Minds & Hearts, June 2020

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Issue 09 | June 2020

COVID-19 ISSUE

How Fulbright Scholars are joining the global effort

Public Health | Epidemiology | Healthcare & Ethics | Combatting Disinformation


The Fulbright Program The Fulbright Program is the flagship foreign exchange scholarship program of the United States of America, aimed at increasing binational collaboration, cultural understanding, and the exchange of ideas. Born in the aftermath of WWII, the program was established by Senator J. William Fulbright in 1946 with the ethos of turning ‘swords into ploughshares’, whereby credits from the sale of surplus U.S. war materials were used to fund academic exchanges between host countries and the U.S. Since its establishment, the Fulbright Program has grown to become the largest educational exchange program in the world, operating in over 160 countries. In its seventy-year history, more than 370,000 students, academics, and professionals have received Fulbright Scholarships to study, teach, or conduct research, and promote bilateral collaboration and cultural empathy. Since its inception in Australia in 1949, Fulbright has awarded over 5,000 scholarships, creating a vibrant, dynamic, and interconnected network of Alumni.

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Our future is not in the stars but in our own minds and hearts. Creative leadership and liberal education, which in fact go together, are the first requirements for a hopeful future for humankind.

Fostering these—leadership, learning, and empathy between cultures—was and remains the purpose of the international scholarship program that I was privileged to sponsor in the U.S. Senate over forty years ago. " Senator J. William Fulbright The Price of Empire


Contents

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"This Could Change Very Quickly.."

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A Primary Care Physician at the Heart of COVID-19

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Developing an App-Based Home Flu Test

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Stay Calm & Banish Fear: A Doctor’s First Day Treating COVID-19 Patients

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Transitioning to Telehealth

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Seeing Beyond Disability/My Vision for Ability Equality

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They Might Be a Liar, but They’re My Liar

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Healthcare Ethics During a Pandemic

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Evacuation Order

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Global Citizenship Amid and After COVID-19

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How Should Organisations Respond to Complex Challenges?

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Higher Education in a Post-COVID-19 World

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The Dangers of Disinfo

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FULBRIGHT SCHOLARS IN ACTION COVID-19

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The COVID-19 pandemic caused dramatic disruption to organisations across the globe, and the Fulbright Program was no exception. Australian and American Scholars alike were advised to return home as soon as possible if it was safe to do so, or shelter in place if it was not. This caused many programs to be suspended or cut short. Some Scholars found their research thrown into new trajectories, as they joined the global efforts to understand and fight this new viral threat. These are their stories.


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THIS COULD CHANGE VERY QUICKLY BY

SARA JAMES

Cheung, who earned a Master’s in Public Health and a Bachelor of Science in Molecular Biology from Yale University, had recently landed a job helping Australia battle the virus that curtailed her scholarship. “I decided that when I looked back in 20 years, I’d be glad I delayed going to medical school for a year in order to fight this deadly pandemic.” Cheung arrived in Australia in July, 2019 to commence her Fulbright at the University of Melbourne working in veterinary epidemiology. “When you have diseases transmitted from animals to humans, you want veterinarians and doctors to work together. I wanted to spend this year dabbling in the animal side to get a perspective of what the challenges are.” Cheung was especially intrigued by statistical models. “I wanted to study how effective diagnostic tests are for brand new diseases. That turned out to be pretty timely.”

When news broke in December of a new corona virus in Wuhan, China, Cheung says the alarm bells started ringing. “Back then, there were only animal-to-human cases reported. But I knew from my work that this could change quickly.” When the danger of the fast-moving new virus became clear in late January, Cheung decided it was time to put her academic skills into practice. “I approached my Fulbright supervisor at the University of Melbourne and asked if he knew of anyone working on Covid-19.” By February 10th, she was invited to take up a role with the Department of Health for the State of Victoria. “I work on the epidemiology and surveillance team nestled under the intelligence team. I contribute to data management and data analysis of all the cases in Victoria.” An essential worker, Cheung arrives at the office in Melbourne’s Central Business District at five in the morning. “We observe social distance and we work in shifts.”

Cheung says she not only draws on her Fulbright experience, but on what she learned during an internship with the World Health Organisation in 2018. Again, her timing was uncanny. Two weeks after Cheung arrived in Geneva to intern with WHO’s Viral Haemorrhagic Fevers Team, there was a deadly Ebola virus outbreak in the Democratic Republic of the Congo. “The Fevers Team deployed immediately. Bam. I was the only one left in my unit. Let’s just say I got to do a lot more than a typical intern.” Cheung says she’s grateful for the chance to help Australia, and the world, battle this international health emergency. “Our tasks are different every day. It’s fascinating. We all work together. And no one ever asks about my American accent.” Sara James is on the Board of Fulbright Australia. An Emmy award-winning journalist, she is also the author of An American in Oz and co-author of The Best of Friends.

ALLISON CHEUNG, Fulbright Future Scholar (Veterinary Epidemiology/Yale University)

When the COVID-19 pandemic resulted in the suspension of the Fulbright U.S. Scholar Program, 23-year-old Fulbrighter Allison Cheung was among a handful of Scholars who chose to remain overseas as private citizens.

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A PRIMARY CARE PHYSICIAN AT THE HEART OF COVID-19 BY DR

PALLAVI PRATHIVADI, 2020 Fulbright Future Scholar (Medicine/Monash University)

I had planned to move to Stanford in the first week of June as a Fulbright Scholar. April and May 2020 were meant to be full of goodbye parties, comparing shipping rates, and packing up my life in Melbourne to spend a year undertaking my PhD with a terrific team at the Stanford School of Medicine. Instead, I have postponed my trip, and written an Advanced Care Plan for myself if I end up critically unwell with coronavirus.

I am preparing for surge workforce and being called in to help at the local hospital. I’ve stopped hugging my family and I am back wearing scrubs to reduce the risk of carrying contaminated clothes into my house. For my 31st birthday last week, my friend Sarah, an anaesthetics registrar, gave me a brand-new reusable P95 respirator with filters. Was there ever a time I thought a gift like that would have moved me to tears? No. I have worked in the same clinic for 3 years now; it’s small and wonderful. I know all of the families of the staff and often immunise their kids. 6

We have four nurses; Brooke is in her third trimester of pregnancy with a toddler at home and is still working. Winnie is a breastfeeding mother, intermittently expressing between patients and is still working. Cindy got married last weekend and is still working (no honeymoon).

Emily is trying to manage the schoolwork of her two kids while they are at home and is still working. All of our doctors, nurses and receptionists have chosen to keep working as normal during the pandemic, knowingly placing themselves at risk.

"It’s been reported that 10% of COVID-19 positive people in Victoria are healthcare workers. But we are not simply statistics. We are also people with families and lives..." It’s been reported that 10% of covid-19 positive people in Victoria (where I live) are healthcare workers- but we are not simply statistics. We are also people with families and lives, and without adequate personal protective equipment (PPE) and with increasing rates of covid-19, the wonderful nurses you have just read about are at risk.

You might have followed the backlash on social media when this point is sometimes made about a healthcare worker; that we are choosing to place ourselves at risk. That no-one is forcing us to see patients. That is true, but do you honestly expect most doctors and nurses will bail during a pandemic and deny care to patients? We are here to help. And in return we are all begging help from you; conserve PPE for those who need it most and stay home. We are trying to move to telehealth to reduce face-to-face contact with patients. I never learnt about telehealth in medical school. I am learning it now, as a consultant specialist GP in metropolitan Melbourne. Our rural colleagues have far more experience and are providing the world with very useful advice. I’m sorry we needed a pandemic to widely embrace telehealth; video and telephone consultations with doctors help thousands more patients access healthcare in a timely manner.


The difficulty I am experiencing is when I have finished taking a history, and I need to examine the patient. Easy in real life; hard via telehealth. Many people have blood pressure machines and thermometers at home and can provide their own vital signs to me over the phone. None of my patients yet have had oximeters at home, so I haven’t been able to get an oxygen saturation level. We try to manage as best as we can. Sore throat? Can you try and look in the mirror and tell me if you see pus on your tonsils? Red swollen knee? Can you copy the movements I am doing so I can see your knee’s range of movement over the screen? Here’s where it gets harder; the baby that the firsttime mum thinks has been ‘feeling hot’ but has been swaddled in several layers because it is cold and raining outside. OK, parents don’t have a thermometer at home. I can’t tell if the baby has a fever or not. If there is a fever, is it 37.8 degrees and low grade, or is it closer to 41 degrees? What about this one: preteen has abdominal pain. OK. Parents not fluent in English but they sound worried. He’s quiet and not particularly chatty — is he just shy or is this unusual behaviour for him? How do I organise a telephone interpreter, and how can this patient be examined?

It’s easier with an obviously unwell person (send them to an emergency department). Someone with epidemiological and clinical criteria warranting covid-19 testing- also straightforward (send them to a testing centre). The 20-year-old woman with epilepsy whom I have been looking after for years and know very well - I can do this appointment via telephone no problem and fax these scripts to the pharmacy. In our medical training, our teachers tell us that 70-80% of the diagnosis can be made from the history alone and encourage us to develop superb history-taking skills.

I think we generally do pretty well, and we can sort out most problems using telehealth, but not being able to examine patients is hard. What do I do about the kids in the aforementioned situation?

