The Mike Hosking Breakfast

Doctors at the Vatican's pediatric hospital said today they have successfully separated conjoined twins whose skulls were fused back-to-back, an exceedingly rare surgery for an equally rare congenital defect.
The twins, Ervina and Prefina Bangalo, were born June 29, 2018 in Mbaiki, the Central African Republic, with their heads attached and sharing critical blood vessels around their brains. Such cases of conjoined twins occur once in every two million births or so.
The Bambino Gesu Pediatric Hospital, which is Vatican-owned but operates within the Italian public health system, brought the twins and their mother to Italy soon after their birth. The hospital said the toddlers are recovering well a month after their third and definitive separation surgery on June 5.
Video released by the hospital showed the girls waving along to music from their beds, clapping and holding markers, as well as celebrating their second birthday in their mother's arms as hospital staff sang "Happy Birthday" to them in Italian.
The key goal of the surgery was "to obtain a separation with the girls in perfect condition. So the objective we gave ourselves was very ambitious, and we did everything to reach it," Dr Carlo Marras, chief of pediatric neurosurgery at Bambino Gesu, said.
Marras led the team that worked for nearly two years planning and executing the separation.
At a press conference to announce the outcome of the sisters' surgery, Marras said the prognosis was "these girls can have a normal life" after a phase of rehabilitation.
There have been successful separation surgeries in the past of twins joined at the head, but most have been for twins whose heads were fused vertically, at the top. Ervina and Previna's skulls were joined back-to-back in what is known as "total posterior craniopagus."
That made the surgery particularly challenging since the back of the head is a far more critical place for blood supply to the brain and drainage of blood away from it, said Dr Jesse Taylor, head of plastic surgery at the Children's Hospital of Philadelphia who has participated in some separation surgeries.
"It's one of those configurations that I think a lot of centers, when they see it, say, 'You know, we're not sure that this can be done safely,'" Taylor said. "The venous drainage tends to be the main limiting step for separability" in twins connected at the back of the head.



A doctor looks at a 3D monitor showing the skulls of twins Ervina and Prefina during surgery.
He said in typical separation surgeries, doctors can "borrow" some blood vessels to give to each twin. "But when it comes to the back of the head, you don't have a lot of wiggle room for borrowing veins," Taylor explained.
Marras said that indeed, the most complicated aspect of the Bangalo twins' separation was to give each child autonomous venous drainage systems — procedures that began with two surgeries in May and June 2019. The final, 18-hour surgery last month to physically separate them involved a team of 30 doctors and nurses, who made use of 3D imaging and neurosimulators.
Before the separation surgery, members of the Vatican hospital's staff gave the girls mirrors so they could see one another. They knew what each other sounded like, but the mirrors helped them associate facial expressions with their personalities and sounds, Marras said.
"It was an experience that wasn't just professional but above all human: to think that you can arrive at something that we had only imagined, with all the possibilities of failure. It was a magical moment. Marvelous," he said.
Marras said there was only one previously known case of a separation of twins conjoined at the back of the head, performed in the United States during the 1980s. He said the outcome in that case was poor.
He was referring to the 1987 surgery at Johns Hopkins University by a team led by Dr Ben Carson, who is now US...

If you're sick enough to visit your GP, you should probably be tested for Covid-19.
Chris Hipkins says in recent days the number of tests processed does not meet Government expectations.
The Health Minister's instructed officials to ramp up testing for the virus, with daily testing rates not meeting targets on a number of occasions this week.
Officials want 4000 tests conducted a day.
Royal College of GPs medical director Bryan Betty told Mike Yardley GPs are a bit confused over who should be tested, because symptoms are similar to a flu or cold.
"The problem is working out who should be tested. That's been the problem trying to work that out."
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Relief for both employers and people on temporary work visas.
The Government's announced some short-term changes to visa settings.
Temporary work visas due to expire by the end of the year will be extended by six months.
The national announcement was made by Immigration Minister Iain Lees-Galloway.
Lees-Galloway also announced the cap on the number of workers allowed into NZ scheme will no longer rise as intended next year.
Each year up to 14,400 workers, mainly from Pacific Island nations, arrive in New Zealand to fill seasonal labour shortages in the horticulture and viticulture industries.
Lees-Galloway said around 9000 seasonal workers were still in New Zealand, a number of those stranded with no flights home and no way to support themselves after the harvest season had ended.

