Angst and composure: In the third week of March 2020, the world lost its equilibrium. It went into a collective nervous breakdown in response to the “novel” coronavirus. Only now is the world starting to recover its composure. Over-reaction dominated the mood of 2020. Government, media, political and academic classes all catastrophised. Yet reality was anything but catastrophic. In 2020 the total number of deaths attributed to COVID-19 was 0.028 per cent of the world’s population. That is smaller than the 0.031 per cent of the global population estimated as excess deaths due to the H2N2 flu virus in 1957-58. In 1918-19, 1.1 to 2.75 per cent of the world’s population died from the “Spanish flu”, which targeted the young. Worldwide 2.2 million persons had deaths attributed to Covid in 2020 compared to the 57 million who died from all causes in 2019.
This essay appears in the latest Quadrant.
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The increase in total deaths in 2020 in comparable (OECD-type) nations ranged from the negligible to the pronounced when matched against the five preceding years (Table One).
TABLE ONE Mortality 2020 compared with 2015-2019
|Country||65+ age cohort, deaths all causes, percentage of population, 2020||Deaths all causes, percentage of population, 2020||65+ age cohort, deaths all causes, 2020 compared with 2015-2019, increase or decrease||Deaths all causes, 2020 compared with 2015-2019, increase or decrease|
|Part year (weeks)|
|Taiwan (39 w)||0.40%||0.54%||-5%||-7%|
|Australia (42 w)||0.40%||0.46%||-4%||-7%|
|South Korea (49 w)||0.43%||0.55%||7%||4%|
|Canada (42 w)||0.51%||0.64%||6%||6%|
|Italy (44 w)||0.88%||0.98%||11%||10%|
|Sources: The Human Mortality Database, University of California Berkeley and Max Planck Institute for Demographic Research https://www.mortality.org/; World Population Review, Total Population by Country 2020, https://worldpopulationreview.com/countries; United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision|
|Note: As of January 31 2021, several nations had reported the 2020 all causes mortality data for periods covering less than 52 weeks. For those countries, the 2020 part year is compared with the corresponding weeks in 2015-2019|
In most cases the increase that occurred was never more than a moderate fraction of the less than one per cent of the population that every year dies from all causes. It might be assumed that the varying national outcomes were the result of government action. However, there is no correlation between the levels of national morbidity in 2020 and the stringency of government restrictions and shutdowns (Table Two).
TABLE TWO COVID-19 policy severity compared with morbidity outcomes, 2020
|Country||Level of stringency, COVID-19 containment and closure policies, 2020||COVID-attributed deaths per million, 2020|
|Note: The level of stringency indicates the relative severity of a nation’s combined policies of school closures, workplace closures, restrictions on public events, restrictions on gatherings, closures of public transport, stay at home requirements, restrictions on internal movement, and restrictions on international travel. On a scale of 1-4, 4 is the measure of a dystopian hell, 3 is the equivalent of the Gulag Archipelago, and the span from 0.5 to 1.9 ranges between the relatively mild and the harsh|
|Sources: The Oxford Coronavirus Government Response Tracker, Policy indictors (C1-C8), containment and closure index; Worldometer, Coronavirus, December 31|
A number of comparable nations exited 2020 with rates of morbidity close to their five-year average. These included countries like Australia that had very restrictive Covid policies and those like Taiwan, Norway and Finland that applied mild policies. Sweden had a middling policy approach and a mid-range increase in morbidity in 2020. Canada, France and the United States applied tough policies. Canada had a mid-range increase in morbidity while France and the US were appreciably higher than in recent years. Germany and the United Kingdom enacted similar stringencies with lower and higher morbidity outcomes respectively.
In short there is no evidence of systemic government efficacy in dealing with the COVID-19 pandemic. And how could there be? A virus can be transmitted through potentially any of the millions and billions of micro-interactions between persons daily. Government “control” of that is inherently as vain an aspiration as that of the old Soviet economic planners who sought to grow an economy by trying to centrally plan all economic transactions, something that was absurd. The planning instinct again rose to the fore in 2020 and the results were similarly meagre. The feeling that “government can fix the problem” is never far from the surface in modern societies. This is a kind of false-hope voluntarism. It can’t deliver what it promises on a large scale and it usually results in a series of bad unintended consequences.
It is fair to say that governments had a meaningful prudential role in controlling infections in organisational settings such as nursing homes and hospitals where immune-compromised persons were concentrated, or in overcrowded poorly-ventilated indoor public places where prolonged close social contact was liable to exacerbate viral transmission. Even then some governments managed to do this kind of targeted public health management better than others. The Daniel Andrews government in Victoria instituted one of the world’s harshest lockdowns. Yet, unlike every other Australian state, that government could not ensure effective infection control in the state’s nursing homes. Instead the Victorian government spent its time chasing the chimera of daily “case numbers”. These numbers fed the headlines of the nation’s newspapers and its broadcast media as well as the declamatory hysteria of social media.