The 25-year-old woman for whom I was supposed to insert an Implanon contraceptive device — what do I do now? Can I trust you’ve been staying at home and have minimal coronavirus exposure for us to bring you into the clinic for your procedure? What if our inadequate PPE means you come in healthy, and then we unwittingly pass on coronavirus to you while we are still asymptomatic? Do we do what’s safer for everyone and postpone, although that may place you at risk of unintended pregnancy? How long do we postpone immunisations, breast cancer screening, diabetes risk assessment, check of iron levels post iron transfusion, or review of a suspicious skin lesion? For how long do we put off all of these ‘non-urgent’ bread-and-butter general practice issues? For how many months do we prioritise urgent care and put preventative health on the backburner? We are short on PPE and may need to conserve it for the coming weeks if disaster strikes. So, can I justify using our very limited PPE to perform a ‘non-urgent’ cervical screening test? Should I not be saving my precious N95 respirator filters if the nightmare scenario happens and I am called in to help run a coronavirus ward at the hospital? So many questions.

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For how long do we put off all of these ‘non-urgent’ bread-and-butter GP issues?"

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It must be frustrating for you to read this article — I have not neatly provided solutions for each problem that I point out. I have offered no happy updates on what happened to the patients above, just described their uncertain clinical scenarios. We are all figuring this out as we go. Our clinic is debriefing every night to review how we performed that day. Perhaps we need to make changes to our clinic protocols for tomorrow. Perhaps a doctor has developed a mild runny nose that evening - she now has to self-isolate and be tested for coronavirus - and we will have to scramble to cover her patient lists for the next 4-5 days at least.

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Here’s what’s been happening with examinations: if we are worried during the telehealth consultation, we’ve been asking patients to come in face-to-face so we can properly look in their mouth, feel their abdomen or listen to their chest. We wear gloves, scrubs and a surgical mask, and use a single examination room (which our nurses will thoroughly clean after each use). We hope (we desperately hope) the patient is not in the incubation phase of coronavirus and placing everyone at risk. We are trying to get into the mindset of ‘assume everybody has coronavirus’ and take the appropriate measures to protect ourselves and other patients.

If we can avoid seeing you, we will. But if we’re worried and we need to examine you, or you need face-toface care, we will place ourselves at risk to do what is needed. I am not an epidemiologist and I have never worked in public health. I know very little about covid-19 prediction models or virology. My PhD is about opioid prescribing in general practice. I am just a GP, but like most of my medical colleagues, I can see that this pandemic is going to need all-hands-on-deck and so I am choosing to stay and help. I guess we’ll see what happens.


DEVELOPING AN APP-BASED HOME FLU TEST BY

SARA JAMES Chilver’s work in influenza and infectious disease surveillance systems led to a 2020 Fulbright Scholarship.

“I wake up in the morning reading COVID news from around the world and go to sleep reading publications on PubMed.”

But her upcoming project at the University of Washington in Seattle was put on a hold when a new corona virus became Public Enemy Number One.

Chilver is an Australian expert in flu pandemics and infectious diseases. Over the last decade, she’s studied respiratory viruses that go global, including the H1N1 Swine Flu pandemic of 2009.

She planned to work on a project developing an appbased home test for the flu.

Chilver’s job is to stalk what the ever-irreverent Aussies have nicknamed “The ‘Rona.” To bring the deadly virus to heel, successful surveillance is paramount.

The data that Chilver and her team collect goes to top state and federal health authorities and to the World Health Organisation. While COVID-19 has put Chilver’s Fulbright plans on hold, the virus hasn’t ended her collaboration with the University of Washington. “We speak every week. We’re collaborating on a Point-of-Care test -- a way for physicians to diagnose the flu, or COVID-19, more quickly -- that we’ve been developing in the form of an app known as Flu@Home” Chilver admits life is busy. “Although my job revolves around planning for a pandemic, I never imagined the virus would blow out this way. I’ve been working 60 hours a week.”

“Flu Surveillance aims to test community transmission of COVID-19 -- cases that aren’t linked to overseas travel or a known case.”

Like other parents, she must juggle her job with helping her daughter tackle school online. Then there’s the health crisis with the family betta fish. “I think that it is certainly a case of the fish tank imitating life, as the fish started dying off in January. Not to mention the fact that the isolated fish have been completely unharmed! Social distancing works in many settings.”

MONIQUE CHILVER, Fulbright Future Scholar (Molecular Biology/University of Adelaide)

The COVID-19 pandemic means medical researcher Monique Chilver now works from home. But the efforts of this Fulbrighter at the University of Adelaide could help all of us get back to business—and life as usual—sooner.

But Monique Chilver has no complaints. “I love what I do. And I find time for walks with my partner and daughter. "I remember the silver linings.”

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A Doctor’s First Day Treating COVID-19 Patients

A mother’s heart harbours, in equal measure, dread and love. 10

“Can’t you take sick leave?” mine suggests before realising the answer for herself. I have just shown her a text message from a colleague. “The Covid round is arduous, take good care.” In the now forgotten past when we knew so little, I had agreed to join the Covid-19 roster. Now, with a global toll of 200,000, that casual offer has turned consequential.

In preparation, I talk to my friend with Covid skills, a new category born just weeks ago. Slow down. Don and doff PPE (personal protective equipment) with great care. Carry your stethoscope in a kidney dish. Don’t touch your face. But it’s his last exhortation that strikes me. Remember that our patients are scared. Spend time with them and calm their fears. The irony of how to reconcile the sage advice with the natural instinct to get in and out of a room as quickly as possible doesn’t escape me.

The night before the round, I memorise the PPE process, as if watching the video from three countries will make me thrice as safe. In the morning, I shed my wedding ring, find old clothes and head off quietly before the children wake up. No point in creating unnecessary drama. The roads are deserted but the handover room in the hospital is bustling as the night and morning teams meticulously go through each admission.

DR RANJANA SRIVASTAVA, Fulbright Future Scholar (Public Health/Monash University)

STAY CALM AND BANISH FEAR:


A ward of “suspects” await swab results. Patients, young and old, have arrived with many symptoms. The community rate of carriage is as yet unclear and the tests aren’t perfect, which means that some patients must be retested. One only has to cast an eye on the global havoc to appreciate that Australia has been guided into a very fortunate position, but no one thinks it’s time to relax. Consequently, every suspected patient must be considered positive and no clinician will let complacency trump caution.

(So? Isn’t that how ward rounds work?) In the unequal world of medicine that aspires to lose its hierarchy but often comes up short, I realise that my seniority has bestowed upon me a privilege with life-anddeath implications. Institutions around the world are trying to navigate the tricky balance of who is exposed to patients and how often, although in inundated places there is little choice. “I’ll go in,” I say. “I need to know the patients.” Shoulders relax.

“Good luck,” everyone says to the Covid team, an acknowledgement of our increased risk.

“Would you like someone to scribe inside the room?”

On the ward I am greeted by six doctors, three of them interns caught in this maelstrom within a month of starting their career. I feel for them.

“Would you mind being watched as you don and doff?”

Why did I think the first decision of the day would be where to begin the round? “The consultant decides who goes in,” a trainee says. When I was still seeing cancer patients in clinic, I was shielded by everyone who understood the importance of keeping me safe to keep my patients safe. Now, that need has abated as outpatients have moved to telehealth. Suddenly, I recall my colleague’s words that had meant nothing at the time. “Just to let you know, I’ve been going in every time.”

“No, that’s unnecessary.”

Appreciating the care it takes to say this to one’s boss, I reply: “I’d really appreciate that.” The PPE feels foreign and being alone in every room is strange but once inside the pattern is the same.

An elderly man bursts into tears at his negative status. He only had a few years to live, anyway, he cries as his emotional nurse celebrates the end of his isolation. Other patients don’t speak English, can’t hear the interpreter and can’t operate a smartphone. For now, universal gestures for discomfort, breathlessness or nausea must do.

A young woman is clammy and feverish. Her relief crashes when I say that her negative test doesn’t yet reassure me.

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Take a good history, examine the patient, provide counsel. Don’t interrupt unnecessarily. Say urgent things calmly. Make eye contact even if it’s from behind plastic. A young woman is clammy and feverish. Her relief crashes when I say that her negative test doesn’t yet reassure me.

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Through the glass panel, one trainee has eyes set on me. The doffing is stressful because it’s when the wearer faces the highest risk of exposure. I remind myself to slow down and banish awful stories from my head. One cannot be a calm and methodical doctor without making some sort of peace with the knowledge that one or more patients could be infectious. It would be unproductive and frankly indulgent to view every minute spent seeing patients as self-sacrifice. Resentful doctors can’t be effective doctors. On the other hand, to be loose with words or ignore the very real consequences of sloppy hygiene or lax protection would be unconscionable. I work my way through these new learnings, pausing outside between patients to dictate notes and still trying to find teaching moments, which mostly have to do with the importance of empathy. When everyone is on edge, we really are in it together.

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Late in the afternoon I reach the final patient and the stakes truly rise because he is a confirmed patient who was not expected to live. My colleague had emphasised the emotional flux of such patients who prepared to die but find themselves alive, not sure whether to feel guilty or glad. He is pacing the room, looking dejected. But his numbers look so good that I feel a stirring of happiness. “Would you like to go home today?” He stops short in his track. No matter how little English they possess, no patient has ever been confused by “home”. “For real?” he stammers. “Yes.” He starts crying, not having dared to imagine leaving alive. I’ve removed my gown when he reaches out to hug me. I leap back, surprised by my own agility but also embarrassed to treat him as untouchable.

