Yeah, and it's having adults around who aren't f*ckwits.
And a lot of people don't have that.
Hi, welcome back.
Berger and I had a chat the other day about the ostrich phase of the pandemic that we're
in now, which is the one where we're on a public health and government level, just sort
of trying to ignore it and hope that it goes away.
Bertrand Russell, the famous philosopher said that we have to deal with the facts as they
are and not as we wish them to be.
And much as we may wish that there's not much COVID around and that it's no longer evolving
and that people are not dying from it or getting long COVID from it, those things just aren't
the facts.
It's a strange schism to be dealing in a world where you understand that and yet you have
to get on with a life surrounded by people who don't understand it.
So it's important that we keep drawing attention to the truth and also support one another
through what is a very difficult phase.
Over time, the evidence becomes undeniable.
But in communities that are not vaccinated and are very young and not doing things like
monitoring wastewater, at least we can point to places like the USA that do do those things,
imperfect as they are.
And we can continue to look after ourselves by masking when we're in crowded situations
and continuing to test and isolate.
But it is a lonely place to be, particularly if you're surrounded by those who just do
not or do not want to understand that this is still a significant ongoing health problem.
A bit like climate change in some levels where our communities are also ignoring much of
those parameters as well.
So we need to stay strong, stay focused on the science, stay supporting one another in
a compassionate and empathetic manner, and occasionally we need to talk about nonsense
and to take time out to de-stress by enjoying life as much as we can.
And Berger and I had a little bit of a reflection on all those things in this brief chat.
So how are you?
Berger?
All right.
I mean, going around the country side.
I'm doing various remote outback locums, which is always interesting.
Have you been flying yourself from place to place?
Yeah.
Quite convenient, flying from little town to little town.
It's amazing how different they all are, actually.
You don't quite kind of get the sense of that if you just pass through as a tourist, but
they're all completely different.
And what's happening with the pandemic then?
Things seem to be increasingly ignored in terms of testing in the population, and we
seem to be getting between four and five waves every 12 months, but we're now trying to just
kind of absorb them as business as usual.
Is that fair analysis?
Yeah.
I think so.
The intention of governments from fairly early on has come to fruition.
We now have pretty high level endemicity.
It's pretty high background levels all the time with frequent peaks.
By not testing, that's concealed to a large extent, and the impact on vulnerable people,
particularly hospital patients, anyone in hospital who catches it, with anywhere from
an 8% to an 11% mortality, is being ignored.
And so I think the calculus that this was an acceptable, that we needed to get to a
position where there was an acceptable, in inverted commas, toll, we've got there.
The question is who that toll is acceptable to.
And we've seen some very strong information initiatives from governments around the world
about how everybody's tired of masks, we've got to go back to normality, status quo, situation
normal, 2019, it's all over.
That has been a very strong political requirement for a political narrative.
And we see the kind of resources devoted to creating and propagating that political narrative,
which we're not, we're not devoted, and are not devoted to promoting the public health.
So it's hard not to be disappointed.
It's certainly been getting me down a bit recently.
Because we see this, it's, I don't want to overstate it, but it does feel like the death
of public health, at least the aspiration to improve the public health, year on year,
simply because that is a good and humane thing to do.
We're now in a situation where we just are managing for best economic outcome.
And that's depressing.
Is it economic outcome or is it popularity of elected officials that we're managing for?
Because they're slightly different things.
And I think that a lot of this is being led by branding.
And the thing that surprises me about it all is that if you were to adopt all of these
current measures, but actually be fairly aggressive in your public health settings in terms of
clean air, vaccination, antiviral availability, and surveillance of wastewater, to have at
least a sense of how much disease is out there if you're not going to be testing people,
then I don't think that would detract from politicians' popularity, because it seemed
to me that the ones who improved their popularity were those who had a sense of protecting the
general population.
And I would have thought the smart way would be to thread the needle and do those things.
But it seems like we're adopting the worst of the UK approach at the moment, which is
to pretend that infection is a good way of protecting people against infection, which
is about as smart as saying the more you spend at a 50% off sale, the more money you're going
to have.
So I think that it comes back to medicine being politics and politics being public health
at the moment.
And people are afraid to fight against that, because their careers depend on their acceptance
by the political master.
Yes.
And ultimately, this comes down to, I think, a lack of courage, vision, and the ability
to inspire politicians.
Because yes, I mean, the message that you're giving there, combining good public health
with the best economic outcome.
I mean, it's obvious that over the long term, that is the best thing to do, that healthy
economies require healthy people.
But the short term interests, the interest that are watching the quarterly balance sheet,
the quarterly profit, do not think like that.
So I suppose on the good news front, my assessment is that the vaccines are pretty good in most
respects and certainly a lot better than we anticipated early in the pandemic.
And that masking, strategic masking in particular, you can lead a pretty good life whilst still
protecting yourself.
I mean, as far as I know, I haven't had COVID to date.
And part of that is because I'm lucky with where I work and I'm privileged with my living
conditions and so on.
