Locking down NSW: Go harder Gladys. Now.

Here's a question.

What do folk seeking a diagnosis and treatment plan from certain medical specialists have in common with those living under lockdown in parts of Sydney and are acting socially irresponsibly?

More than you'd think.

And I should know, having recently emptied my wallet seeking advice for an illness from a specialist in a leading Sydney hospital for a sleeping disorder, only to be blithely offered a prescription for a benzodiazepine (Tamazepam). Rejecting that offer, as the drug can become addictive, I was then recommended a tricyclic antidepressant (Amitriptyline), which I was told in low doses would lead to some shut eye.

The above two drugs were prescribed after some cursory questioning and without a formal inquiry into my sleep architecture, let alone investigating why I sleep very poorly. That is, how long does it take me to get to sleep and how long do I stay asleep? Why do I awake no less than half a dozen times at night? Eschewing the physician's suggestion that I take either drug daily for a month and only then if I still have a sleeping problem would he consideran investigation to get to the root of the disorder, I decided to find a less lazy physician who, if opposed to my request for a diagnostic sleep study, would at least review my clinical history thoroughly in addition to my current symptoms and then pony up robust, verifiable and defensible reasons why he's/she's decided to deny me the sleep study.

In the event, I found another sleep physician, who agreed that an inquiry was warranted and arranged a sleep study at Sydney's very fine Royal North Shore Hospital. The study confirmed my suspicions: I sleep for 4 hrs a night and am up 8 times a night. Why, is the question.

The first physician's assessment of my illness was, frankly, a non assessment. It was a lazy, cut and paste job in prescribing one drug and then another which may resolve my symptoms. No different in application to the generic clampdown imposed on say, SW Sydney. A clampdown similar to that which was earlier shoehorned on the burghers of the Northern Beaches, but with wildly different results.

Both the first physician (and Team Gladys) did not ask the right questions: what is the unique history of the patient (and community) which if known, may well yield a different diagnosis and require an alternative treatment plan? In the case of "heavily" locked down SW Sydney, the virulent Delta strain coexists with the lowest vaccination rates in Australia's biggest city: 14.6% (fully)and 33.1 (first dose). Why, is the question.

Ideally bureaucrats will ponder what it is about the demography of SW Sydney that is responsible for the appallingly low vaccination rates. Compare that with say Sydney's very Anglo Northern Beaches citizenry whose vaccination rates are 20.9% (fully) and 47.7% (first dose). Is the gulf between Sydney's NE and SW communities:

Cultural?

Religious?

The contrasting attitudes to government and/or to those enforcing the law?

Or is it something else?

Whatever it is, let's hope the well-meaning bureaucracy finds the explanation, fast and crafts a means to address it. Pray that political correctness doesn't impede their fact finding mission. After all, lockdown provisions that worked well amongst books stores and fresh food retailers in Warringah Mall have failed to work their magic amongst kebab stallsin Canterbury-Bankstown. Why, is the question.

Sky News Australia on Saturday reported that the nation's Chief Medical Officer, Prof Paul Kelly called for a "circuit breaker"to snap the back of the Delta variant in NSW. Team Gladys (in cooperation with the Feds) could, early this week, follow Kelly's advice and flick the switch to "tough" by sharpening the health orders and compliance requirements in the hot zones as follows:

1. Limit the movement of people to no more than 1 km from their home;

2. As supermarkets have been proven to be venues of social gathering (and very likely super spreaders) it's time to shutter Coles and Woolworths. Don't worry. These folks will still be able to order groceries online;

3. Stop penalising only those that breach health orders, by issuing fines. Don't flag custodial sentences as some in the media have suggested. Instead, target their whole extended family. In their hip pockets. After all, they are all in it together, mixing illegally in large numbers, preventing the rest of us getting back to normalcy. For those who behave in a socially unacceptable manner, such as not being tested or if tested positive, not self-isolating as required, then all welfare payments to all extended family members must be stopped. For those who choose not to be inoculated, the rest of us can choose to stop their welfare payments, because their free choices have unintended consequences: they impact on the rest of us;

4. Give employers the legislative tools to require their staff and customers to be vaccinated, as not doing so endangers others. This should go well beyond say the private sector, for instance, allowing Bunnings and Virgin Australia to decide if their staff and customers must be vaccinated. This must include public authorities such as the bureaucracy, public hospitals, Sydney Buses, Trains and Ferries as well as ServiceNSW shopfronts, to name a few; and

5. Allow any person/company that hires a tradesman/tradesmen to be able to lawfully insist that only the vaccinated can attend.

A fortnight or so of such carrots and sticks in the hot zones should knock sense into the heads of those whose reckless, boorish and selfish behaviour gives the rest of Sydney the impression that those communities are operating a state within a state.

If after a couple of weeks it's clear that certain communities will continue to thumb their snouts at the concept of mutual obligation to the rest of us, then Gladys and the Feds have only one course of action: turn off the taps to the trough.

Their state within a state will need to find other suckers to fund it.