[AMA] COVID ICU Doctor in Sydney [closed]

Lshatter on 26/08/2021 - 09:30
Last edited 28/08/2021 - 04:49

Hey everyone, long time lurker here.

I'm a junior doctor in a COVID ICU of one of Sydney's tertiary hospitals.
Wrote this post to hopefully shed some light on what it's like inside the unit, since rarely does the general public have a chance to see or get a feel for what goes on inside the unit.
COVID ICUs are very strictly regulated units - most hospital staff are forbidden to enter (and wouldn't want to be there anyway)

I should probably describe what it's like to be a patient inside COVID ICU.
- there probably aren't good windows, so you don't have much access to natural light and don't know if it's day or night
- we give you dexamethasone which helps reduce the inflammation in your lungs, but it gives you insomnia
- your family cannot visit you at all
- you can't recognise anyone who is coming into your room because of all the PPE we have on
- the usual reason for ICU admissions is oxygen support which can range from uncomfortable (having large volumes of oxygen jetted up your nose - high flow nasal prongs), very very uncomfortable (having pressurised oxygen pushed into you via a tight mask - it feels like trying to breath with your head outside the window of a moving car), or completely intubated.

If there's one thing I want to say, it's please get vaccinated! I have not looked after a single fully vaccinated patient.
If you're in Sydney and eligible for Pfizer and AZ but have to wait 2 weeks for Pfizer, I wouldn't wait.

Some questions I can answer, some questions I can't
I'm studying at the same time as this, so sometimes can take some time to answer, sorry!
Opinions here are my own

Addit - I am closing this AMA, thank you for your questions. There's a number of questions that keep being recycled, which I can't answer eg. Opinion on novel drugs and I am being DM'd for specific health advice. I cannot provide that information to you responsibly on the internet, I am sorry. Please ask your local doctor/attend ED if especially concerned.

Introduce Yourself

closed Comments

        • trev likes bargains on 27/08/2021 - 07:07
          +2

          Good stuff. Things here in SA can change pretty soon so it's great that you are getting the vaccine

      • CMH on 26/08/2021 - 22:17
        +3

        I think it basically comes down to a level of fear involved with the "what ifs" of getting vaccinated.

        I would think the easiest way to help against this sort of "what if" thinking is by essentially providing insurance against any long-term negative health complications from getting the jab.

        Not a foolproof method, but at least the question of "who will take care of my kids/dogs/goldfish" is no longer valid.

        • Gravy on 27/08/2021 - 23:13

          Yeah but not only are they not doing that, but they are also removing liability from the pharma companies if something does go wrong. Fear of what will happen to dependants if something goes wrong is certainly something that could be addressed though.

      • mincemeat on 27/08/2021 - 08:22

        They need to watch ICU videos and listen to medical people. No decision should be made from watching news, or being on Facebook

      • John3000 on 27/08/2021 - 10:50
        -2

        Yeah…'cause genuine immunity comes in a syringe.

      • Jackson on 27/08/2021 - 15:33
        +2

        I also think it doesn't help when people are asked to sign waivers, or companies are given a pass on if something goes wrong. If there's an issue, why are the recipients wearing it if there's a problem? Some countries have a fund in case people have issues from taking the vaccine, but that isn't everywhere

    • morse on 26/08/2021 - 12:12
      +1

      This podcast is worth a listen re convincing people to get a jab https://www.thisamericanlife.org/736/the-herd/act-two-6

        • morse on 26/08/2021 - 12:43

          This podcast kind of looks at this - if found it really interesting.

        • emrifusion on 27/08/2021 - 14:09

          Your comment about trump is just stupid and ignorant. He has been pushing for the vaccine since the beginning! He was even boo'd at a speech he gave in support of the vaccine in front of a crowed in the last week. So realistically if you have taken the pfizer/ bio tech than you should be thanking Trump…
          Fox news is a mixed bag, some for, some against. Its major push overall is about free choice and not mandating vaccination.

          • Orico on 27/08/2021 - 16:05

            @emrifusion:

            Your comment about trump is just stupid and ignorant.

