‘No man is an island’, wrote John Donne in 1624. It’s as true today as it was then; perhaps more so in our connected world and economy. Australia is a wealthy island and arguably the best place in the world at any time, and especially during a pandemic. COVID-19 has been to health what the GFC was to the economy in 2008-9. How do we move forward? Jeremy Irons’ character in Margin Call gives three ways: ‘Be first, be smartest, or cheat. I don’t cheat and it’s a hell of a lot easier to be first than smartest’.
Not Jeremy Irons
Australia has benefitted from being a wealthy island and we have been spared from the mortality and morbidity of COVID-19. We can see India struggling with this now (click here to help them out!). How can we move forward? Dr Nick Coatsworth, moving on from his widely quoted ‘make your bed‘, says vaccination. Like me, he thinks zeroism is a false god. Like me, he thinks voluntary vaccination is the way to go. What will that take?
Many of you may have concerns about the vaccines; here is some reading and I will get some more information up in the next couple of days. Let’s get open and move forwards!
PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now with new vaccines here to END the pandemic. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.
Better, for you.
Want more?
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If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!
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If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.
The Australian Government is expecting approval of safe and effective COVID-19 vaccines by the end of this month, with a rollout to priority groups beginning mid-February. In addition to being able to administer the vaccine when available, healthcare professionals will also be able to receive the vaccine in the following rollout phases:
Phase 1a
Frontline at-risk health care workers including staff in GP respiratory clinics and COVID-19 testing facilities, ambulance staff, paramedics, ICU and emergency department staff and clinical and ancillary support staff Residential aged care and disability care staff Residential aged care and disability care residents Quarantine and border workers
COVID-19 Vaccine Roll-out to RACFs
*The information provided in this section is relevant to residential aged care facilities (RACFs). Information relating to general practice and other health providers will be distributed as it becomes available. The Australian Government has commenced the COVID-19 vaccine roll-out across Australia, with RACF residents being among the first who can choose to receive the vaccine. Phase 1a of the vaccine roll-out is due to commence next week in some RACFs, with only the residents of the facilities able to receive the vaccine in the first instance. The Department of Health has released a COVID-19 vaccine aged care readiness toolkit to assist RACFs in planning for the vaccine roll-out and preparing facilities for vaccination. The toolkit includes a Site Readiness Checklist and Written Consent Form.
Information is available for aged care workers and residents, their families and representatives to help make an informed decision about COVID-19 vaccination.
As with all other vaccines, valid consent is required before administering each COVID-19 vaccine dose.
Workers and residents may choose to talk to a health professional about the benefits and risks of vaccination. This will help to decide if vaccination is suitable.
The following resources will assist in deciding about COVID-19 vaccination:
Consent by a guardian or substitute decision-maker
Some jurisdictions have specific requirements relevant to guardians (or substitute decision-makers) consenting on behalf of another person.
If consenting to participate in the COVID-19 vaccination program on behalf of an aged care resident, refer to the enduring guardianship legislation in your state or territory for more information.
Phase 1b
Adults over 70 years All other health care workers Begin to vaccinate Aboriginal and Torres Strait Islander people Younger adults with an underlying medical condition, including those with a disability Critical and high risk workers including defence, police, fire, emergency services and meat processing.
Vaccine eligibility checker
The vaccine eligibility checker, hosted by healthdirect, is now live. Users are asked a number of questions relating to age, location, occupation and underlying medical conditions to determine whether they’re currently eligible for the COVID-19 vaccine. If you’re eligible to receive the vaccine under phase 1a, vaccinations will be organised by your employer, or facility where you consult, who will contact you to provide further information on how to receive your vaccination.
Some information for those whose first language isn’t English:
The Department of Health have developed a stakeholder pack for multicultural audiences with information on the COVID-19 vaccines.
The pack contains in-language communication resources and key messages to inform and educate everyone in Australia about the COVID-19 vaccines. Resources in the pack include audio files, videos, social media content, posters and factsheets.
You can also find a letter from Dr Lucas De Toca, Assistant Secretary of the COVID-19 Primary Care Response at the Australian Government Department of Health, about how you can help support in sharing the latest information.
Provisional approval of the University of Oxford/AstraZeneca COVID-19 vaccine is currently anticipated in February 2021, subject to regulatory requirements being met. Both vaccines will progressively be distributed through an expanded number of sites, including general practice clinics, existing Commonwealth GP respiratory clinics, state-run vaccination clinics and pharmacies.
