The European Medicines Agency (EMA) is recommending Novavax’s COVID-19 vaccine carry a warning of the rare possibility it will cause two types of heart inflammation.
Key points:
TGA figures show about 189,200 doses of Novavax have been administered in Australia to 24 July 2022
The EMA has requested more data from Novavax about its vaccine
An Australian epidemiologist says “a very small number of people” have been affected
The heart conditions — myocarditis and pericarditis — should be listed as new side effects for the vaccine, Nuvaxovid, based on a small number of reported cases, the agency said.
Myocarditis is inflammation of the heart muscle, while pericarditis is inflammation of the outer lining of the heart.
US vaccine developer Novavax said no concerns about heart inflammations were raised during the clinical trials of Nuvaxovid, and more data would be gathered.
“We will work with the relevant regulators to assure our product information is consistent with our common interpretation of the incoming data,” the vaccine developer said.
Adelaide epidemiologist and biostatistician Adrian Esterman said all medicines carried a risk of causing unwanted side effects, but overall severe adverse outcomes from vaccines were very rare.
I have added that the Australia’s medicines regulator, the Therapeutic Goods Administration, would be well aware of the EMA’s recommendation.
“My take on this is really there’s nothing to be worried about,” he said.
“In reality, it’s a very small number of people. This is not considered to be a major issue.”
How long has Novavax been in Australia?
The Novavax shot joined Australia’s national vaccine program in February after being approved by the TGA.
TGA figures show about 189,200 doses of the Novavax shot have been administered in Australia to July 24 this year. Last month it was provisionally approved by ATAGI for COVID-19 vaccination use in children aged 12 to 17.
Of all of those doses, the TGA said it had received a small number of reports of suspected myocarditis and/or pericarditis in people who had received Nuvaxovid.
“Three cases were likely to represent myocarditis and 21 were likely to represent pericarditis,” the latest TGA Vaccine Safety Report said.
“As a result of our investigation, the Product Information (PI) for Nuvaxovid (Novax) has been updated to include pericarditis as a potential adverse event.”
Professor Esterman said regulatory bodies like the TGA had a few ways to deal with reported adverse events.
“The first is to include a warning on the product Information sheet in the packet,” he said.
“If it’s more serious, in addition they can insist on a warning label on the packet. And, finally, they can take the product off the market.”
In June, the US Food and Drug Administration (FDA) flagged a risk of heart inflammation from the Novavax vaccine.
Myocarditis and pericarditis were previously identified as rare side effects, mostly seen in young men, from RNA vaccines made by Moderna and the Pfizer and BioNTech alliance, with the vast majority of those affected recovering fully.
What is the Novavax jab?
Novavax was hoping people who had opted not to take Pfizer and Moderna’s vaccines would favor its shot because it relies on technology that has been used for decades to combat diseases including hepatitis B and influenza.
Unlike mRNA and viral vector vaccines, which contain genetic material telling your body how to make the spike protein, the Novavax vaccine contains the actual spike protein.
In Novavax’s nearly 30,000-patient trial, conducted between December 2020 and September 2021, there were four cases of a type of heart inflammation detected within 20 days of taking the protein-based shot.
About 250,000 doses of Nuvaxovid have been administered in Europe since its launch in December, according to the European Center for Disease Prevention and Control.
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Since Alex Stosic’s heart failed in 2021, everyday tasks like waking up and getting dressed take hours and require a herculean effort.
Key points:
Mr Stosic is one of more than 87,000 people waiting for elective surgeries in Victoria
Quarterly government statistics show the wait has stabilized despite a rise in emergency department presentations
Ambulance Victoria faced its busiest quarter on record, for the third time in a row
For more than a year, the normally energetic 71-year-old Frankston man, who runs his own business with his wife, has been living with his heart only operating at a fifth of its usual capacity.
Earlier this year his surgery for a new valve was deemed semi-urgent, also known as category 2, which meant treatment was recommended within 90 days.
But he has been waiting more than 150 days.
Since his body shut down, Alex has lost more than 30 kilograms, is struggling to keep his small business running and has barely been able to see his grandkids, who live in regional Victoria.
“I can only take about 20 or 40 steps and I have to have a significant rest,” he said.
“Even working on the computer, I can really only do a few hours and then I have to have a rest.”
