Tag Archives: emergency

When COVID patients are intubated in ICU, the trauma can stay with them long after this breathing emergency

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Deb Massey, Southern Cross UniversityThe current wave of COVID cases is leading to more hospital and intensive care (ICU) admissions. Frontline health workers and experts use the term “intubation” for the extra breathing support some patients need in an emergency.

But many people don’t know what this procedure involves and the trauma it can cause.

Patients with COVID-19 who deteriorate and need additional support with their breathing require intubating and ventilating. That means a tube is inserted and a ventilation machine delivers oxygen straight to the lungs.

Inserting the tube

Intubating a patient is a highly skilled procedure and involves inserting a tube through the patient’s mouth and into their airway:

  1. patients are usually sedated, allowing their mouth and airway to relax. They often lie on their back, while the health-care professional stands near the top of the bed, facing the patient’s feet
  2. the patient’s mouth is gently opened. An instrument called a laryngoscope is used to flatten the tongue and illuminate the throat. The tube is steered into the throat and advanced into the airway, pushing apart the vocal chords
  3. a small balloon around the tube is inflated to keep the tube in place and prevent air from escaping. Once this balloon is inflated, the tube must be tied or taped in place at the mouth
  4. successful placement is checked by listening to the lungs with a stethoscope and confirmed via a chest x-ray.
surgical instrument
A laryngoscope is used to guide a tube into the airway.
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Can breathe, can’t speak or swallow

While intubated patients are attached to a ventilator and their breathing is supported, they are unable to talk or swallow food, drink or their saliva.

They often remain sedated to enable them to tolerate the tube. They can’t attend to any of their own needs and disconnection from the ventilator can be catastrophic.

For this reason any patient who is intubated and ventilated is cared for in an intensive care unit with a registered nurse constantly by their bedside.

American lawyer and editor David Latt recalled his experience of being intubated and ventilated following a diagnosis of COVID-19, saying:

When they were giving me anesthesia to put me to sleep so they could put a tube in my mouth that would enable me to breathe, I just remember thinking, ‘I might die.’ Sometimes in the abstract, you think, ‘If it’s my time, it’s my time.’ But when I was on that table […] I just thought, ‘No, I don’t want to go.’

Latt feared he would never see his two-year-old son or his partner again.

Taking the tube out

The length of time a COVID patient requires intubation and ventilation varies and depends on the reasons for it and the response to treatment. However, there are reports of patients being intubated and ventilated for over 100 days.

Once a patient’s respiration improves and they no longer require breathing support, the tube is removed in a procedure called “extubation”. Like intubation, extubation requires highly skilled health-care workers to manage the process. It involves:

  1. a spontaneous breathing trial, which assesses the patient’s capacity to breathe unassisted before extubation to decrease the risk of respiratory failure
  2. an assessment by the treating doctor, intensive care nurse, speech pathologist or physiotherapist of the patient’s ability to cough (so they can effectively clear their own throat and prevent substances entering the lungs)
  3. treatment from a physiotherapist is usually required before and after extubation if the patient has had mechanical ventilation for more than 48 hours. This is to ease the process of weaning the patient off the ventilator and help them learn to breathe independently again.

Once extubated, patients remain in ICU and are closely monitored to ensure they can safely maintain a clear and effective airway. Once they are able to do this and are stable enough to transfer to the ward they are discharged from the ICU.

Intubation, ICU and trauma

Patients with COVID-19 who require intubation and ventilation have witnessed a number of stressful events in the ICU, such as emergency resuscitation procedures and deaths. This may increase the risk of post-traumatic stress disorder, anxiety, and depression.

Although we don’t have definitive long-term data, patients who have been critically ill from COVID often have a long and difficult journey of recovery. They will likely remain dependant on health care services for some time.

Many patients who have been intubated and ventilated recall it as being one of the worst experiences of their lives. Clearly it is something we should try to avoid for as many people as possible.

