Ever since the pandemic hit our consciousness, Melbourne emergency physician Stephen Parnis has been working on the crest of each wave of COVID.
Her job demanded long hours: treating patients, following new therapies and life-saving strategies, while managing the impact of rising virus numbers and multiple lockdowns on overworked hospital staff and grieving families
Every day, as he went to work, Parnis knew the virus could get the better of him, and month after month he carried with him the weight of two questions: How many lives could be saved today? How many would be lost?
Then, three months ago, Parnis hit the wall.
“I was exhausted. For most of us in healthcare, the pandemic has been the biggest challenge of our entire career and mine started in 1992,” says Parnis, a former vice-president of the Australian Medical Association. “I’ve done a lot of soul-searching, looking at where my limits are and asking how do I sustain myself through this?”
For the first time since 1995, Parnis took three months off.
“I wasn’t myself and if I had kept doing what I was doing I might have ended up having some kind of flame out,” he admits. “It was important to have time and space. My GP and psychologist have been a big part of that time, but they’ve also relied on friends and colleagues.”
The key lesson, Parnis says, was understanding how to lower his expectations of himself: “I don’t have to be perfect. My teammates don’t have to be perfect. We don’t have to have all the answers. You just have to know where to look.” “.
Dr Stephen Parnis faced burnout from the pressure of working as an emergency doctor during Melbourne’s many COVID surges and lockdowns. (Supplied)
It’s ironic that as Parnis prepares to return to work tomorrow, Australia has the highest number of COVID infections, hospital admissions and deaths of any time during the pandemic. His medical colleagues remain under pressure.
“My timing is impeccable”, he says with irony. “I’m coming back at a time when things are kind of diabolical. I’m humbled by the support my colleagues have given me and a little shocked by the number of people who have come to me saying they’ve felt the same way.”
On Friday, Australia recorded 44,203 new cases of COVID-19 in the previous 24 hours, bringing the total caseload to 10 million. The hospital system is juggling 5,122 COVID patients, including 162 in the ICU.
The saddest statistic of all is the deaths. A total of 157 people died of COVID-19 across Australia on Friday. The pandemic has claimed the lives of 11,669 Australians so far.
“I would say the hospital system is keeping its head above water, but only just,” says Parnis, who met with hospital colleagues last week for an update before his return.
Experts contacted for this story, from frontline doctors like Parnis to epidemiologists, virologists and health policy researchers, agree that the trajectory of this wave of the virus is steep and the peak may yet lie ahead.
Epidemiologist Professor Catherine Bennett hopes next week will show more clearly where hospitalizations for COVID are headed. (ABC News: Peter Drought)
Modeling predicts that August will see a significant increase in cases before the curve starts to go down again.
Catherine Bennett, chair of epidemiology at Deakin University, says next week will provide a clearer idea of how long this wave may last.
“I think we’ll know in the next week or so if these are true plateaus that are forming now,” he says, noting that every state is different.
BA.5 has rewritten the rules
COVID has forced us to contend with so many rapid changes, from lockdowns to the “new normal,” that it’s hard to believe that only this time last year state premiers were still in front of the media every morning with updates details of COVID.
Back then, double donut days were the goal and lockdowns were an ever-present possibility. Australians under the age of 40 were not yet eligible for vaccination.
On July 31, 2021, in NSW, for example, the state was deep in a lockdown that eventually lasted more than 15 weeks. In the previous 24 hours, 210 cases were reported and contact tracing was still being attempted. The total number of pandemic cases in NSW had reached just 8,725 infections.
Fast forward a year and yesterday NSW had 177,013 active cases statewide, with 2,210 of them in hospital and 68 in intensive care. In the 24 hours since Friday afternoon, 46 people died of COVID-19.
In retrospect, concern about such low numbers, compared to our current situation, seems almost exaggerated.
However, the disparity speaks volumes about how far we’ve come and how far we need to go.
Without vaccines and lockdowns, many, many more people would have died in last year’s wave, Bennett says.
But this year, despite the launch of vaccines and offers of third and fourth booster doses, pressure on the hospital system is intensifying as the rise of the highly transmissible BA.5 variant, potentially as infectious as most viruses contagious of the earth. , measles and chicken pox – has rewritten the rules.
The new data suggests more than 46 per cent of Australians have had a COVID infection, a figure which is likely to be a significant underestimate, Bennett believes.
‘The Next Epidemic’
However, despite the deaths and those who have suffered as a result of their infections, many have been tempted to ask why we still care about COVID, given the widespread experience of mild illness. The fear of what a COVID infection could mean has dissipated for some who are asking, isn’t it time to get on with things?
Experts are determined to keep this approach cool. And the potential strain on the healthcare system is just one reason.
The most uncomfortable question is this: who will become the victims of this new wave?
Will it be the elderly who, despite vaccination and the availability of new oral antiviral drugs, are unable to fight the virus?
Will it be teenagers and those in their 20s and 30s who often drive the transmission of the virus by becoming infected a second or third time with as yet unknown long-term ramifications?
Will children receiving treatment for chronic conditions such as rheumatoid arthritis be the ones lowering their immunity?
Will it be women who are emerging as the cohort most likely to suffer from COVID for a long time?
When you talk to these experts, leaders in their fields, who have spent more than two years and thousands of hours trying to understand SARS-CoV-2, it’s surprising how often one phrase keeps popping up: “We don’t know . . .
“The fact is, we have more people dying from this virus than any other virus. If things continue in this direction, COVID could be the leading cause of death, surpassing heart disease,” believes Parnis. “This is unacceptable. How bad is it? What are the long-term consequences? There’s a lot we just don’t know.”
Virologist Sarah Palmer, co-director of the Center for Virus Research at the Westmead Institute for Medical Research and professor in the Faculty of Medicine and Health at the University of Sydney’s Faculty of Medicine, believes it’s the unknowns that harbor some of the biggest potential threats, arguing that, left unchecked, rampant infection and reinfection threaten to make COVID “the next epidemic.”
Professor Sarah Palmer’s team is making progress with the development of a universal booster shot. (Provided by: Westmead Institute)
Epidemiologist Bennett agrees with Parnis and Palmer that if the numbers of COVID continue to rise, it will become a major cause of death and disability in Australia, driven simply by the math: a small risk multiplied by a large, infected population still yields numbers worrying
She’s worried about the current wave: “To say it’s disappointing is an understatement,” says Bennett, noting that the BA.5 variant that’s driving the rise in infections is escaping the immunity built up by those who contracted BA .2 more efficiently than I expected.
“We have more than half of the population vaccinated, but people who are in the line of fire for the virus have multiple infections,” he says. “That keeps the infection strong and it’s pushed out into the community and it’s sustained. Even though you might be at very low risk if it’s sustained week after week, at some point you could have that unfortunate exposure.”
But what are we going to do, asks Bennett: “We want to encourage people to stop spreading the virus, but we don’t want to go back into lockdown because then what do you expect? You have to stay for the rest of your lives. It just doesn’t work.”
While Omicron variants have proven to be persistent and resilient, Bennett believes we should be thankful that “it’s not a new variant.”
“We’re not going through that moment where we have absolutely no idea how the virus is going to behave,” he says. “Omicron has been sitting in place longer than other variants have managed to do and that can be a good thing. As long as it doesn’t evolve into something we’re more concerned about.”
The problem, he notes, is that while BA.5 is spreading rapidly through the population, the chance for the virus to mutate again remains a threat.
Space for play or pause, M for mute, left and right arrows for search, up and down arrows for volume. Hematologist Nada Hamad describes how much COVID has changed her life.
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