But I still will wear a decent mask when I feel I'm in a crowded situation.
When I travel, I went to the UK for work and for family reasons for a week.
About a week ago, I came back and I masked the whole time I was in the airport and on
the airplane except to eat and drink something at altitude.
And didn't catch so much as a sniffle while those around me were trying to cough up a
lung apparently.
Most of the way home.
So even if there was no COVID, you wouldn't get some good news for personal protection
in the midst of the new world regime, I think.
Definitely.
And listen, that's the thing.
You know, one of the things that really galls me about this whole situation is we've learned
a lot since 2019.
Okay, we don't want to go back to 2019.
I used to get ill all the time when I particularly when I worked in general practice, a bit less
so when I worked in hospital medicine, but still I used to get ill all the time.
I haven't been ill in four years.
It's absolutely wonderful.
I mean, I do not understand why we are not adopting the highest level of respiratory
protections in hospitals now that we've all actually figured out that for years we've
been ignoring and neglecting the evidence on airborne transmission of respiratory and
other illnesses.
It's a mystery to me why hospitals and hospital systems are tolerating such high levels of
staff sickness and the levels of staff sickness are very high, not just with COVID, also with
flu, also with RSV, people are off all the time when that could be dramatically reduced
and quite why we are tolerating infecting already sick patients with these diseases
is absolutely beyond me.
So exactly what you say.
Well, it's like the military.
It's like the military.
There's a chain of command and there's a section that deals with certain things and we have
a failed infection prevention control system in place at the moment that's based on nothing
better than religious beliefs and ego and being part of a team which is on any objective
measure failed us dramatically and continues to fail us in the hospital setting.
And I can't believe that that will continue for the long haul, but unfortunately these
things take a depressingly long time to turn around because there's a lot of people who
need to move on from their positions before honesty will be allowed to prevail in my view
as to airborne transmission within healthcare facilities.
There might be individuals here and there who get it, but if you want to change something
it has to come from the top down and CEOs have to follow the advice that they get from
the experts in that area.
We would expect them to do so in anesthesia and surgery and in emergency medicine.
And so likewise they do an infection prevention and control, but when we have an audit and
they come in and they're checking very carefully whether we're washing our hands in a stuffy
little room, it's nonsense.
Whilst I'm wearing a mask and the people doing the audit are not, then what can you expect?
The emperor has no clothes.
Now what we all want for ourselves and for our families is to be cared for.
The reality is that the approach.
I hope so.
You hope.
And the approach to the pandemic is much more on the side of farming humans for profit than
it is caring for individual humans.
So the rhetoric.
I think so.
When you see the usual talking heads coming out and saying it's important this inquiry
discusses whether our response was proportionate.
Well proportionate to what?
I mean, you know, you're either, is our response to saving lives proportionate?
Well we sent the Navy to get one solo sailor out of the Southern Ocean at one stage.
Tony Bullemore.
Tony Bullemore when he was trapped down there was that proportionate?
We spend billions on chemotherapy every year for people who will die from their cancer
at some stage.
Is that proportionate?
We spend billions on running large public hospitals to treat people with advanced stage
disease of all descriptions, including dialysis, transplantation.
Is that proportionate?
Nothing was disproportionate about our pandemic response.
That is how you respond to it.
But if you go into it saying, well, we've got to accept that a whole lot of people are
going to die, then that to me is a fundamentally corrupt ethical position to take because it's
corrupt because it's not what you would want for yourself or your loved ones.
If it was your own children, your own partner or family, you wouldn't just say, oh, well
that's okay.
Somebody has to die during a pandemic.
Now if we were all just struggling to get by and survive as a community, then you know,
that would, a few hundred years ago, then that would be the state we were in.
But we're not.
You can't possibly say that it's reasonable for people to live the lifestyle that we have
here and yet not look after our elderly people or our people who have an increased vulnerability
to disease.
It's an untenable position and one that we should attack whenever possible.
Absolutely.
And that paradox of being such a wealthy nation with such a high standard of living and at
the same time, you know, penny pinching and going, oh, well, no, we can't afford this.
It's absolute, it's just absolute bollocks.
I mean, and we're wealthy enough that we can afford the ridiculous discretionary products
that are advertised between ridiculous discretionary breakfast television segments.
Yeah.
Which, so I think that it's very reasonable for us to fight about these things and for
to continue to make that commentary and to call people out on it because I can tell you
this, they don't like it.
No, they don't like it.
They really do not like it.
I would say that it's a fallacy to say that the life of the 90 year old is not worth as
much as that of the 20 year old.
Completely.
Because we're not saying let's abandon the 20 year old.
What we're saying is maybe we're going to ask that 20 year old if they wouldn't mind
wearing a mask when they're in a nursing home.
Yeah.
Maybe we're going to ask that 20 year old, would they please wear a mask up if they're
going on to an oncology ward?
Oh, what an imposition.
We're not saying that we're going to kill 20 year olds instead of 90 year olds.
