Now This Trend Really Is An Existential Threat Longer Term!

This appeared last week:

Fertility crisis Women

Birthrates are plummeting worldwide. Can governments turn the tide?

Nations are deploying baby bonuses, subsidised childcare and parental leave to try and reverse a rapidly declining fertility rate – largely to no avail

Tory Shepherd

Sun 11 Aug 2024 00.00 AEST Last modified on Sun 11 Aug 2024 09.58 AEST

Sophia and her partner have been thinking about having children for about five years. They are concerned about humanity’s impact on biodiversity loss and climate change and worried about what the future holds.

“Our conversation has two parts,” says Sophia, a communications specialist who preferred not to use her full name. “One is: what’s the contribution of a child to the global [climate] crisis? The second one is [about] what would their life be like.

“I live with heaps of grief about biodiversity collapse. I think about the future and what the future of a child would be like in that sense.”

The fear of climate change has led to couples having fewer babies; about one in five female climate scientists say they will have no children or fewer children because of the crisis.

It’s not the only reason for what governments and headlines are calling a baby crisis, a population crisis, a fertility crisis, a demographic crisis, an ageing crisis and an economic crisis. The cost of living, housing security and a lack of opportunity also play their part.

The upshot is that all over the world (nearly – but more on that in a bit), governments are concerned that women are simply not having enough babies.

Elon Musk thinks falling birthrates are a bigger risk to civilisation than global heating. There’s a burgeoning movement of pronatalists wanting to have “tons of kids” to save the world.

It’s fairly clear that, when women are more educated, more liberated, and more able to access contraception, they start having fewer children. What’s not clear is how to convince them to have more. Cheaper childcare? More flexible workplaces? More help from the menfolk? Affordable housing? More optimism about the future?

‘Low-fertility future’

Statistics show most countries are now below replacement rate – that’s 2.1 children per woman, enough to replace the existing population with a bit of a buffer.

Five decades ago, Paul Ehrlich’s book The Population Bomb sparked global fears of “mass starvation” on a “dying planet” because of overpopulation. Now, experts are warning the fertility crisis is set to leave a dwindling youth base supporting a swelling ageing population and panicked governments around the world are throwing money at the omnicrisis.

On 11 July, the United Nations released World Population Prospects 2024, a revision of their population estimates from 1950 to the present for 237 countries, with projections to the year 2100. The report said that “women today bear one child fewer, on average, than they did around 1990”, and that the world’s population is now expected to peak at about 10.3 billion in the mid-2080s (up from about 8.2 billion today) before starting to fall.

That peak will come earlier than expected for reasons including “lower-than-expected levels of fertility”, it found.

In March, an article published in the Lancet set off a new wave of headlines warning of catastrophe. A study titled global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the global burden of disease study 2021, by the University of Washington’s Institute for Health Metrics and Evaluation (IHME), found the world was approaching a “low-fertility future”.

The IHME study said by 2050, more than three quarters of the countries will be below replacement rate. By 2100, it will be 97%.

The only countries projected to have more than 2.1 by then are Samoa, Somalia, Tonga, Niger, Chad and Tajikistan.

“Governments must plan for emerging threats to economies, food security, health, the environment and geopolitical security brought on by these demographic changes that are set to transform the way we live,” an accompanying press release said.

Low-income places with higher fertility rates – such as sub-Sarahan Africa, which is set to contribute over half the world’s births by 2100 – will need better access to contraceptives and female education, the researchers said.

Low-fertility, higher-income countries such as South Korea and Japan will need open immigration and policies to support parents.

The study also looked at pro-natal policies already in place, such as free childcare, better parental care leave, financial incentives and employment rights. But the findings suggested that even pro-natal policies could not boost fertility rates up to replacement levels, although “they may prevent some countries from dropping to extremely low fertility levels”.

Dr Natalia V Bhattacharjee, a co-lead author on the study, said the trends would “completely reconfigure the global economy and the international balance of power and will necessitate reorganising societies”.

Bhattacharjee also warned that some countries might try to “justify more draconian measures” to limit reproductive rights.

We are not replacing ourselves through births

Dr Liz Allen

Meanwhile, in Taiwan, where the fertility rate has now fallen to 0.865, they are closing schools. In Japan, where the rate is 1.21, sales of adult incontinence products have outstripped nappy sales. In Greece, where it’s 1.264, some villages have not seen a birth in years and people are being encouraged to work a six-day week. And in South Korea, where it’s 0.72, the population is expected to halve by 2100.

“Australia’s population is structurally ageing and that means that we are living longer and we are not replacing ourselves through births,” says Dr Liz Allen, a demographer and lecturer at the Australian National University centre for social research and methods.

Australia’s fertility rate peaked at 3.5 in 1961. By 1975 – not long after Gough Whitlam abolished the luxury tax on the contraceptive pill – it had dropped to replacement level (2.1), and now, a couple of years after the 2021 figures the study used, it sits at 1.6.

That 70s dip was thanks to the pill, Allen says, but also other big social changes around gender equality, with women increasingly educated, working and with access to no-fault divorce.

There are those who decide they don’t want any children. There are women deferring having children, and therefore having fewer as their personal fertility declines. And in Australia and other developed nations there are fewer teen pregnancies – generally considered a good thing, but also something that contributes to a lower fertility rate.

Childcare, baby bonus, parental leave: can governments fix it?

Governments throughout the OECD – and increasingly in developing countries – are trying all manner of ways to boost fertility.

Most low-fertility countries have some form of maternity leave. Many have subsidised childcare and some form of family allowance and just over half have flexible work hours or tax credits for dependent children, according to the United Nations. But even Nordic countries, with their focus on gender equality, parental leave and a strong social services network, are experiencing declining fertility.

