28 March 2020

Gen C, the world v Dr Swan, hotel Corona, and more COVID-19 stories

Communicable Disease COVID-19

Last week when I sat down to pen this column, I’d been prompted to post for the first time on a Saturday, after reading the Ruby Princess cruise ship story in the paper that morning while getting coffee at the local café. Things were getting crazy.

One week later, I’m not going outside except to walk the now stir-crazy three dogs (oversized, not so bright lab, weird french bulldog, and 18-yo retriever with bad leg) and wouldn’t think of picking up a paper in a café, let alone going in one.  It’s not getting crazy now, it’s going surreal.

Here’s a few things just breaking, some interesting stuff from outside the world of medicine, for context, and some of the more important and weirder stories from the week.

Boris gets it (literally), why is UK being more transparent than Oz?

If you hadn’t heard, Boris has COVID-19. Lots of coverage in the consumer press of course. We  wrote on Thursday that the UK seems to be doing a much better job of running the COVID-19 crisis from a leadership, transparency and communication clarity point of  view than Australia (see NHS site vs health.gov.au site, and you’ll get it), but you wonder how good when the PM and the Health Minister both get it. Maybe they’re more on the frontline trying to get things done?

As good our medical experts are, if you are watching across each country, political leadership is clearly a big swing factor in every country’s and state’s attempt to get their curves to start to turn hard-right off the vertical trajectory many are on at the moment. In this respect our PM has come in for quite a bit of stick this week for his confusing messaging, his swift change of guises, first as the calm family ‘bloke’ going to the footy, then to the angry headmaster castigating his idiot students for going to the beach, then back again to the nice guy, who loves his people. Author Richard Flanagan, writing in the Guardian Australia, summed it up pretty well HERE.

This single quote from Flanagan resonates if you saw that tuesday night press conference:

“As my nephew, a teacher, texted me last night, he’s still allowed to teach a class of 30 children but if he dies from the virus caught there only 10 can come to his funeral. If he remarried only four others could be there but if he called it a boot camp 10 could come. Which makes for a clear message.”

And it’s not just the left wing press having a go. Chatting to my daugher who is stuck in London for the foreseeable future, I joked about Boris getting COVID-19. She said that Morrison and his press conference was the source of a few viral memes on the internet. Here’s one.

It could be worse. It feels like the tide has gone out well and truly on the US president Donald Trump. Bad leadership is killing people. Not so funny any more. This post in the the UK Guardian doesn’t mince words about it.

The government vs Dr Swan and the definition of ‘expert’

 One of the less edifying themes of the week was various officials in the government taking the time out to have a go at Dr Norman Swan for questioning the government’s official strategy of “proportional response”, or, “protect the economy, wait, see and step our response as we go”. Some think that might be “step up our response a couple of two weeks late each time”.

There are a mass of doctors who don’t like Dr Swan reasons I don’t entirely fathom, but I think it’s to do with him not  practising long formally as a doctor (I’ve been told he had to practice at least for 3-4 years for the qualifications he has, DHC, and MRCP), and therefore somehow not having the right to put the Dr in front of his name. I guess I get that confusion. But he’s a journalist not a doctor. And as a medical journalist he is the best one we have in this country.

Swan doesn’t suffer fools for sure and can be cantankerous at times, but he is a pretty good bloke generally, and our best medical journalist. When he is asking important questions, even if he’s asking them of our governments quiver of ‘experts’, it’s probably not a bad idea to at least listen, and answer them before attacking him. He may not be a ‘medical’ expert, but he is an ‘expert’ at medical journalism.

On Tuesday night, our deputy medical officer Paul Kelly, deflected  a question asked by an ABC interviewer, which Swan had been asking for a week.

“Does your modelling show that if we lockdown now, the curve will flatten earlier”.

