Samoa’s stunning election result: on the verge of a new ruling party for the first time in 40 years


Tamasailau Suaalii Sauni, University of Auckland and Patricia A. O’Brien, Georgetown UniversitySamoan politics is on a knife edge. After the country voted in general elections on April 9, counting so far has resulted in a dead heat between the two major parties.

This is a stunning and unexpected electoral rebuke of the ruling party, the Human Rights Protection Party (HRPP), which has dominated Samoa for four decades.

What are the results so far?

Coming into the election, HRPP held 47 of the 51 seats and Prime Minister Tuilaepa Sailele Malielegaoi predicted his party would win 42 of the 51 seats. It only won 25.

The nine-month-old opposition, Fa’atuatua i le Atua Samoa ua Tasi (FAST) party, also won 25 seats, just shy of the 26 needed to form government outright.

FAST’s leader, former Deputy Prime Minister Sa’o Faapito Fiame Naomi Mata’afa, says her party will consider a coalition deal with the winner of the 51st seat, independent Tuala Tevaga Iosefo Ponifasio.

Tuala has indicated he favours change. But Tuilaepa – a formidable and longstanding leader of 23 years — has not yet conceded defeat. Meanwhile, recounts and potential challenges to results will also slow a final outcome.

Why did we get this result?

The Samoan public was becoming increasingly dissatisfied with its government. This situation then quickly deteriorated when three controversial bills were passed last year, thanks to the government’s huge majority. These bills fundamentally altered the operations of the Lands and Titles Court, giving it additional powers over the bestowal of lands and titles within families and villages.

As Samoa-based lawyer Fiona Ey wrote last year, they also

undermine judicial independence and the rule of law, with significant implications for human rights.

In protest, Fiame – who had been Tuilaepa’s right-hand person — resigned as deputy prime minister in late 2020. In March, she joined FAST as its new leader.

Support for HRPP was also damaged by claims the government badly mishandled the 2019 measles epidemic.

On top of this, despite having no active COVID-19 cases in Samoa, the country is still under state of emergency restrictions. So there are increasing frustrations over continued border closures, which are straining the economy and preventing family reunifications.

But even with all these indications the government was out of favour, few predicted the weekend’s result.

Where did FAST come from?

Fiame’s move to FAST and appointment as leader was both politically astute and perfectly timed.

Fiame would give FAST what they needed to ultimately unseat the HRPP from its 40-year hold over Samoa’s governing systems. Her value was, and is, twofold. First, her chiefly and political lineage gives her significant domestic appeal. Second, her already established profile and experience on the world stage is invaluable should FAST become Samoa’s next ruling party.




Read more:
Devastated by disease in the past, Samoa is on high alert after recent coronavirus scares


FAST was formed in July 2020 in reaction to the three bills. It began employing savvy tactics, attracting notable candidates and carrying out extensive social media outreach.

Through social media, FAST was able to reach across Samoa and beyond, connecting particularly with the substantial Samoan communities in Aotearoa New Zealand, Australia and the United States (many of whom donated significant amounts of money and time towards its election campaign). Due to the border closures, the large numbers of eligible voters residing outside Samoa could not return, as required, to cast ballots.

FAST’s success can be attributed to the combined leadership of Fiame and deputy leader La’auli Polataivao Leuatea Schmidt and their ability to capitalise on HRPP’s clear underestimation of the national mood, both against the three bills and for appropriate access to clear and robust policy information.

HRPP, on the other hand, relied heavily on its “business as usual” approach. The party’s underestimation of both the mood – and FAST — has cost it dearly.

What does this mean?

For Samoans, the election outcome is less about launching an attack against the prime minister and HRPP, and more about making an unequivocal point about Samoa’s commitment to protecting its two core “independence institutions”. These are the Samoan aiga (family) and the Samoan rule of law.

In voting for a non-HRPP majority, Samoa’s voters have signalled loud and clear they are prepared to step up to protect their “faasinomaga”, or their Samoan values, identity and heritage.

If the post-election negotiations go FAST’s way, Fiame is poised to be Samoa’s next prime minister. Although she would be the first woman in the position, pre-colonial Samoa has a strong tradition of national female leaders.




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Traditional skills help people on the tourism-deprived Pacific Islands survive the pandemic


A transformed political landscape energised by new leadership promises renewed approaches to the many challenges facing the nation, including climate change and economic development.

Samoa has a rich history as a pioneer of political independence in the Pacific. It’s protest movements against colonial ruler Germany and New Zealand eventually led to Samoa becoming the first independent nation in the region in 1962.

With this election, Samoa resumes its place as one of the Pacific’s most innovative homes for Indigenous self-determination and democracy.The Conversation

Tamasailau Suaalii Sauni, Associate Professor in Criminology Programme, University of Auckland and Patricia A. O’Brien, Historian, Visiting Fellow in the School of History, Australian National University and Adjunct Professor in the Asian Studies Program, Georgetown University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

View from The Hill: Voters could wreak vengeance if Scott Morrison can’t get rollout back on track


Mick Tsikas/AAP

Michelle Grattan, University of CanberraLast week, people were falling over themselves to get vaccination appointments and had to be told, by their doctors and their government, to be patient.

