Australian Reports of the Virus Spread

[lovetravellingoz]

For those interested ( which I am as reports like this are part of my career) in the technical details of how aersols move in healthcare settings, and suggestions for control and prevention ( to minimise the spread of the virus) you can read this new Health Technical Advice.

This Health Technical Advice has been provided in the context of recent developments in the COVID-19 pandemic in Victoria which include increased health service worker transmissions and the need to reduce the risk of transmission of COVID-19 in healthcare settings. Recent data and early studies1 demonstrate increased risk and a steady rise in the number of healthcare workers contracting COVID-19. The data highlights the importance of effective infection prevention and control strategies in health facilities to reduce the risk of transmission of COVID-19.








Full report at:

https://www.dhhs.vic.gov.au/sites/default/files/documents/202106/Aerosol-study-within-healthcare-environments.pdf

 

[bcworld]

Plenty of people have suggested moving quarantine out of the cities into the regional areas.

If people means people in the comments section or on Twitter, yes, but I'm not sure any govt or health body has suggested building 'remote' quarantine facilities.

 

[lovetravellingoz]

Extract from VicDHHS Daily Report
Media release
14 June 2021

Update: Outbreaks​

The two new locally-acquired cases are children – one is a contact linked to Reservoir cases announced Thursday, and one is a contact linked to a case in the City of Melbourne announced Saturday.

No community exposure is associated with these cases during their infectious period.

Public health teams investigating the unlinked case announced Saturday have determined transmission likely occurred in a shared facility within a low-rise townhouse and apartment complex in the City of Melbourne.

Yesterday, the Department contacted the registered owners of residences in the complex to inform them of the potential transmission.

Most residents at this private residential setting will be managed as Tier 2 contacts – with a further number closely associated with the shared facilities to be required to quarantine for 14 days.

Department of Health specialist nurses have been on site today working with residents, and a pop up testing facility was established across the road by 9am. More than 100 tests have been conducted so far.



In relation to other investigations, contact tracers are also focusing in on an industrial precinct in Thomastown just south of the Metropolitan Ring Rd.

There have been ten public and private exposure sites within this precinct – some are published online, some have since expired past their 14 days exposure period, and some are smaller private settings.

While this precinct is not an exposure site, the Department wishes to remind everyone who has worked in the precinct – or who regularly delivers goods and services there – to stay vigilant for symptoms and get tested if they have, or are, experiencing them.



Full report at: Department of Health and Human Services Victoria | Coronavirus update for Victoria – 14 June 2021

 

[suze2000]

Annastasia wanted the fed govt to fund one at Toowoomba. There is a large freight airport at Wellcamp ( 8km outta T'ba) that can take international flights, but also Toowoomba Hospital would also need a major upgrade to cope with a large number of sick Covid patients !

But the thing is there aren't "a large number" of sick covid patients. Currently Australia has a 3% death date. Assuming today's number of 119 active cases, that's 5 deaths (maybe) and I'd guess maybe 3 times that number end up in hospital, that's 15 or so people might be in hospital right now all across the country. That's not many patients per state. Now I know that QLD for some reason sends all their covid-positive patients to hospital, but most of these patients would be non-acute and could be driven the extra hour or so to Brisbane from Toowoomba. I just do not see these as insurmountable challenges.

ETA: turns out there are 25 in hospital right now, but I bet that number is skewed by the number of people in QLD who are there and not "very sick".

 

[dajop]

ETA: turns out there are 25 in hospital right now, but I bet that number is skewed by the number of people in QLD who are there and not "very sick".

Looking at states that don’t hospitalise al positives, righr now there are 64 active cases in VIC. 3 in hospital and 33 in NSW with 1 in hospital. Seems to be a rate of 3-5%.

 

[oz_mark]

If people means people in the comments section or on Twitter, yes, but I'm not sure any govt or health body has suggested building 'remote' quarantine facilities.

Depends how remote is remote, but the WA government suggests Christmas Island, Exmouth and Derby as good locations.

 

[suze2000]

Depends how remote is remote, but the WA government suggests Christmas Island, Exmouth and Derby as good locations.

I'd argue those places are too remote. Needs to be close to Perth. Or at least, Gerro or Bunbury. Decent sized hospitals.

 

[oz_mark]

I'd argue those places are too remote. Needs to be close to Perth. Or at least, Gerro or Bunbury. Decent sized hospitals.

They seem to have settled on Busselton as their suggested location, but to get a flavour of the WA governments position,

“The best solution is obviously the Commonwealth using a remote location for these purposes next to an international airport but, so far, they have steadfastly refused to do so.

Exmouth, Busselton ‘make sense’ for new quarantine facility: McGowan

The WA Premier says if the federal government was to create purpose-built quarantine facilities it makes sense to do it somewhere with an internationally capable airport.

www.watoday.com.au

 

[lovetravellingoz]

Looking at states that don’t hospitalise al positives, righr now there are 64 active cases in VIC. 3 in hospital and 33 in NSW with 1 in hospital. Seems to be a rate of 3-5%.

