29 June, 2021
Our clinic has decided to transition all patients to telephone
consultations from 30 June until when the lockdown finishes. I’m very glad
about this decision. After all, with patients who come in, when you ask them
about whether they’ve got cold-like symptoms, you never know whether they’re
tell the truth about their symptoms. Sometimes we get people who were
previously advised to get a COVID test trying to come back without doing the
test, saying their symptoms have resolved already so don’t think they need to
do the test. Occasionally we even have to turn away people who try to get a
face to face consult before their COVID results are out. Anyway, it does feel
risky seeing patients face to face when the Delta variant is running wild in
Sydney!
30 June, 2021
Someone posted a photo of him having the COVID vaccine at the Sydney
Olympic Park. He booked 8:15am and the cue was very very long! There’s no
social distancing, and he waited 40minutes before getting his shot! This makes
me wonder whether people can catch COVID just in the process of lining up in a
long cue like this. Could the reason why the mortality rate post-vaccination in
Taiwan is so high be because people already caught COVID when they were lining
up to get the vaccine?
3 July, 2021
Symptoms of nasal congestion, sore throat and voice change in the
evening. This is the first time I’ve ever had cold-like symptoms, since the
pandemic started. Guess a trip to a COVID drive-through testing centre is
inevitable!
4 July, 2021
First time ever to get COVID-tested since the pandemic began! Woke
early and went early to the 95 Epping Road Macquarie Park drive-through testing
centre, as I don’t want to wait in a long cue or get any cross-contamination as
the collectors test more people. At 7:40 am, I was the only car there. However,
as soon as my engine is off, two or three cars came up behind me. Anyway, the swabbing
process is very quick and I was out of there in approximately three minutes.
5 July 2021
Fortunately the COVID test was negative. In fact, the respiratory
viruses swab was negative too. I wonder if I am having vasomotor rhinitis? It’s
been extremely old in Sydney lately, sometimes down to 3oC!
8 July, 2021
Today, the NSW COVID numbers is the highest it’s ever been since the
Sydney Delta variant outbreak! 38 new locally acquired cases! The lockdown will
be extended! Just as I am starting to feel very tempted to get the Pfizer
vaccine, suddenly came a young man who became unwell with chest pains after
having Pfizer. Ran an ECG and sent him straight off to the ED, because the ECG
showed ST changes suggestive of myocarditis/pericarditis.
The last time I felt particularly tempted to have the Pfizer was in late
April, when GPs still couldn’t get the Pfizer vaccine, and our primary health
network suddenly emailed us saying a limited number of appointments had become
available at Westmead for GPs in our network to have the Pfizer vaccine.
Suddenly, a middle aged health worker who suffered a small bleed in her brain
after her Pfizer vaccine came in for review. She had no past medical history
whatsoever before the shot. After getting the vaccine she felt unwell, her
blood pressure shot up through the roof, and she was subsequently found to have
a small bleed in her brain!!
About a week ago I had asked my obstetrician what he thinks about the
COVID vaccine in pregnancy, especially now that the RANZCOG and ATAGI updated
their recommendation in mid-June saying pregnant women are should be routinely
offered Pfizer mRNA vaccine at any stage of pregnancy. His reply was like what
I expected: he could not give a yes or no answer. He mentioned that “theoretically
speaking” the mRNA vaccine shouldn’t do harm. However, everything needs to be
around for at least ten years or so before we really know what’s going on, and
mRNA is a new technology. The risk in Sydney is not that high at the moment but
my occupation puts me at a higher risk than the rest of the population. So
let’s see how things develop over the next few weeks.
Now, I’m not a fan of “theoretically speaking.” I am someone who take
into account “lived experiences” seriously. And my “lived experience” is that
I’ve personally seen two people with serious complications from Pfizer, but no
one from AstraZeneca so far, despite our clinic having first hand experience as
a vaccination centre of the AstraZeneca vaccine since April this year.
