These three charts show pandemic and post-pandemic excess deaths by age group. I highlight South Korea in light of this RNZ piece of ‘journalism’. For Omicron-related deaths, look for the period from February to May 2022. I include Italy and New Zealand for comparison; Italy and South Korea were – in February 2020 – the most publicised countries other than China in relation to the beginnings of the Covid19 pandemic. (South Korea clearly was much more successful than Italy at suppressing Covid19 in the northern spring of 2020.)

As I understand it, Italy has had substantially less facemask use in the Omicron (2022) phase of the pandemic than has South Korea. New Zealand is somewhere in between, and the eventual cost in lives in New Zealand remains hard to gauge.

The RNZ article also mentioned Japan and Singapore as role models for New Zealand. To follow the ‘exemplar’ countries, look to these charts on Worldometer. (I add populations for each, because the important charts – daily cases, active cases, daily deaths – are not adjusted for population.) I’ll include Republic of China – the second jurisdiction claiming to be the legitimate government of the whole of China, though unofficially named Taiwan – one of Michael Baker’s previously cited exemplars for New Zealand.

• Japan (population of 125,670,000)
• Singapore (population of 5,946,000)
• South Korea (population of 51,361,000)
• Republic of China (population of 23,907,000)

The three countries which I have charted here – South Korea, Italy and New Zealand – all have the same life expectancy at birth: 83 years.

The Korean chart may be distorted by demographics affected by both WW2 and the Korean War hot episode of the ‘Cold War’. People there born from 1945 to 1956 have been dying in substantially excessive numbers through 2021 as well as 2022. While younger people (at least until the Omicron wave) were largely unscathed by the ‘grim reaper’, they would appear to be not immune.

In Italy young people have also been dying at alarming rates, though at declining rates since Omicron has been the dominant variant of covid. In New Zealand, so far, young people have been largely unscathed by the reaper, though they clearly have been substantial amounts of adversity.

My sense is that, as with other countries, the impact of Covid19 in New Zealand on working-age people will eventually show up; and that, whatever facemask protocols New Zealanders follow from now, the harm that will lead to younger people’s death rates will eventually lead to an ‘Italian story’ in New Zealand.

The excess-deaths approach will also pick up non-covid deaths arising from reduced immunity to all forms of respiratory illness. (See my recent One Sari Sari Night.) Probably both Italy and South Korea have already had a significant impact from these other illnesses. Acculturated (see the RNZ article) and excessive facemask use tends to reduce deaths by postponing them. South Korea – and maybe New Zealand too – may be paying a high interest rate.

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

https://www.rnz.co.nz/news/world/472013/habitual-mask-wearing-is-likely-helping-japan-singapore-and-south-korea-bring-daily-omicron-deaths-down-epidemiologists-say

Respiratory Virus Hospitalisations in Counties-Manukau, as reported by Stuff

The chart above splits the patients in Middlemore Hospital into the different categories of Severe Acute Respiratory Illness. The vast majority are what in the past we have called ‘common colds’. There is no indication that any of these ‘colds’ are due to human coronaviruses other than the Covid-Omicron. Indeed, as well as ridding us of Covid-Delta and its ancestor variants of the original SARS-Cov2 virus, Covid-Omicron may well have sealed the fate of the human coronaviruses which previously caused about 15% of all ‘colds’.

We do not know what percentage of covid hospitalisations end up becoming deaths. (My guess is that about half of covid deaths occurred in people’s homes, including age-care facilities.)

It is likely that the deaths associated with the 93% of SARI hospitalisations which were not covid are a relatively low number compared to covid deaths, mainly because a large proportion of these other cases will be children. But it is appropriate to remind ourselves that, in normal times, about ten percent of all winter deaths are attributable to ‘common colds’, and that this figure will be higher this year, maybe 20% of all winter deaths.

Recent Changes to the Reporting of Covid19 Deaths

The recent changes have been very confusing to media trying to report these. But I will summarise the three main measures, using data from Tuesday 26 July until today.

• Deaths of people who became Covid19 cases within 28 days of their death: 154
• Deaths of people for whom Covid19 was the principal cause: 90
• Deaths of where Covid19 was the principal or a contributory cause: 130

The last of these has become the favoured measure of the Ministry of Health. It is important to note, however, that because of times required to verify that Covid was the underlying or a contributory cause of death, this last favoured measure is not as up-to-date as the first (previously favoured) measure.

To impute weekly deaths (and allowing for lower weekend reporting) we should scale-up these four-day totals by 50%: giving 231, 135, and 195.

Then, to convert them into weekly deaths per million in the population, we must divide by five. That gives, for each measure:

• 46 per million
• 27 per million
• 39 per million

These last three numbers should be seen in the context of this Worldometer screenshot (22 July 2022) which showed New Zealand last week as the country with the world’s highest Covid19 death rate.

Based on the above calculation, New Zealand’s current comparable rate of Covid19 mortality is 46 per million (up from the 34 per million shown in the screenshot). And even if we use the much more conservative measure above (27 per million), that’s still the same as the number given for Malta, and well above the high numbers for Taiwan and Australia.

And we know that significant numbers of people are also dying from the other SARI viruses. SARI deaths would appear to be being substantially downplayed by the Ministry of Health.

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

I try to write about general issues of importance, in a general – indeed global – context. This time I will write just about me.

I am the same age as Phil Goff, Mayor of Auckland. And I want to be appropriately protected from Covid19. I have had three shots of the Pfizer Covid19 vaccine. My most recent vaccination – the so-called booster – was on the first of February this year. On 27 June I enquired about getting another ‘booster’ shot on Tuesday 28 June, before going away ‘on holiday’ on 30 June. I was not allowed to, because of a set of rules that have never been adequately explained. (RNZ‘s Kathryn Ryan tried to ask an expert on 13 July, but gave up in frustration.) The best I could do was to get a vaccination booking at my local Health Centre, for Wednesday 3 August.

(Between 28 June and 3 August, about 700 people in New Zealand will have died with Covid19. The substantial majority of these are Pakeha aged over 70 who received a booster vaccination ahead of the March wave of Covid19, and who have died (or will soon die) of Covid19. How many of these are dying for want of a vaccine booster?A rhetorical question. But the answer will be that at least one of these would have had a booster had they been allowed.)

I am classed as being in the ‘vulnerable age group’. Now, I’m not ‘very old’. But if I was the same age as Joe Biden, or even Jimmy Carter, I would also have been refused. I’ll bet that Jimmy Carter faced no impediments in getting a fourth vaccination shot. But Jim Bolger will have had to wait.

Anyway, I continue to be one of the dwindling number of people who has yet to get Covid19. Today, I asked if I could get my vaccination booking brought forward to Monday 1 August. “No”, they said, “we only do Covid19 vaccinations on Wednesdays and Thursdays”.

So I went to the local shopping mall. At the first pharmacy, I asked if I could come in for a vaccine on Monday 1 August? They said I could ‘walk-in’ any time from Tuesday 2 August. Why not Monday I asked; after-all Monday will be six months since my previous shot. They said I had to wait six months plus one day!! I asked why the Ministry of Health (MoH) requires that I wait that extra day. They had no answer.

So I went to another pharmacy and asked the same question. They said that “I could try coming in on Monday”, and that they can sometimes override the MoH computer. It was a roundabout way of confirming that I am meant to wait ‘six months plus one day’. I further questioned the Ministry of Health’s reason for this extra day’s wait, but the pharmacist had no explanation. He did say, though, to come in on Monday 1 August, implying that he would be able to do the system override.

At first impression, this situation – the needlessly long six-month wait – is a case of ‘bureaucracy gone mad’, killing a significant number of New Zealanders. And, regardless of the answer to that question, why must I wait that extra day beyond the six months?

MoH: Please just answer – not necessarily to me personally, but preferably to this publisher – these three questions? [Reminder: I got my third ‘first booster shot ‘ on 1 February 2022.]

• What is the medical reason why I cannot get my Covid19 ‘second booster’ on Friday 29 July?
• Why was I told by a health professional that I will not be allowed to get my Covid19 ‘second booster’ on Monday 1 August?
• Given the large number of people who become eligible for another vaccination in August, when and how will you tell the vaccination-willing New Zealand public that the rule is that they must wait ‘six months plus one day’?

