Australian Reports of the Virus Spread

[jase05]

A friend came back from Broken Hill today and said the traffic going both ways phenomenal. Obviously some trying to beat the deadline to get out and some being caught unawares that need to be back here

 

[dajop]

Victoria tried regional lockdowns and they were an abysmal failure, I see no reason that SA would repeat that.

I wouldn't necessarily say that. Victoria tried an intra-Melbourne lockdown which was an abysmal failure, but the differential approach between Melbourne and regional Vic and the de facto lockdowns in Colac and Kilmore seemed to work well. (as did NW Tasmania and Barossa Valley lockdowns).

I think we can conclude it is almost impossible to partition an urban area, but possible to isolate a regional hotspot.

 

[lovetravellingoz]

No this is not true. Patients attending Public Hospitals in NSW are tested if they meet the criteria for suspected COVID-19 infection including travel, etc.
I do not know what happens in Private hospitals as I don’t currently work in one.

Plus that would be large number of tests. I think public hospitals in NSW is about 4,500 admissions per day. Private admissions on top of that.

Sources - Hospital data

www.health.nsw.gov.au

 

[Pushka]

We don't - but note that Queensland backdated its requirements to isolate.

Starting from the 6th November?

 

[lovetravellingoz]

I wouldn't necessarily say that. Victoria tried an intra-Melbourne lockdown which was an abysmal failure, but the differential approach between Melbourne and regional Vic and the de facto lockdowns in Colac and Kilmore seemed to work well. (as did NW Tasmania and Barossa Valley lockdowns).

I think we can conclude it is almost impossible to partition an urban area, but possible to isolate a regional hotspot.

The Melbourne Postcode restrictions were too late. By the time they were restricted the wave had already been washing through other parts of Melbourne. Plus people could still go to work etc and so mixing was only partly restricted.

Colac had more of a self-imposed lockdown. Though with two large employers isolating staff that also locked down many people.

Kilmore was basically third ring isolation.

The apartment tower lockdowns all worked very well.

 

[Lynda2475]

This is completely unworkable. The test takes 12-24 hours currently to be reported. Anyone who has a COVID test pending and is admitted goes to a COVID Orange (potential case) bed and/ or ward.
We would need to turn the whole hospital into a COVID orange full PPE environment.
Or we could do rapid turnaround tests on everyone, these cost approximately $3K per person. I don’t think the NSW tax payer can afford it ?

I never suggested you need to wait for the results to treat the person. You can do the same risk assessment that you do now to decide who is high risk and needs to be put in an orange bed pending a result.

But test everyone, so in the event you miss an asymptomatic person when doing the admission risk assessment, you can then move them within a day, instead of waiting for symptoms to appear which could be many days later.

Testing all those who are admitted (never said anything about everyone who attend the ER, we all kow too many lazy people go to the ER when they should go to their GP just to avoid paying for for a consult) will give everyone greater certainty that there is not more undetected community transmission.

As a data point my Dad had a day procedure done at private hopsital recently, he was surveyed re his movements in the 2 weeks lead-up and tested as part of the check in, its standard policy at that private hopsital. Even though he hadnt been to any high risk locations and had no symnptoms and he was home when he got the result.

WRT to rapid tests, I was lead to believe the saliva testes were cheaper (although less accurate) than the swab tests as they do not require a pathologist. If we are paying $3k, then how can airlines in Europe afford to offer them at much less to clear travelelrs at airports? And why was Dan Andrews suggesting they may start using these at MEL to clear SA arrivals?

Im quite horrfied to learn that not all hospital staff interacting with patients arent wearing PPE during a pandemic. Given the high risk of working in a hospital, i would not want a nurse, doctor or orderly to come near me without wearing a mask and face shield - hell even the technicians at my local nail salon wear a mask and face shield.

 

[oz_mark]

Starting from the 6th November?

Back to the 9th.

 

[lovetravellingoz]

Anyone who has a COVID test pending and is admitted goes to a COVID Orange (potential case) bed and/ or ward.

The hospitals that I have direct knowledge in Vic also do this.

At the peak of the second wave this meant that at the hospital my daughter worked at went up to 5 Covid wards some of which were for Covid possible. The number of Covid wards has fluctuated throughout the pandemic.

