COVID-19 impacts Victorian elective surgery waitlists

Recent Victorian Agency for Health Information (VAHI) data shows there are more than 15,000 patients waiting for elective surgery compared to this time last year.

The VAHI statistics released in the December 2020 quarter review health services performance and the data reveals a major reduction in elective surgery waiting times and treatment for patients in all categories.

VAHI said the restrictions put in place during the COVID-19 pandemic have had significant consequences on the number, efficiency, and kind of elective surgery procedures at hospitals.

According to VAHI at the end of the December 2020 quarter there were 65, 621 patients overall on a waiting list in Victoria for elective surgery, compared to 49,326 people in the December 2019 quarter.

An analysis of the VAHI data shows a significant increase of 16,295 patients waiting for elective surgery across all categories in Victoria, with patients on the category three non-urgent waitlist the most impacted.

The Australian Institute of Health and Welfare (AIHW) said the COVID-19 pandemic restrictions have caused national elective surgery waiting list admissions to decline 9.2% between 2018-19 and 2019-20.

The initial COVID-19 pandemic elective surgery restrictions set by the Australian Government in March last year stipulated only category one and exceptional category two procedures could go ahead, these guidelines were revised a month later in April allowing all category two and important category three procedures.

The VAHI data found in urgent category one, where a patient must be treated within 30 days there has been an increase of 309 patients waiting for elective surgery, in semi-urgent category two, where a patient requires treatment within 90 days, there has been a major increase of 6, 160 patients and in non-urgent category three, where a patient is treated within 12 months, there has been a significant increase of 9,826 patients waiting.

Elective Surgery is essential surgery that can be postponed for a minimum of 24 hours, in Victoria a patient is assessed by a surgeon as needing elective surgery and then placed on a hospital-based waiting list categorised by urgency.

The waiting time is defined between the date the patient was recorded as requiring the elective surgery and the date they were admitted to hospital for the procedure, this does not include days the patient was not ready for surgery.

Patients with life threatening illnesses take priority, a hospital can postpone an elective surgery appointment in this situation, or if emergency services demand becomes unpredictable, the Victorian target is to have seven or less hospital-initiated postponements per 100 scheduled patient admissions.

In the December 2020 quarter the VAHI data shows a slight improvement with 5.71 patient appointments rescheduled per 100 admissions compared to 6 patient postponements per 100 people a year ago.

Despite this statistic, the percentage of patients waiting longer than 365 days for treatment in Victoria increased from 1.26% in the December 2019 quarter to 5.18% in the December 2020 quarter.

Elective surgery patients waiting treatment have suffered during COVID-19, with the median waiting time for all Victorian patients increasing significantly by six days and the percentage of patients receiving treatment dropping 13.63%.

During this time, the My Hospitals data reveals it took 15 more days for 90% of Victorian patients to be admitted for all surgery, with the longest wait being ophthalmology surgery at 32 more days, followed by orthopaedic surgery, general surgery and gynaecology.

The AIHW My Hospitals data shows there were 24,264 less patients admitted by surgical specialty between 2018-19 to 2019-20 in Victoria.

The VAHI website regularly updates elective surgery waiting time statistics in Victoria.

National Emergency Department patient presentations drop during COVID-19

The impact of COVID-19 restrictions in Australia has caused a reduction in Emergency Department (ED) hospital presentations in 2019-2020.

The Australian Institute of Health and Welfare (AIHW) data shows 8.2 million patients presented to Emergency Departments in 2019-2020, a 1.4% drop compared to 2018-2019.

The AIHW said the introduction of restrictions, between February and June last year, on travel, business, social interaction, and border control to reduce the spread of COVID-19, caused the recent decrease in ED presentations.

Factors that effected ED activity during this period included the closure of healthcare providers, patients with COVID-19 symptoms being asked not to enter premises or re-directed to other services, facilities being used for coronavirus testing and patients using the Medicare Benefits Schedule telehealth scheme.

In Australia, an ED presentation occurs when a patient arrives at a hospital and begins at the point of being triaged; an assessment by a medical practitioner who determines what type of care the patient requires.