Patience is still needed — indeed, more than ever — but now there’s rising vaccination hesitation and the message from the government is people should remain eager for the jab.

Conservative advice from the Australian Technical Advisory Group on Immunisation (ATAGI), recommending against the AstraZeneca vaccine for the under 50s (because of the very small danger of blood clots), has alarmed many people.

The danger is the advice has a knock-on effect, spooking people to whom it doesn’t apply.

Apart from younger frontline workers in health and aged care, those with underlying health conditions, and certain others, under 50s are not presently being vaccinated.

But with changing messages, some of the over 70s — the cohort now at the head of the vaccination queue — might start to have second thoughts, despite being told they shouldn’t.

They may or may not be reassured by Prime Minister Scott Morrison on Friday declaring his mother is lining up for her AstraZeneca shot soon. Or Commonwealth Chief Medical Officer Paul Kelly sharing the fact he’s urging his 86-year-old father to do so.

Thursday’s unwelcome medical advice was just the latest setback to the rollout and the Morrison government.

There have been the blocks and delays imposed on supplies from Europe and CSL production (of AstraZeneca) has been slower than anticipated.

The logistics haven’t all gone smoothly. Despite protestations to the contrary, the Commonwealth’s distribution has been sub-optimal.

Some doctors have complained of getting inadequate supplies; the arrangements for nursing homes have had glitches.

The whole program is running massively behind the original schedule. The government on Friday was celebrating passing one million doses administered, when we should have been well past four million.

We’re marching at a much slower pace than the United States or the United Kingdom. In the UK, incidentally, the authorities are being less conservative about AstraZeneca — it’s the under 30s who are being offered an alternative.

One can only imagine Morrison’s reaction when he was delivered the ATAGI advice, which of course he had to follow (even though some experts disagree with it). As he said, “You don’t get to choose the medical advice that’s provided by the medical experts”.

One guide to the prime ministerial mood is the fact he stresses it’s only advice to avoid AstraZeneca if you are under 50. The decision is up to you, and your doctor (though you will be signing a rigorous consent form if you ignore it).

But that line just contributes to the muddled messaging many people will feel they’re receiving.

With an already disorderly program thrown into further disarray by the medical advice, the government on Thursday night and Friday went into overdrive.

Another 20 million doses of the Pfizer vaccine — now the one for the under 50s — were instantly procured (this is on top of the 20 million already purchased). This is good news, if you are patient. They are not due to land until the last quarter of the year.

Health Minister Greg Hunt says Pfizer doses scheduled to arrive in coming days will ramp up, but details are sketchy.

The government is anxious to say the immediate stage of the vaccination schedule should not be much delayed.

The elderly who are being vaccinated now are good to get AstraZeneca.

As for the health and aged care workers? Determinedly looking on the bright side, Morrison noted many are over 50. Pfizer vaccines will have to be arranged for the younger ones, however, which could involve some scrambling.

But the rollout generally has to be recalibrated and delays are expected to hit in coming months when the program gets to the younger section of the general population.

For these people, vaccination is not as critical in health terms as it is for those older. But for the economy, vaccinating them as soon as can be done is vital.

At one level, Australia is being protected by our previous (and continued) success on the health front, which has left us with little or no community transmission. The rollout problems would be a disaster if we had COVID raging.

But we are riding on our luck. There are no guarantees against serious outbreaks.

Even without those, the longer the rollout drags on, the more we have the disruption of small lockdowns, and the slower the re-opening of Australia’s international border, with all the consequences that brings.

Morrison, who recently talked so confidently about everyone who was eligible and willing receiving one vaccine shot by October, now won’t commit to any date.

It would be a nightmare for him if the rollout wasn’t finished by year’s end, and the international border remained substantially shut.

He’d be only months from an election campaign, and Australians would probably be suffering a bad dose of cabin fever.

Politically, state and territory leaders have reaped rewards in elections from being seen to handle COVID well. A few months ago the pundits predicted Morrison would do the same.

But if they come to believe he has comprehensively mishandled the vaccine rollout, the voters could wreak vengeance.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Here’s why the Coalition favours optional preferential voting: it would devastate Labor


Benjamin Reilly, University of Western AustraliaCould a change be afoot in the way Australians vote in federal elections?

The Coalition government may be eyeing a shift to optional preferential voting — as used in New South Wales — which allows voters to simply vote “1” or allocate only a partial list of preferences on their ballot, instead of a full ordering of preferences for every candidate.

The proposal was included in a series of potentially revolutionary changes to our electoral system that were quietly released by a parliamentary committee in December, when few people were paying attention.

The joint standing committee on electoral matters claimed a shift to optional preferential voting would help address rising rates of “informal voting” in NSW caused by the differences between the state and federal systems. The reason: a valid vote at the state level with less than a full list of preferences would be invalid if repeated at a federal election.

