Mortality tolerance

From Australia, it seems like the US is easing its COVID-19 restrictions too early.  Over the last three days, we have averaged less than 0.01 COVID-19 deaths per million of population, while the US is at 4.94.  That is, their death rate at the margin is running about 500 times the Australian death rate.

Australia, of course, benefited from an earlier response and perhaps a more compliant population, but that doesn't explain why we are reopening at a similar rate (I'm generalising).  One reason, I suspect, is because the US has a higher death rate tolerance.  The absence of an Australian-style economic safety net in the US means that the shut-down pain inflicted on its population is much greater.  News reports from the US have described long queues at food banks and public demonstrations calling for a re-opening of the economy.  Some of the latter are no doubt supported by right-wing and libertarian organisations, but the dire economic impact on the middle and working classes are clearly visible.

Poor weather didn't deter the surfers today

You could argue that the American people have decided they are willing to accept a much higher prevailing death rate than Australians if it means they can return to work.  They may not want to see distressing overflowing hospital wards and mortuaries, but now that lack of capacity seems to have been addressed, they are willing to accept the overflowing obituary columns.

Every country is making this calculation, explicitly or implicitly, and they will all be hoping that the marginal death rate does not climb to the point where people are again willing to accept an economic shut-down.

It was hosing down outside the Post Office today

The degree to which I am prepared to tolerate physical pain depends on a similar (but much more trivial) calculation.  Not against the economic benefits, but against my more general sense of well-being.  The longer I don't exercise, the greater the degree of pain I am willing to accept in return for that well-being.  Although I am hoping to return to running without the chronic hip/hip flexor pain that caused me to stop, I know that I am willing to accept some pain, as I have done with other chronic injuries that still dog me.

I walked to our local Post Office to collect a parcel today and heavy rain arrived while I was there.  After fruitlessly waiting some twenty minutes for it to ease, I decided to jog home.  Disappointingly, I could feel soreness in the hip flexor the whole way.

Self-sufficiency

Terrigal this morning

I find one of the less-attractive political aspects of the COVID-19 pandemic is the call it has generated for Australia to become more economically independent.  It gives currency to some commentators, lobby groups and politicians who see the extent of Australia's interdependence on the global economy as a national threat.  They want Australia to become more independent with respect to medical supplies, strategic materials, fuel and defence equipment.  It sounds like a good idea, but I think the matter deserves deeper analysis.

Terrigal this morning

Firstly, it has to be a matter of degree.  Australia cannot become completely self-sufficient in everything it needs to meet every major challenge.  For instance, I think you could argue, that despite the angst about shortages of Personal Protective Equipment (PPE), ventilators, hand sanitiser, etc., Australia did manage to source sufficient supplies to deal with the pandemic threat.  Future pandemics might take different forms and require different medical supplies.  We cannot cater for every possibility.  Likewise with fuel and defence supplies.  There has to be a balanced judgment about how much independence we need, based on the probability of the threats and consequent requirements.

Looking towards Wamberal this morning

Secondly, economic and military independence, comes at a cost.  It requires government intervention in the market, either through mandates, taxation and/or subsidy.  Inevitably, this affects the allocation of scarce resources, meaning that people end up paying higher prices and/or more in taxation.

Thirdly, I believe globalisation and economic interdependence is a good thing.  It provides goods and services at lower prices both to Australians and the people of other countries, raising incomes and living standards across the world.  It creates a better understanding of other cultures making it less likely we will see them as "other", and a threat.  And, the very fact that we are interdependent means that we are less likely to resort to hostilities to resolve differences.  The challenges that face everybody in the world -- climate change, pandemics, etc. -- will be far better met through participation in global forums and bodies, than by each country retreating into isolation and economic independence.

Terrigal Haven this morning

There should be a review of how the Australian people can be better prepared for future pandemics and other threats, but it needs to be a balanced assessment.

A desire for self-sufficiency may also be a problem in dealing with running injuries, especially for me.  Rather than consulting with physiotherapists and doctors (and thereby raising their incomes and living standards), I believe, given time, that my body will either repair itself or adapt to some new structural deficiency.  That's certainly my current approach, encouraged by my wish to avoid creating medical records detailing yet another pre-existing condition of interest to a future travel insurer.