Triage categories are defined by the urgency of patient care and divided into the areas of Resuscitation; requiring treatment within seconds, Emergency; requiring treatment within 10 minutes, Urgent; requiring treatment within 30 minutes, Semi-urgent; requiring treatment within 60 minutes and Non-urgent; requiring treatment within 120 minutes.

Time measurement in an ED is documented in 5 stages, presentation time is the first contact with a clinician when the patient is triaged, and a health professional commences care, the non-admitted patient records an episode procedure end time, and the physical departure time completes the ED activity.

The AIHW said the national rate of ED presentations had increased at an average rate of 3.2% each year from 2014-2015 to 2018-2019 before the 1.4% drop this year due to COVID-19.

An analysis of the ED triage category data by percentage of patients seen on time in the year 2014-2015 and 2019-2020 shows a decrease of 4% in Emergency, 2% in Semi-urgent, 1% in Non-urgent, and only a 1% increase in the Urgent category, with the Resuscitation category remaining steady at 100% of patients treated.

The AIHW data shows the national median waiting time in an ED was quicker with 17 minutes median waiting time in 2019-2020 and 74% patients seen on time, compared to 19 minutes in 2015-2016 and 73% patients seen on time.

The median length of an ED presentation for all patients increased by 15 minutes from two hours and 41 minutes in 2014-2015 compared to two hours and 56 minutes in 2019-2020.

The overall length of ED stays increased by 36 minutes, with 90% of all patient presentations taking seven hours and 30 minutes in 2019-2020 compared with six hours and 54 minutes in 2015-2016.

There has been a 3.9% drop nationally in the proportion of care completed within four hours with 69.2% departing the ED within four hours of arrival in 2019-2020 compared to 73.1% of patients treated in 2015-2016.

Patients who had the most presentations to EDs recently in 2019-2020 were children under four years and patients over 75 years.

The most common principal diagnosis of ED presentations in the AIHW 2019 -2020 data were patients with an injury or poisoning, patients that showed unusual symptoms and signs consistent with abnormal laboratory findings, diseases of the respiratory system and digestive system, musculoskeletal issues, and infectious diseases.

Of all ED presentations by triage category during this time, the most patients, 38.6% required Urgent treatment, followed by 38.1% in the Semi-urgent category, 14.2% classified as an Emergency, 8.2% were Non-urgent, with only 0.8% needing Resuscitation.

The proportion of presentations allocated a triage category of Urgent increased between 2015-2016 and 2019-2020, and the proportions assigned a category of Semi-urgent and Non-urgent decreased.

A patient often arrives at an ED by ambulance or another transport mode, during 2019-2020 most ED presentations, 72%, arrived in the mode of Other, which suggests the patient walked, came by private, public or community transport or taxi.

Generally, ED presentations were evenly divided between males and females, although children were most likely male under 15 and people aged 15 to 34 and over 85 tended to be female.

Of all presentations 31% were admitted to hospital at the end status of the patient’s episode in the ED, with 66% of these patients over 85 years and 17% aged under 24 being admitted to hospital, and 61% of all presentations recorded an end status of departed without being admitted or referred during 2019-2020.

Particularly, in early March this year daily average ED presentations increased from 24,600 to 26,000, by the middle of March they had dropped by 38%, and then began to steadily increase in June, although still 8.4% lower than the previous year.

The AIHW projected that without COVID-19 the average daily ED presentations would have remained consistent at an average of 23,000 per day.

Check the Emergency Department care section of the AIHW website for specific information.

Black Lives Matter protests spark effective Australian demonstrations

The American Black Lives Matter (BLM) movement has caused homegrown protests with thousands of Australians campaigning against Aboriginal deaths in custody.

Australia’s protest groups started the country’s own BLM movement after the death of African American man George Floyd on May 25 last year in Portland, America.

The Australian Human Rights Commission said the death of Mr Floyd in custody and the violence that erupted in America reminds Australians of the unacceptably high rates of deaths in prison of Aboriginal and Torres Strait Islander peoples.