We're saying that it's perfectly reasonable to take small steps in order to protect elderly
people so that they can stay alive.
We shouldn't wantonly be letting them die because they're 90.
What we're really talking about is quality life years and we're also talking about level
of the attitude of that particular person and these are things that we look at in medicine
all the time.
We've got a 20 year old with a terminal disease whose quality of life is terrible who says
I want to give up now.
We in fact have in place even voluntary assisted dying around the country for those people.
We're not saying life at any cost but what we're saying is let's be a just society, a
moral society, a good society, a caring society, an empathetic society.
Not one that just writes off large bits of the population so that the rest of us can
carry on blithely without any consideration.
Even the most minor alteration in what we do.
Which now labels you-
This is just ingenuous and false premise.
Really it needs to be counted.
Saying that now labels you as an extremist.
It's extremist to apparently request as you say that the 20 year old wears a mask in a
nursing home when they go to visit grandma.
It's ridiculous and it's this kind of infantilisation of adults actually that you can't just go
and expect the poor loves to do this.
What happened to compassion?
What happened to care for others?
That's what distresses me.
I find it particularly distressing actually as an immigrant to Australia because this
country, the ethos of this country is looking after your mates.
Mateship.
I'm not sure that the scenario was ever really that solid.
Australians are quite civic minded.
They like to do that kind of stuff.
There was a narrative that could have been explored and promoted in the pandemic.
It was to start with.
Everybody around the country was going, oh yeah, go Victoria, thanks very much for doing
this for us.
But then there was a shift and it just went bang like that and now it's all about lockdowns
have ruined children's education forever, including in Western Australia where there
weren't any lockdowns, et cetera, et cetera, et cetera.
The poor loves are totally evidence free.
Well I think it's worth keeping these things at the forefront of mind and keep putting
them on record, particularly this issue of understanding how much disease there is around.
I think we need to be monitoring that a lot more carefully.
In the end, obvious reality becomes these people will still deny anything, but the sensible
heads will start to prevail and there'll be change in some of these positions.
I'm optimistic that in the long term we'll get somewhere, but in the meantime that'll
be too late for some, which is a very difficult thing to live in in society, but I suppose
it then makes it equivalent to many of the other things we live with in society where
we've had unfair health outcomes in lots of ways.
What does the rest of your week?
We shall keep buggering on and being a thorn in the side of everybody who wants to treat
us humans as an economic commodity to be farmed.
Yeah, no, the rest of the week.
I agree.
I'm very excited because I'm going to New Zealand on Saturday, actually going to do
an emergency trauma medicine course in Christchurch, which I've done before a couple of years ago.
It's actually the best one.
It's called the ETM course.
It's one of the alphabet courses, ALS, APLS, EMST, ETM, all that kind of stuff.
Anyway, it's a really good course.
It's about how to deal with trauma patients.
As you know, Andrew, my weakness is it's arriving.
It's arriving.
It's quirky, quirky aircraft.
So this aircraft that I bought from a friend in America, 1946 Republic CB amphibious flying
boat is assembled.
Sorry, I thought I misheard you.
I thought you said it was built in 1946.
1946, 1946.
Yeah.
They were built in 1946, 1947.
They were going to revolutionize the process of aircraft construction and be very, very
cheap to build.
And the returning pilots from the war were all going to buy them and fly their families
around at the weekend.
It never eventuated, but they did produce what is probably the best single engine amphibious
flying boat ever produced, which may not mean a lot to many people listening to this.
But anyway, New Zealand's got a lot of water you could land it on if you need to.
Got a lot of lakes.
So I'm going to be flying it down to the Southern Lake country.
Hopefully.
I have never flown it before, but hey, how hard can it be?
I don't know anything about that, nor do I know anything about what it is that I'm embarking
on this week.
Oh yeah, go on.
And well, you're talking about if you needed an evidence base to do things, you would never
get anything done, you know, in the end.
So that's the human way.
No, I'm getting married on Thursday.
Yes, you invited us.
You invited us and we couldn't come.
This is, yeah, no, that's, that's, that's, there's a bit of a party later in the year,
but this is the actual heading down to the registry office.
Well, congratulations.
Congratulations.
Fantastic.
Okay, fair enough.
It will be a, it will be a happy occasion with family only this week and my 96 year
old mother, no doubt saying, making comments like this will never last.
That's what I'm from, from the front row, which is fantastic.
Things she likes to say to impress, impress strangers.
Yeah, scare, scare the celebrant on this occasion.
Yeah.
Well, it's good to talk to you.
Yeah, great to talk.
And keep following the flag and we need to put in a bit of video in here of your flight
of the bumblebee.
Flight of the bumblebee.
Yeah.
Well, we'll see.
Very excited.
Anyway, great to talk to you, Andrew, as ever.
As ever.
Keys.
I'm back here again, I told myself I'd stay a while away
Solutions ahead, but don't carry on Blinded by nothing, won't wait through it all
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