            Are you a Trump supporter? Figures…

            https://www.vanityfair.com/news/2021/08/donald-trump-vaccine…

            So realistically if you have taken the pfizer/ bio tech than you should be thanking Trump…

            I lived in the USA prior to COVID-19 and during it when Trump was president. I can make my mind up on Trump by myself, thank you.

            Fox news is a mixed bag

            no

    • SpendLess on 26/08/2021 - 18:58
      +2

      Only way is if they have a near death experience with covid. Even after that there was an article online where anti vaxxer still said he was not going to get vaccinated after almost dying from covid haha

      I was arguing with one idiot online and he would link to stuff on thelancet to back up stuff like very low mortality rate in kids but then would go against other things in science journal. Its just mind boggling sht. I dunno how anyone can make sense of someone with that kind of logic.

      • MrThing on 27/08/2021 - 07:29
        +1

        they have much more experiencing at being stupid, dont bother trying to argue with them - your out gunned.

        let them die of their own stupidity

    • [Deactivated] on 26/08/2021 - 22:46

      You would have explain why Malthusians that consider human being to be the greatest danger to the planet due to overpopulation and to be the main cause of climate change want to save as many lives as possible.

      Once you work it out yourself come back and try convince me.

    • lunartemis on 27/08/2021 - 07:15

      The sad reality is unless it happens to them, they won't budge and by the time it happens to someone they care about, it is often too late just like other rules such as not wearing seatbelt, using mobile while you drive, drink driving, etc

    • trapper on 27/08/2021 - 10:15
      +1

      I think the single most important thing is to not politicise this.

      Or we will repeat what has happened in the US.

      Don't demonise them, don't censor them, don't suppress them, let them be.

      Just go out and get your vax asap and encourage your friends and family to do the same.

    • nfusion on 27/08/2021 - 11:19
      +3

      If people choose not to vaccinate and they get COVID and need hospitisation, they should face consequences of THEIR choice which they fight so much for and be told to pay the full cost of being in ICU. Should not be the cost to people who chose to vaccinate. You can choose one and demand another.

      • ryderdt5 on 27/08/2021 - 12:48

        By that logic, we should deny care to anyone with conditions directly related to their poor lifestyle choices?

        • nfusion on 27/08/2021 - 13:09
          +1

          I didn't say deny care. I said they should be responsible for paying it.

        • cameldownunder on 27/08/2021 - 16:36

          Like smoking? Yes. But there is a tax on Cigarettes.

        • BoneDr on 28/08/2021 - 07:14

          We do in some areas - there are guidelines on who can get specific procedures for example you are excluded from a Joint replacement if you have a BMI >40 in the public health system in a number of queensland hospitals.

          We do this because the outcomes are poorer for these patients.

    • HoffyP on 27/08/2021 - 14:56
      +3

      You know how I know the vaccine isn't deadly? Why would the government want to kill off compliant people and be left with a bunch of idiots that always argue? Makes no sense.

      • Gravy on 27/08/2021 - 23:26

        This is similar to the question I have posed to a few friends and random facebook conversations with strangers who have been vaccine hesitant.

        Although I worded it into more of an opposite conspiracy to what was in their heads ….. "What if it IS actually a plan to depopulate… BUT by intentionally creating distrust in vaccines so that you are only left with the compliant people alive and ready to work?"

        • ozhunter on 28/08/2021 - 02:26

          Sounds like a movie. As malicious as that would be, it's quite a clever plan. They would be left with those who lap up everything they say and view them as some incorruptible beings whose only care about others

          • Gravy on 28/08/2021 - 07:59

            @ozhunter: Yeah would certainly make for an interesting twist eh.

    • cameldownunder on 27/08/2021 - 16:35
      +1

      Everyone is allowed to have their own opinion, and in our society we should be able to adhere to that. If someone does not want the jab, it is his right to not get it. And if society forces him ( even if it's a majority decision ) it is an indication of oppressive government.
      We don't need to convince the anti-Vaxers, we just need to give everyone time to get vaccinated who wants to get vaccinated, and then let the rest run its course. If someone unvaccinated needs hospitalization, they just get charged a substantial "prcessing" fees.