Embarrassed, he retracts. On the spur of the moment, I extend my gloved hand because anything less feels churlish. He says what every patient does. Thank you for saving my life. I think what every doctor does. Actually, I did nothing; your body held up. The rounds done, the team debriefs, remembering everyone working in far graver circumstances. I exit through a staff entrance and take in the queue of anxious visitors waiting to get in for the hour they’re permitted. At least I am heading home, I think. At least my kids won’t have to wave at me from behind glass as I drive past. People were sick and scared but at least no one died on my watch, I think gratefully, scarcely able to imagine what it would be like to move from one dying patient to the next and the next. And not for the first time, I feel incredibly lucky to work in a universal healthcare system that has again shown its very best side. We should never stop holding it accountable but hopefully this experience will provide answers for sceptics and be the impetus to acknowledge every individual, especially those outside the limelight, who make the Australian healthcare system the jewel that it is.

Ranjana Srivastava is an Australian oncologist, award-winning author, Guardian columnist, and Fulbright Scholar. Her latest book is called A Better Death. This article originally appeared in The Guardian.


Transitioning to Telehealth |

BY

SARA JAMES

“We haven’t run out of ICU beds – yet,” Dr Mehrotra tells me. Dr Mehrotra works non-stop. First, there’s his job as a hospitalist – a physician who treats patients in the hospital. These days, virtually all of his patients suffer from Covid. He agonises over the need to get in and out of a “hot” room quickly to minimise the risk of catching the deadly virus. “I really feel for patients who are struggling physically but also emotionally because they’re so isolated,” Dr Mehrotra tells me. He describes the fear as “palpable.” Some improve, he notes with relief. Others, “old and young,” are dying. Even as more patients arrive in what seems an endless flow. Massachusetts ranks third in the US for Covid-19 cases and fourth in fatalities, according to local news reports. On May 3, the state’s department of health reports more than 68,000 confirmed Covid cases and more than 4000 deaths. Among those whose lives were cut short by the deadly virus are a 31-year-old man who loved Karaoke, a veteran police officer, and the older brother of former Democratic presidential contender, Senator Elizabeth Warren. Massachusetts Governor Charlie Baker has mandated face masks in public places where social distancing is impossible as of May 6. “This is going to be a way of life.” This need to create a new way of life in the wake of Covid is an international imperative. It also explains why Dr Mehrotra is such a busy man. He has two vital jobs. Dr Mehrotra is also Associate Professor Mehrotra, a specialist in health care policy at Harvard Medical School. His research is front-and-centre when it comes to responding to the pandemic. “My speciality is telemedicine.” Dr Mehrotra had just begun a Fulbright Scholarship at the University of Queensland in Australia to further his telemedicine studies when the pandemic struck. He and his family rushed back to Boston and he parachuted back into hospital work, but his vital research continues.

“This virus has created a paradox,” he says, and I watch the doctor morph into the research scientist. While COVID-19 has overwhelmed hospitals, he explains, it’s also emptied many doctors’ offices. “We have roughly a million doctors’ appointments a year in the United States,” Dr Mehrotra explains. “That dropped by 60%” in a few weeks. This drop in visits translates into many patients not getting the care they need and therefore putting their health at risk. It puts some health care providers in financial peril. “If we lose those providers, the access problems that we had before are only going to get worse.”

DR ATEEV MEHROTRA, Fulbright Future Scholar (Telehealth/Harvard Medical School)

Dr Ateev Mehrotra is on the front lines of the global Covid-19 pandemic. I reach him by Zoom in the basement of his family home, fresh from Beth Israel Deaconess Medical Center in Boston. I note the shadows beneath his eyes.

Enter telemedicine. “Something that would take a decade to happen occurred in the span of a few weeks,” Dr Mehrotra notes. His research indicates 30% of doctors’ appointments now happen remotely – just like our interview. But Dr Mehrotra says more research is vital, since this trend has happened so swiftly, much of his previous research is outdated. Still, two things are clear. Telemedicine has arrived as a welcome, crucial tool. And some visits must take place the old-fashioned way. As he reminds me to keep up “with your doctor,” I watch the scientist transform back into the physician. As of May 7, Boston has started to see the tide turn, and COVID-19 diagnoses decline for the first time. Dr Mehrotra hopes this trend will continue.

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Seeing Beyond Disability Dr Paul Harpur’s Fulbright Future Scholarship originally aimed to critically examine how universal design systems are made to ensure that the most silent and vulnerable persons with disabilities are not excluded from this transformational reform agenda. His project involved primary research on disability and technology, with plans to enhance links with overseas disability research centers, including the Harvard Law School Project on Disability and the Burton Blatt Institute at Syracuse University. Yet face-to-face interviews, workshops and conferences became a sudden and abrupt impossibility with the social distancing caused by the COVID-19 pandemic that hit in full force two weeks into his three month project.

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The pandemic meant his method was impossible, but despite the setbacks, Paul still found a way to not only keep the project alive, but broaden its scope to include the impact that public health crises have on society’s most vulnerable. “In my wildest dreams I would not have wanted to live through a pandemic, but what an opportunity to gather data on how society reacts to ability diversity when the institutions and rules in society fall apart.”

Paul rapidly pivoted his plans to analyse how the pandemic was impacting upon people with a disability, and he immediately sought ethics clearance for a new project: Academics with disabilities during COVID-19. He reorganised meetings to source feedback from experts working in medical and data ethics at Harvard University, including the Harvard Law School Project on Disability, the Petrie-Flom Center, and the Berkman Klein Center, resulting in significant new connections and new publishing opportunities.


Across March and April, with the pandemic rapidly escalating in severity, Paul still forged ahead with meetings, workshops, and symposia making use of technology where social distancing prevented face-to-face meetings. His findings have resulted in research papers, articles, and even a speaking spot in an upcoming TEDx talk. In the midst of all this, he was nominated for, and won, an Australian Award for University Teaching through Universities Australia, for his work leading ability equality in the university sector and promoting universal design on campus. But it wasn’t easy – Paul faced a number of challenges as a sightimpaired individual alone in a foreign country. The Harvard Law School Project on Disability had arranged exceptional supports, and when they fell apart with COVID-19, went above and beyond expectations in offering alternative assistance. It turns out that support was needed. Paul had left his guide dog back in Australia and was navigating using only a white cane.

He had worked out certain locations to source food and supplies, only to have the doors on several shops close when social distancing rules hit. Bus services and taxis became harder to source as services became suspended. When libraries shut their doors and most student and staff started working from home, it was unfortunately time for Paul to head home to Australia. “My time at Harvard began with a splash – my hosts at the Harvard Law School Project on Disability had organised a fantastic workshop, jointfunded with the Harvard Committee on Australian Studies. Through this I was able to actually meet with the people tasked with drafting the new University-wide Digital Accessibility Policy. “The policy aims to make information and resources more easily available to those who need it at Harvard, and while I believe the rules still need to be broader in scope, their commitment to improving information access should be applauded.”

Now back home, Paul plans to maintain the links he forged during his time in Boston, and follow up on at least five new projects that have stemmed from his Fulbright research. Despite the dire circumstances that brought him home early, Paul’s thoughts on it all is refreshing and circumspect. “Those of us who were privileged to be abroad in the first half of 2020 had the most unique of all experiences -- we are the only Fulbright cohort to have lived through a global pandemic. COVID-19 cut our projects short and caused us anguish, but it also bought us closer to our fellow Fulbrighters, those who we were visiting and provided new opportunities. “This is a moment in time that washed away society’s veneer and laid stark prejudice, challenges and love.” Paul’s vision for ability equality is closer than ever to being realised, thanks to his resilience in the face of overwhelming challenge; a hallmark of his approach to life thus far.

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My Vision for Ability Equalit y | My Past Vision When I lost my eyesight in a train accident at the age of 14, I realized you do not need sight to have vision. As a Paralympian and internationally competitive athlete I learned about creating a vivid vision. To create my vision, I first imagined what I wanted to achieve in the next 2 to 4 years. I did not imagine the outcome of standing on the podium, but instead the process that got me to the medals:

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What would I eat on the day of the race and do before the race?What would the starting gun and crowd sound like?

What would it feel like when I was coming home in front?

How would it feel to have the adrenalin pumping through my system?

How would I pound my feet at the end of my burning legs?

How would I manage the moment to ensure I kept focused?

I imagined this experience in detail every day. Every time I trained, I imagined the sound, smell, taste and feel. I was there in that moment daily. I shared this vision with my family friends and supporters. For me it was a reality. Then when the finals came in the 400m in the 2003 world titles I made this vision a reality. I ran the race and won silver. I ran the race of my dreams in the 2006 Commonwealth Games and achieved a career best performance. This approach has successfully translated to my academic career and can also be translated to my vision to improve society.

BY

DR PAUL HARPUR

My vision is for a world where it is not us and them but just us. There will always be a need for disability specific interventions, but Ability Equality will only be achieved when there is strategic commitment to designing in everyone in society, regardless of their abilities or disabilities. My vision is to align the frameworks that guide society with the new disability human rights paradigm swept in by the Convention on the Rights of Persons with Disabilities. These frameworks can be designed by a single organization, across an industry, by local or national law makers, or situated in the international law arena. This might seem impossible, but remember, impossible is only a few characters from possible. My vision for Ability Equality in Universities As an academic and leader in Ability Equality I see universities as one powerful means of driving broader change. Universities train the leaders of tomorrow, provide the leaders of today employment and are uniquely positioned to produce high quality critical, operational, transformational and regulatory research to support a vision of ability equality. In five years, we could be in a place where universities are welcoming of everyone. I like to illustrate my vision for Ability Equality by telling the story of five friends. A story that has not happened yet, but in five years could and should.


Five friends across the lifespan: the test for ability equality Five students arrive for their first day of university. They all enter the campus office to collect their student cards, they all are assigned rooms, they collect their keys and cheer as they move into the university dorms. These five students become friends and find they are all in the same course. They head off to social functions during orientation week and plan to go to the first lecture together. At the first lecture the professor speaks of resources and course outlines and group work.