What the committee did not say is that based on current voting patterns, a shift to optional preferencing could also cement the Coalition in government.

As a follow-up to a newly published study, we have modelled how recent federal elections would have changed if an optional preferential system had been used. We found the results would have been devastating for Labor.




Read more:
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Labor supported by Greens preferences

The reason the Coalition would benefit from an optional preferential voting system is simple.

In recent decades, Labor’s primary vote has slumped in federal elections, but full preferential voting has kept its two-party preferred vote high.

This is because Labor benefits from consistent preference flows from parties to the left, in particular the Greens. Approximately 80% of Greens preferences at federal elections go to the ALP at present.

A significant proportion of this preference flow is the result of Greens voters being forced to choose between Labor and the Coalition at some point – even in their final preference markings on the ballot – so their votes are valid.

Labor and the Greens oppose changing the current voting system, but the proposal from the joint standing committee reportedly has support from some Senate cross-benchers.




Read more:
With One Nation on the march, a change to compulsory voting might backfire on Labor


How Labor would have fared under optional preferences

Data collected by the ABC’s election analyst, Antony Green, at the 2015 NSW election shows the rate of Greens preferences transferring to Labor declines precipitously from 82.7% under full preferential voting to just 37.4% under optional preferential voting.

In our study, we extrapolated how past election outcomes would have been affected if this was repeated nationally. We were conscious of the challenges that come with generalising in this way, and comparing one state’s data to the country as a whole.

We found that in most seats, switching to optional preferential voting would have partisan effects that are sharply skewed to the right.

This is best illustrated by looking at the seats Labor has won in recent elections by overtaking the Coalition after trailing on first preferences. These would be the seats most affected by a shift from full to optional preferential voting.

These “come-from-behind” victories would become much rarer under optional preferential voting. By our calculations, Labor would have won somewhere between five and eight fewer seats at each recent federal election, as the graph below shows.



Author provided

This means Labor would have lost the 2010 election outright and suffered heavier defeats in the 2013, 2016 and 2019 elections if optional preferences had been in use. Labor would also have lost the byelections in 2018 and 2020.

In 2010, the fragile Labor minority government would have likely won independent Andrew Wilkie’s and The Greens’ Adam Bandt’s seats under optional preferential voting, but would have lost four others to the Liberals, including Treasurer Wayne Swan’s seat of Lilley. Labor would not have had enough seats to form government.

Labor won a total of 36 come-from-behind seats in the 2013, 2016 and 2019 elections. Our analysis suggests Labor would have won less than half (17) of these seats under optional preferencing.

Minor parties and independents would also be shut out

Our model also suggests minor parties and independents would struggle to win under optional preferential voting.

As mentioned before, Labor would have won the seats of Melbourne and Dension from Bandt and Wilkie in 2010.

And the Liberals would have triumphed over Cathy McGowan (independent), Clive Palmer (Palmer United Party) and Bob Katter (Katter’s Australian Party) in 2013; Rebekha Sharkie (Nick Xenophon Team/Centre Alliance) in 2016 and 2019; Kerryn Phelps (independent) in 2018 and Helen Haines (independent) in 2019.

Our modelling suggests Independent MP Cathy McGowan would have lost the 2019 election for the seat of Indi under optional preferential voting.
Lukas Coch/AAP

With fewer independents and minor parties, the House of Representatives would be a less diverse and colourful place, and the crossbench less politically influential.

Given this, it is striking that both Centre Alliance and One Nation will reportedly back the government in the Senate if it decides to push for a change to optional preferential voting.




Read more:
Explainer: how does preferential voting work in the House of Representatives?


Whether the government pursues reform before the next election probably comes down to the Senate numbers, given Labor and the Greens will bitterly oppose any change.

It will also depend on internal Coalition management considerations, with the National Party traditionally opposed to optional preferences, and the government’s more precarious numbers in the House since Craig Kelly’s move to the crossbench.

The government response to the joint standing committee’s report is currently being prepared by the assistant minister for electoral matters, Ben Morton, a former party secretary.

While tightly guarded, we can say with confidence that the reason advanced by the committee for the change – that it will reduce informal voting – is unlikely to feature highly in his calculations. Instead, raw political calculations must make this a highly tempting reform for the government.


Jack Stewart, a Bachelor of Philosophy (Hons) student at the University of Western Australia, compiled the data for this study.The Conversation

Benjamin Reilly, Professor, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

New AstraZeneca advice is a safer path, but it’s damaged vaccine confidence. The government must urgently restore it


Jane E Frawley, University of Technology SydneyThe federal government’s recommendation last week that the Pfizer COVID-19 vaccine is now the preferred vaccine for adults under 50 has shaken public confidence in the COVID-19 vaccine rollout.

The Australian Technical Advisory Group on Immunisation (ATAGI) advised the AstraZeneca vaccine, previously planned as Australia’s main vaccine, will no longer be the preferred vaccine for adults under 50. It came after an extensive review of data from the United Kingdom and Europe which found an association between a very rare type of blood clot and the AstraZeneca vaccine.

