NOOSA – Dr John Gerrard is the chief health officer of Queensland and there are two unusual and important things about this.
One is that, under Queensland law, it is the chief health officer, not the premier, who has absolute power to give public health directions.
Professor Evelyne de Leeuw of the University of NSW says the role has more clout than any other CHO in Australia and “even internationally [as the] final decision-maker on public health.”
And what’s the premier’s role? The chief health officer may act “in consultation” with her.
The other unusual thing about Gerrard is his propensity to make insensitive remarks about the spread of the coronavirus in Queensland, his opinions having the appearance of official policy:
“Not only is the spread of this virus inevitable, it is necessary,” the ABC quoted him as saying.
“In order for us to go from the pandemic phase to an endemic phase, the virus has to be widespread.
“We all have to have immunity [and] there’s two ways you can do that – be being vaccinated or getting infected.
“Once we’ve done that, once the virus is spreading, once we all have some degree of immunity, the virus becomes endemic and that is what is going to happen.”
Aghast at sentiments that sounded more like a threat than an explanation, and which seemed to ignore how safely such transition should be made, blogger Ikonoclast wrote that “these statements are astonishing and a complete abrogation of his responsibilities as a medical professional and chief health officer.”
Ikonoclast was on point in analysing the consequences of Gerrard’s approach, emulated in other jurisdictions:
“The spread of the virus has been made inevitable by deliberate acts (and refusals to act) of public policy.
“There was nothing intrinsically inevitable about it. It was a set of policy choices by Australia’s governments and officials plus the foolish actions of an indulged section of the population.
“To claim that it is necessary to spread a dangerous disease to go from pandemic to endemic is to turn upside down all the precepts of public and preventive medicine developed from about [the year] 1800 onwards.
“Yes, we all have to acquire immunity (realistically partial immunity) if we can, and preferably by vaccination [but] the absolute or near absolute acquisition of immunity by all is impossible.
“There are many immune-compromised people in our Australian community. The number of people with comorbidities which increase the risk of severe illness and death from Covid-19 number in the millions.
“Here are a few examples: 1.2 million people with diabetes in Australia; 600,000 with coronary heart disease; 1.7 million with chronic kidney disease.
“Then there is the weakened immunity of the elderly and the people who can’t be vaccinated at all for medical reasons or who develop no immunity after vaccination.
“The spread of the infection is NOT necessary. The suppression and eradication of Covid was and still is necessary.
“The new variants are making natural immunity and vaccination immunity seriously leaky.
"Indeed, it is looking like Covid might acquire extensive immunity evasion capabilities unless there are further vaccine and medicine developments.
“This is a watershed moment. Late-stage capitalism has given up on public and preventive medicine. It leaves vulnerable people to die.”
Strong words. True words.
Gerrard has an unfortunate characteristic of seeming to look pleased or self-satisfied as he makes statements that leave other people feeling hopeless.
I get the sense that he has set aside the compelling and illuminating words of the ancient Greek physician, Hippocrates (460-370 BC).
First. Do. No. Harm.
In his book, Of the Epidemics, Hippocrates wrote:
“The physician must be able to tell the antecedents, know the present, and foretell the future — must mediate these things, and have two special objects in view with regard to disease, namely, to do good or to do no harm.”
The Hippocratic Oath, one of Hippocrates' most significant contributions to medicine and still an important step in the formal process of becoming a doctor, echoes these words:
“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”
Dr John Gerrard is no Hippocrates.
He was quoted in the Naracoorte Herald last Thursday warning that the number of infections in Queensland would be in the “tens of thousands”:
“That's what a pandemic is about," he blurted with some enthusiasm, "a very large numbers of cases.
"The number of people we expect to get infected with the virus is very large. We are not going to stop the Omicron virus.”
What a remarkably defeatist statement. It offered no indication of his responsibility to seek to manage the outbreak, not merely comment on it.
And on Tuesday Gerrard doubled down, as cited by the Canberra Times: “The numbers of cases we are expected to see through January will be very high, certainly in the hundreds of thousands.”
Tens of thousands had become hundreds of thousands in four days.
And not so much as a word about how the steeply climbing infection curve might be restrained by more effective disease management.
It really is appalling. Having tossed out of the window or thoroughly vandalised basic challenges like planning, ordering, delivering and thorough testing, governments across Australia seem to have decided that people are the problem.
The ultimate deflection, finger pointing and blame shifting. The people's fault. Those dreadful voters.