The five friends work together, get all the resources at the same pace, can access the individualised supports they require to realize their potential and after the first week of classes go to a dinner and wine bar on campus. The fact one of the friends is blind, one is a leg amputee, one is in a wheelchair, one has autism and one is able-bodied, is irrelevant. The university has embraced the United Nations Convention on the Rights of Persons with Disabilities and its paradigm shifting model and has implemented systems to enable full ability equality.

Ability equality means every student has an equal opportunity to succeed. Obstacles that disable people with impairments are actively sort out by operational and leadership teams and removed. Some students and staff will have additional support, targeted advocacy and leadership training, but most importantly the system ensures that people can be judged upon their commitment and merits and not upon their disabilities. Before the five friends commence, people with expertise have assessed the barriers, removed them, tailored programs to provide the support required by all students, regardless of their individual needs. All students have mentors in the academy and professions with the same disability as them and can see university leaders across the sector who have a disability. They can see their diversity counts, as it is counted in university and national statistics and inclusivity is mainstreamed through university life. They can see they have equal opportunities to become academics, professional staff members or leaders of universities. Imagining how these five friends experience university life can be applied across their life experiences: to their careers, their experiences using public transport, accessing a library and its resources, using health care, finding a home or getting married and having children.

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My role in this vision I have a vision, but I also vividly imagine how this might apply to me. While this has not occurred yet, I believe it will. In 2019 I was privileged to be nominated and be awarded a citation as part of the Outstanding Contributions to Student Learning, as part of the Australian Award for University Teaching program. The citation, for "outstanding leadership in translating disability strategy into a vision of Ability Equality and core university business”, was awarded just prior to my 2020 Fulbright Future Scholarship, where I had the honour of spending time working with other experts at the Harvard Law School. I am building upon these successes and I can imagine a future where my vision has become a reality.

I can imagine how the press release would read following the launch of the “Universities Australia Disability Inclusion Group” and the appointment of Professor Paul Harpur as its first chair in 2025. This press release would explain that the Universities Australia Disability Inclusion Group, formed and supported under Universities Australia’s Disability Action Plan, is fully funded by partners and competitive grants.It would outline the Group's aim to provide strategic advice and high-level guidance to Australian Universities and their governing bodies, relevant associated organisations and state/territory-based networks committed to realizing Ability Equality across the sector. Further, it would detail more broadly how the Group's goal was to improve the representation of people with a disability, both academic and professional, throughout universities, including at executive levels of university leadership and governance.

This group would: •

Perform and support research to develop theoretical and practical resources to realize Ability Equality in the higher education sector.

Sponsor/commission targeted investigations around strategies to address systemic barriers to advancement of persons with a disability through university ranks to executive level in the Australian university sector.

Actively promote and support university-led initiatives to enhance the representation of persons with a disability across the higher education sector, including in executive leadership roles.

Provide evidence-based briefings to relevant high-level groups such as Government, the Chancellors, Vice-Chancellors, Deputy Vice-Chancellors and other senior university stakeholders.

On request, provide advice and guidance to universities and their governing bodies, associated organisations and state/territory-based networks on initiatives they have planned or are implementing to assist the development of persons with a disability.

Help collect, collate and share information and good practice relevant to international and sector-wide strategic responses to Ability Equality in universities.

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When we say “yes” to ability equality, we enable everyone in our community to innovate, inspire and lead. - Dr Paul Harpur, Fulbright Scholar, University of Queensland


They Might Be a Liar, but They’re My Liar BY

SARA JAMES

Briony Swire-Thomson is a clinical psychologist whose field of research is so new, she’s helping to write the map. “You’re completely in the wild west.”

But misinformation seems to spread as quickly as the virus. Social media giant Facebook reported that during the month of April, it placed warning labels on some 50 million pieces of misleading content.

Swire-Thomson studies “fake news” – how it spreads, and why we find it so enticing. The associate research scientist at Northeastern University’s Network Science Institute says its vital to help people separate “fact” from “fake” when it comes to the COVID-19 pandemic and the 2020 US election.

Why do we fall for it? Swire-Thomson says one reason we’re susceptible is that we humans, like nature, hate a vacuum.

“One of the biggest differences between political disinformation and health [disinformation] is that the risk to people’s livelihoods and mortality is very real… we are only beginning to understand the ramifications.”

Swire-Thomson, who studied political misinformation as a Fulbright Scholar at MIT, says an astonishing 80% of misinformation can be traced back to 0.1% of people.

As the COVID-19 pandemic spread, governments have warned against ingesting bleach and dismissed as piffle a conspiracy theory that links the Coronavirus to 5G, including on Twitter:

“People are notoriously bad at understanding, ‘well we just don’t know yet….’ A lot of mis- and disinformation has rushed in to fill that void.”

“We call them Cyborgs,” she notes. This fake news ricochets around the internet, gaining traction and credibility, because we share it with our friends. The good news? When confronted with proof that they’d shared misinformation, Swire-Thomson says people will accept a correction, especially if the correction is kind. “People updated their belief remarkably well.” But there’s a catch. “What we found was that didn’t change people’s voting intentions. People would acknowledge that these politicians were saying inaccurate statements but voting intentions would stay absolutely stable.” She notes that this is true across the political spectrum. Which might explain why Swire-Thomson’s 2019 article in Political Psychology about the 2016 US presidential election had the provocative title, They Might Be a Liar, but They’re My Liar.

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Healthcare Ethics During a Pandemic Xavier Symons is a Lecturer in the Institute for Ethics and Society at the University of Notre Dame Australia. He will be completing his 2020 Fulbright Future Postdoctoral Scholarship at the Kennedy Institute for Ethics (KIE), Georgetown University. He recently completed a PhD on the ethics of healthcare resource allocation.

DR XAVIER SYMONS, Fulbright Future Scholar (Healthcare Ethics/University of Notre Dame)

How has COVID-19 affected your day-today life?

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The COVID-19 pandemic has led to some fairly radical changes in my life. Last month I had to self-isolate for two weeks after returning from a trip to Oxford, and, like most people, I’m now working from home. I work for a research institute at the University of Notre Dame, and we’ve had to completely readjust our 2020 calendar. As part of my work, I organise regular seminars on ethics in social and professional life. Most of our upcoming events, however, have been postponed or cancelled. There’s even a possibility that I may have to delay the start date of my residency at the KIE. I’m slowly adjusting to several hours a day of teleconferences, and getting used to instant coffee rather than heading to my favorite cafes. But perhaps there’s a silver lining to the solitude of the current situation. I’m an ethicist with a background in moral philosophy. And many of the great philosophers wrote their best work while on retreat in the countryside or in front of the fireplace at home. Who knows, maybe the next few months may be more productive than I’m anticipating.

What are some of the ethical challenges that decision-makers could face in the coming months? Culturally-speaking, how does Australia typically respond to these challenges? Ethics is always relevant to life, even when it’s business as usual. But ethical reflection is particularly important during a crisis such as the current COVID-19 pandemic. One issue that I’ve written about recently is the ethics of healthcare resource allocation during a pandemic. ICU physicians in countries like Italy, France, the UK and the US are being forced to ration precious resources like ventilators as their wards are overwhelmed by critically ill coronavirus patients. These rationing decisions raise a number of complex ethical questions. For example: Is it permissible to ration health care on the basis of age? How can we obtain maximal benefit from healthcare resources while not discriminating against people with disabilities? And should people with important social and political roles (such as healthcare workers and politicians) receive priority access to scarce resources? Rather than having to face these agonising ethical questions, Australian authorities have sought to “flatten the curve” through aggressive social distancing measures. Current modelling suggests that this strategy is working. Culturally, I think that Australia’s response to the pandemic reflects a sense of solidarity with society’s most vulnerable. State and Federal Governments have made minimising loss of life their primary priority. I think this is a laudable approach, and one that gives due importance to the value of each human life. It’s also important to note that the risk of burnout for clinicians is heightened in a time of crisis, and so healthcare professionals must be given adequate time off during the coming months. Patients are put at risk when they are being treated by a clinician who is on the verge of a breakdown. In this sense, burnout and fatigue become ethical issues.


In your recent ABC interview, you spoke about the ethical issues surrounding critical healthcare rationing during public health crises, and concerns over a fundamental shift in how emergency medicine deciaiona are made following the end of this pandemic. Can you briefly explain your concerns? The area of resource allocation ethics has come into sharp focus in the current crisis. New guidance for the COVID-19 pandemic was recently published by the Australian and New Zealand Intensive Care Society and the Australasian College for Emergency Medicine. These documents, however, are fairly general, and leave scope for individual ED and ICU departments to decide how they will assess and triage patients. Fortunately, new government modelling suggests that we may not face the surge in hospital admissions that was originally expected. Like many ethicists, I think we need to take a balanced approach to resource allocation. I don’t want to be alarmist, but I do think there’s a risk in adopting an avowedly utilitarian approach to healthcare rationing. Guidelines recently published by the Italian Society for Anesthesia, Analgesia, Resuscitation and Intensive Care, for example, focus not just on the possibility that someone will survive the coronavirus, but also on someone’s overall life expectancy. Yet an approach like this will be to the disadvantage of persons with a lifelimiting disability, as well as older persons. We should, therefore, be cautious about including long-term life expectancy as criterion for rationing in our official guidelines.