There are currently 138 patients patients intubated and ventilated in ICUs across Australia. That’s 138 patients who cannot communicate with their loved ones, who are scared, frightened and vulnerable.

Most of these patients have not been vaccinated. The most important thing we can do to reduce the risk of being intubated and ventilated as a result of COVID-19 is get vaccinated.



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The Conversation

Deb Massey, Associate Professor, Faculty of Health, School of Nursing, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Should the ADF take a bigger role in bushfires and other domestic emergencies? The answer isn’t so easy

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SHANE CAMERON/ROYAL AUSTRALIAN NAVY

Susan Harris Rimmer, Griffith University

The Commonwealth and state governments are responsible for keeping people safe, and the role of the ADF is to protect the nation. But how these two roles fit together is not always so clear.

After a tumultuous year of bushfires and the ongoing pandemic, we need a more fundamental conversation about the role of the ADF in responding to domestic emergencies.

The Morrison government has introduced a new bill that would give the ADF more power to respond to emergencies. And a Senate committee has recommended it be “passed without delay”, despite dissent from the Greens.

But questions remain around whether the legislation is even necessary or meets all the recommendations set out in the Bushfire Royal Commission report.



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When the Commonwealth can use the ADF domestically

The scope of the Commonwealth’s “nationhood power” is not settled in constitutional law and so, despite the number of times the ADF has been called out in peacetime, the legal basis of these interventions has always been contested. Section 119 of the Constitution says:

The Commonwealth shall protect every state against invasion and, on the application of the executive government of the state, against domestic violence.

It is generally agreed this does not authorise unilateral military action by the Commonwealth government. The need for this section is due to the fact the states are unable to raise a military force themselves.

But the Commonwealth has radically expanded how the call-out power is used — first in preparation for the 2000 Sydney Olympics, and then in response to the Sydney Lindt Cafe siege in 2018.

A convoy of Army vehicles transporting more than 100 Army reservists and supplies on Kangaroo Island during this year’s bushfires.
DAVID MARIUZ/AAP

A bill was passed in 2018, for example, that authorised the use of ADF soldiers to protect Commonwealth interests in Australia and offshore from “domestic violence” if a state requested it.

This bill raised significant concerns over human rights, related to the definition of “domestic violence” and whether ADF or foreign troops would be held accountable for the use of deadly force against civilians.

What does the new bill do?

The new bill would streamline the use of military personnel in a severe natural disaster or emergencies, such as a pandemic. But questions about the parameters of ADF involvement remain unanswered.

For example, the states and territories currently need to ask the Commonwealth for ADF personnel or assets to be deployed and must consent to ADF support during emergencies.

The Bushfire Royal Commission recommends allowing the Commonwealth the power to declare a national natural disaster and get ADF personnel ready to respond. If there are significant risks to lives or property — or it is deemed in the national interest — the government may then deploy the ADF to those areas without state or territory consent.

A child is helped onto an ADF helicopter as Mallacoota is evacuated this year.
Corporal Nicole Dorrett/Australian Department of Defence

This may raise future questions about the scope of the Commonwealth’s call-out powers, as noted in the bills digest and by Professor Anne Twomey’s submission.

Under the legislation, ADF personnel and soldiers from foreign countries would also have immunity from civil and criminal liability when responding to disasters, similar to state and territory emergency services workers.

What else does the Bushfire Royal Commission report say?

The royal commission focused mainly on ways to improve coordination between federal, state and local fire and emergency service agencies in future bushfires.

The commission’s report identified the need for more clarity from state, territory and local governments about how their fire and emergency responders should interact with ADF personnel on the ground, and what they can expect from the ADF in terms of performing certain tasks.

There are many ways the ADF can help states during an emergency, such as logistics support (including both fixed and rotary wing aircraft), sealift (such as the Mallacoota beach evacuation), land transport, engineering and medical support, the building of temporary accommodation and helping to restore communications.