While waiting for surgery, Alex Stosic is only able to work on his computer in short bursts.(ABC News: Danielle Bonica)
Normally Alex is on the tools in his small business, which specializes in removing scratches from surfaces like glass, but since he fell ill he has only been able to do accounts.
“It certainly limits my lifestyle and limits what I can do,” he said.
Alex Stosic’s dog Suzie Q barely leaves his side since he got sick.(ABC News: Danielle Bonica)
The poor state of Alex’s physical health has left him and his wife Maureen basically housebound, which has taken a heavy toll on his mental health and prevented him from seeing his three children and five grandkids as much as he used to.
In Victoria, elective surgery is defined as any necessary surgery that can be delayed for at least 24 hours.
During the COVID-19 pandemic, elective surgery has repeatedly been put on hold to help the state’s health system cope with an influx of cases, which has led to a backlog.
At the beginning of April, the Victorian government announced a $1.5 billion investment package to address that backlog, but as the most recent wave of Omicron ramped up, individual hospitals began deferring all but category 1 cases again.
The latest quarterly data, released today, shows that at the end of June 87,275 people were on the waiting list, slightly down from the three months earlier.
That is due in part to the more than 41,000 elective surgeries conducted during the quarter, almost 50 per cent more than the previous three months.
But the waitlist is dramatically higher — about 21,000 people more — than the same time a year earlier.
And while the hospital waitlist showed small signs of stabilization, other areas of the health system were put under increasing pressure.
Busiest quarter in Ambulance Victoria during ‘unprecedented’ demand
The three-monthly data, released by the government a week later than expected, showed hospital emergency department presentations had risen by 5.1 per cent in the three months to June 30.
That took the number to 486,701 emergency presentations, an increase of more than 23,000 on the last quarter.
The surge is being attributed to a number of factors, including deferred care from lockdowns and a more severe influenza season than previous years.
“What we are seeing in Victoria at the moment is unprecedented demand,” Health Minister Mary-Anne Thomas said.
The average stay in hospital also rose, with sicker patients staying in beds for longer.
The number of code-1 callouts for paramedics has continued to rise.(AAP: Diego Fedele)
For the third quarter in a row, Ambulance Victoria experienced its busiest three months on record.
Urgent code 1 call-outs rose to 97,982, up by nearly 5,000 on the previous quarter. That’s 16 per cent more than the same period a year earlier.
Only about 64 per cent of those urgent code-1 cases were responded to within the benchmark 15 minutes, a drop on last quarter.
The pressure has led to at least seven code red escalations being called in as many months, in comparison to the nine called between 2017 and 2021.
Authorities have continued to urge Victorians to save triple-0 for emergencies only, with Ambulance Victoria saying about 500 callers each day did not need paramedics.
The Health Minister thanked paramedics, healthcare workers and those in the hospital system for their work during a time when up to 2,000 hospital staff are furloughed each day.
“This is our third COVID winter,” Ms Thomas said.
“All winters are hard in our hospital system, but indeed this winter has proven particularly challenging.”
A study published in June showed deadly ambulance ramping was already on the rise before the pandemic hit.
The Opposition has criticized the government for the delay in releasing the statistics and called for more to be done to address problems within the system.
“This isn’t just because of COVID,” Shadow Health Minister Georgie Crozier said.
“It’s years of under-investment and mismanagement by the Andrews Labor government.”
The government has announced a suite of measures as part of its $12 billion pandemic repair plan, including the expansion of virtual EDs, new paramedics and the overhaul of the crisis-riddled triple-0 system.
Alfred among hospitals restricting operations due to Omicron wave
The Alfred Hospital, where Alex Stosic is due to be treated, put out a statement in mid-July saying that because of the winter wave of Omicron, it was making operational changes such as deferring some elective surgeries and procedures.
It was one of a number of health services across the state to implement similar measures.
“It should never have got to this,” the opposition’s Ms Crozier said.
“These are huge numbers of Victorians who are waiting for this vital surgery, and while they’re waiting, they’re waiting in pain.”
Despite the way the wait has been affecting his life, Alex described his attitude as “stoic.”
Frankston man Alex Stosic was in good health in the years before he fell ill.(Supplied: Alex Stosic)
“Provided I readjust my whole lifestyle, I can cope,” he said.