Indigenous Social Justice Association secretary Raul Bassi, who organised the vigil for George Floyd at the Sydney Town Hall on June 6, said between 20,000 and 40,000 people attended the protest and it was the biggest number he had seen in Sydney since the Invasion Day march.

“People don’t care about Aboriginal people, they don’t understand how they can live 20 years less than the rest of the population,” said Mr Bassi.

“David Dungay was attacked by six guards in Long Bay jail and…he started to say ‘I can’t breathe’, George, what happened with the police in the neck…he was saying exactly the same. ‘I can’t breathe’.”

“If we respond, if we make enough noise, they are going to be careful…what they do.”

“I hope one day the white people of this country understand the fact that the white people have an advantage in this country is on the basis of the tragedy of the Aboriginal people.”

“Whatever is worth [something] in this country is coming from the land and the land like it or not [belongs] to the Aboriginal people,” he said.

The United States Department of Justice Attorney General William P. Barr said, “the video images of the incident that ended with the death of Mr Floyd, while in custody of Minneapolis police officers, were harrowing to watch and deeply disturbing.”

Warriors of Aboriginal Resistance (WAR), organisers of the Melbourne BLM protest on June 6, said roughly one Aboriginal has died every month in prison over the last 30 years.

WAR said that no police or prison officer has been held accountable for the 438 deaths in prison since the 1991 Royal Commission into Aboriginal Deaths in Custody.

Media advisor for climate change activist group Extinction Rebellion Victoria, James Norman said the Australian Black Lives Matter protests were inspired by what happened in America and the tradition of non-violent protest.

Mr Norman said that we need to work closely with Indigenous people and put them at the centre of the movement.

“I think the whole world was shocked when those images came out and sparked this current rise of protest so that has definitely led to a huge increase in those issues being expressed directly on the streets globally and I do think that’s a good thing,” said Mr Norman.

According to the Australian Institute of Criminology data, Indigenous deaths in prison custody have been consistently lower than death rates of non-Indigenous prisoners since 2003-04.

Minister for Indigenous Australians, Ken Wyatt said that every death in custody is a tragedy, and there was no simple solution, the factors that contribute to high Aboriginal incarceration rates need to be addressed such as health, education, and employment.

The Morrison Government is pledging $2.1 million over three years to “establish a formal Custody Notification Service (CNS) in Victoria…a critical step in ensuring culturally appropriate care is provided to Aboriginal and Torres Strait Islander people detained by police,” Mr Wyatt said.

The Victorian Aboriginal Legal Service currently has an informal CNS and will deliver the expanded system.

A CNS will be established in NT and WA and the Morrison Government is continuing to fund the CNS in NSW and the ACT, with a total investment of $3.4 million next financial year.

The Australian Human Rights Commission regularly updates the public about Aboriginal and Torres Strait Islander Social Justice issues.

Medicine shortages in Australia regulated by the TGA

The Australian Government Department of Health Therapeutic Goods Administration (TGA) has announced there is a medicine shortage in Australia.

A medicine shortage occurs in Australia when there are insufficient amounts of a prescription available to those who require it.

From January 2019, the TGA introduced mandatory regulations where suppliers must report shortages of prescription medicines and some over-the-counter medicines.

Using the data on supply shortages provided by sponsors, the TGA mandatorily releases information on medicine shortages that have critical patient impact.

The Medicine Shortages Reports Database on the TGA website publishes detailed information on specific single product medicine supply shortages, usually a consumer will find there are alternative medical brands, strengths, and doses available after consulting with their doctor or pharmacist.

The aim of the Medicine Shortages Reports Database is to provide consumers with timely notifications so they can plan during a medicine shortage and seek advice from their doctor on potential alternative treatments.

Causes for a medicine shortage in Australia are often due to the discontinuation of products, product recalls from consumer, manufacturer and wholesaler complaints, product defect correction, hazard alerts, and the impact from COVID-19 panic buying and stockpiling.