In China, the “one-child policy” has become a “three-child policy”, along with better maternal health care – and decreased access to abortions. Japanese politicians are trying to outdo each other with pronatalistic policies including subsidies, free daycare, better job security and support for fertility treatments. And the South Korean government has spent more than US$200bn to support families to have children.

It hasn’t worked. The best-intentioned policies have consistently led to less of a baby boom and more the occasional baby bump.

Take Australia’s baby bonus, for example, introduced by then treasurer Peter Costello with the exhortation: “One for mum, one for dad, and one for the country”.

It worked, a bit, but experts describe the fertility uptick as more of a “blip”. That hasn’t stopped countries including Russia, Greece and Italy giving baby bonuses a go.

Jennifer Sciubba, an American demographer, political scientist and author of 8 Billion and Counting: How Sex, Death and Migration Shape Our World, was on the Ezra Klein podcast recently talking about the complex interplay of factors determining baby desires.

She says following the “success sequence” – getting an education, a great job, a home, some savings – means pushing back having children. And once people have more money, they also want to have other things in their lives that kids might detract from – going out for a nice meal, taking a holiday, a full night’s sleep.

Having more than two can seem unimaginably intensive, hard and expensive, she says, but it’s never just the money. What about family and community support? Religion? The “little logistics” like needing a new car to fit enough car seats?

Through east Asia, Sciubba says, the idea is spreading that “marriage is no longer required to have a good life”.

“It might actually stifle your life because of gender relations within the household,” she says.

Sciubba questions how much the state can do. Then there’s the prevailing culture; in South Korea, for example, there’s paid paternity leave, but men don’t take it.

“[And] once [countries] fall below [replacement level], they tend to stay there,” Sciubba says.

Hungary, under Viktor Orbán, has offered free IVF, tax breaks and low-interest loans for families with children – and while that has pushed up the fertility rate, it is also a cloak for nationalist identity politics and comes with restrictions on birth control and abortion.

“You can strip away individual rights” in order to increase fertility rates, Sciubba says. “I am not advocating for that.”

She points to the example of Romanian leader Nicolae Ceaușescu, the dictatorial communist leader who came to power in the late 60s. He tried to boost the fertility rate by outlawing contraception and banning abortion for women under 40 with fewer than four children; women died from childbirth or backyard abortions and orphanages filled up with abandoned babies.

“You did see births increase … as long as his thumb was pressing on it. Then it went back down,” Sciubba says.

A 2022 review done by the Australian National University for the federal government’s centre for population found financial incentives like the baby bonus and the family tax benefit can have a positive effect on fertility. “However, the effect is usually small because transfers represent a minor fraction of the total direct costs of children,” it found.

The baby bonus potentially increased births, temporarily, by about 2%. Other policies, including better childcare and better parental leave, can all do a bit, but they are not fixing the problem.

The top three most important factors associated with fertility decisions, the ANU review found, were the cost, job security, and “having someone to love”.

Allen says by about 2054, it’s likely there will be natural population decline – more deaths than births. So immigration will be more important than ever to fill skills shortages and fuel growth. To build homes and infrastructure. In Australia, immigration is used to buffer the fertility rate – but it is its own policy battleground.

‘The blame gets placed on women’

With no answers in sight, Allen says, there’s also an ethical problem. Women are asked to have the kids, care for the elderly, participate in the workforce and do the unpaid labour at home. And young people now see through this, she says.

Allen says the push for women to shoulder the burden of the demographic “crisis” has been going on in Australia since colonisation. It was part of displacing First Nations people and creating a European outpost, she says, of ensuring the “right kind of women” breed.

“We see echoes of these encouragements from these politicians over time. They say things like ‘populate or perish’. ‘Lie back and think of England’. ‘One for mum, one for dad and one for the country’. ‘The right women aren’t having enough babies, the wrong women are having too many babies’,” Allen says.

“The blame gets placed on women. Women are seen as the gatekeepers of population and are seen as hedonistic and selfish if they do not populate.”

She points to a 1944 inquiry into Australian birthrates, where women were – for the first time – allowed to have a voice. In response to (yet another) call for women to “populate or perish”, one woman voiced her frustration at the burden thrust upon her.

“You men in easy chairs say populate or perish,” she said. “Well I have populated and I have perished with no blankets.”

Sophia is now pregnant – just in the early stages – which is why she didn’t want to use her full name.

“I was pretty sure that I didn’t want children. There was a big lifestyle factor. It changes your life to be responsible for another human.

“Ultimately it was a very selfish decision … on this one I’m going to own it. I selfishly wanted that extra depth in my life. But it wasn’t an easy decision for my partner or I ... we really laboured on it, pun intended.

“But on balance we decided it was what we wanted for our lives.”

More here:

https://www.theguardian.com/world/article/2024/aug/11/global-birthrates-dropping

The having of children is a complex and very personal topic and it is interesting to see how each generation works out what suits them.

Long term I suspect it will all even out, with people deciding pretty rationally, what they wish to do. No doubt – as a population – we are all still learning to handle the fact that, for all practical purposes sex has been separated from parenthood! I am also not sure Governments should interfere at all!

How you feel about this fact that sex and reproduction are now largely separate is up to you but there are very divergent views on the topic as we all know!

Comments and perspectives welcome!

David.

We Won’t Have A Functioning Health System If Our Society Unravels!

This appeared last week:

Disturbing societal trends raising the risk of a terror attack

ASIO director-general Mike Burgess has done more than raise the level of Australia’s terror threat. He has redefined our security challenge to recognise an increasingly intolerant and divided country.

Cameron Stewart

12:00AM August 10, 2024.