“I feel there’s people there who are probably worse off than me who have contracted COVID and need ventilators — I don’t need a ventilator.”
The keyhole surgery he requires is relatively new, meaning only a handful of surgeons are able to perform it.
In the meantime, Alex said he was not able to do much except wait for the phone call about the surgery likely to put his life back on track.
He said he was extremely grateful to the paramedics, doctors and other healthcare workers who saved his life and stabilized his organs after his body first shut down last year, and was trying to remain patient.
Alex Stosic’s life revolves around waiting for news he can have surgery.(ABC News: Danielle Bonica)
“I’ve always had an attitude that you can play the cards that you’re dealt with and they’re the only cards you can play,” he said.
“I’ve been dealt these cards so I just have to play them.
“The only thing I can do is live a fairly sedentary, restricted life and hope that somehow we get the hospital system and COVID under control so I can get in there and get my operation.”
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The New South Wales upper house inquiry into the appointment of former deputy premier John Barilaro to the lucrative US trade role will agree again on Friday.
An additional fourth hearing comes after the resignation of Trade Minister Stuart Ayres on Wednesday, following questions raised about his involvement in the process.
Mr Ayres denies any wrongdoing but will be investigated for a possible breach of the Ministerial Code of Conduct.
Mr Barilaro’s former chief of staff, Siobhan Hamblin, the managing director of Investment NSW, Kylie Bell, and the Public Sector Commissioner, Kathrina Lo, will give evidence from 10am.
Earlier in the week, in her second appearance before the committee, Investment NSW chief executive Amy Brown granted the appointment was not done “at arm’s length” from the state government.
Mr Barilaro — who has withdrawn from the $500,000-a-year job — is due to appear at the inquiry on Monday, August 8.
Meanwhile, the NSW opposition leader Chris Minns said it does not make sense to have highly paid Trade Commissioners based overseas when the state’s finances are under extreme pressure.
He said Labor would abolish the six Senior Trade and Investment Commissioner positions, if it wins the state election in March.
“The modern Australian economy, particularly when you’re chasing export opportunities, is so diverse and so big that a single person driving that agenda around the world just doesn’t make sense,” Mr Minns said.
COVID-19 cases in state slowdown
NSW Health says its latest surveillance data suggests that COVID-19 infections have peaked and hospital admissions have plateaued across the state.
The report — which analyzes the week ending July 30 — found the rate of COVID-19 notifications per 100,000 people had decreased, or remained stable, across all local health districts.
Infections have also decreased, or remained stable, across all age groups, except those aged between 10 and 19 years.
The seven-day, rolling average of daily hospital admissions also decreased by 14.8 per cent.
Meanwhile, the highly “sticky” BA.4 and BA.5 Omicron sub-variants are still the dominant strains, rising to 97 per cent of specimens sampled at the end of last week, compared to 94 per cent at the end of the previous week.
NSW Health says there is still no evidence of a difference in disease severity between these and previous Omicron variants.
Monkeypox doses available soon
The vaccine will be eligible for some people from Monday.(Reuters: Given Ruvic/Illustration)
Those most at risk from monkeypox in NSW can access the first doses of the smallpox vaccine from Monday 8 August, as part of a targeted rollout across the state.
NSW Health has secured the first 5,500 doses for high-risk groups, such as people with suppressed immune systems, sex workers and homeless men who have sex with men.
Chief Health Officer Dr Kerry Chant said doctors will identify people who should be vaccinated against Monkeypox and more information will be released in coming days about how to register interest.
Australia has recorded about 60 cases of Monkeypox, which is a usually mild disease similar to smallpox, and until May was endemic to Central and West Africa.
Another 30,000 doses will be delivered to the state next month.
Man charged with stalking teacher
A man has been charged with intimidating and stalking a teacher at Auburn in Sydney’s West.
Police say the 26-year-old threatened the teacher at the basketball courts of the PCYC on Wednesday.
He has been granted bail and is due to face court next week.
Natural disaster organization under fire
The future is unclear for Shane Fitzsimmons, who leads Resilience NSW.(AAP: Mick Tsikas)
New South Wales cabinet is expected to approve a recommendation to dismantle the organization created to lead the response to natural disasters.
A report into this year’s floods has recommended dismantling Resilience New South Wales.
Flood victims have criticized the organisation’s performance.
