoring wastewater, at least we can point to places like the USA that do do those things,

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imperfect as they are.

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And we can continue to look after ourselves by masking when we're in crowded situations

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and continuing to test and isolate.

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But it is a lonely place to be, particularly if you're surrounded by those who just do

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not or do not want to understand that this is still a significant ongoing health problem.

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A bit like climate change in some levels where our communities are also ignoring much of

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those parameters as well.

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So we need to stay strong, stay focused on the science, stay supporting one another in

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a compassionate and empathetic manner, and occasionally we need to talk about nonsense

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and to take time out to de-stress by enjoying life as much as we can.

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And Berger and I had a little bit of a reflection on all those things in this brief chat.

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So how are you?

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Berger?

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All right.

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All right.

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I mean, going around the country side.

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I'm doing various remote outback locums, which is always interesting.

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Have you been flying yourself from place to place?

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Yeah.

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Quite convenient, flying from little town to little town.

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It's amazing how different they all are, actually.

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You don't quite kind of get the sense of that if you just pass through as a tourist, but

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they're all completely different.

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And what's happening with the pandemic then?

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Things seem to be increasingly ignored in terms of testing in the population, and we

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seem to be getting between four and five waves every 12 months, but we're now trying to just

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kind of absorb them as business as usual.

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Is that fair analysis?

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Yeah.

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I think so.

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The intention of governments from fairly early on has come to fruition.

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We now have pretty high level endemicity.

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It's pretty high background levels all the time with frequent peaks.

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By not testing, that's concealed to a large extent, and the impact on vulnerable people,

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particularly hospital patients, anyone in hospital who catches it, with anywhere from

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an 8% to an 11% mortality, is being ignored.

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And so I think the calculus that this was an acceptable, that we needed to get to a

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position where there was an acceptable, in inverted commas, toll, we've got there.

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The question is who that toll is acceptable to.

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And we've seen some very strong information initiatives from governments around the world

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about how everybody's tired of masks, we've got to go back to normality, status quo, situation

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normal, 2019, it's all over.

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That has been a very strong political requirement for a political narrative.

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And we see the kind of resources devoted to creating and propagating that political narrative,

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which we're not, we're not devoted, and are not devoted to promoting the public health.

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So it's hard not to be disappointed.

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It's certainly been getting me down a bit recently.

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Because we see this, it's, I don't want to overstate it, but it does feel like the death

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of public health, at least the aspiration to improve the public health, year on year,

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simply because that is a good and humane thing to do.

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We're now in a situation where we just are managing for best economic outcome.

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And that's depressing.

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Is it economic outcome or is it popularity of elected officials that we're managing for?

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Because they're slightly different things.

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And I think that a lot of this is being led by branding.

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And the thing that surprises me about it all is that if you were to adopt all of these

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current measures, but actually be fairly aggressive in your public health settings in terms of

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clean air, vaccination, antiviral availability, and surveillance of wastewater, to have at

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least a sense of how much disease is out there if you're not going to be testing people,

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then I don't think that would detract from politicians' popularity, because it seemed

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to me that the ones who improved their popularity were those who had a sense of protecting the

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general population.

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And I would have thought the smart way would be to thread the needle and do those things.

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But it seems like we're adopting the worst of the UK approach at the moment, which is

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to pretend that infection is a good way of protecting people against infection, which

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is about as smart as saying the more you spend at a 50% off sale, the more money you're going

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to have.

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So I think that it comes back to medicine being politics and politics being public health

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at the moment.

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And people are afraid to fight against that, because their careers depend on their acceptance

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by the political master.

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Yes.

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And ultimately, this comes down to, I think, a lack of courage, vision, and the ability

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to inspire politicians.

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Because yes, I mean, the message that you're giving there, combining good public health

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with the best economic outcome.

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I mean, it's obvious that over the long term, that is the best thing to do, that healthy

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economies require healthy people.

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But the short term interests, the interest that are watching the quarterly balance sheet,

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the quarterly profit, do not think like that.

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So I suppose on the good news front, my assessment is that the vaccines are pretty good in most

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respects and certainly a lot better than we anticipated early in the pandemic.

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And that masking, strategic masking in particular, you can lead a pretty good life whilst still

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protecting yourself.

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I mean, as far as I know, I haven't had COVID to date.

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And part of that is because I'm lucky with where I work and I'm privileged with my living

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conditions and so on.

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But I still will wear a decent mask when I feel I'm in a crowded situation.

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When I travel, I went to the UK for work and for family reasons for a week.

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About a week ago, I came back and I masked the whole time I was in the airport and on

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the airplane except to eat and drink something at altitude.

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And didn't catch so much as a sniffle while those around me were trying to cough up a

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lung apparently.

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Most of the way home.

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So even if there was no COVID, you wouldn't get some good news for personal protection

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in the midst of the new world regime, I think.

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Definitely.

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And listen, that's the thing.

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You know, one of the things that really galls me about this whole situation is we've learned

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a lot since 2019.