Across the world the battery of lockdowns and other NPIs (non-pharmaceutical interventions) by governments is not correlated with a significant measurable effect in reducing the reproduction of the virus or the mortality attributed to the virus. Government measures though had numerous debilitating consequences. Many of these will be felt for years and decades. Australia exited 2020 with a lower than average annual death rate on the plus side and longer-term collateral damage on the minus side. The latter includes an increase in the rate of suicide, increased incidence of clinical depression, undiagnosed fatal illnesses due to the closure of health services or the fear of accessing them, stress-induced reduction in life-spans due to unemployment and the crippling of small businesses resulting from stay-at-home orders. If the exceptional state of a novel coronavirus justified emergency measures, what became apparent is the extent to which good physical and psychological health depends on normality. That is, on the normal state of persons going to regular scheduled doctors’ visits, accessing routine pain-alleviating therapies and surgeries, having life-saving ambulance services not delayed crucial minutes by cumbersome anti-virus procedures, as well as enjoying psychologically essential regular social contact and outdoor exercise, and not retreating into anxiety-numbing alcohol and drug consumption and obesity-fuelling comfort food consumption.
In spite of all the melodrama that exuded from the political and media classes in 2020, the most effective prophylactic in dealing with the coronavirus was not government but a normally-functioning society. Normality has several dimensions. Consider first what those nations with a modest annual death rate in 2020 had in common. It was not government policy. Among other factors these are societies where social distancing was a natural and unconscious habit. The everyday micro-sociology of these societies is such that the typical distance between people (proxemics) in intimate, friendly and public interactions is high while the propensity for physically touching (haptics) is low. Social distance, significant as it is, though, pales in causal effect compared to the variable state of the body’s immune defences.
If there is a hero of 2020 it is the human immune system. Viral infections and the human species have co-evolved. The immune system, which is still little understood, has a remarkable ability to fight infections. As we get towards the end of life, our immune systems tend to become less effective. Flu infections every year play some role in the death of many elderly people. Their immune systems have stopped working proficiently. Much is made of vaccines. A vaccine is a weakened or modified form of a potentially lethal virus. It prompts the human body to better identify and respond to the viral enemy. A vaccine though is not the agent that defeats the invading virus. That’s the job of the body’s own immune defences, which are multi-faceted in the way they work. What matters in all this is the quality and robustness of an individual’s immune response. That robustness is affected by the social environment. Social behaviour has an observed effect on the body’s immune system. In particular, anxiety, worry and stress degrade the body’s ability to fight infections.
There is an extensive sixty-year highly-cited science literature on the negative effects of stress on the body’s immune system. Very good studies also exist of the effects of stress on common cold infections—a third of which are coronaviruses. Stressful life events are a reliable predictor of cold symptoms while a person’s negative affects (such as anger, depression, feeling scared, perturbation) and their self-perception of stress are reliable predictors of infections caused by common cold viruses (many of these infections can be asymptomatic). 2020 was a stressful life event on a mass scale. It was accompanied by elevated levels of negative emotions and self-assessments of stress. It was also a chronic event that was drawn out month after month. Along with ageing and the co-presence in the body of other non-viral diseases, chronic stress (among all the different kinds of stress) appears to be the most likely factor that will cause a reduction in the effectiveness of the body’s anti-viral immune response. Chronic stress, age-related morbidity and co-morbidity collectively were very prominent characteristics of the Covid year.
Whatever their other views, virtually everyone agrees that 2020 was a stressful year. The stress was by no means simply a function of the spread of a “novel” virus. New viruses appear periodically with generally modest stress-inducing flight-or-fight responses from human populations. 2020 was different. The flight-or-flight response was magnified by additional sources of stress. These derived from aggressive public policy measures, including blanket public health warnings, stay-at-home directives, mandatory business and school closures, travel bans that locked persons out of their state or country, obsessive media coverage, behavioural policing, exercise bans or limitations, and depression-inducing enforced social isolation and confinement of populations indoors. Stress-related behaviour accompanied these enactments, including reduced physical exercise, increased sleep deprivation, marital conflict and chronic alcohol consumption.
Each of the public health measures was intended for the public good. But the consequence of public policy often ends up being the opposite of its intent. The measures were intended to reduce the harm caused by the coronavirus. But if stringent measures had a consequential stress-magnifying, immune-comprising effect then, rather than reducing harm, the effect of the measures was unintentionally to increase harm. It is observable that nations with the highest per capita rates of death imposed the most stringent lockdown measures (Table Two). In Australia, Victoria, the state with the highest per capita rate of death, similarly imposed the toughest measures. Causality does not necessarily operate in one direction only. Death, certainly, may trigger stringency. But stringency may have its own negative consequences.
