Flatten the Curve, Fatten the Crisis

If war is too important to be left to the generals, epidemics are too critical to be entrusted to the doctors. That is the only conclusion to be drawn from Australia’s foolish rush to hysteria over Covid-19. As a result an artificially-induced recession has shut half the country’s economic activity, legitimised criminally dangerous policies and criminalised normal activities.

From the beginning, Australia’s characterisation of Covid-19 as the twenty-first century’s Black Death was designed to terrify a malleable population, inducing it to accept the dictates of doctors crying “the curve must be flattened” or the hospitals would be overwhelmed. That slogan determined the strategy for every subsequent government action.

Mr Morrison made an initial mistake by pushing Dr Brendan Murphy as the government’s spokesman. Where else have public servants taken the microphone to explain what course of action to take in a crisis, and have the Prime Minister and the health minister  obediently endorse that advice? If the medical advice had been given in private, as it should have been, Greg Hunt, a competent minister would have been in a position to require an immediate and continuing evaluation of the statistics as a basis for policy.

Instead, from the pandemic’s dawning in February, the horrific numbers from Wuhan were extrapolated, deliberately or subliminally, to imply what awaited this nation.  As the Chinese numbers contracted, the conclusion was allowed to be drawn that draconian measures, principally “shutdown” was the only effective response. Parents picked up the signal faster than governments; truancy rates rose through 40 per cent to 80 per cent as premiers argued with Dr Murphy.

After China, then Italy and Spain, nothing was done to counter the meme that the plague would be exactly replicated here. The numbers tell the story of the difference: When Italy’s caseload stood at 2700 cases on March 4, there had been 107 deaths; Australia, as of March 26, had a similar number of identified infections but only 10 fatalities.

Nevertheless, a state of emergency was declared, billions of dollars thrown to undeserving constituencies, creating a stock market rout and inducing an economic collapse. With the first financial package came promise of a second; with the second, intimation of a third. No wonder every group still left working put out their hand for “virus money” and every other industry, from airlines to sporting codes, demanded compensation.

The media has played a devastatingly destructive part in the decline in public confidence.  ABC interviewers have descended to arguing with ministers (As Fran Kelly admitted this week after an especially impertinent confrontation with Greg Hunt); Dr Norman Swan launched his campaign against the schools’ policy to assert the ABC’s authority on policy issues; even The Australian succumbed to hyperbole, railing against the disobedience of a thousand  people sprinkled over Bondi beach as “a human tsunami”!

As I have explained, experience of the virus in other countries cannot be a reliable guide to what will happen here, and no necessary model for strategy. Living conditions in China, Italy and New York differ vastly from those in Australia. What appears to work in South Korea or Singapore is not necessarily a good model for us. Yet three months’ experience elsewhere may be a guide on what not to do in a country with many small businesses dependent on service in tourism, food and leisure industries.

Unfortunately, policy still seems to derive from raw score-keeping, and health departments better at tally-keeping than analysing. The Commonwealth and state health departments publish daily new and total cases, segmented by age.  NSW has just shy of 1500 cases as of midday on March 27 over 1000 cases, running at about 200 more each day. Based on the previous day’s final numbers, about 300 (29%) are over 60, and about 500 (49%) in the range of 30-59 years. There is no attempt to explain why this distribution. NSW reported 10 people in intensive care, with four  on ventilators. There are 500 ICU beds available, and the ability to at least double that number, so why is the government panicking to cancel elective surgeries?

Seven people have died of the virus in NSW (not recorded on the health website) but what were their ages and conditions? Surely sensible forward policy should be based on an assessment of the age and vulnerability of everyone who succumbs, not merely a blanket assumption that everyone at risk of contracting the virus may die. If only a small proportion of those who contract the virus develop serious conditions, and an even smaller proportion of those die, isn’t it likely that most of us can go about our lives with little risk? On an infinitesimally low probability, pre-emptive government policies have destroyed the economy and inflicted even more damage. What was a required was a discriminating policy to protect the vulnerable — the aged and those with serious medical conditions that are known to enhance risk of dying.

