GPs scramble to navigate vaccine rollouts amid worsening floods

Anastasia Tsirtsakis

23/03/2021 4:01:09 PM

Ripped up carpet, towels on the floor and telehealth: How GPs have kept serving their community, even as the torrential rain covering large parts of Australia shows no sign of stopping.

Man kayaking down a street.
Thousands of people have been evacuated as swollen rivers flood towns and torrential rain continues. (Image: AAP)

‘Nobody can really remember a prolonged wet period like this. We started out with drought in 2019, bushfires at the end of 2019, then COVID, and now floods – it’s just another thing on top.’
That is Woolgoolga GP Associate Professor John Kramer, speaking to newsGP from his practice on the mid-north coast of New South Wales where torrential rain has led to damaging floods and the evacuation of 18,000 people, with a further 15,000 residents on standby.
The carpet of his practice has been ripped up and towels are dotted around the floor, soaking up flood waters that have seeped through the walls.
‘But the power’s on and I’m still working, so it’s not a danger issue,’ Associate Professor Kramer said.
‘We’ve had a number of people being rained in, and we’re converting some of our consultations to phone consultations. So that’s been good that we have the ability to do that.
‘It’s been much more difficult in places like Kempsey and Macksville, where the CBDs were evacuated.’
Parts of the coast have recorded two-thirds of their normal annual rainfall in just one week, and the NSW Bureau of Meteorology reports there is still heavy rainfall coming through, with the Australian Defence Force joining emergency efforts.
Dr Ashlea Broomfield, a GP also based on the NSW mid-north coast, told newsGP the floods have led to road closures, impacting local deliveries and forcing local businesses to close their doors.
‘Down south in Port Macquarie there’s been quite extensive flooding. We’ve had landslides from hills on some of the major roads that connect different towns,’ she said.
‘There’ve been businesses that have had to close because they hadn’t received their supply over the week. We get deliveries … in terms of either bakery goods or fresh fruits and vegetables, and those supply delays have affected people.
‘We’ve also had people that … haven’t been able to attend their appointments or have been stuck because of weather and have had to delay their appointments.’
Myhealth Medical Centre Kable Street in Windsor has been forced to close its doors due to flooding, and their batch of coronavirus vaccines has had to be transported to a different site.
Dr Broomfield said the clinic she works at had received their vaccines late last week, but there is mounting concern over how much the floods will impact the rollout.
‘There is concern regarding deliveries and cold chain management of the vaccine when we have road closures or significant issues where transport’s not able to get through to communities,’ she said.
‘Given that we were supposed to receive it last week and it didn’t get delivered till the Friday, a lot of practices were concerned that they may not be able to get it this week either.’

Deputy Chief Medical Officer Michael Kidd said that around 200,000 doses of the Oxford University/AstraZeneca will be delivered to practices throughout the week, but that flooding has caused ‘inevitable’ delays.
‘Safety has to come first, for staff and patients and for the people delivering the vaccines,’ he said.
‘Over 1000 scheduled deliveries have already been made and the remaining are ready to go as soon as roads are safe, and practices are able to reopen and receive the deliveries.’
Associate Professor Kramer, who plans to push ahead with administering the first COVID vaccines at his practice on Wednesday, said the impact will be widespread.
‘It definitely will impact the rollout, especially in worse affected places such as Kempsey, Macksville, Taree, Port Macquarie – the list just goes on and on,’ he said.
‘We’re juggling the COVID vaccine rollout … and also flu vaccines arrived last Friday. So [that has] started, and pre-consenting people for COVID. So it’s a hectic time, [even] without any floods.’
Meanwhile, Associate Professor Kramer says GPs will once again have to contend with the disease burden in the aftermath.
‘After flood events the mosquito populations breed up and we’re going to have to be watching out for … mosquito-borne diseases,’ he said.
‘There was also a graphic photo of a dead cow washed up on the river shore in Port Macquarie … so when you’ve got dead animals going down rivers, you’ve got public health issues. There’s a risk of sewage treatment plants failing under these conditions and raw sewerage getting into the environment.
‘Mental health has already become a bit of a focus due to all the ongoing stressors that have already been acknowledged, and this just adds to the burden. So it’s something that we will have to be even more mindful of monitoring in ourselves, our staff, but also patients, and especially those that have been previously traumatised with previous flood or fire events.’
Dr Broomfield, who is a member of the RACGP Specific Interests Climate and Environmental Medicine network, says the trauma of the past 12 months is sure to have a significant flow on effect for the entire region.
‘If communities are affected by disaster events, often it’s time afterwards to respond and reflect, and change things. This is such an unusual situation where we’ve had multiple disasters,’ she said.
‘But we also need to talk about how this is not unexpected – droughts, floods, pandemics – it’s all part of what we know when our planet is affected by the effects of climate change.
‘One of the biggest things that I think as GPs we can do is really stand up and advocate for political input and action into improving our planet’s health, and therefore human health.’

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