Second wave incoming

The dreaded second wave. How we wished we had avoided it, that Victoria had quietly snuck under the radar and eradicated the virus. But that was never the case, since we consistently experienced low numbers in the community. Except now there are higher rates of community transmission and the burden on our hospitals is readily rising.

For those who don’t know, our state has recorded the highest numbers since the pandemic began. 288 cases on Friday and 216 cases on Saturday. 273 today. These may be low numbers compared to some other countries, but for us, it has been a massive jump that doesn’t seem like its declining. 200 may sound manageable right now, but if it continues to spread it will become uncontrollable. Melbourne has been put into a 6-week lockdown, where we cannot leave our houses unless it is for supplies, work/schooling, exercise and medical care. A major hospital has already reported 8 of its workers testing positive, meaning a large number of employees will have to go into isolation. I wouldn’t say things are looking terribly grim yet, but it’s certainly concerning.

I am definitely closer to the frontline than most, being a final-year medical student on the respiratory team at a central metro hospital. We share the load of COVID patients with the infectious disease team as well as intensive care. I’ll be honest, things have become a little bit tenser in recent days and whilst we’ve consistently had around 3 patients under our team at a given time, we are anticipating an influx of patients over this weekend. 2 of our 3 patients were intubated in ICU last I heard, but not sure what’s happened since. That’s why we’ve been trying to discharge as many people as possible to free up spots for those who will inevitably need it. We also only have a few doses left of remdesivir (the one drug that supposedly has some benefit) that may be able to serve one person. I’m not sure when, or whether new stock will come, but to quote the words of my registrar, “it’ll be first come, first served.” I don’t think we initially intended on covering COVID cases, as it is definitely more of an infectious disease thing, but we are helping out likely because we are the next most relevant speciality. It is also probably because the head of our unit is fascinated by COVID and genuinely seems excited when cases come through the door. He goes to see these patients on his own (sometimes without even telling us) and seems doubly animated when talking about it. He’s quite an elderly gentlemen (mid-70s), so I am a little concerned this continual exposure is going to lead to an unfortunate diagnosis. But it has become a rule for us, that only senior doctors should see COVID patients. Therefore, whilst we always to try to minimise any contact with confirmed cases (negative pressure rooms, speaking through glass or phones connected to the inside), whenever face to face contact is needed it will be done by either a registrar or consultant. As a student, I’m pretty glad to be far away from it all, although if anyone in my team has it then there’s pretty much no hope for me either. But I only have one more week left in this rotation so I’ll be moving on soon!

I did have a tiny, tiny scare a few weeks ago. I was sent down to the emergency to admit a patient into respiratory. Mind you, our ED department has essentially been turned into a coronavirus hot zone. Most of the area is sealed off and you must be in full protective gear before walking in. We did also have 2 workers test positive so I suppose people were even more vigilant. Anyways, back to this patient I saw. His history and CT scan clearly demonstrated a large clot in the lung to be the perpetrator, therefore we all assumed the risk was essentially negligible. I spent a good hour with him, interviewing and examining, and felt pretty good afterwards. I realised a little later his scan also showed bleeding in the lungs, that was reported as “possibly COVID-related”. Now, this was just for precautionary reasons and radiologists always report what they see, therefore it’s very important to fit things into your clinical picture. But I have to admit just the word made me feel slightly uneasy. I wouldn’t say I was anxious, but the thought was there in the back of my mind. His swabs also took forever to come back, therefore it was a few days before I could confidently rule out a possible exposure. In hindsight, it was just me being paranoid, but I suppose you could never be too safe. It does make me wonder how I’d feel properly working during this pandemic, because let’s be honest I don’t think we will have resolved it by January of next year. Should I be resigned to catching it? How scared should I be? Who knows. I suppose I’ll find out once I start!

Anyways, that’s all I wanted to update everyone on. I’m also due to find out which hospital I am going to tomorrow morning, therefore will share once I know! I hope everyone is staying safe and being vigilant, now is not the time to become complacent. Goodnight!


26 thoughts on “Second wave incoming

  1. Oh gosh. I’m in Melbourne, Helen. It’s not so fun going into another round of lockdown, hey. 🥺Good luck with all the hospital stuff. It must be a completely different view of covid, and I hope it’s not too overwhelming for you. Sending so much love. You’ve got this. xx

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  2. First, a disclaimer: I absolutely don’t mean to downplay the stress of your experience or the danger of the virus for those who become seriously ill.

    But I confess that from where I sit, I just don’t see what you see. Two of my brothers are MDs and they lean more toward your view, so in practical terms, I follow their lead. But ever since the Diamond Princess, it looks to me like the pattern is consistent: most exposed people don’t get infected, most infected people don’t get sick, most who get sick don’t get very sick, but yes, a small number die and it’s not pretty (it rarely is). Healthy people under 60 seem to be at low risk, but the risk increases dramatically for older groups, and of course in your environment viral load seems to be a significant factor; you don’t want to intubate someone if you’re not wearing PPE because you’d get a faceful of it.