To return to the issue of the unmodulated medical advice leading government: Professor John Ioannidis, of Stanford University, says the data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. “We don’t know if we are failing to capture infections by a factor of three or 300,” he said. “No countries have reliable data on the prevalence of the virus in a representative random sample of the general population.” He describes the Covid-19 situation as an evidence fiasco.

Professor Ioannidis, whose scepticism about the profession began from his discovery that most medical findings are contradicted by subsequent studies, argues that if the case fatality rate, population-wide is as low as 0.05%, it is lower than the seasonal influenza. Locking down the world with potentially tremendous social and financial consequences may be totally irrational. “It’s like an elephant being attacked by a house cat” he says. “Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.”

Australia, pursuing its favourite precautionary principle, seems to have unleashed the cat.

14 thoughts on “Flatten the Curve, Fatten the Crisis

  • DG says:

    The media, politicians and the public like nothing but a good panic. Its a case of here we go again. Surely a more sensible approach would have been to sequester the aged and infirm and direct resources to supporting them, closely managing ports, and being rather more sensible about everything else.

  • Peter OBrien says:

    Geoffrey has touched on an issue that is intriguing me which is the lack of public data about just what is going on in hospitals – how many people are hospitalized, how many are in ICU, what are their ages, pre-existing conditions and, importantly, when were they admitted. If that information is available I haven’t been able to get hold of it. Italy went from 107 deaths to 197 in three days. Italy is not a good basis from which ‘modellers’ should draw their assumptions.
    Another irritation is the use of half-arsed statistics. Here are three examples:
    Judith Sloan:
    An assumption here is that younger people won’t be much affected, even though the data suggests that in France, for instance, half of those in intensive care units with COVID-19 are younger than 60.

    Natasha Robinson and David Ross:
    Analysis of coronavirus infections data recorded by the federal Health Department reveals that those aged under 49 make up almost half of diagnosed cases.

    But Australian intensivists receiving briefings from their counterparts in Italy, the US and China – where between 30 and 50 per cent of COVID-19 hospitalisations have been of patients under 65 – are also braced for relatively younger patients with life-threatening COVID-19.

    Under 60, under 49 and under 65 covers a lot of people most of whom are probably at the top end of the range. And again, this tells us nothing about deaths, which is surely, what this panic is all about. We are not shutting down the economy because some people might get sick. Or rather we shouldn’t be.

  • Lo says:

    It is frightening seeing what is happening, hearing presumably rational people expressing fear of touch or contact, (my lawyer said he couldn’t shake my hand) and watching people’s reactions, some quite overreactive or overbearing in the supermarket and the community.
    Not to mention that our carefully husbanded savings, intended for repair of the roof etc for the rest of our lives have diminished by so much I’m afraid to look.


    “Locking down the world with potentially tremendous social and financial consequences may be totally irrational”.

    Is the suspicion, that there is devious rationale to the financial consequences, unfounded? Collapse of the current world economy? One world Government Beta?

  • pgang says:

    Nice one Geoffrey. Your opening two paragraphs are particularly spot-on and reveal the true contagion we are facing.

  • March says:

    Thanks Geoffrey. Now if only someone will listen before its too late.

  • Peter Smith says:

    I consult worldometer for information on the number of “cases” in each country. The number of cases it shows worldwide as being serious or critical is trivial. It shows 23 in Australia. If this is right how do we square it with the hysteria? We keep getting information on case numbers, without any detail on how serious they are. It is beyond frustrating. Boris Johnson is a recent new case. But he is at home at number 10 with a slight cough and slight fever. I had at least two colds last year with a sneezing, coughs and slight fever. God help us.