During this year’s bushfires, for instance, the ADF deployed some 8,000 personnel, including 2,500 reservists, to assist with rescue operations and medical and disaster relief. About 500 defence personnel from New Zealand, Papua New Guinea, Japan and Fiji also provided assistance.

Army personnel from 5th/6th Battalion, the Royal Victoria Regiment (5/6 RVR), joined Victoria police in a search for bushfire victims.
Department of Defence/Supplied

However, the ADF insists it will not directly fight bushfires. There has also been some reluctance to commit more resources to domestic emergencies, arguing this reduces its focus on preparing for conflict and could reveal its capabilities to potential enemies. Using the ADF is extremely expensive, as well.

Calling in reserves instead of permanent ADF staff would mitigate some of these issues. Reservists have training and can provide personnel support with some specialist skills.

Also, it is easier to compensate and insure reservists, rather than the complicated (and sometimes contested) arrangements around compensation for volunteers and their employers.



Read more:
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The royal commission found more employment protection and accessible compensation would be required to ensure volunteer firefighters are not “worse off” than ADF personnel or reservists.

There was also some uncertainty in the report about the “thresholds” that must be met before seeking the assistance of the ADF — as in, when a locality has exhausted all government, community and commercial options and needs ADF support.

The Commonwealth government says it is working to clarify this.

The future of the ADF as a ‘dual use’ force

Changes are clearly needed to the ways in which we respond to disasters because, as the report makes clear, they are only going to get worse.

As I’ve argued with colleagues elsewhere, the ADF should become a “dual use” force that should respond to natural disasters both here and in the region.



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In order to justify our current level of military spending at 2% of GDP, the ADF should be trained and ready to deal with the increasing risks associated with climate change, such as handling mass displacement and responding to natural disasters.

Defence should earn their keep. But these interventions should come with strict civilian controls, human rights standards and clarity about roles. The current legislation creates more uncertainty about the ADF’s role in disasters and emergencies, when what the community needs now is clarity.The Conversation

Susan Harris Rimmer, Professor and Director of the Policy Innovation Hub, Griffith Business School, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Drought, fire and flood: how outer urban areas can manage the emergency while reducing future risks

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Elisa Palazzo, UNSW; Annette Bardsley, University of Adelaide, and David Sanderson, UNSW

First the drought, then bushfires and then flash floods: a chain of extreme events hit Australia hard in recent months. The coronavirus pandemic has only temporarily shifted our attention towards a new emergency, adding yet another risk.

We knew from the Intergovernmental Panel on Climate Change (IPCC) that the risk of extreme events was rising. What we perhaps didn’t realise was the high probability of different extreme events hitting one after the other in the same regions. Especially in the fringes of Australian cities, residents are facing new levels of environmental risk, especially from bushfires and floods.



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But this cycle of devastation is not inevitable if we understand the connections between events and do something about them.

Measures to slow climate change are in the hands of policymakers. But, at the adaptation level, we can still do many things to reduce the impacts of extreme events on our cities.

We can start by increasing our capacity to see these phenomena as one problem to be tackled locally, rather than distinct problems to be addressed centrally. Solutions should be holistic, community-centred and focused on people’s practices and shared responsibilities.

Respond to emergency

We can draw lessons from humanitarian responses to large disasters, including both national and international cases. A recent review of disaster responses in urban areas found several factors are critical for more successful recovery.

One is to prioritise the needs of people themselves. This requires genuine, collaborative engagement. People who have been through a bushfire or flood are not “helpless victims”. They are survivors who need to be supported and listened to, not dictated to, in terms of what they may or may not need.

Another lesson is to link recovery efforts, rather than have individual agencies provide services separately. For instance, an organisation focusing on housing recovery needs to work closely with organisations that are providing water or sanitation. A coordinated approach is more efficient, less wearying on those needing help, and better reflects the interconnected reality of everyday life.

In the aid world this is known as an “area-based” approach. It prioritises efforts that are driven by people demand rather than by the supply available.