Over-65s and the AstraZeneca vaccine
The Therapeutic Goods Administration (TGA) has provisionally approved the AstraZeneca COVID-19 vaccine for use in Australia for people 18 years of age and over.The TGA statement notes, ‘There are currently limited data available for the efficacy and safety in individuals over 65 years of age. However, the vaccine has been shown to create an immune response in this group and can be used based on the efficacy and safety demonstrated in the general clinical trial population. The decision to immunise an elderly patient should be decided on a case-by-case basis’.
In his General Practice COVID-19 update newsletter, Deputy Chief Medical Officer Professor Michael Kidd states, ‘There is no requirement for people over the age of 65 to discuss with their GP whether they should or should not have the AstraZeneca vaccine, unless they are very frail and/or rapidly approaching the end of life. Patients who are very frail, or their carers, are advised to discuss any vaccination with their GP’.
All vaccines used in Australia must be approved by the Therapeutic Goods Administration (TGA). The TGA assesses the safety, quality and effectiveness of vaccines before they are registered for use.
COVID-19 vaccines will be free for everyone living in Australia and the Government has made it clear that COVID-19 vaccination will be voluntary – but it is strongly encouraged. More information about training for health professionals will be available in the coming weeks that will cover vaccine specific information, multi-dose vials, infection control, wastage, and adverse event reporting.
The Department of Health developed a new vaccine website so you can stay informed. This website is regularly being updated with more information as it becomes available. Information will also be available in 63 languages. Subscribe to the COVID-19 vaccines updates to ensure you receive the latest updates available on the website. Thanks to the AMA for all of this – become a member!
In summary, version 1.0
PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.
Better, for you.
Want more?
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.
Is there a plan? Yes, there is. More accurately, a roadmap!
Australia’s COVID-19 Vaccine Roadmap
The Australian Government is expecting approval of safe and effective COVID-19 vaccines by the end of this month, with a rollout to priority groups beginning mid-February. In addition to being able to administer the vaccine when available, healthcare professionals will also be able to receive the vaccine in the following rollout phases:
Phase 1a
Frontline at-risk health care workers including staff in GP respiratory clinics and COVID-19 testing facilities, ambulance staff, paramedics, ICU and emergency department staff and clinical and ancillary support staff Residential aged care and disability care staff Residential aged care and disability care residents Quarantine and border workers
Phase 1b
Adults over 70 years All other health care workers Begin to vaccinate Aboriginal and Torres Strait Islander people Younger adults with an underlying medical condition, including those with a disability Critical and high risk workers including defence, police, fire, emergency services and meat processing.
Provisional approval of the University of Oxford/AstraZeneca COVID-19 vaccine is currently anticipated in February 2021, subject to regulatory requirements being met. Both vaccines will progressively be distributed through an expanded number of sites, including general practice clinics, existing Commonwealth GP respiratory clinics, state-run vaccination clinics and pharmacies.
COVID-19 vaccines will be free for everyone living in Australia and the Government has made it clear that COVID-19 vaccination will be voluntary – but it is strongly encouraged. More information about training for health professionals will be available in the coming weeks that will cover vaccine specific information, multi-dose vials, infection control, wastage, and adverse event reporting.
The Department of Health developed a new vaccine website so you can stay informed. This website is regularly being updated with more information as it becomes available. Information will also be available in 63 languages. Subscribe to the COVID-19 vaccines updates to ensure you receive the latest updates available on the website. Thanks to the AMA for all of this – become a member!
In summary, version 1.0
PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.
Better, for you.
Want more?
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.
Many of you will be concerned about COVID19 vaccines – especially the mRNA vaccines (because they are new!). Let’s reclaim copium and hopium and give some more reassuring information.
While the Pfizer/BioNTech vaccine had already been approved for use on 25 January, reports of around 30 deaths among more than 40,000 older Norwegian people who received the vaccine prompted the Therapeutic Goods Administration (TGA) to further investigate its suitability for that cohort. But the regulator has determined that older patients can receive the mRNA vaccine, with no cap on the upper age limit.
‘The TGA therefore has concluded that there is no specific risk of vaccination with the Pfizer/BioNTech COVID-19 vaccine in elderly patients.’ Broader discussions with regulators in North America, the UK and Europe reportedly reached a similar conclusion, while the EMA’s COVID-19 vaccine safety update contains further information that helped the TGA form its decision.
In the second phase of vaccine rollout, with the Oxford/Astra Zeneca vaccine (a more traditional vaccine), Australian General Practice and PartridgeGP will do our bit to get those who want to be vaccinated protected ASAP, at scale, as safely as we can. Our plans are well advanced. It is super important to us to play our part – and important that people are informed, and not coerced. We can see that countries and areas overseas – the UK, Europe, the US – are being more affected by COVID, and they are having to take more risks than us. We will learn from them. We will have their data and experiences to look upon before we take the plunge ourselves.
