Category Archives: Health

Living in limbo

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Please forgive the self-indulgence, but not only is this the 9th week of Melbourne’s 6th lock-down, we now hold the world record for total number of days under “stay at home” orders. I know we love our sporting superlatives and gold medals down-under, but surely this is one title that even the most fanatic supporter of our fair city wished we had conceded (to Sydney, perhaps…).Of course, I understand why we find ourselves in this situation – the government fears that the COVID pandemic will overwhelm the local health system if the virus is allowed to run riot, and before a sufficient proportion of the population has been vaccinated. Clearly, lock-down has helped to reduce the total number of cases and deaths per capita compared to many other countries. And vaccinations appear to be mitigating the impact of the Delta variant, depending on what numbers you track.

However, while most people I know have generally been supportive of the public health measures, the effect of continued lock-down is taking its toll on peoples’ income, mental health and general well-being. It feels that our collective nerves are frayed from the shifting goal posts (in terms of targets and milestones), the continued in-fighting and bickering between the States and the Commonwealth (and with each other), the constant blame games, and the drip-feed of information (despite the daily press conferences and media updates).

This current lock-down, which was initially expected to last a week(!), has been particularly hard to endure. Especially so for the majority of people who, hitherto, have been prepared to buy in to the lock-down measures (albeit somewhat reluctantly and not necessarily willingly). But to be told by our political leaders and their public servants that the growth in case numbers (and the lock-down extension) is due to members of the public breaching the public health orders (“AFL Grand Final parties”) or not complying with the lock-down measures (“household visits”) is extremely galling for those “doing the right thing” – it’s all stick, no carrot. At the same time, in the vast majority of alleged infringements there does not appear to be any consistent approach to penalties or other consequences. (So, why bother with compliance, since the lack of enforcement can lead to the law falling into disrepute?)

The government has long since given up the idea of achieving zero cases, yet seems unwilling to give much relief to people who are fully vaccinated and who have consistently observed the lock-down measures, other than the prospect of small picnics outdoors. Increasingly, the lock-down itself feels like a blunt instrument – why not apply it in a more targeted fashion, rather than a blanket measure? By now, it looks like a game of whack-a-mole as outbreaks keep popping up again (and again) in the same “settings”.

I appreciate that the government wants to keep us safe, and overall I’m extremely grateful that we have not seen the sorts of health statistics witnessed elsewhere. But by maintaining the prolonged lock-down, our elected leaders and their civil servants risk wearing out our patience and burning up any goodwill they may have accrued in the process.

We are living in a sort of limbo, with severe restrictions on the one hand, and uncertainty/anxiety on the other. Among other things, the current situation makes it very difficult to plan any trips to visit family and friends inter-state, let alone abroad. (I’ve not seen my immediate family overseas for nearly 3 years.) While I am extremely thankful that I don’t work in the “front line”, and I am very fortunate in being able to work from home, the inability to meet in person after such a lengthy hiatus does mean some of those relationships have become impaired or have become a little harder to manage and maintain.

Anyway, as I look forward to a second birthday under lock-down, I try not to look too far ahead, maintain the daily routine and walks (and enjoy the occasional glass of wine).

Next week: “What Should We Build?”  

 

 

Same, same – but different?

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At the time of writing, Melbourne and the rest of Victoria are waiting to know when (if?) the current lock-down will be lifted.

Just to recap: Melbourne is presently in its sixth shut down since March of last year, and the fourth so far of 2021. All combined, Melbourne has now clocked up more than 200 days under lock-down. The present measures were introduced on August 5, originally scheduled to last one week, and came barely a week after the previous lock-down ended. Lock-down #6 was soon extended by another week, and then by another two weeks, and will now extend beyond September 2. This is not counting the “stay at home” directive that was in place for most of 2020, along with the various limits and restrictions on social interaction, workplace capacity, public gatherings, hospitality, events, sport, gyms, retail, schools, funerals and weddings. We also have a night-time curfew for good measure.