A peculiar spiral is at work here. Stringent health policy measures and messaging boosted stress and worry. But those policies and messages were also primed by a lengthy prelude. An atmosphere of angst had been building across the world for a decade. The political symptoms of this are well known. The decade of the 2010s saw a tidal wave of wokeness on the political Left and populism on the political Right. Often this is described as political polarisation. In one way it is. However, these polarities are also the contrary expressions of a common root: a wave of anxiety that spread across the world after 2008. The Global Financial Crisis and the recession that followed it triggered a decade-long rise of stress-related negative affects (worry, sadness and anger). These eventually separated from their trigger and became free floating, seeking objects of “concern”. At the margins these “concerns” ranged from environmental doom and racist holocaust to social carnage and global conspiracies. This was not a uniform process. The degree of angst versus sang-froid varied from country to country.
Less visible were the psychoneuroimmunological changes that have occurred at a global level. It is worth noting, for example, the significant growth of autoimmune diseases that has occurred among a cohort of wealthy nations across the world. These are diseases in which the immune system treats the body’s own tissue as an invader and attacks it. These diseases have been increasing dramatically and (like the coronavirus) in a nationally uneven manner. Between 1985 and 2015, rheumatic, endocrinological and gastrointestinal autoimmune diseases increased the most in Israel, the Netherlands, the US and Sweden. The very wide variation in national (even regional) incidence of Covid-related deaths seems more logically explained by variations in bodily susceptibility to disease than by government interventions. While COVID-19 received a historically unprecedented amount of attention in 2020, there may be a larger and ultimately more significant issue of the interaction (over a much longer duration) between levels of social anxiety, the mixed biology and social psychology of stress, and the psychoneuroimmunology of immune systems. Of these the factor that a society has most control over and most responsibility for is anxiety. Yet it is the factor that in the past two centuries has become not clearer but rather more opaque to modern minds. Anxieties continue to spiral up in ways that are not just self-defeating for societies but that suggest we have lost to a significant degree the means to dampen them down.
In Australia in the nineteenth century the rate of death ranged annually between 1 and 2 per cent of the population. Between 1900 and 1990, with growing life-spans, this trended down from 1 per cent to 0.7 per cent. In 2019 it was 0.57 per cent. Such trends were typical of OECD-type countries. Yet, paradoxically, as the incidence of death became rarer, the fear of death increased. As the world became a safer place, the more people fretted about their safety. Religion’s ability to placate worries about death declined as existential nervousness grew. The traditional Christian god of faith, love and charity and the modern sceptical Enlightenment’s laissez-faire clockwork-universe god of beauty tended to be edged out by the paleo-modern gods of anxiety, melancholy and intervention. After the middle of the nineteenth century, traditional religion waned only to be replaced by a series of crypto mind-over-matter religions, religious proxies and placebos, and various secular religions including socialism and communism. When socialism collapsed in the 1980s, it was replaced by the ideology of safetyism.
Among numerous supernumerary creeds associated with the paleo-modern gods is the syncretic phenomenon of the health religion. In the United States this phenomenon is traceable back to the 1870s, to Mary Baker Eddy and her “Christian Science”. To its credit this proxy religion had an appreciation of contemplative (prayer-mediated) psychological relaxation. Mind-body therapies have a well-documented positive effect on the immune system. 2020 saw a great revival of the health religion, this time in a secular anxiety-driven form. This was most notable of all in Britain where we saw the re-emergence of a kind of state worship that we have not seen since the totalitarian era of the 1930s. In the case of Boris Johnson’s Britain, the health religion took the form of an officially sponsored veneration of the National Health Service (NHS). This was a substitute for the country’s much-diminished state church, the Church of England. A cult of sublimity replaced what once had been a religion of beauty. The orchestrated public reverence for the NHS saw doctors treated as priests, nurses as angels and hospitals as church-like proxies.
Sociologists have long held that the world has become increasingly secular. Measured by church and other institutional religious attendances, that is true. Yet the underlying battle between images of an interventionist god and the laissez-faire god of beauty have continued even in the most nominally secular contexts. Whatever the proponents of secularism say, the religious impulse is not dead. It has just been re-routed. Many of these are kitsch or ersatz in nature. Some of them are powerful. In fact such was the explosion of the secular health religion in 2020, many erstwhile libertarians and classic liberals among the political class discovered their inner interventionist.