    At least in the United States, most of the harm outside of nursing homes seems to have come from the lockdowns and the panic instead of the disease itself. Economic damage, deferred medical care, and “deaths of despair” seem to have claimed at least as many lives as Covid-19, like the cytokine storm that kills some Covid-19 sufferers who die not from the virus, but from their body’s over-reaction to the threat. We face a horrible choice: either way, people will suffer and die, so we must try to choose the path of lesser evil — which is still evil.

    Certainly, everyone in the world admires and is grateful to the medical professionals who deal first-hand with the illness. But we cannot stay locked down forever, or even much longer. In the last few decades, we’ve made great progress against starvation, extreme poverty, and other illnesses. It is a value judgment, not a scientific one, but I don’t think we should become so preoccupied with one virus that we forget those other important goals.

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    1. Dear Mr. Palmer, I understand what you are saying, and yes, there is some truth in it. However, the rate of diagnosed infection skyrocketed in Tennessee immediately after the removal of the stay at home order. A lot of that is because of a cavalier attitude. Bars full of patrons, shoulder-to-shoulder, not wearing masks. Demonstrations over the racist murder of an unarmed blackman by the police. Folks no longer feeling like they need to wear masks when in public. Lots of churches re-opening their doors. We are now #1 in new cases in the country. You can’t tell me that all these new cases are from the elderly and high risk, not when we look at the surge and it’s correlation with public events.
      I hope you do not take this as an argument or critisism. I just felt it had to be said. Stay well.

      Liked by 1 person

      1. I think we should welcome rational argument and criticism because it helps us find the truth and improve ourselves. In this case, however, we’re talking about a value judgment that can’t be definitively proven either way. So if you offer rational arguments, you never need to be shy about that. You are doing the right thing.

        We could look at death rates from Covid-19 versus other causes, and at various other measures of human welfare. That would give us more information on which to base a value judgment, but it still wouldn’t make the judgment for us. It is no wonder that many people flee from the burden of freedom: it is truly daunting to bear such responsibility. No one should take it lightly, but it’s still going to be there. Careful attention to facts helps a little. God bless.

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    2. I’d like to make a small counter point, but do understand I’m very limited in my knowledge.
      The thing is, you really don’t know how severe the effects of the virus will be on someone who’s been affected. I searched a bit on the Internet, and at Reddit( I confess,probably not the best of sources but I wanted to find out facts from those who had been exposed to it.)the only thing most of the people seem to agree on is that you don’t know how aggressive the virus is going to be against the immune system. You may just have a slight fever and a dripping nose, but there are people(said by those at Reddit who were exposed or closely knew someone who was infected) who although were energetic and healthy, but had high temperatures, had difficulty in breathing and couldn’t move. Many got sent to the ICU. A lot of these people were under the age of 60. So, how exactly you’ll be affected if you contract the virus is still a gray area, and therefore dangerous.

      Now you’re right about the fact that most of the people who test positive make a recovery( Thank God they do) while only a small percentage die. But what scares me is this. The symptoms usually take a week or two to manifest AFTER you’ve been exposed. Imagine a scenario where 90% of the healthy 20- 50 years old in the world are affected and they just don’t know it. They come into contact with the people they like and love, old people on the street and cuddle their children and babies goodnight. With underdeveloped/weak immune systems, there is an even slimmer chance to survive. By the time you realise you’ve been infected it is already too late. Your father, mother or/and child is in the ICU, and there’s not a good chance they’ll make it. You’ve infected a few people in your age group too, and while most of them make it, some of them don’t.

      I know 90% is a VERY high number, and we’ve a long way to go before THAT amount of shit hits the fan, but there IS a percentage that exists. There are scenarios where infants, children and senior citizens won’t make it. A family can literally lose two generations of their loved ones and while that probability may be low, with the growing number of cases worldwide it is bound to increase.

      Apart from that becoming a doctor is a long and hard journey. Becoming a good doctor with years of experience is even harder, and becoming a good doctor WITHOUT any experience is probably not possible. An environment with continuous exposure to the virus because people just don’t get how its not right to move out of the house except for work/emergency and give a damn about their hygiene and what they touch and keep wearing masks and gloves and generally be cautious will only increase patients. You really don’t want doctors to get infected, because they don’t grow on trees. There’s already a shortage of medical staff in the US, people are working back-to-back 24 hour shifts (at least, that I know of. I may be wrong.) because there are not enough people and the cases just keep on coming. What do you think will happen if someone gets infected or has a heart/ lung problem or had a horrible accident and has to wait for 6-7 years because all the doctors are infected and new ones just take that much time to create?

