Week 1: The birds a little louder

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The birds are louder this week

Ending the first week of the COVID–19 proper, although still feels like a prelude. We have done a lot of talking. So many emails. Not many patients.

At least two cases of COVID–19 confirmed pneumonia have been admitted to a rural hospital. A DHB freaked out. Interesting. Sanity prevailed after several hours. The patient stayed for a few days. The patient deteriorated and was transferred. This went smoothly. Suprising.

People have stopped coming to hospital. Seemingly unnecessary investigations have stopped – this seems to have been accepted by patients. Interesting.

Some DHBs have become more helpful and communicative. Some are visiting rural health services, some are building negative pressure rooms. Most are talking to us and some are listening. Others…

The birds are louder this week

The kids are at home. Our bubble is huge. It still hasn’t rained.

The city seems to have come to the beach for a ‘holiday’. Anxiety over how we will cope if they get sick. DHBs didn’t make a statement. Mayoral pleas didn’t make the mainstream media. Road blocks and dynamite?

The are birds are louder this week

Maybe it will rain tomorrow…. I hope we stayed home early enough.

Some news:

Associate Professor Garry Nixon, Department of General Practice and Rural Health, University of Otago, comments:

“Rural communities will be more vulnerable to the impact of Covid–19. This is because the residents of rural towns are on average older, have a lower socioeconomic status, are more likely to be Māori, have poorer health status, and less access to health services, than urban dwellers.

“Rural indigenous communities may be particularly at risk around the world. We know for example the swine flu epidemic hit rural aboriginal communities very hard, and rural Māori communities suffered considerably in the 1918 ‘Spanish flu’ pandemic.

“Only a handful of patients have so far needed hospital admission in New Zealand but at least two of these have been admitted to small rural hospitals. This is potentially a significant problem for three reasons:

  • Rural hospitals lack ‘surge capacity’. They are largely driven by acute need and are often at capacity in the winter months and they do not have outpatient clinics or elective surgery that can be cancelled in order to create urgent additional capacity.
  • The majority of rural health services are chronically understaffed and are often heavily reliant on locums.
  • Because of the infection risk, very unwell Covid–19 patients are difficult to safely transfer from a rural to a base hospital.

“The isolation and low population density of rural towns may help but the large numbers of tourists will increase spread. The Coromandel Mayor has urged people not to use their bach for isolation – with the Rural GP Network saying their health services won’t cope. In Norway, urban dwellers have been banned from using their vacation homes for isolation. It will be important to limit movement into rural communities to the absolute minimum.”

COVID–19 and digital technology: The roles, relevance and risks of using telehealth in a crisis​

Under Pressure One Italian Doctor Triages by Ultrasound

The Canadian Association of Emergency Physicians & The Society of Rural Physicians of Canada Press Release: Rural Emergency Departments & COVID19

Keeping the Coronavirus from Infecting Health-Care Workers What Singapore’s and Hong Kong’s success is teaching us about the pandemic. By Atul Gawande

 

Send through comments, experiences, thoughts and any COVID-19 related links to rural.postgraduate@otago.ac.nz so can be included in next weeks entry.

This entry was posted in News, Postcards from the Edge by Rory. Bookmark the permalink.

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