ASIO director-general Mike Burgess did more this week than raise the level of Australia’s terror threat. He redefined our security challenge to recognise an increasingly intolerant and divided country.

Burgess has been forced to broaden ASIO’s traditional focus to respond to a host of new and disturbing trends that, taken together, have undermined social cohesion and increasingly have normalised violence as a part of protest and public debate.

While some of ASIO’s grim assessment reflects the manifestation in Australia of violent trends in the US and Britain, it also has been influenced heavily by the extraordinary fire and fury ignited at home by the war in Gaza.

Burgess was adamant this week that his decision to raise Australia’s terror threat level from “possible” to “probable” was “not a direct response” to the local fallout from the turmoil in the Middle East. But in the same breath he made a powerful case as to why the heated local response to that conflict is the most “important”, “relevant” and “significant driver” of the country’s “degrading security environment”.

“The conflict has fuelled grievances, promoted protest, exacerbated division, undermined social cohesion and elevated intolerance,” Burgess says.

His comments have led each of the major political parties to point the finger at each other for their part in this outcome.

Anthony Albanese slammed the Greens for fuelling community divisions over Gaza while Peter Dutton said the government should share the blame for failing to tackle anti-Semitism decisively since the Hamas attack on Israel on October 7 last year.

Meanwhile, the Greens, who have refused to strongly condemn Hamas, anti-Semitism or the defacing of MPs’ office by anti-Israel activists, accused the government of politicising the issue, claiming their supporters were only “pushing for peace”.

ASIO’s assessment of this new volatile mood is stark, with Burgess declaring “politically motivated violence now joins espionage and foreign interference as our principal security concerns”.

But the critical part of his assessment is that this risk of politically motivated violence is no longer caused by a singular terror driver, such as the rise of Islamic State in 2012.

Instead it is now likely to flow from a range of growing social ills, including a spike in political polarisation and intolerance, violent protests and debate, anti-authoritarian beliefs in part fuelled by excessive Covid lockdowns, conspiracy theories, distrust of institutions and a normalisation of provocative and inflammatory behaviours. What’s more, many are combining these beliefs into what ASIO calls “new hybrid ideologies”, all amplified by the internet and social media, which remains the primary platform for radicalisation. Hard-to-detect lone wolf attacks with a gun or a knife are the likely method of attack, rather than old-style terror cell plots to blow up major landmarks or cause mass casualties.

The relevance of the Gaza conflict to ASIO’s assessment is not that it has created these dangerous trends but, rather, it has helped to fuel them.

The storming of the US Capitol building on January 6, 2021, on the basis of Donald Trump’s “Big Lie” about the 2020 election result was the first major global illustration of the emerging social trends Burgess talks about. These volatile social and political trends have continued to evolve in the US and are reflected in the savage and inflammatory language used by both presidential candidates, Trump and Kamala Harris, on the campaign trail. No one knows precisely why shooter Thomas Crooks chose to try to assassinate Trump last month, but the act was an illustration of the darker, more intolerant times ASIO speaks of.

Meanwhile Britain has been deeply shaken this week by violent anti-immigrant and anti-Muslim riots fuelled by online misinformation and extremist views following a deadly knife attack on children in Southport.

In Australia, ASIO says it has disrupted eight potential terror attacks in the past four months, all involving radicalised youths between the ages of 14 and 21.

This included the stabbing of an Assyrian Orthodox bishop in western Sydney in April by a 16-year-old who was interacting with extremists online. The boy was a part of an online group of fellow extremist youths called Brotherhood, and he used a smiling portrait of Osama bin Laden as his WhatsApp profile picture.

What ASIO fears most is that these dangerous new factors are being turbocharged by the divisions caused in Australia by the conflict in Gaza.

“We’ve been seeing all of the trends that Burgess spoke about in his address for quite some time now, they pre-dated Covid and were certainly accelerated during Covid,” says Lydia Khalil, director of transnational challenges at the Lowy Institute. “The Gaza conflict is similar, it is a contentious societal and political issue contributing to the legitimisation and the normalisation of the use of violence to achieve political ends.”

The Hamas massacre of Israelis on October 7 last year triggered the first ugly manifestation of this in Australia when a flag-burning mob celebrated the Hamas killings and chanted anti-Semitic slogans outside the Sydney Opera House.

Since then there has been a record spike in anti-Semitic attacks across the country, including bashings and verbal abuse of Jews, online harassment, the forced closure of Jewish businesses, the targeting of Jewish performers in the arts and Jewish students on campus during the university encampments.

The pro-Palestinian movement in Australia since October 7 has expressed legitimate concerns about the high civilian death toll during Israel’s war on Hamas in Gaza. But the activist rump of this movement has gone much further than legitimate protest and has embraced exactly the sort of “provocative, inflammatory, intolerant, unpeaceful and uncivil” behaviour that Burgess warned of when he raised the terror threat level.

These pro-Palestinian activists have proved to be anti-Israel activists above all by failing to distinguish between Israeli politics and the Australian Jewish community. They repeatedly have encouraged chants advocating the eradication of Israel and the carrying of blatantly anti-Semitic signs and slogans.

The sort of politically motivated violence Burgess has warned about erupted in Melbourne’s Jewish heartland of Caulfield late last year when pro-Palestinian protesters were arrested for charging at Jewish counter-protesters during a provocative rally outside a synagogue.

Shortly afterwards, pro-Palestinian activists confronted Israeli family members who had lost their loved ones in the October 7 massacre, storming into the Melbourne hotel where they were staying and placing dolls covered in fake blood on the floor.