Remember, I’ve also written about risk, here, and here. Bayesian thinking is probabilistic thinking – rather than this will or won’t happen, we consider what is more or less likely to happen. This applies to risk. As Jim O’Shaughnessy has said, ‘we are deterministic creatures living in a probabilistic world’. We want certainty. We get probabilities. Vaccines are not 100% effective or 100% safe (NOTHING IS). Neither are masks, nor social distancing, nor even simple hand sanitiser. Yet all of these, little by little, piece by piece, will lower our risk so we can get back to the new normal of life. Better probabilities, not 100% certainty.
Let’s act.
PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.
Better, for you.
Want more?
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.
Yesterday we talked about risk. Risk is mitigated by knowledge and experience. I don’t know who said this, but I’m going to take a wild and crazy guess and say it wasn’t from Terry Pratchett’s wonderful Discworld series. This gives us another way to mitigate risk. Insurance.
Risks come at us everyday in our personal and professional lives. We accept that life involves risk. Risk happens.
‘Life is a risky business, no-one gets out alive’
unknown
Health concerns us all, especially now, and we try to improve our health or at least to manage it. Some risks are foreseeable but some are not. These drive our uptake of health insurance. Health insurance is therefore a bit of a ‘grudge purchase’ – we don’t really want to buy it but we don’t want to do without it. Is it worth the money we pay for it? Some high profile voices say no. A past president of the AMA agrees:
if you increase the number of GPs by 1 per 10,000 people the death rate goes down 9%
Dr Bastian Seidel; Past President, RACGP
Your health is your wealth, as the saying goes, and you build wealth by spending wisely.
Some tests, treatments and procedures provide little benefit. And in some cases, they may even cause harm. Use the 5 questions to make sure you end up with the right amount of care — not too much and not too little.
Do I really need this test, treatment or procedure?
Tests may help you and your doctor or other health care provider determine the problem. Treatments, such as medicines, and procedures may help to treat it.
What are the risks?
Will there be side effects to the test or treatment? What are the chances of getting results that aren’t accurate? Could that lead to more testing, additional treatments or another procedure?
Are there simpler, safer options?
Are there alternative options to treatment that could work. Lifestyle changes, such as eating healthier foods or exercising more, can be safe and effective options.
What happens if I don’t do anything?
Ask if your condition might get worse — or better — if you don’t have the test, treatment or procedure right away.
What are the costs?
Costs can be financial, emotional or a cost of your time. Where there is a cost to the community, is the cost reasonable or is there a cheaper alternative?
Your GP can be a great ally in navigating through the health system, a great support for you in times of need, and a great investment in your health.
“Patients whose care is well managed and coordinated by their usual GP are less likely to cost the health system more in the long run because their GP-coordinated care will keep them out of hospital.
“Supporting general practice to continue managing these patients – who are growing in number each year – is an investment in health care that can help make the health system more sustainable.”
Past AMA President, A/Prof Brian Owler
PartridgeGP works with you to help you make your best health decisions. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.
Better, for you.
Want more?
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.
In 1990 I watched Graham Gooch of England make 333 and 123 in a Test Match against India at Lord’s. It was a different time and a different country. Gooch looked decidedly unathletic (although apparently a fitness fanatic) and I certainly don’t remember the Indian pace attack as anything like the current potent crew. As Gooch approached his three hundredth run, the BBC cut to a horse race showing the usual tin ear of public broadcasters. It was compelling but hadn’t quite reached exciting. For those of you not baptised into the religion of Test Cricket, simply put, one fellow throws a small hard leather ball in a special way (bowling) at some wooden poles (the wickets) from a distance of 22 yards (the pitch) while another fellow (the batsman) uses a wooden club (bat) to prevent this. Other fellows stand around to catch or intercept the ball, and also provide commentary on the batsman’s skill, character, and parentage.
I moved to Australia and one of the instant upgrades was supporting the Australian cricket team. Staying up in 1995 to listen to Steve Waugh wearing bouncer after bouncer after bouncer as Australia finally rolled the West Indies in their own backyard was incredibly exciting. Part of that excitement was risk. The players had arm/chest guards, gloves, pads, boxes, helmets, and increasingly large bats but the spectacle and danger of confronting 140-150 kilometre missiles was enthralling.