Public confusion has already resulted in mass cancellations of vaccine appointments at GP clinics, by adults both over and under 50.

It’s important to remember the Australian government can afford to choose a safer path because we are not in the midst of a large COVID-19 outbreak.

But a decrease in vaccine confidence may be an unintended consequence of this path.

Now, the federal government must urgently restore public confidence in the vaccine rollout. It needs to quickly reassure adults aged over 50 the AstraZeneca vaccine is safe.

It’s essential the government gets this right. Concerns about one vaccine can damage public trust in other vaccines.

Why has a safer approach decreased confidence?

Vaccine confidence can be fickle. There are many recent examples of established vaccine programs that have been undermined by unrelated events or errors. This has led to mass disease outbreak and preventable death. For example, in the Philippines, a new measles outbreak that infected 47,871 people in 2019 and killed 632, mostly children, was fuelled by a drop in measles vaccination spurred by concerns about a dengue fever vaccine.

Vaccine program resilience is an even bigger ask during a new vaccine rollout where rare effects are expected once the vaccine is given to hundreds of millions of people.

Research from the Australian National University published last week found young women are the most likely to avoid vaccination. Women who did not approve of the government’s handling of recent sexual harassment scandals were less likely to accept a COVID vaccine. This demonstrates the importance of trust, and shows a lack of trust in one area of the government’s remit can spill into other areas.

Because the risk of catching COVID-19 is currently so low in Australia, many people are feeling less interested in being vaccinated.

One Australian study, published in September last year, found fewer people were willing to accept a COVID-19 vaccine compared to a similar study done two months earlier. This decrease was evident following a decreased number of new COVID-19 cases in Australia in the time between these two studies. People can change their intention to be vaccinated when they fear the effects from the vaccine more than the disease.

On top of all of this, some members of the community are still concerned COVID-19 vaccines were developed too quickly and without appropriate checks and balances — even though this isn’t true.

Changing recommendations during a vaccine program rollout can compound these concerns.




Read more:
Less than a year to develop a COVID vaccine – here’s why you shouldn’t be alarmed


How can confidence be restored?

While the federal government was quick to accept the recommendation from ATAGI, the confusion has added to the rollout chaos. Public confidence has been damaged, and further vaccine delays are imminent across the board, including for younger health and aged-care workers.




Read more:
4 ways Australia’s COVID vaccine rollout has been bungled


Vaccine program resilience is essential to survive the bumps along the way and the government has not invested enough in understanding public sentiment and developing plain language information resources.

The challenge for public health and the federal government now is to address the understandable concerns and prevent them from contaminating the broader public dialog on COVID-19 vaccination.

With high numbers of Australians needing to be vaccinated to prevent further COVID-19 outbreaks, there’s very little room for vaccine rejection.

The government urgently needs to use clear messaging for all communities and health professionals. This includes communities with diverse cultural and language requirements

These efforts will greatly benefit from multidisciplinary teams of infectious disease, vaccine, social science and communication experts.

We need a compensation scheme

During Australia’s COVID-19 vaccine rollout, so far one man in his 40s has developed blood clots following vaccination with the AstraZeneca vaccine. There’s a 25% death rate following a vaccine-related clot according to ATAGI. Four to six clots are expected per million doses of AstraZeneca vaccine (first dose) and while this reaction is exceedingly rare, it is severe.

This also highlights the importance of a no-fault vaccine injury compensation scheme.

Such a scheme recognises that if the government promotes whole of community vaccination for collective good, then it also accepts the ethical and financial burden for the few people who will sustain a serious injury. The federal government should implement one as a matter of priority.




Read more:
Bad reactions to the COVID vaccine will be rare, but Australians deserve a proper compensation scheme


The Conversation


Jane E Frawley, NHMRC Research Fellow, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As Australia’s vaccination bungle becomes clear, Morrison’s political pain is only just beginning


Mick Tsikas/AAP

Mark Kenny, Australian National UniversityAmong many surprising things about 2020 was how a novel coronavirus drove an equally novel upending of Australia’s political orthodoxy.

The hackneyed election straightener, “it’s the economy, stupid”, got shoved aside for a refreshing new imperative, “it’s the community, stupid”. Australians unhesitatingly turned to government, embraced expertise, and willingly abided by society-wide deprivations in the interests of the whole.




Read more:
Australian vaccine rollout needs all hands on deck after the latest AstraZeneca news, mass vaccination hubs included


Reluctantly at first, centre-right politicians fell into line. Those who had built their careers on the virtues of small-government and gruff fiscal discipline, flipped to become big spending hyper-Keynesians.

Necessarily, political combat took a back seat to problem-solving. In an atmosphere of policy-not-politics, voters backed incumbent governments, marking them favourably for doing their jobs. Every election since the crisis began has returned the incumbents: in the Northern Territory, ACT, Queensland, and Western Australia. In the latter case, Labor’s Mark McGowan — arguably the country’s most aggressively parochial premier — was endorsed so strongly in March that the Liberal opposition officially ceased to exist.

