COVID 19 Fiveways Surgery Update 15 April 2021

By Dr Jared Dart BSc BA MBBS PhD FRACGP
 
Dear Patients
 
In this email I will discuss:our COVID 19 vaccination clinics;our flu vaccination clinics; care during lockdowns; and,recent recommendations about the Astra Zeneca vaccination and under 50sCOVID 19 vaccination clinics To date we have delivered around 350 COVID 19 vaccinations.

At the outset I want to thank our wonderful patients for their understanding at this time. I would like to remind the small minority of patients who have been rude, demanding or threatening that this is not appropriate behaviour.  Rude, threatening or intimidating behaviour may lead to us terminating the therapeutic relationship and require us to transfer your care elsewhere.  

We applied for 600 vaccinations per week. We were allocated 80-100 per week. We have 1200 patients over 70 alone, not including patients with cancer receiving chemotherapy or those with multiple serious health conditions. Supply is the major issue we are dealing with and this is entirely out of our control. 

We took the decision to open 8 weeks of clinics to provide patients with an appointment rather than turning them away. We received 500 bookings in three hours. Our Practice Manager, Receptionists, and Nursing staff have done a fabulous job and I am extremely proud of them all. 

While we appreciate that patients are anxious about receiving their vaccination and applaud their enthusiasm, please remember we are doing the best we can in the current circumstances. 

We have recently received advice from the Federal Government that we no longer have to see new patients and can prioritise our own patients. As a result, we are no longer accepting new patients to our COVID 19 vaccination clinics. We will still be offering a COVID vaccination to new patients already on our waiting list. 

For our existing patients on the waiting list, we will contact you to make a booking in due course. If there is a cancellation or if we receive additional doses we will contact people on the waiting list to ensure we vaccinate as many people as possible, as quickly as possible. We are prioritising people on the basis of when they were placed on the waiting list but also their risk of a bad outcome from COVID 19 (see graphic below regarding death rates by age). 

For those of you who would like to try elsewhere – we encourage you to look elsewhere. We want to be able to vaccinate our own patients but in the circumstances, we encourage you to receive a vaccination as early as possible by whatever means possible. Please let us know if you have booked or do receive the vaccination elsewhere so that our busy staff know not to contact you to make a booking. You can use the link here to search for other locations to receive your COVID19 vaccination.  If you are unsure if you fit the criteria for Phase 1B,  please check the Govt Vaccine Eligibility Checker at https://covid-vaccine.healthdirect.gov.au/eligibility.

If you are an existing patient who is eligible for Phase 1B but not yet on our waiting list , please click on the following link to complete your consent form and go on our waiting list: https://fiveways.snapforms.com.au/form/covid-19-wait-list-consent-form


We are providing our COVID 19 vaccination clinics as a community service and have gone to considerable lengths to make sure this is a safe, effective, and efficient service for you. 



UPDATED INFORMATION regarding AstraZeneca and blood clots

There has been a lot of coverage in the media and announcements from the government in recent weeks about the AstraZeneca vaccine and a possible causal relationship with particular types of blood clots.

Rare cases of Vaccine Induced Prothrombotic Immune Thrombocytopenia (VIPIT) have been reported following administration of AstraZeneca COVID-19 Vaccine globally, including one case in Australia as of 8 April 2021. These cases can present as clots in the brain (CVST), abdomen or other locations.

As of 4 April 2021, 169 cases of CVST and 53 cases of SVT were reported to the European Medicines Agency out of 34 million vaccinations. About 4-6 cases per million vaccinated population were reported elsewhere. Of the European reported cases 18 were fatal (0.5 per million vaccinated population). There have been reports of 10-25 percent case fatality from VIPIT.

The onset of reported cases was between 4 to 20 days after vaccination.

At the moment we do not know what causes this condition and have not identified any specific biological risk factors or pre-existing medical conditions which may increase or decrease the risk of VIPIT occurring after the AstraZeneca vaccine. The analysis of UK data suggests that the risk of serious harm to those vaccinated by AstraZeneca vaccines is relatively low and distributed by age groups as per the below table (Based on March 2021 UK data)
 Age (yrs)Potential serious harm per 100,000 20-291.130-390.840-490.550-590.460-690.2
The risk of ongoing health issues and death from COVID19 is highest in older age groups, particularly rising from 50 years of age. In the context of the ongoing risk of COVID-19 in Australia, ATAGI considers that the benefit-to-risk balance is favourable for use of AstraZeneca vaccine in all older (>50 years old) adult age groups. As the table above indicates the risk of VIPIT it less than 1 in 250 000 for over 50 and extremely rare over 70. 
 
