In this latest edition of The Health Wrap, Associate Professor Lesley Russell looks back on an extraordinary fortnight in United States politics as Trump refuses to concede defeat in the US Election.
Also, she previews the uphill battle ahead of the Biden Administration in tackling an out-of-control coronavirus pandemic, highlights the importance of rebuilding trust in US Centers for Disease Control and Prevention and, in lighter news, looks at what we might learn from our ageing canine companions.
Lesley Russell writes:
Whew! What a fortnight of US politics – and it’s not over yet.
When James Blackwell and I convened a #CroakeyLIVE Zoom forum on #USvotesHealth on November 4 (late on election day in the US) we had no idea how it would all turn out – but thanks to our guests Professor Adam Elshaug, Dr Andrew Leigh MP, and Larry Irving and questions from those who joined us, we had a great discussion. If you missed it, there’s a great summary from my Croakey colleague Marie McInerney here.
Since then we have all been mesmerised, maybe even appalled, at Trump’s refusal to acknowledge the (almost final) result. The experts agree that the recounts and lawsuits are just delaying the inevitable, although there are fears that Republican-led states may try to play games with the Electoral College vote, set for December 14.
The other important thing to watch is the run-off races for both Georgia Senate seats, the outcomes of which will determine who controls the Senate. Stacy Abrams, who two years ago lost the Georgia race for governor which many believe was subject to racially motivated voter suppression, has done sterling work getting more Democrats enrolled and turning the state from red to blue.
Now our attention is turning to president-elect Joe Biden, his vice-presidential choice Kamala Harris, and the work of their transition team – what a relief to see priorities, policies, plans and progress.
Here are some articles from me and others on the transition:
Lesley Russell in Inside Story: Tracking the Transition
Lesley Russell in The Conversation: Biden has announced a COVID taskforce to guide him through the crisis. But there are many challenges ahead
Bruce Wolpe in Sydney Morning Herald: Scarred nation braces for more hurt and division
John Dwyer in Pearls and Irritations: Biden wins the poisoned chalice as we pray for a coronavirus vaccine
Sandro Galea in Croakey: Learning from November 3: A wake-up call for public health
Sharon Friel in Croakey: On the United States election, and ways forward for global health.
Marie McInerney in Croakey: What Biden and Harris promise for health, climate change, COVID-19, racial justice, media freedom and more
As an aside – in their phone call late last week it was noted that Biden and Prime Minister Scott Morrison discussed Australia’s success in controlling the coronavirus pandemic (my Twitter feed was full of complaints that Morrison was claiming too much credit for something that was very much a shared victory with the premiers) and climate change (not that Morrison let on to this aspect of the conversation).
On this latter point, I’m hoping the incoming Biden Administration will hold the feet of Morrison, Taylor et al (and yes Labor too) to the fire over Australia’s lack of climate change targets.
On the former point – you can read the report from Professor Alan Finkel on Australia’s coronavirus tracking efforts, the National Contact Tracing Review, here.
Pandemic out of control in the US
Months ago Trump and his Administration abandoned any federal efforts to control the pandemic and put all their eggs in the vaccine basket. They are not really doing anything around prevention and the situation has deteriorated to the point that last week Pulitzer Prize-winning science author Laurie Garret said:
 The gates of Hades have opened.”
The Trump Administration’s approach to the pandemic in recent months was succinctly summed up by White House Chief of Staff Mark Meadows’ proclamation (so ironic in light of his own infection) that: “We are not going to control the pandemic”.
The urgency of the problem is highlighted in forecasts released recently by the Centers for Disease Control and Prevention which predict that in the week ending November 28, there will be 450,000 -960,000 new coronavirus infections and 4,600-11,000 deaths from COVID-19.
Shockingly these might be under-predictions – on November 13 there were 163,402 new cases and 1172 deaths across the US. By now over 10 million Americans have been infected, and significant numbers remain disabled with long-lasting side effects. Without effective interventions, the toll by Inauguration Day will be crippling and intolerable – yet it seems the Trump Administration is happy for that to be its lasting legacy.