  • Nezysquared says:

    Simple numbers. Total (recorded) cases via Worldometer 600,000. Total deaths + severe critical 50,000. This represents a potentially poor outcome for 9% of the total. Much worse than flu and we’re only 2 months into the pandemic. It’s probably too early for reliable epidemiological assessments (Chinese liars haven’t helped), which take into account relative population densities and the effect of co-morbidities etc, when the virus mechanism is still so poorly understood. We don’t yet have a quick, cheap and reliable test for antibodies yet to determine a clearer picture of the scale of infection. No doubt the government have taken a sledge hammer to crack a nut but, if anything, the criticism should be aimed at political paralysis when a short sharp reaction early in the piece would have made a world of difference.

  • Bernie Masters says:

    I’m unimpressed by the article. The tone is set early when the author describes students kept away from school by their parents as truants, which is not an accurate description of their absence from school. More importantly, the threat to our hospital system from coronavirus cases needing admission to hospital was and still is immense, so governments around Australia – federal, state and territory – chose damage to our economy rather than chaos in our health care system and many more deaths of our citizens.

  • Alice Thermopolis says:

    PS: “We keep getting information on case numbers, without any detail on how serious they are. It is beyond frustrating.”

    Go to: https://www.health.gov.au/news/deputy-chief-medical-officers-press-conference-about-covid-19-on-28-march-2020

    “In terms of hospitalisations, up to now – so this is from the very beginning of the first cases in Australia back in January – we have had 389 cases who have been hospitalised. So that represents just over 11 per cent of the total cases. And there have been 30 cases now that have been reported to be admitted into intensive care. That’s throughout the whole epidemic.”

    As of last Friday, 62% of cases “overseas acquired”; 18% “contact with a confirmed case”; 4% “locally acquired, no known link”; 16% “under investigation”; 16 deaths. AFR chart

  • talldad says:

    Sir Humphrey Appleby: “Politicians like to panic, they need activity. It’s their substitute for achievement.”

  • talldad says:

    Alice, the link shows:
    Altogether 3400 cases and just 30 have died with the infection present. That is still less than 1% morbidity, and not enough to even blip the normal mortality statistics.

    Although Dr Kelly says “died OF the virus” I would like to know how that was determined: have autopsies been carried out? If all the deaths were of people in the old age category, did they have any pre-existing conditions, or were they vulnerable through a weakened immune system?

  • Max Rawnsley says:

    Make no mistake this virus issue is another in the seemingly endless continuum of media driven anxiety and rage.. Our politicians dine on it and patronising the madness as we drift steadily into socialism.

    Yes the death toll in a number of places is high. Is there an objective analysis of it? By age? By pre existing heath problems? By congenital issues such as asthma etc? There seems agreement on its origins and a failure to identify a vaccine or act on the cause. The latter is a political issue we are unlikely to resolve. Indeed the China proxies are out there is stout defence.

    Removing the Henderson and Ruby Princess sources that struck aged persons in particular and a few other instances such as the wedding near Sydney that produced 34 infections etc is a more tgan useful reality check.

    We know the fatality rates are almost certainly a cause for older Australians, lets say 70 yro on wards to be in some isolation from others going about their normal day.That is where the public reaction should be placed. Not imposing yet another albatross on the wider community with debt arising from over reaction.

    We lose 000’s each year to flu, its contagious maybe not quiet at the cvirus level but we do know that reasonably health men,women and children are not at mortal risk in either instance.

    Lets roll back the overreaction, look after the elderly and stay home in isolation if you have the symptoms, just like the flu. .

  • David Flint says:

    This is an excellent assessment of a political leadership, so long apologists for the Beijing communists who completely failed to control the entry of the virus. I flew in from a cruise on 26 February to a lax reception, for example, no temperature scanning. More recently, The Australian’s Troy Bramston had an identical . Two months after following Trump’s early action on travel from China, the politicians put in some real controls, closing the gate after the horse had bolted. The dictator-premiers, embarrassed by their failure introduced police states at least in NSW and Victoria. As Geoffrey demonstrates , all so unnecessary. Meanwhile, experts say the danger of more pandemics is increasing, and that exponentially.

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