This ugly activism is driven by what intelligence agencies describe as a “self-righteousness” about the pro-Palestinian cause that blinds these protesters to the normal standards of protest behaviour. Hence, we have seen acts such as the bizarre and offensive defacing of Australian war memorials with pro-Palestinian slogans when these memorials have no relevance to the current conflict in the Middle East.

More ominously for ASIO is the movement’s support for the vandalisation and defacing of the electorate offices of more than a dozen federal MPs and ministers, some of whom can no longer work from those taxpayer-funded workplaces.

In June pro-Palestinian activists set fire to the electorate office of Melbourne Jewish MP Josh Burns and painted horns on his image in a poster. ASIO would have noted Burns’s response when he said: “I’m nervous about someone getting hurt or worse. How is this a peaceful act? It didn’t bring about peace in the Middle East. If it did, I would have vandalised my own office.”

The government shares part of the responsibility for the rise of this out-of-control racist activism because from October 7 it has failed to call out anti-Semitism as strongly as it should have, fearing an electoral backlash from Muslim voters in its western Sydney electorates.

But it is the Greens who have done more than any other political group in the country to fuel this increasingly violent protest movement and undermine the country’s social cohesion that Burgess has warned about.

The Greens have refused to call out the excesses of pro-Palestinian activists including the defacing of war memorials, where Greens leader Adam Bandt glibly dismissed the issue, saying the Prime Minister and the Opposition Leader “were more agitated about graffiti than they have been about the slaughter of people in Gaza”.

Greens deputy leader Mehreen Faruqi has even refused to say whether the listed terror group Hamas should be dismantled.

Former ASIO chief Dennis Richardson says political leaders need to avoid any actions that can lead others down a pathway to violence. But he also says those most likely to carry out acts of terrorists or politically motivated violence don’t usually take their leads from politicians.

“It’s always a bit difficult in a liberal democracy because part of the liberal democracy is robust public debate, and part of that robust public debate is politicians having a go at one another. But I don’t think it’s appropriate for politicians to be encouraging those who would seek to essentially blockade electoral offices,” Richardson says, without naming the Greens. “That strikes me as being fundamentally anti- democratic.

“And if you’re going to encourage people to do something like that, you do run the risk of perhaps even unintentionally creating a framework in which it’s easier for people to rationalise what other things they may want to do. So you’ve certainly got to watch that.

“But, equally, I doubt whether too many of those who do engage in politically motivated violence get their lead from politicians.”

Richardson says the key question for ASIO is whether the local passions inflamed by the Gaza conflict could spill over into a deadly act.

“I think (Burgess) was in part saying, ‘Look, there are people out here who at the best of times are borderline, and developments such as we see in Gaza can amplify in their own minds and make it more likely that they might do something.”

For example, Richardson says Australia “would be a much better place if no one in the country had any sympathy for a terrorist organisation like Hamas”.

However, he says among those who do have some sympathy for Hamas in Australia, there’s “a whole spectrum of views”.

“These could range from just being sympathetic to Hamas, through to actually being prepared to do an act that might put people’s lives in jeopardy and actually kill people,” he says.

“The great challenge for ASIO and law enforcement is to monitor a whole range of people who exist right along that spectrum and try to identify those who might actually take that fatal step. And that’s a pretty tough challenge for any organisation.”

The Lowy Institute’s Khalil agrees that this new and broader range of potential security threats identified by ASIO makes the agency’s job of protecting Australians more difficult.

“There are manifestations of political violence now in our society, or concerns around them, that go beyond terrorism,” she says. “It’s becoming an increasingly blurry line between what is legitimate in a democratic society and what should be proscribed, and that is one of the things that makes responses a bit more difficult, because it’s not like it was in the past, where you had these discrete organised groups which would try to conduct various plots and attacks. Now it’s very muddy.”

Khalil says there are now numerous triggers for the type of grievance extremism that Burgess refers to.

“A lot of people are frustrated with the way that democracy is working and they’re increasingly believing that it doesn’t meet the needs of the average person, that it’s really focused on elite interests,” she says. Perceptions of growing inequality and cost of living have led to frustration with governments, fuelling anti-authoritarian views and a wariness of institutions.

“I think it’s not just an issue for ASIO, they’re just one part of the broader spectrum of the response,” Khalil says. “This isn’t just a security issue. So while ASIO will deal with the pointy end of it, where people are radicalised to violence based on whatever mix of grievances they have, that is just one end of this issue. The rest of it is really a broader societal issue.”

Burgess is at pains to say this new range of potential threats is “significant but not insurmountable” and that a terror threat level of probable does not mean inevitable.

But his conclusions are a wakeup call to the real-life consequences of the country’s drift towards intolerance, violent political rhetoric and crumbling political and social civility.

“Like you, I still think we live in a paradise and I think we are the lucky country,” he told Sky News. “But this is stretching us and testing us.”

Here is the link:

https://www.theaustralian.com.au/inquirer/disturbing-societal-trends-raising-the-risk-of-a-terror-attack/news-story/698e0e0204e8f0aa5c23769ef4594bee

I am becoming increasingly concerned that we are all taking the stability of our democracy and its institutions for granted and that we all need to think if there is anything we can do, as citizens, to help just a bit!

The functioning of our society is very complex and can be easily disrupted – witness the IV fluid shortages at present – and we all need to do what we can to move things in the right direction. Sadly there are many these days who would frustrate our efforts – witness the UK at present!

Stay alert and a little bit alarmed I reckon!

David.

A Good Reminder Of Just What Matters In Preserving Health!

This appeared last week.

Bernard Salt

Think the internet changed Australia? How about sewerage.

12:00AM August 10, 2024

The Weekend Australian Magazine

It is a topic that surfaces at centenary celebrations, workplace farewells and, poignantly, eulogies too. It is the idea of looking back and remarking upon how much Australia has changed over the decades.