One of the functions of religion is to reconcile human beings to the inevitability of death. We are mortal beings with a strong awareness of our own mortality. The need to find ways to accept mortality cannot be extinguished. The need has to be satisfied some way or other, or human beings will experience distressing feelings of anxiety. In place of the traditional view of an afterlife has come the paleo-modern belief in an interventionist deity. This paleo-god assumes the guise of the benevolent state and offers a form of salvation by doctors and public health authorities who wield the catechism of “the evidence” and the dogmas of a melancholic science. This melancholic science mixes a downbeat vision of society, the undebatable mysteries of “expertise” and (in place of the afterlife) the secular miracle of “saving lives”. It does so in order to quell the natural human anxiety about death. It forgets the clockwork-like bell-curve structured behaviour of viral pathogens, preferring to concentrate on the self-important ersatz heroism of interventionist health state authorities.
There are plenty of good reasons to accept without question the larger part of settled science. But qualifications apply to that rule. Modern science owes much to the philosophy of moderate intellectual scepticism, a strain of thought that has its origins in classical antiquity. The twentieth-century reformulation of this philosophy of science by Karl Popper said that science advanced by conjecture and refutation. Popper observed that much actually-existing science eventually is shown to be wrong. For example the miasma (pollution or bad air) theory of disease held sway in Europe until the end of the nineteenth century even though the pathogen (germ or microorganism) theory had been proposed by Girolamo Fracastoro, an Italian doctor, scientist and philosophical atomist, in 1546. Prominent public health “reformers” of the nineteenth century such as Florence Nightingale vigorously advocated the miasma theory. Only after 1849 when the surgeon John Snow demonstrated a statistical correlation between a postulated water-borne pathogen and outbreaks of cholera in the UK did the micro-organism theory of diseases start to gain ground. Science is a long history of wrong theories.
Today the popular imagination still assumes a pollution theory of disease. In 2020 the miasma theory of the pathogen made a big comeback in public policy. Out of nowhere face masks became an instant panacea for airborne aerosol or ballistic droplet transmission of the Covid pathogen. Bad air theories once again came crashing back into fashion even though the experimental lab-based evidence that masks work is virtually non-existent. To raise scientific doubts about masks in public became verboten overnight. Conjecture and refutation had a terrible time amidst the Covid scare. Panic neutered almost all critical faculties.
Part of the problem is the contemporary idea of truth. When post-modern philosophies began to spread widely after the 1970s, a lot of people started to say that we were living in a post-truth age. On the contrary, if anything our age is far too preoccupied with “the truth” in the form of correctness. Being “correct” has its value. If I do a calculation, I want it to be correct. But correctness is also often juvenile. It functions like the eight-year-old child stamping and shouting, “I am right, I am right”. Throughout 2020, a crescendo of people shouting “I am right, I am right” descended on the world. Malicious tags were applied to anyone who dared to disagree with them. Truth in the petulant form of “correctness” offered certainty in the face of anxiety. It was an emotional anaesthetic and soporific. But this hardly rose to the level of Popperian science.
We tend today to think of scepticism as “asking critical questions”. But historically it was more than that. The intellectual sceptic was someone who could weigh competing considerations. It involved a balancing of pros and cons. Scepticism doesn’t mean nay-saying. It means: have you thought about this countervailing factor? Are you sure that all the good you claim is being achieved is not cancelled out (or worse) by the ancillary effects of your measures? Have you thought about seeking a multifaceted optimal series of measures rather than pursuing a single maximal set of methods? In short, is the harm obviated by the measure you plan outweighed by the harm caused by your measure?
Policy sciences today find sceptical assessments that balance pros and cons difficult to carry out. The “one right answer” attitude has subsumed sceptical reasoning. The value of being “correct” swamps the sense of balance or proportion. Models of single-factor or single-direction causality replace models of multi-factorial and reciprocal causality. Peripheral epiphenomena like “case numbers” that are a statistical artifice of the number of virus tests carried out by a government become the focus of “the science” in place of hard thinking about physiological causality and the even harder thinking required to understand sociological-physiological causality. In short, classic moderate scientific scepticism got completely trampled in 2020. Public health science and policy science for the most part became monomaniacal. Governments avoided carrying out any kind of cost-benefit analysis of their Covid policies.
The Danish philosopher Soren Kierkegaard wrote one of the first modern studies of anxiety in the 1840s. Principally he thought of it as a religious phenomenon. On first reading, this approach to anxiety seems odd. Is it not a psychological or social psychological syndrome? It is true that psychology is an offspring of nineteenth-century philosophy and Kierkegaard had many psychological insights. Yet is anxiety really a religious phenomenon? The answer is probably yes. Human beings are conscious creatures. They are aware of what they do. But they are also aware of that awareness. They are self-conscious beings. So they are both acutely aware of death and meta-aware of their own awareness of their mortality. Religion, philosophy and art all deal with this strange meta-awareness of the human being.