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

Problems make the world go round. Many of us – maybe the majority of workers, and certainly the majority of well-paid workers – earn our living addressing problems. A problem-free world would represent a major crisis for modern social-capitalism. (Yet standard economic theory continues to present the productive economy as a mechanism for ‘satisfying wants’, as distinct from ‘addressing problems’.) We also note that while much income is earned addressing problems, the problems being addressed are rarely solved. (Examples of problems actually being solved were the elimination of horse manure street pollution at the beginning of last century, eradication of smallpox at the end of last century, and the elimination of SARS in 2003.)

One issue here is the macro-micro problem. In the case of many ‘games’, such as legal disputes, two (or more) parties have problems. Both hire ‘good lawyers’. Eventually, one party wins – meaning its problem is largely solved, though it still has the lawyer’s bill to pay. The other party loses. On balance, this may be a ‘negative-sum game’; the overall problem may be even bigger than before, though the burden of the problem will have been redistributed. We tend to say things like ‘the lawyers were the winners’. Though, from a macro perspective, if the combined efforts of lawyers mainly result in a burden-shifts rather than lasting solutions, then the productivity of the lawyers’ collective labours will have been rather low.

Generalising, we may say that, for much of the time, the social productivity – ie productivity broadly defined – of professional problem solvers (such as lawyers) is rather low. (The productivity of soldiers is an extreme example of the same issue; soldiers – when waging war – destroy rather than produce. Nevertheless, so long as ‘they’ have soldiers, then ‘we’ must have soldiers too; from a micro point of view, soldiers are necessary for each country.)

Commonly, problems are not solved because they are defined too narrowly. When a problem is defined too narrowly, then the problem may in fact be being made worse, even if the problem, as defined, is being solved.

Examples relate to road-safety and to public health. Before looking at these examples, however, we may note that these kinds of problem may be represented through the imagery of concentric circles. The micro perspective is represented by the inner circle(s); the macro by the outer circle(s).

Concentric Circles

Just about any problem can be understood both narrowly and broadly; in many cases there are degrees of ‘broadness’. This can be visualised as ‘concentric circles’, with the narrowest specification of the problem represented by the inner circle, and the broadest measure of the problem represented as the outer circle.

The issue here is that solving the problem at the narrowest level of definition may, to a lesser or greater extent, shift the problem to the next level or levels. An inner circle solution may spill the problem into the next circles out. And, indeed, as the second circle problem is addressed, the actions undertaken may further broaden the problem, rather than closing it. (We should acknowledge that there may also be ‘spillover’ benefits, as well as costs. Narrow vision occurs when the spillover effects are biased towards costs over benefits.)

We should note the role of time. A problem, narrowly perceived and addressed, may be able to yield relatively immediate fixes. However, the broader aspects of the problem may take much longer to show up, let alone to address. (These broader problems are often assigned to the ‘too-hard basket’.)

Interesting examples are where literally ‘saving lives’ is presented as the key ‘solution metric’. In a public health context, it will be easier to save more older lives than younger lives within a ‘political attention-span’ timeframe, because more older people will die ‘this year’ than younger people. But highly focused political actions taken to save older lives may place burdens on younger people. Such burdens cannot be easily assessed within a short period. If younger people’s lives will be shortened as a result, it will always be hard to prove in the future the extent that this life shortening was in any way due to an overly narrow understanding of the initial problem. A problem solved, politically, may be, unknowingly, a problem exacerbated in reality.

In our context here, ‘external’ costs and benefits are new costs and benefits in the outer circles which result from activities undertaken within the inner circle (or circles). Such narrow ‘inner-circle’ focus can be appropriate if we can reasonably expect that external costs will be balanced (or more than balanced) by external benefits. Scientists – including social scientists and others with a ‘scholarly’ bent – are, by the nature of their work, narrowly focussed. (They are ‘dot-makers’ rather than ‘dot-joiners’.) Although these expert contributions are very important, they need to be balanced by intellectuals and realists with broader focus. By and large, in this regard we are not well-served by politicians and mainstream journalists; two of the groups we look-to to communicate broader ‘joined-up’ thinking to the populace. They, in recent times, have been more under the thrall of narrow-sighted experts than since the ‘rogernomic’ and ‘ruthenasia’ times (in New Zealand) in the 1980s and early 1990s.

Car Safety

One way of addressing the ‘existential’ problem of climate change is to subsidise certain types of ‘clean’ motor vehicle. This is the central focus of the New Zealand government’s latest policy to address climate change. (Refer to On The Emissions Reduction Plan Non-Event, Scoop, 17 May 2022.) This policy acknowledges that cars are dangerous in a very broad sense, in that they contribute to emission-caused global warming. But the Minister for Climate Change has a different brief from the Minister of Transport; specific car safety policy is formulated within the narrower brief of the transport ministry.

This is not our first attempt (eg in New Zealand) to subsidise certain types of car. Until a few years ago, the price of car registration was the same for all private cars. Then the New Zealand government introduced a system of registration subsidies, based on car-safety assessments.

The concept of car safety was narrow. A safer car was a car that would be less likely to lead to the death or serious injury of its occupants in the event of a crash. This meant that bigger cars were ‘safer’, because, in the event of a collision with a smaller car, the occupants of the bigger car would on average suffer less harm than the occupants of the smaller car. So safer bigger cars were subsidised.

The flaw in the logic is quite obvious. The second concentric circle (counting out from the inside) relates to non-occupant road-users; ie occupants of other cars, motorcyclists, cyclists, and pedestrians. For these road users, it is clearly more dangerous to be struck by a big car than by a small car. Macro thinking about road safety leads to bigger subsidies to smaller cars, not bigger cars. (Yes, there will always be some big vehicles on the roads, especially trucks, but the fewer big vehicles the better, from the point of view of private-car occupants.) Smaller cars can be as safe as bigger cars, even to their occupants, in a world with few bigger cars.

There are third and fourth circles, further out. It is almost universally accepted that car exhaust emissions have an adverse impact on human health, as well as creating visual pollution in the form of haze. Thus, the issue of air pollution in cities has long been a classic textbook example of the ‘negative externality’ problem. I remember Mexico City in 1976.

The fourth circle is that of ‘climate change’. It is generally accepted that the adverse consequences of climate change are worse for humans – and most other species – than are the beneficial impacts. At the worst end of these possibilities is the extinction – or near-extinction – of humans and most of the other species we know and love. Bad indeed. Though the worst of the harm is not immediate; or at least not immediately immediate.

This last issue is of course much bigger than an issue of road safety. But it does show that the subsidisation of large cars – something done in the recent past to facilitate road safety – is counterproductive both in terms of the narrower issue of road safety and the wider issue of public health. Experts have narrow views of ‘safety’; views which are generally (and appropriately) confined to their focussed areas of expertise. Fortunately, experts are not policymakers.

Policymakers are assigned, by the people in a democracy, the task of problem-addressing using a wider field of vision. When policymakers simply defer to those with narrow expertise, then they are negligent in the performance of their duties. When a problem is at an acute phase, narrow expertise may need to prevail, but not without question. As a problem moves into and through its chronic phases, the policy fields of vision need to broaden.

Street immunity and other health defences

Last week I heard the term street immunity for the first time, in relation to the immunity (or otherwise) to infectious diseases in the domestic dog population (ref to Vet Council warns about kennel cough spreading around NZ, RNZ, 18 May 2022. The narrow way in which humans have addressed and evaluated the Covid19 pandemic has created a loss of ‘street immunity’ in our domestic dogs, and, almost certainly, our domestic humans. (Whether the current ‘monkey pox’ scare is related to this, we do not know, and will never know if the question is not addressed.)

When it comes to a new infectious disease, the inner defensive circle is for governments – local or national – to establish barriers between the new pathogen and its prospective host population; with particular concern by humans, naturally, for humans as prospective victim hosts. This response can most succinctly be described as ‘quarantine’, and it involves international and domestic border closures, ‘lockdowns’, and facemasks. Barriers. Barriers which may include barriers to people – people stranded, people without permissions to travel or work, private-sector innovators – who could help save lives.

The second circle is the human immune system, narrowly defined. Immunity to particular viruses is derived from exposure to those viruses, or to agents (such as vaccines) which mimic them. For some pathogens (such as viruses), immunity is long-lasting; for other pathogens – and human coronaviruses have been long known to be in this category – specific immunity is short-lasting. Pathogen evolution, where viruses etcetera ‘learn’ to evade host immunity, is part of the reason for waning immunity, but not the only reason. An optimal immunity balance may develop, whereby both pathogen and host achieve an infection equilibrium that confers benefits, as well as costs, to both micropredator and human (or animal or plant) host. Barriers, by their very nature, compromise immunity; vaccines may counter compromised immunity.