A third lesson is give people money, not goods. Money allows people to decide what they really need, rather than rely on the assumptions of others.

As the bushfires have shown, donations of secondhand goods and clothes often turn into piles of unwanted goods. Disposal then becomes a problem in its own right.



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Combining local knowledge and engagement

Planning approaches in outer urban areas should be realigned with our current understanding of bushfire and flood risk. This situation is challenging planners to engage with residents in new ways to ensure local needs are met, especially in relation to disaster resilience.

In areas of high bushfire risk, planning needs to connect equally with the full range of locals. Landscape and biodiversity experts, including Indigenous land managers, and emergency managers should work in association with planning processes that welcome input from residents. This approach is highly likely to reduce risks.

Planners have a vital job to create platforms that enable the interplay of ideas, local values and traditional knowledge. Authentic engagement can increase residents’ awareness of environmental hazards. It can also pave the way for specific actions by authorities to reduce risks, such as those undertaken by Country Fire Service community engagement units in South Australia.



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Managing water to build bushfire resilience

Regenerating ecosystems by responding to flood risk can be crucial to increase urban and peri-urban resilience while reducing future drought and bushfire impacts.

Research on flood management suggests rainwater must be always seen as a resource, even in the case of extreme events. Sustainable water management through harvesting, retention and reuse can have long-term positive effects in regenerating micro-climates. It is at the base of any action aimed at comprehensively increasing resilience.



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In this sense, approaches based on decentralised systems are more effective at countering the risks of drought, fire and flood locally. They consist of small-scale nature-based solutions able to absorb and retain water to reduce flooding. Distributed off-grid systems support water harvesting in rainy seasons and prevent fires during drought by maintaining soil moisture.

Decentralisation also creates opportunities for innovation in the management of urban ecosystems, with responsibility shared among many. Mobile technologies can help communities play an active role in minimising flood impacts at the small scale. Information platforms can also help raise awareness of the links between risks and actions and lead to practical solutions that are within everybody’s reach.

Tailor responses to people and ecosystems

Disrupted ecosystems can make the local impacts of drought, fire and flood worse, but can also play a role in global failures, such as the recent pandemic. It is urgent to define and implement mechanisms to reverse this trend.

Lessons from disaster responses point towards the need to tailor solutions to community needs and local environmental conditions. A few key strategies are emerging:

  • foster networks and coordinated approaches that operate across silos

  • support local and traditional landscape knowledge

  • use information platforms to help people work together to manage risks

  • manage water locally with the support of populations to prevent drought and bushfire.

Recent environmental crises are showing us the way to finally change direction. Safe cities and landscapes can be achieved only by regenerating urban ecosystems while responding to increasing environmental risks through integrated, people-centred actions.The Conversation

Elisa Palazzo, Urbanist and landscape planner – Senior Lecturer, Faculty of Built Environment, UNSW; Annette Bardsley, Researcher, Department of Geography, Environment and Population, University of Adelaide, and David Sanderson, Professor and Inaugural Judith Neilson Chair in Architecture, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Explainer: how will the emergency release of NSW prisoners due to coronavirus work?

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Thalia Anthony, University of Technology Sydney

The New South Wales government has passed emergency legislation providing the Corrections Commissioner with powers to release some of the state’s 14,034 prisoners.

This legislation was introduced in the wake of the global release of prisoners to cope with the COVID-19 pandemic. Most recently, the United States has begun to release thousands of prisoners across four states.



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Legislation to release prisoners in NSW was drafted amid the growing number of cases of COVID-19 infections in prison populations, including staff. The overcrowding and poor sanitation and health conditions in prisons make them ripe for the rapid spread of disease.

Long Bay jail in Sydney was locked down this week when two prison staff tested positive for COVID-19 and several inmates displayed symptoms. The higher incidence of chronic health conditions among inmates predisposes them to suffer serious and critical outcomes from the virus.

