[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

  • fredk1000 on 26/08/2021 - 22:06

    Thanks for your most important work to the world.

    With the PPE, like in this documentary about the Wuhan ICU
    https://www.youtube.com/watch?v=KpYhePFx1qo

    You can draw on your PPE, I am pretty sure they did it because of the same reason, they cannot recognise with the gear on.

    Thanks again.

  • TEER3X on 26/08/2021 - 22:11

    What kind of HVAC system does the hospital have?

    Does it recirculate the air? Are there any special uvc filters installed?

    Is it common for staff to contract the virus?

    • shatter on 26/08/2021 - 22:29

      I have no idea! Not a hospital engineer! We have had a few positive cases in surveillance testing, for which the hospital quickly enacted very significant testing and measures to keep staff and patients safe

  • SydBoy on 26/08/2021 - 22:23
    +1

    Why TGA has not approved following medicine approved by FDA?are they waiting for more death or their EGO stoping them ?

    1. Actemra (Tocilizumab)
    2. Baricitinib (Olumiant)

    Also, have you started giving following to patients? How is the response?

    1. REGEN-COV (Casirivimab and Imdevimab)
      2.Sotrovimab

    Importantly why home test kits not available at chemistwarehouse? When in UK and US people can use those but here we can't is BS by TGA.

    Sydney is in bad shape because of failed management of Gladys and whoever advising her.

    Look at WA…Everyone is living life while we are suffering here because of the current government decision.

    • shatter on 26/08/2021 - 22:30
      +2

      These questions are well beyond my scope as a junior ICU doctor sir

      • SydBoy on 27/08/2021 - 04:36
        +5

        You take care mate and we all proud of what every medical and administrative staff doing for NSW but feel sorry for the condition you are in due to failed government strategy in NSW.

        Good luck and take care.

    • TEER3X on 26/08/2021 - 22:35
      +1

      WA and QLD both have better weather in winter so there is lots of time spent outside (plentiful natural vitamin d) and are less densely populated than Sydney or Melbourne. I think Dan and Gladys are crap, but the delta variant was always going to spread once it reached Australia

      • SydBoy on 27/08/2021 - 04:44

        Don't talk about vitamin D. Indian had Covid even though they are full of vitamin D(majority) so warm weather is nothing to do with Covid control.

        Density probably works but not in Perth or Brisbane where in CBD it is easy to get it if Covid was there

        Both states QLD and WA managed well due to strict lockdown unlike NSW where Gladys government want people to die so other get scared and take vaccine similar to UK. If Sydney had lockdown when cases started in Bondi then we all would be in better space then where we are.

        Today Gladys want to open Sydney but regional NSW remain under lockdown because National don't want to loose election next year but there is no one to represent Sydney !

        • TEER3X on 27/08/2021 - 07:17
          +2

          First off there are lots and lots of studies showing the link between low vitamin d levels and poor covid19 outcomes (i.e. death).

          Secondly you cannot compare India to Australia for 2 reasons, one is population density, the other relates to hygiene and health.

          Furthermore, darker skinned people cannot as easily raise their vitamin d levels by going out in the sun.

          Also, if it's stinking hot outside and you're not near a beach, where do you spend your time? Inside!

          Melbourne has a strict lock down, and guess what, it's not working nor is it going to work!

          • SydBoy on 27/08/2021 - 08:18
            +1

            @TEER3X: I don't know whether poor vitamin D is responsible for Covid death but I can say that majority people in India are not deprived of vitamin D and still Covid spreaded all over country and still going on.

            Lockdown do work and they did worked in QLD and WA. Recently in Brisbane there were 10 cases in one school and they locked down entire Brisbane not just 1 or 2 suburb.

            Gladys didn't lockdown Bondi and that decision followed by decision of soft lockdown for 2 months costed many people their life.

            Gladys can play with words but it will be written in the history that she failed people of NSW and many lost their life due to Liberal Government decision.

        • kanad on 27/08/2021 - 19:15

          Indians have one of the lowest level of Vitamin D, nothing to with warm weather.
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942730/

    • bs0 on 27/08/2021 - 00:43
      +2

      are they waiting for more death or their EGO stoping them ?
      Actemra (Tocilizumab)
      Baricitinib (Olumiant)

      Idk where you get your information from, but these are both being used for covid patients.

      Would be nice if people stopped criticising our healthcare system on top of all this misinformation.

      • SydBoy on 27/08/2021 - 04:32

        They both approved by TGA but one is for Covid in Aug 2021 while other still not approved for Covid.

