Second Lockdown 😥😥😥😥😥😥😥

[otherclive]

Reading yesterdays DT there seems to be some efficacy questions being raised. Pfizer “promises” 95% whilst AZ Oxford say 62%.. The question is do you take what you are given or opt for the one with the best”promise”? An Australian vaccine has just failed , needing further research. Overall our virologists have done brilliant work getting this far. I intend having faith and taking what I am offered.

Will you get a choice of vaccine. There may be medical issues that point you to one or the other but I can’t see Primary Care wanting to be messed about much. I noticed in a link that I posted from HMG that Pfizer administration had a comment regarding suitability for those on anti coagulation therapy. My son did some asking around and believes it only relates to the possibility of bleeding or bruising from the needle.
Despite the Oxford being lower at 62% I would happily go with that as it exceeds the required minimum. Do we question our flu jab which sometime be below 50% and what level are pneumonia, shingles, HPV, meningitis etc.

“ The better is the enemy of the good enough”

 

[ProfJohnL]

Reading yesterdays DT there seems to be some efficacy questions being raised. Pfizer “promises” 95% whilst AZ Oxford say 62%.. The question is do you take what you are given or opt for the one with the best”promise”? An Australian vaccine has just failed , needing further research. Overall our virologists have done brilliant work getting this far. I intend having faith and taking what I am offered.

Presently, you will have the right to refuse to have the vaccination you have been offered**, but I doubt that you will be able to personally elect to choose a different vaccine.

Possibly, and only for medical reasons you might be offered an alternative vaccine, and it might mean having to travel to a different vaccination center.

** I actually think most will actually want it, but I suspect if the take up of vaccines is poor, I think the Government might change their attitude towards strong recommendation or even compulsory vaccination except where there is medical reason not to.

 

[Beachball]

Just to let you know my wife had a birthday she been working since 15 and she done her bit helping in the first lockdown and second lockdown now she going back to retirement and that would be better for me, in the longterm seeing i am vulnerable group .

 

[Dustydog]

My 78 Mil received a phone call this pm inviting her to a Covid jab next tuesday. Now she’s very worried she is totally vulnerable in category one😥. Hopefully the rest of us will get a call in the next few weeks.

 

[Beachball]

Here hoping we all get a call but some of us on here it will have go through the doctor"s surgery because of the medication we are taking and to say it safe to have the Covid Jab

 

[otherclive]

Here hoping we all get a call but some of us on here it will have go through the doctor"s surgery because of the medication we are taking and to say it safe to have the Covid Jab

If you read #61 in Covid regulations the link gives information. There have been no interactive studies with other medications, but there are notes relating to those on anti coagulation therapy, and/or immune suppressed., and anaphylactic shock. Therefore I would discuss early with your GP before you get the invite. Currently the vaccination has to be given in the presence of a doctor or advanced nurse practitioner as a further safeguard. But this is likely to change in future when more knowledge has been acquired. The Government in mid October enacted legislation to enable other healthcare professionals such as pharmacists ( vets. 😷) to administer the vaccine subject to training. Even doctors and nurses who have not been vaccinating patients within a defined timescale will have to do the PHE training module, which for some will involve hands on training not just interactive. The link below gives a summary and provides links to official sites too.

It is an ongoing programme so some of the information may have been revised in light of recent experience. But it does show how careful the health community are being in their efforts to roll out these vaccines. I have no qualms whatsoever about receiving either of the candidate vaccines when I am offered the opportunity.

https://www.chemistanddruggist.co.uk/news/covid-19-vaccine-training-guidance-released-phe

 

[Buckman]

In the past at our surgery only 2 out of about 9 doctors were able to administer injections. It was mostly done by the nurses.

 

[Beachball]

Same at our surgery it only the nurses that gives them and i have a injection every 12 weeks since i was young .

 

[ProfJohnL]

In the past at our surgery only 2 out of about 9 doctors were able to administer injections. It was mostly done by the nurses.

I'm certain it's not that the doctors couldn't give injections (that is part of their basic training) it's more likely their time is better spent diagnosing and managing and prescribing individual health care matters rather than giving non specialised treatments, like injection,s wound management, and basic observational checks like temperature and blood pressure.

I'm sure that most doctors know how to answer a telephone, but that would be a waste of their training and skills to put them on reception.