Why is legislation needed?

The NSW government has introduced the COVID-19 Legislation Amendment (Emergency Measures) Act 2020 (NSW) to address the escalation of COVID-19 cases in the state.

NSW has the highest per capita rate in Australia, with more than 1,000 cases as of March 25. The emergency legislation provides for the release of prisoners. The provision will apply for a minimum of six months and may apply for up to 12 months under regulations.

This emergency provision is concerned with protecting vulnerable inmates and releasing prisoners who pose a low risk to the community. Attorney-General Mark Speakman said the legislation was designed to protect the health of inmates and frontline prison workers as well as the “good order and security” of prisons.

Freeing up prison space through the early release of prisoners will enable the remaining prisoners to be isolated, to prevent or control an outbreak. It also allows the health needs of remaining inmates to be better addressed.

We have seen what happens without this action in prisons overseas: infection spreads rapidly and foments unrest among prisoners. In Italy, prisoner fears that they faced a death sentence because of COVID-19 resulted in riots in 23 Italian prisons and the deaths of 12 prisoners.

Who can be released under the legislation?

The COVID-19 legislation allows for the release of prisoners who belong to a prescribed “class of inmates”. They may be defined according to their health, vulnerability, age, offence, period before the end of the prison term and any other matter as set down in regulations.

Serious offenders are excluded. This not only rules out those specifically mentioned, including prisoners convicted of murder, serious sex offences and terrorism, but also high-level drug and property offenders.

The Corrections Commissioner will determine an individual’s release where it is “reasonably necessary” due to “the risk to public health or to the good order and security of correctional premises”. Community safety and the prisoner’s access to suitable accommodation outside prison are necessary aspects of the decision-making. Other consideration are whether the offender has previously committed a domestic violence offence and the impact of the release on the victims.

Prisoners will be released on parole and subject to standard parole conditions. They will, for example, have to be of good behaviour and not reoffend, as well as any additional conditions determined by the commissioner, including home detention and electronic monitoring.

Does this cover all prisoners?

There are some concerning omissions from this legislation if it is to achieve its objectives of protecting inmates, prison staff and the community.

First, it is not clear whether it will apply to youth detention centres. This vulnerable group requires special protection in this period when they are denied visits from their parents, family and lawyers, have fears about COVID-19 infection and most likely are unaware of their rights to health care.

The legislation also does not refer to remand prisoners, who constitute over one-third of prisoners in NSW. The legislation explicitly refers to parole, rather than determinations on bail.

Administrators must set down regulations to include this group in the prescribed “class of inmates” for release. Otherwise, those most entitled to liberty – who have not been convicted or sentenced – will be left in prison to suffer through the pandemic. The suspension of new jury trials will mean they spend further time in prisons until well after the COVID-19 crisis.

Critically, the legislation is silent on people who are facing a prison sentence or remand order, but not yet in prisons. For those people, there is no legislation urging the courts to consider the coronavirus pandemic in promoting non-prison sentences or allowing bail applications.



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Over the past week, lawyers have rushed to collect evidence on the effect of the pandemic on prisoners to support their clients’ pleas not to be imprisoned. Supreme Courts in Victoria and the ACT have accepted the relevance of COVID-19 in bail applications. But there is a lack of guidance elsewhere on bail and sentencing, increasing the risk of more people being sent into the prison system.

Schedule 1 of the emergency legislation granted controversial powers to the attorney-general to alter the bail laws by regulation during the crisis. The NSW government has indicated it intends to use these powers to deliver changes on bail to prevent more prisoners entering jail on remand. The timing and scope of these changes have not been detailed, but are certainly critical to preventing the pandemic entering our prisons.

Not only would the entry of new inmates add to the burden on prisons, it could also create a devastating situation where unknown carriers of the coronavirus enter the system.