The TGA provides access to medicine pathways for health professionals and consumers during a shortage by providing advice on alternative medicine solutions.

A pharmacist will instruct if there is more than one brand of medicine available, if there is a medicine shortage and no alternative brands, a doctor can advise on a substitute treatment and they might be able to arrange a medicine replacement from overseas through one of the TGA’s access schemes.

A consumer should first check the TGA Medicine Shortage Reports Database for detailed information on how long the shortage is expected to last, even if there is a national shortage, a patient can consult with their pharmacist to ascertain if they can order some medicine through their wholesaler or sponsor.

If the TGA lists the medicine as being in a critical shortage, consumers can pursue a variety of medicine access options, these include seeking an alternative medicine in another country, finding an unregistered alternative medicine, taking a different strength or dose instructed by a pharmacist, obtaining a personal alternative product, or asking your doctor to prescribe a different medicine.

Medicines not on the Australian Register of Therapeutic Goods (ARTG) can be approved for import and supply in Australia through the database of Section 19A if there is a medicine shortage and the medication is required for public health.

Medicines approved for import through the Section 19A database initiative are subject to TGA conditions.

The Special Access Scheme (SAS) allows health practitioners to apply to access therapeutic goods for a single patient such as: medicines, medical devices, and biologicals, which are not on the ARTG.

Individual patients need to discuss the implications of using ‘unapproved’ therapeutic goods with a health professional and the practitioner must assess the evidence and risks to support the consumer accessing an ‘unapproved’ therapeutic product.

The Australian Government is implementing A Serious Shortage Substitution Notice (SSSN) initiative that will allow community pharmacists to substitute certain medicines without requiring approval from a doctor in some situations where a medicine is unavailable.

The aim of the SSSN is to allow patients to receive medications from a pharmacist without delay and to minimise the stress on doctors.

Through the SSSN a pharmacist will be allowed to distribute different strengths of a product, for example two 20mg tablets instead of one 40mg tablet, or a different dose of the same medicine, a capsule instead of a tablet, medicines identified for substitution will be listed in the SSSN on the TGA website.

The Personal Importation Scheme is a medicine pathway where consumers can legally import therapeutic goods for their own treatment or immediate family, if they do not sell or give the medication to any other person.

Through the Personal Importation Scheme, without requiring approval from the TGA, an individual can import up to three months’ supply at one time of unapproved therapeutic goods if they follow the importation guidelines.

Alternative medicine access pathways can incur increased cost to consumers, medications accessed through the SAS are not subsidised under the Pharmaceutical Benefits Scheme (PBS), section 19A products can receive a PBS subsidy if the ARTG product is already subsidised or the sponsor applies for a subsidy, although the TGA cannot instruct the sponsor to apply.

Consumers and health professionals can always keep regularly informed on medicine shortages, availability, impact, and expected supply dates by accessing the TGA Medicine Shortage Reports Database.

Australia is at risk of running out of homegrown rice by early 2021

The Australian Bureau of Statistics (ABS) data shows the value of Australian rice crops dropped a staggering 86 per cent in 2018-19 forecasting a homegrown rice shortage.

The data revealed that the gross value of the Australian rice crop commodity was worth $34.3 million in 2018-19 down from the previous financial year of $246 million in 2017-18.

Gross Value of Australian Rice Crop Farm Production 1979 – 2021 (forecast), source: ABARES

The Ricegrowers’ Association of Australia president Robert Massina said recent water reforms have impacted allocations both at a State and Federal level which has made it difficult to farm rice crops with the water they require to grow.

“I would say early 2021 the availability of Australian rice in packets on Australian supermarket shelves will be very, very minimal.”

“To put it into perspective in 2018, 17-18, our farming operation delivered over 2,000 tonnes of rice into SunRice and since that time we haven’t delivered one single kilo, so the main cause of that is obviously drought,” he said.

A statistical summary from The Rice Marketing Board for the State of NSW shows there were 1,186 rice farms producing 799,676 tonnes of rice in the 2017 crop compared to just 104 rice farms producing 46,175 tonnes in the 2020 crop.

