Doctor and activist


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Author: Arthur Chesterfield-Evans

NDIS- An Unsuccessful Privatisation of the Welfare System

13 January 2022

I was never in favour of the National Disability Insurance System as I saw it as a defacto privatisation and reliance on a ‘market’ which would have another layer of assessors, who may or may not get it right in a single interview, the award of ‘packages’ of money which may or may not be enough and/or may or may not be wisely spend.  The greatest problem was that as a ’market’ it would be always liable to have glossy marketing to vulnerable families, with services delivered as cheaply as possible, by unqualified people and profits skimmed off.  The government coffers were topped up by increasing the Medicare levy, which just ensured that the private sector was given huge amounts of public money.

When I was in the NSW Parliament’s Social Issues Committee  which looked at the issue, a key problem was that there was no actual numbers of what the needs were for disability services. There were two ways of calculating it. The first was to add up all the people on benefits on the assumption that everyone who needed benefits was getting them. The other way was to ask the Australian Institute of Health and Welfare (AIHW), the government-funded research body what percentage of the population had a disability and multiply that percentage by the population.  Their answer was many multiples of those on welfare, presumably either because their relatives or support networks were looking after their problems, or there was unmet need. 

It seemed obvious that:

  1. There would be a huge increase in demand when more resources were (at least in theory) available
  2. There would be a lot of bureaucracy that would waste a lot of money
  3. Those actually doing the job and who knew the needs at a practical level would  have less control so the decision making would worsen
  4. There would be a lot of profiteering
  5. Disability workers would face a race to the bottom in pay and conditions.

It might be noted that NDIS cuts out when you are 65, so the whole process restarts with recipients having to apply for a Disability Support Pension (DSP). The current government has boasted that it is putting only a third as many people  on the DSP as formerly.  My experience was that when the NSW government stopped all Workers Comp payments after 5 years, many people who had been on this support for 5 year at least had to apply for the DSP. Figures were rubbery as the NSW government did not want to know how many people were simply tipped off income support, but the best estimate was that about 20% got the DSP and the rest had to go on Jobseeker. I wrote a lot of detailed medical reports for people who were still unable to get the DSP, and then the government wrote to me and said that I could only charge a very modest Medicare amount to write such reports, so presumably doctors will not be able to take much time on them.  I cannot write them in the time that the allowance pays.  I had one patient who was 61, ethnic, unskilled and illiterate in English who had been on compensation for a back injury 13 years and was carer for an invalid wife and was refused the DSP despite my best efforts and put  into the ‘mutual obligation’ multiple job application system.

But to get back to the NDIS itself, I recently chanced across this article recently from an old issue of Green Left Weekly- a personal story.  It seems very credible.

My view is the NDIS needs to be abolished, but it will be very hard to rebuild a public welfare support system against a well-funded and established private lobby that is making a fortune and has at least one major party ready to undo any efforts in this direction.

NDIS is also making life harder for disability workers

Janine Brown, Melbourne, February 8, 2019, Green Left Weekly Issue 1208

I am employed as a disability support worker by a council and, since the introduction of the National Disability Insurance Scheme (NDIS), I will soon lose my job. This is my story.

I am in transition to becoming “self-employed” with an ABN (Australian Business Number), which makes me a small business, and enables me to sign individual contracts with each client.

The other alternative was to become an employee of a private company that has contracts with NDIS clients.

From these two bad choices, I decided to go with the former.

We have been told that NDIS will be much better for hundreds of thousands of Australians. But is it?

Once families receive NDIS funding, it is their responsibility to make the choices for their child or adult family member and manage their finances over a 12-month period.

The idea that they are in control of the life choices of their family member may sound appealing. But the stress levels rise with the amount of bookkeeping required and when it is difficult to clearly define their needs.

Parents are encouraged to employ an advisor, but that person is paid for by the funding for their family member. That NDIS planner will recommend “one of theirs”, someone who will ask many questions and tick many boxes but who doesn’t really know the needs and interests of the person concerned.

I was once supporting a child at home when the NDIS planner was interviewing his parents. One of the questions was “Do you own your home?” I invited the planner to meet the child but she declined, saying it wasn’t necessary.

As much as I agree with giving parents options in choosing a carer for their child, the options being presented are often inadequate to the task at hand.

By privatising the disability sector, many people are obtaining an ABN (which is easy to do online) and presenting themselves as a qualified support worker. They do not need background checks and parents who search online for support workers only see promotional material.

I am qualified and have many years of experience, but l am now in competition with an untrained person who is willing to provide “services” at a cheaper rate. They call it business. I call it a dangerous rort.

NDIS has also meant that our work is now casual: we no longer have permanent employment with leave benefits, superannuation and union support.

A few weeks ago a parent asked me to do a buddy shift with a potential new carer as she lives near the client. Having a carer nearby is appealing for parents who may need to call on you at the last minute.

l agreed to do the shadow shift. I found that the inexperienced carer had no idea about the work responsibilities or the safety measures. She had no knowledge about supporting someone who is non-verbal with behavioural difficulties, who needs support in all aspects of daily life. She appeared to be more interested in the times of shifts, rather than the child’s needs.

It is easy to be blinded by the NDIS marketing, but just as the privatisation of the aged care sector has led to cuts in staff, quality meals and wound management, the same is true for the disAbility sector.

