Australia to Face an Honest Inquiry

On 19 October, the Australian Senate agreed to hold an inquiry under the auspices of its Legal and Constitutional Affairs Committee into proper terms of reference for a Covid Royal Commission to be established in 2024. An impressive alliance of groups sceptical of the Australian federal and state governments’ Covid pandemic management policies joined forces to develop such terms of reference and submitted its paper by the deadline of 12 January.

A team from the collaborating groups presented oral evidence to the committee in Canberra on 1 February. While the team responded to many questions from the attending senators on the day, other questions asking for additional details and information were taken on notice and various individuals were asked to respond as appropriate by the deadline set by the committee. I was then tasked with writing an introduction to the whole 756-page package that was submitted on 1 March. What follows is the text in its entirety (pp. 13–16).

Introduction

Pandemics are relatively rare occurrences in history. Looking back at a little over the last one hundred years, the world has experienced only five pandemics: the Spanish flu of 1918–19, the Asian flu of 1957–58, the Hong Kong flu of 1968–69, Swine flu 2009–10, and Covid-19 in 2020–23.

Over that same period, advances in medical knowledge and technology have greatly expanded the toolkits of prevention, treatment, and palliative care, using both pharmaceutical and non-pharmaceutical interventions; and there have been major advances also in medical education, training, and research.

Alongside these developments, countries learnt from one another and cooperated to build national and international public health infrastructure to promote people’s health around the world. This has been especially relevant and critical for infectious diseases since, by definition, people everywhere are potentially vulnerable to the outbreaks of such diseases anywhere.

Combining the three trends, many countries drew up pandemic preparedness plans that drew on the century’s worth of science, data, and experience to map and institutionalise best practice contingency plans for the outbreak of pandemics as low-probability but high-impact ‘black swan’ events. The World Health Organisation (WHO) published its own report as recently as September 2019 that summarised the ‘state of the art’ policy advice for governments on health interventions to deal with pandemics.

The world therefore should have been well-prepared for Covid-19 in 2020. Instead, some key and influential governments reacted with great panic that itself proved both highly contagious and harmful to health and society. Liberal democratic systems had delivered the greatest combination of gains in freedoms, prosperity, living standards, health and longevity, and education in human history. Good decision-making processes and structures had ensured good policy development and implementation to deliver all-round good outcomes.

The herd panic of early 2020 led to an abandonment of good process, an abandonment of carefully prepared pandemic preparedness plans, and a centralisation of decision-making in a narrow circle of heads of government, ministers, and health experts. Whether it amounted to a worldwide coup against liberal democracy, or represented a hysterical mix of ignorance, incompetence and/or malfeasance, what is beyond dispute is that the 2020–22/23 years were among the most disruptive in many countries, including Australia. The health, mental health, social, educational, and economic consequences continue to be felt and will continue to impact public life for many years into the future.

Did Australia’s Covid-19 policy interventions represent the greatest triumph of public policy, with an unprecedented high number of lives saved as a result of timely, decisive, and appropriate measures instituted by governments acting on the science- and evidence-based advice of experts? Or will they prove to be the biggest public policy disaster of all time?

These are big questions. The answers to them need and demand an independent, impartial, and rigorous inquiry helmed by credible people with the appropriate mix of qualifications, experience, expertise, and integrity, who are not tainted with conflicts of interest.

Eight Sets of Issues to be Examined

The origins of the virus are beyond the terms of a national Australian inquiry.

Instead, the first set of questions should examine why the existing pandemic preparedness plans and medical decision-making practices were abandoned. The science did not change. In the very brief timeframe between when the WHO and national pandemic preparedness plans were written and adopted, and when the recommended guidelines were thrown out and extreme interventions of society-wide shutdowns were ordered, the data and empirical evidence behind the radical departure from established understandings would have been limited in volume, of low quality and reliability, and derived largely from one city, Wuhan, in one country.

Second, what methodologies were used by Australian experts and authorities to perform key measurements in relation to the pandemic, and how do these compare to other advanced Western democracies? For example, the PCR tests were widely used to check for Covid infection. Yet, the test suffers from two major problems. It can be run continually until it detects a virus.

However, the tests are only useful for finding an active virus run up to 28 cycle threshold (CT) counts. Any higher and positive results were known to be fragments of inactive virus. Different jurisdictions used different and much higher thresholds as cut-off points, up to 42 CTs, resulting in millions being deemed actively infected, when in truth this was not the case. In addition, the PCR regime is apparently plagued with false positives and negatives and requires careful analysis to come to reliable conclusions. Were Australian State and Federal testing protocols uniform, and did they prove accurate and reliable?