“I have a property right to water of 1,000 megalitres and, in the last couple of years, particularly in our valley, we have had zero per cent, so we have had no ability to access that 1,000 litres of property right,” said Mr Massina.

“Last year…temporary water in the Murray got up to $700 per megalitre. Today I can buy temporary water for about $130 or $140 so there is a big difference…that is all based on supply and demand… you can’t go and grow rice at $700 a megalitre…because you won’t make any money whatsoever,” he said.

An analysis of the ABS data shows in 2018-19 drought conditions meant only 75,600 megalitres were used to irrigate rice crops, a 90 per cent water usage drop on Australian farms compared with the previous year.

The ABS data also revealed a record high 66 per cent increase in 2018-19 of extra temporary water purchased for Australian agricultural farm production, although volumes purchased were down.

“Over the last two years we’ve seen the second lowest and the third lowest crop ever …Australian, domestic consumption alone would take 250 to 300 thousand tonnes of…Australian rice and last year we produced 44,000 and the year before we produced 53,000 so SunRice itself has probably flexed its supply chains overseas,” said Mr Massina.

“We are just planning our rice crop now…it will be harvested in April 2021…so a fresh lot of Australian crop probably [won’t hit] supermarket shelves until the second half of 2021,” said Mr Massina.

Australian Rice Crop Areas 1970 – 2021 (forecast), source: ABARES

“It all comes down to climate and the Riverina lends itself very well to a climate for growing rice. It has been well documented and regarded that 98 per cent of the rice growing in Australia is grown in the Riverina,” he said.

“SunRice has invested in a small mill at Brandon up in Queensland in the Burdekin and there is a small amount growing up there,” said Mr Massina.

Aerial photography of rice field Queensland, Australia, source: Carnaby on Unsplash.

Minister for Agriculture, Drought and Emergency Management David Littleproud said the Australian Government is investing $2 billion in water infrastructure to assist the agriculture industry to achieve their $100 billion growth target by 2030.

Mr Littleproud said the Government is spending $270 million on 11 initiatives to put communities at the centre of the Murray-Darling Basin plan.

“Water reform in this country in the last 10 years has made rice producers in Australia a high-cost producer so water has become the number one cost input, so the only way to fix that ultimately [is] to increase yield and decrease water use,” said Mr Massina.

“We have probably reached a target milestone of growing a tonne of rice per megalitre of water and our whole [Research and Development] focus is to be better than 1.5 tonne per megalitre of water,” he said.

Treasurer Josh Frydenberg and Minister for Resources, Water and Northern Australia Keith Pitt have announced a Productivity Commission inquiry into national water policy that will review the efficiency of Australia’s water use for production in rural communities as part of the National Water Initiative (NWI).

The Commission will assess the water reforms agreed in the NWI, an intergovernmental national blueprint for water reform that reviews the process of Australia’s water resources sector every three years.

The next NWI is due for completion in 2021.

Australian Government invests in Melbourne COVID-19 vaccine research

The Australian Government has invested $3 million from the Medical Research Future Fund (MRFF) Coronavirus Response into Melbourne-based COVID-19 research to develop two vaccines.

The University of Melbourne received the funding to develop the receptor binding domain (RBD) COVID-19 vaccine candidates: the protein vaccine at the Doherty Institute and the mRNA vaccine at Monash Institute of Pharmaceutical Sciences.

Melbourne-based COVID-19 vaccine research candidates secure Australian Government investment, source: Daniel Schludi on Unsplash.

Doherty Institute Immunology Theme Leader Professor Dale Godfrey said the coronavirus can be described as a crown where the spikes are the arms, and the tip of the spike is the hand.

“It is a bit like if you’ve got a home invader…the part that they use to get into your house is the hand…you can hold their arms, which is the spike, but they might still be able to open the doorknob, so really the most important part is the hand, the receptor binding domain…why don’t we make a vaccine that is only the hand of the virus, the RBD,” said Professor Godfrey.