        FDA approved this long ago then TGA. TGA is slow and very very slow during Covid… when compared to FDA.

        Chemistwarehouse still doesn't sell home test kit thanks to slow TGA and scomo policy.

        Our doctors are great except those who think relaxation is good on the day of getting 1000+ cases… Obviously it is decision made by Glady's on the name of medical advice and we all suffering.

        Gladys uses scare tactics to get people vaccinated but innocent people loosing life due to her government tactics and failed gold standard and it is not fair. She should be sacked and never be voted in again.

        • bs0 on 27/08/2021 - 08:21
          +3

          They both approved by TGA but one is for Covid in Aug 2021 while other still not approved for Covid.

          Why TGA has not approved following medicine approved by FDA?are they waiting for more death or their EGO stoping them ?

          When you're not inconsistent with what you say, you sound like you're just rambling and have no idea on what you're talking about …. Kinda like Gladys who you dislike so much.

  • acersaurus on 26/08/2021 - 22:27

    Thanks for your service, can't be easy.

    Are many children ending up in hospital? I heard it was very rare for them to goto ICU but they can get long COVID. Trying to figure out the risk to under 5s.

    • shatter on 26/08/2021 - 22:31

      I have only looked after adults, so unfortunately I do not know, sorry!

      • butwhy on 26/08/2021 - 22:49

        In Texas, paediatric icus are full…

        • Spets on 27/08/2021 - 15:18

          Is there proof or is this hear say

  • acersaurus on 26/08/2021 - 22:43
    +1

    What's your view on treating people at home? Today there were 3 people announced as having died after being treated at home - which is not to say it's a bad idea necessarily and it may be necessary due to resource scarcity, though I wonder if they would have done better in hospital.

    • shatter on 27/08/2021 - 07:41

      Like literally at your house? What kinds of treatment are you thinking of?
      I did hear about the unfortunate three people having died on the news, but I didn't hear about any of the specifics so can't really comment

  • butwhy on 26/08/2021 - 22:45
    +2

    Shatter, please take the time to look after yourself and your loved ones. Rest and don't get burnt out. Unfortunately, the worst is yet to come.

    The other states look on in great fear, knowing what you are going through is just around the corner for the rest of us.

    • popsiee on 26/08/2021 - 22:53
      +2

      I kind of know what you are talking about with Gladdy looking after the state .
      Whole goal is opening and God will only be the one that can help when she and her greatest Ally Scomo opens up too early .

  • Boba on 26/08/2021 - 23:01

    When the young kids / teenagers are admitted to hospital for COVID, is it because they're in a very bad state? Do they need ventilators just the same as adults or do they on the whole seem to be more resilient?

    I'm still a bit uncertain about sending children (under 12 and unvaccinated) to school and have read various things with mixed opinions. For adults it seems more straightforward, just get vaccinated and hope for the best but it's harder to have confidence when you also need to factor in the kids.

    • popsiee on 26/08/2021 - 23:03

      Move to WA . Eastern States are the experiment that WA will have the luxury of watching without being in it .

      • sparkles on 27/08/2021 - 14:41

        Don't get too cocky. Look how that worked out for Gladys.

    • shatter on 27/08/2021 - 15:27

      As above, cannot comment, have not looked after children.

  • megabytez on 27/08/2021 - 00:26

    How often do you get tested?

    If everyday, do your nostrils become so irritated having the swaps up there so frequently?

    • shatter on 27/08/2021 - 07:36

      Not that often actually! Our hours make it quite difficult to get surveillance testing done given we work in the hours of the clinic being open

      • beefmaster on 27/08/2021 - 08:30
        +4

        I would have thought hospital would provide easy access to testing for staff around the clock.

        • megabytez on 27/08/2021 - 13:02

          Or they could organise self-swabs (given medical staff would know how to do the swabs themselves), seal in a plastic bag, and drop-off in a designated area off hours…

        • shatter on 27/08/2021 - 15:27

          Yes, but that means keeping the clinic open around the clock, which stretches our nursing staff further

          • beefmaster on 27/08/2021 - 18:08

            @shatter: Well, for your safety, your family and your patient I thing it is worth it.

  • FareEvader on 27/08/2021 - 00:34

    Aside from wearing a mask, social distancing, washing my hands and getting the vax… what else can I do to protect myself and my family?
    From a doctor's perspective, how can I up my chances of beating covid if I get it?

    I already exercise regularly (HIIT and cardio) weights, healthy diet, don't smoke cigarettes and don't drink that much anymore.