The third circle is that of cross-immunity – or co-immunity, or street immunity – whereby occasional exposures to less dangerous (and more endemic) pathogens may raise levels of host defence to new and more dangerous pathogens. This is the circle of street immunity, which is a more general – less specific – type of immunity. An important part of this circle is the need to avoid germophobia (also called ‘mysophobia’); germophobia limits individuals’ opportunities to acquire street immunity.

The next circle out is nutrition. Balanced nutrition, including vitamins which by definition must be consumed (because the body cannot synthesise them), is part of this level of self-help health. Different health threats may require different nutrients in order to be able to mount bodies’ best possible defences against those threats. Advice by some dietary experts can be counterproductive if it encourages less balanced diets. Likewise, expert recommendations to avoid vitamin supplements can be counterproductive to disease immunity. Much dietary expertise suffers from the same narrow-vison as other forms of expert advice.

The next ‘disease defence’ circle out is general happiness, including as many people as possible being able to live lives in ways that minimise their risk of incurring mental illness, or of experiencing substance dependence.

A final circle is that of existential population dynamics. It is indeed natural, and under some circumstances, appropriate, that populations sometimes get smaller rather than bigger. For example, unsustainable economic growth can create a situation whereby population decline becomes necessary. Such declines can happen in an orderly and organic way, through preventative rather than positive checks. In history though, the declines of civilisations have generally been disorderly and tragic affairs. In science fiction, it’s usually the elites who seek the lifeboats when the follies of their narrow-thinking ways are eventually exposed. (I cannot but help thinking of the final scene from the Netflix movie Don’t Look Up.)

Policies to address health threats

To address a problem of a single new virus within a narrowly-defined inner circle of understanding, there will almost certainly be impacts on each of the outer circles, for better or worse. Back in the winter of ’20, we thought that we were adding to our health by keeping out all respiratory viruses (ie not just the Covid19 coronavirus). Many thought we were improving general health, as well as protecting ourselves from Covid19. Early in 2021, information was coming out suggesting that knowledge of (and even infection by) familiar viruses could help protect us from the covid virus.

(Note Coronavirus: How the common cold can boot out Covid, BBC, 23 March 2021. And note how a single paragraph in the midst of this recent article refers to, but without emphasis, common specialist knowledge of human “common-cold coronaviruses”. Still, after nearly 29 months of covid, very few narrators – narrative-pushers – seem to be aware that human coronaviruses have always been part of our lives, or that Covid19 is not the first coronavirus pandemic. The problem appears to be that the epidemiologists who most pronounce on Covid19 have very little specialist knowledge of the history of the common cold.)

The problem was that too few of us noticed – or commented publicly – on these findings, including too few epidemiologists. During the pandemic, especially its early stages, we became poor at discriminating between useful narrative-critical information and useless narrative-reinforcing chatter. The mainstream Covid19 narrative, which is presented as our best ‘truth’, suffers from too many omissions; omissions resulting from expert narrow-vision, and uncritical responses by those who we pay to evaluate narratives, rather than from any conspiratorial intent.

Important findings that questioned aspects of narrow narratives were rarely identified, let alone emphasised. Concerns about mental health consequences arising from extended emergency mandates were too readily dismissed as conspiratorial. Particular problems faced by, for example, stranded people were glibly dismissed. Overreach, as in the 1980s, was once again normalised.

The second circle is the still-narrow epidemiological circle, which focuses on vaccines and pathogen-specific natural immunity. As such, this narrow focus of scientific attention sees few problems with the prolonged use of the quarantine (barrier) approach. Here, too much attention to covid leads to too little attention to the more general problems of immunity, and viral side-effects and after-effects. Conditions like ‘long-covid’ are seen as highly specific to Covid19 infection, and not as a new variant of chronic fatigue syndrome. Less narrow vision could have led us to better examine the general problem, and to help all sufferers of chronic fatigue rather than just those who could show a past positive covid test result.

The third circle is where the loss of street immunity takes place, thereby leaving human hosts subject to massive uncertainty about how they will fare in future under previously familiar viruses, while leaving them more exposed to evolving new viruses. The third circle, especially, suffers unestimable external costs from the prolonged use of the quarantine (barrier) approach. The immune system can be more than the sum of its parts, and – like a car – the immune system may benefit from regular and not infrequent tune-ups.

The fourth circle recognises that immunity is enhanced by a healthy and varied diet; and indeed through the taking of such supplements as ascorbic acid (Vitamin C). Having a store of nutrients helps the immune system to ‘do its stuff’; it’s one thing for the system to be educated, it’s another for it to have the capacity to execute its lethal defensive military operation. While Vitamin C will never be the sole means to good health, it is an essential part of the immune system’s armoury which has been over-downplayed by the medical science establishment. We may think of Vitamin C as necessary but not sufficient to good health. Reserves of this vitamin are particularly helpful in mitigating many types of infection.

The fifth circle emphasises general happiness; contentment with life, including fulfilment through experiences such as travel, fulfilling relationships, and being able to contribute under pressure in a field that a person has some passion for. Under these conditions of happiness and public purpose, mental illness may be minimised, and the desire to indulge in unhealthy pastimes (such as substance abuse, reckless gambling, comfort eating, passivity) is unlikely to be present. Happiness itself may create some degree of protection from disease. This means that any autonomy-reducing actions taken (and narratives perpetuated) by narrowly-focussed public problem solvers may have health repercussions, especially in overly constraining the choices of young people. (I note that the most recent edition of the New Zealand Listener has a feature subtitled “How Covid has scarred an entire generation”.) Harm here can take a long time to manifest itself, and, when such harm happens, it may be especially difficult to prove these connections of cause and effect.

It’s not much use protecting some of us from severe health problems if the means of doing so actually make others of us more vulnerable to substantial health problems.

The final circle is population dynamics, whereby certain environmental ‘crises’ may require lower population levels to maintain the overall health of the species. Here plagues and the like ‘cull’ host populations in ways that may be necessary to maintain the health of those populations. These are positive checks. Preventative checks are generally preferred. We know – and have known for many years – the kinds of social security and education that are the means to facilitate orderly reductions in population sizes. General education (with emphasis on abstract skills and civic awareness), apprenticeship (broadly defined), and a universal approach to social security, are indeed the best recipes for much more than demographic sustainability.

While it can never be good public policy to let nasty pathogens ‘rip’ through populations in order to rapidly reduce unsustainable populations, it is as well to remind ourselves that we are subject to the same laws of biology as are other species. In this regard, weakened long-term defences are probably more of a problem than are novel threats. Narrow vision too easily leads to short term ‘solutions’ which, if allowed to persevere, weaken human resilience.

Technocrats and Bureaucrats

Ultimately, good policy is policy that leads to happy people (as defined above) and sustainable outcomes. One form of unsustainability is the cost of carrying well-paid problem solvers (often but not always in the public sector) who – due to systemic narrow-vision – do not, and cannot, actually solve the problems that we expect them to solve. Better – though less orderly – solutions come from the educated masses rather than from the elite; from capable people living good lives, rather than from a blind-citizen reliance on technocrats and bureaucrats.

Nobody really believes that we are safer driving bigger cars. Public safety is multi-dimensional. And there’s more to happiness and sustainability than safety. Experts and managers have important jobs to do. But not to rule, overtly or covertly.

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

We know that New Zealand has one of the world’s lowest mortality outcomes, so far, in the Covid19 pandemic. (So has North Korea.) It’s still far too early to access the costs incurred – loss of utility enjoyed by actual and ‘would-have-been’ New Zealand residents – and is also too early to properly assess covid’s death toll.

The above 2022 chart shows that New Zealand is rejoining the world, in having excess pandemic death. Still not high by the standards of most other countries. And the actual excess death peak in March almost exactly matches the covid-reported death peak, albeit allowing for reporting delay. So, so far, the upside and downside biases in the official Covid19 death toll for New Zealand are evenly balanced. Just as some people have died with covid but not of covid, some others have died of covid, undiagnosed. This is usual. (The ‘difference’ plot in the chart, for recent weeks, is caused by the reporting delay, and not by any net bias nor from public health quarantines.)

In addition to the recent excess deaths, the main chart feature to note is that July and August 2021 look very different from July and August (midwinter) in 2020. These deaths – matching the usual seasonal peak – have not yet been explained. While normally at that time of the year these would be influenza deaths, there were in fact neither influenza nor covid deaths in July 2021.