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Okay, we don't want to go back to 2019.

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I used to get ill all the time when I particularly when I worked in general practice, a bit less

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so when I worked in hospital medicine, but still I used to get ill all the time.

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I haven't been ill in four years.

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It's absolutely wonderful.

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I mean, I do not understand why we are not adopting the highest level of respiratory

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protections in hospitals now that we've all actually figured out that for years we've

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been ignoring and neglecting the evidence on airborne transmission of respiratory and

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other illnesses.

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It's a mystery to me why hospitals and hospital systems are tolerating such high levels of

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staff sickness and the levels of staff sickness are very high, not just with COVID, also with

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flu, also with RSV, people are off all the time when that could be dramatically reduced

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and quite why we are tolerating infecting already sick patients with these diseases

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is absolutely beyond me.

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So exactly what you say.

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Well, it's like the military.

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It's like the military.

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There's a chain of command and there's a section that deals with certain things and we have

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a failed infection prevention control system in place at the moment that's based on nothing

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better than religious beliefs and ego and being part of a team which is on any objective

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measure failed us dramatically and continues to fail us in the hospital setting.

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And I can't believe that that will continue for the long haul, but unfortunately these

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things take a depressingly long time to turn around because there's a lot of people who

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need to move on from their positions before honesty will be allowed to prevail in my view

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as to airborne transmission within healthcare facilities.

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There might be individuals here and there who get it, but if you want to change something

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it has to come from the top down and CEOs have to follow the advice that they get from

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the experts in that area.

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We would expect them to do so in anesthesia and surgery and in emergency medicine.

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And so likewise they do an infection prevention and control, but when we have an audit and

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they come in and they're checking very carefully whether we're washing our hands in a stuffy

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little room, it's nonsense.

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Whilst I'm wearing a mask and the people doing the audit are not, then what can you expect?

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The emperor has no clothes.

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Now what we all want for ourselves and for our families is to be cared for.

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The reality is that the approach.

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I hope so.

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You hope.

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And the approach to the pandemic is much more on the side of farming humans for profit than

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it is caring for individual humans.

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So the rhetoric.

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I think so.

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When you see the usual talking heads coming out and saying it's important this inquiry

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discusses whether our response was proportionate.

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Well proportionate to what?

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I mean, you know, you're either, is our response to saving lives proportionate?

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Well we sent the Navy to get one solo sailor out of the Southern Ocean at one stage.

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Tony Bullemore.

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Tony Bullemore when he was trapped down there was that proportionate?

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We spend billions on chemotherapy every year for people who will die from their cancer

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at some stage.

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Is that proportionate?

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We spend billions on running large public hospitals to treat people with advanced stage

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disease of all descriptions, including dialysis, transplantation.

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Is that proportionate?

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Nothing was disproportionate about our pandemic response.

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That is how you respond to it.

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But if you go into it saying, well, we've got to accept that a whole lot of people are

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going to die, then that to me is a fundamentally corrupt ethical position to take because it's

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corrupt because it's not what you would want for yourself or your loved ones.

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If it was your own children, your own partner or family, you wouldn't just say, oh, well

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that's okay.

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Somebody has to die during a pandemic.

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Now if we were all just struggling to get by and survive as a community, then you know,

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that would, a few hundred years ago, then that would be the state we were in.

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But we're not.

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You can't possibly say that it's reasonable for people to live the lifestyle that we have

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here and yet not look after our elderly people or our people who have an increased vulnerability

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to disease.

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It's an untenable position and one that we should attack whenever possible.

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Absolutely.

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And that paradox of being such a wealthy nation with such a high standard of living and at

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the same time, you know, penny pinching and going, oh, well, no, we can't afford this.

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It's absolute, it's just absolute bollocks.

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I mean, and we're wealthy enough that we can afford the ridiculous discretionary products

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that are advertised between ridiculous discretionary breakfast television segments.

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Yeah.

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Which, so I think that it's very reasonable for us to fight about these things and for

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to continue to make that commentary and to call people out on it because I can tell you

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this, they don't like it.

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No, they don't like it.

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They really do not like it.

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I would say that it's a fallacy to say that the life of the 90 year old is not worth as

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much as that of the 20 year old.

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Completely.

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Because we're not saying let's abandon the 20 year old.

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What we're saying is maybe we're going to ask that 20 year old if they wouldn't mind

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wearing a mask when they're in a nursing home.

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Yeah.

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Maybe we're going to ask that 20 year old, would they please wear a mask up if they're

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going on to an oncology ward?

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Oh, what an imposition.

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We're not saying that we're going to kill 20 year olds instead of 90 year olds.

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We're saying that it's perfectly reasonable to take small steps in order to protect elderly

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people so that they can stay alive.

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We shouldn't wantonly be letting them die because they're 90.

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What we're really talking about is quality life years and we're also talking about level

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of the attitude of that particular person and these are things that we look at in medicine

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all the time.

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We've got a 20 year old with a terminal disease whose quality of life is terrible who says

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I want to give up now.