The 3 in Vic are I think all aged care residents who are in hospital mainly to remove them from the Arcare Aged Care Facility. I don't believe that they are unwell with covid but they may well have ongoing medical conditions.

If they were not from that Arcare Facility, and if they do not have other ongoing medical issues (and they may) , they would most likely be in quarantine elsewhere.

 

[Pushka]

Surely the issue with remoteness is well addressed by regional hospitals and if needed RFDS. People residing in remote areas get sick too yet there’s (obviously) no thought of moving everyone to CBD and metro areas. Not CI remote though

 

[drron]

Regional hospitals are not always the best places to treat a Covid outbreak.Having worked in Tasmania during the NWRH outbreak that was brought home forcibly.
They would need an ICU with intensivist cover and preferably a hands on ID physician which the NWRH now has.
When I worked there Geraldton did not.Basically all serious cases went out by RFDS.Great for me as when on call it was only until midnight.any case needing physician input after that was sent out on RFDS.Not the ideal for a quarantine establishment.
As for Christmas Island they did try that out but didn't continue using it.This months occurrences with the transfer of a child to Perth also suggest it is not a viable option.
I have already reported that the medical establishment in Toowoomba has doubts about the suitability of Toowoomba for a quarantine facility.

 

[Pushka]

Regional hospitals are not always the best places to treat a Covid outbreak.Having worked in Tasmania during the NWRH outbreak that was brought home forcibly.
They would need an ICU with intensivist cover and preferably a hands on ID physician which the NWRH now has.
When I worked there Geraldton did not.Basically all serious cases went out by RFDS.Great for me as when on call it was only until midnight.any case needing physician input after that was sent out on RFDS.Not the ideal for a quarantine establishment.
As for Christmas Island they did try that out but didn't continue using it.This months occurrences with the transfer of a child to Perth also suggest it is not a viable option.
I have already reported that the medical establishment in Toowoomba has doubts about the suitability of Toowoomba for a quarantine facility.

We aren’t talking of Covid outbreaks though. Just treatment, if needed, of Covid positive people who were in quarantine. It seems most don’t even require treatment - just stricter isolation. How do regional hospitals now deal with infectious patients for the usual infections that require isolation because they currently exist as part of hospital life but don’t make the media.

 

[dajop]

Regional hospitals are not always the best places to treat a Covid outbreak.

Where is the line drawn? I assume it depends on capability. If you draw an arbitrary cutoff of 100,000, you're looking at the following, if you draw the line at 200,000 population, it narrow further to basically status quo + Newcastle, Central Coast, Geelong & Wollongong.

NSW: Newcastle, Wollongong, Central Coast
Vic: Geelong, Bendigo, Ballarat
Qld: Townsville, Cairns, Sunshine Coast, Toowoomba (Gold Coast already OK),
Tas; Hobart,
NT: Darwin
Interstate: Canberra/Queanbeyan, Albury Wodonga

 

[justinbrett]

Where is the line drawn? I assume it depends on capability. If you draw an arbitrary cutoff of 100,000, you're looking at the following, if you draw the line at 200,000 population, it narrow further to basically status quo + Newcastle, Central Coast, Geelong & Wollongong.

NSW: Newcastle, Wollongong, Central Coast
Vic: Geelong, Bendigo, Ballarat
Qld: Townsville, Cairns, Sunshine Coast, Toowoomba (Gold Coast already OK),
Tas; Hobart,
NT: Darwin
Interstate: Canberra/Queanbeyan, Albury Wodonga

It's got nothing to do with population - the term is tertiary hospital and relates to the services it provides.

 

[drron]

We aren’t talking of Covid outbreaks though. Just treatment, if needed, of Covid positive people who were in quarantine. It seems most don’t even require treatment - just stricter isolation. How do regional hospitals now deal with infectious patients for the usual infections that require isolation because they currently exist as part of hospital life but don’t make the media.

Covid is different to ordinary infectious diseases even most serious ones.
Bacterial infections you often are able to identify the bug and antibiotics that are the most apprpriate.Sometimes the disease- eg pneumonia where the bug can't be isolated there are well known protocols for which antibiotics should be used based on the severity of the pneumonia.
Diseases such as TB,HIV etc have also accepted treatments and proticols.
With covid it is still a work in progress.Certainly there have been incredible advances but still a lot more to learn.

As to which hospitals it depends on facilities,staffing levels and the expertise and experience of the staff.
For example the largest cities outside of Adelaide and Gawler are Mt.Gambier and Whyalla.I have worked at both and won't go back as it is too dangerous.Especially Whyalla.When I worked there I was the only physician for 5 days of the week covering Whyalla,Port Lincoln and Port Augusta.At the time when I worked at the NWRH which had less population than Whyalla I was one of 4 physicians and there were also recognised Intensivists and FACEMs neither of which were in Whyalla.