    • shatter on 27/08/2021 - 07:44

      I think you're doing well! Pretty much following the public health guidelines is all we can do

  • Eeples on 27/08/2021 - 01:01

    Hey.
    Have you seen or heard about any patients being admitted with blood clots with likely AstraZeneca being the cause?
    And if so what was their prognosis?

    • shatter on 27/08/2021 - 07:42
      +3

      I have never seen a patient or heard anecdotally from a colleague re: the rare clotting disorder associated with AZ, sorry - it's quite rare after all!

  • rlf on 27/08/2021 - 01:45
    -1

    How is it possible we are 18 months into this pandemic and doctors still cannot tell us why someone people are completely asymptomatic and some people die from this? This cannot be normal? I come from a computer science background and therefore I understand nothing is truly random, there have to be factors and whilst I'm sure you'll say there are - we can't pinpoint some obvious ones?

    And if there is, why has no governments around the world (including ours) focussed on improving personal health to reduce deaths and hospitalisations and only looked at case mitigation? There are benefits outside Covid-19 of course too.

    Lastly, how did India get Covid-19 seemingly under control? I keep hearing they used Ivermectin but I'm not a conspiracy theorist and think it's misinformation - but their vaccination rates aren't good - so how?

    • ozhunter on 27/08/2021 - 06:06
      -1

      why has no governments around the world (including ours) focussed on improving personal health to reduce deaths and hospitalisations

      You'd think the medical industry would make this a priority. I guess if they did, they wouldn't be selling as many drugs.

      I keep hearing they used Ivermectin

      Same.

      https://covid19criticalcare.com/ivermectin-in-covid-19/epide…

      They have such low deaths considering they have a low vaccination rate.

      https://www.theguardian.com/world/2021/jul/21/covid-19-antib…

    • Ughhh on 27/08/2021 - 06:21
      +5

      nothing is truly random, there have to be factors

      Human beings aren't robots or computers. There are way more variables between each individual.

      why has no governments around the world (including ours) focussed on improving personal health to reduce deaths and hospitalisations

      Those are long term solutions that may contribute to better health, but has no short term effects ie. will do nothing to help the issue now. Also, some of those are lifestyle changes, which unless you want to go full dictorship, good luck changing people. Afaik, health eating and exercising has been promoted on TV, school etc for at least the last decade.

    • DingoBilly on 27/08/2021 - 06:35
      +1

      I also find it frustrating but it is just extremely complex.

      Think of the billions thrown into cancer research and many peoplecsmarter than you or I who have worked on that without resolving it. Human biology is just unfortunately hard.

      There are factors that make it worse which shatter highlighted, but it'll never be consistent. Think of the 90+ year old who smokes daily whole life and is still chugging along fine despite high risk for various issues,

      India isn't really under control? 500 deaths a day (+100s or 1000s unreported) atm isn't good? But there is no scientific basis for ivermectin despite a number of studies.

    • shatter on 27/08/2021 - 08:08
      +14

      You sound angry and confused, I get why you feel that way.
      It does seem however, that you and I think in very different ways - the idea that everything can be explained in code in a 'reasonable' amount of time, is not necessarily possible in medicine.
      You could look upon the same idea and ask - how is it that we have not cured every cancer yet? How are there still diseases much older than COVID which we don't understand the cause of? Why have we not developed a silver bullet or drug for everything yet?

      You did however ask 'there have to be factors and whilst I'm sure you'll say there are - we can't pinpoint some obvious ones?'
      - we can. Being vaccinated massively reduces your chances of ever meeting me, or even being in hospital at all.

      "And if there is, why has no governments around the world (including ours) focussed on improving personal health to reduce deaths and hospitalisations and only looked at case mitigation? There are benefits outside Covid-19 of course too."
      I don't know what to say to you man.

      Preventative health is how we have managed serious disease before. When was the last time somebody in Australia got smallpox? We literally eradicated smallpox with vaccination.
      Basically every government in the world is trying to get their populations vaccinated! Pushing COVID awareness campaigns. Lockdowns to reduce spread when needed.
      Someone - like actual real people btw, have to actually organise these huge efforts!
      To say that governments are not focused on improving personal health to reduce deaths and hospitalisation is just blatantly untrue.

      I don't know about India, but last I heard, they were running out of oxygen. I can't comment on that situation there, I don't work there.

      • rlf on 28/08/2021 - 03:08

        Thanks for the reply. I can totally appreciate how complex humans are but like I said, in my field to investigate problems we look at data.