Some governments have said that they may extend the current COVID-19 lockdown for several months until a vaccine is available. Other health analysts have suggested an alternative herd immunity strategy which would allow for an easing of social distancing measures, albeit with much higher rates of infection. What do you think of these competing strategies? Several commentators have published articles recently arguing for implementation of a herd immunity strategy for managing the coronavirus. Herd immunity is a term usually used in the context of child vaccination for diseases like measles. When a sufficient number of children have been vaccinated for a disease, this provides a degree of protection for those persons who are unable to be vaccinated. In the context of the coronavirus, some people have argued that governments should ease social distancing measures and allow the virus to spread in the community, while ensuring that those who are most vulnerable (such as older people and people with disabilities) remain isolated. It’s stimulating to read different perspectives on the aggressive social distancing measures that governments are enforcing around Australia. But in the end, I fear that a herd immunity strategy would have disastrous consequences. Epidemiologists estimate that approximately 60% of the Australian population would need to contract the virus before we achieve herd immunity. This would include massive rates of hospitalisation and also a very high death rate. Despite the economic benefits that may come with easing the social distancing measures, and I’m not sure this is a wise approach all things considered.

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EVACUATION ORDER |

Dr Sue VandeWoude, 2020 Fulbright Future Scholar

I had been in Hobart, Tasmania, off Australia’s southern coast, for nearly two months on my first, and almost certainly my last, sabbatical. I had seen wombats, echidna, kookaburra, regularly heard the calls of forest ravens and cockatoos, and had visited a handful of local brewing establishments. And, yes, I had also been at work. This included taking baby steps in learning statistical computing and graphics (R programming) and a set of mathematical modeling principles (structural equation modeling). Along the way I had become a fan of Sewall Wright, a population geneticist who had famously studied guinea pigs, and I had created a twocolor correlation graph with actual data that I had proudly shared with my adult children. The goal of my sabbatical was to use these tools to understand a novel process by which a cat’s immune system could resist infection with feline immunodeficiency virus, or FIV. I hoped my findings would not only lead to new treatment options for cats with this disease, but, by analogy, guide novel ways to modify infections caused by the human disease correlate, HIV. This One Health project – linking animal disease to its human analogue – could push my laboratory studies in a new direction.

But on March 12, I received an unexpected notification from the U.S. Department of State advising “all current U.S. Fulbright participants to make arrangements to depart their country of assignment as soon as possible.” Despite the growing pandemic pandemonium I had watched unfolding in news reports, it had not dawned on me that I might need to truncate my visit to the University of Tasmania, Australia, more than a month early. At that point, the small island state had very few confirmed cases of COVID-19 compared to countries coping with mounting catastrophe.

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Sue VandeWoude learned about Tasmanian ecology and history. Scenes included, clockwise from top left: Churchill Avenue Overpass, University of Tasmania; Mersey River, near the town of Mole Creek, on ancestral lands of the Aboriginal people; Forester kangaroos on Maria Island; the mouth of River Derwent near Taroona; a mother wombat and joey on Maria Island; sea eagles at Arthur River; and Point Puer, site of a former British boys prison at Port Arthur. At right, VandeWoude is pictured near the campus of Colorado State University in Fort Collins, Colorado. Photo by Mary Neiberg


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Flora and fauna were untouched by the spasm gripping the human world, and this added surreal features to the circumstances.

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I had been poised to travel the next week to the University of Queensland and University of Sydney to visit veterinary colleagues working in the field of viral spillover and infectious disease. I was looking forward to meeting with Edward Holmes, a virologist at the scientific center of the growing pandemic, who for years has predicted events that could lead to a global disease outbreak. I was intending to ask Dr. Holmes about the practice and applications of One Health, the study of systemic problems that incorporate environmental, human, and animal considerations, using transdisciplinary approaches.

The thoughts of this world expert on one of the most high-profile One Health topics – transmission of microbes from animals to humans when the environmental context favors rare events – would be of great assistance when I returned to Fort Collins at the end of my sabbatical to assume the role of director of the CSU One Health Institute. Yet, my visit was canceled by the most severe One Health crisis of our lifetime. After receiving the State Department’s notice, I wrestled with the decision of whether to ride out the pandemic in a secluded spot about 3,600 miles north of Antarctica or endure a 30-plus hour trip through at least four airports during the exponential phase of SARS-CoV-2 spread.

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Mount Wellington rises above Hobart, on the island state of Tasmania.


While considering my options, I biked and hiked along the River Derwent. Signs of the pandemic were virtually absent, other than hand sanitizer and social distancing behavior at the café. Flora and fauna were reassuringly untouched by the spasm gripping the human world, and this added surreal features to the circumstances. Communications with family, interspersed with final trips to Hill Street Grocery and other favorite haunts, helped me realize I needed to wrap up my trip. This decision was punctuated by announcements that Australia’s two primary airlines would be suspending all international flights. So with great inner sadness, I boarded a plane the next week in Hobart, and 30 hours later found myself back in Fort Collins. The procedures in place at international terminals to intensify screening for COVID-19 consisted of collapsing each planeload of passengers into a small hallway to be asked individually if we had recently visited China. Given the number of passengers congregating through the small passageway – many of whom were wearing masks, some stifling coughs and sneezes – I spent my first two weeks in Fort Collins in self-isolation before transitioning home.

How does it feel to be here? Nothing is the same, and everything is the same. It is spring, the house is dusty, birds are deep in preening activities. Vistas of Pacific bays and stands of eucalyptus are replaced with prairie and foothills and old cottonwoods. I can’t stop thinking about how extraordinarily lucky I am. I have become immersed in COVID-19 research activities and preparations to advance the CSU One Health Institute as a powerhouse. I am convinced CSU can be an absolute leader in this area; we have a remarkable coalition of passionate faculty who thrive on rolling up their sleeves, being practical, and working together. Yesterday, for the first time in weeks, I looked at a spreadsheet and prepared to import it into R studio. I thought about standard equation modeling. I listened to the boreal chorus frogs and spotted a great horned owl. I reviewed the latest scientific findings about COVID-19 on bioRxiv and counted my blessings for living in a safe and secure environment. I realized it is time for One Health. By Dr Sue VandeWoude. Originally published in State.

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Sue receives her Fulbright certificate from Australian Federal Education Minister, the Hon Dan Tehan in February 2020, mere weeks before COVID made social distance the new norm.


Global Citizenship Amid and After COVID-19 BY

MARK CZEISLER

A mandatory evacuation from Australia cut Fulbright Scholar Mark Czeisler‘s exchange trip short, but rather than give up on his research plans, Mark decided that this was an opportunity to start a new collaboration to help evaluate the effectiveness and impacts of COVID mitigation strategies.

The Fulbright Program mission to improve cultural diplomacy and intercultural competence motivated me to travel to Australia as a Fulbright Scholar. I remember proudly applauding US firefighters volunteering to join Australian firefighters fighting devastating bushfires as I was boarding the 10,000-mile flight from Boston to Melbourne. I landed on January 24th, less than 24 hours before the first confirmed COVID-19 case in Australia. Like many, I soon realized the gravity of the emerging pandemic. The suffering across Italy forewarned nations worldwide of the rapid transmissibility and potency of the virulent disease. Among early responses by the US government, on March 19th Secretary of State Mike Pompeo suspended the US Fulbright Program globally and recalled all Scholars back to the US immediately.

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Abruptly leaving Australia for the U.S. seemed counterintuitive, given the significantly lower prevalence of COVID-19 in Australia, and was disappointing given that I had just established myself in Melbourne. However, despite the harrowing 33-hour, 3-flight journey back to the US and into quarantine isolated from friends and family, I appreciated the support of my country. After bringing citizens abroad home, nations worldwide have turned inward, restricting international travel. Absent widespread testing, effective treatments or vaccination, government and health officials have resorted to stringent mitigation strategies, causing massive disrupted socioeconomic, political, cultural, and educational systems.

Rising tensions have produced a myriad of demonstrations and retaliations ranging from protests to conspiracy theories and xenophobic, racist, and violent attacks. Xenophobia started toward people of Chinese and East Asian descent and has progressed to include hotspot European countries, even though the US now has more cases than any other country. As the pandemic continues, balancing physical isolation while maintaining threads of global citizenship will be imperative. Australia and New Zealand may serve as models for safely achieving transnational partnership. Both nations are on the brink of eradicating COVID-19, and assuming the last push of stringent mitigation strategies is effective in doing so, they plan to create a travel bubble between the two countries as they re-open. The move, which would greatly benefit both economies and reinforce an alreadystrong transnational bond, could be something to consider once safe travel becomes possible.

MARK CZEISLER, Fulbright Future Scholar (Medical Science/Harvard University)

After World War II, Senator J William Fulbright sponsored legislation to establish a program for the “promotion of international good will through the exchange of students in the fields of education, culture, and science.� Since 1946, the Fulbright Program has supported nearly 400,000 scholars in 160 countries.


However, a return to widespread global travel is unlikely in the short- or even medium-term, and creative strategies will be required to overcome xenophobic and nationalistic ideology. Recovering and strengthening international ties to meet the unprecedented pre-pandemic-era levels of economic, political, and cultural globalization in the absence of physical exchange will depend on reciprocal cooperation and mutual understanding of an important and overlooked reality: we are all on the same team in the fight against COVID-19. Senator Fulbright alluded to the value of this perspective in his book about American global engagement during the Cold War Era in The Price of Empire. "The essence of intercultural education is the acquisition of empathy—the ability to see the world as others see it, and to allow for the possibility that others may see something we have failed to see, or may see it more accurately. The simple purpose of the exchange program...is to erode the culturally rooted mistrust that sets nations against one another. The exchange program is not a panacea but an avenue of hope..."

