The wonderful Peter Yang
Medical response in chaos in swine flu pandemic
June 17th 2009 05:48
Siobhain Ryan and Adam Cresswell | June 13, 2009
ANGRY GPs have slammed a "conspicuous lack of leadership" in Australia's response to the swine flu crisis, with some patients waiting eight days for test results or receiving anti-viral drugs too late to limit the infection.
The doctors have blamed delays and inconsistent responses at state and federal levels for undermining efforts to contain the disease in Australia, placing the nation on the front line of the world's first flu pandemic in more than 40 years.
The World Health Organisation conceded defeat early yesterday in global efforts to confine the novel H1N1 strain, upgrading its six-level warning system to full-blown pandemic.
Despite the worldwide upgrade, Australia yesterday did not lift its own pandemic alert status to the highest level, on the basis that the disease remained a mild one for most of the population.
The number of Australians infected with the new H1N1 strain is, however, believed to be far higher than last night's official national tally of 1391 because Victoria has abandoned its daily caseload updates.
The state last Wednesday cut back its laboratory testing for the virus from about 500 to 1000 samples a day to 50 to 70 a day, after acknowledging it could no longer contain the disease.
Even then, patients were falling through the cracks in the testing system, Melbourne GP Kirstin Charlesworth told The Australian.
She said a 17-year-old boy who came to her Toorak practice two weeks ago with classic flu symptoms, including a 39C fever, had to wait for eight days for test results to confirm his diagnosis, by which stage he was back at school.
The patient was initially refused priority testing because he fell outside Victoria's risk criteria, and could not be fast-tracked even after classmates tested positive to swine flu.
"They said they couldn't do it - it was on the slow train to nowhere and had been sent interstate," Dr Charlesworth said. "I asked if I could at least have Tamiflu for the patient, for his household, and for myself - and they said, 'No, because he doesn't have swine flu at this stage'."
Thomas Lyons, a GP from Eagleby, southeast of Brisbane, said logistics were "falling over" in the fight to contain the virus, and likened the bureaucrats responsible for organising the national swine flu response to the generals in charge at Gallipoli.
"There is a conspicuous lack of leadership at the state level here in Queensland," he said. Dr Lyons said a woman who had been a passenger on the Pacific Dawn cruise liner, which hosted a major swine flu outbreak, had told him hospital staff had promised that masks and other equipment needed for her quarantine would be sent to her home.
"It arrived eight days later - much too late to be of any epidemiological or biological use whatsoever," Dr Lyons said. Pathology companies were quoting him testing turnaround times of between two and five days, yet the anti-viral Tamiflu commonly used for treatment was largely ineffective more than 48 hours into the course of the disease.
"Giving it more than 72 hours after the onset of symptoms is a waste of time," Dr Lyons said.
Sydney GP Mike Moore, chief executive of the Central Sydney GP Network, said authorities could have managed the situation better.
"If we had been more careful, we could probably have delayed entry of the virus into the country, and (if) various jurisdictions had been more co-ordinated," he said.
Federal Health Minister Nicola Roxon yesterday sought to head off doctors' concerns by announcing almost $4 million in new funding to provide extra support for GPs.
"It is about ensuring that those people who have to provide the frontline care are provided with up-to-date information about swine flu, including things like testing protocols, infection control, and how to use the personal protective equipment properly, and how to organise practice systems to help manage a potential pandemic," she said.
Kevin Rudd defended Australia's preparation for the swine flu epidemic as "among the best in the world".
"Our response throughout has been to respond calmly and in a measured way to the medical and scientific advice given to us daily by the Chief Medical Officer of the commonwealth and of the states," the Prime Minister said.
Cross-border relations between health agencies have, however, deteriorated as the virus has spread, with Victoria first criticising NSW's lax quarantine rules in its handling of the Pacific Dawn outbreak, then accusing its neighbour of imposing too tough a school exclusion regime on children returning from visits to Melbourne.
Queensland Health has also come under fire, with Broncos chief executive Bruno Cullen declaring the department's quarantine advice after star fullback Karmichael Hunt's diagnosis with swine flu too inconsistent to be taken seriously.
As one of our closest neighbours - New Zealand - yesterday forecast that up to one million Kiwis could be infected with the virus, Swiss drugs giant Novartis completed a first batch of swine flu vaccine for pre-clinical trials and aims to make a version available by the end of the year.