Biden has announced his bipartisan coronavirus taskforce, which is headed by three physicians: Vivek Murthy, the former US surgeon general; David Kessler, the former commissioner of the Food and Drug Administration; and Marcella Nunez-Smith, who is recognised for her work on promoting health and healthcare equity for marginalised populations. All are well known in public health, science and political circles.
A coronavirus briefing was the first order of business for Biden and Harris, followed by a public statement from Biden on his plans for tackling the pandemic and rebuilding the economy. His statement coincided with news from Pfizer about their coronavirus vaccine. Biden’s response was one of cautious optimism, in stark contrast to Trump’s which hyped the stock market implications.
The task facing Biden and his transition team and then his administration is immense. This is exemplified by the response from Republican governors to Biden’s call for more mask wearing. Sixteen Republican governors have rejected this outright, even in states like South Dakota, Oklahoma and Nebraska which are overwhelmed by new cases. These governors say mask wearing should remain a personal choice, not a legal obligation – despite recommendations from health officials and updated guidance from CDC stressing that masks protect the wearer, not just people nearby, from infection.
Rebuilding trust in Centers for Disease Control and Prevention
To successfully tackle the huge problems ahead, Biden must begin the heroic task of restoring trust in government and science, ensuring transparency and accountability, and building a common purpose so that people will act for the common good. As part of this, he must look to the future of the CDC.
At the start of the coronavirus pandemic, the CDC was seen as the world’s public health gold standard. The agency earned that respect through decades of shielding its scientific independence from politics.
In early spring, before states started to re-open and the coronavirus began to surge again, polls showed more than 80 percent of Americans trusted its coronavirus information. Â in early spring, before states began to re-open. Â However public confidence in the CDC dropped 16 points between April and early September, even more among Republicans as Trump has undermined the agency and its work.
But a lot of blame gets sheeted to the CDC Director, Dr Robert Redfield. He is known for his work as a military doctor on HIV/AIDS, but he has repeatedly undermined and over-ruled his scientific experts – and then, too often, denied it.
Now a former director says, “The integrity of the agency has been compromised. That falls to the director.”
USA Today recently published a damning investigation of Redfield’s conduct over the past months.
In late September, Dr William Foege, a former CDC Director, wrote a letter urging Redfield to rebel and orchestrate his own firing and expose the White House.
“You could upfront, acknowledge the tragedy of responding poorly, apologize for what has happened and your role in acquiescing,” Foege wrote. He said simply resigning without coming clean would be insufficient. “Don’t shy away from the fact this has been an unacceptable toll on our country. It is a slaughter and not just a political dispute.”
Redfield has obviously not taken that advice.
Are governments following the science?
It isn’t just the US where scientists are feeling ignored.
A recent article (sorry it’s behind a paywall, but you can see the chart) in The Economist examined the results of a survey by a Swiss publisher of scientific journals in May and June that asked some 25,000 researchers whether lawmakers in their country had used scientific advice to inform their coronavirus strategy.
Not surprisingly, there’s a fairly strong correlation between the percentage of scientists who believe policymakers have taken scientific advice into consideration and success in controlling the pandemic.
New Zealand tops the list with more than 75 percent of scientists in this category; Australia sits just about the middle (about 60 percent) and Brazil and the United Kingdom (at less than 25 percent ) and the US (at less than 20 percent) are at the bottom of the list.
What man’s best friend can teach us about ageing
(Something to lighten the mood after so much focus on coronavirus and politics)
A recent article in The New York Times provides a great summary of research on ageing in dogs and the ways that links into ageing in humans (and then again, maybe it doesn’t). It’s part of the search for a good model for human ageing.
It seems that dogs are similar to humans in how they act during adolescence and old age and in terms of what happens to their DNA as they get older. They also suffer a lot of similar ailments as they get older, such as obesity, arthritis, hypothyroidism, and diabetes.