 

[Buckman]

I'm certain it's not that the doctors couldn't give injections (that is part of their basic training) it's more likely their time is better spent diagnosing and managing and prescribing individual health care matters rather than giving non specialised treatments, like injection,s wound management, and basic observational checks like temperature and blood pressure.

I'm sure that most doctors know how to answer a telephone, but that would be a waste of their training and skills to put them on reception.

Nope. Been to see one doctor and then referred to one of the two doctors for administration of injection which can only be done by a doctor and not a nurse. Same happened with OH.
TBH I think the issue is that the other doctors are not skilled enough to administer the injection at the correct site plus dosage,

 

[ProfJohnL]

Nope. Been to see one doctor and then referred to one of the two doctors for administration of injection which can only be done by a doctor and not a nurse. Same happened with OH.
TBH I think the issue is that the other doctors are not skilled enough to administer the injection at the correct site plus dosage,

There are a number of other possibilities as to why you might have experienced this. For example my wife sometimes requires certain injections into her joints. This is a job that requires specialist training, and a GP would not be expected to be able to do this within their general work. There will be other specialisms where similar advanced training will be required.

But just becasue this has happened for the treatments you have needed does not mean doctors don't know how to administer general treatments.

There is another possibility. My practice is designated a "teaching practice", becasue it works in close collaboration with the University of Birmingham's Medical School, and it regularly hosts doctors from the University as part of their F2 training. The scope of their training may restrict them from carrying out some more specialised treatments. In such cases they might need to refer actual treatment to other more qualified and experienced members of staff, or becasue it is practice policy and they have trained nurses or HCA, who are qualified to do them.

It really shows how your practice is trying to look after your wellbeing, and manage its resources effectively. It should not be seen as failings in doctors training. These days all members of a practices staff are expected to have Continual Professional Development as part of their employment/professional designation remit, and its at times like the present pandemic where the variety of roles really makes a difference.

 

[Buckman]

There are a number of other possibilities as to why you might have experienced this. For example my wife sometimes requires certain injections into her joints. This is a job that requires specialist training, and a GP would not be expected to be able to do this within their general work. There will be other specialisms where similar advanced training will be required.

But just becasue this has happened for the treatments you have needed does not mean doctors don't know how to administer general treatments.

There is another possibility. My practice is designated a "teaching practice", becasue it works in close collaboration with the University of Birmingham's Medical School, and it regularly hosts doctors from the University as part of their F2 training. The scope of their training may restrict them from carrying out some more specialised treatments. In such cases they might need to refer actual treatment to other more qualified and experienced members of staff, or becasue it is practice policy and they have trained nurses or HCA, who are qualified to do them.

It really shows how your practice is trying to look after your wellbeing, and manage its resources effectively. It should not be seen as failings in doctors training. These days all members of a practices staff are expected to have Continual Professional Development as part of their employment/professional designation remit, and its at times like the present pandemic where the variety of roles really makes a difference.

We do not regard it as a failing but rather a bonus as you kniow it is someone with experience administrating the injection. No fun being jabbed several times until the person gets the right spot. LOL!

 

[Dustydog]

From what I read today only fully qualified medical professionals, doctors and nurses will administer the vaccine. Questions will be asked and reference to the patients notes made before the deed is done. This is not a simple prick(sic) but a very precisely targeted muscle and depth. Sadly we hear this evening London and South East goes into Tier 3 Wednesday. Also the C19 has mutated making the latest vaccines not as effective as planned. On a brighter note my 95 mum gets her vaccine Thursday.

 

[Parksy]

On the TV news we've seen nurse practitioners vaccinating patients.
At our surgery when it's flu jab time the doctors and the nurse practitioners who usually run the health and wellbeing clinics give the injections to try to get them done in the shortest time span.

 

[Dustydog]

On the TV news we've seen nurse practitioners vaccinating patients.
At our surgery when it's flu jab time the doctors and the nurse practitioners who usually run the health and wellbeing clinics give the injections to try to get them done in the shortest time span.

If you look back to a link Clive posted the C19 injection isn’t quite as simple as the Flu one. The on-site mixing process will take a lot longer than we all anticipated. Historically the Black Death lasted 7 years. Others 2 or 3. The Plague 1 year but only because of the Great Fire of London. Not sure how we will eradicate C19?

