Update from the Covid 19 Clinic- Dr Trevor Cheney

Dr Trevor Cheney gives his weekly report from the Bellingen Shire Covid-19 Clinic

Dear Bellingen Shire

 

We have been given permission to get out and about. This is great. The beach venues along the coast were thriving. At caravan parks it was a perfect weekend and some even brought their large screen TVs, so vital was it to see a game of footy at last.

Gosh let’s hope the decision was the right one! We are back to the situation of again watching the next 2 weeks to see if there is an uptick in cases, or whether we have dodged the proverbial “bullet”.

It is curious to see Covid19 dropping off the news a bit. As is our habit, the next big crisis has taken over. Now the poor folk devastated by the bushfires – as victims, as exhausted heroic firefighters, and some were both – are now 2 crises ago. This is tragic, not the least in that we run the risk of those in power forgetting, (or not being held to incorporate) the lessons that were being literally burned into our consciousness, and the bush fire season here is only another 3 months away.

Covid 19 is being reported in 213 countries around the world now. That does not leave many. Australia is sitting at No 66 in number of actual reported cases, and as I have previously asserted, I think our numbers will be pretty honest. It is probable that some countries will be not reporting or even diagnosing cases because of politics, vested interests, lack of resources, or breakdown of civil structures, despite how hard their medicos try.

Nevertheless, we are in a much less bad position with 7265 cases, and only 102 lives lost. Perhaps more relative statistics are : cases per million population; or deaths per million. The US is up there with >6000 cases/M, and tragically 340 deaths/M. The UK is worse in Death rate. Australia is sitting at 285cases/M and only 4 losses of life/M.

These kind of numbers are why almost all the reporting and discussion in medical newspapers and journals is almost universally positive about the shutdown, in full acknowledgement of the cost.

So having caught up with protective systems, hospital crisis surge planning, commissioning ICU beds with respirators, building testing capacity, getting a bit more Personal Protective Equipment, we watch the community venturing forth.

And then the protests.

As a medico it is terribly hard to watch thousands take to the streets when we know there is a deadly virus lurking out there. Yet we are also by definition carers and at times advocates for the less fortunate, the uncared for, the suffering.

In civil society, law councils, social conscience groups, I also see concern raised that the Covid crisis , as big as it is, must not be allowed to be a cover for suffocation of civil rights, unaccountability, bad behaviour by the powerful as well as the public.

At the same time we are carers for police officers, so many good (often young and principled) people trying to help or protect their communities. Yet they are thrust into a position of conflict with so many others that they could see as friends otherwise. Perhaps the Supreme Court’s last minute permission for the rally was the least of 2 evils –recognising the medical nightmare of so many people out and mixing, yet preventing the social and medical nightmare of a great big conflict.   Tim Costello, a very interesting commentator and elder statesman (regardless of your politics or faith) made a comment on Friday night that perhaps the steam could be just taken out of that protest movement by governments simply implementing all the findings of the royal commission thqt we paid for 20 years ago!!

But back to Covid – now we have tens of thousands of people mixing in the streets of our capital cities, and more thousands breaking out of the cities this weekend. Please keep thinking social distance and hygiene – the next 2 weeks once again will tell. On the upside at least we now have monitoring and treatment systems ready that can respond very quickly if there is an outbreak.

Trials are getting on regarding treatment options. Once again there is some controversy. The world’s premiere medical journals -the Lancet and New England Medical Journal have retracted a couple of major Covid papers. One claimed to demonstrate that hydroxychloroquine was not helpful, while the other suggested some common medications were harmful. Now again we don’t know.

Previously we were asked –who does one believe? –especially when there is controversy in science. Everyone wants some certainty to clutch at this worrying time. Ironically, this turnabout demonstrates the best of all scientific endeavour – the ability to question and correct itself. As I have pointed out before the most fiercely held and unshiftable assertion about causes and conspiracies is more likely to be the hoax. The constant questioning, testing, evolving, arguing and ultimately best possible evidence may not seem so forceful but is so much more real. Follow the fuzzy path.

This is also why it takes so long to get some safe treatments. The first flush may be a disaster. There are still many who remember with horror the word Thalidomide, who will hopefully take some comfort from the fact that well controlled anti Covid trials are under way in Australia and everywhere. By the time we cannot avoid this virus with a real wave, it is very likely we will have been lucky enough to benefit from that research. If we can just keep the numbers down!

A final follow up on a previous issue. Last year we had >30 500 cases of influenza by this time. Currently we have 208!! Yes, last year was a bad year, but still usually the numbers are in the thousands. Once again the simple message is hand washing, staying home when sick (esp kids), don’t cough on people!

With these messages Thousands of lives have been saved from Covid, Thousands have been saved from Influenza A.

And please feel confident – we will be very keen to let everyone know if there are cases in the region. We all have so much to gain from trust and honesty about this threat.

May we take that old lesson to all of our dealings – big and small.

 

Dr Trevor Cheney

Please note that this is one perspective – please check any questions with your own GP

 

4 Comments

  • Doerthe says:

    Thank you for your continued updates. Much appreciated.

  • Jaki says:

    ‘We all have so much to gain from trust and honesty about this threat.’
    About this threat, all threats … Such a life lesson.
    Thanks and deep regards to you Trevor ,

  • Anne Latham says:

    Very interesting article. Thankyou for your time and insights.
    Anne

  • Paul Netterfield says:

    Thank you for your thoughts and updates. To get the information from a medical perspective it is important for me. I’m staggered by the influenza decrease, being orders of magnitude lower than previous year(s). I’m wouldn’t argue against vaccination because I usually get the flu vaccine, but you have to wonder if the better way to go is to not infect other people every year by ‘soldiering on’. And even then, does it work? I have no idea, but it seems to work for me. The science might one day tell us the best way, but at the moment it seems to be isolate and don’t spread it. Especially in offices, and other enclosed spaces. Anyway, thank you.

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