    • burns13 on 27/08/2021 - 18:33

      You need to show them the Reddit sub, r/HermanCainAwards

  • A4444 on 26/08/2021 - 09:34
    +124

    Hi Doc, just want to say thank you for helping us. Ordinary people are afraid to go in hospital in these challenging times. However, you and your colleagues are there, helping everyone, needs great courage. Thank you.

    • topppbloke on 26/08/2021 - 16:42
      +6

      I actually logged into my account to 'plus' your comment, well said & big thanks to all our brave healthcare workers out there.

  • Big Lenny on 26/08/2021 - 09:43

    is ivermectin more effective than these vaccines?

      • brendanm on 26/08/2021 - 13:41
        -6

        Imagine a surgeon who doesn't know that ivermectin has been used to treat humans for decades.

        https://www.chemistwarehouse.com.au/buy/37944/stromectol-3mg…

        • johnwinkle on 26/08/2021 - 17:05
          +10

          didnt know covid was around for decades. there are no studies that suggest it works for covid specifically, why dont you use panadol to cure covid since thats been used to treat humans for decades too

          • brendanm on 26/08/2021 - 17:16
            +5

            @johnwinkle: You'll notice I said nothing at all about covid. The headline for that "article" is " "You are not a horse" Knoxville surgeon urges caution on using Ivermectin to fight COVID-19". What does being a horse have to do with it? As I said people have been using ivermectin for decades. Whether it does anything for covid, I don't know, I'm simply pointing out that if a surgeon doesn't know that ivermectin can be used for things other than horses, that's a bit of a worry.

            • [Deactivated] on 26/08/2021 - 22:13
              +7

              @brendanm: Because people are buying it from vet stores, versions of it designed and dosed for horses specifically, and then trying to work out what their dose should be of that tasty apple or carrot flavoured paste. It explains this in the article if you were somehow not aware, so you must not have actually read the article that you're complaining about…..

    • shatter on 26/08/2021 - 09:51
      +31

      I do not give opinions on drugs here, not well versed enough in the research. I have never prescribed ivermectin

    • Gravy on 26/08/2021 - 10:12
      +1

      Whilst I can't say either way, I did think this article was worth a read. https://www.nature.com/articles/d41586-021-02081-w

    • dazweeja on 26/08/2021 - 10:31
      +5

      This is one of the best articles on the subject I've read:

      https://www.smh.com.au/national/examine-ivermectin-and-under…

    • Gravy on 26/08/2021 - 12:30
      +28

      Please don't downvote questions people, it may mean valid questions will not be shown. Big Lenny asked a question, it was not a statement.

      It also means that the people asking the questions will feel like they are being silenced/shamed and actually increase their resistance one way or the other, it is better to answer the question, direct the person to relevant resources or else provide a reason why it is not possible to answer.

      • John3000 on 27/08/2021 - 10:52

        When people don't wish to entertain questions…there's a far bigger problem than COVID.

        • cheng2008 on 27/08/2021 - 17:05
          +1

          I don't think it's about entertaining questions, I think it's about the suspicion that the question asker is only asking the question to troll/lead with a preconceived agenda. But yes, we should give them the benefit of the doubt first.

    • Raybert on 26/08/2021 - 21:50
      +1

      This is a presentation that sums up a lot of findings of research that has been done into COVID-19 & medications. It says that there is essentially no benefit in giving someone Ivermectin. It also has some other interesting findings.

      https://dcricollab.dcri.duke.edu/sites/NIHKR/KR/GR-Slides-08…

    • DingoBilly on 27/08/2021 - 06:07
      +1

      No reliable evidence for it. There is a good reason it's not used - doctors are not in on some conspiracy to avoid treatments that will help lives!