        If you look at the data with say 100 variables of data of people who get severe symptoms and compare it to the asymptomatic cases with millions of samples there have to be variables that stick out why Covid only affects certain people?

        Your response seemed to be hinting I don't believe in vaccination or something, of course, I do.

        If people end of dying from a lack of oxygen, is it not true that increasing one's VO^2 max would be a good start to defeat Covid?

        • Yamun121 on 28/08/2021 - 09:56

          Exercising can increase your VO2 max over time, is that what you mean?

    • prjcarr on 27/08/2021 - 10:15
      -6

      Your question on Ivermectin is a good one. The main reason why it is not being used is because it is cheap - there is no money to be made from Ivermectin so there are no big pharmaceutical companies lobbying for it. Its the opposite, there are big forces lobbying against it and they have the media well and truly on board.

      You, yourself even have to validate that you are not a conspiracy theorist because you mentioned Ivermectin. Have a think about that, and think how well the lobbying has shaped your view on this drug.

      You mentioned India - look at Uttar Pradesh. They adopted Ivermectin early and made it readily available. They came out of the last wave the quickest in India, and are now averaging 21 cases a day, for a population of 200M, in the densely populated conditions that they live in.

      In the last week, Japan has also given the green light for early Ivermectin treatment. They know it works, if prescribed early. Once in ICU its too late. If Australia adopted an approach to provide Ivermectin early, and provide it to close contacts as a prophylactic, I am confident we would get on top of Covid in this country.

      If the above doesn't make you think. Consider this - Ivermectin as a Covid treatment was discovered by Australian, noble prize winner, Prof Thomas Borody. The Australian government ignored him, so he has to go overseas to conduct his trials. His trials showed amazing success, yet all the media want to show is American's taking veterinary Imermectin and getting poisoned - trying to discredit it even more.

      • Lurk Hartog on 27/08/2021 - 10:29
        +1

        If you are genuinely interested in the evidence (or rather, lack thereof) for Ivermectin in treating COVID, read this extremely comprehensive review. The Plain Language Summary is sufficient for most.

        https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD…

        You'll find that there is one good reason why it is not approved as a treatment, and it doesn't involve any conspiracy theories. There just isn't any good evidence.

        • prjcarr on 27/08/2021 - 10:49
          +1

          Yes I have seen the Cochrane review. The issue, along with most Ivermectin studies is that they are judging the effects of Ivermectin when it is given too late. There is lots of evidence that when given early it is extremely effective.

          Even the Chairman of Tokyo Medical Association is now on board:

          “In Dr. Ozaki’s recent speech, he declared that ivermectin has demonstrated significant benefits in reducing infections and deaths where the regimen is prophylactically administered for another indication. The head of the Metropolitan Medical Association declared that while clinical trials were important, it was time to greenlight doctors to prescribe ivermectin in association with giving the patient informed consent.”

          • huggsymersh on 27/08/2021 - 13:25

            @prjcarr: If there is lots of evidence that it is extremely effective, would it not be included in the Cochrane review?

            As Cochrane is a meta-review of all studies, not itself a study, it's meant to establish a baseline of efficacy after considering and reviewing disparate studies. It does state however, that it excludes reviews that are considered lower quality (i.e. papers that aren't peer reviewed, for example). Not all studies are created equal, or conducted with the same rigour or sample size or duration etc etc and so they shouldn't be accorded the same weighting.

            If these other studies that show efficacy of ivermectin have not been included in the meta-review, what might be the reason for their exclusion? Are they low quality? Were they carried out after the Cochrane review was completed? Other reasons?

            For what it's worth, I'm of the view that we throw everything at these viruses. But only if it's tested as actually having an effect. Not showing efficacy now doesn't mean it won't later, with variations in dose/treatment/timing or whatever variable. But with limited resources, best to back those treatments that are shown, as far as objectively possible, as actually working.

            • prjcarr on 27/08/2021 - 14:33
              +1

              @huggsymersh: In meta-review studies I guess you can achieve any results based on your selection criteria? In the University of Liverpool meta-review study they found at 56% reduction in mortality in the Ivermectin group, along with a with favorable clinical recovery and reduced hospitalization. If we are going to throw everything at this virus, how does it hurt for the government to allow/encourage off label Ivermectin use? There are so many doctors around the world anecdotally saying it works, what have we got to lose in prescribing a 50 year old safe drug?