Federally, Prime Minister Scott Morrison reaped the dividends of Australia’s tandem run of good management and good luck. While our closest allies, the United States and United Kingdom, descended into death and division, Australia closed its international borders early. It then compartmentalised further with the states episodically insulating their own populations and their own hospital systems.

Of course, there were mistakes. But the aggregate impact of these measures, high public trust, and the deliberately consensual mechanism of Morrison’s national cabinet has served the country well.

2021 brings new pressures

But 2021 has been a whole new ball game, and one for which a prime minister not accustomed to pressure, has proved far less equipped.

Prime Minister Scott Morrison, Health Minister Greg Hunt and health authorities at a Canberra press conference.
Prime Minister Scott Morrison and Health Minister Greg Hunt have found themselves in crisis-management mode over the vaccine rollout.
Mick Tsikas/AAP

The vaccine rollout — which remember, started stubbornly late — is in disarray. A promised four million inoculations by the end of March and completion by the end of October proved wildly unrealistic.

As of Sunday, the government says it hopes all Australians could receive at least one dose of vaccine by the end of the year. But as Morrison posted on Facebook, the government has no plans for any new targets because

it is not possible to set such targets given the many uncertainties involved.

Through the second half of last year, as it became clear there would be effective vaccines, Morrison, Health Minister Greg Hunt, and health authorities assured worried Australians the government was up to the global competition. And that Canberra was being sufficiently front-footed about procuring vaccines.

As Morrison boasted in a press statement on August 19,

Australians will be among the first in the world to receive a COVID-19 vaccine, if it proves successful, through an agreement between the Australian Government and UK-based drug company AstraZeneca.

In November, he also said,

Our strategy puts Australia at the head of the queue.

This was always unconvincing. That claimed “agreement” turned out to have been an over-egged letter of intent. Even ordinary observers could see demand from wealthy countries would be strong, and binding contracts would need to be signed quickly if Australia was to secure early adequate supplies.

It is now clear Australia’s risk-averse pandemic management — much of which was driven by premiers — has been followed by an insufficiently risk-aware vaccine contingency, controlled by the Commonwealth. And so we see another bizarre inversion: Australia being trounced by Britain and America, countries that had persistently botched their infection response.

Post-Trump America is now vaccinating three million people a day, and has gone above four million at least once. Covid-ravaged Britain is also roaring ahead. More than half of adults have had their first jab.

Textbook vaccination program?

What is not clear is why Morrison et al insisted the absence of urgency was an advantage because — combined with our judicious “portfolio” approach to multiple acquisitions — our health authorities could plan and execute a textbook public vaccination program.

Trouble is, the states have complained about a lack of genuine cooperation in the rollout, critical supply problems have been obscured, and the much vaunted broad “portfolio” approach has had its narrowness exposed.




Read more:
Blood clot risks: comparing the AstraZeneca vaccine and the contraceptive pill


Clearly, the slow and steady approach failed to build in redundancy for the wholly imaginable interruptions to supply from international competition and technical limitations in production and transporting. Then there is straight-out vaccine nationalism, as has been the cause of a blocked shipment from Italy.

Australia’s approach rather relied initially on two locally producible vaccines primarily with Pfizer (and later Novavax) as a back-up — the University of Queensland one which fell over in December, and AstraZeneca which is now “not preferred” for under 50s. While the AstraZeneca clotting risk is hardly a public health disaster — it has been compared to that of long-haul flights — it is certainly a disaster for an already fractious vaccine confidence.

Morrison now faces multiple, serious threats

Coupled with a poorly managed political crisis over the treatment of women, Morrison’s 2021 has been tin-eared. A sharp decline of public trust in government, in expertise, and in institutional competence looms as a clear and present danger for Morrison’s popularity.

Brittany Higgins walks through the crowd at the women's march in Canberra.
The prime minister has taken a hit to his approval ratings over his recent handling of gender issues.
Lukas Coch/AAP

Business-as-usual politics is already making a comeback with Labor’s Mark Butler toughening up of criticism of the rollout and calling for more transparency and a greater sense of urgency. Labor has little choice. Voters themselves see other countries are surging ahead while Australia inches along, tempting the fate of another outbreak, and delaying the economic recovery dependent on vaccination.

And that’s the next inversion we’re likely to see. Business and Coalition hardliners were outspoken last year against state border closures, lockdowns, and other restrictions, on economic grounds.

Expect to hear those voices too in coming weeks as the penny drops about a whole extra year lost to the pandemic.The Conversation

Mark Kenny, Professor, Australian Studies Institute, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A balancing act between benefits and risks: making sense of the latest vaccine news


Shutterstock

Hassan Vally, La Trobe UniversityLast night, the federal government announced substantially revised plans for the use of the AstraZeneca vaccine in Australia.