To @dajop 's list in Tasmania both Launceston and the Mersey hospital treated more patients with covid than Hobart.The LGH has an infectious diseases physician who is one of the ATAGI team.The Mersey hospital has a physician who had an interest in infectious diseases.In February 2020 he anticipated problems.He got the hospital to order large supplies of sanitiser,also limited hospital entrances to 2 during the day and 1 at night.He also alerted businesses and even distributed sanitiser to the districts service station and gave advice on cleaning the pumps.He ended up treating 14 patients,all over 80 with multiple co morbidities.They were admitted there as they were expected to die.9 got out of hospital.

In QLD Townsville would be a definite starter.A well staffed hospital with all needed facilities.Deals with a huge referral area.

 

[Pushka]

Covid is different to ordinary infectious diseases even most serious ones.
Bacterial infections you often are able to identify the bug and antibiotics that are the most apprpriate.Sometimes the disease- eg pneumonia where the bug can't be isolated there are well known protocols for which antibiotics should be used based on the severity of the pneumonia.
Diseases such as TB,HIV etc have also accepted treatments and proticols.
With covid it is still a work in progress.Certainly there have been incredible advances but still a lot more to learn.

As to which hospitals it depends on facilities,staffing levels and the expertise and experience of the staff.
For example the largest cities outside of Adelaide and Gawler are Mt.Gambier and Whyalla.I have worked at both and won't go back as it is too dangerous.Especially Whyalla.When I worked there I was the only physician for 5 days of the week covering Whyalla,Port Lincoln and Port Augusta.At the time when I worked at the NWRH which had less population than Whyalla I was one of 4 physicians and there were also recognised Intensivists and FACEMs neither of which were in Whyalla.

To @dajop 's list in Tasmania both Launceston and the Mersey hospital treated more patients with covid than Hobart.The LGH has an infectious diseases physician who is one of the ATAGI team.The Mersey hospital has a physician who had an interest in infectious diseases.In February 2020 he anticipated problems.He got the hospital to order large supplies of sanitiser,also limited hospital entrances to 2 during the day and 1 at night.He also alerted businesses and even distributed sanitiser to the districts service station and gave advice on cleaning the pumps.He ended up treating 14 patients,all over 80 with multiple co morbidities.They were admitted there as they were expected to die.9 got out of hospital.

In QLD Townsville would be a definite starter.A well staffed hospital with all needed facilities.Deals with a huge referral area.

I understand those difficulties but again, you are talking of outbreaks. The 'remote' issue is more about treating one of two Covid positive people who have come from overseas and who need hospital medical support. It seems, according to what the Health people are telling us that most if not all, except for one or two Covid positive passengers, need no medical support at all. They just need isolation from others until infectious period has passed. In SA it is rare to have anyone in hospital.

 

[blackcat20]

Donuts for Victoria again.

 

[Lynda2475]

I understand those difficulties but again, you are talking of outbreaks. The 'remote' issue is more about treating one of two Covid positive people who have come from overseas and who need hospital medical support. It seems, according to what the Health people are telling us that most if not all, except for one or two Covid positive passengers, need no medical support at all. They just need isolation from others until infectious period has passed. In SA it is rare to have anyone in hospital.

The risks of transporting seriously ill covid positive from a remote facility (road, RFDS, road) to specialist intensive care respiratory unit are much higher, than a 15 min ambulance ride in the CBD.

My understanding is the reason the Qld proposal was rejected were - not on commonwealth land, state was unwilling to run the facility, nearby hospitals did not have facilities required to treat seriously ill arrivals. The remote locations suggested by WA - Christmas Island and Learmonth/Exmouth also have limited medical facilities as was demonstrated with having to evacuate a child from the detention centre on CI and the shark attack victim form Coral Bay in the last week.

 

[lovetravellingoz]

Donuts for Victoria again.

With Monday being a public holiday it looks like the vaccinations were down.

 

[drron]

I understand those difficulties but again, you are talking of outbreaks. The 'remote' issue is more about treating one of two Covid positive people who have come from overseas and who need hospital medical support. It seems, according to what the Health people are telling us that most if not all, except for one or two Covid positive passengers, need no medical support at all. They just need isolation from others until infectious period has passed. In SA it is rare to have anyone in hospital.

But you can't quarantee that will continue to happen.In both the UK and US vaccinated patients are still being admitted to hospital and a few go on to ICU and some die.You must look at worst case scenarios and the belief that that can't happen in Australia is wrong.
Here is an article from last week making that point.

Brace for a major COVID-19 outbreak - InSight+

Australia’s COVID-19 vaccine rollout is “absolutely” a race, says Laureate Professor Nick Talley AC

insightplus.mja.com.au