I will be seeing her tomorrow and one question I will be asking her is how much , if any, the protocols have eased.

 

[jakeseven7]

If the national goal is eradication then I agree. Would be nice if someone told us as citizens though.

SA CHO cracked and broke the national secrecy code and admitted SA wanted to return to an eradication state tonight on 7.30.

WA and QLD have trashed NSW this week as a failure to manage covid properly.... (to eradication).

So it is beginning to seep out...

 

[dajop]

Colac had more of a self-imposed lockdown. Though with two large employers isolating staff that also locked down many people.

Kilmore was basically third ring isolation.

Hence the term "de facto" lockdowns. The media even suggested Shepparton folk were taking on themselves to restrict their movements somewhat. Regional communities tend to have more "skin the game" so to speak when it comes to looking after their own community than a broad sprawling metropolis. Within Melbourne, the only real hope for some sort of partioning would be using the Yarra River, Maribyrnong River, or Merri Creek as dividers, with limited crossing points.

 

[Princess Fiona]

I never suggested you need to wait for the results to treat the person. You can do the same risk assessment that you do now to decide who is high risk and needs to be put in an orange bed pending a result.

But test everyone, so in the event you miss an asymptomatic person when doing the admission risk assessment, you can then move them within a day, instead of waiting for symptoms to appear which could be many days later.

Testing all those who are admitted (never said anything about everyone who attend the ER (we all kow too many people go to the ER when they should go to their GP just to avoid paying for for a consult) will give everyone greater certainty that there is not more undetected community transmission.

As a data point my Dad had a day procedure done at private hopsital recently, he was surveyed re his movements int he 2 weeks lead-up and tested as part of the check in, its standard policy at that provate hopsital. Even though he hadnt been to any high risk locations and had no symnptoms and he was home when he got the result.

WRT to rapid tests, I was lead to believe the saliva testes were cheaper (although less accurate) than the swab tests as they do not require a pathologist. If we are paying $3k, then how can airlines in Europe afford to offer them at much less to clear travelelrs at airports? And why was Dan suggestign they may start using these at MEL?

Im quite horrfied that all hospital staff interacting with patients arent wearing full PPE during a pandemic. Givent he high risk of workign in a hospital, i would not want a nurse, doctor or orderly to come near me without wearing a mask and face shield.

Sorry, perhaps I didn’t make myself clear enough. Anyone who is COVID swabbed and admitted to hospital (for any reason) pending results must be admitted to a COVID unit/ bed.
If we swab everyone who is admitted to hospital then the entire facility needs to be a COVID unit. It’s simply not practical or desirable. Patients with respiratory illnesses and suspected COVID should be managed separately from other patients in the hospital.
I don’t know why you would be horrified that staff aren’t wearing full PPE for every patient encounter, every shift in every facility.
If they were we would run out in days and supposing that we didn’t the untold morbidity and risks to safe patient care would far outweigh the benefits in a place where we have virtually zero COVID in the community.

 

[lovetravellingoz]

Im quite horrfied to learn that not all hospital staff interacting with patients arent wearing PPE during a pandemic. Given the high risk of working in a hospital, i would not want a nurse, doctor or orderly to come near me without wearing a mask and face shield - hell even the technicians at my local nail salon wear a mask and face shield.

There are different levels of PPE. Full PPE is a greater level of PPE. Facemask and shield is not full PPE.

In Vic staff in Covid Positive or Probable Wards wear different PPE in quality and more PPE in type of PPE.

I doubt your nail salon staff are wearing duckbills and PPE suits.

Mask wearing is still required in Vic for everyone where interactions occur, hospitals or not.

 

[Lynda2475]

WA and QLD have trashed NSW this week as a failure to manage covid properly.... (to eradication).

NSW is working to the national goal of suppression and has kept the sporadic community cases to manageable levels. NSW has no obligation to eradicate Covid-19 just because that is what Qld and WA want, it isnt the national policy nor NSW's policy. Gladys has bene pragmatic and at least I feel confident to book a holiday within NSW,

Those of us living in NSW are very happy that we havent been in a severe lockdown, that our schools and business are open and economy starting to recover, whilst supressing outbreaks when they arise.