              • ozhunter on 27/08/2021 - 14:36

                @prjcarr:

                what have we got to lose in prescribing a 50 year old safe drug?

                Apparently the pandemic isn't bad enough.

                Imagine the billions some companies will lose out if word gets out there's an available drug on the market that could help.

              • huggsymersh on 27/08/2021 - 17:02
                +2

                @prjcarr: "In meta-review studies I guess you can achieve any results based on your selection criteria?"

                Yes, potentially. But my understanding is that the Cochrane review is the most comprehensive tool for assessing efficacy across the many different studies. It's basically the best tool that we have. If some of the trials that show promise didn't make it in for any specific reasons it isn't good enough to just say that the review was unfair. The criteria are transparent. These scientists all grownups. Advocates of ivermectin need to put on their big boy labcoats and big girl labcoats and do their trials again and do it better!

                "There are so many doctors around the world anecdotally saying it works"

                • anecdotal evidence really isn't very helpful. Anecodote doesn't weed out the many variables of individual circumstances that may impact on a patient's treatment and recovery. The whole point of testing/studies is to try and create a controlled environment to isolate what you are testing to determine if it, and it alone, is causing the recovery, or harm. Anecdote just creates so many opportunities for confirmation bias (i.e. we've prescribed this drug in the hope that it works, wow it's helping, but let's not investigate other factors that may contribute). This is not to suggest that any such bias is intentional. Or that these doctors don't have the best intentions. But they are only human, with our susceptibility for our emotions and desires to cloud judgment.

                "what have we got to lose in prescribing a 50 year old safe drug?"

                • All drugs have potential side effects. Advocating widespread community wide uptake of a drug for off label purposes, at dosages different to that which has been tested to be efficacious and safe for a particular ailment, in the absence of comprehensive and accepted evidence of it's efficacy, strikes me as being significantly risky.

                In this instance, science is the tool for us to be able to make objective assessments about the impact of certain substances on human physiology. As a tool, I accept that it's not necessarily applied neutrally (i.e. Big Pharma funding trillions of $ into diseases that impact wealthy populations like male impotence, heart disease, cancer, and not spending as much money to research cures preventable diseases in the developing world i.e. malaria, TB etc). But I think it's the best tool we have to drill down and figure out what this works.

                I'm not a scientist. Just a science interested lay person. I'd be the first person to celebrate a efficacious cheap effect drug that helped everyone. But at the moment, I'm happy to trust the scientific consensus about what works and what doesn't (while also appreciating that the process is a continuing one).

                Anyway, hope you and your family are going well as can be through all this.

      • Viper8 on 27/08/2021 - 13:29

        " The main reason why it is not being used is because it is cheap "

        1 dose of vaccine is typically $10-20 depending on the type, with some being much cheaper. So sorry, I don't by this idea.

        • prjcarr on 27/08/2021 - 14:52

          ok, consider this. CDC quickly approved Remdesivir - costs US$2340 for a five-day course. Ivermectin $79 for a supply of 20 tablets - still not approved by CDC. The evidence for Ivermectin over Remdesivir in treatment of Covid is far better and has been known for longer.

          I guarantee you that if Ivermectin was still under patent and cost $2000 a course, it would be approved by now.

          • Viper8 on 27/08/2021 - 15:18
            +1

            @prjcarr: Yet all vaccines are far cheaper yet 2 billion are estimated to be produced by years end, which undermines that line of thinking?

            Also where is this wealth of peer-reviewed medical scientific studies on large controlled groups showing it's vastly superior efficacy?

            • [Deactivated] on 27/08/2021 - 15:30

              @Viper8: Where are your references?

              Your leaky modified RNA 'vaccine' is being clinically trialed as we speak and the trials will not be completed until OCTOBER 27, 2022.

              https://clinicaltrials.gov/ct2/show/NCT04470427

              It seems even a parrot (or in this a clinical trial volunteer/guinea pig) can repeat media talking points.

              • Viper8 on 27/08/2021 - 16:35

                @[Deactivated]: Lol. That's Moderna, which isn't yet available. Apples and oranges.
                As you say, my references are common knowledge and readily available including from the Australia Gov.
                These other claims however, not so readily available. Hence me asking for proof which hasn't yet been provided.

            • prjcarr on 27/08/2021 - 15:33
              +1

              @Viper8: I never compared vaccines to Ivermectin. Vaccines are used on the healthy, whereas Ivermectin would be used on the sick, or their close contacts as a prophylactic. Why are they mutually exclusive?