Making do without access to modern technology (mail versus email), the formality of everyday dress (hats and gloves) and the stiffness of interpersonal protocols (Messrs and Mesdames) are popular observations. So too is the overarching belief that all this change places us, today’s Australians, at a unique time in history. And that we, the players, are dealing with pressures that did not exist decades ago.

There is some merit to this way of thinking. Previous generations disconnected from work when they left the workplace. This is less so today with access to smartphone technology.

However, the question isn’t so much “How have things changed?” The question should be reframed: how has Australia changed in the past 60 years (1964-2024) as compared with the previous 60 years (1904-1964)?

It’s fair to say that we the people of the 2020s have had to manage an avalanche of change over six decades. There’s the rise of China, the empowerment of women, the invention of the internet, the use of mobile phones, the emergence of diversity, equity and inclusion, and recognition of the marginalised.

Nevertheless, those still alive in 1964 (and born in the 1890s or earlier) recalling events of the previous 60 years could equally lay claim to have lived through an era of profound change.

Let’s start with the impact of Australia losing 60,000 men in World War I and then having to navigate the Spanish flu epidemic. These events were followed by the broader use of electricity, the popularisation of cars, the greater use of the telephone, and the idea of working in a city factory as opposed to being “in service” on a country estate. Toss in the Great Depression, World War II and the atomic bomb, and then finish this era of profound change with a baby boom to express our unbridled confidence in Australia’s future.

In the previous 60 years (1844-1904), the Australian colonies unified to become a commonwealth. Australia was then, and still is today, the only continent to be claimed by a single nation. The idea of federation (of a continent) was bold thinking for the time. This was an era of wealth generation delivered by gold, wool, wheat and export of refrigerated meat. It was a time when our biggest cities were sewered, ultimately delivering longer lifespans and a better quality of life. (Arguably, the advent of sewerage did more for average Aussies than the invention of the internet.)

So, yes, the development of the smartphone and DEI and being able to order Thai food and have it delivered by Uber Eats is a world away from the privations and the triumphs of any previous 60-year era.

The more interesting question is what Australia might look like 60 years hence, in 2084. This future era will be shaped by exiting baby boomers, by the impact of trading blocs, and by the clarification of Australia’s role as a food producer, resources provider and safe harbour for civic-minded people wanting a better life for their kids.

We should aim for this future Australia to always be a place of peace and opportunity.

Here is the link:

https://www.theaustralian.com.au/weekend-australian-magazine/think-the-internet-changed-australia-how-about-sewerage/news-story/6756b92cb843b5762358c3239b7f0a3a

I reckon this is a thoughtful piece that does preserve a longer perspective that can be easily lost. I am probably just a few years older than the author but I find the perspective true and valid.

Amazingly my parents memories go back all the way to the early 1900’s and my grandparents actually lived and could just remember, and tell me about, the end of the 1800s! Good generational timing I suppose.

The point of all this is to remind us all of the debt we owe to public health initiatives – now over a century old – that have so helped longevity and quality of life! These measures really matter as you can see each time they break down in war, famine etc.

It really helps to keep perspective to consider what steps have made the most difference to all our lives!

David.

We Sure Have Seen Fear Return To Markets In The Last Week – Should We Be Concerned?

This popped up late last week:

‘Don’t be terrified’: experts call for calm after a wild week on global markets

Glenda Korporaal

7:38PM August 09, 2024.

The Australian Business Network

Bell Potter veteran stockbroker Richard Coppelson was having to reassure some nervous clients this week.

“Corrections are just a normal part of the market,” he wrote in his daily newsletter.

“Don’t be terrified each time one hits. While the sell-off has worried many and it looks ­chaotic, the truth is that it is a sign of a healthy market. You should expect two or three 5 per cent corrections and one 10 per cent correction every year.”

“Coppo” was writing after a volatile start to the week, which saw the Australian market lose ­almost 6 per cent over two days (Friday, August 2 and Monday, August 5), wiping almost $160bn from its value in its largest two-day fall since the pandemic in March 2020.

Days before, he had summarised Monday’s market in more bearish terms, describing it as the “worst day since the pandemic” with the markets “smashed on US recession fears”.

“US futures smashed, Asian markets and cryptos whacked, US market under siege,” he wrote.

“Sahm rule (predicting a US recession) triggered,” he said, warning that “US corporate insiders are dumping stock at the fastest rate in more than a decade”.

While the Australian markets stabilised later in the week, one player described the market as having conflicting views, with some seeing global sharemarkets having an overdue correction after some major gains, while ­others were more worried about the outlook. “People are nervous,” one executive with a global executive bank said. But at the same time, he pointed out, there were plenty of cashed-up Australian investors looking to buy on the dip.

“We have been expecting the market volatility for a while,” Ord Minnett chief executive Karl Morris said. “This has been the hardest market I have ever seen because there are so many things happening at the same time – from elections to the political risks and wars.”

While some of these could have prompted a market “meltdown”, he said the past year had seen a “melt up” where prices had continued to rise, particularly tech stocks.

“We have been surprised how strong the markets have been. People have been expecting this (market volatility) for a while.”

But he said investors in Australia were now considering whether they should “buy on the dip” or wait longer to see if shares fall further. Trading volumes had been up on Friday and Monday as the ASX fell, Mr Morris noted.

He said there had been overoptimism in the US market about the earnings prospects from artificial intelligence, which had boosted the prices of tech stocks.

“The only people who are making money out of it are the chip manufacturers and people selling the dream. A bit of reality is setting in,” he said.