The following two pictures convey similar human sentiments, but they also represent very different responses to the situation we are living under. One is an example of the numerous messages of hope and encouragement that I see around my neighbourhood on my statutory daily walks. The other is a discarded placard seen a few days after an anti-lock-down protest.

The first reflects a “let’s grin and bear it” attitude – nobody likes being in lock-down, but we are all in this together, and if we can just remain positive, we will come through it OK.

The second is more reactive, and emotionally charged – the enforced isolation brought on by the lock-down is having an enormous effect on peoples’ mental health.

It’s hard to argue with either message….

I thought I would be able to cope better with each successive lock-down. Building a daily routine, maintaining some physical discipline (courtesy of the permitted daily exercise), managing at least 2-3 AFDs per week, treating myself to a nice restaurant-prepared meal now and then, catching up on films that I didn’t get to see at the cinema. But despite the recurring groundhog scenario, this lock-down seems different, and much harder to manage mentally.

First, the uncertainty of when it will end creates a sense of dread that we could be like this for 100 days or more (like lock-down #2). Second, the daily drip feed of data and the endless press conferences only reinforce the sense that we are not being given the full picture. Third, the sense of helplessness that for all our individual sacrifices of the past 18 months, we don’t seem to be any further ahead (if anything, we have gone backwards on so many counts). Fourth, State politicians seem to view this public health scare as a war of attrition between themselves and the voters (and their interstate and Federal counterparts). Gone is any sense that we are all in this together.

Quite apart from the cracks in Federation that the pandemic and its response has exposed, entire sections of the community are being driven apart and/or pitted against one another. Despite the so-called “National Plan” that the Commonwealth, State and Territory governments have all signed-up for, it’s clear that individual Premiers each reserve the right to interpret it differently, and will continue to impose internal border closures if they see fit. So, while Victoria and New South Wales seem aligned on this National Plan, Western Australia and Queensland in particular are more circumspect. Then there is the “race” to vaccinate their respective populations (or, as has been said a few times already, “our State citizens”, rather than “our Commonwealth citizens”).

At what point will the 70% and 80% vaccination levels be achieved to herald the promised social and economic freedoms? Is it the % of total population, or only the adult population, or only the eligible population, or only those between certain ages? Is it going to be calculated Federally, or at the State/Territory and/or LGA level? What about mandatory vaccinations for essential and front line workers, and those that have face-to-face dealings with the public? What about employers who require their staff to be fully vaccinated, but face resistance from unions?

Continued lock-down risks becoming a blunt instrument, and a tool of first (rather than last) resort. As such, it also risks alienating the majority of the population who are doing the right thing, in observing the public health directions and getting vaccinated (like, where’s the benefit?). And a prolonged lock-down risks undermining the efficacy of the vaccine, so we’ll need booster shots before we know it!

It seems that Covid19 is challenging our notions of the social contract between the government and the governed, and even testing the social license to operate we grant to big business (especially monopolies and cozy duopolies). The pandemic is also demonstrating the limits of individual responsibility and accountability, and potentially undermining the duty of care we owe to one another. If I knowingly, recklessly or carelessly (and as a result of breaching public health orders or OH&S measures) infect my family, my neighbour, my colleague or my customer, am I culpable? Does that mean I forfeit certain of my rights, especially if infection leads to death?

Just on the data, another reason the current lock-down seems different is because the information is being presented is not the same. Last year, everything was about the R0 number, flattening the curve, and “double-donut days”. There was also confusion over agreed terminology for “clusters”, “unknown cases”, “hot spots”, “red zones”, “complex cases” and “linked cases”. Politicians and bureaucrats talked about “settings”, “circuit breakers”, and “gold standards” for contact tracing. This year, it’s all about the “number of days infected”, “chains of transmission”, “mystery cases”, as well as the number of tests and vaccinations – much less analysis, it seems, on the number of confirmed cases per 1,000 tests or per 1,000 of the population, recovery rates or deaths as a percentage of cases.