Maleko Sole, RSE workers' spokesman working on the stables at Hawke's Bay Showgrounds, Hastings in June. Photo / Warren Buckland
"The Government is supporting Pacific Island governments to repatriate their citizens but many are expected to remain in New Zealand for some time," he said.
"RSE visas limit workers to specific work, which is now drying up.
"The RSE scheme is part of our special relationship with the Pacific. As a country, we have a responsibility to support these workers and their employers, whose pastoral care responsibilities include accommodation for the workers."
The responsibility remained with RSE employers to comply with employment law and pastoral care requirements, he said.
"We are facing a rise in unemployment among New Zealanders and we expect more New Zealanders to be available for work next season," said Lees-Galloway.
"For this reason, the Government has decided to keep the RSE scheme annual cap at 14,400 for the next year.
"This is not what we originally announced and planned but we anticipate that more New Zealanders will be available to do this work next year so we could not justify another increase of the cap as we originally planned.
"I want to give employers in the horticulture and viticulture industries as much certainty as possible in uncertain times, so I have taken the decision now even though next seasons workers will only be able to enter New Zealand when it is safe to relax border restrictions.
Horticulture New Zealand chief executive Mike Chapman said while HortNZ welcomed increased government support and flexibility for RSE workers who are still in New Zealand waiting for repatriation back to the Pacific, the decisions should have come a lot earlier.
"We really needed these government decisions three months ago," Chapman said.
"While local communities have rallied to support RSE workers, government's delays have caused RSE workers and their employers unnecessary anxiety and cost."
Chapman said out of the approximately 9000 RSE workers still in New Zealand, 4000 were waiting to get home.
"'Summerfruit NZ, NZ Apples and Pears, NZ Kiwifruit Growers Incorporated and HortNZ have worked in partnership with the Government to find ways to get these workers home safely and as quickly as possible," he said.
"More than 1000 RSE workers have made it home thanks to these efforts, which continue."
He said while it was good these workers were now going home, it was important the RSE scheme, operating for more than 10 years, continued as it supported both New Zealand and the Pacific nations.
"As horticulture spearheads New Zealand post-Covid recovery, skilled RSE workers in similar numbers to this year will be needed to complement the New Zealanders entering the horticulture industry for the first time," Chapman said.
"At the same time, the RSE scheme is vital to the Pacific. The scheme enables these workers to earn money to support their families back home, set up businesses, and build storm-proof houses, schools and community facilities."
From July 1, struggling foreign nationals could also...

