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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.



WRESAT Tests (Image source: Australian government)

Australia is a lucky country, run by second-rate people who share its luck

At the end of WWII my country could make its own aircraft, radar sets, ships and tanks. By 1947 Ben Chifley our war-time prime minister had launched the Snowy Mountain scheme,  and by 1958 we had built HIFAR our first nuclear reactor. In 1967 we were the fourth nation to launch a satellite into orbit, and were pioneering digital computers on the Snowy scheme. So how did a nation that did all these things not because they were easy, but because they were important, end up in a situation where the dying heart of it’s industrial might is considered a few foreign-owned car manufacturing plants in Victoria?

I had in mind in particular the lack of innovation in Australian manufacturing and some other forms of Australian business, banking for example. In these, as a colonial carry over, Australia showed less enterprise than almost any other prosperous industrial society.

Donald Horne

We seem to have lost the ability to imagine a tomorrow different from today, and then to act on that imagining. Instead our future is mapped out by the great and the good as little more than a large open cut mine. Nation building? We’ll have none of that, it’s all about homo-economicus, the citizen defined as consumer and the devil take the hindmost. Energy policy? Why would we need that? We’ve got plenty of coal to burn for another two centuries. Imagination and reflection? No time in the feeding frenzy media cycle that substitutes for informed and rational debate. Nor are our so called business leaders any better, an obsession with short term gain and an unwillingness to take risks has led to our best individuals and their ideas decamping overseas.

The problem is that this century is shaping up to to be even tougher than the last and any nation that lacks imagination, courage and the tenacity to stay the course will just go under. I wish I could report that I think Australians have what it takes to weather the coming storm, but viewing the puerile partisan debates swirling around the latest casualties in a long dying half century of neglectful myopia I am less than optimistic.

Way off topic for this blog but I watched the ABC’s 7:30 current affair report on thursday in which Kevin, our illustrious prime minister, was put on the spot about why he has publically supported Australia having a population of 35 million people. His response? Well basically his argument was “it’s bigger than both of us so jus lie back and enjoy it”.

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