Soon, more data will be on hand as our clinic give out the Pfizer vaccine to
our regular patients from mid-July onwards.
Anyways, if I wasn’t pregnant I would have gotten my COVID vaccines
already. Currently I do not know what will happen to the children of pregnant
women who received the mRNA vaccine during pregnancy 5 years or 10 years from
now. But if there is no clear and consistent downward trend to this Sydney
outbreak within the next two weeks, I might just get the vaccine.
11 July, 2021
New COVID cases continues to rise every single day! 77 new locally
acquired cases today! This morning, the RACGP sent a mass message to all its
members urging GPs 1) to shorten the dosing interval of the AZ dose to 6 weeks,
2) to use telehealth or wear full PPE, and 3) to check that all GP staff have
had a COVID vaccine.
As usual, our clinic was way ahead of the government/ Royal Colleges
when it comes to COVID response. We had already been doing all of these since
29June! And remember how the government was slow to recommend masks last year?
Staff in our clinic have been wearing masks every day since 28 Jan 2020!
Spent the rest of the day joining the annual Taiwan Association of
Family Medicine online conference! Learnt some useful information.
12 July, 2021
Today’s new locally acquired cases are in 3 digits: 112! I’m really
going to have to do telephone consultations only until the current outbreak is
over!
Our clinic’s landline phone has been overwhelmed by people calling in
about the Pfizer vaccine since the beginning of this month, but today it is
totally non-stop! I couldn’t even use the clinic landline to do telephone
consults and had to use my own mobile phone! In fact, people experienced so
much trouble with the landline that they started trying to flood into our
clinic reception to try and book their appointments!
14 July, 2021
The newly locally acquired cases are in 2 digits the last two days: 89
and 97. Lockdown is now extended until 30 July. I actually feel safer during
lockdown, because once lockdown is lifted, I don’t know if I can keep doing
telephone consults, and the flow of people will become more complicated again. If
I am to get vaccinated in time for the opening up, I probably need to do so
next week when I reach week 28, when the baby might be strong enough to endure
the insult if I were to get sick from the vaccine. My mom was well after both
doses of Pfizer, hope I’ve inherited the same response as her. Will ask my
obstetrician again next week when I see him.
Meanwhile, telehealth is not without its troubles. As our landlines are
being clogged up by calls about Pfizer, people who actually want to book phone
consultations probably have difficulty doing that. Some patients are getting
more agitated and aggressive due to frustrations about being unable to get
through to our phone line and turn up at the reception quite angry. Furthermore,
phone consultations take a longer time than the normal face to face
consultations for me, because I can’t see the patient in 3D which means I don’t
have the opportunity to do spot diagnosis, so I have to ask more questions, and
it takes time to print and scan documents and email it back to patients etc. Medicare
does not allow us to bill long consultations for phone consultations even if we
go beyond 19 minutes. You earn more with face to face because you get a
combination of normal length consultations and long consultations each day. It’s
much easier to accidentally go beyond 19 minutes from face to face
consultations because people have a greater tendency to go overtime face to
face, but I can often catch up when because there are also some simple face to
face patients who take up very little time.
15 July, 2021
News article: A nurse at Sydney’s Westmead Hospital has tested positive
for Covid-19, despite being fully vaccinated and wearing full protective
equipment.
https://www.news.com.au/world/coronavirus/australia/sydney-nurse-at-westmead-hospital-tests-positive-for-covid/news-story/dfd1af792008dc79e4d12cfee1872e9a
So don’t go around thinking you’re invincible once you’ve been
vaccinated. I think vaccines are only a short-term fix. In fact, I am quite
concerned that if people don’t continue to be careful after getting vaccinated,
they can potentially catch the COVID but remain asymptomatic and keep spreading
it to other people, which gives the virus more opportunity to mutate into
something even more virulent in the long term.
16 July, 2021
The mystery box have finally arrived in our clinic at noon today. Why
do I feel like this is the calm before the storm?