Dr Kelly deflected three times. The federal government has not published its modelling for us so we can’t check ourselves. But the UK UK does, complete with CVs of the modellers, and history of the modelling in the literature. It comes from Imperial College in London, so it’s likely as good or better than ours anyway and not surprisingly it says that “yes” the curve will flatten earlier if we lockdown quicker.

So why can’t someone ask the questions without some government apparatchiks suggesting they are screwing the process up and being un Australian? Deflecting and denigrating Swan for not being a team player won’t work. Journalists aren’t team players. They are full time whistleblowers – the good ones. They can get stuff wrong, but they are there to test the edges.

We aren’t being transparent like some other countries with our information. We are being asked to ‘trust’ the ‘experts’ and to trust the PM. Is it any surprise that 6,000 doctors wrote to the PM by Thursday and said, they didn’t actually trust them entirely, and could they please lock down a bit earlier.

By the way, the best analysis of the models per country and what it means for australia is  THIS peice of data journalism/lessons in Math 101 from the ABC.

Gen C, the world outside medicine for a sec…telehealth

Everyone of course, gets the world outside medicine, as everyone has a life outside medicine. But given how frontline doctors have to be now, and increasingly into the coming weeks, I thought it might it might be interesting for context to bring you some takes from a past employee who runs a blog for the advertising and marketing industry. Reading part of it, which concentrates on how marketing and media will never the same after COVID-19, I started thinking about the same for being a doctor, especially a GP. You see the key themes emerging already in how things might change – telehealth should be a game changer for the profession after COVID-19. We did lots on that this week – see below at the end of blog for summary. Most important is this one which gives you the MBS numbers and lowdown on GPs being able to bulk bill phone or video consultations with all patients.

Advertising, media and marketing is lucky according to my ex employees email blog today (his name is Tim Burrowes). Here’s a few interesting excerpts that hopefully give  you a look onto another, non health world amid the crisis. Each paragraph is a different excerpt. If you want to read the whole thing you’ll need to go to Mumbrella, and get the email as it’s not posted on the web for a week or so.

… jobs started vanishing all across Australia, like clouds drifting across the stars, blinking them out inexorably. First the tourism industry. Then airline jobs. Hospitality. Then airlines. And boom, I bet there’s not a single person reading this who hasn’t seen multiple friends lose marketing, agency or media jobs this week.

First people queueing for toilet paper. Then for Centrelink. It’s going to change us.

Now, a generation (I see it’s already being described as Generation C, for coronavirus, by the way) will grow up in a recession, or possibly depression, in which I suspect that nobody will take their jobs for granted for many years to come.

 Marketing to Generation C might be different. They may not be quite as susceptible to expensive luxuries. And they may not be able to afford them either.

 Just how deep the resulting change to the consumer psyche may depend though not just on this shock, but what comes next. If we all look back on that blip when our lives were paused, then perhaps old habits will return.

 There is even some practical advice for doctors here on the best video conferencing technology emerging, given the world of paid telehealth is with us, at least for now, and some doctors are struggling with what to use and how. Hint: just use the telephone for now.

Tim thinks Zoom is best for formal stuff like virtual meetings being broadcast, but the sound is still bad, Google Hangouts is best for quick video meetings internally, and microsoft’s product doesn’t work very well.

But it’s pretty clear that for doctors on the go, the telephone is the tool that will be most effective and least time consuming, especially when the rebate expands on Monday to include all patients and doctors. That combined with a good appointment engine audit trail for rebates for when one day the dust settles and the PSR resumes normal programming.

Welcome to the hotel Corona (you know the tune)

We wrote about the Ruby Princess stuff up last week. As of today, 88 from the ship have the virus, and the pass on of that is not worth thinking about.

The government is slowly co-ordinating to avoid a repeat performance, but that neither the NSW government or the feds have said sorry, and they started blaming each other, isn’t a good sign that the government is quite there yet on the importance of transparency and clarity.

Now at least, it’s ‘welcome to the hotel Corona’ for everyone arriving from overseas. Although for the unlucky ones, it’s apparently welcome to ‘Corona Caravan Park’….that’s got to be worse than missing the last toilet paper roll role at Coles.