It’s thought the agency’s responsibilities will be reallocated to existing government departments.
Varroa mites spread
Varroa mite infestations have been identified at nine more properties in the Newscastle region.
The nine new detections bring the total number of infested premises to 73.
All of the new detections have been linked to other cases or to the movement of other hives and equipment, and were found within existing emergency zones.
Varroa mites spread viruses that cripple bees’ ability to fly, gather food and pollinate crops, leading hives to collapse and die off.
Australia was the last continent to be free of the parasite, with previous detections in Queensland and Victoria eradicated.
While PCR tests are still available and remain the “gold standard” for testing, many have turned to rapid antigen tests (RATs) out of convenience or as part of a requirement to return to work or school.
They can provide results within minutes, don’t require a healthcare worker or lab to process, and help to catch COVID-19 cases that otherwise would have gone undetected.
But with these benefits comes a range of limitations – the biggest one being that they can provide false negative or false positive results.
Recently, some doctors have warned people against relying on a negative RAT result.
Meanwhile, the makers of RATs have hit back, blaming false negatives on a lack of education about how and when to properly use the tests.
So is there any evidence that indicates the effectiveness of RATs has been impacted? And does it have to do with people using them incorrectly?
Australia faces ‘an education gap’ that was ‘never filled’ after RATs went on the market
Pathology Technology Australia, the peak body for test manufacturers and suppliers, defended the performance of rapid tests against new variants of Omicron, accusing critics of “fearmongering”.
“Nothing has changed, we’re yet to see any evidence that clearly indicates performance has been impacted by the subvariants,” chief executive and clinical biochemist Dean Whiting said in a statement.
“There is an education gap in Australia that was never filled after RATs became available.”
“I think a lot of the false negative results are due to incorrectly collecting the sample,” Mr Whiting said.
Here are the essentials to taking a RAT.
Store the test at 2C-30C
The Therapeutic Goods Administration (TGA) warns that tests “may not work properly” if they have been exposed to excessive light or heat, or if the packaging is damaged.
The instructions for a RAT specifically say to store it in a cool, dry place at 2 degrees Celsius up to 30C.
Do not freeze the kit and do not store it in direct sunlight.
Check the expiration date
According to the TGA, RATs can be stored for 12 months from the date of manufacture.
Do not use the test after its expiration date.
Blow your nose
David Speers, a clinical microbiologist and head of the microbiology department at PathWest, told ABC Radio Perth this will clear any excess mucous so that it won’t interfere with the results.
“What you want to do is sample the lining of the nose — you’re not sampling the secretions as such,” he said.
Only open the kit right before use
If you open the kit components, don’t suddenly delay taking the test and leave it out until you decide to.
When you open the kit, take the test straight away.
Don’t contaminate the test
Whether it’s with your fingers or your kitchen tiles after dropping it (there’s no five-second rule here), the tip of the swab should not touch anything.
So make sure it doesn’t come into contact with any other surfaces.
Swabbing at the wrong angle and depth
You’ve made it to the hardest part.
It’s easy for many to get the angle or depth wrong when it comes to swabbing.
Mr Whiting said he has seen many people wave the swab around the inside of their nostrils when taking a RAT.
“This is not the way the manufacturer intended for you to use the test,” he said.
“The manufacturer intended you to put the swab at least 1.5cm up your nose and swish it around five times, then do the other side.”
A guide published by the Public Health Laboratory Network (PHLN) and the Department of Health says to insert the swab tip 2cm to 3cm into each nostril.
The key is to insert the swab all the way up your nostril until you feel it rub against the back of your nose.
Watery eyes and the urge to sneeze indicate you’re taking the test correctly. (Supplied: John Hopkins Medicine)
Rather than going directly upwards with the swab, make sure the swab passes horizontally.
Then rotate the swab gently against the walls of the nasal passage five times, for 15 seconds in each nostril.
“You will know when you’re doing this correctly because it’s slightly uncomfortable,” Mr Whiting said.
“If your eyes aren’t watering or you’re not resisting the urge to sneeze, then you’re not taking the sample correctly.”
Swirl the swab in the tube for 10 seconds
Hold the solution tube firmly with one hand.
Once you’ve inserted the swab into the tube, swirl it around in the fluid for 10 seconds.
