Dear Bellingen Shire
23 March 2021
Well it is just on 1 year exactly since the Prime Minister of Australia recognised the severity of the Pandemic of Coronavirus and declared the shutting of our national borders. We became an island again. We mostly have been able to hold the invader at bay. So far!
All along we have been saying there will be road bumps in the roll-out of vaccines, and there will be times when there appears to be adverse reactions, when the scientists need the space to assess and ensure the best safety outcomes. Well, didn’t we get one of those last week? Unfortunately I believe some of the roadbumps in vaccine supply or delivery, and some of the announcements are to do with politics manipulating news, overshadowing other crises, and nationalistic foot stamping. That is not a scientific assessment I know.
Nevertheless, it is yet again reassuring to see that the European Health Agencies have clarified that scary reports of blood clots forming in people who have had a Covid 19 vaccine are not significant. Yes, blood clots occur all the time and in Medicine it is one of the “red flag” events we look for. When I was a medical Student in the early ‘90s it was an exam question. At that stage Pulmonary embolus – (P.E.) or a roaming little bit of blood clot breaking off from a silent big clot in one of the big veins in the legs when someone is sick and laid up, which then moves to the lung, gets stuck and kills off a big bit of lung – was the biggest cause of sudden death in hospitals! We have come a long way! There are strong protocols in hospitals now that prevent this complication of many diseases or immobility. It’s been a long time since I saw a hospital inpatient with a P.E., but not long since we saw some in the community (and nothing to do with Covid). Smoking increases the risk a lot. Vaping is no better. Covid vaccination seems not to.
You may remember that throughout the worst of Spain’s horror Covid crisis last year there were many reports that Covid19 infection was causing a bizarre blood clotting phenomenon, just like chilblains, or worse – severe frostbite. The abnormal process of clotting is also one of the deadly consequences of an out of control Covid 19 infection in the lungs.
Once again, they have looked at the numbers – 30 something cases reported after over 14 million doses of the vaccine. No more than random chance. But, all over the world doctors, researchers, vendors and governments will keep watching closely for any concerns. Happily as every week and every 10million doses go by, the risk from vaccination is looking smaller and smaller.
At the moment the availability of vaccines in Australia is also a little smaller. The political statement from Italy a couple of weeks ago arresting exportation of vaccine out of Europe to Australia has impacted our access. I suppose they have suffered so much more, and are again diving into another wave over the last week, so it is easy to sympathise with them.
A little closer to home you may have noticed the reports of the rising tide of infections in our nearest neighbour – PNG. Much as I want to see us getting vaccinated, I applaud the government for planning to redirect some of the precious allotment to them. Their need is more urgent. Our need is to provide for their need. I took a position at the beginning of the crisis that in management of infectious disease, we stand or fall by how we treat our most vulnerable. This is just as relevant on a national scale. We could be proud and thankful to help our less resourced island neighbours with any vaccines we can share.
The roll-out of vaccination has gone slower than expected. It looks like in our Shire we will be starting the week after Easter, if the flood waters recede and couriers can make it up the highway. The President of the Royal Australian College of GPs informs us that the change to individual GP practices – all getting a little slow supply – was in response to patients demand stating that they would prefer to have it done at their own GPs practices, where they are known and know the clinicians. Fair enough. It probably also eases a little of the logistics as we can easily verify who fits into the phases of the roll out. As the CSL Labs in Melbourne ramp up local production, we will no longer be hostage to international events. We will be able to let you know that more are available and how we are being directed to make more bookings available.
You can go to the Federal Health Department Covid Vaccine eligibility checker to work out what phase you can be expected to be in. And please take any relative who does not get IT along for the visit. The scenery might be fun.
Now that GPs are administering to our familiar populations we will of course be targeting the over 80s first, as per the government guidelines and “ Rollout Roadmap”.
For anyone with a history of Cancer – Cancer Australia – via canceraustralia.gov.au has lots of FAQs about the role of vaccines for someone living with Cancer.
Some news out of the blue. We were expecting a delay to the flu vaccine this season. Remember last year we had the biggest ever uptake of flu vaccine and that, along with border closures, social distancing and hygiene, mean I have not seen a case of real influenza since February last year.
But now, The Influenza vaccines have arrived! Well ahead of expected timing.
The expert advice is that you need 14 days between a Covid19 vaccine and the flu vaccine. So for those who will be more likely to be getting a Covid vaccine at the start of the local rollout, you have time to get a flu vaccine early this week – Please speak to your GP. Aged care and Health Care workers who are getting the phase 1a rollout in the next week or so will need to wait 14 days after their Covid Vaccine before the flu vaccine. There is a recommended 12-week wait between the first Covid19 and the booster shot.
Some good news in the medical Journals is the foreseeable arrival of a new flu vaccine that is not grown on chicken eggs, and so will be ok for people who have established egg allergy. Don’t know when it will be available however – it might not be this year.
So for the 53rdtime – Please keep safe, and keep remembering hand hygiene, social distancing and an ever so slight readiness to jump back into Pandemic restrictions should there be a break out. Sadly our European cousins are diving into a third or fourth wave with cases rising and hospitals filling, and again talking of locking down too late, while fending off protests against any restrictions or protections at all!
We are safe and well here because of the border closures, the social distancing, the hand hygiene, the mask wearing when there is a breakout. These are the things the evidence shows to work.
The local Covid Testing clinic has run a bit foul of the foul weather today (Monday) – some staff are not able to make it into town with the floods, but then neither are some of the school kids who are the main carriers of respiratory diseases at the moment. We will try to get it going again as soon as bridges are secure.
Remember this is one, non-commercial, and non-brand endorsing observation of the information to hand. Please check with your own GP and if you have vaccine questions get them out now. When we all start our vaccine clinics we will be wanting them to be slick and quick.
Dr Trevor Cheney