The British government unveiled a raft of measures Wednesday it hopes will limit an anticipated spike in unemployment as a result of the coronavirus pandemic.
Most noteworthy were a new bonus plan aimed at getting firms to retain workers that have been idle for months, as well as tax cuts for hard-pressed firms in the tourism and hospitality sectors and a new “Eat Out to Help Out” discount scheme.
Treasury chief Rishi Sunak said his latest major intervention is aimed at weaning the U.K. economy off emergency measures announced when the country was put into lockdown in March, while at the same time protecting and generating as many jobs as possible during the recession.
“People need to know that although hardship lies ahead, no-one will be left without hope,” he told socially distanced lawmakers.
So far, Britain has been spared the sharp rises in unemployment seen in the U.S., for example, because of the Job Retention Scheme, whereby the government has been paying the majority of the salaries of workers who were not fired. Some 1.1 million employers have taken advantage of the program to furlough 9.4 million people at a cost to the government of 27.4 billion pounds ($35 billion).
While confirming that it will end in October, Sunak said the government is introducing a new program that could cost a further 9.4 billion pounds if everyone who has been furloughed is given his or her job back. Under this plan, the government will pay companies a 1,000-pound bonus for each employee they take back.
“Leaving the furlough scheme open forever gives people false hope that it will always be possible to return to the jobs they had before,” he said. “The longer people are on furlough, the more likely it is their skills could fade, and they will find it harder to get new opportunities."
The government hopes employers will make use of the new program as they try to get back on track during what is a historically savage recession — in March and April alone, the U.K. economy shrank 25%. Many economists think unemployment could more than double to over 3 million this year, to levels last seen in the 1980s.
Anneliese Dodds, the economics spokesperson for the main opposition Labour Party, said Sunak should have made the Job Retention Scheme more flexible rather than scrapping it outright.
“It should have been the day when the millions of British people worried about their jobs and future prospects had a load taken off their shoulders," she said.
Sunak reserved extra support for tourism and hospitality, which were shut down during the lockdown. Pubs and restaurants, for example, only reopened Saturday for the first time in over three months.
Sunak said firms within those sectors will see taxes on sales of food and non-alcoholic drinks as well as on accommodation and admission to attractions slashed to 5% from 20%. This measure, Sunak said, is worth 4 billion pounds and should help companies support 2.4 million jobs.
He also announced a new dining discount plan for August that will give people a 50% discount at participating restaurants, cafes and pubs between Monday and Wednesday up to a maximum 10 pounds per person.
U.K. Hospitality, which represents the sector, said the measures provide many firms “much-needed help to get going again in earnest.”
However, Frances O’Grady, general secretary of the umbrella Trades Union Congress, said Sunak should have given low-paid workers a pay increase rather than offering "a dining out discount for the well-off.”
Other measures announced included 2 billion pounds to fund work placement schemes for 16-to-24-year-olds, a 3 billion-pound environmental package and the temporary elimination of a tax on house purchases below 500,000 pounds.
Make U.K., which represents companies in the manufacturing sector, praised Sunak’s “bold intent” and singled out the training measures for the young.
“This is not the beginning of the end of...

Calls for stricter rules for people at managed isolation facilities.
So far, two people have escaped from their facilities, the second on Tuesday evening, from the Stamford Plaza hotel in Auckland.
The 32-year-old man went to the Victoria St West Countdown, and has since tested positive for coronavirus.
Otago University infectious diseases expert David Murdoch says we need to have a reliable and secure system in place.
“We have all worked very hard to get to this point – and we would hope people coming into the country should respect that."
For breaching the Covid-19 Public Health Response Act, the punishment could be a fine of up to $4000, or six months jail time.
Murdoch says the facilities need to be working well, so we can continue our elimination strategy.
“Victoria is a good example of what could happen if we continue to have people breaching the rules. We should be highly motivated to make sure our system is secure.”
The Victoria St West Countdown is reopening to the public at 7 this morning.

So first we had the break out from the Pullman. Now the sneak out from the Stamford. Public confidence in our MIQ facilities is wobbly, despite the military precision that was drafted in to beef up our MIQS, two weeks ago.
The absconders have exposed that this trust-model system is heavily at the mercy of voluntary compliance. It’s the chink in the armour.
But how many breakouts should we be prepared to tolerate?
Clearly we can’t transform downtown hotels into super max prisons, fortified with razor -wire, watch towers and hungry dobermans.
But the fact that this homecoming halfwit from Delhi has returned a positive test, after skiving off to the supermarket on a very wandery circuit, vividly lays bare the public health risk. This selfish individual turned himself into a walking roulette wheel, for unsuspecting shoppers and staff at Countdown Victoria Street West.
The tale of the tape on CCTV has led authorities to determine there’s only a low risk that he could have infected anyone. But isn’t it insidious how one drip can open the door on the spectre of renewed community spread.
And wouldn’t you feel infuriated if you happen to manage, own, work or shop in that supermarket? This absconder has cost this shop a bomb in lost sales, closed for a clean, then weirdly reopened and hastily closed again for a deeper clean, forcing staff and shoppers into self-isolation. All because of this idiot’s wilful disregard for the law, while parked up in a five star hotel, on the taxpayer’s tit.
So, are we too trusting? Is the MIQ system still too loose, despite the military oversight? Absolutely.
Six foot fences have now been erected around the outside areas adjoining MIQ hotels. But this regime needs more security blankets. And maybe ankle bracelets for returnees.
Until you have passed a negative test, I don’t believe you should be allowed outside for a smoke, if you can make a break for it. And let’s reinforce the uniformed presence around these hotels properly, with a damn sight more military or police boots on the ground.