There are also many grey areas concerning the care of people with a disability.

Statistics show that as the number of people being diagnosed with autism (done by general practioners) has increased in the past few years. This adds to the NDIS budget.

As a result, NDIS bureaucrats are thinking of using “their people” to make the diagnosis. If this happens, we can expect a decline in the numbers of people being diagnosed with autism and many who need support will not be eligible for funding for appropriate services.

Another grey area concerns supporting people transitioning from childhood to adulthood, and teaching them to become more independent.

It is sometimes possible to teach a person to take public transport to an activity. However, it becomes a crisis situation when the bus/tram/train is late or cancelled and the person has lost all points of reference and they have to navigate replacement measures.

The NDIS planner may have ticked a box for someone to take public transport to an activity when things are going well, but an unexpected or crisis situation which causes the person anxiety is not factored into the plan.

It is imperative that we continue to support vulnerable people in our community. We must not be blinded by the NDIS hype when the reality is vastly different.

www.greenleft.org.au/content/ndis-also-making-life-harder-disability-workers

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Djokovic Fiasco reflects no credit on Australia

6 January 2022

Most people know that Novak Djokovic is pushing to be the Greatest tennis player Of All Time (GOAT) and needs just one Grand Slam victory to achieve this. Most also know he has been very successful in the Australian Open, which starts next week.  There is little doubt that a lot of people, myself included would be very interested in whether he can win after his failure against Medvedev in the US Open.

Many people are aware that he has been anti-vax and he unwisely attended a tournament last May and he and a number of others got COVID19, presumably by the Delta variant, but this is not recorded.

He has never been a popular as the smooth Roger Federer, or the rougher battler Raphael Nadal who are his great rivals for the GOAT title.  He was seen as not quite as warm a character.  He was praised by the President in his native Serbia for his early victories, but this cooled a bit when he made politically progressive statements.  His anti-vaxx statements have been frankly embarrassing.

Australia has a rule that if you are not vaccinated you cannot have a visa. 

Whether this should be the only criterion for entry should be a moot point.  With most infectious disease, having antibodies at a certain level assumes that you are immune to reinfection with the same disease.  This works for polio, but with ‘flu, where the virus changes, people get infected by a different strain every year.

The CDC (US Centre for Disease Control) guidelines are somewhat equivocal about antibodies. They will not say that having antibodies means either than you cannot be infected or that any infection will be minor.  It seems that COVID is considered more like ‘flu than polio.

It was not clear on what ground Tennis Australia allowed him to come, but now Border Force have excluded him, and the Prime Minister smugly talks about rules being rules.

It is important that we are protected, and many Australians have endured a lot of suffering in lockdown to achieve this, so they have little time for people to be treated differently.  But if Djokovic had COVID 6 months ago, it is hard to believe that he constitutes a high risk when the whole country has decided to abandon masks, distancing, QR codes and venue number restrictions. One might wonder what his antibody status is, or whether this was known.

It is important that various agencies in a country remain independent. We do not want Border Force deciding medical issues, nor Tennis Australia deciding immigration policy.  But Australia looks pretty silly, when one group allows him and another does not.  As a tennis watcher, I would like to see him play, and it does seem that the politics are overcoming the science. 

Now we bring in the lawyers, another idiot factor?

www.smh.com.au/sport/tennis/novak-djokovic-launches-court-bid-to-fight-deportation-20220106-p59mdp.html

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Fake Science now an Industry

6 January 2022

Many years ago (?1977), I applied for the job as editor of the Medical Journal of Australia.  I had done two years as a surgical trainee and took a year off from the somewhat disillusioning hierarchical system.  I had done 3 and a half years of university English, but in terms of my experience editing, it was perhaps a long shot.

The salary was roughly the same as a second year resident, though more than half that salary had been overtime.  The job seemed a bit of dangerous niche, but it was worth thinking about.  I didn’t get the job (Dr Alan Blum from the US did), but was invited to apply for Deputy Editor.  The salary here was $20,000 less, which was more than a third. But the key reason I declined is that I hate having someone else waste my time. 

There is such an incentive to publish in order to climb academic ladders that most writing is done for the writer, not the reader.  As many papers are written as possible, so the idea of spending a lifetime sorting through thousands of papers to find ones of merit seemed a hazardous occupation with a great danger of drudgery.

When I thought about the issue I devised the Chesterfield-Evans theory of knowledge acquisition. It is an exponential graph with time on the horizontal axis and knowledge in the vertical.  With a little time you can get quite a lot of knowledge, but to get a little more or to get the forefront takes an immense amount of time, for the last bit of knowledge. This extra bit of knowledge may be well rewarded financially in medicine if you get it ‘approved’ as a specialty, but in many scientific endeavours there is no reward at all.  Getting to the forefront is made harder by the lack of incentive to write concise papers for the benefit of the reader.

In practices as a medical professional the explosion of information of indifferent quality has made reliance on key journals the easiest way to go, but even here the increased specialisation makes even being a reasonable generalist more difficult. The monetisation of knowledge makes the specialties not want to share all their information, the college and universities act like businesses and the drug companies want to sponsor a certain view.

