Return of masks welcome

Transcript: AMA Queensland Council of General Practice Chair, Dr Maria Boulton, 4BC, Weekend Breakfast with Bill McDonald, Sunday, 19 December 2021

Subjects: Mask mandates, community care of COVID patients, PPE for GPs, booster shots

BILL McDONALD:    Dr Maria Boulton runs a family practice here in Brisbane and is also chair of the AMA Queensland Council of General Practice. Good morning to you, Maria.

MARIA BOULTON:     Good morning.

BILL McDONALD:    Lots of things to talk about, among them changes in the past few days, we've seen the reopening of the borders, the vaccination mandate at all but essential venues, and the return of the masks. Is it good policy, in your opinion, is it hitting the mark?

MARIA BOULTON:     The return of the masks? Absolutely. We saw that they made a huge difference in Melbourne during their lockdowns before vaccines were introduced, we know that they're effective at reducing transmission. So we're definitely supportive of that. And we've been wearing masks at my practice for a couple of weeks now since community transmission started happening. And we do recommend that people who cannot socially distance do wear them. And I know that there's a mandate now for masks to be worn in certain situations like retail outlets.

BILL McDONALD:    I read in the paper today GPs are being thought of or asked that they may have to treat COVID patients in their homes if the numbers spread and require hospitalisations. Is that a going concern for GPs?

MARIA BOULTON:     Queensland Health are developing a plan for community cases to be looked after by GPs. These cases would be the people who are relatively well, not people who are severe or who have risk factors. And basically the plan is for GPs to keep in touch with them. We're still waiting on the details of the final plan, so I can't comment on the final plan yet. And as GPs, you know, we're always keen to help people. Of course, a lot will depend on the resources and the support that we get as to whether the plan will work or not. And we're still waiting to hear.

BILL McDONALD:     And the availability of the PPE protection equipment was also raised as a possible concern in terms of GPs protecting themselves. Is that an issue?

MARIA BOULTON:     Definitely. And that's been an issue since, oh, my goodness, about 18 months ago. I do fit-testing at my work, so I know a lot about masks, and I know that a well-fitting N95 mask is the best thing that a health care worker needs. We've struggled incredibly to get PPE delivered to GPs from the State or Federal stockpile, and a lot of GPs have struggled accessing fit-testing. That is something that should have been delivered to us a long time ago, because for us to remain open and for our health care workers to remain safe, they need those N95 masks.

BILL McDONALD:     Who's responsible for that? Where's that fallen over?

MARIA BOULTON:     Well, GPs receive some funding through Medicare, federal funding. However, we are in the State of Queensland, and if a GP clinic closes down because they've been exposed, then the patients end up in the hospital. So it doesn't matter who gives us our PPE, we just need it.

BILL McDONALD:     That's crazy, that you haven't got the PPE for all you've had to go through. Can we just talk a little bit about the importance of the booster shot in terms of this Omicron? And we'll talk about Omicron - it seems like it's a moving feast and experts are still trying to work out what how bad it is, how sick people are going to get from it. But the booster, the effectiveness of vaccinations and the booster, the importance of that?

MARIA BOULTON:     This is really important and yeah, I get it, people are a bit fatigued with COVID and COVID vaccines, but we use boosters a lot with tetanus needles, whooping cough needles. So they do happen already. And the advice is for people who are due for their booster, people who have had the second vaccine more than five months ago, to go and get a booster.

There is a group of people who have severe immune suppression, so, for example, people who are on high doses of immunosuppressants, who should be getting their third dose two months after the second dose, so they’re a different population. But the advice is that a lot of us, especially health care workers, we received our second dose about six months ago. So we're all due. Go to your GP who delivered your vaccines or to go to your pharmacy or to go to the Queensland Health Hub, and get your booster before cases start climbing more.

BILL McDONALD:     Do we know much about the efficacy of the vaccinations in those that maybe had AstraZeneca early, in terms of Omicron?

MARIA BOULTON:     It appears that people will need that booster for the vaccines to be more efficacious. And that's why it's so important for people to source one.

BILL McDONALD:     And what do you make of what we're seeing in Europe at the moment, and America, where Omicron seems to be getting out of control, and there’s crisis meetings, there's talk of shutdowns and lockdowns, again, in Holland? Is that something that we're likely to see replicated here?

MARIA BOULTON:     We expect the cases to increase. And we know that Omicron’s already in Queensland. Look, we're in a different position to a lot of other countries in that in Queensland, we have 80 per cent vaccination rates. Some pocket sites aren't there yet and it's essential that those communities get there. But you know, from all the data coming from overseas, what we're learning is that it is essential to get that booster dose. And what vaccines do in the end is they reduce the risk of transmission. It won't be zero, but it'll reduce it and reduce the chances that you'll end up in hospital with severe COVID.

BILL McDONALD:     Are you starting to see people come in now and really wanting to get the booster?

MARIA BOULTON:     Oh, yes, we've had a run on boosters in the last two weeks. And there’s two factors there – people were due, and there’s also a lot of people travelling, or who are concerned about travelling to Sydney or Melbourne, and they want to be fully vaccinated before they go down. So that's really good to see. And there's also a proviso, so if it's not quite five months since you've got your second dose and you're travelling in the next week or two and your booster’s due in a week or two, you can go and get your booster a couple of weeks early.

BILL McDONALD:     It is a massive change from what we're used to here because the borders have been tight and the State Government has had a very strict policy in the past that was almost zero transmission. Now, the new Chief Health Officer has said, no, we won't be having shutdowns, no lockdowns anymore. Are you confident that will be the case, and the Government will listen and take that advice, or do you expect there may be a Panic at the Disco at some stage?

MARIA BOULTON:     I think that'll be up to the Government, as it always is with lockdowns. But I guess it'll be interesting to see what happens if it's the case of going to a community where the vaccination rate isn't great. So, you know, they're particularly vulnerable there, so it'll be interesting to see what happens in that situation.

BILL McDONALD:     And crystal balling here - there's been reports as well as speculation that COVID will just keep mutating, it'll be different variants, and they'll outrun the vaccinations. What's the long term-view on COVID?

MARIA BOULTON:     I think the long-term view will be that yes, we'll get different mutations like the flu. The flu mutates every year and, every year, the flu vaccine is slightly different to cover off on different strains. And I think that's where COVID has headed. I'm not I'm not a virus expert, but that's what I've been reading through the scientific advice and all we can do is hopefully keep developing the vaccines that will hopefully keep people out of hospital.

BILL McDONALD:     Does our climate have anything to do with it at all? Obviously, in Europe, you're talking winter, and it's summer out here at the moment, it's hot, and it's less favourable to the transmission.

MARIA BOULTON:     Yeah, I'm not sure about that. I think population density has a lot to do with it. In areas where there's overcrowding and lots of people, it seems to be running a lot more rampant, but also, the other thing that's important with the borders opening is the flu. So, ATAGI are advising for people who haven't had a flu vaccine this year, or are due, to get a flu vaccine, because the last thing we need is the flu and COVID circulating in the community at the same time. We've had very little flu this year because our borders have been closed, but we're expecting as the borders open for flu to start circulating again as well.

BILL McDONALD:     I appreciate your time this morning. Thanks very much.

19 December 2021