‘Let’s get real’ about how badly Pfizer and AstraZeneca’s rollout has been stuffed up

Crikey readers have much to say about how COVID-19, the vaccine rollout (or lack of) and their privacy has affected them over the past 18 or so months of the pandemic. And “omnishambles” has become the word du jour.

Vaccine omnishambles

Victor Ayers writes: Omnishambles would be putting it mildly, but as usual the government does what it does best: put spin on it and pass the buck to anyone it can think of. It seems not to take any responsibility for its actions. If it was in the private sector, it would have been removed ages ago.

Lee de Percy: As reasonably informed as many people aged between 50 and 60, I reluctantly got my first AstraZeneca shot because it’s the right thing to do. Seconds later the advice changed and Pfizer is now recommend for my age group. Blah blah blah. So I made as informed a decision as I could and, regardless of the advice, I decided to jump the AstraZeneca ship and go with Pfizer. To ensure that was possible (given the complete lack of any clear and consistent advice from leaders) I contacted the COVID hotline which confirmed I could do so. Not being a trusting soul I sought and got confirmation in writing from said hotline. So confirmation in hand I confidently booked my Pfizer shot. When I turned up for my appointment at the Pfizer clinic not only did it not have a record of my first vaccination but I was booted out when I said I had had one AstraZeneca shot. Neither the ACT nor federal health minister’s offices could give me any advice on what I needed to do. What a complete debacle.

Merrill Witt writes: Regardless of whether the government gives indemnity to GPs who administer the AstraZeneca vaccine to people under 60, surely doctors have an ethical responsibility to follow the advice of both the AMA and ATAGI, which says Pfizer is the preferred vaccine for this age group? Was Mitchell Squire GP joking when he said: “And since it is the responsibility of individuals to arrange their own vaccine, most GPs will understand that a person under 60 showing up for AZ is reasonably informed. Add an individualised discussion, establish informed consent and we can proceed with the vaccination.” Really? How can you say someone is reasonably informed when the GP is recommending an approach that is contrary to the advice of the medical experts? At least the premiers are showing good sense in reminding people to follow the medical advice. Let’s hope the GPs do too.

Donald Alan Kay writes: Thanks for your article but I am really frustrated that no one is putting the AZ risk into context. Saying it is rare is not very meaningful. Most people can’t grapple with the reality of any number bigger than 100. It is not that they are thick — it’s just outside their normal experience. I am an engineer — numbers are my life (although I have no medical, demographic or statistical qualifications).

It occurred to me that the chance of dying from AZ is about one in 1 million people treated (TTS one in 30,000, TTS fatality one in 30 = one in 900,000). Australia’s road death toll for 2019 was 1200 and for a population of 25 million that is a one-in-20,000 risk of dying from a car crash each person a year. AZ is 1/50th of that level. Not many people stop using their car because it is dangerous.

Let’s get real. Not having access to Pfizer is a stuff-up of immense proportions only because of the complexity of selling AZ — not because of its safety or efficacy. The selling of AZ is more botched than the Pfizer purchasing.

On police using COVID check-in data

Ross Anderson writes: Yes, I think the police should be granted access to COVID check-in data but only if they have just cause and a warrant. More specifically, there needs to be a suspect in a serious crime — a name they are legitimately looking for as identified on the lawfully obtained warrant. All other unrelated names on the specific check-in data need to be obscured. I would assume this process would be subject to the same rigour as a lawful intercept of user voice or data communications since both are an invasion on an otherwise innocent party(s) privacy.

Steve Blume writes: QR codes use are mandatory to enter premises. As long as there is a warrant — preferably with the “in extenuating circumstances” requirement — I am not sure why anyone would be concerned. How many people would not use the QR codes because the police could use a warrant to check them? Do we not realise that the phone reading the code has both cell tower triangulation and, mostly, GPS data? The QR code data simply makes the premise’s identification easier, valuable for urgent contact tracing, but using existing location data and data matching with other parties of interest already makes tracking possible.

Bob Pearce writes: I have no problem with the police using the check-in data if they have a valid warrant. They have CCTV all over the place checking on our movements without court approval.

David Harris writes: Should police have access to data from COVID check-ins? If such data could legitimately be used in a criminal prosecution, to deny access could amount to allowing guilty people to go free. This is a high a price to pay for privacy. The degree of trust which a community can have in its police force — to be confident it will behave honourably — goes back to the police minister. If the police, from chief commissioner down, know that dishonourable behaviour will not be tolerated by the minister, it will be less likely to happen. The minister will also put into place methods for finding and trapping this behaviour. But if the minister, or others, are seen as being open to misuse of such data, public trust will vanish. The only alternative then is to ban its use by police. Given the low level of public confidence in most politicians, especially those in Canberra, a ban seems the only option.

On the role of private health insurance

Dr Peter Sumich writes: I was really encouraged to see your article which promotes the discussion about the role of private health insurance. Yes, we need more debate. The “send the eagle home” campaign was both a warning and a call to debate private health insurance openly and in an informed manner.

The level of ignorance among our politicians is extraordinary. I know this because I have talked to dozens of them over the years about private health insurance and their understanding is minimal. So many decisions are made behind closed corporate doors by financially incentivised executives and stockbroker advisers. We were not going to let that happen this time with the nib/Cigna joint venture.

The central tenet of our protest is that doctors should not be contracted to health insurers in a manner which allows an insurer to control, manipulate or direct a doctor’s clinical decision-making. Such contracts are invariably opaque to patients who usually want decisions to evolve from the consent between an unencumbered doctor and themselves. The primary concern of the health insurers is cost-minimisation which ends up with corner-cutting and eventually restrictions on patient choice and the control of their clinical journey. We don’t have to imagine this because it happened in the US.

We keep seeing claims that that could not happen in Australia because of the health legislation. Well, it can — and tricky coercive contracting by health insurers is the way through the legal loopholes. The nib/Cigna joint venture is a concrete step in the direction of US managed care by its use of secret contracts, including clinical management protocols. I am quite sure the initial iteration of these contracts will be relatively vague, but over time they have been shown to become stricter, more binding and more directive of clinical management as they gain market strength.

Please keep debating this. If we do sleepwalk into US managed care it would be better that people at least understood what they were getting into rather than never having been warned.