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Feature

July–September 2020: The pandemic winter and spring


Doug Hendrie


16/12/2020 3:12:28 PM

With harsh lockdowns and massive spikes in coronavirus cases, millions of Australians were experiencing especially difficult times – while the RACGP experienced its own terrible loss.

Collage of Melbourne lockdown
Melbourne’s stage-four lockdown meant people could only leave their house for groceries, exercise, caregiving or permitted work.

What started as a seemingly minor uptick in cases eventually led to Victoria’s spiralling second wave of COVID-19, which escaped hotel quarantine and seeded itself across Melbourne, with worrying metastases into the regions.
 
In response, the Victorian Government imposed the country’s most stringent measures to date, culminating in a hard stage-four lockdown, where most residents could leave their houses only for groceries, an hour of exercise, caregiving or permitted work, and only travel within 5 km of their homes.
 
Healthcare workers were largely spared from infections during the first wave of COVID, but the second wave saw thousands of aged care workers, nurses and doctors contact the virus.
 
That triggered major ructions at high levels, with public debates over how healthcare workers were getting the virus. Was it inadequate personal protective equipment (PPE)? Was the virus airborne? Were healthcare workers getting sick during doffing and donning of protective gear?
 
GPs were largely unscathed by the infections, protected by their rapid moves to telehealth, efforts to acquire PPE stockpiles and heightened precautions for face-to-face consultations.
 
But there was grief nonetheless, with the RACGP’s well-respected President, Dr Harry Nespolon, dying from pancreatic cancer in July. His death saw an outpouring of tributes from everyone from his patients to GP colleagues to health ministers.
 
‘[Harry’s] tenure as president coincided with a period of reform and then, of emergency – both the bushfire emergency and more recently the ongoing COVID-19 pandemic,’ Federal Health Minister Greg Hunt said at the time.
 
‘Throughout these challenges, and his own personal battle with cancer over the past nine months, he remained tireless, eloquent and cogent in his leadership and drive for positive change.’
 
Associate Professor Ayman Shenouda was named RACGP Acting President following Dr Nespolon’s death, a role he would maintain until the RACGP’s Annual General Meeting on 30 November.

The RACGP also confirmed the appointment of a new CEO, Dr Matthew Miles, in July. Following an exhaustive recruitment process, the former MS Research Australia Chief Executive began his new role with the college on 3 August.  

‘The next couple of years will be absolutely laser-focused on the needs and wants of the members,’ Dr Miles told newsGP upon starting the role. ‘I want to provide that surety to the membership that we’re listening.

‘Any sort of suggestion or criticism of the past that the RACGP wasn’t listening to members or didn’t have the GPs’ best interests as their main focus is now completely over.’

WA-VAD-Harry-3-hero.jpg
The July death of RACGP President Dr Harry Nespolon triggered an outpouring of tributes from around the country.

The second COVID wave led to strong interest in new findings on COVID treatments and research.
 
As millions of people who contracted the virus early on in the pandemic grappled with unexpected long-term consequences, research began in earnest on what has been called ‘long COVID’ – a suite of residual effects ranging from pulmonary damage to neurological issues to post-viral fatigue to chronic heart complications.
 
In response, Melbourne hospitals and GPs began rolling out post-COVID pathways for survivors.
 
Calls came for clinicians to consider COVID as a diagnosis even if patients only had gastrointestinal symptoms, following new symptoms added to the list kept by the US Centers for Disease Control and Prevention.
 
In a surprising finding, people with blood type A were found to be at higher risk of contracting the coronavirus, though experts cautioned further research was needed to tease out potential biases and other factors.

As the world at large grappled with an uneven pandemic – with the virus surging in some nations and going quiet in others – a number of high-profile experts gave their views on how the coronavirus would eventually be tamed. Vaccines, they said, would not be a silver bullet and better treatments and public health measures would still be necessary for the foreseeable future.
 
New research also put paid to hopes that the old drug hydroxychloroquine could effectively treat COVID, which US President Donald Trump had hyped as a cure. Australia’s National COVID-19 Clinical Evidence Taskforce found that the drug was no more effective than standard care, and was in fact potentially harmful.
 
‘Hydroxychloroquine should not be used as a treatment for anyone with COVID-19,’ Taskforce director Associate Professor Julian Elliot said.
 
Anti-parasitic drug ivermectin was held up as a potential treatment for COVID, though experts cautioned that the evidence was not in.
 
More evidence emerged suggesting immunity to the SARS-CoV-2 virus that causes COVID-19 was short-lasting, in news seen as a challenge to vaccine-makers.
 
By the end of September, Victoria’s second wave was at last showing signs of receding. Other states such as New South Wales had to deal with periodic flare-ups, while being able to avoid the type of major lockdown implemented in Victoria.
 
While the COVID-19 pandemic took the lion’s share of attention, other healthcare issues continued to bubble away in the background.
 
GPs were outraged when the Department of Health announced plans to limit their ability to be reimbursed for interpreting electrocardiograms (ECGs). Many GPs took the decision as professional slight and an indirect cut to funding.
 
In response, Federal Health Minister Greg Hunt said the decision would be reviewed after six months, while the Chair of the Cardiac Services Clinical Committee that recommended the changes said the intention was not to strip GPs of the right to interpret ECGs.  
 
In response to GP concerns over the sudden emergence of telehealth-only services, the Federal Government moved to restrict telehealth to a patient’s usual GP or clinic they had visited in the last 12 months. This move was welcomed by the RACGP, which had advocated strongly for this outcome in order to help maintain continuity of care.
 
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