When I wrote both my Masters theses, getting a good supervisor was a problem. No one really wanted to go through the writings of yet another postgrad.  My supervisor, Dr Chris Winder said that he would simply prefer students write concise papers and send the lot to a publisher, giving degrees to the ones considered worthy of publishing. 

But there has been a profusion of journals, initially driven by the profitability of these.  Now the pressure from students has been joined by a rogue element, the dodgy rip-off factories.  Plagiarism and now straight out fraud are now industries.

Those who seek knowledge now have to be more discerning. There is delight amongst the non-scientific who can, like Pontius Pilate ask, ‘What is truth’ and then also like Pilate not want to know the answer.

Sadly, politicians and managers who have agenda other than optimal knowledge are flourishing  in this environment.

I am glad that I did not become a medical editor; it is hard enough getting a broad-based knowledge of reasonably indisputable facts.

I am quite unsure how the confluence of factors favouring ignorance can be countered.  Making everyone learn some science and maths at school might be a start.

How fake science is infiltrating scientific journals

Harriet Alexander

January 5, 2022

In 2015, molecular oncologist Jennifer Byrne was surprised to discover during a scan of the academic literature that five papers had been written about a gene she had originally identified, but did not find particularly interesting.

“Looking at these papers, I thought they were really similar, they had some mistakes in them and they had some stuff that didn’t make sense at all,” she said. As she dug deeper, it dawned on her that the papers might have been produced by a third-party working for profit.

“Part of me still feels awful thinking about it because it’s such an unpleasant thing when you’ve spent years in a laboratory and taking two to 10 years to publish stuff, and making stuff up is so easy,” Professor Byrne said. “That’s what scares the life out of me.”

The more she investigated, the more clear it became that a cottage industry in academic fraud was infecting the literature. In 2017, she uncovered 48 similarly suspicious papers and brought them to the attention of the journals, resulting in several retractions, but the response from the publishing industry was varied, she said.

“A lot of journals don’t really want to know,” she said. “They don’t really want to go and rifle through hundreds of papers in their archives that are generated by paper mills.”

More recently, she and a French collaborator developed a software tool that identified 712 papers from a total of more than 11,700 which contain wrongly identified sequences that suggest they were produced in a paper mill. Her research is due to be published in Life Science Alliance.

Even if the research was published in low-impact journals, it still had the potential to derail legitimate cancer research, and anybody who tried to build on it would be wasting time and grant money, she said. She has also suggested that journals could flag errors while articles were under investigation, so people did not continue to rely on their findings during that time.

Publishers and researchers have reported an extraordinary proliferation in junk science over the last decade, which has infiltrated even the most esteemed journals. Many bear the hallmarks of having been produced in a paper mill: submitted by authors at Chinese hospitals with similar templates or structures. Paper mills operate several models, including selling data (which may be fake), supplying entire manuscripts or selling authorship slots on manuscripts that have been accepted for publication.

The Sydney Morning Herald has learned of suicides among graduate students in China when they heard that their research might be questioned by authorities. Many universities have made publication a condition of students earning their masters or doctorates, and it is an open secret that the students fudge the data. The universities reap money from the research grants they earn. The teachers get their names on the papers as contributing authors, which helps them to seek promotions.

International biotechnology consultant Glenn Begley, who has been campaigning for more meaningful links between academia and industry, said research fraud was a story of perverse incentives. He wants researchers to be banned from producing more than two or three papers per year, to ensure the focus remained on quality rather than quantity.

“The real incentive is for researchers to get their papers published and it doesn’t have to be right so long as it’s published,” Dr Begley said. He recently told the vice-chancellor of a leading Australian university of his frustration with the narrative that Australia was “punching above its weight” in terms of research outcomes. “It’s outrageous,” Mr Begley told the vice-chancellor. “It’s not true.”

“Yes,” the vice-chancellor replied. “I use that phrase with politicians all the time. They love it.”

According to one publishing industry insider, editors are operating with an element of wishful thinking. This major publishing house employee, whose contract prevented him from speaking publicly, said when his journal started receiving a torrent of applications from Chinese researchers around 2014, the staff assumed that their efforts to tap into the Chinese market had borne fruit. They later realised that many of the papers were fraudulent and acted, but he was aware of other editors who turned a blind eye.

“Obviously there’s so much money in China and the journals have their shareholders to answer to, and they are very careful not to tread on Chinese toes because of the political sensitivity,” he said. “There’s a lot more they could do to sort the good from the bad because there is good science going on in China, but it’s all getting a bad name because of what some Chinese people have worked out — that there’s a market here for a business.”

Last month, SAGE journals retracted 212 articles that had clear evidence of peer review or submission manipulation, and subjected a further 318 papers to expressions of concern notices. The Royal Society of Chemistry announced last year that 68 papers had been retracted from its journal RSC Advances because of “systematic production of falsified research”.

To indicate the upswing in cases, German clinical researchers reported last week that in their analysis of osteosarcoma papers, just five were retracted before the millennium and 95 thereafter, with 83 of them from a single, unnamed country in Asia. University of Munster Professor Stefan Bielack, who published the study in Cancer Horizons, said some open access journals charged academics US$1500 to $2000 to publish their work, so they were more interested in publishing lots of papers than their scientific validity.