More than 1000 jobs appear set to go in Southland, with Rio Tinto announcing it plans to close the Tiwai Point aluminium smelter next year.
The Australian mining giant announced on Thursday that it will start a wind-down of operations and the eventual closure of New Zealand Aluminium Smelters (NZAS).
It comes after its own strategic review concluded that the business is no longer viable given high energy costs and a challenging outlook for the Aluminum industry.
The company gave notice that it was terminating its electricity contract with Meridian Energy in August 2021 "when the wind-down of operations is expected to complete".



Invercargill deputy mayor Toni Biddle told Newstalk ZB this morning that it was "incredibly disappointing news" - which she learned of at the same time as the media.
Biddle said the local community had fought hard for the community and she felt let down by the Government.
"All we really wanted was a fair operating environment, so we are very disappointed, but we're also very, very resilient down here, so we will stand together as we face this announcement together, moving forward," Biddle said, expressing hope that Rio Tinto could be convinced to change its mind.
"I don't believe it's over until it's over."
In a statement, the company added that a strategic review concluded "that the smelter, which has made Rio Tinto an underlying loss of NZ$46m in 2019, is not economically viable due to energy costs that are some of the highest in the industry globally, coupled with a challenging short to medium term aluminium outlook".
NZAS is a joint venture between Rio Tinto (79.36%) and Sumitomo Chemical Company of Japan. (20.64%).
It says it employs around 1000 people directly and creates a further 1600 indirect jobs in Southland.
In October the company announced it was undertaking a strategic review, with the head of its New Zealand operations indicating it needed "tens of millions" in annual relief of both transmission costs and electricity pricing.
At the time the Government indicated that the position of the New Zealand Government was that there would be no more relief from taxpayers for the smelter.
A spokeswoman for Energy Minister Megan Woods said the minister was not immediately able to comment this morning.
The review was meant to be completed in late March, but the company has made no announcement about its future since.
Rio Tinto said that "extensive discussions with a wide range of interested parties have failed to secure a power contract that will enable the operation to become both competitive and profitable".
Over the next 14 months the owners will progressively wind-down and close the operation.
"We recognise the decision to wind-down operations at NZAS will have a significant impact on employees, the community and our customers," Rio Tinto Aluminium chief executive Alf Barrios said.
"It is not a decision we have made lightly and without significant careful consideration. It is very unfortunate we could not find a solution with our partners to secure a power price reduction aimed at making NZAS a financially viable business. We will therefore terminate the power contract and move to close the operation.
"We are committed to working with our partners as we progress through detailed planning towards closure and we will do all we can together with the government to find ways to support the Southland community."
Late in 2019 Barrios flew to New Zealand to meet with Woods and Finance Minister Grant Robertson to stress the risk that the smelter could close.
It appeared to lead to progress, with Barrios writing to the ministers the following day thanking them for an offer to help build a business case for the smelter.
Tiwai Point is the country's biggest electricity consumer and among the world's lowest-carbon producers of aluminium.
It's closure will have a major impact...