“We are about to start doing challenge studies [testing on mice], so we know we can make a good immune response, we can make good antibodies, the question we don’t yet know is will the mice that we’ve immunised now be able to resist actual virus infection,” said Professor Godfrey.

“The research they have invested in is everything up to the point where we are ready to do a phase one clinical trial with humans,” he said.

Doherty Institute Immunology Theme Leader Professor Dale Godfrey speaking on the COVID-19 protein vaccine research.

“One thing that you really don’t want to do is to rush a vaccine to the point where it’s in people and you don’t know if it is safe, you don’t want people getting sick or dying because of your vaccine,” said Professor Godfrey.

Health Minister Greg Hunt said both vaccines are using different approaches to target the tip of the spike protein, the RBD, to compare which vaccine creates the most neutralising antibodies as part of Australia’s response to COVID-19.

Monash University Professor Colin Pouton said messenger RNA is new vaccine technology, the cell creates a message of RNA from the genetic information in the nucleus, the RNA translates the code for making a protein, so you can use the mRNA to vaccinate by injecting the code.

Messenger RNA new vaccine technology research, source: Fernando Zhiminaicela from Pixabay.

Professor Pouton said vaccine research builds up over three clinical trial phase efficacy studies in human volunteers, which expose more people each time: a phase one trial might start with 500 patients, phase two 1,000 patients, up to a phase three trial in 30,000 patients.

“Some of the leading vaccines that have been developed commercially at the moment for COVID-19 are actually mRNA vaccines and presumably one or more of them will probably be the first mRNA vaccines approved for human use,” he said.

Professor Pouton said the first wave international mRNA vaccines have received a lot of funding but depending on how they progress through the clinical stages, Monash University and the Doherty Institute is providing an Australian COVID-19 vaccine research response.

“For the Australian Government you could say, well gosh, to invest a billion dollars in getting a product into production is a huge risk but on the other hand to vaccinate the Australian population is probably going to cost a billion dollars,” he said.

Monash University Professor Colin Pouton speaking on the COVID-19 mRNA vaccine research.

“The amount of funding you need starts to escalate dramatically once you get into the efficacy studies…the phase one study is a safety study and…is not that expensive that is the sort of study that we are hoping to do through Government MRFF funding,” said Professor Pouton.

Keep informed on COVID-19 vaccines with the Department of Health.

Refreshed Stonnington Leader stirs contention

Leader Community Newspaper reporter Kiel Egging has been a journalist with News Corp for four years and in June this year he took over as reporter for the Stonnington Leader.

Mr Egging explained when he started at Leader they still had newspapers published each week, although some people started subscribing to read the print replica online, on their tablet or computer if they didn’t get it delivered.

Mr Egging recollects there being 26 Leader titles when he started with the group. In April this year, there were twenty or so mastheads and now we cover about fifteen patches of Melbourne he said.

ePapers are an online replica of the Leader newspaper and they stopped in April, when News Corp suspended the print editions of the Leader because of COVID and followed with a restructure deciding to make all the Leader titles in Victoria digital only with online reporting Mr Egging confirms.

The Stonnington History Centre, dedicated to preserving the natural history of the City of Stonnington, dates the first Stonnington Leader newspaper back to 2000 and archived the last hard copy of the publication on March 24 this year.

Stonnington Leader Community Newspaper from July 28, 2015, source: Stonnington History Centre.

City of Stonnington Mayor Steve Stefanopoulos, elected by council for the last three years, said he was not surprised they decided to stop printing the Leader.

“I think the local publication has gone already, it was gone a number of years ago when they reduced the content [of local newspapers] from being very local to being metro wide…when you look at the newspapers back in the eighties and nineties, very different volume, and very different number of local articles and local issues,” explained Mr Stefanopoulos.

“It was not very news focused it didn’t have a lot of local news items in there, so it hasn’t been a real newspaper for a very long time,” he said.

The printed hard copy only had one or two articles that were Stonnington based and the rest were from elsewhere in Melbourne he remembers.

“When the front page of the Stonnington Leader was no different to any of the others in metro Melbourne you wonder why they even produced it in hard copy form,” he said.

