Dear Bellingen Shire
11 May 2021
Happy May Day, or Harvest Festival or more important than most days of celebration – Happy Bellingen Show! What a great success and congrats to organisers, volunteers and participants. The same thoughts to Dorrigo Show organisers as well – planning their beaut show in late November – a nice spring contrast. I hope everyone felt a lift seeing so many kids participate. And I hope some folk felt a surge of achievement meeting some resolutions learnt from the Lockdown about participating in life and the community, while we can.
May Day is celebrated in many countries, as well as NT and QLD (who often like to think of themselves as unique countries), on the first Monday in May to commemorate the achievement of working 8 hour days and recognising the value of one’s life is more than work. Oh dear, some of us missed that concept badly. I remember in High school in the 70s seriously being given talks on how we should plan our lives, as the future was predicted to be a time of leisure where we all worked probably less that 20 hours per week, got paid heaps for it, and needed to spend our time pursuing leisurely interests! That was when they called Australia the “land of the long weekend”. How it has changed. Certainly there are a lot of people now only working half time but that is not what they want and the half income doesn’t cut it. And I have seen statistics that we now do amongst the longest working hours in the OECD. For farmers, nothing much changed either way.
Of course May is also the time of federal budgets. Should we touch on that and it’s implication for health? Nup!
Lets get back to Covid19, world wide rampaging disease and lives on the edge. At least I can see what is real there and have some impact on that.
Each week there are changes in vaccine rollouts – after changes in information and supply, and worst of all -developments in international vaccine nationalism and disease diplomacy.
So state of play this week:
Most GP clinics have more AZ vaccines to offer – now to all their patients over 50;
We can also offer it to people under 50 on the frontline or with serious medical conditions if they are happy with the information given;
The Coffs Hospital hub now has been allocated some Pfizer vaccines that they will be giving to hospital staff and volunteers under 50;
Eventually the Coffs Hospital hub will also be giving the Pfizer vaccine to other/all people in health care settings or with medical conditions under 50– please check the Federal governments eligibility checker;
Some time – Maybe the end of the year if supplies arrive – they will extend the Pfizer vaccine to all 18-50 year olds;
Most of our aged care facilities in the region have been visited at last and a dose of vaccine given – or at least offered – to most residents;
In the capital Cities State governments are opening mass vaccination hubs to try to move things along.
Professor Macintyre – epidemiologist and now celebrity par excellence, was on Norman Swan’s Health Report radio show with a decidedly frustrated sounding voice. Her team has crunched numbers looking at different roll out strategies to see if there are some staging approaches that lower our collective and individual risk more effectively…. Nup!
They show that trickle out of vaccines will result in the next 2 or more years of rolling lockdowns and pressure on life style, restricted travel, economic risk, let alone the chaos of a big breakout. “Ring fencing” – an idea where you immediately vaccinate everyone round a known case – only works with long incubation diseases. And it is not helped by the fact that it takes up to 3 weeks before the vaccine has effect – as exemplified by a serious proportion of people in hotel quarantine with the disease claiming that they were vaccinated just before coming home.
She says we only need to get 100 cases in NSW – much less than was in Melbourne’s starting phase, and we would lose the game. The only way to get to a protective level for our community, state, nation, world, is to get masses of people protected all at once – or as soon as possible.
Now, one of the international projects working to that aim is trying to get all nations to suspend patents on Covid19 vaccines, so that manufacturing can be done in many more places. This may seem obvious and a no brainer, except for the dirty greed of “big Pharma”. Unfortunately it’s not so cut and dried. Quality control and faultless technology issues are huge and we need to maintain confidence of vast populations that what they are getting is what it is meant to be. Not every jurisdiction can do that. Anyway, the new American president and about 80 other countries think it is do-able. Curiously Australia has not signed up yet!?
The bottom line is to get moving through the process of protecting as many people as possible so that when the virus marches across our shores there is not enough fertile ground for it to replicate like in India or Brazil, or Sweden, or UK. Again, I am encouraging all over 50s to think hard about this. If supply is about to no longer be the bottleneck then hesitancy and “I’ll just wait a bit longer till the best one comes along” is the next danger. There is no perfect option. There is no successful treatment. There is no perfectly risk free vaccine. There is no place to hide! – (oops perhaps that takes the melodrama a bit far. I know of some really cool caves…)
You no doubt have heard of the mystery cases in Sydney last week. Wow, that guy got around! The trick is that we still don’t know the link between the virus importation and the fellow who was unfortunate to pick it up. We assume there is someone walking around in Sydney who had no idea they had the virus and were (or still are) of course shedding it. Please think about this if you are on your way to Sydney, or indeed have just come back, and look up the State government website of places under alert. There are still activity restrictions in the public health orders for Greater Sydney this week.
There is still a sewerage-testing program, and they have found viral particles in Marrickville and Allambie heights treatment plants. Fortunately not in Bellingen Shire, Nambucca or Coffs. So you think your S*** don’t stink? Well, sort of.
The Critical Intelligence Unit is trying to gather more data on the safety of people with immunosuppression and cancer. I seem to get asked about this every day – and that’s fair. While no one has definitive evidence, the very strong theme is still that people with any immune disease or immunosuppression, cancer, blood disease, are at way higher risk from an infection, and the only real risk from the vaccines is that the protection won’t be as strong. I know this seems repetitive, but just making the point those researchers will keep looking to see if the advice is solid. There was even an article advising those with inflammatory bowel disease (eg Crohn’s, Ulcerative Colitis) to get any vaccine that is available ASAP. People at the severe end of conditions with organ transplants, aggressive chemotherapy or stem cell transplant need to talk with their primary specialist, as there is just an issue of timing that is important.
Just on something completely different, I heard a discussion on the first prospective malaria vaccine that looks like it might actually work. It is going out to trials in sub Saharan Africa. UNICEF States that Malaria kills 3000 children per day. So far the most effective intervention ever invented has been nets impregnated with pyrethrin. Kind of a domestic border closure -just at night. They reduce the risk to a child by 50%. Less than 5% of children in Africa have one. A vaccine has been a holy grail for researchers, but the complicated lifestyle of the parasite has beaten them so far. Watch this space.
As the climate changes it is easy to see Malaria coming to Australia. There are surveillance sites around the Northern coast looking for the mosquitoes that carry it. What a wild job.
I would like to take great Joy in admitting to being wrong about something. In a previous letter I mentioned that there was a flu vaccine coming that is not grown on eggs – so is safe for people with egg allergies. I thought at the time it is years off. Well that was the mistake. It is available now. It is not yet on the free list so you would have to talk with your Dr and the pharmacist, but it is available for those folk who could never get flu season protection before now.
As always these are observations on the various news and reports from one perspective, without advertising, commission or any relation to any Pharma, though pretending to be a farmer.
Please check with your own GP, and get making something for the Dorrigo Show.
Dr Trevor Cheney