The second chart for excess deaths shows deaths from all seasonal causes, such as influenzas and colds. We see clearly that New Zealand is on a significant ‘excess deaths’ path this year; so far not unlike 2019, though at a higher level.

The question begged by the chart is whether excess deaths this year will reach anything like the peak of the 2017 (undeclared) influenza pandemic. And, if they do, to what extent will the excess deaths be deaths due to Covid19? And how many will be due instead to a range of other transmissible microbes, given our probable loss of ‘street immunity’ (to use a phrase from a New Zealand vet, when discussing dogs getting ‘kennel cough’ this year)? My sense is that seasonal deaths will peak at about 2017 levels. (Street immunity, by the way, should be understood to arise from diet and lifestyle as well as from regular exposure to passing pathogens.)

Note the 2021 winter peak, similar to the influenza peaks of 2015, 2016 and 2018.

The final chart shows New Zealand excess deaths by age cohort. The chart is not directly comparable with the other two, because it shows deaths over the ‘previous three months’. The chart shows that, as with other economically developed countries – eg the small countries in Western Europe – covid deaths are, like influenza deaths, concentrated among the older population. (This is unlike the United States, where there were huge percentages of excess deaths of people under 75 years-old. The United States’ data reflects huge amounts of ancillary unwellness in the middle-aged population. I heard one United States doctor mention in passing, on the Al Jazeera news, that one recent research paper indicates that 40 percent of United States covid fatalities were of people with diabetes. This seems important, though the media haven’t picked up on it.)

(Note that age data for most European countries, while important, needs to be treated with caution; that’s due to the complex demographic consequences of World War 2.)

In New Zealand, it is almost certain that many of the people who died from Covid19 this year are older people who would have died from Covid19 in 2020 or 2021, had covid penetrated the quarantine barriers in the way it did in Eastern Europe and South America. While, from the ‘annual’  and ‘overall’ excess deaths, the chart continues to show a negative overall toll, it shows that excess deaths for the last twelve months are now above zero.

Although the New Zealand’s covid pandemic mortality data is fully consistent with prosperous and relatively equal western countries, there is no guarantee that post-pandemic mortality will continue to fit that pattern. New Zealand’s population has a number of chronic health challenges; challenges which may make post-pandemic mortality more like that in the USA than in the EU. New Zealanders have not yet had their street immunity tested; in all likelihood street immunity has declined precipitously among New Zealand people, just as it has among New Zealand’s pet dogs.

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

The countries shown here have rates of Covid19 mortality comparable with each other, and – with one exception – have recent ‘excess deaths’ data.

We should note that the World Health Organisation (WHO) has just released its world Covid19 mortality estimates for the pandemic so far, suggesting a death toll ‘from’ Covid19 – ie a toll that includes mortality arising from the policy-mandated shutdowns and other measures – which is two-and-a-half times higher than the ‘official’ toll of verified deaths ‘of’ or ‘with’ Covid19. (Refer WHO puts global COVID-19 death toll at nearly 15 million, Al Jazeera, 5 May 2022.)

Netherlands

It’s common for European countries to have excess death rates at about 10 percent in 2021, while having few recorded Covid19 deaths; this is especially the third quarter of that year. And then, when a substantial wave of Covid19 hit that country, the official Covid19 statistics were slow to reflect that wave. Netherlands is an excellent example of this phenomenon.

From the outset, Netherlands was one of the more reluctant countries to properly document the pandemic. Though, unlike many other countries, it does keep timely overall death registration data. In the last month or so, Netherlands has had surprisingly high excess deaths (close to 20 percent of all deaths); comparable to excess deaths in New Zealand in the present ‘omicron’ wave of the pandemic.

The ‘difference’ plot shows two things: mainly uncounted covid deaths when the difference between the two measures of covid deaths is high and positive; and mainly the impact of public health measures (which save some deaths and postpone others) when the difference is negative. In the 2022 omicron-era, substantially negative ‘difference’ data reflects the extent which people have died ‘with’ Covid19 but not ‘of’ Covid19.

An important feature of the European covid demographics is the rapid decline in deaths at the end of 2021. While this will have been partly due to public health measures, it was probably most due to omicron-covid prevailing over its rival delta-covid, in the battle-to-the death between the variants. (To understand these viruses properly, we should see them as the mortal rivals of each other; humans and other hosts are merely collateral damage. Omicron was nature’s solution to Delta.)

Belgium

In Belgium the undercount of Covid19 deaths is markedly lower than the Netherlands, and the undercount period is shorter. Like Netherlands, Belgium has also had New Zealand levels (just under 20%) of excess deaths in late March.

Germany

German death data is a mix of Netherlands’ and Belgium’s. Germany has a smaller ‘delta peak’ than Netherlands, and, in the last month or so, lower excess mortality than both of the low countries.

Denmark

Again, there is the long covid-mortality undercount during 2021; and a dramatic mortality decline as omicron ‘kicked delta’s arse’. Mortality in the omicron-wave is low, but present; while Denmark had a huge case-count in the omicron wave, its excess mortality was very low.

Sweden

Sweden, despite large numbers of recent cases (despite much lower covid-testing rates than Denmark), shows the lowest European death rates over the Northern Hemisphere winter. No sign yet of the recent uptick in excess deaths which is apparent elsewhere. Sweden would appear to have maintained high levels of general immunity to epidemic viruses.

Israel

Israel is the only one of the countries, shown here, to have a very high peak death rate in the omicron-era. Yet Israel missed the late 2021 ‘delta-wave’, so it would seem that these deaths early in 2022 will have been mainly due to a late delta-wave that ended quickly (in early February) when omicron ate delta.

Israel’s recorded covid deaths have been more comprehensive than those in most European countries. Nevertheless, in both of its major death waves, the official data clearly lags the actual data.

South Korea

South Korea, an advance Asian country with early experience of Covid19 in March 2020, and experience of SARS in 2003, shows the same problems in recording covid deaths – in the 2021 delta period – that occurred in Netherlands and Denmark (among others in Europe).

Then after that, unlike Europe, South Korea suffered hugely during the omicron wave. The most likely reason is that public health measures taken in Korea left Koreans with a substantial overall immunity shortfall; Koreans appear to have become more naïve to this virus than have European, African and American populations.

Thailand

Finally, Thailand is one of the few Asian countries with comprehensive and timely mortality data. Thailand copped two delta waves of covid mortality in 2021. Again, like South Korea, it shows significant signs of having a particularly vulnerable population; quite different from, for example, Sweden. Looking at the Thai data, we may conclude that South Korea managed to keep covid in check in the second half of 2021, only to succumb to the inevitable in 2022.

Thailand is also showing a recent upsurge of mortality in the omicron-wave of Covid19. Its specifically covid immunity should be quite high. Yet the people in Thailand (or, maybe, Asia in general) seem to be significantly more vulnerable than people elsewhere. My guess is that there is a lack of general immunity in Thailand, and that excessive public health policy measures may be in part responsible for that vulnerability.

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

In a few countries – already noted – there has been a recent rise in deaths that may be due to omicron-covid. In many other countries there has not been a notable rise in excess deaths, despite rises in recorded deaths with Covid19.

Chile

Chile’s omicron-wave of covid looks more like a severe extension to its late-2021 delta-wave. The big difference is that it is now older Chileans who are dying, whereas in 2020 and 2021 there were unusually large numbers of younger deaths. Chile made a bigger effort than most to protect its older population, with (for example) a strictish prioritisation of older people for vaccination. Maybe we are now seeing that immunity has waned more in older people, because of these past measures to protect them. Or maybe, omicron-covid, which is generally mild and is well on the way to becoming another ‘common cold’ virus, has a disproportionate impact on those populations whose deaths are commonly cited as ‘due to old age’.

USA

The USA is much like Chile (and unlike most countries) in that unusually large numbers of younger people died from covid. This is less true for the most recent uptick in American deaths. While many of these 2022 deaths were due to delta-covid, the upsurge in covid deaths of older people came with the omicron wave of cases.

Israel

Israel has consistently seen more fatalities of older people, unlike these previous two countries. This seems to be especially pronounced in its latest wave. Though, as for the USA, many of these deaths will have been from the second delta-wave that saw case numbers rise markedly in December. This is of some concern, because of the proactive vaccination policies that Israel pursued.

Greece and Bulgaria

Greece, like its neighbour Bulgaria, was unusually late to get a wave of covid fatalities. This may have been in part due to significant influenza being present in both countries in February 2020. Most countries ‘paid the price’, however, in 2021.