After going behind his boss' back and leaking Covid patient details, disgraced National MP Hamish Walker had only one option.
And that was to resign, says National leader Todd Muller.
"He's done the only thing he could," Muller told Newstalk ZB this morning.
Muller said he had no idea why former party president Michelle Boag sent the patients' details to Walker in the first place. "Maybe the motivations of that might come through the review with Mike Heron QC... we'll see. In terms of why someone in their heart of hearts do these things, only they can answer that."
Walker yesterday announced he wouldn't seek re-election for the Clutha-Southland seat as the party board met to discuss whether to de-select him.
Muller said yesterday: "Ultimately it was a serious error of judgment which cost him his career. His judgment was fundamentally flawed ... and he's paid the ultimate price."
Muller said Walker's decision was "the only thing to do" but said it was "unfortunate" because he'd worked hard for his community.
The leader rejected the suggestion he'd lost control of the National Party.
"Hamish Walker went behind my back and made his own judgment and I'm sure he's ruing it today," Muller said.
Last Thursday night, Walker leaked the details of the then 18 active Covid-19 patients, including their names, dates of birth and which border hotel they tested positive in.

A hard border will split metropolitan Victoria from regional areas as the state seeks to limit the spread of the virus outbreak.
Victorian Premier Dan Andrews said the border will separate 31 locked-down metropolitan local government areas and the Mitchell Shire from regional areas.
“No one is pleased to be in that predicament, to having to confront those circumstances, but there is enormous benefit across regional Victoria if we can get that job done,” Mr Andrews said.
Victoria Police Chief Commissioner Shane Patton said hundreds of police officers will be checking people had a valid reason for leaving locked-down metro areas.
A focus will be on main arterial roads such as the Hume Freeway that leads to regions such as Calder, Geelong and Gippsland.
“It won’t be an absolute ring of steel, but there will be a significant police presence,” he said.
“We’re going to be there from midnight tonight. We’re going to be checking people. We’re going to be making sure they’re adhering to those guidelines. If you don’t have a reason to leave, you will be turned back around. If someone breaches those guidelines and leaves when they shouldn’t, you’ll receive an infringement – $1,652.”
FURY OVER STATE BORDER ‘DISGRACE’
NSW’s top cop has hit back at accusations the process at border checkpoints was a “disgrace” as the NSW-Victoria shutdown faces a chaotic first day.
Cars backed up at cross points as the border closure went into effect at midnight and commuters are facing long delays trying to get into NSW as cars are stopped and checked for the necessary permit to cross.
Albury Mayor Kevin Mack told 2GB’s Ben Fordham the delays this morning were a “disgrace” as people tried to get to work across the border.
“This is not Sydney, this is Albury-Wodonga and people just aren’t being treated like they should be treated here,” he said.
“We’re not going to put up with this for a week, this is just horrendous.”
NSW Police Commissioner Mick Fuller told Fordham he was happy with the operation so far.
“I think it’s ridiculous to come out day one on such a large border operation and make complaints,” he said.
“Perhaps he needs to go down and talk to the police who have been working through the night in freezing conditions, protecting the health of the people of NSW.
“It’s not a time to be selfish.”
Overnight, queues of cars lined up at the border were stopped and searched by police and army troops as the historic border shutdown went into effect.
Motorists faced significant delays this morning, with drivers spending almost an hour in traffic for what is usually a five-minute trip across the border. Most of the drivers were Victorian workers trying to get to work via Albury.
It took as many as 12 minutes for cars to cross the bridge into the border town of Moama after being checked by police this morning, the Herald Sun reported.
‘ABSOLUTE JOKE’: PERMIT SITE CRASHES
It was also a difficult night for many of the tens of thousands of people who tried to apply for a COVID-19 border entry permit into NSW.
Many were left frustrated as the NSW government website “kept crashing” and went down after its launch, hours before the state line was closed.
Some users were able to click on a red button labelled “Apply Online”, which disappeared and reappeared throughout the night, while others were told: “This transaction is not available at this time. Try again later.”
It went live about 7.30pm with a number of problems reported in the 20 to 40 minutes that followed.

There are calls for the Government to start planning for the arrival of international students.
Many international students have left the country, or not come into the country due to the coronavirus pandemic.
International education is New Zealand's fifth largest export earner.
Otago University associate professor Sara Walton told Mike Yardley if the Government opens the borders for the first university semester in February, a lot of work needs to be done.
She says there needs to be a lot of planning, to ensure we have enough quarantine and isolation facilities.
"We need to be organised for when the borders re-open. The earlier we start planning... the better."
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