    • DavidFong on 27/08/2021 - 14:02
      +2

      As mentioned, being a relatively cheap and well-used medication (in both public health and veterinary medicine), the idea of ivermectin being a useful treatment or preventative for COVID-19 is attractive, but unfortunately not borne out by the evidence.

      I've prescribed ivermectin to other people (for two parasitic conditions) in Australia, it certainly is an easy drug to use.

      In terms of safety, it has about a 1 in 800,000 risk of serious adverse reaction, half of those reactions being encephalopathy ("Serious adverse events following treatment with ivermectin for onchocerciasis control: a review of reported cases", Twum-Damso, 2003 https://filariajournal.biomedcentral.com/articles/10.1186/14…). Encephalopathy affects the brain, it is serious and often damaging.

      Oh, that's about the same (extremely low) risk as a fatal clot from the Astra Zeneca vaccine (approx 1 in a million).

      But still less than the 20 in a million risk of immediate fatal anaphylaxis (allergic reaction) to a course of penicillin, I guess ("Anaphylaxis in the United States
      An Investigation Into Its Epidemiology" by Neugut et al, 2001. https://jamanetwork.com/journals/jamainternalmedicine/fullar…)

      • Dio on 27/08/2021 - 16:31
        +1

        My friend overseas has used ivermectin among his known friends who got infected. He says it cures the illness if used in the initial stages. Cause this drug is so cheap anyone does not promote it or neither funds to research.

        • [Deactivated] on 27/08/2021 - 16:51

          It is being actively researched including in Australia by Monash, but there is insufficient evidence at this point in time to recommend it as a treatment for COVID-19 outside of clinical trials.

          https://monash.edu/discovery-institute/news-and-events/news/…

        • DavidFong on 27/08/2021 - 18:59
          +2

          Steroids (e.g. dexamethasone) are also cheap, even cheaper than ivermectin (for human use), and yet have been researched and now recommended for use in the situation of serious COVID-19 infections.

  • geek001 on 26/08/2021 - 09:49
    +5

    In your opinion, anedoctally, are you seeing most people that end up in ICU have pre-existing conditions or is it kinda random?

    • shatter on 26/08/2021 - 09:58
      +36

      Having pre-existing conditions is a big spectrum. A bit of hypertension, hypercholesterolaemia is completely different from having significant ischaemic heart disease, COPD.

      We don't take everyone to ICU, because it sometimes isn't the right thing to do. ICU might get you out of the hole that is COVID, but it won't fix your years of ischaemic heart disease and COPD. Drawing on an extreme example - if someone is very elderly, bedbound and severely demented - if normal ward level care has not helped, going further with ICU is likely a futile measure.

      The patients that I see in ICU are patients who are functionally reasonably well at baseline, but it does certainly not account for the full spectrum of COVID patients

      • I should add - I have had a lot of young patients with no comorbidites, often with young children to look after, be absolutely slammed with COVID. We frequently look at our patients and think that if we weren't vaccinated - we could totally be in that bed right now in the same circumstances
      • geek001 on 26/08/2021 - 10:07
        +3

        I guess my question was more around the likelyhood of someone healthy needing hospital care vs someone with an underlying condition, not quite around the prerequisite for admitting into ICU. Apologies if my question was misunderstood.

        Let me reframe my question: Are people more likely to need hospital care if they have a pre-existing condition vs normally healthy people? If yes, what kind of pre-existing condition would make you more likely to need hospital care? I am not looking for a clinically proven answer, just curious about your own personal experience in the hospital.

        • shatter on 26/08/2021 - 10:14
          +22

          It's quite difficult to answer this question, but basically, the more comorbidities you have, the more chips stacked against you.
          In terms of what comorbidities - significant heart and lung disease are very important, but there's a lot to consider which can't be answered quickly.
          There is still a lot of randomness on why one person takes it well and someone else takes it really badly - we still don't really know why this is.

          Plenty of young patients with no comorbidites have ended up doing quite poorly in the unit

          • brandt on 26/08/2021 - 18:57
            +4

            @shatter: Thanks doc. This is something which is very hard for us lay people to grasp. I keep coming across this line of thinking which goes "oh he didnt die of covid, he died with covid" which someone has absolutely no way of knowing without being the deceased's doctor.