"We are as prepared as we can be," health minister Yvette d'Ath announced untruthfully tonight. The people are unprepared for this. They are fearful and confused.
And the public communication, never capable, is more confused and contradictory than ever.
Allowing people to die or develop chronic disease seems to be the way out of the Covid management wreckage that Australia's politicians and health bureaucrats, including Palaszczuk, d'Ath and Gerrard, have created.
There’s no way of knowing, but I reckon that down the centuries bureaucrats have been responsible for many more deaths than generals.
As for bureaucrat-generals, of which we have one who disgraces his uniform - our uniform - by freelancing at public relations on national television.…. no words.
The guy at our local Woolworths who puts my regular delivery together every couple of weeks has more supply chain and logistics nous.
And then there’s another critical matter. Gerrard, D’Ath and premier Annastacia Palaszczuk seem to not want to know about - Long Covid.
This is the dirty underbelly of the relentless claims of Omicron being 'very mild', short-term, the final variant, easy on rats’ lungs, a great way to build immunity and good for asthmatics (I made up that last one).
The politicians and doctor-bureaucrats rarely, if ever, discuss Long Covid.
In about 60% of cases, people know when they’ve caught Covid because they have symptoms.
This means that between 10% and 30% of people who have had symptoms will develop Long Covid.
A recent groundbreaking Australian study followed 212 intensive care patients for six months after their unpleasant brush with Covid.
The patients were drawn from 30 hospitals across the country.
Unhappily the researchers lost 57 (27%) of the participants, who died during the study.
At the six-month mark, just four (2%) said they were fine and had no further symptoms thanks very much.
But 151 (71%) had acquired some new, persistent and unwanted health problems post-Covid.
Most said they were frequently short of breath and experiencing pain, mobility issues, fatigue and loss of strength.
Let me give you an understanding of what Long Covid may infer for the State of Queensland (population 5.2 million), which would – according to Gerrard’s ‘everyone’s gonna get it’ mantra - be expected to have 2.6 million symptomatic cases.
Fauci and other experts say between 10% and 30% of these cases will end up as Long Covid. That suggests 260,000 and 780,000 Queenslanders.
Let’s take the midpoint and project that, unless there is an intervention to slow the present exponential growth of the disease, about half a million Queenslanders will end up with Long Covid.
In many ways, Long Covid is similar to the neurological disease that brought my career to a halt 20 years ago and which still assails me, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
According to guidelines issued by the US Centres for Disease Control and the UK National Institute for Health and Care Excellence, my ME/CFS is considered to be of a moderate level.
At this level, people are mainly housebound and very restricted in what they can do, including normal leisure and social pursuits.
They can have serious cognitive problems, constant fatigue, reduced mobility and poor quality sleep.
A saving grace is that there are peaks as well as troughs in symptoms and, should these people have a good doctor, as I have, there may be the pharmacological and case knowledge to develop a cocktail of medications that can help alleviate some symptoms.
But Long Covid is worse than ME/CFS, because generally speaking ME/CFS does not cause organ damage.
Any public health policy that ignores Long Covid and does not aim to limit the spread of Covid is flawed and must be ditched.
Last September, health minister D’Ath, defending new government powers to contain the spread of the virus, announced that "these measures are available to allow us to respond rapidly before one case of Covid-19 becomes an outbreak that we can no longer contain.”
Well you failed, minister. Do you want me to draft a resignation letter for you?
While I’m at it, I could pen one for your chief health officer.
What will happen to Queenslanders over the next two months is shaping up as a shocking failure of governance and planning.
It will be measured in terms of deaths and the lingering, debilitating illness that will affect tens of thousands of people.
Welcome to the chronic disease, Long Covid, for the rest of your life.
Earlier today, Gerrard announced 5,699 new Covid cases in 24 hours. Testing showed a 23% positivity rate indicating the pandemic is out of control in Queensland. (Anything over 5% is considered out of control by the World Health Organisation.)
There were also 170 people in hospital, 11 in ICU and two on ventilators.
“We are not going to stop the Omicron virus,” Gerrard declaimed last week as the white flag fluttered.
“Not only is the spread of this virus inevitable, it is necessary,” he said. “The virus has to be widespread.”
Words I never dreamed I’d hear from a doctor. Was he a mortician earlier in his career?
Well, doc, we Aussies are known for having a red hot go when things get tough. That’s what we do in Australia. We have a go.
It’s about time you tossed down a couple of rums and had a go as well.