While there are no laws to limit courts ordering imprisonment during the pandemic, Corrections Commissioner Peter Severin could use his discretion to review the release of prisoners at the point of reception. In other words, the process between the court order and physical entry into a prison cell. Regulations should clarify the use of the commissioner’s power at this point to prevent unnecessary entry of new prisoners.

Does it strike the right balance in community protection?

The immediate release of NSW prisoners will protect prisoners from greater exposure to COVID-19, limit the outbreak of the virus in prisons and minimise the spread between prison and the community.

But there is more to be done. The release of less serious offenders should not be based on the pre-pandemic criteria of the risk of the individual. These criteria often discriminate against Indigenous people, those with mental health issues and socio-economically deprived. Rather, it should be based on the health needs of prisoners and the interests of community safety in managing the health risk.

Given that many prisoners have poor health and are serving short prison terms, the broad use of the commissioner’s discretion could result in thousands of prisoners being released from NSW prisons.

Ultimately, the legislation will only work to minimise the worst effects of COVID-19 in prisons if the commissioner exercises his discretion widely to prevent overcrowding and take the load off already scarce health services in prisons.The Conversation

Thalia Anthony, Professor in Law, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Next time, we’ve got to handle emergency donations better

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Debbie Wills, University of Tasmania

As Australia burned over summer, many of us gave generously, donating an extraordinary A$500 million by mid-January.

Charities had to scramble, as did organisations directing us to charities. For its new year’s eve fundraiser the ABC chose the Red Cross.

Weeks later, the New South Wales state MP for Bega, Andrew Constance, a local whose electorate was in the heart of the fires, attacked the Red Cross, and also the Salvation Army and St Vincent de Paul, arguing not all of the money was getting through:

The money is needed now, not sitting in a Red Cross bank account earning interest so they can map out their next three years and do their marketing.

The Red Cross responded, conceding it was using 10% of donations for administration but noting that it was handing out A$1 million every day.

The confusion and negativity continued, with comedian Celeste Barber seeking legal advice over the fate of A$50 million she raised for the NSW Rural Fire Service.



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It was too much for the fire service to spend quickly on running expenses and buying and maintaining equipment. And it was prevented by its trust deed from passing it on to other charities.

The fallout suggests we want to be sure our money is being used to help, but we’re not sure that it is.

What can charities and donors do?

My research into the role played by reputation in donations indicates that it is important for charities to define their role clearly.

This includes stating plainly how they are meeting the reporting and other requirements imposed on them by the Australian Charities and Not-for-profits Commission and educating the public about those requirements.

We need to do our research, think carefully before donating, and watch out for scammers.

It is important to be comfortable with each charity’s mission and objectives. They cannot act outside them without running the risk of being deregistered.

We can search for information on all charities using the commission’s charity search tool www.acnc.gov.au/charity, or for smaller sets of charities using charity ranking sites such as:

The Australian Charities and Not-for-profits Commission already does a lot, but given the power, there’s more it could do.

What can Australia’s regulator do?

It could require funds raised for emergencies to be kept in trust, and reported on in more detail at regular intervals through a running statement of distribution of funds.

It could require further standardised reporting, although this would be expensive and charities are already heavily criticised for the percentage of funds used for administration.

It could also set up a one-stop shop for disaster relief.

Brian May and Adam Lambert of Queen perform at the Fire Fight Australia relief concert in Sydney, Sunday February 16, 2020.
Joel Carrett/AAP

The department of foreign affairs set up one for foreign disasters that was first used for the Bangladesh-Myanmar appeal in 2017, bringing together eight Australian charities to create a single website and a single phone number that could be used to direct calls to each individual charity.

There are understandable calls to do the same thing for domestic disasters.

Some charities might not welcome combined appeals, fearing they would reduce their own visibility and impose more hurdles. But the hurdles shouldn’t be impossible to leap. A global organisation has been set up to ensure best practice.



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The Advance Global Australian Bushfire Appeal set up by five charities during the bushfires shows what can be done, as does February’s Fire Fight Australia concert.