The traditional human fear was a fear of death that was grounded in tangible events. If you were an English soldier at the battle of Agincourt decisively outnumbered by French soldiers, you had ample reason to be afraid of dying that day. Sentiments based on a mix of Christian faith and hope in the afterlife and a background (philosophically rooted) culture of stoic behaviour and the virtue of courage modulated such fears. Since the mid-nineteenth century the traditional kind of human fear increasingly has been replaced by anxiety. For Kierkegaard, anxiety is the dread that attaches to a very modern idea: the possibility of having possibilities. The modern world of the past 250 years has become rich in contingencies—things that might (possibly) happen. Many people get excited by this. It makes many other people, though, dizzy with dread. Our fellows endlessly dream of possibilities. Yet in many cases these dreams readily turn into nightmares. The dreaming imaginations of our peers turn against them, haunting them with frightening images. They scare themselves witless.
It is the nature of anxiety to magnify and inflate a small or moderate event into towering malevolence. In the case of the mass anxieties of the twenty-first century, such feelings fixate on small troubling things and blow these out of proportion. Looking at some small or modest possibility (say that a novel virus might do some harm) the mind begins to inflate that possibility. It is “possible” that the virus could spell doom or cause mass death. As they dwell on such “possibilities” the famously liberal open societies of modernity then suddenly scurry about trying to close themselves down. This is necessary in order to shut down the thought of such a “dreadful” possibility.
Anxiety is the fear of contingency. People worry not only about “what is” (the Agincourt-style battle that starts tomorrow) but also about “what might be”. The range of “what might be” is large—and every year it expands. In part this is because our sense of “what could be” is defined by the human imagination. Anxiety takes information about small events and magnifies it. A relative handful of deaths from a novel virus is exaggerated by the thought of a large number of “cases”. The pseudo-statistical projection of “potential cases” embellishes this. The “what could be” is a projection by the imagination of the future back into the present. The imagination can do this in a number of different ways. One way is through the operation of the sublime imagination. The sublime is the mechanism of the human imagination that darkly exaggerates things. The sublime imagination readily partners with anxiety.
Since the eighteenth century the imaginative faculty of the sublime has risen in prominence. In 1757 Edmund Burke spent half of his treatise on aesthetics, A Philosophical Enquiry into the Origin of our Ideas of the Sublime and Beautiful, analysing this form of the imagination. It pictured the world as if it was full of terror, darkness, solitude, privation, vastness, suddenness, uncertainty and the absence of checks or balances. Burke struck an objective tone. In a detached manner he enumerated the differences between classic and romantic art and their respective emphasis on the beautiful and the sublime. But his analysis of the sublime clearly prepared him to understand the terroristic pyrotechnics of the French Revolution that were prefigured in the sublime artistic imagination.
Democracies are not terroristic or totalitarian. Democratic peoples do not fear their rulers, who often appear to them to be comic or hapless figures. Rather than directly inciting fear, democratic leaders tap into social anxieties. They do this (among other means) by dark sublime exaggerations. “You may not fear me but dread the looming handiwork of nature—the shadowy virus.” The dread of the pathogen and the resulting anxious trembling is then soothed when government “takes command”. One of the characteristics of the sublime that Burke noted was its appetite for sudden shifts and turns. We see the same disposition echoed in many 2020 governments. The democratic sublime genre of power encourages abrupt kinds of authority that deliver daily unexpected, anxiety-inducing twists and turns. These have the population sitting on the edge of its seats and hanging on every pronouncement by government.
In a world of sublime “possibilities”, no one can be sure exactly what a government is thinking. A classic example of this was the decision by the Victorian government in late December 2020 to suddenly close its border with New South Wales. Tens of thousands of Victorians were left stranded interstate for weeks as a result of the exercise of a kind of power whose essence is to stoke anxiety-pumping uncertainties. A democratic sublime power acts unpredictably and with pirouetting haste. It turns panic into impetuous policing and issues directions without warning, due consideration or obvious consistency. The ability to do this is built into the emergency, administrative and discretionary powers of the modern sovereign state. But the entire history of the modern state is also the history of efforts to check and balance such precipitate power.
The response of middle Australia to the Covid year was largely one of patience. The mind-set of the mass of Australians is phlegmatic. They are not easily drawn into garrulous nervous fretting. The population’s patient stamina has many sides. At times it is naive and almost masochistic; at other times fatalistic, stoic, amused or long-suffering. It varies. The Australian national story (embodied in Anzac) is one of phlegmatic nonchalance in the face of both danger and pompous authority. The Australian media, political and academic classes on the other hand tend increasingly to be melancholic in nature. Doom scenarios appeal to them. They routinely exaggerate problems. Their imagination is typically sublime. The sky is always falling in. Hence the toughness of Australia’s anti-Covid policy measures and the country’s generally forbearing response. Forbearance did not mean freedom from worry or stress. But it also did not mean the catastrophising typical of the extravagantly vocal segments of Australia’s professional-managerial classes.
