#influenza

WHO’s official 2017 pandemic playbook says it all

WHOTWO

The World Health Organisation (WHO) has bungled its response during the coronavirus crisis. Politics always seems to trump principle. This cartoon is particularly blunt.

In mid-January, WHO happily parroted Chinese propaganda which said, “preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCoV) identified in Wuhan, China.” This, instead of independent verification by WHO.

WHO Director-General Tedros Adhanom Ghebreyesus praised China’s “transparency” despite whistleblower doctors being silenced by the propaganda machine. Several have sadly ended up dying.

Ghebreyesus even took potshots at governments looking to close borders to quarantine themselves on the basis of “unnecessarily interfering with international travel and trade” and “increasing fear and stigma.”

The interesting thing is that Director-General was reading straight from WHO’s very own 2017 playbook, ‘Pandemic Influenza Risk Management [PIRM]- A WHO guide to inform and harmonize national and international pandemic preparedness and response‘.

On travel, the report noted,

The International Health Regulations (IHR) (2005) seeks to limit the public health measures taken in response to disease spread to those “that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.” This aligned with China’s rhetoric.

On member state cooperation,

Under the Framework, Member States are responsible for (1) ensuring the timely sharing of influenza viruses with human pandemic potential with Global Influenza Surveillance and Response System (GISRS); (2) contributing to the pandemic influenza benefit-sharing system, including by working with relevant public and private institutions, organizations and entities so they make appropriate contributions to this system; and (3) continuing to support GISRS.” p.16

China covered up the extent of the problem by destroying lab samples taken in December causing the unexplained viral infections in Hubei province. Imagine what might have happened if China had been open and honest at the offset? How lucky to have a WHO that pushed China’s narrative that the spread of COVID-19 was slow?

Indeed it is the chief of WHO that calls the Public Health Emergency of International Concern (PHEIC) and for declaring a pandemic. The PIRM report stated,

The responsibility of determining a PHEIC lies with the WHO Director-General under Article 12 of the IHR (2005). The determination of a PHEIC leads to the communication of temporary recommendations…During the period of spread of human influenza caused by a new subtype, based on risk assessment and appropriate to the situation, the WHO Director-General may make a declaration of a pandemic.”  p.14

Why did it take till March 10 for the Director-General to declare a pandemic? 64 days after the start. 118,000 people had caught COVID-19 by then. Now the number stands at 351,000.

At least there is a get out of jail free clause in WHO’s 2017 PIRM report,

Ethics do not provide a prescribed set of policies; rather, ethical considerations will be shaped by the local context and cultural values.” p.18

We guess it must be ok in WHO’s mind that China’s ethics are shaped by the culture of the Communist Party.

As to the question of the effectiveness of social distancing? WHO concluded with this vague paragraph,

Nevertheless, measures that have been associated with containment such as social distancing, hand/respiratory hygiene and judicious use of antiviral drugs may be effective in mitigating the impact of outbreaks of a new influenza subtype in individual countries. These measures are most likely to be successful and are better supported by data demonstrating effectiveness when implemented in specific local (smaller scale) circumstances, e.g. households and closed or semi-closed institutions. Although there is no evidence of any wider population-level containment effect, these measures may reduce the spread and overall impact of the pandemic and could be considered as part of a country’s national preparedness plan, depending on available resources.” p.62

Has there been an overreaction on social distancing which is likely to produce catastrophic economic side effects? If hygiene and antiviral drugs are effective, does social distancing have any impact at all? If not, aren’t governments submitting companies and employees to unnecessary hardship?

Assuming one self-isolates for 14 days, if one catches COVID-19 the first day out of quarantine was there any point to the first 14?

In Japan, peak hour trains to work remain as crowded as normal yet the country isn’t registering a severe outbreak of the disease. Close quarter drinking parties below the cherry blossoms are in full swing, yet no real signs of mass contagion. Japanese are meticulous with hygiene. Is it a factor? Japan has 1,046 cases and 44 deaths so far.

South Korea’s success would seemingly be driven by the sheer number of tests conducted on its population (270,000) which has made controlling out who needs to be isolated easier, as opposed to social distancing and hoping for the best. South Korea has tested 5,200 people per million population vs America at 74, according to the Centre for Disease Control. We don’t profess to hold any expertise in virus containment, but the data seems to bear out highly inconsistent results.

Yet it doesn’t escape the immutable fact that UN bodies, in general, have terrible track records. Why do so many countries want to entrust sovereign laws to UN groups that can’t keep their own houses in order?

In the last audited set of accounts (Dec 2018), WHO operates on a $2.9bn budget of which $931.22 million is paid in salaries across 8,153 staff or an average of $118,000 each. Although in the FY2018 financial year, expenditures totalled $2.5 billion, leaving a $442 million surplus after financial revenue. 

WHO spent $191.7 million on travel, $178 million on operating expenses and $177 million on medical supplies and materials. Medical supplies and materials are mainly purchased and distributed by WHO including vaccines, medicines, medical supplies, hospital running costs, fuel, as well as related shipping costs.

Contracted services look an interesting line item at $781 million. Medical research activities and security expenses are also included in contractual services. 

Despite Ebola in 2014, MERS in 2012, H1N1 Swine Flu in 2009 and SARS in 2002 it is hard to ignore the fact that with over 8,150 well-paid staff members WHO can’t construct a better policy prescription in limiting the spread other than provide sketchy anecdotal data on what methods seemed effective in containing the spread? Perhaps China can loan some propaganda ministry staff to better shape the responses. That’s right, they already have.

Let’s not forget that Tedros Adhanom Ghebreyesus proposed former Zimbabwe dictator Robert Mugabe as a WHO ambassador in 2017. It is not hard to see where the lack of judgment comes from.

Coronaveristy Cash Crunch will lead to cost-cutting

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Almost 1 million foreign students attend Australian educational institutions.  Of that 28% are from China according to the Dept of Education.

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New commencements are at half a million. These are not small numbers. We are already seeing universities start to fret over the economic impacts.

The latest figures from the Australian Bureau of Statistics (ABS) show that in 2017–18, international education was worth $32.4 billion to the Australian economy, up from $18.9 billion in 2008–09.

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In fees alone, foreign students have forked over $7.4bn in the 2017/18 year from $2.9bn in 2008/09.

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As a % of total university fees, foreign students now represent over 23% from  15.5% in 2008/09.

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By university, we can see where foreign students are most concentrated. Victoria holds 5 of the top 10 destinations for foreign students.

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By number, Victorian universities hold the top 3 places for absolute foreign student numbers, and 31% of the national total. NSW has 25% of all foreign students inside Australia.

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Things will undoubtedly settle down. It is unlikely all of these students will pull the plug and not turn up at Australian universities when Coronavirus issues eventually come under control. As far as attrition rates go in Australia, local kids are far more likely to drop out than overseas students.

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We are already seeing some universities announce they are tightening the purse strings until the situation normalises.

An interesting side topic is a fall-off in permanent residency visas offered by the Dept of Home Affairs to foreign students that graduate in Australian universities. The decadal low numbers don’t seem to have affected foreign student interest.

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Graduate visas have picked up sharply. It will be fascinating to see the post-Coronavirus trends of visas from the DHA.

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Ultimately, Australian schools have been living high off the hog. While the trend of international students has been robust, have any of these schools conducted proper contingency planning if a global recession, pandemic or shock was to ensue?

After 28 years of uninterrupted economic growth, something suggests that most universities have not seriously considered what might happen if the well dried up. Sadly, when such an action plan should have been in place, we will probably see knee jerk cost-cutting in all the wrong places. So much for the educators preparing their customers for the future…