              We know that vaccines do not stop everyone from getting covid, or being hospitalised - why would you be against treating people that do get sick with covid with a cheap, safe and effective treatment?

              • Viper8 on 27/08/2021 - 16:34

                @prjcarr: You compared price points of medical products, and implied anything too cheap will never see the light of day. The vaccines are proof this is not true.

                • prjcarr on 27/08/2021 - 16:49

                  @Viper8: You are comparing apples and oranges. The point is, if a drug has an expired patent and is not financially profitable for anyone, who is going to lobby for its use and approval? Why did Remdesivir get approved by the CDC so quickly?

    • DavidFong on 27/08/2021 - 15:30

      If you come from a computer science background, and think that nothing is truly random, can I cautiously suggest to be careful of 'overfitting the curve'!

      Science-fiction shows sometimes suggest the human body is completley predictable, and a cure can be found with a sufficiently sophisticated computer simulation (a la 'Star Trek', where even the doctors are actually ship engineers).

      There is much more ground for improvement of the use of data and artificial intelligence in medical science. Do a joint Medicine/Data Science degree at Harvard/MIT (it is available)!

      Some really smart people are trying. But the same algorithms and neural networks which predict (sometimes) what you might like to buy from Amazon (the same garbage can you bought last week?) don't always work with medicine.

  • lunartemis on 27/08/2021 - 07:22

    How many anti-vaxxers have you had to deal with coming into the ICU thinking they would never catch it

    • shatter on 27/08/2021 - 07:45
      +8

      Zero. Nobody has ever confessed to me in the ICU that they were against vaccination. The most common reason I hear by far is 'I was waiting for my Pfizer shot'
      That said, perhaps being in ICU sick might change someone's mind

  • Yiddos on 27/08/2021 - 07:47

    A pandemic is inevitable, and like so many things in life, history always find ways repeat itself.

    What would you have done differently if you could turn back the clock 18 mouths? Also, what will you contribute to prevent infectious diseases like this from happening in 100 years time?

    By the way, kudos to you and your colleagues in this very challenging period. Keep up the great work!

    • shatter on 27/08/2021 - 15:40
      +1

      I'm not sure if I (myself as an individual person) could have enacted different actions at that time, to make the current situation now, better. I think 18 months back, which would have been about Feb 2020, we hadn't really felt pressure by the idea of variants of concern, and were grappling with the original covid strain. I remember hearing on the news that there were discussions about concerns of COVID variants back then, but it was thought that it would not mutate quickly and on top of that, we were busy with dealing the original pandemic.

      The country did pretty alright weathering through the original pandemic, but this is a whole new pandemic in itself and we're once again doing it all over, fighting a much tougher opponent, albeit with much better weapons.

      Just a thought - if the present version of me told a past me 18 months ago that there would be a variant of concern that would result in countless young people being tubed in ICU and a whole second pandemic, BUT we have a vaccine which almost eliminates the chances of that, and yet a sizeable chunk of the population remain hesitant … I wouldn't know what to say to myself.

  • beefmaster on 27/08/2021 - 08:26

    What is the risk if I walk into an ICU room full of patients and I only have a face mask bought from chemist warehouse? No eye shield and I do not touch the patient or any equipment.

    Just curious how contagious it is.

    • shatter on 27/08/2021 - 09:07
      +3

      Zero because you won't ever come to the unit if you don't have COVID and don't work there :)
      It's very contagious from what I've heard, similar to chickenpox

        • [Deactivated] on 27/08/2021 - 10:34
          -1

          No cogent response just down votes - go with your reactive feelings then

          • cashless on 27/08/2021 - 16:58
            +2

            @[Deactivated]:

            No cogent response just down votes

            Because you said

            This guy is an absolute shill, not a real doctor working in an ICU

            That is why you get negative votes, it's because of your insulting reply to a really helpful guy who is trying to give us the facts

        • serrin on 27/08/2021 - 10:35

          The first link from the UK government refers to the effective reproduction number (R) not the basic reproduction number (R0).
          The effective reproduction number of chickenpox in Australia is <1 usually. If it were to sit at 10 we would be in the middle of a chickenpox outbreak (but we're not because of vaccination).

          • [Deactivated] on 27/08/2021 - 11:07

            @serrin: we would be in the middle of a chickenpox outbreak (but we're not because of vaccination)

            … because of vaccination OR previously from immunity developed via natural exposure …

            The speed of transmission of Chicken Pox and Covid are not similar - it is disingenuous to claim this.

