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The Health Wrap: “callous disregard for people’s lives” and other COVID concerns, climate updates, and songs for connection

In her latest column, Adjunct Associate Professor Lesley Russell takes a deep dive into the latest news on COVID, climate and research integrity.

She also brings good news in Indigenous health, and reports on a project that found choir singing can provide important benefits for people living with dementia and their family and friends who support them.

The quotable?

Australia is one of the few countries with a developed research sector that does not have a research integrity watchdog, instead relying on research institutions to initiate and oversee investigations into their own researchers.”


Lesley Russell writes:

In the almost four years since the pandemic began, it’s been near impossible to write an edition of The Health Wrap without including some news and discussion about COVID-19 and its consequences: this edition is no different.

The previous edition of The Health Wrap looked at how the federal and state and territory governments of Australia have dropped the ball on pandemic management, even as it seems we are entering yet another wave of infections.

My concerns (and those of many others working in public health) were reflected in an article by Karen Middleton in The Saturday Paper on November 11.

She quotes Dr Suman Majumdar from the Burnet Institute, who says that the new wave of infections warrants more active measures, and it should not be a binary choice between personal responsibility and government edict. He also argues that better data would help significantly.

But increasingly, Australian government public health authorities are choosing not to make data on infections and hospitalisations regularly and publicly available.

A quote in Middleton’s article from AMA President Professor Steve Robson particularly caught my eye: “I don’t know what it is about masks that causes such a violent political reaction from some people.”

I’m a mask wearer – on public transport, especially on planes, in concert halls etc – and increasingly I’m in the minority. I’ve had a few querulous looks but have never been confronted about my mask-wearing. A healthcare worker in a hospital setting did tell me that I didn’t need to wear a mask!

I think mask wearing is important to protect from all respiratory infections, not just COVID-19. That view-point is justified by the findings of a recent paper published on JAMA Network Open. 

It concludes: “Robust available data support the use of face masks in community settings to reduce transmission of SARS-CoV-2 and should inform future responses to epidemics and pandemics caused by respiratory viruses.”

The CDC also refers to mask-wearing in its advice for preventing COVID and other respiratory infections in the holiday season ahead. https://www.cdc.gov/respiratory-viruses/whats-new/stay-healthy-during-holidays.html

Pandemic inquiries

Both Australia and the United Kingdom currently have government-sponsored inquiries into their government’s management of the pandemic.  This work is critical to ensuring better future pandemic preparedness.

Australia

Prime Minister Anthony Albanese announced the long-awaited federal inquiry on September 21. The Terms of Reference are here.

See also the article from Professor Don Nutbeam Australia’s COVID-19 inquiry announced, as public health leaders highlight importance of learning pandemic lessons in Croakey Health Media.

The inquiry’s website says it will “give advice on what worked, what didn’t, and what we can do in the future”, including “opportunities for systems to more effectively anticipate, adapt and respond to pandemics”.

There was backlash over the fact that the Terms of Reference indicated that actions taken unilaterally by state and territory governments would not be part of the inquiry. However, Robyn Kruk, the Inquiry Chair, has indicated that she thinks the terms are broad enough for panel members to examine state and territory responses, including lockdowns.

Federal Health Minister, Mark Butler, now says it would be “extraordinary” to not examine the implications of lockdowns, social distancing rules and other public health measures rolled out by individual states.

While the Terms of Reference are unchanged, explanatory notes recently added to the inquiry’s website now indicate that “the inquiry will consider the roles and responsibilities of the Commonwealth Government, and state and territory governments in managing pandemic responses, the interaction between these tiers of government, and the overall cohesiveness of the joint Australian response”.

The work of the inquiry is going on out of the public view with nothing publicly reported to date. There is information about providing submissions and evidence to the inquiry here.

Submissions close on December 15.

United Kingdom

In contrast to Australia, there has been lots of public revelations (some quite salacious!) about the work of the public inquiry in the United Kingdom.

This inquiry was launched on 28 June 2022. The Terms of Reference are here.

The inquiry is divided into modules. There are currently five underway:

  1. Resilience and preparedness
  2. Core UK decision-making and political governance
  3. Impact of Covid-19 pandemic on healthcare systems in the 4 nations of the UK
  4. Vaccines and therapeutics
  5. Procurement

You can watch all the hearings on all the modules on the inquiry’s YouTube channel, here.