 

[otherclive]

From what I read today only fully qualified medical professionals, doctors and nurses will administer the vaccine. Questions will be asked and reference to the patients notes made before the deed is done. This is not a simple prick(sic) but a very precisely targeted muscle and depth. Sadly we hear this evening London and South East goes into Tier 3 Wednesday. Also the C19 has mutated making the latest vaccines not as effective as planned. On a brighter note my 95 mum gets her vaccine Thursday.

There’s no data yet to assess whether the mutation will affect the efficacy of the vaccines. There’s been other mutations around the world. The one referred to by Hancock seems to have arrived from Spain via tourism. Don’t panic Captain Mainwaring 😂

https://www.bbc.co.uk/news/health-55308211

 

[Dustydog]

There’s no data yet to assess whether the mutation will affect the efficacy of the vaccines. There’s been other mutations around the world. The one referred to by Hancock seems to have arrived from Spain via tourism. Don’t panic Captain Mainwaring 😂

https://www.bbc.co.uk/news/health-55308211

I hope you are right Clive. Another Lockdown year will hurt.

 

[otherclive]

I hope you are right Clive. Another Lockdown year will hurt.

Dusty
I would wholeheartedly agree with you on that score. Wonder if our holidaymakers have given the English variant to Spain?

 

[Dustydog]

Dusty
I would wholeheartedly agree with you on that score. Wonder if our holidaymakers have given the English variant to Spain?

Just remember who truly passed on the Spanish Flu, not the Spanish!👍🤪

 

[Jcloughie]

Like administering anything, even putting a plaster on. The right training is required. As said by a few above. GP’s surgeries have lists of which GP’s and practice nurses specialise in what. Before the pandemic my GP said I needed a shoulder injection. But she couldn’t do it, so made an appointment with the appropriate GP. When I turned up my GP had requested she viewed it as she wanted to get whatever qual was needed so she could do it in the future.

CPD will be ongoing for all professionals, I remember it well. Some required short courses away, others were done in house. A session may only take a few minutes. But competence needs to be demonstrated not assumed.

John

 

[Jcloughie]

How things change! Here in the SW we have had historically low rates of infection and deaths. Now we are having a surge.



I am pleased to be in the narrow green area. But this really shows how being too relaxed, by some, can swing things around very quickly. To bring the numbers back down is then an uphill struggle.

John

 

[Beachball]

Where we are the numbers have gone down hoping we go down a (Tier 3) but saying that i will not be going outside but staying warm in our home .

 

[ProfJohnL]

This "second wave" of infections has been more insidious, as the rate of rise has been slower but its been more sustained, and that is why were are getting reports of hospitals being fuller now than in the first wave.

We are seeing areas that were released to tier 2 restrictions now showing significant increases in infections, and some of them like the SE and London will be moved into T3, along with parts of Wales and Scotland where restrictions were relaxed.

This has to tell us that C19 is sneaky little thing and its ready to exploit almost any weakness in our resolve to get at us. C19 is really going to love Christmas.

I do not appologise for continuing to raise these concerns, becasue presently the evidence is there that in relaxed restriction areas the C19 R value seems to go up. and we must be as vigilant as possible to minimise even the slightest risk of catching or spreading the virus.

There are reasons why this virus represents such a public health hazard even compared to other recent major viruses. In this edition of the Lancet, a learned group of physicians express their opinion (based on a range of identified information) why, and in summary

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30484-9/fulltext

Covid-19 compared to other recent viruses :-

• Incubation period is between 4 to 12 days, and victims can spread high viral loads before symptoms develop. This means its difficult to spot those who might be Asymptomatic or presymptomatic, and to isolate them. Longer incubation period, so epidemics form slower but more deeply.
• 
  
• Symptoms may be mild for some and they may not realise they have the virus, but they can very easily infect others especially those over 60 or with underlying health issues.
• 
  
• The number of victims that require high dependency hospitalisation will put a very significant strain on the health services.

Based on figures from the beginning of September 2020

 

[otherclive]

Our local postcode shows figures of 256 per 100000. But Wiltshire as a whole is only about a quarter of that level. But within our local catchment are two large senior schools, and three primaries that are driving figures in a local area. Our granddaughter has excused herself from school now over the last 10 days and school is fine with that.

 

[Dustydog]

A good link Prof. Thanks. Quite alarming are the morbidity tables. I’m in the second worse league😥😥