A lot of councils are now producing their own newsletters, more often, with local stories, Mr Stefanopoulos remarks.

Stonnington locals can subscribe to an eNewsletter and a hard copy is distributed to residents by the council, funded by rate payers, he comments.

The Stonnington City Centre service centre, Glenferrie road, Malvern.

Mr Stefanopoulos argues “locals won’t be interested in buying, subscribing to a local newspaper, I don’t think there is an appetite in the community for that at all.”

People are not going read the Stonnington Leader online because you have to subscribe to the Herald Sun to get the content, locals aged 60 to 70 years are quite IT savvy and might, but I don’t think people under 40 would, Mr Stefanopoulos comments.

Conveying the news fairly in the community starts with “good quality journalism, that’s open, honest, that presents the facts, not fiction,” Mr Stefanopoulos confirms.

“Subscriptions have now become a thing and journos don’t work for free,” Mr Egging explains.

“It’s an entirely digital product…the Leader is very much linked in with the Herald Sun obviously being part of News Corp…if we have a good enough story…the Herald Sun features it on their website [and] in their print edition,” Mr Egging confirms.

“All our coverage is…online through, as a part of the Herald Sun website…scroll down there and you will see local or Leader…if we still had the paper around that’s the kind of stuff we would be filling the paper with,” Mr Egging details.

Around the middle of the 2010s News Corp brought out their pay wall subscriber take out a subscription to the Herald Sun he explains.

“When I started in 2016…I can’t recall us having a big focus on subscription…I think it really just ramped up probably for Leader stories online…late 2017…that’s when we…were given instructions to make a few more of our stories subscriber only,” Mr Egging recalls.

Detail from the Leader Community family tree, source: State Library Victoria.

Now the Herald Sun subscription gets you a Leader subscription. Once you subscribe you get access to all the Leader news stories, as well as the Herald Sun stories or anything else in the News Corp network Mr Egging clarifies.

“On the Herald Sun website, the coronavirus information…is free…public health and public safety…[is] free as well.”

Mr Egging contends that breaking news remains the focus of the Stonnington Leader. “The key stories are around crime, emergency services, shopping, council and development is a big one,” Mr Egging comments.

“I’m always calling up the cops to see what incidents there have been,” he says.

“I basically just cover general news…filing stories for the website…managing the social media channels as well so we have to keep on pushing out lots of stories,” he describes.

The Chapel Street precinct obviously is a very bustling source for stories Mr Egging remarks.

“We provide a voice for these people…without us…council could just spin things their way, that’s why community news is…so important,” Mr Egging asserts.

“The president of the rate payers’ group…keeps telling me what interesting little tricks the council is up to and things like that.”

“Those who just love the papers or were used to it…could potentially be…disappointed with it the most, hopefully they can get their fix again online,” Mr Egging contends.

“I still got a thrill of holding a paper and you know reading it and finding my work in there…it is that kind of nostalgia element, which was really cool, so to see that go was sad but at the same time I am still very grateful I have a job…because lots of people aren’t as fortunate in my position,” he recaps.

“Community newspapers and community news is all about shining a light on those people who may not normally get their stories…we’re still here and doing that so it’s just in a different environment…without the printed edition now,” Mr Egging summarises.

Read the Stonnington Leader online heraldsun.com.au/leader/inner-east

The push to mandate face masks in NSW

NSW Australian Medical Association (AMA) president Dr Danielle McMullen is calling for mandatory face masks on public transport during COVID-19.

NSW AMA Dr McMullen said the State Government should make face mask wearing mandatory on public transport, particularly on trains and buses as they are enclosed, poorly ventilated spaces where maintaining social distancing is difficult.

GP educator Elizabeth Hindmarsh said this is a new phenomenon and that we do not have the answers to what we should be doing so the recommendation is to do a lot of hand washing and social distancing and masks are another thing that can be helpful.

“At the moment the government hasn’t made that compulsory, so people are making their own decisions about that so there are a lot of face masks being worn, but it’s a personal choice in NSW at the moment,” Dr Hindmarsh said.