“There is a systematic problem and in some countries people might have the wrong incentives,” Professor Bielack said. “I think the journals have a major role. They all need to be more rigorous.”

The problem is not confined to China, but it has accompanied a dramatic growth in research output from that country, with the number of papers more than tripling over the last decade.

In 2017, responding to a fake peer review scandal that resulted in the retraction of 107 papers from a Springer Nature journal, the Chinese government cracked down and created penalties for research fraud. Universities stopped making research output a condition of graduation or the number of articles a condition of promotion.

But those familiar with the industry say the publication culture has prevailed because universities still compete for research funding and rankings. The number of research papers produced in China has more than tripled over the last decade, with dramatic growth over the past two years. The Chinese government’s investigation of the 107 papers found only 11 per cent were produced by paper mills, with the remainder produced in universities.

Until last year, University of NSW offered its academics a $500 bonus if they were the lead author in a prestige publication and $10,000 if they were the corresponding author of a paper published in Nature or Science. The system, which was designed to reward quality over quantity, was discontinued due to financial constraints.

But others have questioned whether the quality of a paper can be measured by the journal in which it is published, and an open access movement has sprung up in opposition to the scientific publishing industry, arguing that research paid for by taxpayers should be freely available to all.

Alecia Carter, an Australian biological anthropologist at University College London, said the emphasis on getting published in a high-impact journal rewarded sensational results over integrity, positive results over negative results and novel findings over building the evidence base. Researchers might inflate effect sizes or omit conflicting evidence because it muddied the overall story they were trying to tell.

“We as scientists know all these things that are wrong with the way the system is set up, but we still play the game,” Dr Carter said. “We’re all chasing the same thing.”

Dr Carter boycotts luxury journals, publishes as much as possible in open access journals and reports negative results, though this has come at a cost to her career. She was once asked at a job interview why she would bother reporting results that were not interesting.

“I said, ‘If it’s interesting enough to do the research then we should publish the results’.”

She did not get the job.

Here is an SMH article which stimulated my post:

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COVID Day 4- a non-PCR Day

5 January 2022

I did nothing today- it just took longer than usual.

I felt much the same, a sore throat, not much energy, a bit of a headache and bouts of a dry cough. I did not feel like exercise and I thought that I had better try to get a PCR test and some Rapid Antigen tests in case we needed to prove we were not infectious, or had other people who were concerned contacts.

I researched online where the PCR (Polymerase Chain Reaction) tests were being done. The site I used 2 weeks ago, a 4Cyte drive through test that had taken an hour to do and 3 days and 16 hours to get results from was closed Wed-Friday. It was not clear why this was but the Laverty Pathology group at 60 Waterloo Rd near Macquarie Centre was open till 4pm. I took a novel in case of a long wait and drove there.

As I approached from the google direction cars in the left lane were not moving from the major intersection as far as one could see to the next hill. Many of them had their tail lights on, so I reflected that they were sitting in a line with the engines on. Bad for the environment, but it at least told me that his was the queue. I turned off the engine and started to read. After a while I was wondering why no progress at all was being made, and I thought I might ask if I was under some misapprehension. As I looked up, a pleasant looking woman in her mid-30s got out of the small car ahead, and went to her boot.

I called to her out the window, ‘Is this the PCR test queue?

‘Reckon so’, she said, ‘I’ve brought some snacks to get through it’. She took some biscuits, grapes and a drink and got back in.

We advanced glacially slowly, and I noticed that there was a side road a little way down the queue. Space had been left so cars could go in and out of this side road, but cars had also started to queue there, and of course the two queues merged at the intersection. I had not thought of this until I was nearly at the corner, and I suppose the woman in the car hadn’t either. Some on the side road were shouting abuse or tooting as if we were somehow pushing in to their queue. There were no signs, no guides and nothing online, so it seemed that the only fair thing to do was to take alternate cars. My young friend had recognised this before I had and moved her car across the middle of the side road, so that cars exiting or entering could go in front or behind her, but she could be sure that the side road queued cards did not just push in. There was a cacophony of abuse from the side street.

The queue moved forward a few cars, so I followed her closely, letting one car in as seemed fair. A large 4WD with a man screaming obscenities at me tried to push in, but I kept him out. I wondered if he would get out and make trouble but he did not. The passenger in the car I had let ahead of me had got out and was remonstrating with the woman who had been in front of me. It was tense. I was very glad we were not in America with some people having guns.

We continued our glacial advance, then a car coming in the other direction stopped. The driver stuck his head our and was shouting something to those in the queue ahead of me. I could not hear him, but he did not seem abusive, so as he passed I called to him to ask what he had said. He said, ‘They have closed early; I was second in the queue and they told me to go away’. It seemed likely that he was right, but most people had waited so long that they were not willing to drive off, so we moved quite slowly till everyone had driven past the ‘Closed’ sign that had appeared in the driveway. It was 2pm. The testing site was advertised to be open till 4.

No test and a couple of hours wasted. I have COVID. It is not recorded in the system. It seems that I will recover. Will I waste another few hours tomorrow? And if I do will I have PCR results anyway? I am scheduled to see my patients again 9 days after the onset of symptoms- presumably I will be non-infectious. Luckily I got some RAT kits.