Like Chile and the United States, they had unusually high numbers of younger fatalities. And like Chile and USA, the latest wave of fatalities seems to be more focussed on those who are older.

Speculation

My sense is, in the coming ‘omicron-winter’ in the southern hemisphere, there will be unusually large numbers of older people dying with Covid19. More like a bad flu season than what we have seen in the above countries last year.

We urgently need to investigate death rates of older people in years following years (such as the year ended October 2020) when relatively few older people died from respiratory illnesses. And we need to learn more about the extent to which recent waves of these kinds of viruses may both protect or aggravate the life expectancy of people in the older age groups more vulnerable to viruses of the respiratory tract.

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Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

The tragic terrorist attack at an Auckland shopping mall on Friday has led to a lot of debate about how it could have been prevented. It turns out authorities were well aware of Ahamed Aathill Mohamed Samsudeen’s severe mental health problems and his capacity for violent extremism if not dealt with appropriately.

Much of the initial debate has been about why Samsudeen wasn’t deported or incarcerated. In the last day, however, the conversation has shifted to questions about how Corrections and Police handled Samsudeen over the last few years. There are allegations that these government agencies failed to provide the necessary and potentially vital services of rehabilitation and deradicalisation, which may have significantly reduced the risks of Samsudeen developing into a violent extremist.

The must-read piece on this is by Australian criminologist Clarke Jones, who was involved in the judicial proceedings around Samsudeen, and argues that at an early stage he was capable of being diverted from going down the ISIS-route. Jones, who is expert in de-radicalising Islamic extremists, believes authorities failed to take seriously the need for Samsudeen’s rehabilitation – see: I assessed the Auckland terrorist – our approach to extremism has to change.

Here’s Jones’ main point: “During Samsudeen’s trial in 2018, his legal team and I offered to run a bespoke, community-led intervention program to support Samsudeen in his transition out of prison, with one of its aims to alter his extreme views. The program, which has been successfully applied in the past with Muslim youth transiting out of prison, was accepted by the crown as the best and most appropriate way forward. Nonetheless, the police opted for a different approach to the crown, instead choosing surveillance and monitoring over rehabilitation.”

The Muslim community is also aghast that authorities passed up their offer to rehabilitate Samsudeen. The New Zealand Muslim Association explained today that they took a proposal to the Corrections agency to develop a formal programme, but the government department turned it down, essentially in favour of an easier option – see Anneke Smith’s Muslim leader ‘baffled’ Corrections passed up rehabilitation offer for LynnMall terrorist.

The same article reports that the Muslim Association were astonished that Corrections then chose this year to release Samsudeen into a small mosque without the necessary resources to deal adequately with him. According to the Association president Ikhlaq Kashkari, Corrections made an odd decision to send Samsudeen to the Glen Eden Masjid e Bilal mosque: “We’re a large organisation. We have skills, capabilities, people and resources to support something like this but we wanted to make sure it’s done properly. I have no idea how on earth they managed to talk this small Islamic centre, who were basically renting a property, to take him on board… I know the person that runs it used to work in the prison on behalf of Muslim community chaplains, a service provided to prisons, but that’s about it. Their skills, resources and capabilities beyond that is very, very limited.”

The Prime Minister is backing Corrections’ decisions. Jacinda Ardern has responded: “I’m confident agencies did everything within their power to keep the community safe” – see Edward O’Driscoll’s New Lynn attack: Community leaders say Corrections shouldn’t have housed supermarket terrorist in mosque. This article also reports that Police supported Corrections’ decision to send Samsudeen to the Glen Eden mosque.

The PM is reported in another article stating that all avenues around housing and rehabilitation were explored, but she admits that official reviews are needed to fully answer questions about this – see Thomas Manch’s PM says reviews will provide answers on terrorist’s management, as questions mount.

This article also possibly sheds further light on why Corrections rejected the Muslim Association’s offer of a rehabilitation programme – because such a programme would have required providing resources, as well as agreeing to a “terms of reference” setting out responsibilities not just for the association but for the government agency. Corrections has also explained that you can’t force rehabilitation on an individual who is unwilling.

Thomas Manch has also written a must-read background on Samsudeen’s life in Sri Lanka and then New Zealand, pointing out the severe mental health problems he developed over the years – see: The terrorist was a ‘highly damaged’ refugee, and efforts to help him failed. According to Manch, these details “raise questions about how the Government handled a psychologically damaged man who was readily captured by the extremist Isis propaganda.”

Manch cites criminologist Clarke Jones saying that he observed back in 2018 that Samsudeen was still redeemable: “At that stage, it was still manageable”, “There was definitely quite a lot of room for rehabilitation”, and “if they’d addressed his mental health needs then we might not have been in this situation now.” But Jones points out that the programme never got the “go-ahead” as “the police appeared to have little appetite for a community-led programme.”

Jones is also cited by Katie Todd in her article, Missed opportunities to deradicalise LynnMall attacker, says criminologist. Commenting on the fact that authorities chose to use surveillance and monitoring rather than rehabilitation, Jones says: “I would say that we haven’t got the balance right. In this case, there was too much focus on the counter terrorism or counter violent extremism narrative, rather than actually getting to the core of what was wrong with Mr Samsudeen.”

The terrorist’s family are also cited in the article, with his brother arguing that Samsudeen would sometimes listen to them when they challenged the ideological path he was going down. His brother also says: “The prisons and the situation was hard on him and he did not have any support. He told us he was assaulted there.”

Columnist Donna Miles has also asked some important questions about rehabilitation, and especially how and why Samsudeen became radicalised: “Why was this rehabilitation programme not effective? It has been reported that he refused the psychological assessment which was part of the programme. Did the police’s independent decision to put the attacker under constant surveillance have any impact on his rehabilitation?” – see: We must be careful not to fall into the terrorism trap.

Similarly, Jehan Casinader argues: “Friday’s incident should spur us to deeply examine the causes of radicalisation, and invest more money in efforts to deradicalise those who have already been identified by authorities” – see: ‘He’s not one of us’: Jehan Casinader responds to terror attack.

Casinader relays how he investigated the case of another refugee involved in a criminal act in New Zealand, finding: “Despite carrying significant trauma, she did not receive appropriate mental health support or rehabilitation, and became isolated and increasingly desperate in the lead-up to her offending.” He argues prevention is more effective than managing an offender: “There’s no point spending hundreds of thousands of dollars on detention and surveillance if state agencies are unable to provide culturally-responsive treatment for an individual at high risk of offending.”

As part of Samsudeen’s community supervision sentence he was required to undergo a psychological assessment this year. He apparently refused, but Corrections has been reluctant to answer questions on this – most importantly on why he was then allowed to continue with his community sentence. But today Charlotte Cook reports that the department “looked at charging him for the lack of engagement with both a private and Corrections psychologist, but was told it was not sufficient enough to be considered a breach of his conditions” – see: LynnMall attack: Terrorist threw faeces, assaulted staff – Corrections.

In this article, Correction’s national commissioner Rachel Leota is said to be “confident that Community Corrections staff were using every lawful avenue available to monitor, assess, mitigate, and manage his risk.”

Finally, there have been questions raised about whether Samsudeen’s mental health issues should be the subject of any public debate at all. The Mental Health Foundation suggests that his psychological condition should not be seen as part of the explanation for what has occurred. For more on this, see Lincoln Tan’s Terrorist couldn’t be detained under Mental Health Act after he refused psychological assessment: Legal expert.

The area of mental health has been a key strength for Jacinda Ardern and her Labour Government over the last few years. They campaigned strongly in 2017 on fixing up the dysfunctional system, and initially they made some vital strides forward in reforming the sector.

An in-depth inquiry was instigated and the Wellbeing Budget of 2019 pledged nearly $2bn. For a while, it looked like the one area in which the Government was achieving true transformation. This has all changed lately. An explosion of bad stories and complaints from the sector suggests that the Government has failed to deliver on this, and that the mental health system is now getting worse under Labour.

Over the last week, in particular, there have been a string of scathing media articles and comments, that together amount to an overwhelming vote of “no confidence” in the Labour Party, the Prime Minister, and the Minister of Health. The latest, published yesterday in the Guardian, is from journalist Oliver Lewis, who has been investigating Labour’s reforms. He argues the Government appears to be more concerned with image management on mental health than making progress to deal with the crisis – see: The gap between NZ Labour’s soaring rhetoric on mental health and the reality is galling.

