|Kia ora from Aotearoa New Zealand!
Feel free to scroll down for the promotions, or read my thoughts below.
It's another beautiful chilly winter's morning here in Auckland. If I stand on our couch and look across our neighbour's roof, I can see the vibrant orange sun rising above the blue waters of the Waitemata and our dormant volcano Rangitoto.
It's currently about 5 degrees Celsius. I love the cold: it's refreshing. It reminds me I'm alive. To me, the power and beauty of nature points beyond our human struggles to God.
This is the season of my 48th birthday. Life has been wonderfully busy with my girls going to their first ball, and my daughter auditioning for our biggest annual concert 'Christmas in the Park'. The audition in its own right was an amazing experience, like being transported into a different world, as though we were entering into 'NZ Idol', or 'NZ's Got Talent'.
What do I want for my birthday? My nation back. I've shared in previous emails about how the events of the last 1.5 years have felt like a tsunami sweeping over my land, not in the physical effects of COVID, which were minimal in New Zealand, but in the profound sociological and political effects. I felt swept out to sea, by a wave of ideology I did not agree with: the lifting of COVID avoidance above all other considerations in our land. One lady replied to my email letting me know of the US reopening, and how she was now able to see her grandchildren for the first time in a year. That really struck me: how is it we felt it was okay for the state to determine whether or not we could see our families? Her reality only accentuated my own sense of culture shock and the overriding of my beliefs in the foundational importance of personal freedom and choice: it struck me all the more deeply how far state control had gone, and how strange it was that our NZ public simply accepted it.
Two years ago I saw New Zealand as free and independent. That perception, over the last 1.5 years, was swept away.
In the management of COVID, my grounding as a doctor in medical ethics was also swept away. I had been raised in an era of focus on patient autonomy: the right of the patient to be informed of options, and to make their own decision, for or against. The right of a patient to decline management is foundational to my formation as a doctor. We doctors must not force our opinions or our management choices on our patients. In the past this would have resulted in professional discipline. Now? In March 2020 a few at the top decided for all 5 million NZers that we should lock down. Projections of worst case scenarios were broadcast to the public, to ensure compliance. Other potential scenarios were known, but not used, so as not to muddy the messaging, to ensure co-operation. Our Director-General of Health communicated to the public that the failure of Elimination was 'unthinkable'. Fear was the medium in which our nation was managed. The UK have acknowledged and apologised to their public for using fear to ensure compliance in lockdowns. Our leaders did the same thing, but I see no apology forthcoming.
1.5 years later our leaders are still making decisions for all 5 million NZers, without consultation. These leaders believe their role is to get NZ vaccinated, rather than to offer the vaccination with balanced information, in order that NZers decide for themselves. In a way, the vaccination, and normal medical ethics, is a nice metaphor for how a democracy should actually work in general: where a new foundational situation arises, inform the public, offer a referendum, let each citizen vote, and then change policy around the choice of the people. What has happened with COVID? One party has ruled. The professional flyers have only presented one view. It's a metaphorical fixed election. The people believe they are free, but in truth they were never given a choice. In our setting this has wider implications, too, because we had a literal election result that came out of the management of COVID. The people were led to fear, were led to be dependent on our leader, and then, a few months later, they voted for that same leader.
This is known as 'Paternalism' in ethics, where the doctor decides for the patient what's best for the patient, like a father choosing for a child. The patient is expected to follow the advice. If there are questions, they are only intended to facilitate compliance. Paternalism is designed for Dependence, and Patient Autonomy is designed for Independence.
In any population there are dependent people and independent people. But what is a Democracy intended for? What is Communism intended for? What is Capitalism intended for?
In NZ we are usually Centrist, balancing the dual realities of the need to provide for genuine dependence at the same time as facilitating independent freedom and productivity. But now we seem to have shifted vigorously left. The lockdown, in a sense, was an experience of enforced communism: a few elite at the top made the decisions, individual freedom was sacrificed for the perceived good of the population, and the state gave everyone in the new enforced dependence the same rescue wage. No wonder I felt culture shock: this was not my home.
Weirdly, these dynamics are all in my A New Kind of Zeal trilogy...the left moving more left, the sense of an overseas threat coming here, a leader controlling and gaining power through fear...I had believed my nation was independent. Now my people have been trained, in COVID Management, to be dependent.
In truth, if I had been in my 80's and COVID had entered into our society, I would have chosen freedom over self-preservation. I would not have chosen for my nation to shut down to protect me, for the education of our children and youth to be interrupted, for many thousands of businesses to be compromised, nor to be locked away from my society in my house. I would have taken calculated risks to see the people who are important to me, and continued to live. I would have upheld our free way of life and the nature of our Centrist balanced society above my own personal protection.
Ironically, as a doctor still at working age I now find myself on the opposite side of this equation of risk management. I have a contraindication to the vaccine: a medical condition that potentially could be made worse by the vaccine. It seems clear my government, in seeking to protect the public from COVID, will eventually make the vaccine mandatory for all public facing work, even after all at risk people have already been offered the vaccine. The thinking is altruistic but seems wrong to me, both logically and ethically, yet our society is not allowing a debate.
In a way, I think our approach to COVID management is a bit like the Titanic: we are being guided by thinking that doesn't actually apply to this current situation. The skipper on the Titanic had a false sense of security in the speed he chose through glaciers, because he believed he could move the ship out of the way readily enough. He had no experience with a vessel the size of the Titanic, and so, when the glacier was seen, he could not move the ship out of the way as quickly as he had believed.
So far as I can see, the concept of Herd Immunity is of limited relevance with COVID if immunity doesn't stop transmission. And the goal of seeking to protect or vaccinate an entire population seems questionable when we already largely know who would benefit from vaccination and who would not. Across the world it is the high risk who are the clinical priority, and for anyone vaccination ought to be a matter of choice.
A society is safer where there is the capacity for debate. In New Zealand, there is no public debate within the politics or the medical profession around COVID Management. The issue to my mind is not that the virus is novel, but that our management strategies, our societal shifts and our politics have become novel, or new. It's A New Kind of Zeal: a new kind of New Zealand.
I bought myself a couple of gifts for my birthday, as I do. I bought a paua shell, reflecting the innate and immense natural beauty of this land, which, like God, existed before Maori, British and all arrived. And I bought a plaque with the map of my home, with the names Aotearoa New Zealand, lit from behind.
A tsunami took my land, and I was swept out to sea. But it's time to swim back to the shore. It's time to take my stand on the coast, and find a way to offer what I believe for the sake of my people.
Well, those are my thoughts for today. Feel free to write back to me and let me know your thoughts, whether they are similar or different from my own. I'd love to hear from you.
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Until next time,
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