            My wife's grandfather died in the first wave in Europe shortly after his 92nd birthday. Was he old? Yes. Was he frail? Yes. Did he have diabetes and early dementia? Yes. Did he die of covid? Absolutely. From the first day he collapsed in his apartment to the 12 days later that he died while in intensive care in a coma.

          • juki on 26/08/2021 - 23:48
            +1

            @shatter: may i ask how young? should i be worried about 4-5 year olds

        • 42 on 26/08/2021 - 19:20

          I remember reading that because covid is a beta corona virus, those that have had been infected with similar beta coronavirus in the past may have some immunity and have milder symptoms.

        • mincemeat on 27/08/2021 - 08:26
          +1

          I am healthy, not old, not overweight. Once I had to wait for a bed in ICU pre-Covid, and when finally there I almost didn't make it, I can't say that the bed wait was a small factor, but I know for sure it had nothing to do with the fantastic level of care and hospital staff, it had everything to do with how my body was inexplicably not responding to treatment. There's only so much help they can give you. So there was no way I was going to stay unvaccinated.

    • BOGOF on 26/08/2021 - 10:00
      +2

      I'm interested in this also. My understanding is obese and overweight people are more prone also. Govt. and media rarely ever comment on whether a covid patient in ICU is overweight?

      • shatter on 26/08/2021 - 10:08
        +7

        So yeah, the honest truth is, the more comorbidities, the more chips stacked against you.
        Yes, it's true, being obese does not help with lung function at a baseline (as well as your risk of ischaemic heart disease, diabetes etc etc)
        That said, there is still a fairly large degree of randomness in how one person takes COVID poorly and the next takes it relatively ok.
        If you're wondering whether it's a good idea to lose weight if you're obese/overweight, it always is (provided it's done in a COVID safe manner!)

        If you're asking about if there's a silver bullet that greatly reduces the odds of you from ever seeing me - you're in luck ahaha

        • Keplaffintech on 26/08/2021 - 11:26
          +6

          There is a silver bullet that reduces the odds, and from your experience (and the science) it's vaccination.

  • MrMeow on 26/08/2021 - 09:53
    +1

    What do you think about NSW opening up at 70-80% vaccination rates? Do you feel like the hospital system can cope with the number of expected px in the wards with the 'surge' capacity.

    • shatter on 26/08/2021 - 09:59
      +29

      Not a question I can answer. That question is best deferred to the epidemiologists

    • orangetrain on 26/08/2021 - 11:01

      Why advocate sacrificing 30-20% people? Do you realise you're pushing the rich class' talking points that subtly means taking innocent people's lives in the name of money?

      LNP screwed up the rollout/lockdown and are desperately trying to push this narrative because they're losing votes and donations from the business community who are suffering from crashing sales. If LNP were good leaders, we would've had multiple different vaccines, Christmas Island/desert isolated quarantine, brief lockdowns and more.

      What is fair to lift the lockdown IMO is opening up at three months after the last Australian is able to get vaccinated. Just last week, 16+ are able to get vaccinated in NSW(?), and they can't get first shot til October. So, considering the second dose which is a month later. I would say lockdown until Feb 2021 or until zero cases but that will depend on LNP.

      • Almost Banned on 26/08/2021 - 11:23
        +34

        Yeah - this answer makes no sense.
        Firstly, some people cannot take the vaccine. Some are too young for the vaccine. And some people will simply refuse. We will never have 100% vaccination.
        All COVID vaccines in Australia are free - so money has little to do with it.
        We currently have two vaccines widely available, and a third on its way. How many vaccines do you need?
        Reopening is inevitable and necessary - unless you live on a farm and are entirely self-sufficient and never have to interact with anyone. The only question is when, and to what extent.
        If you are ok with people huddled in their homes with no power/water/gas/food etc then everyone can hard lock down for however long you like - but what will be left when we emerge?
        The reality is that there were 4000 deaths from influenza/pneumonia in 2017 - and zero lock-down. That is in one year - and is still four times the death rate from COVID over a year and a half in this country.
        We need to roll out the vaccinations, likely promote annual boosters, then get on with our lives.