The Australian Technical Advisory Group on Immunisation (ATAGI) recommends that vaccination with the Astra Zeneca COVID-19 vaccine should be deferred for people who have a history of the below rare conditions:A confirmed medical history of heparin induced thrombocytopenia (HIT)A confirmed history of cerebral venous sinus thrombosis (CVST) or splanchnic vein thrombosis (SVT) For people under 50 years of ageORAt this point in time, we are unable to offer patients under 50 years of age the vaccine. If you are under 50 years of age and wish to have the AstraZeneca COVID-19 Vaccine, we recommend you attend one of the public respiratory clinics. Locations can be found here .

More information about the vaccine can be found here .

Common Side Effects

The table below shows the most common adverse reactions to the Astra Zeneca COVID19 vaccination. The common reactions below can be managed by using paracetamol for pain relief, resting, and maintaining hydration. 

Source:  https://www.health.gov.au/sites/default/files/documents/2021/03/covid-19-vaccination-atagi-clinical-guidance-on-covid-19-vaccine-in-australia-in-2021_0.pdf

You should speak to a health care professional if you have unusual or severe symptoms after any COVID-19 vaccine.

If you experience the following symptoms between 4 and 20 days after vaccination, it might indicate that you have VIPIT:a severe headache that does not go away; a seizure;difficulty moving part of your body;new blurry vision that does not go away;difficulty speaking;shortness of breath;chest pain;severe abdominal pain;new severe swelling, pain, or colour change of an arm or a leg.These symptoms can also be a sign of other serious conditions and should be assessed in an emergency department.

 

Influenza Vaccination Clinics

Patients need to allow at least 14 days between their COVID19 and Influenza vaccinations. 

Our stock has now arrived and we have now opened online and phone bookings. We are running dedicated clinics for patients > 65 years on Friday morning and another influenza vaccination clinic Friday afternoon for other patients. Appointments can also be made at other times as required.

As we are still limited by physical distancing requirements, we will run the process similarly to our COVID vaccination clinics. All patients will be required to wear a mask while they wait and during their post-vaccination observation. 

 Government Funded Influenza Immunisation Eligibility

Fiveways Surgery care during lock down 

During periods of mandated lockdown, Fiveways Surgery, as an essential service, remains open to provide in-person care for patients. If you wish to convert to a telehealth appointment we can do so. 

We always continue to provide face-to-face care for patients without respiratory symptoms such as sore throat, runny nose, cough/sneeze, or fever during lock down periods. We will assess and treat patients with respiratory symptoms via Telehealth and in person if required. 

All patients are required to wear a mask while in the clinic during mandated lockdown periods and at other times according to advice from Queensland Health or our own determination of risk. Please use hand sanitiser before entering. We have a HEPA/UV filter in the waiting room. We are doing whatever we can to protect our vulnerable patients and request you to be understanding when dealing with our staff. 

We realise that telehealth is still a new concept for many patients. All our doctors are set up to use Telehealth and we are using an App called Welio (www.welio.com) which provides a secure video and payment solution for patients. I’ve included some patient testimonials below to ease any concerns you may have about using Welio. 

Elsie, 76 – “As a ‘mature aged’ person and having to use Welio for the first time, I was a bit apprehensive.  I wondered how I would manage to download the Welio App as well as working my way through the form.  I was pleasantly surprised at how easy it was to download and user-friendly. I also found the program worked well and was able to see the Doctor, it felt as if you were practically in the room with him.”

Alan, 66 “As a patient, I suffered trying to use other virtual service providers before Welio was rolled into our local GP surgery. From the first time I tried Welio, it worked. That’s the best endorsement I can give. There may be fancy bits that go on behind the scenes but for me, as a patient . . . It works!”



Please continue to be vigilant, alert but not alarmed 
Even though COVID19 has been a very difficult time for the community, so far we have been spared from large scale outbreaks and the associated deaths and disability. We must not become complacent. I hope that my emails have helped you to prepare for the current circumstances.
 
Our GPs remain available for mental health support. Our psychologist Dr Jayne Orr is also available for tele-consultations and face to face consults for anyone experiencing mental health issues.
 Best regards, 
 
Jared

Dr Jared Dart
Director iHealth Australia
iHealth Centres



Fiveways Surgery is proud to be the first of iHealth Australia’s Clinics 

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