Major stuff for GPs during the week

We started a live blog on Thursday because our normal news cycle, which had been three days a week, went to daily, then twice daily within four days two weeks ago, then went nuts. We found that important info for doctors was moving at an even higher frequency than our newly hectic email schedule, and we didn’t want to bombard people with any more emails.

Our editor, who is ex CNN and the crankiest among us (and News Corp, but we don’t hold it against him), said don’t do it, you have no idea what you’re getting yourselves into. As a result we invested in a whole new journo to help, as our small team were already overworked. And he was still right. He often is.

It’s a simple idea. We break stuff as it happens as it pertains to GPs, make sure it’s relevant and accurate. If a GP wants, at anytime they can check timely updates just for GPs. If you have anything you think should go on it you can send  you’re idea or material to [email protected] or [email protected]

One thing that does work, is we don’t have to do ‘most important of the week’ at the end of the week, as Bianca now does it for us. Here it is below:

·       Could COVID-19 transmit from mother to child in utero? Case study from Wuhan suggests it might.

·       ABC Investigations reveal insurer TAL may be trying to exclude COVID-19 deaths from life insurance payouts.

·       Step away from the pangolin: they can carry versions of SARS-CoV-2.

·       Iceland data suggests around half of positive cases could be asymptomatic.

·       MedAdvisor fast-tracking roll-out of its medication ordering and home delivery service for patients and pharmacists.

·       PM says self-isolation for travellers now legally enforceable.

·       Another 186 cases of COVID-19 diagnosed in NSW in the last 24 hours.

·       How will COVID-19 impact people with HIV, viral hepatitis or other blood-borne diseases? ASHM is on it.

·       And finally, the federal Department of Health has posted its latest video COVID-19 update for GPs, with Principal Medical Advisor, Professor Michael Kidd.

Humanity shining through…

 One thing that comforts me is some of the humour doctors and other healthcare professionals can still see in times of crisis. It all helps. Here’s a few from this week. If you want to see more go to our latest Medical Memes post HERE.

Thanks, keep well (and safe), send in any tips, ideas or comments, and see you next Saturday.

Also, for some our commenting is working, and we are getting some different views which are important to air, so just email per below and I’ll post your comment.

Jeremy Knibbs


[email protected]

Some email comments coming in on the post. Not sure if commenting is working.

Disappointing post from yourself.  Not what we really need to hear at the moment.  Dr Swan is a good communicator but contradicts himself like everyone is doing at present.  He does not have the 24 hour responsibility of Dr Kelly and Dr Murphy. What about a bit of gratitude. Important we all work together I feel. Certainly ask the hard questions respectfully, but cut these people and leaders some slack. No one envies their impossible task – Paul Egan

In reference to Dr Swan not formally practising from Dr David Moore

You have to, to be awarded the DCH and MRCP which he has.


Left to right: Digger, Nigel and Millie




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3 Comments on "Gen C, the world v Dr Swan, hotel Corona, and more COVID-19 stories"

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Andrew Miller
Andrew Miller
2 months 5 days ago

Dear Jeremy,
Why would anyone read a medical article about COVID from little old confused you! Dr Swan is telling you to isolate and there you are having a latte out last weekend! What were you thinking?????

Alan Wallace
Alan Wallace
2 months 5 days ago
Hi Jeremy. Maths 101. Yep. Let’s do some division. Based on yesterday’s World Health Organisation figures (because Europe’s figures for today haven’ t been published yet). The UK , where you have a daughter – 14543 cases positive, 759 dead, a rate of 5.2%. Germany, where I have a son and his family, 50871 cases, 351 deaths, a rate of 0.69%. Australia, where you and I are both fortunate enough to be, 3378 cases, 13 deaths, a rate of 0.38%. I know these are not Case Fatality Rates, (the cases would have to have resolved one way or another for… Read more »