From what I can glean, the stubborn levels of “mystery” cases can only be explained by the following:

  • more asymptomatic cases (are people building natural immunity?);
  • legacy cases shedding (a result of long Covid?);
  • longer incubation (and reporting) periods (less obvious initial symptoms?);
  • novel forms of transmission (or the virus is lingering longer on outdoor surfaces?);
  • QR codes and contact tracing not working (or the data is not usable?);
  • confusion over domestic/social/workplace/health/retail settings (e.g., extended families and multi-generational households?);
  • people being unclear about their movements (for fear of being victimised?).

Finally, I’m also not sure if lessons are being learned from elsewhere. We are still applying 14 day quarantine/isolation periods (albeit now with a day 17 test), yet in Hong Kong, for example, quarantine was extended to 21 days some time ago.

Next week: To be or NFT?

 

Here We Go Again…

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At the time of writing, Melbourne is once again under a COVID19-related lock down. Currently, we are three-quarters of the way through a 14-day “snap” lock down or “circuit breaker”. Variously known as #lockdown4, v4.0 (now v4.1 with the added week), or simply “The South Australian One”. Along with a prevailing sense of déja vu, much of the political, media and social coverage has a very familiar ring to it – like, here we go again!

Overall, I would much rather be in Australia at the moment, compared to many other places in the world that are still struggling to cope with the pandemic. But there is no doubt that this latest lock down is once again revealing some political and structural weaknesses in the Australian Federal and State system – and the people of Victoria (and especially Melbourne) are paying a heavy price for these combined failings.

The blame game between Federal and State politicians is becoming a farce – most of us would rather see some effective leadership and practical solutions, as well as a bit more owning up and taking responsibility for where and when things have gone wrong. After all, the first known case of COVID19 was reported in Australia in late January 2020, so our elected representatives at levels and of all persuasions have had nearly 18 months to sort this out. It doesn’t help that our Prime Minister is generally regarded as being absent whenever there is a crisis – on the other hand, does it help to have him turn up in hi-vis and hard hat for another photo opportunity? And sometimes when he does bother to make it, he’s often made to feel unwelcome.

Here are just a few of the disconnects between Federal and State roles and responsibilities when it comes to managing COVID19:

First, the Federal government is responsible for external border control (i.e., immigration and quarantine). It’s generally argued that the Feds have failed to deliver a workable quarantine solution for anyone coming to or returning to Australia. For whatever reason (and we’ll probably have to wait 20 years before the relevant papers are released), National Cabinet in March 2020 agreed to delegate the management of hotel quarantine (HQ) to the individual States and Territories. The big question is: why did the States agree? Where there incentives on offer, or did they do so because they could see no solution coming from the Federal government? At the same time, the States have applied inconsistent border controls as between each other, and at times, Victoria has been able to suspend in-bound international flights, putting more demand on the other States’ HQ programmes.

On the other hand, Melbourne still managed to host an international Grand Slam tennis event in the summer (notwithstanding some COVID scares and cases), and our nation’s softball players have already been vaccinated prior to heading off to Japan for the Tokyo Olympic Games (which many locals want to cancel for obvious reasons). Plus, AFL teams were somehow able to travel interstate from Melbourne immediately prior to the lock down (did they get a tip-off?). Yet, at least one AFL club has breached COVID regulations, when travelling on a domestic passenger flight. I’m so glad we have got our priorities right when it comes to professional sport!

Second, health services (along with education, aged care and social services) are a strange mix of Federal and State responsibilities, services and delivery. As a result, there is bound to be some overlap and double handling, as well as some obvious gaps. The Federal government is being blamed for failing to secure and distribute adequate vaccine supplies when and where they are needed, and for failing to meet their own aspirational targets in terms of vaccine roll-out. Yet, as with so many public services, there is a (confusing) dual delivery system. Victoria set up a number of vaccination hubs – only it still hasn’t deployed an online booking system: only phone bookings (or walk-ins) are available. But the Federal delivery is via health clinics and GPs, with each service provider offering different booking systems.