On the one hand, Lewis says, “the soaring rhetoric and initial investment – which has often been slow rolling out – has failed to translate into substantive change, and people are rightfully frustrated.” But to make matters worse, and what he finds particularly galling, the government is trying to hide the crisis: “in a bid to paper over failings and push a particular narrative – crucial information seems to be being buried or obfuscated.”

Lewis’ concern was prompted by journalist Henry Cooke’s detailing of how the Government has omitted various mental health metrics in the Ministry of Health’s annual monitoring report on mental health released last week. You can see Cooke’s article here: ‘A lot of data and negative statistics’: Inside the battle behind dramatic edits and huge delays to a Government mental health report.

Cooke’s investigation reveals the quite extraordinary story of how Ministry of Health senior officials battled for two years to remove data from this report, seemingly because it made the government look bad. What’s more, the report was released two years late, and “still showed a very distressing picture of New Zealand’s mental health system – with a spike in the use of seclusion, a practice some liken to torture.”

Cooke reports that “Shaun Robinson of the Mental Health Foundation said it was ‘gobsmacking’ and ‘not acceptable’ that so much information had been removed from the ‘scathing’ report.”

And Cooke follows this up, with further political reaction, including the National Party’s mental health spokesman Matt Doocey claiming “there appeared to be some ‘politicisation’ of the ministry”, and Health Minister Andrew Little being “totally comfortable with the process of the report’s release” – see: Judith Collins says heads should roll over ‘sanitised’ Government mental health report.

For more details of the contents of the “scathing” mental health report, it’s worth reading Tess McClure’s Guardian article: New Zealand mental health crisis has worsened under Labour, data shows. Here’s the article’s introduction: “New Zealand’s mental health system is ‘in crisis’ and in worse shape now than four years ago, practitioners say – despite much-heralded government efforts to reform it and prioritise national wellbeing.”

This followed on from another Henry Cooke piece last week, which covered the “huge growth in mental health patients being locked in rooms alone”, otherwise known as “seclusion”, which the Government was supposed to phase out – see: Huge growth in use of ‘last resort’ seclusion indicates mental health system in crisis, and in worse shape than when Labour elected in 2017.

The fact that the Labour Government aren’t delivering, led prominent psychologist Kyle MacDonald to write a condemning opinion piece for the Herald on Sunday, in which he lays the blame at the Prime Minister’s door, recounting when a tearful Jacinda Ardern spoke to a mental health rally during the 2017 election campaign and promised to fix the problems: “Standing there that day, in the sunshine among the crowd, I believed her. I believed she was going to bring transformative change to our crippled and broken services. We all did, because we wanted to believe our work had come to something. We were wrong” – see: Jacinda Ardern has failed us on mental health – and it’s only going to get worse (paywalled).

MacDonald details how the most recent findings on mental health show Ardern’s promises to have been rather hollow, and calls for the government to stop with the endless reviews and consultations and just take action, especially when it comes to funding service delivery: “It would mean providing fully funded training for psychotherapists, psychologists, nurses, social workers, counsellors and peer support workers – and bonding them to work in the mental health system. It would also mean increasing staffing levels in all front line DHB mental health and addiction services by creating new positions and improving pay and conditions.”

A big part of the problem appears to be underfunding from the Government, and in February clinical psychologist Dr Marthinus Bekker spoke out publicly about the “chronically underfunded” public health sector, being reported as believing “Budget 2019’s headline-grabbing $1.9 billion for a Mental Health Package had in reality made no difference for those working on the front line” – see Nick Truebridge’s Ex-DHB psychologist claims chronic failings in mental health services.

According to Bekker, “Getting into public services has gotten to the point where, at times our waitlist has been in excess of four to five months.” He declares: “The situation is absolutely dire and remains in crisis.” The Minister of Health, Andrew Little, is quoted in contrast, saying: “the message I’m getting is actually things are improving”.

According to Victoria University of Wellington’s Dougal Sutherland, who trains psychologists, the Government simply hasn’t been willing to invest in training enough workforce to deal with the size of the problem, and there appear to be no plans for them to do so – see: No time to waste on mental suffering. What reforms that are taking place, he says, are simply “a reshuffling of proverbial deckchairs”.

Further evidence that the promised changes from Government aren’t actually occurring came out in February via the release of interviews that the new Mental Health Commission carried out last year – see Laura Walters’ Mental health: A top priority stalls.

This article also reports that the former Mental Health Commissioner Kevin Allan recently wrote to the Minister of Health “laying out his concerns about the pace of change, and lack of a long-term action plan for the sector’s transformation.” Furthermore, “In July last year, Allan called on former health minister Chris Hipkins to have a plan ready by the end of the year. There is still no plan.”

The Mental Health Foundation is also growing increasingly frustrated with this lack of action, and have started to speak out much more strongly. Two weeks ago, the Chief Executive of the Foundation, Shaun Robinson, asked: Has the Government lost its vision on mental health?. In this, he argues that the Government is missing out on a once in a generation chance to transform mental health.

The Foundation’s main problem is that, although the Government initiated a wide scale inquiry into mental health, it appears to have ignored the need to implement its recommendations, taking a “piecemeal” approach, and just looking for “obvious wins without making a plan”. Robinson points out that the Government’s own Mental Health Commission report on how progress is going on implementing the recommendations says that 23 of the 36 recommendations receive a 1 or 2 out of six – meaning very poor progress.

So, has Labour given up on real mental health reform? According to campaigner and advocate Dave Macpherson, it’s possible that the system has got worse under the current government – see: Is Labour on top of mental health issues?. Not only is Macpherson is disappointed in Andrew Little, but says that new Chair of the Mental Health Commission has “seemed more concerned with patch and boss protection, than in outlining how they would hold the Government to account on behalf of the community.” Overall, Macpherson believes that a lot of Labour’s problems stem from leaving all the same officials in charge of mental health.

The Minister of Health says the Government will “ramp up” progress to reform the sector, saying, “I’ll keep putting the pressure on officials to do that” – see 1News’ Andrew Little says mental health reforms ‘largely on track’, following criticism.

The Government has also been under pressure from advocates this week, who say they have been fobbed off by the various health ministers – see Ireland Hendry-Tennent’s Nicky Stevens’ mother accused Labour MPs Andrew Little, David Clark of fobbing her off.

There are other signs things are getting much worse. In the weekend, Cherie Howie wrote about how “Mental health conditions among Aotearoa youth have already doubled in the past decade, with experts sounding a call to action in September over what they call ‘a silent pandemic of psychological distress’ already escalating among young people” due to Covid – see: The parallel pandemic: Covid-19 and the mental health impacts on New Zealand young people (paywalled).

An example of this is the skyrocketing of eating disorders amongst youth – see Anna Leask’s ‘Tsunami’ of child eating disorders emerging after lockdowns in New Zealand (paywalled). In this, one psychotherapist, Kellie Lavender, complains that her profession is being treated as “an ambulance at the bottom of the cliff”.

And in Christchurch, there are serious problems at the new hospital: “There are growing fears mental health patients in Christchurch are not getting adequate treatment due to an understaffed and underfunded emergency department” – see 1News’ Christchurch Hospital’s new acute unit still without key services, nurses say (https://bit.ly/3uoqsWH).

The same crisis continues at the University, where a six-month waiting list for mental health help has meant the Psychology Centre has had to close their books – see Chris Lynch’s Where has all the mental health funding gone?. And the same article reports the New Zealand Association of Counsellors asking questions about where all the government funding is actually going.

The problem of all psychological services is well surveyed in Helen Harvey’s January article, New Zealand’s psychological crisis putting lives at risk. According to this, “New Zealand is in a psychological crisis. More people than ever are seeking help but a shortage of psychologists is making it harder for them to get it. And in some cases that can be fatal. Access to mental health and addiction services has increased 73 per cent in the past decade, while funding has only gone up by 40 per cent.”

Finally, is the pressure from mental health advocates leading to a crackdown from the Minister of Health? The Mental Health Foundation claim that in February the government tried to gag them for speaking out about the failures to produce their promised reforms – see Jessica McAllen’s Ministry of Health accused of ‘gagging’ Mental Health Foundation.

The past year is one that few of us will forget. While the impacts of the COVID-19 pandemic have played out unevenly across Asia and the Pacific, the region has been spared many of the worst effects seen in other parts of the world. The pandemic has reminded us that a reliable and uninterrupted energy supply is critical to managing this crisis.