The peculiar anxieties of the voluble modern-era upper middle classes have long been recorded. It was notable in Victoria during 2020 that the retail businesses with the most over-the-top Covid notices on their windows were those catering to virtue-signalling professional-managerial status groups. It is a puzzle why social classes with the most material security often exhibit the greatest degree of publicly vocalised psychological insecurity. The strangest of all of the professional-managerial nerviness was the number of hysterical statements about Covid emanating from doctors and the doctors’ lobby groups. This from a profession that deals daily with all kinds of infectious diseases. Possibly this was a function of selective media reporting. Placid doctors didn’t get coverage and just went about their business unperturbed. Australian media coverage generally was sensational. Every minor inflection in the disease’s upward progress was inflated. That flipped to near silence every time the virus’s predictable bell-curve movement arced downwards. Statistical naivety was rampant, as was gullible innumeracy. The media’s viewership and readership maxim—“if it bleeds it leads”—went into full throttle in 2020. This was not an atmosphere conducive to composure or reflection.
As for Australia’s professional politicians, they had little to say on the subject of Covid that was not orchestrated pabulum. Almost universally they ducked for cover, insisting that public health officials speak for them. Those officials tended to echo the melancholic anxieties of the larger professional-managerial class. Most state and federal political leaders doubled down on this, notably so in the case of Victoria. For months on end, the Victorian Premier, Daniel Andrews, was the chief character in a daily angst-stoking melodrama. Humourless and peevish with a barely suppressed streak of anger, Andrews neatly exemplified the neurotic spirit of his age. Some relief from this bullhorn hand-wringing came from the Premier of New South Wales, Gladys Berejiklian, who successfully applied a lighter-touch set of constraints and whose public appearances tended to be confidence-building rather than anxiety-fuelling. From time to time Berejiklian even managed to smile. In 2020 we had to be grateful for even the smallest of mercies.
Peter Murphy is the author of COVID-19: Proportionality, Public Policy and Social Distancing (Palgrave, 2020). His other recent books include The Political Economy of Prosperity (2020) and Limited Government (2019). He is working on a study of Australian civilisation. An extensively footnoted version of this article is available online.
 The 1957-58 excess death figure (1.1 million) is calculated by C. Viboud, L. Simonsen, R. Fuentes, J. Flores, M.A. Miller, G. Chowell, “Global Mortality Impact of the 1957–1959 Influenza Pandemic”, The Journal of Infectious Diseases 213, 2016, pp. 738-745. Excess death is the count of the difference between those who were expected to die in a given year and the number who actually died in that year. The American Centres for Disease Control (CDC) cite a similar figure of 1 million worldwide “deaths” for the H3N2 flu virus in 1968-69, but the figure is not confirmed in the literature the CDC cites and in any event it is unclear whether “deaths” in this context means total certified flu deaths or estimated excess deaths related to the flu season in 1968-69. https://www.cdc.gov/flu/pandemic-resources/1968-pandemic.html. The figures for certified virus-related deaths in the three pandemic episodes (2020, 1968, and 1957) are not readily comparable. In 2020 there was obsessive counting of COVID-attributed deaths. Persons who died with COVID-19 but not necessarily of COVID-19 numbered in the death statistics. In 1957 and 1968 death certification was not treated in the same compulsive manner. It will probably be some time, perhaps a prolonged time, before we get a statistical estimation of excess deaths in 2020. Further on the question of comparability, a vaccine for the 1957 flu was developed by September 1957; the vaccine for the 1968 flu was released in November of that year. The first COVID-19 vaccine was announced in November 2020.
 N.P.A.S. Johnson and J. Mueller. “Updating the Accounts: Global Mortality of the 1918-1920 ‘Spanish’ Influenza Pandemic”, Bulletin of the History of Medicine 76:1, 2002, pp. 105-115.
 United Nations, Department of Economic and Social Affairs, Population Division, World Population Prospects, 2019.
 Peter Murphy, COVID-19: Proportionality, Public Policy and Social Distancing, Singapore, Palgrave, 2020, p. 128.
 V. Chin, J.P.A. Ioannidis, M.A. Tanner, S. Cripps, “Effects of non-pharmaceutical interventions on COVID-19: A Tale of Three Models”, medRxiv preprint, December 10, 2020 doi: https://doi.org/10.1101/2020.07.22.20160341; R. Chaudhrya, G. Dranitsarisb, T. Mubashirc, J. Bartoszkoa, S. Riazia, “A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes”, EClinical Medicine 25, 21 July 2020.
 Murphy, COVID-19, pp. 32-35.
