Imperial College London just  updated their report on interventions (other than pharmacological) to reduce death rates and prevent the health care system being overwhelmed. The news is not good.

They first modelled traditional mitigation strategies that seek to slow but not stop the spread, e.g. flatten the curve, for Great Britain and the United States. For an unmitigated epidemic they found you’d end up with 510,000 deaths in Great Britain, not accounting for health systems being overwhelmed on mortality. Even with a full optimised set of mitigations in place they found that this would only reduce peak critical care demand by two-thirds and halve the number of deaths. Yet this ‘optimal’ scenario would also still result in an 8-fold higher peak demand on critical care beds over available capacity.

Their conclusion? That epidemic suppression is the only viable strategy at the current time. This has profound implications for Australia which still appears to be on a mitigation path. First, even if we do our very best there will be a reduction of at best 50% in the death rate. This translates to on the order of at least 100,000 deaths. To put that in context that’s more than Australia lost in two world wars. The associated number of sick patients would undoubtedly also overwhelm our critical care system.

The only viable alternative Imperial College identified was to act to suppress the epidemic, e.g. to reduce R (the reproductive number) to close to 1 or below. To do so would need a combination of strict case isolation, population level social distancing, household quarantines and/or school and university closure. This suppression would need to be in place for at least five months. Having supressed it a combination of rigorous case isolation and contact tracing would (hopefully) then be able deal with subsequent outbreaks.

However Australia is not doing this, the Prime Minister has made this very plain, he’s not going to, ‘turn Australia off and then back on again’. We also seem to be underestimating the numbers (see this Guardian article on NSW Health’s estimates). So in the absence of the State Governments breaking ranks we are now on an express train ride (see chart below) to a national disaster of epic proportions. Jesus.

NSWCOVID19

 

Farewell

22/02/2019

This will be the last post on this website, so if you want to grab some of the media available under useful stuff feel free.

Well, as someone said, because it’s the worst of social media, combined with the worst of corporate culture and the worst of website design. Because dealing with it regularly is as interesting as cleaning out my sock draw, and because the tone, like an endless ritalin fuelled rotary meeting, is just plain unhealthy. The philosopher Kant once said that you should always treat human beings as ends in themselves, and never as just the means to an end. Well LinkedIn for crimes against the categorical imperative alone you have to go…

Black Saturday

07/02/2019

So ten years on from the Black Saturday fire we’re taking a national moment to remember the unstinting heroism displayed in the face of the hell that was Black Saturday day and all that was lost. Of course we’re not quite so diligent in remembering that we haven’t prevented people rebuilding in high risk areas, nor in improving the fire resistance of people’s homes, nor yet in managing down the risk through realistic burn off programs, nor for that matter have we noticed that the fuel burden in 2018 is back up to the same levels as it was ten years ago. So perhaps instead we should reflect on how we’ve squandered the opportunity for reform. And perhaps we should remember that a fire will come again, to burn our not so clever country .

Spruiking zero harm or crusading safety ‘because you care’ raises as much suspicion as having a folder on your computer named ‘DEFINITELY NOT PORN’ – would you get on a plane that had “ZERO CRASH” emblazoned all over it?

David Collins

The deadline for you to opt out of the government’s ill advised national health record system is rapidly approaching, and for the record yes I have opted out. I’ll give you a concrete example of what I’m talking about when I say ‘ill advised’, currently it’s assumed that you’ll be OK to share your anonymised medical data for research purposes by setting sharing it as a default. This is despite it being shown time and time again that the anonymisation of such data just doesn’t work. You might share my concerns about this lack of concern and level of indifference to the idea of informed consent. What the agencies of the state clearly don’t get is that this this information belongs to you and I, it doesn’t belong to my doctor, your medical data is yours your doctor holds it in trust for you. And until the state demonstrates a clear and unequivocal understanding of that point I say no thanks and I’d invite you all to do the same. My Health Record? Not so much.

PS. The architect of My Health Record is Tim Kelsey, yes that same Tim Kelsey who presided over the UK Government’s Care.data, program which tanked over sharing data without explicit consent. And unfortunately for us that attitude is baked into My Health Record’s DNA.

PPS. To me the carelessness of of the government in this whole affair is indicative of the increasingly totalitarian relationship between the government and the people.

Facebook and Google back Labor changes to laws which break encryption