Beyond ensuring that hospitals and healthcare facilities continue to function, energy supports the systems and coping mechanisms we rely on to work remotely, undertake distance learning and communicate essential health information. Importantly, energy will also underpin cold chains and logistics to ensure that billions of vaccines make their way to the people who need them most.

The good news is our region’s energy systems have continued to function throughout the pandemic. A new report Shaping a sustainable energy future in Asia and the Pacific:  A greener, more resilient and inclusive energy system released today by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) shows the energy demand reductions have mainly impacted fossil fuels and depressed oil and gas prices. Renewable energy development in countries across the region, such as China and India, has continued at a healthy pace throughout 2020.

As the Asia-Pacific region transitions its energy system to clean, efficient and low carbon technologies, the emergence of the pandemic raises some fundamental questions. How can a transformed energy system help ensure our resilience to future crises such as COVID-19? As we recover from this pandemic, can we launch a “green recovery” that simultaneously rebuilds our economies and puts us on track to meet global climate and sustainability goals?

A clean and sustainable energy is central to a recovery from COVID-19 pandemic.  By emphasizing the importance of the SDGs as a guiding framework for recovering better together, we must focus on two critical aspcets:

First, by making meaningful progress on the SDGs, we can address many of the systemic issues that made societies more vulnerable to COVID-19 in the first place – health, decent work, poverty and inequalities, to name a few.

Second, by directing stimulus spending to investments that support the achievement of the SDGs, we can build back better. If countries focus their stimulus efforts on the industries of the past such as fossil fuels, we risk not creating the jobs we need, or moving in the right direction to achieve the global goals that are critical to future generations. The energy sector offers multiple opportunities to align stimulus with the clean industries of the future.

The evidence shows that renewable energy and energy efficiency projects create more jobs for the same investment as fossil fuel projects. By increasing expenditure on clean cooking and electricity access, we can enhance economic activity in rural areas and bring modern infrastructure that can make these communities more resilient and inclusive, particularly for the wellbeing of women and children.

Additionally, investing in low-carbon infrastructure and technologies can create a basis for the more ambitious climate pledges we need to reach the Paris Agreement targets of a 2-degree global warming limit. On this note, several countries have announced carbon neutrality, demonstrating a long-term vision and commitment to an accelerated transformation to sustainable energy. Phasing out the use of coal from power generation portfolios by substituting with renewables, ending fossil fuel subsidies, and implementing carbon pricing are some of the steps we can take.

The COVID-19 crisis has forced us to change many aspects of our lives to keep ourselves and our societies safe. It has shown that we are more adaptive and resilient than we may have believed. Nevertheless, we should not waste the opportunities this crisis presents for transformative change. It should not deflect us from the urgent task of making modern energy available to all and decarbonizing the region’s energy system through a transition to sustainable energy. Instead, it should provide us with a renewed sense of urgency.

We must harness the capacity of sustainable energy to rebuild our societies and economies while protecting the environment in the pursuit of the 2030 Agenda for Sustainable Development.

Armida Salsiah Alisjahbana is Under-Secretary-General of the United Nations and Executive Secretary of ESCAP

A Fijian psychologist is calling on people in Fiji to work together to tackle issues associated with mental health amid the covid-19 pandemic.

Addressing a prayer vigil to remember the victims of suicide in Suva, Dr Selina Kuruleca said people must assist one another and reach out to those struggling due to the pandemic.

The Health Ministry says about 90 Fijians have died from suicide this year while there have been 82 attempted suicides.

Dr Kuruleca, who is chair of the National Committee on Prevention of Suicide in Fiji, said suicides were responsible for the majority of deaths of younger Fijians.

“The highest number of deaths in young people or youths between the ages of 15 to 29 is deaths by suicide. These are preventable deaths. There are more deaths from suicides than there are from road accidents or drowning,” Dr Kuruleca said.

Dr Kuruleca urged community and church leaders to reach out to their members and help those suffering depression or other mental health-related issues.

Fiji marked International Suicide Prevention Day last week with September named the country’s Mental Health month.

Traumatic for those left behind
Last week’s vigil was organised by Lifeline and supported by Psychiatric Survivors Association, Youth Champs for Mental Health and the Fiji Council of Social Services.

Speaking at the vigil, Dr Kuruleca said death from suicide was traumatic for all those left behind and it should never be an option.

She encouraged those present at the event to support those families that had been impacted by the suicide of a loved one.

Dr Kuruleca urged people not to judge but show action that they cared for them.

“Make a commitment today to be persistent in your compassion, to be genuine in your advocacy and to be mindful of our realities,” she said.

“Everyone needs to work together – from Empower Pacific, Lifeline, youth champs for mental health, medical services pacific, women’s crisis centre, women’s rights movement, the LGBTQI community and of course, our faith-based organisations.

“We all have a part to play and we must play it.”

The theme of the Mental Health Month is Working Together, she said.

• Fijians who need help can call the 24-hour child helpline on 1325, domestic violence on 1560, Lifeline on 132454 and Empower Pacific on 7765626 if they need counselling or want to talk to a counsellor.

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

Article by AsiaPacificReport.nz

Today’s first chart looks at death rates for six major countries. We see that Spain has overtaken Italy, and that France and United Kingdom are likely to catch up with these in a week. We also note that United Kingdom death rates, as reported have been understated; these are basically hospital deaths. All four countries are likely to end up with between 300 and 500 deaths per million people; that’s about 30,000 deaths in United Kingdom.

The United States and Germany are well behind, and likely to stay so; both are showing more signs of stabilising than are France and United Kingdom.

The most important story here is that of Belgium. Not only does it now have the highest death rate in the European Union – higher than both Italy and Spain – but it is far from having stabilised. It looks like Belgium is heading for 800 deaths per million people; nearly the one in a thousand that San Marino has already reached.

To understand the extremely high incidence of Covid19 in Belgium, it is necessary to read my yesterday’s story: ‘Europia’ and the Spread of Covid19. Belgium – especially central and eastern Belgium – is an important part of what amounts to the federal district of the European Union.

In this regard it is worth noting that the French covid story shows that France is a country of two halves. If you draw a line from Le Havre to Marseilles, the vast majority of France’s Covid19 cases are to the northeast of that diagonal line; in particular the parts of Frances that border Belgium, Luxembourg and Germany. France did not get its viral load from Spain, despite Spain’s high incidence of Covid19.

This chart shows two other important stories. Compare Netherlands with Portugal.

We have been hearing in the international media that the Netherlands in particular is making it very difficult to set up an EU-wide financial mitigation process; and that they are blaming Southern Europe for creating the crisis, as they did for the 2012 Eurozone financial crises from which the south has not yet fully recovered from. I have written elsewhere about the role of Netherlands in exacerbating these crises by prioritising its mercantilist view of national economic progress. (Northern European Mercantilism and the Covid19 Emergency.)

In the present crisis, Italy and Spain caught the bug very early. Today Ursula von der Leyen – head of the European Commission since December – offered a profuse apology for the European Union’s complete inaction and inability to protect Italy. Indeed, in this case the European Union bureaucracy has been, at best, asleep at the wheel. Their performance in dealing with Covid19 has been substantially worse than that of United States’ President Trump.

Netherlands pointing the finger at Italy and Spain is very much a case of ‘The Pot calling the Kettle Black’. Portugal, while still having a hard time, has coped surprisingly well and far better than the Netherlands.

This chart shows that Canada, while having less Covid19 than Europe and indeed the United States, seems to be showing the fastest rate of increase of the countries shown. Canada very much left it too late to halt the spread of the virus. Ottawa City (federal capital, population 1 million) has had 14 Covid19 deaths so far, and 678 laboratory confirmed cases. 25 percent of cases are due to community transmission. (refer)

The final story from this chart is that both New Zealand and Australia have now reached China’s death rate from Covid19. Our deaths will increase further. 21 New Zealand deaths will have New Zealand at the South Korean death rate.

The final summary chart for the week shows that New Zealand cases are very much on par with the world as a whole, though death incidence is one tenth of the world average. The difference on cases is that New Zealand has stabilised – the thick black line is horizontal – whereas the world has not.

Further, New Zealand case statistics are almost certainly as reliable as those from Iceland and from Australia where there have been very high rates of testing, and presently have very low positivity rates. So, New Zealand’s level of coronavirus infection is already much lower than the unknown world average. It is that world rate that poses the biggest ongoing threat to New Zealand.