"Excess" mortality

The Skillion this morning (courtesy Julie)

Reported deaths from COVID-19 around the world are generally considered to be underestimates.  To get a better idea of the true number, statisticians are starting to look at the "normal" number of deaths registered for the same period in previous years to calculate "excess" mortality, and these do imply a higher death rate.

North Avoca beach this morning (courtesy Julie)

Of course, not all of these "excess" deaths will be directly attributable to COVID-19.  However, of the balance, most will be indirectly attributable to the pandemic.  The lack of medical resources to treat other illnesses and conduct elective surgery will have caused deaths, along with the documented reluctance of people to consult with their doctors about their ailments.  Other deaths will be attributable to effects such increased obesity, mental illness, etc.

Trail on Kincumba Mountain this morning (courtesy Julie)

But even these "excess" mortality calculations may be underestimates after the "normal" death rates are adjusted for factors such as the decrease in road deaths (resulting from much less travel and commuting), fewer flu deaths (because of social distancing) and increased exercise.  Although, I guess, you could argue that these offsetting "non-deaths" are also attributable to COVID-19 and thus should not be deducted from the "normal" death rates when calculating "excess" mortality because of the pandemic.

I've only had nine days of no exercise, but I'm already feeling less healthy.  It's not really the impact on my life expectancy that concerns me, more that I know how hard and long the road back to fitness will be once I start exercising again.  I don't plan to do that until I cannot feel my hip/hip flexor injury when doing my normal daily stretches.  I haven't reached that point yet.

Unused capacity

Terrigal sunrise today (courtesy Julie)

In Australia, the hospitalisations resulting from COVID-19 have been low.  I haven't been able to find statistics on the peak hospitalisations, but as of yesterday, across the whole of Australia, there were 160 COVID-19 cases being treated in hospital, of which 21 were in intensive care and 19 of those were on ventilators.

Currently, the estimated Australian capacity is about 2,500 available intensive care hospital beds all of which have a ventilator, so we are using only about 1% of our capacity.  If needed there are plans to nearly double the capacity.

Terrigal sunrise today (courtesy Julie)

There hasn't been much discussion in the media about what appears to be enormous spare capacity, but there must be a lot of empty hospital beds and under-utilised medical staff. Ultimately, I think there will be criticism of this oversupply by the "coronavirus is a hoax" crowd, but personally, I applaud the Australian authorities for getting so far in front of the curve.  Not only have we have avoided the worst of the COVID-19 pandemic thus far, but our medical system responded in good time to cope if it had been worse.

I feel a bit under-utilised myself at the moment, exacerbated by the additional time I have on my hands because I am not exercising.  I have finished a project to risk assess and redraw maps of all of my running club's regular routes which occupied a lot of the past month, and will now turn my attention to some other projects.  Some more of my daughter's PhD thesis chapters have arrived for proof-reading and there is some research to do for the latest iteration of our adventure plans for later this year.  I also have about ten years of monthly newsletters from my old running club to scan and make available on the web.  Even with all of the above, I'm not going to be very busy.

Plan D ... or is it Plan E?

Terrigal beach this morning (courtesy Julie)

It seems likely Australians will be allowed to travel domestically by August, assuming there is not an unexpected surge in COVID-19 cases.  After thinking some more about what our adventure options are for the next six months, Julie and I have come up with yet another plan.

Sunrise this morning (courtesy Julie)

We will go ahead with hiking the 1200km Heysen Trail in South Australia, as planned if our round Australia cycling trip didn't work out, but go earlier.  Although August nights will be cold in the spectacular Flinders Ranges at the northern end of the Trail, the daytime weather will be ideal for hiking and and we would get to see the spring wildflowers as we travel south to the coast.  We will depart for Adelaide, driving a scenic route, about two weeks after borders are declared open, leave the car there somewhere there and then use public transport to travel to and from the Trail.

After the Heysen, finishing around the end of September, we will drive a scenic route to Western Australia, leave the car in Perth or Albany, and then hike the 1000km Bibbulmun Track between those two cities in October/November before driving back home.