The methodology used to ascribe Covid as a or the cause of death also varied enormously between different jurisdictions around the world. These included inconsistencies or irregularities in recording deaths as Covid-caused if people had tested positive either at any time before their death, or within 28 days of dying; recording the deaths of people who were not up to date with the current recommended vaccine dosage, or had received only the first dose, as unvaccinated; categorising all who died within 28 days of a vaccine as unvaccinated; giving financial compensation to hospitals and states for each death recorded as a Covid death, etc.

All of these badly distorted the distinctions between dying with and from Covid and confounded the key Covid metrics on hospitalisation, ICU admissions, and deaths by vaccination status. So, too, did the under-acknowledgement and under-registration of serious adverse events, including fatalities, related to vaccines. Until these facts, as they apply to Australia, are authoritatively and credibly elucidated by a duly empowered independent inquiry, public trust in health experts and institutions is unlikely to be restored to pre-pandemic levels.

Third, what data was used to estimate the infection and case fatality rates (IFR, CFR) of Covid-19? It rapidly became clear that the risk gradient for severe cases that would require ICU admissions and could cause death of otherwise healthy people, was extremely age-segregated. Why then were the interventions not designed to align with the age-dependent risk profiles?

It also became quickly clear that the spread and severity of Covid-19 was highly regionalised around the world and that, unsurprisingly, it was also seasonal. And third, the accumulating evidence from around the world suggested that highly-credentialled experts who questioned the frighteningly high levels of IFR and CFR behind the most alarmist models were closer to the truth than the catastrophists.

Some of these modellers had a track record of predictions of infectious diseases that should have induced extreme caution in adopting their recommended interventions. Even the modelling from the Doherty Institute that triggered Australia’s lockdown overestimated the hospitalisation, ICU, and death numbers by several orders of magnitude.

On all these considerations, did Australian experts and authorities undertake urgent seroprevalence surveys to estimate more reliably the numbers who had already been infected, and the Australian IFR and CFR?

A fourth set of questions should probe why long-established guidelines to evaluate competing demands, in particular the quality adjusted life years (QALY) and cost-benefit analyses of the different policy interventions, including the risks of side-effects and collateral harms, were not undertaken. Of course, if the public perception is wrong and they were undertaken, then it would be helpful to establish this.

A fifth set should examine the lack of treatment in the period between being infected, and severe illness requiring in-patient hospital and ICU care. In particular, why did Australian authorities not undertake high-quality randomised control trials of repurposed drugs, with well-established safety profiles?

A sixth set should ask for the science, data, (including quality and reliability) and decision-making behind mask and vaccine mandates, especially in the context, once again, of the steep age gradient of people at risk of severe and fatal infection among otherwise healthy people. In granting emergency use authorisation, did the Australian regulator(s) require local trials to establish safety and efficacy? If not, why not? Did they undertake their own analyses of the trial results presented by the vaccine manufacturers?

The seventh set of issues that needs authoritative public examination is the relationship between the professional regulatory bodies and clinical practitioners of medicine. The doctor-patient relationship in Western societies has long been governed by four important principles: (i) the sanctity of the doctor-patient relationship; (ii) first, do no harm or, alternatively, avoid doing more harm than good; (iii) informed consent; and (iv) prioritising the health outcomes of the patient over that of any collective group.

All four principles would appear to have been gravely compromised when it came to Covid. Moreover, it is counterintuitive to believe that distant colleges and bureaucrats operating remote controls were in a better position than the doctor to assess the best interests of the patient.

Finally, of course, we need an authoritative answer to the most critically important question of all: on balance, did the totality of Australian pharmaceutical and non-pharmaceutical interventions to manage Covid-19 as a public health challenge do more good than harm? What lessons must be drawn for courses of action that are recommended and not recommended? What principles, procedures, structures, and institutional safeguards must be put in place to ensure optimal health and public policy outcomes in future pandemic outbreaks?

Conclusion

The following comprehensive submission sets out terms of reference for a Royal Commission that could help to answer these big questions on just what was done, by whom, why, and with what consequences. The Australian people deserve these answers. The Parliament of Australia, representing the will of the people, owes it to them to establish a Royal Commission to inquire into and establish the truth of the Covid-19 years. A properly constituted and conducted commission will begin the process of healing and help to restore trust in the major institutions of public life. Anything less will be an abdication of responsibility.