Mr Morris said the Australian market had “settled down” towards the end of the week with trading volumes coming down to more normal levels. But he said he was still expecting “volatility” on world markets would continue.

“We don’t see this as being the end of volatility, especially when markets around the world are pretty fully priced. Valuations in some parts of the market are still extremely high.”

The Australian market was “still substantially above where we were a year ago”, Mr Morris said. “There have been a lot of reasons where, normally, markets would pull back, but they haven’t. They have just kept going up.”

He said there were also concerns in the US whether the US Federal Reserve had been too slow to cut interest rates and could push the US economy into recession. But there was “no real panic from any of our clients”.

Matthew Haupt, a lead portfolio manager with Wilson Asset Management, said the sell off in the Japanese and Asian markets on Monday, with the Japanese market down by more than 12 per cent – its biggest one day fall since 1987 – was “historic”.

“It was pretty intense,” he said.

Mr Haupt said the fall on Monday in Japan had been sparked by weak US jobs data on Friday night which triggered concerns about whether there could be a recession in the US.

He said the prospect of lower US rates and higher rates in Japan had prompted a “deleveraging” by investors who had borrowed cheaply in Japan to invest for higher returns offshore.

Weaker than expected economic data from the US and a tightening of Japanese monetary policy began to change the investment equation.

“The yields in America fell, which made the yen rally, which meant all the carry trades had to be closed,” he said. “These deleveraging events are quite quick but painful.”

He said the past few days had seen “a bit of normalcy come back into the market” but he said nervousness and the prospect of further unwinding of the carry trade “mean it is still bubbling away”.

“We are probably half way through the deleveraging (process) but there is still more to go.”

Mr Haupt said next week would see more focus on local factors as the annual results of companies started to come out.

“We are watching earnings season in Australia now. The results are starting to trickle in now. But the level of uncertainty is still high because of the deleveraging and the uncertainty about the US economy. Markets don’t like uncertainty and we got a real dose of uncertainty this week.”

A bank holiday in NSW last Monday would have normally been expected to have been a quiet day trading day.

But the Australia market had already begun its fall on Friday on concerns about a fall in US tech stocks. Concerns that the share price of companies like Nvidia had overshot were exacerbated by the announcement last week that Warren Buffett’s Berkshire Hathaway had sold more than half its holdings of Apple shares.

The unexpectedly strong increase in interest rates by the Bank of Japan on July 31 and rhetoric that the central bank was looking at more tightening of monetary policy was also causing problems in global markets as investors who had borrowed cheap Japanese currency to invest in the US and other markets, were forced to unwind some of their positions.

At around midnight on Friday last week the US payrolls data also indicated that the US economy was weaker than expected. The figures sent Wall Street down with talk that the figures had triggered the Sahm indicator of a recession. When traders in Australia came to work on Monday for their pre-market meetings they were expecting a bad day.

What caught them by surprise was the rout in the Japanese market which plunged by 12.4 per cent, the biggest one-day fall since 1987 stock market crash, on concerns about the Bank of Japan raising rates.

Investors were also selling out of Japanese bond and equities as “the carry trade” – which had allowed investors to borrow ­cheaply in Japan to invest offshore – began to unwind.

The Australian market had had the roughest two days since 2020, but the drop was nowhere near the big market falls of March 2020 amid fears of the implications of the Covid pandemic.

There were big fears in Australia of another fall on Wall Street on Monday night, but nerves calmed on Tuesday when it didn’t happen. By Tuesday afternoon the focus in the Australian market was back home, with the statement from the Reserve Bank that it was keeping rates on hold and news from the press conference that rates were not coming down any time soon.

There was welcome news on Wednesday from the Bank of Japan that it was backing off its plans to further hike interest rates, aware of the disturbing impact that its rate rise of the week before had had on global markets.

But when Australian traders came into work on Thursday there was bad news from the US that a 10-year US Treasury auction had not gone as well as expected. US investment banks were raising the prospects of a recession, with JP Morgan declaring that there was a 35 per cent chance that the US economy would fall into a recession by the end of the year – up from 25 per cent at the beginning of the year.

Close attention is now being given to intra-day movements as investors are trying to get a clear sense of direction in markets.

“We need these intra-day movements to settle down so we can get a clear sense of direction,” said one market participant.

“People are moving their money out of these high-growth plays into ultra-defensive areas – market staples.”

Rob Nash, ASX’s head of equities relationship management, said the market falls of Friday and Monday were nowhere near as steep as those in March 2020.

He said Monday had seen a total of almost $11bn in shares traded across the two exchanges, which was above more normal days of around $7bn to $8bn. But the “bounce” in the market on following days had seen volumes go back to normal.

The Australian share market had not rallied as much as those in the US and Asian countries such as Japan and South Korea over recent months as it did not have the same exposure to technology stocks. This was giving the Australian market more of a buffer as tech stocks in other markets fell. “The markets which had a heavy exposure to tech, including the Asian markets, rallied the most on the way up,” Mr Nash said.

Here is the link:

https://www.theaustralian.com.au/business/markets/dont-be-terrified-experts-call-for-calm-after-a-wild-week-on-global-markets/news-story/8e1b98fe815529e200b672f0b9f0cd0f

It has been a big week on the markets last week – and given how many of us have Super invested in the self same market the losses have been a bit harrowing for many.

We have had all sorts of breathless, alarmist headlines but in the vast majority of cases we know the best thing to do is just let the hubbub pass and see where we are in a month or two – as it is more than likely the fuss will have passed and we will all be back to normal.

FWIW I can assure you it is pretty much certain that the markets and all our portfolios / super will be back to normal in a month or two and importantly the health system will have trundled on doing all the good things it does quite undisturbed!

