Weekly Report from the Bellingen Covid-19 Clinic: Dr Trevor Cheney

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

Dear Bellingen Shire

19 January 2021

 

After last week’s rambling journey with philosophical overtones that might have gone on a bit long, I thought this week it might be nice to focus just on a few succinct key points.  Actually the key issue is that there is a key issue looming, and we don’t yet have enough decisive information on the topic yet to be clear and unambiguous.

I am referring of course to the roll out of the vaccine program.

Personally I think there has been far too much conjecture and comment in the general media about the minutia of the choice of vaccines (which is yet to be defined), with media outlets seeking controversy and debate.  There always is found space for a confusing “counter” view.  Controversy is what sells papers, or baits clicking eyeballs, and we are mostly all complicit in that process.   So there is not much high moral ground to complain.

We (GPs) have been informed by the chief medical officer and the Royal Australian College of GPs, and the Australian Medical Association, that we will be involved in helping provide vaccines to the community.  Fair enough. However the how, where, when, with whom, etc , have yet to be sorted.

Smart people are working on it and the logistics will be huge.  Even from our own little shire’s perspective there are big logistical questions to be asked and answered.  I would like to think that the collaborative of the Shire’s Covid19 clinic will be a good template to help us plan how it will all work.

All the GP practices in the region will have an interest in this working, so please feel confident that when we have some details and can see a plan through we will participate in making that very public.  And very clear.  And that is more likely the key point.

There has been so much mixed messaging, and mis-communication, and of course misinformation, ie made up conspiracies, that I don’t want to speculate any more about which vaccines and why and to whom, in what order, till we have some solid info.

This weekend in an edition of “ This American Life” (a radio broadcast from Public Radio in the US) one article was about some chaos and confusion already in the roll out of vaccines in New York.  That was a jurisdiction so terribly hit and in so much need of a clean lifeline.  But I suspect their health authorities have been in survival mode all year.  Paradoxically, clinics were reporting that they have had abundant  vaccines but not where they have people booked to get them.

It is very difficult to plan strategies and invest in the future when one is facing an existential threat.  Interestingly Nations, communities, individuals and biological systems operate in just the same way.  Even down to a cellular level.  Animals and plants will conserve resources and cease reproduction when immediate danger is present, but fall into chaotic behaviour if the threat persists.  Organs in your body shift resources when threatened. When under stress less blood goes to your intestine and internal organs while more is directed to your muscles, lungs, heart and senses – ready to be alert and fast.   This is the adrenaline or “Sympathetic Nervous  System” effect.   Then, when the coast is clear, the opposite part of your nervous system – called the “Parasympathetic Nervous System” gets the guts, digestion, general maintenance under way again.  Hence too much stress – physical or mental can have abdominal/gut side effects.   Even individual cells in your body have a  “danger signal” system that alters chemical processes in each tiny little cell to weather a storm, but at the expense of long term health if the stressor does not pass.

So, we again are in a very lucky position of seeing what is happening elsewhere, and then learning from it and doing the best we can.    According to the Federal Dept of Health, Australia managed to administer 17 million flu vaccines last year – without much hiccup, so we can organise it again.

Speaking of lucky, the Bellinger Shire sewage is now being tested and to date we have not heard of any fragments of Covid19 in the sewage, despite all the visitors to the area.  Your poo is clean!!!, sort of.

From the RACGP there was an appeal this week, to pass on.  Apparently 3 of the new Sydney cases  of Covid19 last week had attended GP surgeries with symptoms  – BEFORE they were  tested and found positive.    This is precisely why we wanted to set up our local clinic.  The message again is that we are not out of the woods yet and the arrival of vaccines somewhere in the country in February will certainly not be the panacea (cure all).

With the holiday season and all the people moving around the region, if you have any -even slight – symptoms please attend the testing clinic.  The wait for results at present is only about 1 day.  The local clinic is there to redirect the question ‘Could this be Covid?’  to a safe place, that is free, and gives you the quickest answer,  while we get on with the rest of the medical and pharmaceutical services to you and the community.

The Clinic opens at 0900 weekdays till either 0930 or 1000 depending on the demand.

Because the cases are still occurring in Sydney, our hospital system is still on Amber alert. That means that visitors to the hospital are restricted, staff and visitors are required to wear masks. Emergency Department presentations are isolated if any respiratory signs.

You may see that obsessions in some medical and general media go on about whether Covid19 is droplet spread, surface spread or airborne.  I have seen impassioned arguments stating that we are ignoring the possibility of airborne spread.  The simple answer is that I believe we are not ignoring any aspect because it is “yes” to all of the above.  Hence cleaning hands helps a lot, distancing helps a lot (big droplets fall to the ground before hitting you), wearing masks helps a lot, cleaning surfaces – eg cafes, tables etc helps a lot.

In anticipation of the vaccine news I just want to restate 1 point.  Whichever vaccines we get, they all work best after the SECOND dose.  1 shot does not save the world.  Immunity only starts about  7-10 days after the shot – which explains some US memes going around about people getting the vaccine but having Covid 3 or 5 days later.  Nothing wrong with the vaccine.  The poor buggers just copped a silent passenger before they got to the vaccine clinic.   Please expect to return for a second shot within a month – whichever vaccine you get. So don’t try to book an overseas flight straight after your first vaccine.

As always this is just one perspective and please check any detail with your own, yet to be Immune, GP.

 

Dr Trevor Cheney

3 Comments

  • Kate Burns says:

    Thank you again Dr Cheney for your reflections. ‘ Controversy is what sells papers, or baits clicking eyeballs, and we are mostly all complicit in that process. So there is not much high moral ground to complain.’
    What a true statement that is.
    Complicit in the junk click bait short cycle media of the circulation of stimulation and conjured controversy.

    If we stop clicking, buying, reading, it has no audience and quickly ceases to exist.

  • Jaki Lockyer says:

    Thanks again for passing on to us your informed awareness of what is happening locally, nationally and globally. It is such a dynamic field with information being gathered continuously, we are all in a state of constantly updating what we have learnt so far. So valuable to have the good oil coming to us from a medical professional to counteract the media headlines.

  • Louisa Fallon says:

    Thank you as always Trevor. Your column is the only source of information I trust! Great to know our sewage has stayed covid free through the crazy holiday season too!

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