 

[andye]

Sorry, perhaps I didn’t make myself clear enough. Anyone who is COVID swabbed and admitted to hospital (for any reason) pending results must be admitted to a COVID unit/ bed.
If we swab everyone who is admitted to hospital then the entire facility needs to be a COVID unit. It’s simply not practical or desirable. Patients with respiratory illnesses and suspected COVID should be managed separately from other patients in the hospital.
I don’t know why you would be horrified that staff aren’t wearing full PPE for every patient encounter, every shift in every facility.
If they were we would run out in days and supposing that we didn’t the untold morbidity and risks to safe patient care would far outweigh the benefits in a place where we have virtually zero COVID in the community.

I know I am not as good a doctor when I am wearing a mask and less good again when I am in full PPE. So much of my hospital practice comes from communicating with my patients and these are small but significant impediments. The older, more hard of hearing or confused the patient, the greater the effect. Of course I do my best to compensate for the deficiencies.
Full PPE slows me down markedly so I can do less work in a day.
I am very happy to do things where (a very cautious) risk/benefit makes sense but all actions have consequences on the rest of the day

 

[jakeseven7]

NSW is working to the national goal of suppression and has kept the sporadic community cases to manageable levels. NSW has no obligation to eradicate Covid-19 just because that is what Qld and WA want, it isnt the national policy nor NSW's policy. Gladys has bene pragmatic and at least I feel confident to book a holiday within NSW,

Those of us living in NSW are very happy that we havent been in a severe lockdown, that our schools and business are open and economy starting to recover, whilst supressing outbreaks when they arise.

Totally agree.

But the actual national goal eradication it’s just that no one will admit it.

 

[Lynda2475]

I didnt say FULL PPE i said PPE. I stand buy my assertion that if you are not wearing a mask and face shield Im not leting you treat me.

BTW many of the technicians at my nail salon do wear the KN95 duck bill masks, all wear a minimum of surgical/cloth mask and face shield. Face shields can be disinfected and reused, only surgical and KN95 masks are single use.

When i went to the dentist a few months ago all the staff - dentist, hygenist and dental nurse worse KN95 masks and face shields and gloves of course they have always worn surgical masks and surgical gloves, but the upgrade to better masks and face shields gives patients confidence, for their own safety I wouldnt exepct less from medical staff at a hopsital given hospital is a high risk location.

 

[Lynda2475]

But the actual national goal eradication it’s just that no one will admit it.

I dont think this is true, that is the goals of some state/territory premiers, its not official policy at a federal level nor in NSW.

Whilst ever we are receiving international arrivals and have no herd immunity (which we may get if 80% of the population is immunised with a lasting vaccine) then teh risk remains, which is why only suppression and not eradication is practical.

 

[lovetravellingoz]

I didnt say FULL PPE i said PPE.

With respect you did state full PPE.

 

[Princess Fiona]

I didnt say FULL PPE i said PPE. I stand buy my assertion that if you are not wearing a mask and face shield Im not leting you treat me.

BTW many of the technicians at my nail salon do wear the KN95 duck bill masks, all wear a minimum of surgical/cloth mask and face shield. Face shields can be disinfected and reused, only surgical and KN95 masks are skingel use.

When i went to the dentist a few months ago all the staff - dentist, hygenist and dental nurse worse KN95 masks and face shields and gloves of course they have always worn surgical masks and surgical gloves, but the upgrade to better masks and face shields gives patients confidence, for their own safety I wouldnt exepct less from medical staff at a hopsital given hospital is a high risk location.

Don’t know if you are aware or not but it’s currently mandatory to wear a Surgical face mask for all patient encounters in NSW Health.
In practical terms we have been wearing them throughout our shifts since the end of July which is when this was introduced.
And you did in fact state “full PPE”

 

[jakeseven7]

I dont think this is true, that is the goals of some state/territory premiers, its not official policy at a federal level nor in NSW.

Whilst ever we are receiving international arrivals and have no herd immunity (which we may get if 80% of the population is immunised with a lasting vaccine) then teh risk remains, which is why only suppression and not eradication is practical.

Sorry I will correct myself.

Its pretty clear all states except NSW (and the Feds) are on a eradication goal.

No state is exactly flinging open the door to international arrivals either, capping arrivals to the lowest number they can politically get away with...