The point is that the market is not the real world for most and that while interesting it is only in the most exceptional of circumstances should we be really concerned!

My rule is that I will worry when Alan Kohler on the ABC news tells me to – and before that I will remain calm and relaxed!

The lesson is to only worry about what you can change / improve and ignore the ‘noise’ – and more importantly only sell or buy when your adviser tells you to!! Unless you are a real expert the best thing is to take the advice of the real experts!

In broad terms the same goes for how you treat your health!

David.

AusHealthIT Poll Number 759 – Results – 11 August 2024.

Here are the results of the poll.

Do You Think The Overall Impact Of AI Has Been Over-Hyped?

Yes                                                                                 21 (62%)

No                                                                                 13 (38%)

I Have No Idea                                                               0 (0%)

Total No. Of Votes: 34

A pretty clear cut vote suggesting we may just be a little ahead of ourselves on the impact of AI.

Any insights on the poll are welcome, as a comment, as usual!

A fair voting turnout. 

0 of 34 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

This Tool May Be Useful For Some To Help Advise Their Patients.

This appeared last week:

COVID-19 Risk Calculator expanded

GPs can now use the tool to undertake a personalised assessment for patients’ risk of developing long COVID-19 six months after infection.

Michelle Wisbey

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01 Aug 2024

Globally, at least 65 million people are thought to suffer from long COVID-19.

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Healthcare professionals are set to be aided in their assessments of long COVID-19 after a popular risk calculator was updated to include the condition.
 
The online COVID-19 Risk Calculator’s (CoRiCal) expansion was announced on Thursday and now includes a personalised risk assessment of developing long COVID-19 six months after infection.
 
The calculator takes into account a range of personal factors including age, sex, comorbidities, vaccination status, number of previous infections and use of antiviral medications.
 
CoRiCal was developed early in the pandemic to provide clinicians, and patients, with a shared decision-making tool to help determine the possible risks and benefits of having a COVID-19 vaccine and booster.
 
In its latest update, the long COVID-19 calculator was specifically designed to assess the risks of going to hospital or an intensive care unit with the condition, and of having it six months after catching COVID-19.
 
And the impact of living with long COVID-19 is something Kylie Trounson knows all too well.
 
A busy Melbourne lawyer, Ms Trounson was struck down with the illness more than two years ago and its impacts continue to be devastating.
 
‘I started having really extreme symptoms that I couldn’t explain – I woke up in the middle of the night with my heart racing, I had a heart monitor, and it was at 190 beats per minute while I was lying down,’ she told newsGP.
 
‘I had a such a severe form of it that I lost my identity, so I wasn’t a mum, I wasn’t a lawyer, I wasn’t a partner, I wasn’t a daughter, I was just someone who could lie in bed.
 
‘My GP was my anchor at that point … now that most of the long COVID clinics are not available, the importance of GPs is huge.’
 
The project’s co-lead, and former RACGP Expert Committee – Quality Care Deputy Chair, Associate Professor John Litt said the expanded tool will help GPs to introduce earlier interventions to mitigate the disease’s severity and duration.
 
‘While the median duration is about four months or so, that means 50% of people will have symptoms for longer than four months,’ he told newsGP.
 
‘The GP feedback is it’s even quite complex for them to understand and their time is really precious.
 
‘What we’ve done with this one is we’ve actually brought in the comorbidities, and there are quite a few comorbidities that increase the risk of the severity of COVID, and they increase your risk of long COVID.’
 
University of Queensland Associate Professor Kirsty Short said at least 65 million people globally are thought to suffer from long COVID-19, which can cause more than 200 symptoms across 10 different organ systems.
 
‘Incomplete vaccination, missed drug treatment during acute infection, and repeat infections are the greatest controllable influencers that increase risk, so there are actions you can take right now to reduce that,’ she said.
 
‘Health managers and individuals in conjunction with clinicians can use the risk assessment tool for shared decision making on vaccination, infection-avoidant behaviours and pursuing early treatment during acute infection.’
 
Associate Professor Litt said while many adults do not see COVID as a big issue, many remain concerned about getting long COVID.
 
‘The chance of suffering long COVID increases with every bout of COVID-19 a person catches,’ he said.
 
‘The vaccines are continuing to provide benefit, but it’d be great if they provided a longer-term benefit against getting infected or passing it on to people who are vulnerable.
 
‘Clearly vaccination has largely been the primary cause which has led to a substantive reduction in long COVID, so that’s the good news, the bad news is we don’t have a definitive treatment.’
 
The tool was designed by a team of experts from Flinders University, the Queensland University of Technology, the University of Sydney and the Immunisation Coalition, and included input from GPs and clinicians.

Here is the link:

https://www1.racgp.org.au/newsgp/clinical/covid-19-risk-calculator-expanded

This may be useful to know about to ask your GP for an assessment if you are concerned!

David.

Is This Report Just The Same Old, Same Old? Looks like Bureaucracy Squared To Me!

 This appeared last week:

Council for Connected Care inaugural review report released

Friday, 02 August, 2024

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The Australian Digital Health Agency (ADHA) has welcomed the inaugural annual report of the Council for Connected Care.

The council is a multi-stakeholder advisory group that provides strategic guidance and direction on how to improve health outcomes for Australians through a more interoperable digital health system.

ADHA CEO Amanda Cattermole PSM said, “The Council for Connected Care has been a catalyst for change and a champion for healthcare interoperability. It has brought together an outstanding group of leaders who share a common vision of a more connected and integrated healthcare system.

“All Australians expect a healthcare system where information is shared safely, securely and seamlessly with the right people at the right time to deliver the best clinical outcomes.”

