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On the Covid exit plan, and 9/11 media memories

Is it OK to feel nostalgic for the period only a couple of months ago, when the government seemed to have a plan for exiting from the elimination strategy? Ah, the good old days. That plan included inviting firms to nominate a few hundred of their best and brightest to go overseas on essential business. On their return, we’d then see how the public health system coped. If all went reasonably well, there would be a gradual re-opening through the first quarter of 2022.

Such was the plan. But as Mike Tyson once said, everyone has a plan until they get punched in the mouth. The Delta variant has changed the outlook. Can our public health system – any health system, anywhere in the world - readily cope with Delta’s ease and speed of transmission? Delta has all but dissolved the zone between an acceptable level of risk, and an unacceptable level of carnage. Sleep on Delta for a few days or a week, and New Zealand would be well on the way to looking like New South Wales.

That’s the key problem. Meanwhile, getting to full vaccination ASAP – 85? 90%? – has become the imperative before we can even begin to explain what a rational co-existence with Covid might conceivably look like. At yesterday’s post-Cabinet press conference, PM Jacinda Ardern understandably declined to specify what – even at 90 % levels of vaccination – the country might be willing to treat as being a tolerable level of Covid sickness, hospitalisation and death, in order to avoid any further level four lockdowns. On much the same point, the resilience of the public health system is also being left for now as something of an unknown. Yet surely, any decision to abandon the elimination strategy would need to weigh just how many extra hospitalisations and extra ICU patients that the public health system could sustain, before being overwhelmed.

Even at 90 % levels of vaccination, the trade-offs involved in “living with Covid in the community” won’t be tidy. Delta will not deliver a static, predictable rate of extra infections. All over the country, the health system would be left scrambling to cope. After all, even a 90% rate of full vaccination with a vaccine that -at best- offers something between an 85% to 95% level of protection against the Delta variant, still means (a) havoc among the unvaccinated, and (b) a lot of room for “breakthrough” infections among the fully vaccinated. In addition, that 90% vaccination ideal would not be evenly spread across the community. Pockets of low vaccination – defined by income, ethnicity, age etc – would deliver correspondingly higher levels of serious illness, hospitalisation, and death.

For now, the very hard decisions involved in shifting from an elimination strategy to one of “living with Covid” are being postponed, for another day. Fair enough. All going well by Christmas, we will be in a somewhat stronger position to make choices, if only because there will be fewer people likely to sicken and die. But is anyone – let alone David Seymour – willing to take responsibility for the toll that would be likely to ensue after the removal of restrictions? Hardly.

Judging by the Doherty Institute modelling in Australia, the comparable death toll here would be staggering :

Assuming 80 per cent vaccination coverage for only those over 16, as per the National Plan, there could be approximately 25,000 fatalities [in Australia] and some 270,000 cases of long COVID.In contrast, and if children are also fully vaccinated, national fatalities – for all age groups – would be reduced to 19,000 with 80 per cent adult vaccination coverage. This would fall to 10,000 at a 90 per cent adult vaccination coverage.”

Adjusting for population size, that 90% vaccination scenario would suggest the price of unrestricted “living with Covid” would result in the deaths of around 2,000 New Zealanders, or an average of about 20 deaths per day over the three months of summer. That seems a high price to pay for a few hours of fun in the sun. Yesterday though, Ardern virtually guaranteed that the summer music festivals –potentially, super-spreader events - would be allowed to proceed because they‘re so much a part of our national identity. Such events may provide the first tests of this country’s appetite for Delta risk. Risky indeed. Even by Christmas, it seems hard to believe that the target audience for music festivals will have hit 90% rates of vaccination.

White and righteous

In the meantime, I guess there’s nothing wrong – or unique – about treating full vaccination as an end in itself. Over the past decade, successive governments have treated other things (austerity drives, the size of government, the balancing of the budget) as fetish objects, and ends in themselves. In the case of the vaccination drive, there is encouraging evidence that the “wait and see'' faction among the vaccine hesitants is starting to climb down off the fence, and get their shots. Good.