Recent Austrian research in Nature shows that dogs’ personalities change over time. They seem to mellow in the same way that most humans do. Scientists also reported recently that adolescent dogs share some of the characteristics of adolescent humans like reduced trainability and responsiveness to commands.
Hmm, surprise? All this might depend on which breed you are looking at and how willing you are to anthropomorphise the animals.
And finally, another recent paper concludes that the calculus of seven dog years for every human year isn’t accurate. The correct calculation for dog years is to multiply the natural logarithm of a dog’s age in human years by 16 and then add 31 (eg, the natural log of 6 is 1.8, roughly, which, multiplied by 16 is about 29, which, plus 31, is 60).
The Mozart effect in operating rooms
Everyone knows that the music that is played during surgery is a big deal for those involved (except the anaesthetised patient?) and some surgeons are quite zealous about their playlists.
New research from Scotland finds that surgeons’ performance in the operating theatre can be significantly improved by listening to classical music played at low to medium volume. It finds that Mozart and Bach can boost doctors’ performance by up to 11 percent and that procedures are completed 10 percent quicker with music in the background.
There actually is a recognised “Mozart effect” where gentle music reduces stress levels and helps focus. It works for babies and it works for surgeons. It turns out that patients benefit too, needing fewer painkillers or anaesthetic while music was playing.
And it seems that playing loud or high-beat type music in operating theatres can be distracting.
New reports and associated news
1. What is the Australian Digital Health Agency up to?
Recently Australian Doctor (if you can get beyond the paywall it’s here) and Medical Republic (here) shared an expose on the work of ADHA around MyHealthRecord. After 10 years and billions of dollars, this is a system that it still not working as needed for any of the stakeholders.
2. Why do some countries do better or worse in life expectancy relative to income?
A recent paper from Professor Fran Baum and colleagues published in the International Journal for Equity in Health, looks at why – despite the general increase in life expectancy with national income – some countries “punch above their weight” and others “punch below their weight”. The paper looks at Ethiopia (three years better than expected), Brazil (two years better than expected) and the United States (2.9 years worse than expected).
The authors conclude that issues like equity, an inclusive welfare system, high political participation, a strong civil society, and access to employment, housing, safe water, a clean environment, and education are all important in determining life expectancy.
There’s yet another task outlined here for President-elect Biden.
3. AIHW International health data comparisons 2020
The Australian Institute of Health and Welfare has recently released comparative health and healthcare data for 37 OECD countries. There are some pluses and minuses for Australia, including:
- Australian life expectancy at birth (82.8 years) is above the OECD average (80.7 years) and the 7th highest among OECD countries.
- Australia ranked 6th out of 22 countries with available data for the proportion of people aged 15 and over who are overweight or obese (65 percent). This was greater than the OECD average of 59 percent. Australia had the second highest rate of obese men (32 percent) behind only the US (38 percent).
- Australia’s infant mortality rate of 3.1 deaths per 1,000 live births was below the OECD average (4.1 deaths / 1000 live births) but almost twice that of Estonia (1.6 deaths / 1000 births) which had the lowest infant mortality rate.
4. State of the Climate 2020
The Bureau of Meteorology and CSIRO have released their latest biannual report on Australia’s climate. The findings are clear: Australia is already truly experiencing climate change and it will get worse.
- Australia’s climate is warming
- Atmospheric carbon dioxide is rising
- Extreme weather is increasing in frequency
- Sea levels around Australia are rising
- Sea surface temperatures are rising
- Oceans around Australia are acidifying.
The best of Croakey
Don’t miss this wrap of Dr Chris Bourke’s tweeting for @WePublicHealth during NAIDOC Week.
The good news story
There’s lots to like in a story about a Maori community centre in New Zealand that is distributing bags of donated fish heads to families in need. This is more than just charity; it’s a model for reducing food waste. Maori and Pacific Islanders prize fish heads as a “chiefly” food.
You can read more here.
Croakey thanks and acknowledges Dr Lesley Russell for providing this column as a probono service to our readers. Follow her on Twitter at @LRussellWolpe.
Previous editions of The Health Wrap can be read here.