Senator Fulbright’s perspective has inspired me to continue conducting research with my Australian supervisors despite global suspension of the Fulbright Program. We initiated an AustralianAmerican collaboration to study public support of COVID-19 mitigation strategies. International collaboration has enabled scientists separated by 10,000 miles to harness differences in COVID-19 prevalence, mitigation strategies, and cultural contexts to gain insights on the public response to this pandemic that transcend national borders. Five months into the pandemic, there have been more than seven million confirmed cases and 400,000 deaths among 188 countries that have reported cases worldwide. While facing inward to address the nations’ needs is crucial, Senator Fulbright’s message cannot be lost. Rather, in the absence of widespread physical exchange in the wake of the destruction and suffering caused by the COVID-19 pandemic, intercultural collaboration and empathy have never been more needed. By Mark Czeisler

- J William Fulbright

"The exchange program is not a panacea, but an avenue of hope..."

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How Should Organisations Respond to Complex Challenges? Well-functioning institutions are critical to society’s response to grand challenges. Yet getting institutions to function effectively, especially when the objectives are multifaceted and into the future—like responding to climate change, or preparing for pandemics—is complex. As an organizational theory scholar, my research focuses on how organizations address complex challenges. In this project I take a unique focus: studying the role of universities. Although as academics we rarely reflect on universities as institutions, they do in fact play a crucial role in community and industry responses to grand challenges. This is particularly true of Stanford University, with the impact it has had through institutes like the Woods, Bio-X and beyond. Funded as a Fulbright Senior Scholar, my time at the Global Projects Centre has turned the research lens “inward”, so to speak. Throughout winter term and into spring I met with and interviewed dozens of significant leaders – deans, vice provosts, chairs of the Board of Trustees, and others - who served into Stanford University’s leadership under the presidency of John L. Hennessy.

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My questions probed how they came to their roles, what their visions were, how the organized with those around them, and what they felt they had accomplished by the time their posts had ended. What emerges is a complex and multi-vocal picture of Stanford University as an institution between 2000 and 2016, and the moves it made as a university to develop inter-disciplinary partnerships, fundraise, transform curriculum, and pursue entrepreneurial endeavors that oriented toward addressing some of world’s the most significant challenges in environment, sustainability, human health, and beyond. My study will form part of an edited book, which will capture the voices of the Hennessy presidency. I am publishing it in collaboration with the Stanford Historical Society and their Oral History program. It will contain the accounts of several senior leaders from Stanford and how they organized the university toward these higher goals during two critical decades in the institution’s history.


The end of my time at GPC coincided with the outbreak of the global pandemic. Since returning to my home country, Australia, I am now working beyond this project to contribute a blueprint for Australia’s economic recovery after COVID-19. My interest is to locate the higher education sector in Australia and globally with the broader set of institutions – government, business, start-ups, pension funds, amongst others – who will be implicated in ensuring that Australia recovers to an economy goes beyond its mining roots and can sustain the high paying jobs needed for its future in the region.

I intend for U.S. relations to play a crucial role in that and, vice versa, for Australia to play a crucial role for the U.S.’s position in Asia. As a higher education leader, my hope is that we together can build the graduates that will contribute to the high tech economy that Asia and the United States need. I look forward to staying connected with the Global Projects Centre to ensure we make a successful transition. Originally published as Professor Eric Knight: In His Own Words on Stanford GPC.

Images: (From left) Eric meets with Gerhard Casper, fmr. President of Stanford University (1992-2000); Eric talks energy technology with Prof. Steve Chu, Nobel Laureate/fmr. Secretary of Energy (2009-2013); Eric in the quad at Stanford.

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Higher Education in a Post-COVID World Dr Gwilym Croucher and Professor William Locke The COVID pandemic is magnifying existing pressures for universities but is also providing new possibilities. How universities respond will determine their future. What the coming months and years will mean for higher education in Australia and around the world depends on the response of governments and providers to the unfolding disruption caused by the coronavirus pandemic. While the speed of developments during the pandemic makes prediction fraught, past experiences of similar economic, political and social ‘shocks’ to the provision of higher education in advanced economies provide some hints to where we might be heading. The pandemic is magnifying existing pressures for universities but is also providing new possibilities. We outline here some trends and their implications for Australian higher education and public policy. Diminishing student capacity and preference for travel to undertake international education For many students their preference for traveling to another country for study will diminish because leaving their home country for study becomes perceived as less safe. Growing nationalism may also promote studying domestically, exacerbated by the relationship between a home country and the one where students study. This will be framed by shifting geopolitical tensions that are almost entirely divorced from people-to-people or educational relationships. Moreover, many students will face stricter rules and regulations in gaining entry to a chosen host country for study and, possibly, poststudy residence and employment.

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For Australia, this means the international student market may recover somewhat but, at best, slowly, and the incentive for studying abroad will be much diminished because of the perceived risks. This will likely have most impact on laboratory and practice-based disciplines, some of which have high proportions of international students. The impact could also be particularly acute for business and commerce disciplines, which have the most international students and are usually in the higher margin range of offerings. Australia may be better positioned to attract students than the two other large destination countries, the UK and U.S, if there is continuing success in Australia mitigating the worst effects of the pandemic. China and one or two other Asian countries may take advantage to retain students who might have gone abroad to study, as well as attracting more international students from the region and beyond.

Much depends on how and when the government is in a position to lift travel restrictions. Yet, as international education has particular cultural dimensions and is not just another trade in services, sociopolitical factors may inhibit recovery of the market even if the government does open the borders. The reputational effects following the uneven initial response have yet to be fully known. So, too, is the impact of the sudden shift to online teaching and learning and how engaged international students continue to feel, especially when those students already in Australia start to return to campus. There are uncertain prospects for university-delivered transnational education, too, such as at international branch campuses. Despite Australia’s success over several decades, there may be little practical option to grow new largescale provision overseas in the immediate term. Existing markets may become increasingly challenging as more countries and multi-national companies look for new opportunities outside their own markets. For Australian international and transnational education, the future may be uneven. One factor affecting this is the growth of online study. Growing student acceptance of online study Many, if not most, large institutions in major higher education systems have made this shift to more online study with a likely growth in students’ acceptance of it, even if it does not remain their preference. Yet, the perception of online course delivery as inferior to face-to-face delivery will likely remain for many students, as will concerns that it is not equivalent or equally valuable to face-to-face no matter how well it is done.


The global lockdown and disruption to many industries may affect the future trajectory for some, such as accelerating and amplifying use of automation"

For many the cognitive learning may be deemed to be as good but not the rest of the educational experience. Some disciplines have not been able to transition as easily, especially those relying on experiences out of the classroom, nor can some cohorts of students transition as well due to limited access and capability of technologies. Australia is unevenly positioned to respond. In many ways its universities have been at the forefront of online education provision and some have developed sophisticated modes of delivering wholly online programmes. For instance, universities now partner with MOOC (Massive Open Online Courses) platforms (e.g. Coursera, EdX, FutureLearn) or dedicated online programme managers (e.g. 2U, Wiley, Pearson, Keypath Education) to support wholly online programme delivery. Australia’s proximity to key markets (in the Asia-Pacific especially) and a shared time zone with Asia are advantages in terms of enabling synchronous communication, service and support. For example, strong demand for English language courses continues, particularly from some Asian countries, such as Vietnam. Yet the online capacity that has been built in this crisis will allow international brands and leading universities to offer courses without the need for residence.

An increasingly competitive landscape raises questions about which areas of demand universities should focus on and what are realistic expectations about demand and growth. There are also challenges in implementing innovative pedagogies for wholly online courses, particularly when some students will continue to prefer a more traditional, classroom approach. Nonetheless universities can benefit from economies of scale in the development of online delivery across their offerings. Diminishing attractiveness of certain degrees and programs Deteriorating economic circumstances in most countries and growing unemployment affect decisions about what to study and whether it will provide financial benefit and employment security in the future. While recession often means that study is an attractive option for those unemployed or underemployed, it also means students are more likely to select courses perceived to lead to professional entry or to enhance their employment prospects. The global lockdown and disruption to many industries may affect the future trajectory for some, such as accelerating and amplifying use of automation, data analytics (including Artificial Intelligence) and online systems, and so reduce the requirements for some skills sets and degrees, such as accounting.

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For Australia, there may be less domestic and international student demand for courses not perceived to lead to professional entry or to enhance employment prospects, such as arts, some pure science and commerce degrees such as marketing. Australian providers that specialise in professional and vocational subjects may be well placed to accommodate the shifts in student demand. These trends have significant implications for universities and higher education policy, which we examine below, as well as compounding factors including the diminishing capacity for governments to invest in education and research and the reorganisation of universities and their workforces. Greater reliance on areas of expertise deemed relevant to economic and social recovery Governments and other actors may come to rely on areas of expertise seen as relevant to economic and social recovery as the scale of the social and economic disruption is akin in many crucial ways to the Great Depression and is the largest outside of wartime, meaning that expertise becomes a valuable part of the response, as it has been for previous crises. While genuine debate will continue as to the best response, the differing responses to the pandemic to date in different countries shows the importance and effectiveness of expert advice for those governments that have followed it. Many news media organisations have given a high profile to expert commentary, in contrast to disinformation spreading on social media.

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Diminishing capacity for governments to invest in higher education and research Governments in many countries will have less capacity to invest in higher education. The public policy response to the coronavirus has seen governments outlay huge sums for health, social and employment programs, as well as for other measures. It is likely that these stimulus and safety net programs will need to be funded for several years following the initial pandemic. Along with reduced taxation revenue due to recessions across most advanced nations, governments are in a difficult position as citizens demand that areas of public policy and public service delivery other than higher education, such as healthcare and school education, be prioritised.