A government-certified single point of contact, backed up with specific reporting requirements, could provide a level of certainty that the public feel more comfortable with in times of emergency in the future.The Conversation

Debbie Wills, Lecturer in Accounting, University of Tasmania

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Government triggers emergency plan for COVID-19 pandemic, and considers economic assistance

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Michelle Grattan, University of Canberra

The federal government has activated its emergency response plan to deal with a spread of the coronavirus locally, in anticipation of it becoming a “pandemic”.

It is also considering limited assistance for those hardest hit by the economic fallout.

Prime Minister Scott Morrison told a news conference late Thursday Treasurer Josh Frydenberg and Treasury was working on possible measures to give some relief.

Morrison stressed any measures would be “targeted, modest and scalable” – that is, able to be built on if necessary.

“This is a health crisis, not a financial crisis, but it is a health crisis with very significant economic implications,” he said.

“We’re aware, particularly in the export industry, in the marine sector, there are particular issues there especially in North Queensland, but these problems are presenting in many other places,” he said.

The tourism and education sectors are being heavily affected as the crisis worsens. But the government has stressed universities have good liquidity to deal with the situation.

The travel ban on arrivals from China has been extended for at least another week. There will be no carve out for the tens of thousands of university students unable to reach Australia.

Treasury has not yet finalised an estimate of the economic impact of COVID-19.

Cabinet’s national security committee met for three hours on Thursday to discuss the latest information on the virus and what should be done now.

“What has occurred, in particular, in the last 24 hours or so as the data has come in is that the rate of transmission of the virus outside of China is fundamentally changing the way we need to now look at how this issue is being managed here in Australia,” Morrison said.

Stressing Australia had been ahead of the World Health Organisation in its previous response, he said “based on the expert medical advice we’ve received, there is every indication that the world will soon enter a pandemic phase of the coronavirus”.

“So while the WHO is yet to declare … it’s moved towards a pandemic phase, we believe that the risk of a global pandemic is very much upon us and as a result, as a government, we need to take the steps necessary to prepare for such a pandemic.”

The actions were “being taken in an abundance of caution,” Morrison said.

Health ministers will meet on Friday to discuss the emergency planning, to respond to a future situation where there is sustained transmission in Australia – in contrast to the present containment to a handful of cases. As the virus spreads internationally, the chances increase of a major spread in Australia.

The emergency plan covers special wards in hospitals, and ensuring key health workers have access to adequate protective equipment from the medical stockpile.

It includes provision for aged care facilities to be put into lock down if necessary.

There would also be contingency alternative staffing for key facilities if staff got the disease.

On another front, Border Force would if necessary extend screening to passengers arriving from multiple countries.

Morrison said consideration was being given to how school children would be protected.

The Prime Minister emphasised there was no cause to consider cancelling events or for people not to be out and about.

“You can still go to the football, you can still go to the cricket, you can still go and play with your friends down the street, you can go off to the concert, and you can go out for a Chinese meal.

“But to stay ahead of it, we need to now elevate our response to this next phase,” he said.

“There are some challenging months ahead and the government will continue to work closely based on the best possible medical advice to keep Australians safe.”

So far, Australia had had 15 cases who had come from Wuhan and all 15 had now been cleared, he said. Eight other cases had come from the Diamond Princess. There had been no community transmission in Australia.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How to manage your essential medicines in a bushfire or other emergency

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In an emergency, like a bushfire, making sure you have enough of your regular medication can mean the difference between life and death. But there are many ways to prepare.
from www.shutterstock.com

Andrew Bartlett, University of Sydney and Bandana Saini, University of Sydney

Some people find managing their medication difficult at the best of times. But in an emergency, like a bushfire or cyclone, this can be harder still.

As catastrophic bushfires burn across Australia, here’s what to think about as part of your emergency planning to make sure you have access to the medicines you need.



Read more:
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As part of your emergency plan, list your medications and where you keep them, along with contact details for your doctor and pharmacist and any other relevant emergency services.