It had a lot of value for the players involved and for the audiences in the West Indies, Australia, and around the world. The West Indies are a collection of independent island countries who only come together as the West Indies for cricket. Much the same could be said about Australia and it’s Federation of States (especially in light of recent border shenanigans). Australia had been planning this assault for years. The West Indies were coming off a long period of world domination and were raging against the dying of the light as their great players aged.
Fast forwarding again, I went back to England in 2013 to watch the Australian team play England at Lord’s. One of the Australian players to watch was a star of the future – Phillip Hughes. He didn’t have the most auspicious day at Lord’s but certainly looked a player of the future. It was to be his final Test Match. Hughes was a short man, like many of the great batsmen, and so had become accustomed to bowlers aiming at his chest and head. He was an accomplished player of this style of (short pitched) bowling. Sadly, in 2014, Hughes was batting in a State game and despite all of his protective apparel, was hit in the neck by a short pitched ball. He was incredibly unlucky to be hit in the neck in precisely the wrong spot. Wikipedia recounts:
causing a vertebral artery dissection that led to a subarachnoid haemorrhage. The Australian team doctor, Peter Brukner, noted that only 100 such cases had ever been reported, with “only one case reported as a result of a cricket ball”
The risk that made the matches in the West Indies so enthralling and the risk that added value to that spectacle was the same risk that ended with Phil Hughes’ death. Certainly players, spectators, and officials thought long and hard about this risk afterwards. As a result of this we now have something called a stem guard which is a little bit of plastic that protects that very vulnerable area of the neck. Hopefully this particular type of injury will never happen again with these consequences. The amount of short pitched bowling decreased, for a while, but then returned to previous levels (perhaps regressed to the mean). Then, something else happened.
Today we can see players like Neil Wagner eulogised for bowling into the batsman’s armpit, shoulder, and head. This line of attack into the batsman’s blind spot can hit them, hurt them, or just put them off their game. Wagner recently won a Test Match for his country like this (with two broken toes).
Further statistics during the current Australia vs India test series show a clear advantage gained by short pitched bowling. Furthermore, almost uniquely in top level sport, this involves the some of one team doing what they do best against some of the other team doing what they do worst (bowlers bowling at bowlers batting). Is this too much risk and who makes this decision and on what basis?
This conundrum – the risk of injury and death versus the benefits of economic value resulting from the spectacle – mirrors some situations we face in medicine and life:
Lockdowns vs Targeted Protection
New Vaccines vs New Viruses
Medication vs Lifestyle
I don’t have a universal answer for this, in cricket, life, or in medicine. I firmly believe that we should have these conversations and come to answers that are transparent and workable. From the macro level in Australia and the world to the micro level in the consult room, I think this is the way we should manage risk. We should be mindful of risk in all of our consultations and all of our dealings with patients. If you would like to be part of a team that can afford and prioritise the time taken to consider risk in each and every consultation and dealing then the way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200 or…
here are the steps!
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.
We live in strange days. Humans have always made sense of their lived experience through stories. Here are some, courtesy of the excellent Morgan Housel (yes, this guy).
Three days after Ronald Reagan was inaugurated in 1981, New York City Council President Carol Bellamy joined a group of speakers at a luncheon to discuss the country’s future.
The group tried to make sense of a world that was hardly recognizable from a generation before.
When it all turns to custard, as they say in New Zealand, one of the safest places on Earth (as I type), your GP is there for you. Your GP is, really, your best insurance.
If you’re a patient, looking for a great GP, PartridgeGP is here to help you, safely and well. You can book a face to face or telehealth consult right here.
If you’re a great GP/Allied Health Professional wanting PartridgeGP to provide you awesome services, facilities, and team so you can serve patients to the best of your ability, contact us here, here, or call Mrs Hayley Roberts on 08 8295 3200.
We live in strange days. Humans have always made sense of their lived experience through stories. Here are some, courtesy of the excellent Morgan Housel (yes, this guy).
Three days after Ronald Reagan was inaugurated in 1981, New York City Council President Carol Bellamy joined a group of speakers at a luncheon to discuss the country’s future.
The group tried to make sense of a world that was hardly recognizable from a generation before.
When it all turns to custard, as they say in New Zealand, one of the safest places on Earth (as I type), your GP is there for you. Your GP is, really, your best insurance.
If you’re a patient, looking for a great GP, PartridgeGP is here to help you, safely and well. You can book a face to face or telehealth consult right here.
If you’re a great GP/Allied Health Professional wanting PartridgeGP to provide you awesome services, facilities, and team so you can serve patients to the best of your ability, contact us here, here, or call Mrs Hayley Roberts on 08 8295 3200.
partridgegp 