        • orangetrain on 26/08/2021 - 13:24
          +3

          Able to get vaccinated IS not the same as 100% vaccination. Please reread the post.

          There are still people who are booked very late. If we reach 70/80%, before their booking dates, they could die from covid by then and next morning Gladys will gleefully say they they were unvaccinated.

          Do you want to open up without 100% of Australia getting the chance to have both shots but instead open up at an arbitrary vaccination number like 70%?

        • juki on 27/08/2021 - 00:17

          but you cant compare for the same reasons, what would the death rate have been for covid if left rampant?
          I believe the flu is also non existent in Australia this year (which is not the case for covid)..

          in countries with fewer means the vaccines were more efficiently rolled out, maybe it was slow here because it was better controlled thanks to lockdowns.

          maybe i misunderstand your post, its late, but i think aus didnt do too badly

        • ThithLord on 27/08/2021 - 10:21
          -1

          All COVID vaccines in Australia are free - so money has little to do with it.

          With over %50 of the workforce in casual work (LNP vastly under-reporting underemployment) they cannot just simply afford to take time off to:

          A) Get the jab
          B) Take time off/sick leave to deal with the the random side effects

          • DavidFong on 27/08/2021 - 14:10

            @ThithLord: There is no shortage of vaccination clinics open on weekends.

            The administration of the vaccine is mandated to be free, even in clinics which normally charge in excess of the Medicare public insurance rebate.

            Over a course of six months, even if the casual worker normally only takes one week of annual leave in the year, there must be a few days free and, so to speak, "nowhere to go", especially during lockdown periods.

            I'd like to add there has been no shortage of AZ vaccine, and that is damn good enough (safer than a course of penicillin, and if someone said "take this course of penicillin, and you will be 90+% protected against fatal delta-COVID infection for at least the next six months", I think most people would take it), but I know that is not a universally popular opinion.

            • ThithLord on 27/08/2021 - 15:26
              -1

              @DavidFong: Are you talking with any authority here, mate?

              I say this as a early 30s lad whom cannot for the life of me book in a vaccination in SEQ. So you suggesting it's so easy is confusing, to say the least.

              • DavidFong on 27/08/2021 - 15:57
                +1

                @ThithLord: Thanks @Thithlord, I'm a vaccinator (and a GP), and I work in a community health service which, other than the GP practices, has multiple dedicated vaccination sites throughout Melbourne.

                The dedicated sites are open during weekends, including with Pfizer (yes, there has been waiting lists for those. Sometimes a few hours (even "we are really quiet right now. send your patient along"), sometimes a few days, sometimes a few weeks, it has been really variable).

                Young people also come for AZ vaccines (which is also available to young people in state-run vaccination hubs in Victoria). I understand the conversation about AZ is a little bit different in Qld. Obviously AZ is not the favourite option of many people, and the conversation regarding taking AZ has become a rather overly sophisticated discussion.

                I'm also aware, and afraid, that the 'Pfizer for everyone' attitude in some 'Pfizer-only' clinics might make it just that bit more difficult for younger people to get the Pfizer vaccine.

                • ThithLord on 28/08/2021 - 10:27

                  @DavidFong: Fair enough, thanks for the insight! I was genuinely enquiring about your authority, I wasn't being accusatory. Was just checking you weren't some opinionated COVID blaster!

                  The conversation is that you can't AZ in QLD in my age range, I thought. I don't care about the politics of which vac to take but our CHO said take Pz at my age range?

                  Anyway, The four locations I can get Pz were unable to let me complete the booking. We're going to try again, of course - but the booking system is quite…. unwieldy! You have to completely fill it out and then it'll go to the clinic to check if they can take the booking and if not, clears the form and you need to start again to try a different clinic.

                  Maybe we were using it wrong, we'll see.