However, the hard core anti-vaxx minority – is it 5%, 10% or 15% of the population? - will be much more difficult to turn around. On the evidence from other vaccine efforts, it would be unwise to assume that most anti-vaxxers are Maori and/or Pasifika. As Werewolf reported a few years ago, the 2012 MoH evaluation of the take-up rate of the Gardasil vaccine (which provides young girls protection against cervical cancer in later life) found this:

Basically, the tables show that among low decile schools and among Maori and Pacific Island girls, the take-up rate of the HPV vaccine is very high, up around Australian levels. Conversely – and no doubt surprisingly to some – the vaccination programme has been less successful among white, higher income school communities, and it is the resistance from these groups that is dragging down the national average in New Zealand.

The MoH evaluation included this :

The greatest opportunity to increase the HPV vaccine uptake for the ongoing cohort is to target parents who are delaying the decision to address low uptake by Pākehā girls.

And there was also this:

“ Of the 73 schools that declined to participate in the [vaccination] programme (5%), half were decile 6–10, primary schools, or religious or alternative schools.”

As Werewolf pointed out at the time, additional research done by students at Otago Medical School confirmed that ‘Consent rates decrease as school decile increases. New Zealand Europeans have lower consent rates than Maori or Pacific Island groups.”

As yet though, the messaging around the Pfizer vaccine has not been reflecting the likelihood that the hardcore resistance to all vaccines is concentrated among relatively high income, comparatively well-educated Pakeka communities. New Age sentiments of natural bodily purity and fundamentalist Christian beliefs (faith can heal, God willing) both provide strong motivations for rejecting any vaccine that has been developed by Big Pharma. Such beliefs are sincerely held by people who seem totally oblivious to the risk they pose to themselves, their families and to the wider community.

Footnote One: BTW this week, there have been US media reports that the Pfizer vaccine may soon be FDA authorised (i.e. in October) for children aged from 5 to 11 years of age.

Selective Memory and 9/11

If you add together the death toll at the Twin Towers, the Pentagon and from the United Flight 93 crash in Pennsylvania, a total of 2,996 Americans died in the attacks that al Qaeda launched on the US mainland on September 11, 2001. Not to belittle that toll, but on 13 January of this year, 3, 930 Americans died from Covid. On January 28, 2021 a further 3,868 Americans died from the virus. Yet those deaths received barely a fraction of the media coverage afforded to the January 6 invasion of the US Capitol building, in which five people died.

Reportedly, an estimated 2,606 people died in the collapse of the Twin Towers alone. Yet again, and almost on the eve of the 20th anniversary of 9/11, a further 2,202 Americans died last Wednesday from Covid. Point being: while the 9/11 attacks united the country in shock, grief and outrage, the Covid toll of death and suffering continues to divide the country as to whether the virus is real, whether vaccines are safe and necessary, and whether wearing a mask is a lefty liberal costume.

What can explain these vast differences in cultural meanings and media coverage? Well, 9/11 was extremely cinematic. Many of this week’s anniversary accounts have dwelt on the blue skies over New York that morning, before the planes appeared, and smashed into the Twin Towers. The enemy responsible was external, identifiable and hateful. By contrast, the coronavirus is invisible and indifferent. It can’t be bombed. That aside, the US might still have been able to unite effectively against the virus. Unfortunately, the President at the time chose to weaponise the pandemic, and use it to further his own divisive agenda.

Finding a context

The context of 9/11 has been missing from much of the 20th anniversary coverage. A lot of it consisted of nostalgic memories of the day, and tributes to the first responders. (At the Twin Towers, 344 firefighters, 71 law enforcement officers and 55 military personnel were among those killed.) Perversely, the accidental proximity of the 20th anniversary to the recent fall of Kabul has mainly served as an added critique of President Joe Biden, who is paying a political price for ending the war in Afghanistan. Yet the 20th anniversary remembrances have been spectacularly reluctant to criticise President George W. Bush, who used 9/11 as a rationale to launch two disastrous wars in Afghanistan and Iraq.