The importance of experts in advising governments amplifies the status of science, expertise and research as bedrock of the evidence-base for policy. As universities are central providers of expertise and research, their social, economic and public policy purposes are clear, as academics with expertise in infectious diseases, public health, mental wellbeing, social media, economic recovery, etc, are being seen as important sources of advice for ministers and premiers. The role of expertise in assisting recovery and reconstruction presents an important opportunity for universities and their academics to lead public debates and shape outcomes on multiple fronts.

In Australia there will likely be little scope for additional government support for higher education. While it is possible government will need to consider radical policy options to focus public outlays, these would cause massive disruption. In the immediate term there could be significant disruption from the introduction of higher student fees, targeting equity and other support programs to particular institutions, mandating student contributions differentiated by mode and level of study, separating research funding from teaching funding even further, and funding some institutions at a reduced rate to only teach. More certain is that universities will employ a range of measures to reduce outlays in the immediate term and will reconfigure their offerings and business models.

However, there are risks to university finances that may make this harder.

Reorganisation of universities and their workforces The significant disruption to operations during 2020 means that many casual staff and those on short term contracts may be forced to seek employment outside the sector.


Changing student demand for particular courses, reduced activity in some areas and the shift to online may mean universities require more staff in some areas and fewer in others, especially where there is a shift in the skills requirements. Over the longer term this may mean the nature of much academic work may change, with larger roles played by learning designers, educational technologists and study support staff, for example. We may even see the rise of global academic ‘superstars’ going freelance and offering content to a number of universities. There is the risk that, as Australian higher education reduces its workforce, the next generation of academics and researchers are lost to other careers and that they will need to be replaced to avoid a permanently reduced capacity. Equally, career progress of early career academics could be stalled due to the lack of opportunities to develop their research and move between universities, including internationally. There is a case for prioritising support for the next generation of teachers and researchers. Uncertain future opportunities for research and collaboration The prospects for future opportunities for research collaboration are uncertain. There are uncertainties about how the global research system will cope with restricted international travel and the shift to online communication may inhibit some forms of collaboration and will reduce opportunities for visiting researchers. The forced use of teleconferencing for collaboration may mean that Australia’s distance from Northern America and Europe is less of a disadvantage as face-to-face collaboration ceases. Both philanthropic donors and government programs that support the generation of new ideas and international collaborations, such as Horizon Europe, may have diminished funds and capacity to support new projects. Research associated with dealing with the pandemic and post-pandemic recovery will likely be the focus of many academics, and so will present new opportunities. The growth in international collaboration may slow and stagnate, with long term implications for the pace and direction of advancement in some fields. There will be an opportunity for Australian researchers as online communication ‘levels the playing field’.

For Australia, like other countries, collaborators may come to rely more heavily on government support in their own countries and advancements in knowledge may be more tied to where researchers are all located in a single country than at present. There will potentially be fewer students traveling for international doctoral study because of difficulties gaining visas and entry and where universities cannot afford to offer the same level of internally funded scholarships for international students. Australian higher education could benefit from reduced provision of doctoral programs at international competitor institutions. Yet it may also suffer as students either decide against, or are not allowed to, travel for study. The combined impact of the pandemic on international research students and the reduction in fees from all international students may have a serious knock-on effect on Australia’s research and development capacity. Policy questions The possible trends summarised here suggest a range of outcomes and questions for Australian higher education. The international market may be slow to recover, and a number of strategies for growing revenue and activity, such as philanthropy, transnational education and commercial research contracts will be less viable. Some difficult public-policy choices become more likely and are contingent on the return of the international market. This begs the question of what is a realistic funding model that covers the teaching component of university spending where universities come to rely more heavily on public funding in Australia? And of how many universities might face severe to catastrophic financial problems? Depending on what the future holds this may present hard choices for governments. Originally published on John Menadue – Pearls and Irritations

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The

DANGERS DISINFO

of

This Tweet, and the YouTube video referenced have both been scrubbed from the internet, and ChiefPolice, a prominent anonymous conspiracy theorist Twitter handle with close to 20,000 subscribers, has been suspended – all for violating guidelines aimed at preventing the spread of dangerous or harmful misinformation.

34

“20-20-20 spray” is Miracle Mineral Supplement (MMS) – an extremely toxic solution of chlorine dioxide touted by grifters and frauds across the globe as a miracle cure-all for everything from HIV to autism. “It cures nothing.” Said Jim Humble in 2016, a decade after self-publishing the book that first coined the MMS name, The Miracle Mineral Solution of the 21st Century.


There are always groups trying to exploit any crisis to try and push their agenda, including by propagating questionable information. Worse than curing nothing, MMS can actually cause life-threatening injuries if ingested. “It’s a bit like drinking concentrated bleach.” According to Naren Gunja, director of the New South Wales, Australia Poisons Information Centre.

This is why disinformation can be so dangerous today: its presence online is prolific, it spreads quickly, it’s difficult to find and fact-check in realtime, and the most successful examples of it tend to reappear, even years after being corrected. It also seems to propagate most during times of crisis or uncertainty.

Humble had performed no clinical trials, and had no scientific evidence to back up the claims in his original book.

But why? Who benefits when swathes of people poison themselves by gargling bleach? The answer to this is rather complicated.

Yet thousands of people liked and shared ChiefPolice’s tweet about MMS before it was taken down, and the YouTube video explaining how to concoct or buy the deadly elixir already had tens of thousands of views, despite being based on disinformation that had been debunked and re-debunked many times over the past ten years.

“There are always groups and people who are trying to exploit any crisis or opportunity to try and push their agenda, including by propagating questionable information,” said Arjun Bisen, a Fulbright Scholar who studied disinformation at Harvard University, and now works as an information quality expert in the U.S. tech sector. “This pandemic is no different, and in fact, the stakes are much higher.”

The motives for people spreading disinformation online generally fall into four broad categories – ignorance, spite, profit, and political benefit. The first two warrant no real analysis – some people will share an entirely erroneous fact online simply because they find it interesting and don’t realise that it is untrue. Some people will go out of their way to confuse or mislead others with misinformation online, simply because they enjoy doing so (see trolling). Others, however have more concrete objectives, and these are arguably the most dangerous actors.

This pandemic is no different, and in fact, the stakes are much higher.

"

35


A Silver Bullet for COVID In some ways, the advent of the internet made life rather challenging for career-conmen and purveyors of snake oil – the ability to simply Google search claims to prove or disprove their veracity made it difficult to get away with claiming that a miracle tonic actually worked. With greater access to expert information, people become more sceptical and discerning. However attacks on expert opinion from a variety of sources (including current world leaders) combined with the growth of closed loops and echo chambers via social media has opened the door for a new kind of conman to operate – one who doesn’t need to go door to door anymore and can find new audiences with a few easy clicks. Alex Jones is one of these. His website, InfoWars, peddles misinformation and far-right conspiracy theories to a massive audience of nearly 10 million visitors/month.

36

His diatribes against the nefarious activities of concocted enemies such as the Deep State inevitably end with a pitch for a dubious safeguard in the form of a dietary supplement or patented device, conveniently sold through his online shop, InfoWarsLife. Last month the U.S. Food and Drug Administration issued a cease and desist to Jones for claiming that a colloidal silver toothpaste would prevent his viewers from catching COVID-19. "The patented Nano Silver we have, the Pentagon has come out and documented, and homeland security have said this stuff kills the whole SARS corona family, at point blank range." He said, in a video posted March 10. In another video Jones promoted the products as a way to boost users' immune systems, saying that "regardless of how deadly this virus is … if it kills you, it's bad news."

Laboratory tests of products sold for premium prices on InfoWarsLife have demonstrated that the contents, while not harmful, contain quantities of active ingredients that are "too low to be appropriately effective" and claims to their positive health benefits are highly dubious. During court proceedings in 2014, Jones revealed that his site generates annual revenues of over $20 million. At the time of writing, Jones’ name was in the headlines again for his assertion that should society collapse, he would happily eat his neighbors. Jones is one of the most prolific cyber-grifters around, but he is by no means the only one. There are literally thousands of actors seeking to profit off of the uncertainty and lack of authoritative information on COVID-19.


In March Kenneth Copeland, a prominent U.S. televangelist, claimed that he could cure COVID via "spiritual healing" – viewers needed to touch their television screens for the treatment to be effective. In a previous show, Copeland had called COVID a ‘weak strain of the flu’ and that fear of it was putting faith in the power of the devil. Both broadcasts encouraged donations from viewers. Copeland’s net worth is over $300 million, and his tax-exempt church owns five private jets. Individual actors are also lining up to profit from phoney COVID treatments. Researchers from the Australian National University in April found hundreds of COVIDrelated products circulating online, including reputed animal-trial vaccines, blood from purported COVID recoverees, and vials of hydroxychloroquine – the ‘miracle cure’ speciously promoted by the U.S. president.

Why, then, can these hoax cures continue to generate profits, when their efficacies have already been disproven? One issue is that this disinfo can continue to circulate in closed loops, or echo chambers where expert opinion doesn’t easily penetrate. The InfoWars network is a prime example of this, where the audience is rarely, if ever, exposed to legitimate scientific expertise (and are also to some extent inoculated against expert opinion through consumption of the site’s conspiracy content, which regularly attacks scientific institutions). Another issue is that disinfo thrives in ‘data voids’ where there is no scientific discussion taking place. “A data void is where there is no authoritative information in a particular narrative,” said Arjun Bisen.