      • DogGunn on 26/08/2021 - 11:39
        +1

        No one is advocating "sacrificing 30-20%" of people… jeebus.

        Do you think people instantly die once we start removing restrictions if they haven't been vaccainted?

        People who want to be vaccinated (and who are medically able to), will be able to get vaccinated in the next couple of months.

        • orangetrain on 26/08/2021 - 13:21
          +3

          Actually, they are advocating for lockdown to be lifted at 70% 80%. All those 30% 20% who are not eligible or waiting for shots are at risk. Ie being sacrificed.

          Why the hyperbole of instantly die? Its obvious that no lockdown with unvaccinated people will result in deaths?

          • jjjaar on 26/08/2021 - 13:37
            +8

            @orangetrain: Please also remember it’s 70-80% of eligible population, that is, over 16s, that is the trigger for reopening.

            This 70% actually equates to about 56% of total population when children are added back in.

            So it’s not 20-30% of people at risk, it’s 44% of our total population.

          • DogGunn on 26/08/2021 - 14:56
            +4

            @orangetrain:

            Why the hyperbole of instantly die?

            You literally wrote "sacrifice"…

      • ozhunter on 26/08/2021 - 11:40
        +1

        Sacrificing? 🤣

        You realize there are some people who don't want to get the vaccine?

        Look how many are surviving without it even after getting covid.

        There shouldn't be any issue if 70% is enough. Though I do wonder, what if everything opens up at 65% instead of 70%, does the whole country come crashing down.

        • orangetrain on 26/08/2021 - 13:16
          +1

          Do you think 30% of the country are anti vaxxers? People have appointments in October. If we reach 80% before then, tough luck to those trying to get vaccinated, eh?

          • ozhunter on 26/08/2021 - 13:49
            +2

            @orangetrain: No idea, but there seems to be a lot of AZ available. https://www.theage.com.au/politics/victoria/astrazeneca-stoc…

            • jjjaar on 26/08/2021 - 14:36
              +3

              @ozhunter: Yep, and an AZ today means fully vaxxed in late nov. A Pfizer in three weeks via GP means fully vaxxed in early Oct or via state hubs means fully vaxxed in late Oct. (State hub gap between doses is 6 weeks but GP network is 3 in Vic)

              Of course people will wait when the narrative of opening up is based on double doses.

              Also worth noting that many people have also been explicitly told by their GPs not to take AZ.

              • DavidFong on 27/08/2021 - 14:18

                @jjjaar: Actually, a single dose provides more than 50% of the protection of the complete 'two-dose' course. I think one-dose is very worthwhile, even if the second dose never comes!

                As summarized in the Unimelb/RCH weekly vaccine report, 19th August, slide 6 https://medicine.unimelb.edu.au/school-structure/paediatrics… (which summarizes the result of multiple studies, described on slide 23, specific to delta-variant).

                AZ effectiveness against any infection 60-67% (30-67% after single dose)
                Pfizer effectiveness against any infection 39-88% (36-57% after single dose)

                AZ effectiveness against hospitalization and death 92% (71-88% after single dose)
                Pfizer effectiveness against hospitalization and death 75-96% (78-94% after single dose)

                For this reason, in the situation of a vaccine shortage (which is the case for Pfizer), the dose interval should be six weeks, or longer! In fact, it would be far more equitable if no one received the second dose until everyone at similar risk-level has had the opportunity to have the first dose.

                The two-dose narrative is, I fear, media sensationalizing to dramatize how 'slow' the roll-out is occurring.

                The vaccination program's reasonably high coverage of those aged 70+ (at least one dose in about 80%) has been a stunning success. As evidenced by the relatively small numbers of elderly people dying in the NSW outbreak, compared to when Victoria had similar numbers of cases per day in 2020 (sadly, NSW is likely to overhaul Victoria in that regard. But at least the mortality rate has been reduced compared to Victoria 2020).

                I'm very sad to hear that there are many patients who have been told by GPs to not have the AZ.