With a couple of notable exceptions, the valorisation of Bush as a simple, patriotic leader suddenly confronted by unimaginable evil was a recurring feature of the 20th anniversary coverage of 9/11. The new Apple documentary 9/11: Inside the President’s War Room” was a striking case in point. The narrow focus on the events of the day as self-servingly recounted by Bush, Cheney, Rice, Karl Rove etc ensured that the narrative – a good man, a good country facing an alien threat - insulated Bush from criticism. Sleater-Kinney, in what was maybe the only good song written about 9/11, got it right:

And the president hides
While working men rush in
And give their lives

The few exceptions took the opposite tack. Twenty years on, they were very much about the consequences. The Intercept’s headline “ Two Wars, 900,000 Dead, $9 Trillion Down The Drain” said it all. On his website, Middle East expert Juan Cole likened the subsequent US invasion of Iraq to a notorious 2018 murder case in Florida, where a vengeful woman hired two contract killers to murder a romantic rival. Instead, the inept killers kidnapped the wrong person but killed her anyway, to hide the evidence of their mistake.

This, Cole argued, was basically what Bush, Dick Cheney, Donald Rumsfeld, Paul Wolfowitz etc did in Iraq, nineteen months after 9/11. They used the lingering national emotion around 9/11 to validate their lies about Iraq’s weapons of mass destruction, even though they knew by then that Baghdad had nothing to do with the al Qaeda attacks on New York and Washington .

The difference between them and the misguided love-triangle mob was that the latter whacked one poor, innocent victim whereas the Bush administration set in train events that would leave hundreds of thousands dead, millions displaced, and a country in ruins.

As Cole says, any 20th anniversary commemoration of the 9/11 victims is an exercise in hypocrisy if it fails to mention the hundreds of thousands of victims created by the wilfully misdirected US response. By his count:

In 2003-2008, 4 million Iraqis were displaced and made homeless in a country of 26 million, 1.5 million of them overseas. Something on the order of 200,000 Iraqi civilians were killed in the maelstrom unleashed by Bush. This is certainly an under-estimate…The number of Iraqi dead is certainly higher if you include everyone who died that would not otherwise have died if Bush had not invaded. Most of those killed were parents, so [the US]created a whole class of Bush orphans in Iraq.

In the months straight after 9/11, Bush and Co invaded Afghanistan but failed to capture or kill Osama Bin Laden. At a crucial point, the Bush White House simply lost interest in the Afghan war. New Zealand, over 30 other countries and a wavering US commitment were left to complete (as best they could) the doomed attempt at nation-building that Bush had half-heartedly begun. Biden didn’t sow the seeds of failure in Afghanistan. Bush did.

Bush’s inability/reluctance to focus on winning one war before starting the next one has had horrendous consequences. Among other things, the March 2003 invasion and occupation of Iraq inspired the formation of Islamic State. Over the next decade, IS wreaked havoc across the Middle East and beyond. It attracted thousands of recruits and lone wolf terrorists to its cause. We are still experiencing the ripple effects. For anyone hellbent on waxing nostalgic about 9/11….there’s a chain of cause and effect to be drawn between the September 11, 2001 attacks in the US and the September 3, 2021 attack by an IS sympathiser at the Countdown supermarket in New Lynn.

Obviously, the existence of such links doesn’t exonerate the terrorist for his actions. But remembering the evils of 9/11 without considering the evils carried out in its name seems almost as perverse.

Lockdown blues

Few artists have captured the Covid lockdown mood quite as well - or as accidentally - as Archy Marshall did on last year’s King Krule track “Alone, Omen 3.”

But don't forget you're not alone
Sometimes you're stretched
But don't forget you're not alone

Deep in the metropole…

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