It is not hard to see where anger and frustration comes in all of this.

‘Personal responsibility’ has a very Darwinian edge.

Thank God I am not very sick.

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The Chinese Way

4 January 2022

Everyone want to criticise China as an authoritarian state, but if you stand back and look at how they tackle challenges that we have, there may be lessons to be learned.

There was an interesting show on ABC TV last night hosted by Hamish Macdonald ‘The China Century’, Part 1 of 5.  It looked at the Tiananmen Square protests of 1989 and their ruthless repression.  But next week it will look at how they have combined capitalism and strong state control.

Competition increase efficiency when it lowers prices, but note in the late stage of ‘laissez faire’ monopolies allow supernormal profits and their political influence puts them above the law.  Sometimes the loss of central control may also mean that a fragmented industry cannot produce state of the art products.  I read some time ago that the US is having a problem producing good fighter planes because the intellectual property is now spread over a number of competing companies, so no one company can be state of the art on all aspects.  A single body controlling the situation would not have this problem.

The other aspect is that the Chinese can write the rules for its industries and not simply assume that whatever makes the most profit in the immediate term is the best place to consume resources.

In Australia, our economy is totally out of whack because the tax concession of negative gearing has meant that everyone has simply invested in real estate as a ‘no brainer’ way of making money. But the rise in prices is in a sense arbitrary.  If a house goes up in price from $100k to a million, it is still the same house.  The difference is that the person who now buys it has $million debt.  The ‘profit’ is someone else’s borrowing.  So at a national level, we have the second highest level of private debt in the world (after Switzerland) and just pay interest to foreign banks.  We also have no money to invest in our productive export industries, or even think about them as real estate is so easy.  We note that developers distort the electoral process and do dodgy deals to get their approvals through, but once it is all done, we wring our hands- nothing can be done. The building stands, and it will all happen again next time.

We watch askance as our regulatory systems fail.  The Banking Royal Commission was initiated by a whistle-blower not the regulator, and nothing much has changed; one banker resignation, no one charged. We saw the Aged Care inquiry, the Casino Inquiry were both whistle-blower initiated as well.  We are up to 4 inquiries into iCare and nothing changes.  We hope that our buildings are OK, as the regulatory system has not been working too well there for about 25 years. 

We note that our rich are getting much richer and our poor poorer, but our government does not want to do much about that.  Hey if you can’t afford a Rapid Antigen Test, you can always wait and see if get sick.  ‘Universal health care’ is a good slogan.

We see our kids getting fatter and more addicted to computer games, but there is not much we can do about that. We are moving to high rise schools as so many were sold off in the 1980s and now there is no space for recreation, and we also saved on sport teachers and made serious exercise optional.

We worry that our electoral system is influenced by fake news, trolls and data analysis companies. We understand that the social media concentrates on putting like people together so they will stay logged in and be available to advertise to. We understand that a shock headline also attracts more interest and controversy, so we are hyper stimulated until we ignore what is important.  Advertising always affected media content towards making people more receptive to the ads and purchasing; social media has now put it on steroids.

The Chinese have taken all this on.  They have put a super tax on rich people and made statements about everyone having a decent life. They have tried to lessen kids times on computers and to increase their exercise. They have taken on social media, and most recently forced a major developer to demolish high rise building because the building permit was illegally obtained.  The developer is a major one, and already in danger of going broke.  Can anyone image this happening in Australia or the US? 

Many problems  in the world are universal, and watching what a truly authoritarian government can do is interesting. We have the contrast of our governments, that seem to want to be as small as possible and not even acknowledge problems, and theirs which seems to testing the limits of power.  We may not want to do it ourselves, but if we ever decide to do anything, it will be helpful to have information on the outcome of the range of possible actions.

Here is an article about Evergrande, the Chinese property developer which is going broke and now had to demolish significant assets.  It was in the SMH, from Bloomberg. 

Next Monday on ABC TV at 8.30pm the second article on China, considering its use of the combination of capitalism and central control.

China’s Evergrande halts trading after ordered to tear down apartments

By Jan Dahinten

January 3, 2022 — 3.29pm

Chinese developer shares tumbled following local media reports that China Evergrande Group has been ordered to tear down apartment blocks in a development in Hainan province. Evergrande halted trading in its shares.

An index of Chinese developer shares slumped 2.8 per cent as of 11.37 a.m. local time, with Sunac China Holdings and Shimao Group Holdings plunging more than 10 per cent. A local government in Hainan told Evergrande to demolish 39 buildings in 10 days because the building permit was illegally obtained, news wire Cailian reported on Saturday.

Evergrande gave no details on the trading suspension other than saying it would make an announcement containing inside information.

The government of Danzhou, a prefecture-level city in the southern Chinese province of Hainan, asked Evergrande to tear down 39 illegal buildings in 10 days, Cailian reported on Sunday, citing a document from the local government.

The report cited the document, which was dated December 30, as saying that the Danzhou government said an illegally obtained permit for the buildings had been revoked so the buildings need to be dismantled.

Evergrande didn’t immediately respond to a request seeking comment and calls to Danzhou authorities went unanswered on a public holiday in China on Monday.

The company on Friday dialed back payment plans on billions of dollars of overdue wealth management products as its liquidity crisis showed little sign of easing.