(This article is from www.theaustralian.news.com.au)
ANGRY GPs have slammed a "conspicuous lack of leadership" in Australia's response to the swine flu crisis, with some patients waiting eight days for test results or receiving anti-viral drugs too late to limit the infection.
The doctors have blamed delays and inconsistent responses at state and federal levels for undermining efforts to contain the disease in Australia, placing the nation on the front line of the world's first flu pandemic in more than 40 years.
The World Health Organisation conceded defeat early yesterday in global efforts to confine the novel H1N1 strain, upgrading its six-level warning system to full-blown pandemic.
Despite the worldwide upgrade, Australia yesterday did not lift its own pandemic alert status to the highest level, on the basis that the disease remained a mild one for most of the population.
The number of Australians infected with the new H1N1 strain is, however, believed to be far higher than last night's official national tally of 1391 because Victoria has abandoned its daily caseload updates.
The state last Wednesday cut back its laboratory testing for the virus from about 500 to 1000 samples a day to 50 to 70 a day, after acknowledging it could no longer contain the disease.
Even then, patients were falling through the cracks in the testing system, Melbourne GP Kirstin Charlesworth told The Australian.
She said a 17-year-old boy who came to her Toorak practice two weeks ago with classic flu symptoms, including a 39C fever, had to wait for eight days for test results to confirm his diagnosis, by which stage he was back at school.
The patient was initially refused priority testing because he fell outside Victoria's risk criteria, and could not be fast-tracked even after classmates tested positive to swine flu.
"They said they couldn't do it - it was on the slow train to nowhere and had been sent interstate," Dr Charlesworth said. "I asked if I could at least have Tamiflu for the patient, for his household, and for myself - and they said, 'No, because he doesn't have swine flu at this stage'."
Thomas Lyons, a GP from Eagleby, southeast of Brisbane, said logistics were "falling over" in the fight to contain the virus, and likened the bureaucrats responsible for organising the national swine flu response to the generals in charge at Gallipoli.
"There is a conspicuous lack of leadership at the state level here in Queensland," he said. Dr Lyons said a woman who had been a passenger on the Pacific Dawn cruise liner, which hosted a major swine flu outbreak, had told him hospital staff had promised that masks and other equipment needed for her quarantine would be sent to her home.
"It arrived eight days later - much too late to be of any epidemiological or biological use whatsoever," Dr Lyons said. Pathology companies were quoting him testing turnaround times of between two and five days, yet the anti-viral Tamiflu commonly used for treatment was largely ineffective more than 48 hours into the course of the disease.
"Giving it more than 72 hours after the onset of symptoms is a waste of time," Dr Lyons said.
Sydney GP Mike Moore, chief executive of the Central Sydney GP Network, said authorities could have managed the situation better.
"If we had been more careful, we could probably have delayed entry of the virus into the country, and (if) various jurisdictions had been more co-ordinated," he said.
Federal Health Minister Nicola Roxon yesterday sought to head off doctors' concerns by announcing almost $4 million in new funding to provide extra support for GPs.
"It is about ensuring that those people who have to provide the frontline care are provided with up-to-date information about swine flu, including things like testing protocols, infection control, and how to use the personal protective equipment properly, and how to organise practice systems to help manage a potential pandemic," she said.
Kevin Rudd defended Australia's preparation for the swine flu epidemic as "among the best in the world".
"Our response throughout has been to respond calmly and in a measured way to the medical and scientific advice given to us daily by the Chief Medical Officer of the commonwealth and of the states," the Prime Minister said.
Cross-border relations between health agencies have, however, deteriorated as the virus has spread, with Victoria first criticising NSW's lax quarantine rules in its handling of the Pacific Dawn outbreak, then accusing its neighbour of imposing too tough a school exclusion regime on children returning from visits to Melbourne.
Queensland Health has also come under fire, with Broncos chief executive Bruno Cullen declaring the department's quarantine advice after star fullback Karmichael Hunt's diagnosis with swine flu too inconsistent to be taken seriously.
As one of our closest neighbours - New Zealand - yesterday forecast that up to one million Kiwis could be infected with the virus, Swiss drugs giant Novartis completed a first batch of swine flu vaccine for pre-clinical trials and aims to make a version available by the end of the year.
(This article is from www.theaustralian.news.com.au)
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