“For example, if you do a web search for ‘does broccoli cause COVID?’ you would only be presented with very low quality information, because there are no authoritative or credible sites that are actually commenting on this point.” So tech companies are having to play catch up – it’s impossible to dispel every possible myth in advance, so they essentially need to play whack-a-mole with these hoaxes as they gain traction or go viral one-by-one. “Tech companies are actually becoming much better at identifying these data voids, and helping users navigate them by either providing more context around the issue, or enabling better access to more credible sources such as the CDC, WHO, or even doctors on the front line.” The old adage about leading a horse to water comes to mind, though.

"

There are literally thousands of actors seeking to profit off of the lack of authoritative information on COVID-19.

37


They might be a liar, but they’re MY liar So what of the politically-motivated disinfo actors? Well, they could potentially be the most dangerous of all. They have better access to resources and authoritative voices, and their true motives are often murkier. Coordinated, state-sponsored disinfo campaigns are not a new phenomenon – propaganda has been deployed by Western and non-Western governments alike for decades in efforts to modify public opinion, both at home and abroad. There is obvious benefit in having the power to control the narrative of a political wedge issue, either for partisan, diplomatic, financial, or electoral gain.

Briony’s new research focuses on COVID, and she agrees that data voids are facilitating a greater spread of disinfo than ever before, particularly in political spaces. “What makes this a really tricky time to be studying COVID misinformation is that there’s not a lot of what we know to be true. “In a way it’s a perfect storm – people are notoriously bad at accepting ‘we simply don’t know just yet’ as an answer, so a lot of mis and disinformation can rush in to fill the void before science catches up.” State actors have been taking advantage – the Australian Strategic Policy Institute (ASPI) found that Chinese Communist Party (CCP)-linked social media accounts had been exploiting tensions with the WHO to cast their response to the pandemic in a positive light, and instigate unrest in Taiwan.

38

Their legitimate diplomatic channels have also been propagating conspiracy theories about the origins of the COVID virus. Kremlin-linked news organisations, too, have seized upon confusion to foster negative perceptions of Western responses to COVID, undermine public trust in national healthcare systems and control the narrative to their benefit. Even some Western leaders have been accused of deliberately spreading misinformation to confuse or obfuscate the issue.

Fulbright Scholar Briony Swire-Thompson has been studying the psychology behind disinformation for over ten years. Her 2017 research paper, They might be a liar, but they’re my liar, was focussed on disinformation in the political sphere, and it suggested that even when erroneous talking points from political figures were fact-checked, support for the politician continued relatively consistently. “We found that people are great at updating their opinions when provided with new information, however their voting preferences tend to remain completely stable. We found this replicated on both the political right and the left.”

The 'GREAT AWAKENING' Why would a leader be deliberately providing inaccurate information about a deadly pandemic, and confusing or contradicting their own administration’s response? The explanation will vary depending on who you ask. If you ask Trump why he recommended injecting disinfectant to see if it could cure COVID, he’ll tell you that he was being sarcastic to troll a hostile media pack. If you ask the media, they will explain that he has a history of freewheeling, streamof-consciousness rants during press conferences, and was simply riffing via his extremely limited knowledge of medicine. If you ask a follower of QAnon, a rapidly growing U.S. conspiracy network, they’ll tell you that it’s all part of the plan. QAnon is a prolific group of anonymous conspiracy theorists founded upon the idea that an omnipotent, malevolent government entity, the Deep State, are the puppet-masters behind everything from global warming to autism-inducing vaccines, and whose goal is to suppress the general public through propaganda and mind control. ‘Q’, the leader of the movement, is supposedly a high-ranking member of the U.S. military who communicates purported 'classified information' to his followers. ‘anons’, via encoded ‘intel drops’ – cryptic messages, sometimes just a few seemingly-random phrases sent out via Twitter or through encrypted messaging apps.


"In a way, it's a perfect storm."

39


The basic narrative of Q's 'intel' suggests that President Trump is engaged in some form of clandestine war with the Deep State, and that his impeachment, as well as the preceding Special Counsel investigation, are evidence of Deep State retaliation against him. Q's plot is the type of convoluted that would make Dan Brown blush. It brings in a variety of familiar characters--many of whom have starring roles in previous conspiracy features such as Pizzagate-and conveniently, all of whom sit at the top of Trump's list of enemies. The Clintons (of course) play major antagonists, who lead a cabal of Hollywood cannibal/ child molestors. Various branching narratives have them arranging for the murder of Jeffrey Epstein, working with the Ukraine mafia to implicate Russia in 2016 election meddling, and dispose of the allimportant email server.

40

Supporting roles include former President Obama, former FBI head James Comey, and Presidential candidate Joe Biden, all of whom are implicated in a plot to bring down the President.

Trump has amplified a number of these claims, and retweeted various QAnon twitter handles, despite the movement being declared a domestic terror threat by the FBI in 2019.

Even Australia has a cameo, as UK High Commissioner Alexander Downer plays a doubleagent who frames a member of Trump's campaign team and feeds damaging information to the FBI.

Why would President Trump be promoting wild conspiracy theories that undermine his own administration?

On the 'protagonist' side, convicted criminals such as Gen. Michael Flynn (who pled guilty to lying to the FBI about his contact with Kremlin officials), and Roger Stone (also convicted and jailed for providing false statements, as well as witness tampering) are portrayed as war heroes who became collateral damage in the Deep State efforts to remove a lawfully-elected president from office.

Well, for him the benefits likely outweigh the risks. The idea that he is waging a battle against an unseen, unknown, nefarious institution is of obvious appeal to his base, and undermining faith in the justice system (yes, even his own justice system) actually works in his favour. As of 2019, there were 30 ongoing investigations into the Trump Administration and Trump Election Campaign looking into issues such as potential foreign influence, hush money payments, abuse of power and obstruction of justice. Destabilising the agencies tasked with carrying out these investigations increases the chances that Trump could shrug any impending convictions. Absolving all of the aforementioned Trump allies of their own convictions is also of immediate and obvious appeal, and helps vindicate his longstanding assertion that none of them did anything wrong ('no obstruction, no collusion', 'total exoneration', et cetera), and that his judgement was always perfect ('the best people').


So what does QAnon get out of portraying Trump as a hero of the people? Well, this is a little murkier, however it’s worth noting that many of Q’s ‘intel drops’ are only accessible via encrypted Q apps. Until recently, if you searched for the letter ‘Q’ on the Google Play store website, the top result was for the ‘Q Alerts!’ app, which purported to provide ‘anons’ with “the most up-to-date info for sharing and researching Q”. Apps such as this were finally removed in May 2020 for violating Google's policies against "harmful information".

Before removal, 'Q-Alerts' alone had over 10,000 downloads, and was rated 5 stars. The price: $4.89. Prior to their Twitter suspension, ChiefPolice2, responsible for the tweet at the beginning of this article, posted prolifically about Q, and the ‘Great Awakening’ that would follow Trump’s crusade against the Deep State. These were alongside tweets that attempted to sell poisonous bleach spray to hapless followers, and other endorsements of theories and products sold by InfoWars and Alex Jones. You know what they say about birds of a feather.

Becoming your own Factfinder-in-Chief | BY SARA JAMES So how do we combat disinfo and make sure that the information we're consuming is accurate? Arjun Bisen stresses the importance of being conscious of where we get our news, and why. "Misinformation really thrives on our biases, and targets divisions to stoke our emotion and drive further disunity. We need to make sure we're not just blindly trusting any one source for news."

Beware the Dangers of the “Data Void” It’s easy to stumble into a data void during unprecedented, uncertain and alarming situations — such as a new virus that causes a global pandemic. Conspiracies and misinformation lurk in these murky waters. Be vigilant. Cross-check data with multiple reputable news organisations. Guard Against Your Greatest Vulnerability

To do this, he has a cheat-sheet to help people become their own factfinders-in-chief:

No matter who we are or where we live, one thing makes all of us more vulnerable to misinformation. If it fits our bias.

Master Good Consumption Habits

Bisen spent seven years as a diplomat. He navigated geopolitics and trade discussions and drafted Australia’s cyber strategy. He knows it’s crucial to hear from multiple points of view. Open your network to those who disagree. And pay extra attention when information is provocative.

We all know eating a well-rounded diet is crucial. What we “consume” online is also important. In a global pandemic, Bisen says succumbing to misinformation or disinformation could be dangerous for your health. Seek out the news equivalent of green, leafy vegetables: legitimate sources. Triangulate Information Intake Make it a practice to check three sources. For added certainty, check a few more. Then, just for the heck of it, check a few — You get the idea.

And Remember… There are always groups which seek to exploit divisions and inflame tensions. Such groups thrive during challenging times, Bisen warns. To foster understanding and solve problems, it’s important to share accurate information – whether it’s on a family email chain, or to the world at large.

41


Down 2......The prevention of an increase or spread of something, especially nuclear weaponry. 3......Something that combines contradictory features or qualities. 5......Of, or relating to, the brain or the intellect. 10.....A milky fluid found in many plants, such as poppies and spurges, which exudes when the plant is cut and coagulates on exposure to the air.

Across

42

1......A feeling of worry, nervousness, or unease about something with an uncertain outcome - see eg. the latest season of Game of Thrones. 4......The scientific study of the properties, distribution, and effects of water as a liquid, solid, or gas on the Earth's surface, in the soil and underlying rocks, and in the atmosphere. 6......Meringue-based cake of disputed Australian/New Zealand origin, named after a Russian ballerina. 7......Concerning the role of genetics in the development and function of the nervous system. 8.....The the prevention or treatment of disease through substances that stimulate an immune response. 9.....An animal that moves fertilising elements from the male anther of a flower to the female stigma of a flower. December Solutions: Down: 1. Los Angeles 2. Portugal 4. Ziggurat 5. Organic 6. Harp Across: 3. Aesop 7. Paris Hilton 8. Snotted


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