Due to concerns about the vaccine’s possible links to a rare blood-clotting disorder, and following advice from the Australian Technical Advisory Group on Immunisation (ATAGI), the Pfizer vaccine is now preferred for people under 50.

These developments raise questions about how authorities and individuals assess risk, and respond. Let’s try to make some sense of it.




Read more:
New setback for vaccine rollout, with AstraZeneca not advised for people under 50


What’s happened?

Reports about rare blood clots possibly associated with the AstraZeneca vaccine have been floating around for a few weeks now.

So why has it taken so long for the government to clarify this relationship and make the recommendations? Authorities haven’t been keeping us in the dark.

When you have a new condition like this, and experts are examining data in real time, it takes a while to understand exactly what’s going on: to develop a clear case definition, to be confident what you’re seeing is a real phenomenon, and importantly, whether it’s likely to be caused by something in particular (in this case, the vaccine). It’s made more difficult when the event is very rare.

After reviewing a wide range of data relating to cases of this rare blood-clotting syndrome predominantly in the United Kingdom and Europe, Australian experts have now reached the threshold of evidence they needed to be satisfied there may well be a causal link between the AstraZeneca vaccine and this condition.

An arm with a bandaid on the upper arm.
The Australian government now recommends the Pfizer vaccine for adults under 50, rather than the AstraZeneca one.
Shutterstock

Understanding risk

It’s important to note every therapeutic agent (a drug or a vaccine, for example) carries the risk of unintended consequences. For most of us, most of the time, this will be minimal. This is a biological reality reflecting the interconnectedness and complexity of the human body.

So like for any other therapeutic agents, there are risks as well as benefits we have to accept in taking COVID vaccines. What we need to do is to weigh up these risks against the benefits.

We make these sorts of calculations every day in all aspects of our lives. When we decide to get in the car, we know there’s a risk associated with driving. But we assess the risks are worth taking as the benefits of getting where we want to go quickly are worth it.

Mostly, we make these calculations without being consciously aware we’re doing it. Sometimes the parameters underlying these calculations are easy to grapple with — but sometimes they’re more nebulous.




Read more:
Australia’s bungled COVID vaccine rollout suffers another setback. Here’s how we can get it back on track


Weighing up the risks and benefits of the AstraZeneca vaccine

We know the vaccine offers near-complete protection against severe disease and death from COVID-19.

We also know severe side effects from the vaccine, in particular vaccine induced prothrombotic immune thrombocytopenia (VIPIT, the blood-clotting disorder in question), are extremely rare. But the condition is serious and around 25% of people have died after developing VIPIT.

There are a range of estimates of how often this syndrome occurs. But it’s generally accepted its incidence is about 4-6 cases per million doses of vaccine.

To put it in perspective, this puts the risk in the same order of magnitude to the average risk of dying if you complete a marathon, go scuba diving, or rock climbing.

It’s also important to note that we’ve started to see a pattern in that those who are at higher risk of this syndrome tend to be younger and tend to be women. We don’t have a clear understanding of why this is, but recognising this is really helpful in terms of making decisions about how to mitigate this risk.

Why the balancing act isn’t so easy

Although we have a pretty good understanding of the rate of severe outcomes from COVID-19, since we have over 12 months’ experience now of this illness, context is important. There are different levels of risk depending on where you live and what the rate of transmission in the community is.

While it’s all well and good in some countries to say you’re more likely to get very sick with or die from COVID than experience a complication from the vaccine, in Australia we have next to no COVID, so the risk of adverse outcomes from COVID is much lower. This needs to be factored into the equation.

We also have different strains of the virus, which can vary in how infectious they are and how sick they might make you. This also needs to be added to the mix.

In acknowledging the difficulty in completing these risk-benefit analyses, it’s really helpful to use a visualisation the University of Cambridge has put together based on UK data, which we’ve adapted here, comparing the risks and benefits of the AstraZeneca vaccine.



It depicts the risk of adverse effects from COVID (being in ICU) against adverse outcomes from the vaccine, based on an assumed incidence of COVID in the community of two in 10,000 people. Although the incidence rate in Australia is lower than this, this visual is extremely useful in conveying the nature of the relationship between the risks and benefits of the AstraZeneca vaccine in Australia.

What this visual shows clearly is that the benefits of the vaccine increase the older you are, because the risk of severe disease is higher the older you get.

It also shows that although the risks of side effects from the vaccine are relatively small regardless of age, the gap between risks and benefits narrows the younger you are. This is in part due to the reduced benefit of the vaccine for younger people who are less likely to have severe symptoms from COVID, and in part due to the increased risk of serious side effects, such as blood clots, for younger adults.

This visual clearly communicates the rationale for the changes announced yesterday. Where the risk-benefit becomes marginal, it makes sense to use other vaccines for younger adults — the Pfizer vaccine and possibly the Novavax vaccine down the track. The recommendations are both cautious and sensible.




