COMMENTARY 1: COVID
This commentary is posted May 1, 2020. It’s a bit of a ‘you heard it heard first’ type post, but who really knows what is ahead? One thing is for certain however, COVID is in our lives forever and unless a significant effort is put in place to plan how we deal with it, the social and economic impact will put this country on its knees.
The NZ COVID strategy of elimination is fraught.
We can see already that our politicians love dining out on our country's status as an ‘elimination world leader’ and in fact it’s likely there may even be an election victory later in the year because of it. One thing is for certain, in some shape or form the 2020 election will be a COVID election.
It’s just a shame that the same level of energy and brain power that will be dedicated to spin and political capital is not put into preparing a long term plan for dealing with COVID. We could have this thing aced by the new-year, but I suspect not. It’s not in a politician's DNA. As a population we are inflicted with ‘reactionary’ politics, decision making, leadership and management. There should be a cross party, expert, non-political advisory group that advises on the long term CORONA virus strategy. Public health must be separated from public politics.
In these times, alternative and opposing opinions on the problems and solutions surrounding the pandemic and indeed all major health issues, need to be heard, not silenced. Yet, popular platforms such as YouTube, Twitter and Facebook have reportedly stated “anything that goes against WHO recommendations” on the COVID-19 pandemic would be “a violation of our policy,” and those contents would be removed.” We see locally the influence (subtle or otherwise) placed on journalism. We dare not critique what the decision makers are doing as it doesn’t fit into a ‘team’ (of 5 million) culture. Nice play, but this 'shut up and comply' culture will come back to bite us in the bum, because we are heading down the wrong path. To date, the media have failed miserably in educating the public on how to improve their immune health and have instead relied on the false hope of drugs, a vaccine, social distancing, being kind to others, washing the hands and masks.
On balance, such policies probably do more good than harm, however, they may come at a cost down the line (or even right now). If history is any guide, censoring any opinions that contradict institutional authorities or the conventional wisdom often doesn’t end well.
However, as the German philosopher Hegel put it, the only thing we learn from history is that we learn nothing from history. While COVID-19 presents us with a particularly thorny case of decision making based on scientific uncertainty, this issue is perennial in science. We are our own worst enemies when it comes to identifying any shortcomings in our hypotheses. We are victims of confirmation bias, groupthink, anchoring and a slew of other cognitive biases. The worst part is that we are often unaware of our biases, which is why we’re the easiest people to fool. The political, health and medical professions fall into this category.
As painful as it seems, considering problems and solutions from a perspective that contradicts our own is one of the best ways to enhance our decision-making. But thinking this way, deliberately and methodically, is a practice, and though it’s really hard, it is necessary in order to sharpen our cognitive swords and find real workable solutions. Regrettably - this doesn't seem to occur in NZ.
Elimination will never work. It will never work for the same reason you will never eliminate the seasonal flu virus. Typically, hundreds of people in this country will die with the seasonal flu between April and September 2020. Terrible, sad, but reality. Why does the Government / MoH not throw billions of dollars annually at trying to prevent those deaths?
Because it’s like trying to mop the floor with the tap on. The entire health system is not about prevention or cure – it’s just about treating and retrospect. It is only during a pandemic that prevention becomes a focus, explaining why a policy focused organisation like the Ministry of Health struggles to operationalize a paper run, little own viral testing or the dispensing of protective equipment. It's not their business, it's not their trade in much the same way that prevention and cure of health issues is not their trade. Waiting until disease strikes before springing into action with treatment is their trade. Our national COVID response is the same and I’m sure as we travel through the year we will many examples of being ‘caught out’ because we are being managed through this process by reactive rather than proactive policy and decision making
During the winter months we are encouraged to take the flu vaccine, but that doesn’t guarantee we won’t actually get sick or experience a recurrence of the flu later in the season.
The COVID vaccine will be exactly the same, irrespective of the spin that comes with it. I just wish this every increasing population of epidemiologists could tell the public the truth without fear of having their Government back research grants cut for not towing the party line.