 Summarized in A. Seiler, C.P. Fagundes, L.M. Christian, “The Impact of Everyday Stressors on the Immune System and Health” in A. Choukèr (ed) Stress Challenges and Immunity in Space, Berlin, Springer, 2020 https://doi.org/10.1007/978-3-030-16996-1_6; S. C. Segerstrom and G. E. Miller, “Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry”, Psychological Bulletin 2004, 130:4, pp. 601-630 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/pdf/nihms4008.pdf; S. Cohen, D. Janicki-Deverts, G. E. Miller, “Psychological Stress and Disease”, JAMA The Journal of the American Medical Association 298, pp. 1685-1687, November 2007
https://www.researchgate.net/publication/5918645_Psychological_stress_and_disease_JAMA_298_1685-1687. Segerstrom and Miller in 2004 included 300 empirical studies on the relationship between stress and immunity in their meta-analysis. How does stress “get inside” the body and do damage? Segerstrom and Miller (pp. 4-5, 19) mention the body’s sympathetic nerve fibres, hormonal pathways (the hypothalamic–pituitary–adrenal axis, the sympathetic–adrenal–medullary axis, and the hypothalamic–pituitary–ovarian axis) and behavioural pathways (lack of sleep, decreased physical activity, cigarette smoking). Seiler, Fagundes and Christian’s model of the links between stress and the immune system describes stress as has having the effect of supressing or dysregulating human innate and adaptive immune responses by upsetting the balance between humoral (antibody) and cellular (cytokine) immune responses thereby exaggerating bodily inflammation to an extent that harms rather than protects the body. Cohen, Janicki-Deverts and Miller cite behavioural changes, stressor-elicited endocrine responses, and evidence of a link between stress and the progression of the human immunodeficiency viruses.
 S. Cohen, D. A. Tyrrell, and A. P. Smith, “Negative Life Events, Perceived Stress, Negative Affect, and Susceptibility to the Common Cold”, Journal of Personality and Social Psychology 64:1, 1993, pp. 131-140. Cohen (2021) summarises (pp. 166-168) a series of seven experimental studies that he and his collaborators did between 1991 and 2012. These explored the relationship between stress, colds, influenza, disease risk and the impairment of the immune function. S. Cohen, “Psychosocial Vulnerabilities to Upper Respiratory Infectious Illness: Implications for Susceptibility to Coronavirus Disease 2019 (COVID-19)”, Perspectives on Psychological Science 16:1, 2021, pp. 161-174.
 Negative emotions may be further subdivided into the negative aspect of (a) systems of emotional valence such as the unhappiness-happy pair and (b) systems of emotional arousal such as the stimulated-still pair. Segerstrom and Miller, p. 19.
 Segerstrom and Miller, pp. 6, 14-16, 18.
 J. F. Helliwell, R. Layard, J. D. Sachs, World Happiness Report 2019, Figure 2.1. For the purposes of this international survey, negative affect is defined as the average frequency of worry, sadness and anger on the previous day.
 A. Lerner, P. Jeremias, T. Matthias, “The World Incidence and Prevalence of Autoimmune Diseases is Increasing”, International Journal of Celiac Disease, 2015, 3:4, pp. 151-155.
 Lerner, Jeremias, Matthias, “The World Incidence and Prevalence of Autoimmune Diseases is Increasing”. Some 80 to 100 diseases today are classified as autoimmune diseases. The American Autoimmune Related Diseases Association (AARDA) estimates that something approaching 50 million Americans (15 percent of the population) have an autoimmune disease, many undiagnosed because these diseases are difficult to assess.
 Lundberg and Zeberg observe that “Within Europe, death rates due to covid-19 vary greatly, with some countries being hardly hit while others to date are almost unaffected… we present data demonstrating that mortality due to covid-19 in a given country could have been largely predicted even before the pandemic hit Europe, simply by looking at longitudinal variability of all-cause mortality rates in the years preceding the current outbreak… [These data] suggest that in some European countries there is an intrinsic susceptibility to fatal respiratory viral disease including covid-19; a susceptibility that was evident long before the arrival of the current pandemic.” J. O. Lundberg and H. Zeberg, Longitudinal variability in mortality predicts Covid-19 deaths, medRxiv preprint doi: https://doi.org/10.1101/2020.12.25.20248853
 R.Taylor, M. Lewis, J. Powles, “The Australian mortality decline: all-cause mortality 1788-1990”, Australian and New Zealand Journal of Public Health 22:1, 1998, Figure 1. This is the crude death rate. It does not adjust for age, that is, for the varying proportion of different age groups in a population over time.
 Human Mortality Database. https://www.mortality.org/
 Of all accounts of the God of beauty, probably the most important was that outlined by Anthony Ashley Cooper, the Third Earl of Shaftesbury, in his Characteristics of Men, Manners, Opinions, Times (1711). In that anthology of his writings, Shaftesbury periodically reflects on the idea of a divinity of design and order.
 The Church of Christ, Scientist, was founded in 1879. Mary Baker Eddy’s seminal religious text was her Science and Health with Key to the Scriptures (1875).
