Australian Reports of the Virus Spread

[drron]

There are patients that we decide not to send to ICU regularly even before Covid and those numbers I believe have not changed certainly here in Tasmania.Have made that decision again this morning and the patient is not Covid positive.
Basically if a patient would have been accepted into an ICU unit if they did not have Covid they will be accepted if they are Covid positive.

 

[Princess Fiona]

Question for medicos - maybe @drron might help. Most if not all the 13 deaths in Tasmania have been +70 or 80, I think, and many already in hospital for one reason or another. Therefore in the 'most vulnerable' category and little doubt would be 'in trouble' when they were diagnosed with the virus.

Yet I think only one case total was/has been in ICU: Coronavirus Australia 221 cases | COVID-19 Live .

Question is: why wouldn't more of these cases have been in ICU? Surely they are exactly the group that we have established extra ICU capacity for?

Whilst I am not across any of the medical details of these cases in general terms when an elderly patient with COVID-19 becomes critically ill the goals of care and treatment are the same they would be if they became critically unwell with a similar non-COVID related respiratory disease.
A holistic plan would be developed taking into account the wishes of the patient and the likelihood of success of various treatments.
This may or may not involve admission to an Intensive Care Unit.

Having extra ICU capacity for COVID is due to there being uncontrolled spread of the disease and multiple patients of all ages requiring ICU care.
It does not change the need to give the right care to the right people.

 

[RooFlyer]

Thanks @lovetravellingoz , @Pushka , @drron and @Princess Fiona . (Hoping this discussion doesn't distress anyone who may have a relative with the disease)

Yes, a DNR might apply, but, without knowing anything about the cases, you'd have to doubt that they all had DNRs.

I don't doubt that there is no discrimination between a virus case and a non virus case when admitting to ICU; that wasn't the point of my question. It just struck me that, if you have all these folk, with a disease that we know can be particularly lethal in the elderly, (and if they were in one of the NW hospitals when they caught it, they would have had some other medical issues from the start), then I (in my profound ignorance) would have expected some of them to have been admitted to an ICU. If 13 died, then at some stage most if not all would have been very ill.

Follow-up question. What is the difference in the care and equipment used in an ICU, say that would be offered in NW or northern Tas, and a ward not in the ICU? For instance, maybe its the same care plan and equipment, but just staffed to a higher level? Or maybe ICUs have a higher range of devices that can be applied to a very ill patient?

 

[Princess Fiona]

Thanks @lovetravellingoz , @Pushka , @drron and @Princess Fiona . (Hoping this discussion doesn't distress anyone who may have a relative with the disease)

Yes, a DNR might apply, but, without knowing anything about the cases, you'd have to doubt that they all had DNRs.

I don't doubt that there is no discrimination between a virus case and a non virus case when admitting to ICU; that wasn't the point of my question. It just struck me that, if you have all these folk, with a disease that we know can be particularly lethal in the elderly, (and if they were in one of the NW hospitals when they caught it, they would have had some other medical issues from the start), then I (in my profound ignorance) would have expected some of them to have been admitted to an ICU. If 13 died, then at some stage most if not all would have been very ill.

Follow-up question. What is the difference in the care and equipment used in an ICU, say that would be offered in NW or northern Tas, and a ward not in the ICU? For instance, maybe its the same care plan and equipment, but just staffed to a higher level? Or maybe ICUs have a higher range of devices that can be applied to a very ill patient?

In answer to your first question yes without knowing the individual details of the cases or if the figures for ICU admission are correct, the number of admissions at 1 seems small.

There are varying levels of ICU and HDU (High Dependency Unit) throughout the country.
It’s pretty complex as to what’s offered at each unit, I don’t know the specifics of NW Tasmania except that North Western has ICU, Mersey had HDU.