Read more:
What you need to know to understand risk estimates


The Conversation


Hassan Vally, Associate Professor, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Australian vaccine rollout needs all hands on deck after the latest AstraZeneca news, mass vaccination hubs included


from www.shutterstock.com

Mark Hanly, UNSW; C Raina MacIntyre, UNSW; Ian Caterson, University of Sydney; Louisa Jorm, UNSW; Oisin Fitzgerald, UNSW, and Timothy Churches, UNSWAustralia’s vaccine rollout is due to be reset after the news last night the AstraZeneca vaccine would not be recommended for people under 50. Instead, this age group will be offered the Pfizer vaccine, with the federal government today announcing it had secured an additional 20 million doses.

Although details of the redesigned rollout have yet to be released, our new modelling, which has yet to be published in a peer-reviewed journal, shows how this might work under a range of scenarios, including the logistical requirements of different vaccines, and different vaccination venues.

Once a steady stream of locally manufactured AstraZeneca vaccine is available in Australia, the bottleneck in the vaccine rollout will shift from supply to administration. That’s when expanded GP vaccination clinics and mass vaccination hubs will be needed to deliver these jabs to nine million people over 50 in phases 1b and 2a of the rollout.




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Here’s what we did and what we found

We used mathematical simulations of waiting in line, known as stochastic queue network models, to model the process of running a vaccination clinic.

Queue models allow us to assess the daily vaccination capacity for different venues, taking into account available staff numbers and estimated times to complete each stage of the vaccination process.

The two key venues we looked at were mass vaccination hubs — which could be large venues such as halls, parks or stadiums — and GP clinics.

Mass vaccination hubs and GP clinics lay out their vaccine clinics differently. Hubs with larger premises and more staff can adopt an assembly line approach to vaccination. They can divide the tasks of registration, clinical assessment, vaccine preparation and administration across a series of stations. Smaller clinics are likely to have fewer people available, each performing multiple tasks. We developed two distinct models to reflect these different set-ups.




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We used these models to estimate how many vaccines could be delivered in an eight-hour clinic based on a range of staffing levels, within an average overall waiting time of under an hour.

We estimate a small general practice could administer 100 doses, rising to 300 doses for a large practice. Mass vaccination clinics could deliver 500-1,400 doses in the same period, depending on staff numbers.

We also used our models to test how clinics would perform under service pressures, including increased vaccine availability and staff shortages.

For both delivery modes, sites with more staff were better able to keep waiting times under control as system pressures increased. Unsurprisingly, mass vaccination hubs were more robust compared to GP clinics.




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We can test different scenarios

Our models rely on subjective assumptions about the time needed to complete different stages in the vaccination process. In reality, these timings will vary in different contexts.

For instance, the Pfizer vaccine takes longer to prepare than the AstraZeneca vaccine. Our models can account for this by increasing the expected preparation time and seeing how many extra staff would be needed to run a vaccine clinic with the same number of appointments. When the Novavax or other vaccines come on board, we can re-run the model with updated preparation times.

In fact, we have developed an an app that allows anyone to re-run our simulations based on their own assumptions about service times, appointment schedules and staffing availability.

Vaccination simulator
Anyone can use the app to plug in how vaccination might play out under different scenarios.
Author supplied/UNSW

This can support policymakers, individual GPs and community pharmacies to plan vaccination delivery, as the quantity and type of available vaccine varies throughout the rollout.

However, there are some aspects of vaccine rollout our models do not account for. This includes essential support staff, such as administrators, cleaners and marshals.

Neither do our models address the logistics of distributing vaccines to vaccination centres, which is a separate challenge.




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One isn’t ‘better’ than the other. We need both

Our models suggest mass vaccination hubs and GP clinics are equally efficient in terms of the number of doses delivered per staff member. This supports distribution through both modes, provided GPs are enabled to vaccinate at their peak capacity.

These two approaches offer distinct advantages. Older people or clinically vulnerable patients may benefit from attending their local GP, who will be familiar with their medical history.

Younger males, busy working people and marginalised populations are less likely to have a regular GP and may be easier to reach through mass vaccination hubs. The rollout of phase 2 to adults under 50 may require expansion of the hubs, as not all GPs may be able to store the Pfizer vaccine.

A diverse profile of vaccination sites, drawing on the benefits of different distribution modes, will help maximise the daily vaccination rate and vaccinate the Australian population against COVID-19 as quickly as possible.The Conversation

Mark Hanly, Research Fellow, UNSW; C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW; Ian Caterson, Medical Lead, Royal Prince Alfred Hospital COVID Vaccination Clinic, Sydney Local Health District, Boden Professor of Human Nutrition, School of Life and Environmental Sciences, University of Sydney; Louisa Jorm, Director, Centre for Big Data Research in Health, UNSW; Oisin Fitzgerald, PhD Candidate, UNSW, and Timothy Churches, Senior Research Fellow, South Western Sydney Clinical School, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Phone wet and won’t turn on? Here’s how to deal with water damage (hint: soaking it in rice won’t work)


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Ritesh Chugh, CQUniversity AustraliaIf you’ve ever gotten your phone wet in the rain, dropped it in water or spilt liquid over it, you’re not alone. One study suggests 25% of smartphone users have damaged their smartphone with water or some other kind of liquid.