Today’s first chart looks at three Nordic countries: Iceland, Norway and Sweden. These give us a basis for analysis of underreporting of Covid19, in the main due to limited testing.

Yesterday, Norway was shown as a high incidence ‘recovering country’, even though it was less recovering than South Korea. Iceland, however, has had the worst incidence of Covid19 among the Nordic countries; though it has a low death rate. Iceland also happens to be a very small country with a very high testing rate. So, it’s a fair assumption that Iceland’s known incidence is close to its actual incidence of Covid19.

There is no obvious reason why the incidence of Covid19 should be greater in Iceland than in Norway. Yet the data shows Iceland’s incidence to be five times greater. This is likely to be the extent of the undercount of cases in Norway.

Known cases in Norway (which has flattened) are just a little higher than known cases in Sweden (which has not yet flattened). But deaths per capita in Sweden are four times higher than in Norway and Iceland. This suggests that Sweden’s undercount is much larger than Norway’s. Indeed it suggest that Sweden’s undercount is four times greater than Norway’s, which I have suggested is a fivefold undercount. That would make Sweden’s case undercount twentyfold.

This would mean that Sweden’s official count of 11,445 – multiplied by 20 – gives 229,000; over 2.2 percent of Sweden’s population. That would mean half a percent (five Swedes in 1,000) dying from Covid19, which feels about right.

Of course this is not the end of the matter in Sweden; it would seem likely that, eventually, ten percent of Swedes will contract Covid19; one million people. That is a likely final case incidence for a country for with a substantial amount of ‘natural’ physical isolation and a high normal degree of physical mobility.

Today’s second chart looks further at Sweden. It shows daily known cases, and daily deaths. The yellow lines represent seven-day moving averages. While there is a hint that the long period of exponential growth may be slowing, the proviso is that Sweden – more than any other country I have seen – treats Covid19 largely as a Monday-Friday phenomenon. Deaths in particular are very few in weekends, and last weekend was longer than most.

Sweden has become known as the country most dismissive of the Covid19 threat, and with the fewest restrictions imposed on its people. (Even Brazil has more restrictions, albeit mandated at the state government rather than the federal government level.) Unlike Brazil, there seems to be widespread support for its ‘economy-first’ approach; an approach seemingly led by its ‘public health’ bureaucracy rather than its elected politicians.

Sweden will not experience the tragedy that has been Spain, thanks to voluntary measures informed by Italy and Spain. Sweden stands in marked contrast to Norway and Iceland, both themselves major victims of the new corona virus.

Today’s chart shows the per capita level of testing performed in a number of countries. While the highest testing rate shown is Norway, we should note that Iceland has tested over eight percent of its population; too high to show on this chart.

A high level of testing minimises a country’s undercount of Covid19 cases. When the case:test ratio is low, we are assured that the known count is quite close to the truth.

Switzerland is one of the worst-affected countries, but has been able to contain its death rate through a very high rate of testing. France, on the other hand, is in the opposite situation, and may end up much like Spain. Italy has ramped up its testing, and is now getting far fewer cases than France or Spain. Italy still has a way to go, but will probably come out of the emergency in a better state than Spain, France or the United Kingdom. (Yesterday, Sweden had a higher incidence of known new cases than Italy.)

Australia and South Korea are the stars, with very high testing, and test results that are 98 percent negative. We in New Zealand have achieved higher testing rates than many countries, and the similarly low ratio of positive results assures us that we are shutting down the transmission of the disease. It is now looking as though New Zealand will have less than 10 deaths in total, not the 100 that I previously forecast.

We see Sweden and Netherlands sharply at odds with Norway, with Denmark and Finland coming somewhere in between. I think that the decisions of Sweden and Netherlands to put their economies first will reverberate against them, and that New Zealand could have a substantial export-led recovery, in part as a result of some other countries harming their economies by not putting their people first.

The United States is doing marginally better than the United Kingdom, on both testing and on test results.

At the bottom of the chart we see that Iran still has far to go before its Covid19 emergency is under control. Turkey is also very much on the watch list. Either it got Covid19 late, or it was late to discover that it had a substantial outbreak of the disease.

Brazil is a worry. A vast country of over 200 million people, over 25 percent of its tests are coming back positive, and its testing has only just scratched the surface. Is it mainly Brazil’s well-travelled elite who are getting Covid19, or will it spread through the favelas of its larger cities? Let’s hope that limited social mixing will contain Covid19 there. The worry is that people living in the favelas constitute a large part of the people who provide paid services to Brazil’s well-healed.

All the countries above Spain on the chart – though possibly excluding Ireland and Canada which have unacceptably high death statistics – are optimistically turning the corner. Those below New Zealand on the chart – with the possible exception of Finland – still have a long way to go.

The unprecedented public health emergency triggered by the COVID -19 pandemic and its multi-faceted impact on people’s lives around the world is taking a heavy toll on Asia and the Pacific.

Countries in our region are striving to mitigate the massive socioeconomic impact of the pandemic, which is also expected to affect the region’s economic health. In its annual Economic and Social Survey of Asia and the Pacific 2020 launched today, the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) expects growth in Asia-Pacific developing economies to slow down significantly this year.

Bold investments to sustain the region’s physical and economic well-being are imperative. The Survey advises policymakers to protect the economic health of the region with measures that support affected businesses and households and prevent economic contagion. To tackle COVID-19 in developing Asia-Pacific countries, the Survey also calls for an estimated increase in health emergency spending by $880 million per year through to 2030. Fiscal support will be crucial in enhancing health responders’ ability to monitor the spread of the pandemic and caring for infected people. ESCAP is also calling on Asia-Pacific countries to consider setting up a regional health emergency preparedness fund.

The pandemic is also an opportunity for us to rethink our economic growth path that has come at a heavy cost to people and planet. According to the latest ESCAP assessment on implementing the 2030 Agenda for Sustainable Development, Asia and the Pacific is not on track to achieve any of the 17 Sustainable Development Goals (SDG) by 2030, with regression on several environmental Goals.

This stands in stark contrast with the region’s impressive gains in material prosperity, which have been powered by intensive resource use. We are currently paying the price amid a public health emergency in a region with 97 of the 100 most air-polluted cities in the world and 5 of the 10 countries most vulnerable to climate change. Economic policymaking is understandably focused on maximizing growth to reduce poverty and create jobs. Yet, we need to question this when the methods of growth undermine its sustainability over the long term.

The 2020 Survey is proposing a transition towards a growth path that ensures we bequeath a healthy planet to future generations. It is calling for a shift in the paradigm of production and consumption, which is at the core of all economic activities.

To bring about this fundamental shift in the way we produce and consume, we need to adopt the motto of ‘no more business as usual’ for all stakeholders in planetary well-being, namely governments, businesses and consumers. Policymakers should not lose sight of a looming climate crisis, but rather design economic stimulus packages with social inclusion and environmental sustainability built into every decision.

The Survey identifies challenges and constraints to making this switch for each group of stakeholders. The good news is that it is possible to take on these challenges and align the goals of all stakeholders with the 2030 Agenda’s goal of sustainability.

In particular, the Survey urges governments in the region to embed sustainability in policymaking and implementation, transition out of fossil fuel dependency and support the greening of finance. The region continues to provide $240 billion worth of annual subsidies to fossil fuels while investments in renewables remain at $150 billion.

Businesses can integrate sustainability by factoring in environmental, social and governance aspects in investment analysis and decisions. Carbon pricing will be a key tool to reduce emissions and mitigate climate-related risks. The region is already a leader in adopting the emerging sustainable business paradigms of the shared economy and circular economy.

All of us as consumers must understand the importance of switching to sustainable lifestyles. This will begin with increasing awareness of the impact of consumer choices on people and planet. Governments will have to play a significant role in encouraging consumer choices through positive reinforcements, small suggestions and eco-labelling of products.

Integrating sustainability also requires international collaboration, given the interconnected world in which we live. Asia-Pacific governments need to coordinate their climate action, particularly the development of climate-related standards and policies. Having achieved so much, yet also at the risk of losing so much, the Asia-Pacific region stands at a pivotal moment in its development journey. The next phase of its economic transformation should be more sustainable, with cleaner production and less material-intensive lifestyles.

With headwinds to the region’s development journey strengthened by the COVID-19 pandemic, let us heed the United Nations Secretary General’s call to mobilize for a decade of action to build a sustainable and resilient future.

Armida Salsiah Alisjahbana is the United Nations Under-Secretary-General and Executive Secretary of ESCAP