“If you are going to introduce mandatory…something you have got to have the evidence that it works,” she said.

NSW Chief Health Officer Dr Kerry Chant supported the call for face masks to be worn in areas where physical distancing was difficult.

“People are encouraged to wear face masks particularly in indoor settings where physical distancing is hard to maintain, such as on public transport,” Dr Chant said.

Paddington-Darlinghurst Community Working Group convenor Will Mrongovious said that it is a social responsibility for the government to give clearer face mask advice in NSW to address increased numbers of people returning to work in the CBD.

“In Sydney I have got to say mask wearing is not a big thing and the government gives mixed messages saying people will do the right thing or you know when you need to and they won’t say you have to so it’s really weird and in one instance the NSW Government has also encouraged you not to use public transport,” Mr Mrongovious said.

In a statement on September 15 Transport for NSW spokesperson said “it is encouraging to see the number of people wearing face masks while using the public transport network including Sydney Metro, has increased in recent weeks but Transport for NSW wants to see this number continue to rise.”

Currently NSW Health strongly recommends people always carry a clean face mask, for more information visit http://www.nsw.gov.au/covid-19/face-masks

NSW Government COVID-19 face mask recommendations.

Victorian elective surgery hospital waitlist surge

The Federal Government’s decision to pause non-urgent elective surgery has seen a median increase in the number of days Victorians remain on a waitlist.

Prime Minister Scott Morrison announced that all non-urgent category three elective surgery will be temporarily suspended and only category one surgery and some exceptional category two surgery will continue in public and private hospitals to free up resources to combat the coronavirus outbreak.

In Australia, an elective surgery patient is assessed by category: urgent category one, treatable within thirty days, semi-urgent category two, treatable within ninety days, and non-urgent category three treatable within twelve months.

Non-urgent category three and category two elective surgery suspension in Victorian public hospitals, source: ABC News (Pixabay).

A patient’s condition: in category one has the potential to deteriorate quickly and become an emergency, in category two is causing pain although unlikely to become an emergency and in category three is causing pain although unlikely to deteriorate quickly.

Victorian public hospital elective surgery waitlist surge, source: Fernando Zhiminaicela from Pixabay.

An analysis of public hospital waitlist performance data published by The Victorian Agency for Health Information (VAHI) shows the elective surgery suspension has caused a 49-day median increase in non-urgent category three patients, and an 18-day median increase in semi-urgent category two patients waiting for elective surgery in Victoria, in the April to June quarter this year, compared to last year’s quarter.

Median waiting time for semi-urgent (Category 2) and non-urgent (Category 3) patients, in days, source: Victorian Agency for Health Information.

Australian Patients Association (APA) CEO Stephen Mason said non-urgent elective surgery is an unnecessary risk, taking up bed facilities and surgeon’s time during COVID-19 but that when the non-urgent elective surgery ban is removed there will be a big back log of patients waiting.

“It is frustrating for all those people who can’t have their hip replacement, knee replacement, and various other things that are deemed to be non-urgent but affect their quality of life,” Mr Mason said.

“What’s more frustrating is that they don’t know when these will be rescheduled, the hospitals can’t tell them, so there is no communication,” he said.

The VAHI public hospital data reveals, 4.27 per cent non-urgent category three patients, and 16.15 per cent semi-urgent category two patients, were not treated within the recommended time, in the April to June quarter this year, compared to a year ago.

“It’s really been a mixed bag depending on the hospital…we have had a lot of patients saying, I had a letter saying I had a face to face appointment, then I had an SMS saying it would be a phone, so there has been a bit of confusion, it hasn’t gone that smoothly but I imagine things are a bit chaotic in some of the hospitals,” said Mr Mason.

The Prime Minister said due to COVID-19 slowing elective surgery will be reintroduced in three stages, with each jurisdiction to determine according to their situation.

Currently in Victoria, the initial non-urgent elective surgery suspension still applies.

The APA is an independent not-for-profit organisation, which provides information, advocacy, and support to patients.