Australian Reports of the Virus Spread

[drron]

Unfortunately @JohnK it isn't simple. Common colds don't kill many people. sure Flu and covid kill more but generally it is usually the people at the end of their years. before antibiotics pneumonia was known as the old man's friend. As we control one disease another takes it's place.
One example In the time in Tassie I looked after a 92 year old. he had been in hospital not long before with a bacterial urinary tract infection. he got home but his 91 year old wife couldn't manage. he was already under the palliative care team.
He was admitted under my care to await a bed in the palliative care unit. After seeing him into hospital his wife went to the doctor and had a covid test. Positive. The next morning his test came back positive. When he was told he just said it is time to go to sleep.he did that and never woke. Tell me do you really think that was a "bad" death and we should have done more to save him?

I have had to live with decisions I have made over the last 50 years deciding who gets the last ICU bed etc. It is never easy. The problem though with your solution we destroy the systems we have that have worked to increase our life expectancy and the quality of life. During lockdowns people didn't get followed up and many are now paying the price.

We do hear how our hospitals are over run with Covid cases. But if covid disappeared half of those patients would be in hospital any way. What you don't hear isthat there are other reasons for increased hospital admissions such as a large increase in heart disease. sudden cardiac death in young people is way up on previous years.

 

[jakeseven7]

RSV is putting more kids in hospital than covid at the moment.

Should we put an iso requirement on kids with RSV too…?

 

[Pushka]

RSV is putting more kids in hospital than covid at the moment.

Should we put an iso requirement on kids with RSV too…?

That and bronchiolitis.

 

[andye]

Mstrandye3 (13yo) asked me if an alien came to earth and wanted to see something that was classically human.

We initially thought of talking, working, using technology etc but then recognised that humans are characterised by being sociable. We thought through a party then a religious service.

We eventually thought our best answer was a group musical event with singing (for language) dancing and musical instruments (to show tool-making). We felt this was pretty common to many worldwide cultures.

This wasn't a covid conversation but it did occur to me the idea of social distancing and masking is something that people will struggle to continue despite any putative health benefits

(Accept that some people might feel their party days are over )

 

[RAM]

I really don’t know where you get this info from.

Offical email reminding staff.

There is no shortage or rationing of PPE in public hospitals in NSW.
How on earth would anyone know how many masks someone is using on a shift ?

We have plentiful supplies of N95 and surgical masks. Nobody has been told up to 2 masks per shift.

From my daughter and the rest of her now 'Doctors' spread around Greater Sydney, including an email reminding my daughter and her fellow 'new' doctors of this 'up to' limit.

Your experience may be different but not six new doctors nor their colleagues across a few Sydney public hospitals including one in rotation at a very busy A&E.

Post automatically merged: Jul 28, 2022

Fake news.

On every ward I work in there is a table full of masks of every type including N95.
And all the masks are of “professional grade”.
Today I used 6

At your hospital possibly - not at the one's my daughter & her fellow 'new' doctors are at.

 

[Princess Fiona]

Offical email reminding staff.

From my daughter and the rest of her now 'Doctors' spread around Greater Sydney, including an email reminding my daughter and her fellow 'new' doctors of this 'up to' limit.

Your experience may be different but not six new doctors nor their colleagues across a few Sydney public hospitals including one in rotation at a very busy A&E.

Post automatically merged: Jul 28, 2022

At your hospital possibly - not at the one's my daughter & her fellow 'new' doctors are at.

Please provide the links to this email.
It seems like absolute BS to be honest,
You have absolutely no idea nor have zero credibility on PPE for NSW Health staff

 

[Quickstatus]

Your experience may be different but not six new doctors nor their colleagues across a few Sydney public hospitals including one in rotation at a very busy A&E.

I still say fake news
During the Covid peak(s) there was careful monitoring of PPE/masks use. But there was never rationing to 2 masks per day.

 

[scaredeycat]

This was posted by a surgical colleague from Launceston on Facebook recently:


"A recently widowed, depressed and run down elderly man came under me a few days ago unable to eat, having abdominal pain. The scan showed he had an obstruction of the colon from a tumour. Straightforward case on any other time perhaps, but he has covid too, PCR positive. Today we tried to to a flexible endoscopic examination and biopsy to obtain a diagnosis. The only safe place to do it is in the one operating theatre where there is negative pressure ventilation as it is a procedure involving blowing air. But there are other patients with Covid needing operation too and so at 12:30 in the morning tonight, the endoscopy nurses, the anaesthetist and I who have all been working all day, came back, the only time and place available to us and our patient, to carry out a flexible sigmoidoscopy and biopsy. A procedure that normally would take 20 minutes took over an hour tonight, and after I left the staff is still cleaning away. Could we have left it until tomorrow? Well if more patients with appendicitis or sepsis came in overnight, there would be no guarantee that we can do it during the day tomorrow and we might very well end up doing it tomorrow night anyway. Our patient would have been starved for another 24 hours that he can ill afford.
This is how Covid is affecting all of us. I am sure the same scenario is being played all over the country."