A recent hearing on 31 October for Module 2 (Core UK decision-making and political governance) took testimony from Lee Cain (former Director of Communications at 10 Downing Street) and Dominic Cummings (political advisor to Prime Minister Boris Johnson) and it is shocking, even given what we already knew about Johnson and his attitude to the pandemic. You can access the testimony here.

A media release from the British Medical Association described it as “laying bare the dysfunction at the heart of Government [at the time of the pandemic], a dismissiveness of expert advice, a failure to act quickly and a callous disregard for people’s lives.”

 

An editorial by Dr Richard Horton in The Lancet summarises with horror what the inquiry learned about the attitude of Johnson and his staff in early days of the pandemic, when they were “laughing at the Italians” and their concerns.

The editorial concludes: “The lies, deceptions, and callous conceit that characterised the UK’s initial response to COVID-19 must surely bring some kind of reckoning.”

The UK edition of The Guardian summarised the damning testimony  and appalling revelations from Cain and Cummings – crass and aggressive exchanges between Johnson and his advisors, the flip-flopping over pandemic decision-making and Johnson’s callous attitude towards the fate of older people (“COVID is nature’s way of dealing with old people”).

And in case you missed it: in the reshuffle of Prime Minister Rishi Sunak’s cabinet after the sacking of Foreign Minister Suella Braverman, Victoria Atkins has replaced Steve Barclay as the seventh Health Minister since 2016.

She takes up this position at a time when the National Health Service is facing one of the toughest periods in its 75-year history, including industrial action and record waiting lists.


Impacts on life expectancy

The Australian Bureau of Statistics (ABS) has just released the latest data on life expectancy.  For the first time in some 30 years, life expectancy decreased in 2020-2022.

Life expectancy at birth for males was 81.2 years and 85.3 years for females, a decrease of 0.1 years for both. In contrast, over the past decade, life expectancy increased by 1.3 years for males and 1.0 years for females.

The gap in life expectancy between males and females is 4.1 years.

Australia has the third highest life expectancy in the world – only Monaco and Japan have higher life expectancies than Australia. Australia’s male life expectancy ranked second, and female sixth, internationally.

ABS data: https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-30-september-2023

In the media release accompanying the report, the ABS Head of Demography, Beidar Cho, attributed the decrease in life expectancy to the fact that in 2022 the number of deaths over those expected increased by 20,000, with close to 10,000 of these being due to COVID-19.

Despite the relatively large increase in deaths, the effect on life expectancy was small because over half (56 percent) of all deaths in 2022 were of people aged 80 years and over.

In an article on the ABS data in The Australian, Cho was reported as saying that the decline in life expectancy was a “glitch” – a comment which I found glib at best and actually ageist and abhorrent.

Research has shown that in the first two years of the pandemic, Australia’s life expectancy continued to increase, in contrast to most other high-income countries. This was attributed to the initial relatively stringent restrictions and consequent low mortality rates.

When these restrictions were loosened, there were more COVID-19 deaths and more excess deaths.

There has however been some debate around the decline in life expectancy and we won’t know if this is a trend or a glitch until there are several years’ of data.

A 2019 paper published in The Medical Journal of Australia shows that the yearly increase in life expectancy in Australia was slowing prior to the advent of the pandemic, probably because the declines in mortality from cardiovascular disease and cancer have slowed.

I have regularly reported on the appalling decline in life expectancy in the United States due to both COVID-19 and the so-called “deaths of despair” from drugs, guns and suicides and on the “excess deaths” in the United States, the United Kingdom and Europe due to COVID-19 impacts on the healthcare system. See for example, The Health Wrap, March 15, 2021 here and The Health Wrap, October 19, 2022 here.

It would be awful if the current lack of attention from Australian Governments to the ongoing consequences of the pandemic (and perhaps I should also add obesity, mental health and drug abuse to this?) saw Australia also join that ignominious club.

A study just published in JAMA Internal Medicine shows how rapidly the pandemic and adverse health outcomes have affected life expectancy in the United States, which has seen over 1 million COVID-19 deaths.

Life expectancy for Americans has fallen from 78.8 years in 2019 to 77 in 2020 and 76.1 in 2022, undoing over two decades of progress. This puts the country far behind its wealthy peers.

The picture is especially concerning for men, whose life expectancy is now 73.2 years, compared with women’s 79.1. This 5.9 year gap is the widest between the two genders since 1996.