 For a meta-analysis of 34 studies, see N. Morgan, M.R. Irwin, M. Chung, C. Wang, “The effects of mind-body therapies on the immune system: meta-analysis”. PLoS One 9:e100903, 2014. https://pubmed.ncbi.nlm.nih.gov/24988414/
 There were two schools of scepticism in antiquity, Pyrrhonian sceptics and Academic sceptics. The former derived from the philosophy of Pyrrho of Elis (circa 360-270 BC); the latter were the members of the school of Plato when it was led by Arcesilaus (circa 316-241 BC). The essayist Michel de Montaigne (1533-1592), the astronomer and mathematician Pierre Gassendi (1592-1655) and the philosophers Pierre Bayle (1647–1706) and David Hume (1711-1776) influenced the development modern moderate scientific scepticism as did the republication of Sextus Empiricus’ Outlines of Pyrrhonism in the sixteenth and seventeenth centuries. Immanuel Kant’s theory of the antinomies in his Critique of Pure Reason (1781) has parallels with Pyrrho’s theory of suspended judgment (epochē).
 The hot air theory of climate change (rising carbon dioxide levels heat the air dangerously) has proliferated in spite of the fact that the earth’s temperatures are and remain historically average.
 Conventionally defined, an aerosol particle has an aerodynamic diameter less than 5 μm (micrometres); a droplet is 5-10 μm.
 John Hardie reviewed the literature on the subject in 2016. See Hardie, “Why Face Masks Don’t Work: A Revealing Review”, Oral Health, October 2016. Hardie observed: “The primary reason for mandating the wearing of face masks is to protect dental personnel from airborne pathogens. This review has established that face masks are incapable of providing such a level of protection.” As Hardie notes, quoting an anaesthetist on the subject of the pseudoscience of quality improvement, “many infection control rules are indeed arbitrary, not justified by the available evidence or subjected to controlled follow-up studies, but are devised, often under pressure, to give the appearance of doing something.” Indeed from a functional point of view, face masks appear to serve principally as a means to placate social anxieties. Masks arguably also might function as a behavioural signal indicating that persons should physically distance in order to reduce the effective reproduction rate of the virus. Even then such signalling can only ever be a minor corrective to culturally-defined perceptions of near and far. The practice of physical distancing is an intelligent response to a pathogen carried in liquid droplets capable of being transmitted or propelled short distances through the air and into the body’s upper respiratory system. On the other hand, the lingering mass fascination with miasma theories of disease and harm may have led to a misestimating of the arguably even more important causal factor governing virus-related morbidity: the human immune system. The World Health Organization (WHO) concluded that “There have been a number of high-quality randomized controlled trials (RCTs) demonstrating that personal protective measures such as hand hygiene and face masks have, at best, a small effect on influenza transmission…” Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza, 2019, p. 2.
 Like a political prisoner in 1970s Argentina, John Hardie’s eminently dispassionate literature review of research on the efficacy of masks worn by dental and medical practitioners was “disappeared” from the Internet in 2020. If you visit the article’s erstwhile webpage you will find a statement from the publisher, Oral Health, that says “If you are looking for ‘Why Face Masks Don’t Work: A Revealing Review’ by John Hardie, BDS, MSc, PhD, FRCDC, it has been removed. The content was published in 2016 and is no longer relevant in our current climate.” Current climate, it appears, was the standard for science in 2020. Hardie’s article is archived at https://www.highlander.com/wp-content/uploads/2020/08/John-Hardie-Why-Face-Masks-Dont-Work.pdf
 Reported “case numbers” were a direct function of levels of population testing. In one estimate, as of August 31, 2020, actual case numbers were on average 6.2 times the number of reported cases in 15 OECD-type countries. In some instances, including Belgium, France, Italy and the UK, actual numbers were estimated to be 10 times the reported case numbers. Australia was calculated to be detecting 21 percent of its cases. S.J. Phipps, Q. Grafton, T. Kompas, “Robust estimates of the true (population) infection rate for COVID-19: a backcasting approach”, Royal Society Open Science 7, November 3, 2020 http://dx.doi.org/10.1098/rsos.200909.
 S. Kierkegaard, The Concept of Anxiety. 1844. See chapter 5, “The Concept of Anxiety”.
 Sigmund Freud analysed prevalent anxiety hysteria among the fin-de-siècle Austrian upper middle class. One of Freud’s most famous case subjects, “Dora”, whom he treated for hysteria, was the sister of the Austrian Social Democrat leader Otto Bauer.
 The Machiavellian social theorists from Vilfredo Pareto to James Burnham analysed elites in terms of foxes and lions. The symbolic lions have largely disappeared from the contemporary scene as have even the foxes. What we now are left with in our satchel of political animal symbols are domesticated animal types like the German Shepherd breed—breeds are that increasingly reported as anxiety prone like their human owners.