Property firms have mounting bills to pay in January and shrinking options to raise necessary funds. The industry will need to find at least $US197 billion ($271 billion) to cover maturing bonds, coupons, trust products and deferred wages to millions of migrant workers, according to Bloomberg calculations and analyst estimates.

Beijing has urged builders like China Evergrande Group to meet payrolls by month-end in order to avoid the risk of social unrest.

Contracted sales for 31 listed developers fell 26 per cent in December from a year earlier, according to Citigroup Inc. analysts. Evergrande’s sales dropped 99 per cent, the analysts wrote in a note dated Sunday.

Bloomberg

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COVID Up Close

2 January 2022

I have tried to stay COVID safe, but we had a house guest, a friend of my son, Mike who had been stranded overseas for a year and came back to Brisbane and then to Sydney last Tuesday.  On Thursday he had a cough, so I asked him to Rapid Antigen Test (RAT), and he was positive.  Mike and I were negative, but the separation was minimal.

I was feeling a bit of a sore throat, headache and cough like an early flu and I managed to get another RA Test kit today (Sunday) and got a positive result.  Luckily, I had my 3rd vaccination 10 days ago, which is just long enough for it to start to work, so I am hopeful it will be a mild one.

It is ironic that I have had lots of requests to go back into the hospital workforce and resisted.

I will keep you posted. 

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It is Hard to get COVID tests and likely to get Harder

1 January 2022

The numbers of COVID cases are rising dramatically, many of the clinics have closed for Christmas, and Rapid Antigen Tests (RATs) have sold out from most chemists. You might wonder why this wasn’t anticipated, but it seems that the strategy of ‘Let ‘er Rip’ was meant to stimulate the economy as everyone assumed that either COVID was over, or that the Omicron variant did not matter, (not that Delta had actually gone away).

In fact the people have been mostly quite sensible and are not going out and are wearing masks and isolating, which of course means two things.

1. The ‘Let ‘er Rip’ strategy is not getting the economy back to normal and

2. The government can say that it is not their fault if people choose not to go out and spend, so they don’t need to support business or anyone else.

Here is an explanation of the PCR test unavailability from Kim Hatton:

‘Some people today have been wondering why the Feds are pushing so strongly to reduce PCR testing for COVID and shift to RAT. Yes of course the path labs are overloaded but there’s more to the story than that. Currently Medicare pays $110 for a PCR test, split between the path lab and whoever is collecting the sample. With tests reaching 270,000 a day that’s basically $30million per day out of fed budget.

The plan is to reduce PCR tests down to around 50,000 a day saving $24 million a day.To fill the gap the plan is to use Rapid Antigen Tests which cost around $10 in bulk. The Feds will fund 50% of whatever the states buy. In theory the states would buy enough to bridge the gap ie 220,000 per day costing them $1.1 million and the Feds the same. Meaning fed expenditure drops from $30m per day to $7million.

However that assumes the states buy enough which they haven’t. NSW has placed an order for 2 million which won’t even last 2 weeks assuming infection rates don’t increase – which of course they will.In practice what is more likely to happen is the the public will fund the majority of RATests themselves saving the Govt at least another million a day.

That million a day then becomes part of the economy which comes out as economic growth the federal government has achieved and will use to argue how good a job they’ve done.’ End Quote

This seems quite plausible to me- I will chase the source.

The other aspect is that if you do not have a PCR test and do not go to hospital, you are not recorded as a COVID case, so the statistics look better.

I personally had a contact and did a PCR at about midday on Friday 24th and got a text with a negative result at 4am on Tuesday 27th- 3 days and 16 hours later. If this blows out much more the test is virtually useless, as you would have had to isolate anyway.

It seems if we do not have a PCR test, and/or everyone does their own Rapid Antigen Test (RAT) and then monitors their own health with or without a $20 oximeter to make sure that their oxygen saturation is normal and over 95%, the whole epidemic can be ignored except for the ones so sick as to go to hospital.

This seems to be the effect of the new guidelines as in the SMH. Here is the ‘Do It Yourself’ article from the SMH:

More COVID cases told to manage themselves at home as tests hit ‘bottleneck’

By Mary WardSydney Morning Herald December 28, 2021 — 6.38pm

Private pathology companies have warned that NSW’s rising coronavirus cases are creating a “bottleneck” in the testing system as more people who catch COVID-19 are being directed to manage their infections from home.

On Tuesday, NSW Health updated its advice for people who are COVID-positive, directing that most people aged 65 and under are considered able to recover from the virus without medical involvement.

Under the new rules, people in this age group who have had two doses of COVID-19 vaccine, do not suffer from any chronic conditions and are not pregnant are considered able to safely manage an infection at home.

Previously, this was only the case for people aged under 50.Of the 42,600 COVID-19 cases reported in the state over the past seven days, fewer than 7 per cent of infections were in people aged 60 and older. About 3400 were aged in their 50s.

Those managing an infection at home should also not expect to be “cleared” from isolation by NSW Health. Instead, they may leave after day 10 of their isolation, even if they do not hear from NSW Health in a text message on this date, provided they have not experienced symptoms in the previous 72 hours.