The ADHA said that the Council for Connected Care Annual Review shows progress has been made in advancing the interoperability agenda, with collaboration and knowledge building resources shared centrally on the agency’s website, including:

• National Healthcare Identifiers Roadmap 2023–2028 to increase the adoption and use of healthcare identifiers in health and care settings.
• Digital Health Standards Catalogue, a comprehensive resource that provides a single point of access for relevant standards in digital health.
• Conformance framework to ensure digital health products and systems are operated in a manner that aligns with safety, security and interoperability standards.
• Draft procurement guidelines to provide guidance to healthcare organisations seeking to purchase digital health solutions and harmonise interoperability requirements in ICT procurement.
• Drafting national Health Information Exchange architecture in consultation with jurisdictions and key stakeholders.
• Supporting the adoption and implementation of national interoperability standards, such as FHIR and SNOMED CT, through education, training and testing resources.
   

Council Chairperson Conjoint Professor Anne Duggan said having a more connected healthcare system was an important pillar of consumer safety and puts Australians firmly at the centre of their care.

“It has been a privilege to work with senior leaders across the healthcare system, united by the common purpose of realising fully optimised and interoperable digital health records, which remain foundational to safe and high-quality care.”

The council was established in June 2023 as part of the Connecting Australian Healthcare – National Healthcare Interoperability Plan 2023–2028, which was auspiced by all governments to significantly reduce fragmentation and increase information sharing across the healthcare system.

Here is the link:

https://www.hospitalhealth.com.au/content/technology/news/council-for-connected-care-inaugural-review-report-released-709203735

This is a new grouping for me so I had a look:

Council for Connected Care

Providing strategic advice on interoperability and supporting the implementation of the National Healthcare Interoperability Plan.

Contact us

Phone: 1300 901 001 
8am - 5pm (AEST/AEDT) Monday - Friday 
Email:  help@digitalhealth.gov.au

Role of Council

The Council for Connected Care will:

• identify opportunities to accelerate interoperability in various parts of the health system and ways to harness these opportunities
• facilitate and support the implementation of the Connecting Australian Healthcare – National Healthcare Interoperability Plan 2023-2028
• promote and garner support for digital health initiatives that drive connected healthcare
• identify barriers to achieving interoperability and ways to overcome them.

Here is the link:

https://www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/interoperability/council-for-connected-care

There are 33 members of the council, and they have held six meetings to date.

Here are the members:

Conjoint Professor Anne Duggan (Chairperson)	Chief Executive Officer	Australian Commission on Safety & Quality in Health Care
Professor Peter Sprivulis (Deputy Chairperson)	Chief Clinical Information Officer	WA Health
Dr Jason Agostino	Senior Medical Advisor	National Aboriginal Community Controlled Health Organisation
Mr Simon Bush	Chief Executive Officer	Australian Information Industry Association
Ms Annie Butler	Federal Secretary	Australian Nursing and Midwifery Federation
Ms Amanda Cattermole PSM	Chief Executive Officer	Australian Digital Health Agency
Professor Wendy Chapman	Associate Dean of Digital Health and Informatics	University of Melbourne
Mr Simon Cleverley	Assistant Secretary	Australian Government Department of Health and Aged Care
Dr Elizabeth Deveny	Chief Executive Officer	Consumer Health Forum
Ms Kirsty Faichney	Deputy Chief Executive Officer	Services Australia
Mr Michael Frost	Group Head, Primary Healthcare, Information Standards & Communications Group	Australian Institute of Health & Welfare
Ms Mary Ann Baquero Geronimo	Chief Executive Officer	Federation of Ethnic Communities' Councils of Australia
Dr David Hansen	Chief Executive Officer	Australian e-Health Research Centre, CSIRO
Dr Rob Hosking	Chair Expert Committee on Practice Technology and Management	Royal Australian College of General Practitioners
Ms Emma Hossack	Chief Executive Officer	Medical Software Industry Association
Dr John Lambert	Chief Clinical Information Officer	NT Health
Mr Chris Leahy	Chief Operating Officer	Australian Commission on Safety and Quality in Health Care
Ms Laurie Leigh	Chief Executive Officer	National Disability Services
Mr Keith McDonald	Chief Executive Officer	South Western Sydney, Primary Health Network
Ms Bettina McMahon	Chief Executive Officer	Healthdirect
Dr Danielle McMullen	Vice President	Australian Medical Association
Adjunct Associate Professor Steven Morris	Chief Executive Officer	Pharmaceutical Society of Australia
Ms Anja Nikolic	Chief Executive Officer	Australasian Institute of Digital Health
Ms Jackie O’Connor	Policy Lead	Allied Health Professions Association
Mr Peter O’Halloran	Chief Digital Officer	Australian Digital Health Agency
Dr Christopher Pearce	Chair Digital Health Committee	Australian College of Rural and Remote Medicine
Mr Michael Roff	Chief Executive Officer	Australian Private Hospitals Association
Mr Richard Skimin	Corporate Member Representative	Australian Patients Association
Adj. Professor Ruth Stewart	National Rural Health Commissioner
Mr Tom Symondson	Chief Executive Officer	Aged & Community Care Providers Association
Ms Lisa Todd	Economics, PBS and Data Director	Pharmacy Guild of Australia
Mr Mark Upton	Director, Strategy, Information Management and Governance Office	Tasmanian Department of Health
Professor Trish Williams	Digital Health Expert	Flinders University

We have a meeting on August 8 – so if you wish to raise a matter contact one of those listed above.

It is very hard to tell just what this august membership has delivered for the Australian people.

Perhaps we could have an email – explaining in a page or so – the value that has been added and the difference that has been made? I would love to publish such a summary!

What do you think this Council will deliver other than attendance fees for the members?

David.