Then pinch the swab tip through the tube to remove any remaining fluid.
For some testing kits, you will need to snap the end of the swab. The swab will indicate where to do this.
Don’t add too many drops to the device
Remove the test device from its protective package and place it on a well-lit, flat surface.
Keep the tube vertical with the cap pointed down.
Squeeze three drops of liquid from the tube into the well on the device.
Some tests say two drops, while others may say four. Make sure you follow the instructions of the manufacturer of your test.
Adding too many drops or too few will affect the timeline and the test will be inaccurate.
Follow the no earlier than 15, no later than 20 rule
Keep the test device on a flat surface.
Read the result at 15 minutes.
Do not read it earlier than this, or after 20 minutes.
After 20 minutes, the result might become inaccurate.
Misreading the result
Two lines mean you have tested positive for COVID
A line at C only means you have tested negative for COVID
A line at T but not C means your test is faulty
No means lines your test is faulty
Your RAT result will look like one of these.(Supplied: Antibodies.com)
Dispose of the kit correctly
Make sure you place the swab, tube and test device into the plastic bag provided and seal everything in there.
Then you can dispose of it in the rubbish bin.
As more variants emerge and evolve over the pandemic, many are wondering whether we’re likely to get a variant that can elude testing.
Epidemiologist and biostatistician from the University of South Australia Adrian Esterman said at some point in time, we would likely get a variant that was much harder to detect with existing tests.
But because of Australia’s diverse population and geographical spread, Mr Whiting believes RATs are going to remain highly useful, especially in rural and remote areas.
Florida Gov. Ron DeSantis (R) rejected growing concerns over monkeypox during a press conference Wednesday, arguing that the media and politicians were unnecessarily stoking fear about the illness.
“I am so sick of politicians, and we saw this with COVID, trying to sow fear into the population,” the Republican governor said. “We had people calling, mothers worried about whether their kids could catch it at schools.”
“We are not doing fear,” he added. “And we are not going to go out and try to rile people up and try to act like people can’t live their lives as they’ve been normally doing because of something.”
DeSantis, who has been a vocal critic of the Biden administration’s response to COVID-19, also slammed states imposing emergency measures in regard to monkeypox.
“You see some of these states declaring states of emergency. They’re going to abuse those emergency powers to restrict your freedom. I guarantee you that’s what will happen,” DeSantis said.
New York Gov. Kathy Hochul (D) declared a disaster in her state of her last weekend over the outbreak. California Gov. Gavin Newsom and Illinois Gov. JB Pritzker, both Democrats, also declared states of emergency over the virus on Monday.
Rep. Charlie Crist (D-Fla.), who is running against DeSantis in the Florida gubernatorial race, criticized the governor’s comments on Twitter.
“While Governor DeSantis dismisses Monkeypox, at-risk Floridians still need better information, better testing, and access to vaccines for prevention,” Crist wrote.
The governor’s comments come as Florida has recorded 525 monkeypox cases, according to the Centers for Disease Control and Prevention. There are 6,617 confirmed cases throughout the US as of Wednesday.
Florida Gov. Ron DeSantis (R) rejected growing concerns over monkeypox during a press conference Wednesday, arguing that the media and politicians were unnecessarily stoking fear about the illness.
“I am so sick of politicians, and we saw this with COVID, trying to sow fear into the population,” the Republican governor said. “We had people calling, mothers worried about whether their kids could catch it at schools.”
“We are not doing fear,” he added. “And we are not going to go out and try to rile people up and try to act like people can’t live their lives as they’ve been normally doing because of something.”
DeSantis, who has been a vocal critic of the Biden administration’s response to COVID-19, also slammed states imposing emergency measures in regard to monkeypox.
“You see some of these states declaring states of emergency. They’re going to abuse those emergency powers to restrict your freedom. I guarantee you that’s what will happen,” DeSantis said.
New York Gov. Kathy Hochul (D) declared a disaster in her state of her last weekend over the outbreak. California Gov. Gavin Newsom and Illinois Gov. JB Pritzker, both Democrats, also declared states of emergency over the virus on Monday.
Rep. Charlie Crist (D-Fla.), who is running against DeSantis in the Florida gubernatorial race, criticized the governor’s comments on Twitter.
“While Governor DeSantis dismisses Monkeypox, at-risk Floridians still need better information, better testing, and access to vaccines for prevention,” Crist wrote.