In layman’s terms various levels of advanced respiratory support can be offered throughout a hospital (HDU, Respiratory and General Ward, Coronary Care) these are called Non-invasive ventilation. C-Pap/Bi-Pap, High Flow Nasal Cannulae etc
The only places in a hospital where someone can receive invasive ventilation is in the Emergency Department (on an urgent basis), Operating Suite, Intensive Care.
There are a multitude of other therapies that can be delivered in ICU for other organ support eg. Dialysis for kidney failure in the critically ill.

 

[RooFlyer]

Thanks PF - those differences are pretty much what I imagined. I'm certainly not questioning the level of care those folks got, just seemed odd that ICU admissions in Tas had been so low. Unless, as you intimated, there might be some different configuration of particular equipment and the 'statistics' haven't captured the equivalent of ICU care.

 

[drron]

I certainly have some knowledge of the Tasmanian cases.Having worked at both NWRH and the Mersey I get the briefings for those hospitals as well as LGH.Obviously can't go into specifics but all had reasons to not being admitted to an ICU.
12 of Tasmania's deaths have occurred at the NWRH or the Mersey.
The second person to die was an elderly man at RHH.I have no knowledge of that case.

 

[RooFlyer]

This seems difficult to understand, if its as reported: I get that a very early test may be ... too early, but it reads like they will just not be tested until they show symptoms. Given the history of the NW Tas break-out, surely to God over-caution should rule?

The Labor party has again called on the government to utilise its COVID-19 testing capacity as health officials have confirmed asymptomatic staff at the Mersey Community Hospital were not being tested.

This comes after a female patient at the Mersey tested positive for COVID-19 on Thursday.

Public Health deputy director Scott McKeown said a decision to test asymptomatic staff would need to be made by the Tasmanian Health Service.

Dr McKeown said close contacts of the COVID-positive case had been quarantined and strong infection control measures were in place.

 

[Princess Fiona]

This seems difficult to understand, if its as reported: I get that a very early test may be ... too early, but it reads like they will just not be tested until they show symptoms. Given the history of the NW Tas break-out, surely to God over-caution should rule?

Seems a bit odd if is as reported. Don’t know what their capacity for testing is.
Last week at my hospital we were offering COVID testing over a 5 day period to all asymptomatic patients discharged from our ED.
Voluntary basis, eg. Turn up with sprained ankle go to fever clinic on the way out to get tested.
The more testing we do the better, especially in the areas where outbreaks have occurred.

 

[DC3]

.... The more testing we do the better ....

Yes. Test. Test. Test.

 

[p--and--t]

Interesting today I noticed a popup drive thru Covid-19 testing site in the Bunnings Carpark in Footscray. From what I've read, it appears if you have any doubts at all (runny nose, tiredness, cough, almost whatever) you are encouraged to go get a free test.

 

[drron]

They are offering testing to all people in the North west.Strongly advising it for anyone with even the mildest respiratory symptoms.
Plus any Health care worker from the Mersey or NWRH who has been in quarantine due to contact with a positive patient must have a negative test before returning to work.If they were positive they need 2 negative tests at least 24 hours apart.Many of the Mersey staff would have been in quarantine.Quite a few working at the Mersey also work at NWRH.

So there are Mersey staff who may not have been in contact with a case and asymptomatic that have not been tested but that is their decision.They are being offered testing.
On top of that all staff at the NWRH,Mersey and Launceston have to have a checklist done when entering the hospital-temperature taken and 6 questions on respiratory symptoms.If you answer yes to one of the questions or have a temperature you don't get to work until tested.

So just a political stunt by the Opposition.

 

[RooFlyer]

Seems a bit odd if is as reported. Don’t know what their capacity for testing is.

as drron intimated, is a testing free-for-all at the moment on the NW. Tas had a slow start with testing but is making up for it now.

 

[jase05]

https://twitter.com/x/status/1256907718083751936

 

[p--and--t]

https://twitter.com/x/status/1256907718083751936

The Fed Education Minister must be near choking on his divisive unnecessary outburst at a State Premier Sunday Morning. The public face of the national cabinet seemed quite solid until then.