Just in case anyone remains under the delusion that the pandemic is over and that we should all get back to living normally...

 

[MEL_Traveller]

Three myths about COVID-19 — and the biggest challenge that lies ahead

With four decades of research on antibodies under my belt, I always felt like I had a pretty good handle on COVID-19. But when I caught the virus in May, my hubris quickly turned into humility, writes Professor Chris Goodnow.

www.abc.net.au

The risk of cardiovascular disease, for example, increased after one infection, but doubled in people who had two infections, and tripled in those who had been infected thrice.​

The numbers translate into 50 extra cases of heart disease per 1,000 people who've had COVID-19 twice.​

and

The researchers found similar coughulative risks with each reinfection for pulmonary disease, clotting and blood disorders, neurological disease, mental health problems, kidney disease, musculoskeletal disease, fatigue, and so on.​

​

I will not subscribe to the position that simply ‘being old’ is enough to make someone think your life doesn’t matter. Or that ‘you were going to die anyway so what’s the problem?’

 

[MEL_Traveller]

Unfortunately @JohnK
…
I have had to live with decisions I have made over the last 50 years deciding who gets the last ICU bed etc. It is never easy. The problem though with your solution we destroy the systems we have that have worked to increase our life expectancy and the quality of life. During lockdowns people didn't get followed up and many are now paying the price.

For the interests of both the patient and the doctor(s) involved, decisions such as this should not rest with an individual. There should be open and transparent guidelines with appropriate avenues of review and appeal.

 

[Lynda2475]

decisions such as this should not rest with an individual

How condescending a view. If an individual does not wish to continuing living, that is their choice alone, no committee of do gooders should be able to force them to keep living. I strongly support euthanasia and believe in living wills and advanced care directives, its not for some person of misguided faith to prolong my suffering if I wish to go because their values do not align with mine.

 

[sjk]

I will not subscribe to the position that simply ‘being old’ is enough to make someone think your life doesn’t matter. Or that ‘you were going to die anyway so what’s the problem?’

Well done, you've successfully defeated all those on here who have been arguing those points, i.e. absolutely NOBODY.

You were looking like a shoo-in for Strawman of the Year, but then this beauty came along:

How condescending a view. If an individual does not wish to continuing living, that is their choice alone, no committee of do gooders should be able to force them to keep living. I strongly support euthanasia and believe in living wills and advanced care directives, its not for some person of misguided faith to prolong my suffering if I wish to go because their values do not align with mine.

 

[kpc]

There is no mask / PPE restriction at the major teaching hospital I work in metro Sydney. I'm fitted for the expensive Trident N95 mask (retails for $5 each when I googled it!) and I have 4 boxes in my office...I go through a few a day....nearly every patient I currently look after has Covid or had Covid earlier in ther admission. Very simple really....no PPE / mask and I don't see the patient and the Union backs this. Ministry of Health knows this so I am surprised that there are alleged restrictions on mask and PPE use in some hospitals.

 

[andye]

How condescending a view. If an individual does not wish to continuing living, that is their choice alone, no committee of do gooders should be able to force them to keep living. I strongly support euthanasia and believe in living wills and advanced care directives, its not for some person of misguided faith to prolong my suffering if I wish to go because their values do not align with mine.

I think you have misunderstood the issue. Capacitous patients (or those with relevant ACDs) don't get referred to ICU against their wishes.
The issue is of a doctor prioritising one case over another for a single ICU bed. In practise these days, the person who misses out usually is found an ICU bed in another hospital. There are sometimes cases where the benefit of ICU is borderline who might miss out in these circumstances. There are lots of guidelines around but ultimately it does come down to making a decision but in most hospitals these days there is collaboration between senior colleagues on that decision

 

[MEL_Traveller]

How condescending a view. If an individual does not wish to continuing living, that is their choice alone, no committee of do gooders should be able to force them to keep living. I strongly support euthanasia and believe in living wills and advanced care directives, its not for some person of misguided faith to prolong my suffering if I wish to go because their values do not align with mine.

Yes, this is a misunderstanding of the context, which as andye points out is regarding the prioritisation for an ICU bed. Not a personal choice of whether you want to receive care. This should not be left to an individual, and there should be clear avenues of appeal by the patient or family.

One of the most upsetting parts of the covid discussion was the apparent eagerness of some ethicists and doctors to get into the discussion of ICU prioritisation pretty early on. Some were advocating ICU beds should be given to the young rather than the elderly. Those with ‘the best chance of survival’.