The governor’s comments come as Florida has recorded 525 monkeypox cases, according to the Centers for Disease Control and Prevention. There are 6,617 confirmed cases throughout the US as of Wednesday.
Australia may have seen the worst of the most-recent wave of COVID-19’s Omicron variant, which has swept through aged care facilities and strained hospitals, according to federal Health Minister Mark Butler.
Key points:
COVID-19 hospitalizations are high, but appear to be declining
Australia may have reached its winter peak sooner than expected
Millions of Australians overdue for a booster shot haven’t received one
Mr Mark Butler said ahead of a national cabinet meeting this morning he was cautiously optimistic COVID-19 cases have peaked.
“The data we’re seeing right now indicates we might have reached the peak earlier than we expected to,” Mr Butler said.
“We’re being a bit cautious about that because what we’ve seen through the pandemic is the ‘school holiday effect’, which shows numbers and transmission takes a slightly different course because of different activity in the school holidays.”
The Health Minister said hospital admissions were down, though remained high: about 5,000 admissions across the country.
State and territory health departments reported 66 COVID-19-related deaths yesterday.
In recent weeks, Australia has had one of the highest infection rates in the developed world, exacerbated by the emergence of more infectious strains of the Omicron variant of COVID-19.
The federal government has renewed a push to encourage people to receive their booster shots, including a fourth dose for people, because vaccination rates have plateaued.
Mr Butler said there were still five million Australians eligible for a third dose who had not received it and had gone more than six months since their second dose.
“I’d really, really encourage anyone who is eligible for a booster shot — whether it’s a third dose or a fourth dose — [to] get it now. Get the vaccine that is in front of you,” he said.
Mr Butler said fourth-dose vaccination rates had shot up since eligibility was expanded three weeks ago to include anyone aged over 30 years, and recommended for those older than 50 years.
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A principal says better pay and a free ride to the bush would encourage teachers to follow their profession in regional South Australian schools.
Key points:
Regional schools have faced long-term issues finding teaching staff
A Riverland principal says more incentives are needed to attract teachers
The education sector wants to ensure a new push to recruit teachers nationwide will mean more regional staff
Federal Education Minister Jason Clare yesterday called on his state and territory counterparts to meet to create a national strategy to stop educators leaving the field and to attract more people to the profession.
He said the shortage wasn’t about flu and COVID-19 infections keeping teachers out of the classroom, but a drop in people entering the profession and an increase in educators leaving.
Rivergum Christian College principal Jessica Richards said it was a familiar trend in regional education.
Jason Clare has called on states and territories to address Australia’s teaching shortage. (ABC Riverland: Catherine Heuzenroeder)
“Something like 50 per cent of teachers quit in their first five years of teaching,” Ms Richards said.
She said teachers were an aging population because younger teachers were not coming in to meet demand.
“The pressure on teachers means they aren’t sticking it out for the long haul because there’s just so much that’s demanded of teachers these days,” Mr Richards said.
“Why would you stay in education when there’s other options available to you, even though education is such a vital part of our society?”
Regional stint should be ‘encouraged’
SA Department of Education chief executive Martin Westwell said the department was looking at incentive options for regional teachers.
Extra pay could encourage teachers to move to regional areas.(AAP: Dan Peled)
He said the department was looking at ways to create placements for education students to experience living in the country.
“We want the right people moving to country areas that are going to make the most out of living there and be quality teachers for our students,” Mr Westwell said.
Catholic Education South Australia Port Pirie Diocese education director Nicchi Mardon said the education sector needed to “strongly encourage” teachers to work in regional areas.
Nichii Mardon wants steps taken to strongly encourage teachers to regional areas. (Supplied: Catholic Education SA)
“We know that when people come into our communities they not only come into a school, but a town and regional community and find it so rewarding,” she said.
“There can be incentives as a part of that, but the heart of it that attracts people to come and for them to stay, is actually to experience an amazing community.”
Investing in the next generation
Ms Richards said covering moving costs and better pay for regional teachers were the first incentives that needed to be considered.
Ms Richards hopes more people can realize teaching is a rewarding profession. (ABC Riverland: Sam Bradbrook)
She said while regional education came with its own set of challenges, it was a rewarding job which offered unique experiences.
