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

By July 13, 2020 In Focus 7 Comments
Dr Trevor Cheney gives his weekly report from the Bellingen Shire Covid-19 Clinic

Dear Bellingen Shire,

 

As expected the beast has raised it’s hungry cold snivelling head again!

Sounds a bit over the top -and for most that is true, however for society as a whole it is a clear and present danger.

As some have pointed out, we now begin the anticipated game of “Wack –a- mole”.  As Covid-19 pops up in unexpected spots, to need suppressing, and then we wait for the next spot. Tragically we also now wait for the next 2-3 weeks to see how lethal this version will be.

It is interesting to see that there has been enough ongoing genetic mutation/random change occurring in this virus that epidemiologists can see a genetic footprint in the sample taken from people infected, to help trace back the source of some outbreaks or clusters. This also means, as predicted by virologists, that the virus may mutate to become more infectious and serious – or if we were lucky less lethal?? Such a challenge for developers of a vaccine.

Today a university of QLD team announced the first volunteers to be injected with a candidate vaccine . Before we get too excited we need to remember that this phase is just to see if the vaccine is safe and doesn’t cause some dread side-effect. It will take a year to make that call ( or much shorter if it turns out to be a disaster for those poor brave folk). Testing to see if it actually protects us from Covid 19 may take another year.   This is why I keep reiterating that we cannot sit back and wait for a miracle vaccine. We need to be careful, adopt and KEEP UP behaviours now that limit the spread, and put more hope in finding effective treatments.

Ultimately for each one of us our best protection, and treatment, is a healthy immune system. Once again we have received warnings to make sure patients with diabetes, high blood pressure, heart problems have checked in with their GPs or specialists and that treatment is up to date and working. Once again the warning is out there – There has never been a better time to chuck out those filthy smelly expensive smoking things (that rich foreigners are making a fortune out of) and to look hard at how much alcohol or other drugs you consume, so you can give your body a break.

And so we get to another form of controversial protection – mask wearing. The usefulness of a tool of protection – when the presence of a risk is low, is doubtful. However now that we have community spread in Melbourne and potentially south west Sydney, then the whole game changes. Yes we still have no cases found in the Bellinger Shire or the Coffs Harbour region. They will come. So it is also a great time to ensure you have, and understand how to wear, MASKS. At last we have evidence that all masks help – esp in public transport, taxis, crowds, mixing places, probably retail.

What makes a useful mask: – multi layered; fine weave; preferably water repellant material; tied firmly, with a good fit – eg our surgical masks have a little bit of flat tin or wire over the bridge of the nose to shape it onto the nose; not being constantly touched or fiddled with; AND BEING TAKEN OFF TO BE IMMEDIATELY DISPOSED OF OR WASHED IN HOT WATER WITH DETERGENT ie , you don’t put it in your pocket and pull it out 5 times in the day.

The things that make a mask not useful :– when there are no cases possible in the community – eg Tasmania right now; constantly fiddling with it; pulling on and off; being wet; reused with either the wrong material or without being washed (ew!). The council supported support group have folk with skills or contacts for sewing and making PPE. Home made – if done well – is OK!

The whole point of this argument is now is the time to make, or help someone make for you, a collection of washable masks. Make it a fashion statement and start getting used to wearing them. We are mostly a culture not familiar with wearing face coverings. We are about to become one.

It will take time. At the recent memorial we had for my family – as previously heralded – we had screens and face masks issued to each attendee along with temperature checks, contacts numbers and information on safety, with spacings as per regulation. It is not easy to speak into a microphone with a face shield on, and the scene was a bit surreal. I hit my own shield with food 4 times and had to clean it. It is exquisitely difficult for every one to understand this imperative. Does it make it useless trying if not everyone gets it right? Absolutely not! Everything that even works up to 70% reduces the chance of an infectious disease spreading. It is all worth the effort. Our bubble is worth it.

3 key points have risen from the last week, especially the weekend’s events:

A :Mis-communication ( or lack of information) is the dark horse stalking the epidemic and guiding outbreaks.

B: Places of transit and meeting –Crossroads – is where news, goods and communicable disease spread. A big message for people who travel for their work – be it executive, salesperson or truck driver, or all of you looking for a break after the stillness, filling up your car at a transit station on the highway.

C: Still, not everyone takes the threat seriously.

Re A: Please be careful with the information you read. If you associate with someone for whom English is not their first language you could direct them to SBS “coronoavirus information in your language” I cannot vouch for the information as my Burmese and Amharic is limited to “g’day”, but at least this is a body whose business is about being sure the audience gets it. Or you could try the federal govt sites.

Re B: Remember hard surfaces are great ways to pick up viral particles – eg toilet door handles, café tables, handrails on ramps. When out and about, are you carrying your handwash?

Re C: We just gotta keep saying it!   – we can get through this. Australia’s actions so far have freed up our ICU units, allowed us time to prepare, given us the rear guard position to benefit from treatment developments. The rest of the world is suffering beyond what we have yet experienced, and it is only been made worse by foolish populist leaders’ statements.

Unfortuanately with another 2 outbreaks in aged care facilities our death rate will climb again over the next few weeks. The Aged Care facilities will likely need to lock down again soon. However, if there are folk with care training and finding it hard to get work in the next slow down /shut down, it might be wise to be open mided about being available for Aged Care. If any of their staff get sick, or need to isolate, they will be crying out for skilled help.

Amongst new research/advice: – breastfeeding is recommended to continue (of course!) but sick mums might want to wear mask and use hand cleaners. Perhaps what isn’t said is that anyone else who is sick should be isolating themselves and not be around breastfeeding mums and new babies!

Airborne spread is the new concern.   We have been working on the basis that Covid 19 is predominantly carried in heavy droplets that require you to be within 2 meters of the sneezer. This is under challenge – we will see. Reinforces our positioning of the local Covid swabbing clinic in the outdoors, where it is more likely to be dissipated, failing to land on anyone else if someone sneezes, sterilised by the sun.

 

Stay Safe.

 

Dr Trevor Cheney

This is one perspective. Remember to check with your local GP who knows you and the situation you move in.

7 Comments

  • Errol Wood says:

    Can masks be sterilised by leaving in the sun?

  • Margot Pleasant says:

    We are so grateful for your wisdom and knowledge Trevor. Thank You

  • Vivianne Elliott says:

    Thank you Trevor

  • Thank you so much Trevor – each week I look forward to the well-informed update

  • Lynne Light says:

    Thank you for taking your precious time to write these updates. You are so appreciated.

  • Priya Aldridge says:

    Thank you very much for keeping us well informed. It seems that to some degree folks have relaxed and are not following Covid-19 safety distancing advice (not shopkeepers) in Bello since restrictions have been lifted. Because of the asymptomatic nature of the virus it’s easy to think we are not carriers, however it makes it difficult for those of us who feel concerned about avoiding the virus, and also not wishing to transmit it to others in the community. Wondering if it might it be worthwhile to return the flashing sign covid reminder to the main street again?

  • Marg Hopper says:

    Thank you Dr Cheney

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