Just like the seasonal flu, people do not die because of COVID 19, they die WITH COVID 19 – there is a profound difference. It’s still the frail, the obese, those with diabetes, respiratory or cardiovascular conditions, cancer and autoimmune suppression and other comorbidities that die with the seasonal flu and 10 times more than the 22 (at the time of writing) that have died (or will die) with COVID.
Elimination won’t work for a number of reasons
- You can’t eliminate COVID. It will continually reinvent itself just like a season flu virus.
- Every time we get a community spread the country will hemorrhage (economically and medically) and our reactive mentality will kick in as we scurry to eliminate. Each lock-down will further drain an ever decreasing pool of economic reserves and social tolerance.
- We are a trading nation. We cannot lock ourselves away from the rest of the world and survive. The only way to eliminate this virus (if it were at all possible) is to prevent it from coming across the border.
I suspect history will show that Sweden (and the USA to some degree) got it right. But this incessant comparison between NZ and America (or Britain, Spain, Brazil etc.) is simply a hoax. The American, British, Spanish, Brazilian populations are among the unhealthiest in the world. The more unhealthy people are, the more risk of death from COVID. The cohorts in NZ at greatest risk are Pacifica and Maori. But we would be accused of breaking all the PC rules if we suggested that it’s within these communities that the greatest rates of obesity, diabetes, cardiovascular disease, respiratory disease sit. The truth is – it does, so we just have to hold our breath and hope community spread doesn’t hit these communities.
We simply don’t know how long immunity (antibody neutralization) lasts and it could be two years down the track before reliable data is available. But there are already reported cases of people being re-infected with COVID 19 only (three) months after their initial infection. Immunity from other human corona viruses like the common cold lasts anywhere from 4 to 12 months.
That said, the only way to deal with COVID is SUPPRESSION or in international parlance – herd immunity.
Natural herd immunity over a period of time where communities naturally build antibodies is the only strategy. Sweden got it right. Britain originally got it right but then (not untypically) got cold feet. The USA is doing it by stealth, but because of the poor levels of population health, a lot of people could die.
The Swedish population will naturally build immunity as more and more people develop antibodies.
I suspect by the end of 2021, the Swedish economy will be the ‘global rock star’. If NZ continues down its current path of trying to convince the public that the sun sets in the east (or elimination is our way back to prosperity) our once rock star status will be nothing more than a very distant memory.
The NZ strategy of locking people away every time a little cohort develops the virus is a bit like storing methane gas in a room with the valve open and one day someone opens the door carrying a live flame.
I have no doubt that until the methane door is (involuntarily opened) NZ will continue to show off internationally just how clever we are beating this thing when in actual fact we haven’t been smart enough to work out what’s behind the door.
Remember back in March we suggested there would be a delayed election – well I still think that will be the case. If the explosion doesn’t go off pre-September the Government might just sneak through the door, but the NZ public sometime in 2021 will look back and go – “what the hell were we thinking – how could we have been so played and stupid?” Proving that the only thing that spreads faster than a COVID virus is stupidity. Don’t believe me? Watch what the toilet roll people do next lock down.
If re-elected I’d put money on our current PM not seeing through that second term. The upcoming period of Government will arguably be the most challenging in our most recent political history. The problem for the PM is if she decides to bail out part way through her second term, not guide us through the mess she and her colleagues are responsible for creating, she risks becoming the Quade Cooper of the political world.
(NB: I’m not anti any party or any politician. They do their best when operating under the constraint of re-election and political capital at any cost. I’d be making the same claims regardless of who is in power.)
Here is the thing:
· Throughout COVID we will increasingly become dependent on the state. So much so that a big proportion of the population will feel it’s the Government's responsibility (as they probably do now) to wipe their bottom for them. Already we are experiencing a level of state control and forced conformity that is quite unprecedented. When were we ever a country of people who would respond to a leader asking us to dob-in the non-conformists?
· This bottom wiping expectation extends to personal health. By the time we hit the end of 2020 a huge cohort of the population will be dependent upon the state not just for their health, but their livelihood.
· It is the responsibility of every individual in this country to take ownership of their own personal wellbeing and health. In times like this we pay the price for a lifetime of self-neglect.
· If you have comorbidities – YOU need to take precautions. If you choose not to, you risk serious illness or death. YOUR CHOICE!