            Post the 'latest' R0 number then you will struggle to find anything close to 10

            Some of us remember the R0 number given by the CDC as below 2 and asymptomatic carriers were non-transmissible.

            The thread is being aggressively down-voted but hey thank you appreciate the response.

            • trapper on 27/08/2021 - 11:17

              @[Deactivated]:

              The thread is being aggressively down-voted but hey thank you appreciate the response.

              Because you're talking nonsense.

              • [Deactivated] on 27/08/2021 - 11:34
                -1

                @trapper: Nothing says cognitive dissonance like your avatar and an appeal to authority however we have end the chat here before it denigrates further. Thanks for your response - you may be right.

            • bejahi on 27/08/2021 - 13:14

              @[Deactivated]: It was never below 2, it was 2-2 to 2.7 initial estimates.

              That has been revised to 5.7 by CDC.

              Delta variant is estimated 7-8 by CDC.

              Need to get your facts from the source, not facebook my friend.

              • [Deactivated] on 27/08/2021 - 16:31

                @bejahi: It was never below 2, it was 2-2 to 2.7 initial estimates.

                I don't know why I bother, you have no shame.

                Here is the World Health Organisation Press Conference December 2020 Page 14 "R0 is around 1.5"

                https://www.who.int/bulletin/online_first/20-262295.pdf

                • trapper on 27/08/2021 - 16:47

                  @[Deactivated]:

                  https://www.who.int/bulletin/online_first/20-262295.pdf

                  Conclusions
                  This study indicates an important trends on an early outbreak of COVID-19 based on estimated 𝑅0 for the Middle East countries, mean 𝑅0 =3.76 for COVID-19, with median= 3.51. and interquartile range (IQR) = 1.16. in the Middle East.

                  R0 = 3.76 … This is literally the study that you just linked to… lol

            • Ughhh on 27/08/2021 - 18:44

              @[Deactivated]:

              … because of vaccination OR previously from immunity developed via natural exposure …

              Where is the natural exposure? How can a baby become immune to it when there's hardly anyone with it?

              • [Deactivated] on 27/08/2021 - 22:38
                +1

                @Ughhh: A baby is not immune, the baby is exposed to the wild viruses in the community, and developed an immunity to future exposure to the same virus.

                The original comment was in relation to chicken pox where natural immunity was developed by natural exposure to the virus at a young age. This was before vaccination. i was refuting bejahi's claim that chicken pox would run rampant without a chicken pox vaccine. This was or is simply not the case. Even though Chicken Pox is extremely contagious compared to covid, it's transmission through the community was limited by exposure at an early age. Children would then develop an immunity to the virus which was carried to adulthood thus limiting the transmission to the unexposed - 'natural immunity' that is immunity gained naturally, would protect the community and limit the spread

                With vaccines, this is of course different it is an artificial injection of an attenuated (weakened, less vigorous) virus to stimulate an immune response and provides future capacity for the body to recognise and respond to future viral exposure.

                Modified RNA is different again, is not a traditional vaccine - it is genetically modified RNA that is modified to produce proteins that will develop an immune response and claims to provide protection from future virus exposure. However RNA can affect the DNA (despite denials) - if i have to I will dig up the papers - AND if it affects the DNA those changes can be passed to future generations.

                A recent study found NATURAL IMMUNITY developed by NATURAL EXPOSURE to covid is orders of magnitude more effective than vaccinations.

                The study showed that the vaccinated were ultimately 13x as likely to be infected as those who were infected previously, and 27x more likely to be symptomatic

                A good summary here https://www.zerohedge.com/covid-19/ends-debate-israeli-study…

                Read the paper here https://www.scribd.com/document/521947447/2021-08-24-2126241…

        • greatlamp on 27/08/2021 - 12:58

          is the transition into a new monetary system that will provide the cover of plausible deniability for our pimped out politicians and wastrels.

          We have been living with fiat money since the 70s. This conspiracy doesn't make sense

        • bejahi on 27/08/2021 - 13:13

          chickenpox is R0 of 9-10
          Covid Delta is R0 of 6-7, or 7-8 depending on which body is estimating it.

          As a general statement covid being approximately as contagious as chickenpox is true. In terms of comparison there are very few diseases with a similarly high R0 that you could compare it to for the general public.

          But hey bro, don't let me or any other facts get in the way of your conspiracy theory vibes, it suits you.

          • [Deactivated] on 27/08/2021 - 15:19
            +1

            @bejahi: The speed of transmission between covid and chicken pox is different by orders of magnitude.