Wamberal lagoon this morning (courtesy Julie)

This gives us the opportunity to hike two iconic Australian trails this year that are on our bucket list, and something to look forward to over the next couple of months.  Sure, it means scuppering my plans to run a marathon on 22 August, the 50th anniversary of my first, but I can live with that.  I would much rather do the hikes.

Marathon or hike, I need to get over my injury and get fit.  I'm now thinking I might take as long as six weeks off running and walking if it means I can walk and run without the hip pain.  That would then give me one to two months to get back into shape before hiking which seems doable.  If we can't leave before the end of August, I'll still have a go at the marathon.

Disappointment and regret

Terrigal sunrise today (courtesy Julie)

The word "unprecedented" gets a lot of use these days, but it is hard to argue that it is over-used or inappropriately used (as was often the case pre-pandemic).

Matcham Valley autumn colours this morning (courtesy Julie)

Today was an unprecedented Mother's Day, with the traditional gatherings at cafés, restaurants and homes not permitted in Australia (apart from, maybe, the Northern Territory).  In New South Wales, there was a lot of serial visiting because the state government changed the COVID-19 restrictions a week ago to permit two adults plus children to visit another household.  Julie and I visited her parents, but instead of the usual large family gathering, visits from grown children and their families were sequential.

Compared to many, we were mostly lucky in NSW.  However, for those under lockdown in nursing homes and in other parts of the world, this was likely a disappointing and difficult day.

Because many of the traditional events we have come to anticipate and value have been cancelled or modified -- vacations, professional sport, birthdays, weddings, etc -- due to the "unprecedented" pandemic restrictions, there is a sense of loss and regret experienced to varying degrees.

Wamberal beach this morning (courtesy Julie)

As a serious runner, the same feelings are experienced when through injury you cannot participate in an event for which you have been preparing for months, or longer.  It has happened throughout my running career and with greater frequency as I get older.  It can be particularly painful as the day of the event approaches and you watch the excitement and anticipation of others who will be competing, while you analyse what you could have done differently to reach the start line in good shape.

However, these running frustrations have taught me a valuable lesson.  Despite the pre-event sadness and regrets, once the race day has passed the disappointment is quickly forgotten and new goals are set and anticipated.  So it will be for all of the events and occasions we miss because of the pandemic.

Mood swings

Sunrise at Terrigal this morning (courtesy Julie)

No doubt everybody is experiencing some down days (or more) during the pandemic, and today is one of them for me.

Tuggerah Lake this morning (courtesy Julie)

The more I think about the likely time-frame for easing domestic travel restrictions announced yesterday, the more pessimistic I become about the prospects for Julie and I squeezing in our planned six-month bike ride around Australia before Christmas as hoped.  Not only was I looking forward to the trip, but its cancellation also means more months of essentially killing/wasting time before we are able to do something interesting.

Tuggerah Lake this morning (courtesy Julie)

My gloom is exacerbated by my self-imposed exercise break in the hope that my chronic hip injury repairs.  It's been less than a week, but I think common-sense requires a longer break, maybe three weeks.  I'm super-conscious of my fitness loss and weight gain, and just don't feel as healthy as I would like.  Is that sense of higher blood pressure and a mild headache imagined?

It's not just the joy of running and other exercise that I miss.  I am concerned that benefits to my overall health are being lost, and I know the road back to fitness will be hard and likely punctuated with other injuries.

Rural road on Julie's run this morning

This is all against the backdrop of the activity-limiting pandemic, and my age, which has me pondering how many years I have left during which I will be able to participate in the adventures and lifestyle I love.  Maybe I have ten more such active years, and the loss of one or two accounts for ten to twenty percent.

I don't think I'm feeling sorry for myself.  I know that I have had a fortunate life in many ways.  Instead, I think (and hope) understanding the factors affecting my mood helps me chart the best course for dealing with them.  I need to keep my three-week break from exercise in perspective (where do I want to be in two months), plan an alternative adventure for Julie and me that is feasible for an August start, and find something interesting and satisfying to do until then.