NSW Health advice for managing common COVID-19 symptoms at home

• Cough: Breathe in steam and sip on fluids. Avoid lying on your back. If you are coughing up mucous, it is important to continue to do this as it reduces risk of a chest infection.

• Nausea, vomiting and diarrhea: Eat plain, low fibre foods. Have six smaller meals instead of three. Do not drink alcohol or caffeine. Stay hydrated.

• Fever: Take paracetemol. Put a cool, damp washcloth on your forehead. Wipe your arms and body with a cool cloth.

Source: NSW Health

“It is important that this information is provided to people who are at lower risk of severe illness to allow NSW Health to focus on those who have the greatest risk of poor outcomes, this includes people over the age of 65,” a NSW Health spokesperson said.

“Regardless of age, people are also provided clear advice about what to do if they start to feel worse or in the case of a medical emergency.

”People who have a chronic condition – such as obesity, a severe, chronic or complex medical condition, diabetes – are immunocompromised, have severe mental illness or are pregnant are urged to contact the COVID-19 Care at Home Support Line on 1800 960 933 if they return a positive PCR test to receive further medical assistance.

Last week, Australian Medical Association NSW president Danielle McMullen warned that doctors would struggle to cope with thousands of patients needing virtual care as health authorities flagged they would increasingly rely on the GP network to manage COVID-19.

Tuesday’s public holiday again meant some testing clinics were forced to shut within hours of opening, as wait times for PCR results blew out to more than four days despite the system processing fewer tests than it had previously.

There were 93,581 COVID-19 tests processed in the 24 hours to 8pm on Monday, down from the previous day’s total of 97,241 and nowhere near upwards of 150,000 tests done in September. NSW Health’s Christine Selvey said testing in the state was “under enormous pressure”, urging people to only have a PCR test if they had symptoms, were a household contact of a case or had been advised by NSW Health about attending a high transmission venue.

Premier Dominic Perrottet said he believed up to 30 per cent of tests were for interstate travel, as he and Health Minister Brad Hazzard urged the Queensland government to ease requirements for people to return a negative PCR test before crossing the border, after it scrapped a day five test for people who had already travelled to the state due to pressure on its own system.

“If we can move that PCR requirement to a rapid antigen test requirement that will significantly alleviate some of the pressure on the testing over summer,” Mr Perrottet said.Mr Hazzard said he had asked NSW Health and the federal government to reconsider whether two tests completed by returned international travellers who come through Sydney Airport needed to be PCRs, in light of the delays.

He also asked the ministry to look into recommending rapid antigen tests were used to screen pregnant women ahead of birth after the Herald revealed women had been queueing for tests every 72 hours on the advice of some hospitals.

But while private pathology labs said so-called “tourism testing” did account for some of delay, a higher volume of positive tests was also to blame. More than 6 per cent of tests reported on Tuesday were positive, up from about 2 per cent the previous week.

Greg Granger, director of strategic operations at Histopath, said the proportion of tests which were positive had created “one of the biggest bottlenecks” in the system.

Mr Granger said the method of PCR testing large volumes of samples – where samples are pooled and tested in groups – worked well when fewer than 1 per cent of tests were positive and most “pools” of tests could be cleared as negative.

“When there’s a positive in the pool every single time, you essentially have to double or triple test the samples,” he said, noting laboratories were now needing to figure out, with their available instruments, what a more efficient method would be.

“Obviously in an ideal world, you don’t pool at all. But with these sheer numbers you just can’t … it’s about finding where the balance is.

”A spokesperson for St Vincent’s Hospital, which operates the SydPath clinics, agreed positive tests took longer to confirm in its laboratory than negative ones.

They said the process of reporting a positive case to NSW Health was also “more significant” than the administration needed for a negative test.Despite the high demand, SydPath clinics will operate at reduced hours “in order to maintain the quality of [its] testing”, after more than 800 people were incorrectly sent negative test results over the weekend due to human error. The provider asked people to not attend its clinics, including the Bondi Beach drive-through, seeking a test for interstate travel.

Australian National University infectious diseases expert Associate Professor Sanjaya Senanayake said the state’s high positivity rate meant it was likely more infections were being missed by testing. However, he said, an upside of this was that the hospitalisation rate of Sydney’s Omicron wave was likely even lower than reported.

“At this stage, it does seem like the current infections are resulting in significantly fewer hospitalisations than we saw with Delta,” he said.

There were 557 COVID-19 patients in NSW hospitals on Tuesday, including 60 in intensive care, compared to 168 in hospital a fortnight ago. NSW’s COVID-19 hospitalisations reached a peak of 1266 in mid-September, including 244 in intensive care.

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Scientific Fraud

29 December 2021

I have friends who campaign for various things, sometimes quite alone for many years.

One of my friends is Polish.  He was part of the dissident movement when Solidarity was trying to end the Communist system.  While the Government was forced to negotiate with Lech Walesa, the Secret Police were busy and the second tier of activists and sympathisers simply disappeared overnight, so he spent quite a lot of time moving around.  He learned English and studied industrial hygiene, the safe use of chemicals in industry, so that he would have a qualification that was useful and recognised when he escaped to the West, which he eventually did. 

But he retained an interest in Poland and noted that some of the researchers there simply translated English papers, changed them very marginally, passed off the plagiarism as their original work, and became professors based on their great advances.  When the various academies were informed, they did not really want to know, as it disturbed their internal structures and was also something of an insult to national pride.