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We in fact have in place even voluntary assisted dying around the country for those people.

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We're not saying life at any cost but what we're saying is let's be a just society, a

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moral society, a good society, a caring society, an empathetic society.

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Not one that just writes off large bits of the population so that the rest of us can

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carry on blithely without any consideration.

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Even the most minor alteration in what we do.

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Which now labels you-

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This is just ingenuous and false premise.

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Really it needs to be counted.

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Saying that now labels you as an extremist.

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It's extremist to apparently request as you say that the 20 year old wears a mask in a

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nursing home when they go to visit grandma.

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It's ridiculous and it's this kind of infantilisation of adults actually that you can't just go

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and expect the poor loves to do this.

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What happened to compassion?

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What happened to care for others?

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That's what distresses me.

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I find it particularly distressing actually as an immigrant to Australia because this

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country, the ethos of this country is looking after your mates.

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Mateship.

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I'm not sure that the scenario was ever really that solid.

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Australians are quite civic minded.

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They like to do that kind of stuff.

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There was a narrative that could have been explored and promoted in the pandemic.

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It was to start with.

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Everybody around the country was going, oh yeah, go Victoria, thanks very much for doing

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this for us.

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But then there was a shift and it just went bang like that and now it's all about lockdowns

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have ruined children's education forever, including in Western Australia where there

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weren't any lockdowns, et cetera, et cetera, et cetera.

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The poor loves are totally evidence free.

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Well I think it's worth keeping these things at the forefront of mind and keep putting

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them on record, particularly this issue of understanding how much disease there is around.

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I think we need to be monitoring that a lot more carefully.

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In the end, obvious reality becomes these people will still deny anything, but the sensible

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heads will start to prevail and there'll be change in some of these positions.

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I'm optimistic that in the long term we'll get somewhere, but in the meantime that'll

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be too late for some, which is a very difficult thing to live in in society, but I suppose

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it then makes it equivalent to many of the other things we live with in society where

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we've had unfair health outcomes in lots of ways.

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What does the rest of your week?

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We shall keep buggering on and being a thorn in the side of everybody who wants to treat

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us humans as an economic commodity to be farmed.

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Yeah, no, the rest of the week.

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I agree.

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I'm very excited because I'm going to New Zealand on Saturday, actually going to do

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an emergency trauma medicine course in Christchurch, which I've done before a couple of years ago.

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It's actually the best one.

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It's called the ETM course.

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It's one of the alphabet courses, ALS, APLS, EMST, ETM, all that kind of stuff.

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Anyway, it's a really good course.

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It's about how to deal with trauma patients.

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As you know, Andrew, my weakness is it's arriving.

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It's arriving.

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It's quirky, quirky aircraft.

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So this aircraft that I bought from a friend in America, 1946 Republic CB amphibious flying

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boat is assembled.

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Sorry, I thought I misheard you.

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I thought you said it was built in 1946.

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1946, 1946.

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Yeah.

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They were built in 1946, 1947.

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They were going to revolutionize the process of aircraft construction and be very, very

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cheap to build.

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And the returning pilots from the war were all going to buy them and fly their families

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around at the weekend.

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It never eventuated, but they did produce what is probably the best single engine amphibious

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flying boat ever produced, which may not mean a lot to many people listening to this.

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But anyway, New Zealand's got a lot of water you could land it on if you need to.

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Got a lot of lakes.

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Got a lot of lakes.

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So I'm going to be flying it down to the Southern Lake country.

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Hopefully.

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I have never flown it before, but hey, how hard can it be?

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I don't know anything about that, nor do I know anything about what it is that I'm embarking

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on this week.

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Oh yeah, go on.

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And well, you're talking about if you needed an evidence base to do things, you would never

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get anything done, you know, in the end.

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So that's the human way.

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No, I'm getting married on Thursday.

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Yes, you invited us.

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You invited us and we couldn't come.

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This is, yeah, no, that's, that's, that's, there's a bit of a party later in the year,

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but this is the actual heading down to the registry office.

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Well, congratulations.

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Congratulations.

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Fantastic.

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Okay, fair enough.

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It will be a, it will be a happy occasion with family only this week and my 96 year

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old mother, no doubt saying, making comments like this will never last.

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That's what I'm from, from the front row, which is fantastic.

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Things she likes to say to impress, impress strangers.

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Yeah, scare, scare the celebrant on this occasion.

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Yeah.

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Well, it's good to talk to you.

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Yeah, great to talk.

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And keep following the flag and we need to put in a bit of video in here of your flight

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of the bumblebee.

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Flight of the bumblebee.

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Yeah.

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Well, we'll see.

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Very excited.

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00:22:59,520 --> 00:23:04,520
Anyway, great to talk to you, Andrew, as ever.

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As ever.

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Keys.

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I'm back here again, I told myself I'd stay a while away

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Solutions ahead, but don't carry on Blinded by nothing, won't wait through it all

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Hold on to the dark, there's a grace in the fire and the flames Thus try to live so far In this room where I lost my way