Third, the vaccination roll-out (by age and priority categories) has seen the criteria move around, somewhat arbitrarily. There is anecdotal evidence that due to low take-up rates in March and April, some people within one of the priority age categories (initially 60, it was suddenly moved to 50 in May) could access a jab at a clinic or hub at short notice, as otherwise those stocks were going to waste. It doesn’t help that there was/is confusion over the vaccine requirement for certain front line workers (e.g., in aged care) and who is responsible for administering those vaccinations. Of course, since the latest lock down in Victoria, demand is outstripping supply, and it is difficult to verify data on whether anyone who was in a priority category was initially unable to access a vaccine (or was denied access) at the time they became eligible and wanted a jab.

Fourth, hotel quarantine continues to be the key weak point in the transmission chain. I’m not going to dwell on the systemic failure that led to Victoria’s second (and lengthy) lock down last winter/spring – from which we were only just starting to recover when #lockdown4 was imposed. The fact that the latest lock down was triggered by an apparent breach in South Austalia’s HQ is of some significance, as it re-introduced the Kappa “Variant of Interest” into Victoria. More worrying is the presence of the Delta “Variant of Concern”, whose precise source in Victoria is still unknown, but likely to have come from our own troubled HQ system.

Fifth, the calls for the Federal government to pay for dedicated and purpose-built quarantine facilities in each State are understandable – but I’m not sure why Victoria in particular didn’t just go ahead and build their own (and then later stick the Feds with the bill). It’s not as if there is a shortage of construction work going on at the moment in Victoria (much of it State-funded), so it would have been quite easy to pull that project together without waiting for the Feds to come to the party. After all, construction was one of the few industries to continue relatively unscathed during last winter’s lock down – and with the Federal job keeper and job maker subsidies available at the time, Victoria could easily have completed the task by now, especially with the support of a key developer such as the union-backed Cbus.

Sixth, Victoria has only just mandated a universal QR code system for checking visitors in at all business, commercial, retail and hospitality premises. Why it took so long, and why it allowed a mish-mash of third party apps and pen and paper systems is yet another example of poor IT implementation by government. (The Feds appear to be no better with their own COVID tracing app.)

Seventh, the Federal Government, via last week’s National Cabinet, appears to have established a common definition for a COVID19 “hot spot”. Again, it’s only taken the best part of 18 months, and we still don’t have consistent and national terms for defining “red zone”, “complex case”, “cluster”, “mystery case”, “complex case”, “unknown case”, “fleeting transmission”, “stranger to stranger transmission”, “primary contact”, “close contact” or “exposure site” tiers. Nor do we have a consistent framework for responding to a “hot spot”, especially when comparing Victoria to other States.

Finally, the latest lock down again reveals weaknesses and vulnerabilities in Australia’s manufacturing capabilities and supply chains (in terms of producing and distributing sufficient vaccines). It’s also shown up economic fragility with many people living pay cheque to pay cheque, and many small businesses, especially in retail, tourism and hospitality, will not manage to bounce back from a fourth shut down.

Next week: How about that AAA rating?

Victorian Tech Startup Week – Pitch Night

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As part of the recent Victorian Tech Startup Week, Silicon Beach Melbourne and YBF Melbourne hosted the city’s first in-person pitch night for over a year (thanks to the 3 lock-downs we have had in that time). Compered by Karen Finch of Legally Yours, and supported by OVHcloud, the esteemed judges for the evening were Farley Blackman (YBF), Yian Ling Tan (OVHcloud) and David Hauser (Silicon Beach).