So he has spent years campaigning against scientific fraud, both there and here. 

There are other problems that grossly distort research.  No one really wants to publish negative findings; new discoveries are much more exciting than finding that stuff was wrong.  Also private research is much more interested in funding work that will produce a marketable product, and research that shows a drug works or is better than another.  The government has got into this mode also, wanting ‘partnerships with the private sector’ that will allow them to defray the research costs. This has arguably meant that the private sector tends to have a lot of say in what is studied, gets the government to pay for areas that it might not have bothered with, and can also grab lucrative patents early.  In this competitive environment, researchers have to find funding, and there is not much money in repeating experiments to disprove them.

Some research needs thousands of subjects to see which investigations or drugs are the most useful so that treatment protocols can be developed. Naturally these require huge coordination between many hospitals, health authorities and clinicians.  They require huge budgets. They offer big rewards if a certain investigation or treatment is shown to be beneficial and is included in the final recommendation of a huge trial.  The lead authors will travel the world for years as the definitive experts in that field with all the prestige that that entails.  Yet, as clinicians tied up with clinical work and often departments to administer, they cannot personally manage the logistics or the data and usually rely on ghost writers to put the drafts together.  Who funds that you might ask?  And what are the consequences if the funding company’s products do not work so well?  Will the professor who said it did not work get funding next time?

There is even a whole scam industry of dodgy or even non-existent  journals where you pay to be published or to be a supposed reviewer of papers.

So the pure idea that scientists are only interested in the truth and have no personal or financial interest was never true and has been under even more stress of late. 

Just as self-regulation in banking, aged care, casinos, building, advertising and many other industries has been shown to be inadequate, now scientific publishing is coming under the public spotlight.

The world of academia is more poorly set up than most industries to act as policeman. Evidence is evaluated in good faith.  Universities are expected to fund their courses from fees and donations so they are less in a position to take action that may be expensive and may damage their reputations.

Now, at last, the Australian Academy of Sciences has asked for a research integrity watchdog. This will help with deliberate individual fraud.

How much it can affect the other biasing factors in research remains to be seen.  The political and economic factors are likely to remain in the ‘too hard basket’.  It is still hard to know what the truth is.  Gut feelings about plausibility are of course ‘unscientific’ and what you ‘believe’ at a point of time is supposed to relate to what the ‘facts’ are.  And all this without social media even considered.

On the bright side, my Polish friend will see a significant step for his campaign, and if regulatory oversight replaces one lot of self-regulation there is hope that it will spread to other industries.

www.smh.com.au/national/macquarie-university-considers-investigating-suspected-research-fraud-20211214-p59hfr.html

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Pork Barrelling Works- it probably determined the 2019 Federal Election .

December 28 2021

There has been a lot of publicity lately about pork-barrelling by the Liberal party prior to the last election.

This is based on some excellent research by Shane Wright and Katina Curtis of the SMH (16/12/21), who went through grants that were at Minister’s discretion. They were worth $2.8 billion;  $1.9 billion went to Liberal electorates and $530 million to Labor.  The numbers do not add up exactly as some grants were hard to classify, being given to organisations that spanned different electorates. 

But if you take the money that has clear electorates, it is $1.9 v.$0.53 billion, which means that Liberal: Labor is 78% to 22%.  But it is even worse than that because $58.5 million and $55.2 million (21% of Labor’s national total) went to Lyons and Corangamite, which were seats the Liberals hoped to win. 

Lindsay, the NSW seat around Penrith got $23.1 million and was the only seat in NSW won by the Libs from Labor in the 2019 election. That number did not even count the $55 million in promised commuter car parks. The adjacent 3 Labor-held seats Chifley, McMahon and Werriwa with similar demographics got $5.9 million between them.

In Melbourne 4 Labor seats received less than $1million, while 3 vulnerable Liberal sears received an average of over $15 million each.

In my own electorate, which is safe Liberal against Labor, but had independent Ted Mack for some years, our local ‘moderate’ Trent Zimmermann still always votes on the Party line, just like the most rabid right wingers. He produces a lot of brochures with his ‘electoral allowance’ (which you paid for) and mentions many small organisations and the grants to them that he was responsible for. So even if we don’t like ‘pork-barrelling’ we can be glad that our local member is doing a great job. The idea is that we have a disconnect between criticising pork-barrelling at a general level, and voting Liberal at a local level; smart eh?

It si extremely likely that this degree of pork-barrelling determined the 2019 election, which the Liberals won by one seat, so we have corruption at a very significant level.  It is interesting that the Nine Group, SMH and Age, have produced this material more than 2 years after the election and as we look to the next election.  Had this been available immediately after the 2019 election perhaps Labor would have had another reason for their loss and not blamed it all on stating some policies, and then responding by having no policies that could be criticised since.

No doubt the same pork-barrel literature will keep coming in our electorate where the ‘Voices of North Sydney’ Independent, Kylea Tink may threaten Trent Zimmerman.

The only solution is to have a strong public service that is given transparent guidelines as to where money should be spent, and that their recommendations should be made public and not subject to any ministerial discretion.  It won’t happen without a lot of public interest and pressure.  

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