“There’s nothing quite like seeing an ‘a-ha’ moment where something clicks for a student where they go to a whole other level of their understanding of a task,” Ms Richards said.
“I’m a huge believer in the next generation and we really need to invest in these young people and what better way to do that through education.”
Health industry experts say WA’s rising number of private emergency departments is unlikely to erode investment in public hospitals, but patients should understand the limitations and costs of private EDs.
Key points:
For almost 20 years, the only private emergency department in WA was the St John of God facility in Murdoch
Perth is expected to have three private emergency rooms by late 2025
Patients are urged to be aware of potential costs when visiting private emergency departments
By the end of 2025, the number of private emergency departments — which charge up to $295 to see a doctor — is expected to have tripled in WA.
“It is a little bit curious because emergency departments are not profitable things for private hospitals,” St John of God Health Care Group chief executive Shane Kelly said.
“They’re generally run at a loss.”
For almost 20 years, the only private emergency department in WA was the St John of God facility in Murdoch.
In November, Hollywood Hospital opened a $67 million emergency department.
In May, the hospital said it had seen 5,000 patients in its first six months. It charges a $200 consultation fee.
St John of God Health Care Group has also announced plans to build the state’s third private emergency department at its Subiaco hospital by the end of 2025.
Rise reflects demand, chief says
Dr Kelly said the rising investment in private emergency departments in WA reflected high demand for emergency care overall.
“Obviously, our public emergency departments are pretty busy — very busy, in fact — and, I think, they’re looking for another option,” he said.
Dr Kelly says he does not expect the rising number of private emergency departments in WA to affect public health services.(Supplied)
The motivation for private hospitals, Dr Kelly said, was to fill empty beds by bringing more patients to the hospital door.
St John of God hospitals waives the emergency consultation fee of $295 if patients are admitted into the hospital, he said.
Since it opened in 1994, St John of God’s Murdoch-basedemergency department has seen about 20,000 patients annually.
Fees raised to ‘moderate’ demand
But last year, as the community spread of COVID-19 ballooned, the facility found itself under pressure as patient numbers reached a record high of 25,000.
Pandemic-related staff shortages were also affecting the private ED’s capacity, Dr Kelly said.
Demand for the facility grew so high that the facility raised its fees by $100 to $295.
“We were trying to moderate the demand a little bit,” Dr Kelly said.
He said patient numbers had dropped back to normal in 2022, which he said was likely linked to the fee hike and the launch of the Hollywood facility in November.
Dr Kelly said he did not believe the growing number of private hospitals would reduce investment in public emergency departments, already under enormous stress, because he said the number of private patients was “modest” overall.
“For example, we see about 80,000 a year in our St John of God public emergency department at Midland,” Dr Kelly said.
But, he said, they only saw up to 25,000 patients at the emergency hospital.
“So that puts it in perspective,” Dr Kelly said.
More choice for consumers
WA Health Consumers’ Council deputy director Clare Mullen said providing more choices would be positive for health care overall.
“If somebody has the choice, and they are prepared and informed about the costs, and that’s something that they want to do … by diverting somebody from a public emergency service then they’ll be creating space for someone else who is also needing that care ,” Ms. Mullen said.
She did not believe the rising number of private emergency departments would lead to any change in the quality of public emergency care.
But she said it was important that private health services were transparent about the costs.
“So, if there’s any potential limitations to the care or, obviously, out-of-pocket costs, that’s a really important thing so that people can make an informed choice,” Ms Mullen said.
David Mountain, an associate professor of emergency medicine at the University of WA, said private emergency departments did not necessarily have the same specialist facilities as public hospitals.
“They can’t provide all the services,” Dr Mountain said.
“They don’t have access to everything that’s required to manage patients who are coming through emergency departments.
“There can be problems as well, for the patients coming through expecting they’ll get everything, and in fact, it’s not all available.”
If a private emergency department does not have the specific service needed by the patient, they are transferred to public hospitals at their own cost.
In some cases, those costs, unlike the ED fee, may be covered by their insurers.
Dr Mountain says some private emergency rooms have more limited facilities.(ABC News: Rhiannon Shine)
Dr Mountain does not believe the rise of private emergency departments will have any significant impact on public health care long-term.
He said any reduction in the number of patients visiting public hospitals would be small.