Liquid penetrating a smartphone can affect the device in several ways. It could lead to:

  • blurry photos, if moisture gets trapped in the camera lens
  • muffled audio, or no audio
  • liquid droplets under the screen
  • an inability to charge
  • the rusting of internal parts, or
  • a total end to all functionality.

While new phones are advertised as “water resistant”, this doesn’t mean they are waterproof, or totally immune to water. Water resistance just implies the device can handle some exposure to water before substantial damage occurs.

Samsung Australia has long-defended itself against claims it misrepresents the water resistance of its smartphones.

In 2019, the Australian Competition and Consumer Commission (ACCC) took Samsung to Federal Court, alleging false and misleading advertisements had led customers to believe their Galaxy phones would be suitable for:

use in, or exposure to, all types of water (including, for example, oceans and swimming pools).

Samsung Australia subsequently denied warranty claims from customers for damage caused to phones by use in, or exposure to, liquid.

Similarly, last year Apple was fined €10 million (about A$15.5 million) by Italy’s antitrust authority for misleading claims about the water resistance of its phones, and for not covering liquid damage under warranty, despite these claims.

How resistant is your phone?

The water resistance of phones is rated by an “Ingress Protection” code, commonly called an IP rating. Simply, an electrical device’s IP rating refers to its effectiveness against intrusions from solids and liquids.

The rating includes two numbers. The first demonstrates protection against solids such as dust, while the second indicates resistance to liquids, specifically water.

Here are the various Ingress Protection ratings. The numbering changes based on the level of protection.
Element Materials Technology

A phone that has a rating of IP68 has a solid object protection of 6 (full protection from dust, dirt and sand) and a liquid protection of 8 (protected from immersion in water to a depth of more than one metre).

Although, for the latter, manufacturers are responsible for defining the exact depth and time.

The popular iPhone 12 and Samsung Galaxy S21 phones both have a rating of IP68. However, regarding exposure to water, the iPhone 12 has a permissible immersion depth of a maximum of 6m for 30 minutes, whereas the Galaxy 21’s immersion limit is up to 1.5m, also for 30 minutes.

While IP ratings indicate the water-repellent nature of phones, taking most phones for a swim will land you in deep trouble. The salt content in oceans and swimming pools can corrode your device and cost you a hefty replacement.

Moreover, phone manufacturers carry out their IP testing in fresh water and Apple recommends devices not be submerged in liquids of any kind.

Luckily, water resistant phones are generally able to survive smaller liquid volumes, such as from a glass tipping over.




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Checking for liquid damage

Exposure to water is something manufacturers have in mind when designing phones. Most Apple and Samsung phones come with a liquid contact/damage indicator strip located inside the SIM card tray.

This is used to check for liquid damage that may be causing a device to malfunction. An indicator strip that comes in contact with liquid loses its usual colour and becomes discoloured and smudgy.

Samsung and Apple phones have Liquid Contact/Damage Indicators.
Samsung/Apple

A discoloured strip usually renders your phone ineligible for a standard manufacturer warranty.

If you have any of the more recent smartphones from Apple or Samsung, then your device will be able to detect liquid or moisture in its charging port and will warn you with an alert. This notification only goes away once the port is dry.

New generation Samsung and Apple phones have a moisture/liquid alert notification.
Samsung/Apple

But what should you do if this dreadful pop-up presents itself?

Fixing a water-logged phone

Firstly, do not put your phone in a container of rice. It’s a myth that rice helps in drying out your phone. Instead, follow these steps:

  1. Turn off the device immediately and don’t press any buttons.
  2. If your phone is water resistant and you’ve spilt or submerged it in a liquid other than water, both Apple and Samsung recommend rinsing it off by submerging it in still tap water (but not under a running tap, which could cause damage).
  3. Wipe the phone dry with paper towels or a soft cloth.
  4. Gently shake the device to remove water from the charging ports,
    but avoid vigorous shaking as this could further spread the liquid inside.
  5. Remove the SIM card.
  6. Use a compressed aerosol air duster to blow the water out if you have one. Avoid using a hot blow dryer as the heat can wreck the rubber seals and damage the screen.
  7. Dry out the phone (and especially the ports) in front of a fan.
  8. Leave your phone in an airtight container full of silica gel packets (those small packets you get inside new shoes and bags), or another drying agent. These help absorb the moisture.
  9. Do not charge the phone until you are certain it’s dry. Charging a device with liquid still inside it, or in the ports, can cause further damage. Apple suggests waiting at least five hours once a phone appears dry before charging it (or until the alert disappears).

If the above steps don’t help and you’re still stuck with a seemingly dead device, don’t try opening the phone yourself. You’re better off taking it to a professional.




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The Conversation


Ritesh Chugh, Senior Lecturer – Information Systems and Analysis, CQUniversity Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.