The usual Silicon Beach rules applied – Round One featured 90-second pitches from each founder (and no slide decks), from which the judges shortlisted 3 startups for Round Two. The Round One presentations in order of appearance were (as usual, website links are embedded in the names):

TwistedXeros.com

Using “emotional phase shifting to accelerate personal growth and transformation through Insight, Manifestation and Neuroscience”, the impetus for this startup came about from the founder’s own experience. Designed to help overcome certain mental health issues associated with anxiety, the founder claims his technique can help practitioners overcome events such as panic attacks within 6 seconds (as opposed to 600 seconds with traditional CBT methods). Had been accepted into the Founders’ Institute, then COVID came along.

The Leaf Protein Co.

There is a growing demand for plant-based foods, both as a source of sustainable protein, and in response to the increased prevalence of food-based allergies (e.g., gluten and soy). Add concerns about GMOs, unsustainable agriculture and climate change, the founder is looking to develop a scalable process for extracting specific types of leaf protein, including arid-climate plants and Australian natives such as saltbush to counter soil salination. Currently seeking funding to pay for a CSIRO pilot to scale the protein extraction.

E-Toy Library

Essentially a toy-lending app, that provides an end-to-end process (source, distribute, cleanse, circulate) via a subscription model. In trials, already secured 50 customers and over 100 subscribers. Estimates there is a $2.4bn toy market in Australia – but it wasn’t clear how much of this market the founders aim to capture.

Kido Paint

This app aims to bring childrens’ drawings to life, using AI/ML to scan a photo of the drawing, and convert it into an animated 3-D digital file that can be rendered within the app using augmented reality.

Thorium Data

Using the oft-heard tag line “data is the new oil”, this B2B solution is designed to help companies organise, manage and extract more value from their data. It does this by resolving issues of data inconsistency, privacy, risk and governance. It also derives and assigns numerical factors to to individual datasets to assess the “value” of this data, and uses indices to benchmark that value.

QuestionID

This product feels like a cross between a wiki for academic research papers, and an open text search tool to find answers within the wiki database. I know from experience that repositories of published research reports (especially refereed and peer reviewed papers) are highly structured and tagged, with the emphasis being on classification, authorship and citation. Often, you sort of need to know in advance the rough answer to the question you want to pose. Significant resources are already allocated to maintaining and commercialising these existing databases, so I’m not sure how QuestionID will deal with IP and other rights associated with these reference resources.

HiveKeepers

HiveKeepers is designed to support beekeepers by helping them to establish and maintain healthier hives, and enhance their own livelihoods at a time when the industry is facing numerous challenges. At its core is a smart phone app that monitors IoT sensors (temperature, weather, weight, motion, sound, etc.) attached to the hive itself. Over time, the data will enable predictive analytics. With the launch of its MVP, HiveKeepers has already attarcted 700 customers globally.

Round Two

The three finalists selected from Round One were KidoPaint, LeafProtein and HiveKeepers. Each founder made a longer pitch, and then answered questions from the judges:

Kido Paint – The Q&A discussion centred on the commercial model (B2B/C, gift cards, in-app vouchers), the file conversion process (turnaround time can be 24- 48 hours), options for scaling, and getting the right price pint for user prices. So it’s not an instant result (which may disappoint some impatient younger users), and the 3-D rendering and animation is somewhat limited to the imagination of the AI/ML algorithms used in the conversion process.

LeafProtein – There was a further discussion on the approach to producing sustainable and allergen free plant proteins. For example, the attraction of pereskia is two-fold – a higher protein ratio, and an arid climate plant. Also, the aim is to counter mono-culture and GMO crops. A D2C brand has been launched (using small-scale production processes), while the CSIRO project is to designed to scale protein extraction, as well as develop an emulsifier for use in the food industry.

HiveKeepers – The founder talked more about the need to address climatic and environmental impact on hives. Having benefited from support from the La Trobe University and SVG Thrive AgriFood accelerator programs, this startup is seeking funding for product development – current price point is $105 USD per smart hive per annum. While the industry is seeing a 2% growth in new hives, it is also suffering significant hive losses due to parasites and diseases.

The overall winner on the night was LeafProtein.

Next week: From R&D to P&L