· The Government's role should be to communicate daily where community spread is occurring (as they do daily in Sweden) and the people in those regions at risk need to take care. The rest of the population can get on with life. Testing and the accurate communication of community clusters should be our focus. If people at risk don’t heed, so be it. It’s no different to the seasonal flu.
· As I write this, at this very moment, there is already a vaccine for the COVID 19, just as there is a vaccine for seasonal flu. It’s called good health.
· If you are healthy and well – you will not die with COVID 19. You might develop some symptoms and if you have comorbidities, become more seriously ill, but as it stands at this point in time, less than 1% of any population will die with COVID. Hundreds more people die every day with cancer, CV disease, pneumonia. Over the level 4 lock down period in NZ, 4500 New Zealanders died of other complaints.
· The public just need to take 6 weeks of their life to GET HEALTHY AND WELL, and learn how to live a wellness lifestyle.
· Businesses will still operate with the occasional employee away sick, but our economy won’t tank as is expected by the middle of 2021. The social wellbeing of our communities won’t end up in a grave.
· If you want to function normally as a business – help your people become well. As a family, community, a team, organization – help your people become well.
· Over 90% of existing preventable illness and disease can be reversed. That’s all we need to do as our ‘COVID going forward strategy’
- Screen people coming across the border. Understand where the risk is around the country.
- This constant call for more holidays and sick leave is nonsense. Staff don’t need more sick leave, they just need more wellness support.
- Provide free screening and testing in all communities. Privatize it
- Communicate where the clusters are.
- The people who haven’t looked after their health need to isolate – or risk illness or death.
- The people who are healthy and well will probably develop the COVID infection but most will remain asymptomatic and fine – especially the healthy young. Some may develop stronger symptoms but the chances of death are statistically slim.
- If someone does carry comorbidities – then they isolate until they have restored their health and wellbeing or their community is clear of risk. Think about this – if people go into lockdown or some form of isolation it’s the perfect time to build their personal health and wellbeing literacy. Learn during this time how to develop better health and live a healthier lifestyle. Learn how to improve your current health status without relying on medication that can actually contribute to worse health and greater risk.
- Medical people will argue there is no cure for cancer, heart disease, diabetes, obesity, but what they mean is there is no cure using medication because that’s what they train in. They are medical professionals – they don’t train in illness prevention or cure. They train in treating the symptoms of poor health using meds.
- Within 24-36 months the vast majority of the population will have developed natural antibodies – perhaps 70% of the population. This would get us close to the point where COVID 19 is just a disease of children (like the measles) and with a stronger immune system the impact of the virus is minimal. A reduction in susceptible individuals would weaken subsequent waves. Over time we will reach a point where covid-19 deaths in the elderly are virtually unheard of — but this could take a decade or more. Development of a vaccine would vastly accelerate this process, but those people (politicians included) that think it will be the panacea are deluded and misinformed. The higher the rate of exposure the faster the rate of immunity. BUT WE NEED TO APPROACH THIS FROM A POSITION OF PROMOTING WELLNESS, not waiting for illness to strike the vulnerable then jumping into action.
So there you go
You heard it from PEH first
Let’s see what eventuates by December 2020.
So get your friends, family, and colleagues healthy. It will be the only way we can survive as a country and communities in this new world we live in.
Oh – and another prediction. Climate change will take a back seat to public health by the end of 2021. There is no point having a carbon free planet if we are all too poor, depressed, sick, isolated or dead to benefit from it.
It’s an acerbic fact that COVID is not about health – it never has been. If it is about health, successive governments / Ministry’s would have waged war on cancer, heart disease, diabetes or a host of other health threats that kill far more people than COVID.
The indefensible defense of ‘elimination’ is like trying to convince the world that the sun sets in the east every evening. The best ‘Pivot’ we will see through this whole saga will occur when the government realizes this to be true. The elimination strategy can’t happen because we can’t afford to play the long game with it. COVID is a part of our world, just like the seasonal flu. We can cope with the FLU, so we can cope with COVID 19, 23 or 28 etc. We just need to be smart about how it’s done.
See the next piece titled “The Real Problem with our Health System” Spoiler alert – it’s not the DHB’s