                I have hundreds of elderly patients (and others not-so-elderly). Not one patient has an absolute contra-indication to having AZ vaccine. Though the younger patients do have the general 'Pfizer preferred' recommendation from ATAGI based on general risk-benefit calculation. Though plenty of young patients have either their own particular risks (and so opt to be vaccinated with AZ now), or their own particular benefits (they want to protect their family now).

                However, plenty of patients think they might have a reason not to have AZ. They even tell doctors at the vaccination clinic that 'their GP/specialist/manager/your boss' said that they could have Pfizer. Sometimes the GP is misinformed. Sometimes the patient is lying.

      • ribze1 on 26/08/2021 - 21:37
        +1

        @orangetrain, i'm getting my first pfizer shot tomorrow, my next shot is 57 days later (22 October), that's what the booking system mandated.

      • Ryk on 27/08/2021 - 09:26
        +1

        As the Doc says in the opening comment. dont wait for Pfizer, get AZ today.

        "If you're in Sydney and eligible for Pfizer and AZ but have to wait 2 weeks for Pfizer, I wouldn't wait."

    • trapper on 27/08/2021 - 10:51
      +1

      imho we should not be considering 'freedom day' until essentially every person who wants to be vaccinated has been vaccinated.

      I mean if we get to 75% and there are no more takers, then what else can we do? but if people are still lining up at get vaxed then we need to hold off.

  • rubb3rchick3n on 26/08/2021 - 09:54

    Source: trust me bro

    • Mokr on 26/08/2021 - 10:21
      -1

      Normally people have to submit evidence to moderators in other forums- people making big claims

      • brokenglish on 26/08/2021 - 13:09
        +3

        Well the people who believe in health advice posted in a bargain forum are the problem 😂

  • Price Hike on 26/08/2021 - 09:59
    +3

    Have you personally treated anyone that has presented to the hospital with COVID-19 that you know attended any of the recent protests, including police officers?

    • shatter on 26/08/2021 - 10:17
      +5

      I have not. I do ask about the nature of exposure if they know, but patients don't necessarily tell me the truth and a lot of the time now, nobody knows anyway

  • cainen on 26/08/2021 - 10:03
    +1

    Have you had anyone come in (that you know of) that was a Covid-denier/anti-masker etc?

    • shatter on 26/08/2021 - 10:19
      +3

      Not to my knowledge

      • dust on 26/08/2021 - 11:34
        +6

        Those people probably don't go to the doctor. They just go to Bunnings to buy and drink bleach.

  • Gravy on 26/08/2021 - 10:15
    +1

    What are your thoughts on building/setting up dedicated covid field hospitals, similar to how China was able to do so within a period of just a week or two.

    • shatter on 26/08/2021 - 10:21
      +10

      A question for the epidemiologists and policy makers. That said, even if you make the physical beds, get all the equipment, I don't know where you'll find the staff to man a new hospital. We are incredibly strapped for staff right now

      • Gravy on 26/08/2021 - 10:28
        +1

        My thinking was that covid wards should not be located in existing hospitals given the covid infections occurring in other wards. Should we be looking at concentrating on completely separating covid treatment staff and and their patients from regular hospitals?

        • shatter on 26/08/2021 - 10:30
          +3

          Logistically, it would be so difficult. I honestly don't know how this could be done

          • Gravy on 26/08/2021 - 10:37
            +11

            @shatter: China appeared to be very prepared for this issue within very limited time. They built a massive hospital in 10 days and staffed it with medical staff from their armed forces.

            https://www.abc.net.au/news/2020-02-03/china-completes-wuhan…

            Difficult no doubt but Oz and state govt has now had more than 18 months to consider this.

            • sjj89 on 26/08/2021 - 14:56
              +7

              @Gravy: China can mobilise and coordinate their workforce to build infrastructure in ways not seen anywhere else in the world. It's quite impressive.

              • StarvingOat on 26/08/2021 - 17:42
                -1

                @sjj89: Or you know…..they spread the disease….and hoarded all the masks and machines in advance.

                Im just saying…

                (Please dont whack me, China #1)

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