      All that said, I just want to add that I’m really not against you. You’re actually one of the good people. You’re sceptical about something you see, and you’d like to have a clear idea about what you know and and what is the truth, so you ask people about it. What’s wrong with that? You’re good people, and I hope I’ve answered to some of your doubts. I’m willing to believe that I may not be right about everything I said, because like I mentioned in the beginning, I don’t know everything. I’ll be happy to change my view if someone can give me a good reason to do so.

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    3. I understand and respect your point of view, I certainly thought for a while everything would work out and some were taking things too seriously. But I think being at the hospital and seeing relatively young individuals being intubated and struggling in ICU has made things seem more real to me and feel closer to home. Last I heard our remdesivir stock was quickly being drained and people were beginning to discuss how resources should be delegated. “First come first served,” still rings in my head and it’s such a sad thought. And that’s in Victoria, where our largest daily spike to date has been 484 (tiny compared to states in other countries I’m sure). I live with my parents, both of whom are getting up there in age. It would pain me greatly to see them struggle with this virus, and the problem is we simply don’t know how each individual will respond. And whilst I agree there is no way we can “win” this, I think proceeding with caution and being vigilant is still important.

      We’ve had a case where 3 patients in an aged care unit tested positive, and few days later another 7 were infected. There was no place else for everyone to go so from what I’ve heard they have pushed the beds of sick patients towards one side of the room. Simply put, everyone in that facility are sitting ducks. Herd immunity at this stage is unlikely to be achieved, as individual immunity only seems to last weeks to months. We also cannot sit around and wait for a vaccine, as we don’t know when it will come.

      I agree we cannot remain locked in our homes forever, but the alternative sounds even scarier right now. To let it rip through the community and depend on fate to decide who will escape unscathed, it would frighten me greatly. Perhaps you are right, and that we will have to go down that route eventually for the sake of everything else, but it would be devastating.

      Thank you for sharing, I always support any sort of discussion and you have certainly given me things to think about. Take care 🙂

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  3. Don’t be resigned to catching it. And there are healthy degrees of fright before paranoia. The need to persevere being a degree. There is virtue in taking care, though I know you know this. I need to know it, too.

    At any rate, I come from a place where it’s believed that each life is valuable, even the life of one who disvalues one’s own. I keep thinking the lockdowns and the safety measures should be finished when no one is dying from the disease. Or that that should be our thinking when strategizing: we’ll be finished when no one has to die for lack of treatment. It’s the acceptable loss of none, which propelled the USA’s participation in the first Gulf War. It didn’t happen that way, but that was the expectation in the thinking. The public’s thinking, anyway.

    Doctors have to deal with death, I know. And bless you for it. But no one should have to tell you that a few hundred seriously ill isn’t so bad. We should not tell ourselves that. I don’t mean to seem to want your work to be more onerous, because I don’t. I think I’m agreeing that there are no small numbers regarding this disease. Even one as a number.

    I hope you get a promising selection for your next place of work and training. Please watch after yourself, Helen. I know you watch out for others.–Christopher

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    1. Thank you for all the support Christopher, it is so encouraging to hear. I agree that every single life is valuable and we should seek to preserve them all. It is also hard to not become desensitized to such things, which I something I am worried about. I hope you remain safe as well, all the best 🙂

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  4. Have you heard about the successful treaments using high doses of vitamin C intraveneously? It was supplemented by high doses of one of the D vitamins. I don’t know the details off-hand. I’m not saying replace conventional medicine that works; but when there is no more conventional medicine that works….. Anyhow, it was in a report I read from Dr. Mercola.

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    1. I have to be honest, I have not remained up to date with all of the information. At our hospital we use dexamethasone and remdesivir when appropriate, and there certainly appears to be an association with low Vitamin D and COVID-19 as well. I am sure there’s a lot of research trying to figure out what works, we’ll just have to wait and hope for the best

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  5. I have been thinking of that too… we probably won’t have a vaccine or meds for quite awhile… so chances of catching is high …

    I’m in the United States 🤨

    When our flu season hits … I am scared of that!!

    Do you get a flu shot? Do you believe in those? Do you think would have greater chance of surviving through virus with flu shot?

    Cause the flu… compounded with corona … would be horrific

    I just pray we are all ok 🙏 is scary

    Thank you for caring about people and helping them.

    Please stay safe yourself 🙏 will think of you ✌️

    Liked by 1 person

    1. As a healthcare worker I am required to get the flu shot, so yes I did! I am not sure whether it will improve your chances of surviving coronavirus, but it wouldn’t be a bad idea just as a precaution. I hope you stay safe as well, look after yourself!

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  6. Thanks for sharing this well-written insight into what is going on in the medical world with Covid-19 and your feelings about it. Wish you good health and keep staying well on your journey of such an admirable and helpful to humanity career.

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