If you have advanced warning of emergency conditions, check both your supply of tablets and any prescriptions you may need. Your prescription label will tell you how many repeats you have left. Try and keep at least one week’s medication on hand.

I need to evacuate. Now what?

If you need to evacuate, know how best to store and transport your medication. Most medications for conditions such as blood pressure or cholesterol need to be stored below 25-30℃. These medications will be OK if temperatures are higher than this for short periods of time, while you transport them.

Medicines sensitive to temperature will need to be stored or transported with cold packs in an insulated container of some sort, such as an esky. Putting them in a ziplock bag will help protect them from moisture.



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Insulin is one common medication you need to store cold. Your current insulin pen can be stored at room temperature. But store unused pens with a cold pack in an esky until you find refrigeration.

This also applies to thyroxine tablets. Fourteen days supply (usually one strip of tablets) is OK if stored at room temperature. But keep the rest with a cold pack. If you don’t think it will be possible to keep the rest below 25℃ for a long time, also keep these with the cold pack.

Many antibiotic syrups, such as cefalexin, also need to be kept cold. But check the dispensing label or speak to your pharmacist if you are not sure.

What if I run out of medicine?

If you are caught without essential medication, doctors and pharmacists can help in a number of ways.

This is easier if you have a regular GP and pharmacist who will both have a complete record of your medication. Your pharmacist can call your GP and obtain verbal approval to supply your medication. Your GP will then need to fax or email the prescription to your pharmacist as soon as possible and mail the original script within seven days.

Pharmacists can also dispense emergency supplies of cholesterol medicines and oral contraceptives, so long as you already take them. Under so-called continued dispensing arrangements, pharmacists can dispense a single pack of these medicines once every 12 months.

If you cannot get in touch with your GP, in an emergency, most states allow a pharmacist to dispense a three-day supply of your medication. But this is only if the pharmacist has enough information to make that judgement.

Some medicines, such as strong pain medications and sleeping tablets, are not covered by these provisions.

Medicines for people with lung conditions, like asthma

People with existing lung conditions (such as asthma, chronic obstructive pulmonary disease or bronchitis), older people, young children and pregnant women are most likely to be vulnerable to the effect of bushfire smoke. They can also have symptoms long after a bushfire if fine particulate matter is still in the air.



Read more:
How does poor air quality from bushfire smoke affect our health?

If you have a respiratory condition, follow the action plan you will have already discussed with your doctor, which outlines what to do in an emergency.

This plan includes instructions on what you should do if your asthma gets worse, such as taking extra doses or additional medication. It also tells you when you should contact your doctor or go to the emergency department.

If you have a respiratory condition, such as asthma, and live in a bush fire prone zone, this action plan needs to be part of your fire safety survival plan.



Read more:
Thunderstorm asthma: who’s at risk and how to manage it

You also need to make sure you have enough preventer and reliever medications, for asthma for example, to hand just in case there is an emergency.

If you don’t have an action plan, taking four separate puffs of your reliever medication may relieve acute symptoms. This applies for adults and children.

In a nutshell

Being prepared for an emergency, like a bushfire, goes a long way to keeping you and your family safe. That applies to thinking about your supply of medicines well in advance, if possible.

But if conditions change rapidly and you need to evacuate, an esky containing medicines for a few days, and contact numbers for your GP and pharmacist, could save your life.The Conversation

Andrew Bartlett, Associate Lecturer Pharmacy Practice, University of Sydney and Bandana Saini, Associate Professor, Pharmacy Practice, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Central African Republic in Crisis

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The Central African republic is a nation in crisis, following the recent coup in that country. Persecution against Christians and others has continued, even while some of these groups are attempting to assist those who are suffering as a consequence of the national emergency. The link below is to an article reporting on the situation in the Central African Republic.

For more visit:
http://www.worldwatchmonitor.org/2013/07/article_2617003.html/