            But hey even the creator of the PCR tests claims they are inaccurate as currently used and lead to false positives - increasing the transmission count and R0 value. https://bpa-pathology.com/covid19-pcr-tests-are-scientifical…

            However, I am sure you will be correct eventually, when the next '/must vx the children' lambda version that is going to be way more virulent.

            At least post a link to your claims and some independent sources, of course, it is difficult for me to refute as facebook, youtube and the media generally stifle open debate and delete posts questioning the narrative.

            All I am saying is look deeper, this guy is a shill an ICU covid doctor would not be posting on ozbargain, and would not be so imprecise and avoidant when communicating.

            The OP is masquerading, you all should know (but don't because censored) that doctors in NSW who speak up against the hypocrisy, breach of scientific method or the official narrative are being brought before the board and their licences to practice threatened.

  • desync on 27/08/2021 - 08:33

    is there any point getting vaccinated if you're already recovered from Delta?

    i mean there shouldn't be any benefit in the short term right? since you've recovered you've got the antibodies to deal with it, should have immunity (at least short term), the only reason to consider getting vaccinated post delta is maybe in 12 months post recovery and you need a booster to build up antibodies for a new variant

    i've had alpha before, currently got delta, shortness of breath on both occasions, im either at the end of week one or end of week two (hopefully) since infection, if alpha is anything to go by i'll fully recover at the start of week 3 - so hopefully in the next couple of days

    however if i've just gone through the 1st week i'll probably be calling an ambulance within the next few days

    • shatter on 27/08/2021 - 09:12
      +3

      Yeah, you probably should - bottom of page
      https://www.health.gov.au/initiatives-and-programs/covid-19-…

      Best of luck man. Take care of yourself, and yeah, don't feel scared to call an ambulance if you're feeling unwell

      • jv on 27/08/2021 - 10:33
        +1

        don't feel scared to call an ambulance if you're feeling unwell

        unless you don't have ambulance insurance…

    • morse on 27/08/2021 - 12:54
      +1

      Wow! COVID twice! You should do an AMA… all the best for your recovery.

    • DavidFong on 27/08/2021 - 15:34
      +1

      Yes, as @shatter mentioned, it is still recommended to be vaccinated (though there is also a recommended gap, talk with a vaccinating GP, or your
      current COVID case manager, if you have one).

      It is expected that the immunity after vaccination is more durable than the immunity after the infection itself.

      Take care, don't be slow to ask for help from others. Best wishes for your recovery!

  • sardines on 27/08/2021 - 08:38
    +5

    I have been intubated and have worn a mask that shoves air into your lungs due to pcp pneumonia (immunocompromised) - It took me a year to recover physically from been intubated and it scary shit and you hear other families cry and yell in grief -I recall a woman in the next cubical died and saw all the pictures her kids had drawn hung up above her bed..Please get the vaccine to lower your risks ending up in ICU - The Doctors and nurses are great and saved my life but you dont want to meet them — nothing personal :)

    • shatter on 27/08/2021 - 09:14
      +4

      Good god, I am very sorry to hear what you have been through, that is awful. If anyone knows how it feels to be in ICU for respiratory support, it's you. Thank you for sharing

  • Spamazon on 27/08/2021 - 08:52

    Are you using any medicine as a prophylatic?

    • shatter on 27/08/2021 - 09:15

      Yes…..

      • RecklessMonkeys on 27/08/2021 - 10:38

        Hi Doc,
        Do you ever test patients for Vitamin D deficiency?
        There seems to be good evidence that it helps with respiratory tract infections?

      • Spamazon on 27/08/2021 - 14:41

        May I ask what you take?

  • tabitha731 on 27/08/2021 - 09:07
    +3

    Im not going to engage with the whole argument of this virus is a hoax, and the vaccine is to implant ships into the citizens etc…

    Just want to say thank you for your service and contribution to helping us out if this situation. Please stay safe to finish being a junior Doctor and move onto being a senior Doctor. All the best on your long career ahead!

  • windrc on 27/08/2021 - 09:31

    when you are offshifts and need to visit your local stores for groceries and supplies, do you declare yourselves that you work in covid icu or have been to a hotspot? or do you do all your shoppings online nowdays to minimise exposure?

    • shatter on 27/08/2021 - 15:50

      I try to limit how often I go to the shops, but no, I don't identify myself as a HCW, and no, COVID ICU, ward does not count as a hotspot if you have been PPE'd. I'm just another civilian when I'm off duty

Login or Join to leave a comment
Login Join