 

[lovetravellingoz]

Interesting today I noticed a popup drive thru Covid-19 testing site in the Bunnings Carpark in Footscray. From what I've read, it appears if you have any doubts at all (runny nose, tiredness, cough, almost whatever) you are encouraged to go get a free test.

Well not so much any doubt. You need to meet the guidelines to be tested:

Should I get tested?
If you have any of the symptoms of coronavirus (COVID-19), however mild, you should seek advice and get tested. The symptoms are described in the section below.

During the testing blitz, some groups of people can be tested even when they feel well and do not have symptoms (asymptomatic) of coronavirus (COVID-19). This is only available at some testing locations, as described in the section below.

The groups who can be tested even when they do not have symptoms of coronavirus (COVID-19) are:

• workers who cannot easily work from home in construction, supermarket, healthcare, police, corrections and emergency services jobs
• people with a chronic illness who may be at risk of more severe coronavirus (COVID-19) disease
• Aboriginal and Torres Strait Islanders

What are the symptoms of coronavirus (COVID-19)?

The symptoms to watch out for are:

• Fever
• Chills or sweats
• Cough
• Sore throat
• Shortness of breath
• Runny nose
• Loss of sense of smell

Less commonly, headache, muscle soreness, stuffy nose, nausea, vomiting and diarrhoea have also been reported.

To get further advice, call the 24-hour coronavirus hotline 1800 675 398, your local doctor or use our online self-assessment tool.

Health.vic

At the Department of Health, we're focused on supporting Victorians to be as healthy as they can by delivering a world-class health system that focuses on improving patient outcomes and experiences.

www.dhhs.vic.gov.au

But yes they have greatly freed up who can be tested now as they are seeking to root out anyone that may have CV19 now. And that includes those where the may is only a very small chance. They are looking to mop up any as yet unknown hotspots.

When tests where in short supply it was more who was likely to have CV19, or where in high risk positions etc..


PS: One of my daughter's partners had such a test today at Chastone Shopping Centre for while he had no symptoms, he had just as an essential worker spent the last 2.5 weeks travelling through rural NSW as well as Newcastle, Sydney etc. And will have other similar trips coming up and so he did not wish to be a superpreader.

 

[SydneySwan]

13,000 tests in Victoria yesterday. Number of tests per day seems to be the emerging metric to focus on.

 

[jase05]

13,000 tests in Victoria yesterday. Number of tests per day seems to be the emerging metric to focus on.

Did I hear right that 19 cases are from the one meat processing plant?

 

[SydneySwan]

Did I hear right that 19 cases are from the one meat processing plant?

Apparently + 2 from overseas in hotel quarantine and 1 TBA. Total = 22.

 

[lovetravellingoz]

Did I hear right that 19 cases are from the one meat processing plant?

Yes.

But it is actually good news if you that if have 22 cases that 19 are all from an already known cluster.

Ie 19 from multiple new sources would not be good.

2 were from overseas travellers in quarantine. So no risk there.

So just the 1 case from a new source.

 

[Bundy Bear]

Question for medicos - maybe @drron might help. Most if not all the 13 deaths in Tasmania have been +70 or 80, I think, and many already in hospital for one reason or another. Therefore in the 'most vulnerable' category and little doubt would be 'in trouble' when they were diagnosed with the virus.

Yet I think only one case total was/has been in ICU: Coronavirus Australia 221 cases | COVID-19 Live .

Question is: why wouldn't more of these cases have been in ICU? Surely they are exactly the group that we have established extra ICU capacity for?

Hi Rooflyer, below was a link to a New Zealand story regarding Covid-19 I thought it was an interesting story.

It partly explained why ICU is notused in all cases, having to use a ventilator was probably a too bigger shock to some patients who were unwell.

'Goodbye, Mum. I love you': Son's diary of mother's last days with Covid-19

A son writes of his mother's last days of hope and sorrow as she is lost to Covid-19.

www.nzherald.co.nz