“A lot of the stuff that’s too complex will end up coming back to the public system anyway,” Dr Mountain said.
“Often, all it does is find an unmet need or unmet demand that’s not being catered for by the public system.”
Dr Mountain said Queensland was an example, where the number of public emergency departments remained the same despite an increase in private departments.
Dr Kelly said the new Subiaco facility was still in the planning phase, and there was a small chance the facility could become an acute admission center instead of a full-scale emergency department.
President Joe Biden experienced a “rebound” Covid infection after taking the antiviral drug Paxlovid — and he’s not the only one.
Some patients who took Pfizer’s Paxlovid after contracting the coronavirus have reported the same phenomenon: Days after they finished a five-day course of the oral drug and felt better, their Covid symptoms or a positive test result returned.
Health experts say Paxlovid’s rebound effect doesn’t impact every patient or make it any less effective at its job, which is fighting severe illness from Covid. Still, like with so much about the pandemic, you might have some questions: How severe are rebound cases? Why do they happen? How common are they, and should you still feel comfortable taking the drug?
The answer to that last question is a resounding “yes,” doctors say. Here’s why, and what else you need to know about Paxlovid rebound cases:
Who can take Paxlovid?
In December 2021, the US Food and Drug Administration made Paxlovid available under an emergency use authorization to treat mild-to-moderate Covid cases in a specific group of eligible patients. You can get Paxlovid if you check all three of these boxes:
You tested positive for Covid
You’re at least 18 years old, or at least 12 years old and weigh at least 88 pounds
You have one or more risk factors for severe Covid
That includes patients 65 and older — such as Biden, 79 — or those with underlying conditions like cancer, diabetes or obesity. You may not be able to take Paxlovid if you take certain medications that can interact with the drug and cause serious side effects, according to the FDA.
You can obtain Paxlovid prescriptions from your healthcare provider or through the Biden administration’s “Test to Treat” program, which gives free Covid antiviral pills to patients who test positive at pharmacies across the country.
If you’re eligible, you should start taking Paxlovid as soon as possible after testing positive for Covid, and within five days of experiencing Covid symptoms. You’ll need to take three pills, twice a day, for five days.
Pfizer’s clinical trials last November suggest that Paxlovid does its job: The drug was 89% effective at preventing hospitalization among people who were at risk of developing severe illness.
Notably, that trial was conducted before Covid’s omicron variant emerged — but Pfizer said in January that Paxlovid still works against omicron, citing three laboratory-based studies. It appears to also work against omicron subvariants like BA.5, with no current data showing otherwise, according to Barbara Santevecchi, a clinical assistant professor of infectious diseases at the University of Florida’s College of Pharmacy.
How common are rebound cases, and what are they like?
Some people who take Paxlovid test negative for Covid after finishing their five-day treatment, but then test positive or experience symptoms again two to eight days later, according to the Centers for Disease Control and Prevention.
Roughly 5% of the tens of thousands of Paxlovid users have experienced rebound cases so far, White House Covid response coordinator Dr. Ashish Jha said at a news conference last month. They appear to be very mild: A June CDC study found that less than 1% of patients taking Paxlovid were admitted to the hospital or emergency department for Covid in the five to 15 days after they finished the treatment.
Patients also appear to recover from rebound cases without any additional Covid treatment, the CDC says.
A UC San Diego School of Medicine study released in June identified “insufficient drug exposure” as the most likely cause. In that scenario, Paxlovid stops the virus in its tracks for five days, but doesn’t stick around long enough to purge the infection entirely — allowing the virus to temporarily replicate again once the drug is gone.
Dr. Davey Smith, the study’s senior author and an infectious disease specialist at UCSD Health, hypothesizes that some people may metabolize Paxlovid more quickly, or that the drug might need to be taken for more than five days to fully clear the virus in every patient . But there’s no clinical data to back that up yet, he says.
“We don’t know if it’s safe or efficacious to do double the amount of time of Paxlovid, doing two courses,” Smith tells CNBC Make It. “That’s getting too far out over your skis without the clinical research to guide it.”
If you experience a rebound case, you do need to reenter quarantine until you test negative again. The CDC advises isolating for at least five more days before checking the agency’s current isolation guidelines. You should also wear a mask for 10 days after rebound symptoms begin, the CDC advises.