As it turns out, that may likely have been the wrong decision. As some point out on these threads, very few young people have died from covid, so they probably didn’t need the priority that would have been afforded them.

 

[MEL_Traveller]

Well done, you've successfully defeated all those on here who have been arguing those points, i.e. absolutely NOBODY.

…

Unfortunately that is pretty much the position of those advocating a total removal of all restrictions to try and mitigate the spread of covid. Including not wearing masks in high density situations where social distancing is not possible.

The arguments are that covid is not life-threatening to the young, it affects mostly the old, the elderly were coming to the life expectancy limits anyway, and they probably had comorbidities. And if the vulnerable are concerned they should stay indoors and shield.

It’s very much the argument - by a small, but vocal group - that the elderly shouldn’t be a reason for us to employ any sort of mitigation.

 

[JohnK]

@JohnK
But…

To what extent are we going to enforce all that. Police enforcement?. Make it a crime?

Re healthcare rationing…
Who is more eligible for healthcare and who are less?

I hear what you are saying but I suspect it is very difficult to get such policies just right

I don't think I ever said it was going to be easy but that doesn't mean we should give up trying.

I think it's possible to continue with measures in place to try and stop the spread. And I strongly believe an individual should not be able to male decisions that can affect the health of others.

Can you please explain to me why it is OK to allow children without all their vaccinations go to school unvaccinated because their parents do not believe in vaccinations? The reason they do not believe in vaccination is irrelevant. The only valid reason is cannot vaccinate for medical reasons.

Why isn't flu vaccination compulsory again for the reasons above?

Why isn't covid vaccination compulsory again for the reasons above?

These decisions need to be taken away from an individual. It's not fair that 95% or whatever number comply and the others do what they want.

And @drron you have valid points. That I'm not denying. But as a medical professional I'm sure you don't even know the full impact long covid is going to have in future. Experts are saying that over 500,000 Australians are going to suffer. That's a significant number and one we cannot ignore. What sort of impact is that going to have on the medical system?

One of the basic concepts of a civilisation is coming together and taking care of the weak. We try to do everything to prolong life but then turn around and say it is too difficult to enforce restrictions to ensure health safety for all. So we let people die which contradicts our basic principles.

No vaccination no school.

No vaccination no medical care including hospital. If you want medical care then pay up front.

No vaccination no job.

No vaccination no travel on public transport including overseas travel.

All of the above strictly enforced. See how quickly people comply. People need to accept some responsibility for their actions.

 

[drron]

Unfortunately that is pretty much the position of those advocating a total removal of all restrictions to try and mitigate the spread of covid. Including not wearing masks in high density situations where social distancing is not possible.

The arguments are that covid is not life-threatening to the young, it affects mostly the old, the elderly were coming to the life expectancy limits anyway, and they probably had comorbidities. And if the vulnerable are concerned they should stay indoors and shield.

It’s very much the argument - by a small, but vocal group - that the elderly shouldn’t be a reason for us to employ any sort of mitigation.

I think that you are like a majority of my former colleagues and think of the elderley as decrepit and with major illnesses. The majority of the elderly are in fact not like that and don't end up in hospitals. I well remember a feisty 102 year old who still went out each Saturday night dancing and still participated in Senior Games events. i saw him as his 74 year old daughter really needed nursing home admission. she wouldn't go unless her father went into the same home but the officials wouldn't give their permission for that to happen.

Just remember that the majority of people who die of covid have at least 4 co morbidities. Here is one such paper where the followed everyone 18 and over who had 2 shots of an mRNA or 1 shot of the J&J vaccine in the USA between December 2020 and October 2021 who had a breakthrough infection.

Among 1,228,664 persons who completed primary vaccination during December 2020–October 2021, severe COVID-19–associated outcomes (0.015%) or death (0.0033%) were rare. Risk factors for severe outcomes included age ≥65 years, immunosuppressed, and six other underlying conditions. All persons with severe outcomes had at least one risk factor; 78% of persons who died had at least four.

Risk Factors for Severe COVID-19 Outcomes ...

This report describes risk factors for severe COVID-19 outcome among vaccinated people.

www.cdc.gov

 

[straitman]

How condescending a view. If an individual does not wish to continuing living, that is their choice alone, no committee of do gooders should be able to force them to keep living. I strongly support euthanasia and believe in living wills and advanced care directives, its not for some person of misguided faith to prolong my suffering if I wish to go because their values do not align with mine.

...and what if the opinion of that individual is warped due to mental health issues? What you are saying sounds good on the surface but is appalling in the reality of the real world.

 

[jakeseven7]

Some more data put on who in hospital with covid. 90% of people in hospital are now under vaccinated.

Vaccines have never been easier to get… so take some individual responsibility people, if you are over 30 you can have your fourth shot in AU.