Dr Diarmuid McCoy, originally from Bantry in Co Cork, now lives in Geelong in Victoria, Australia, where he works as a specialist pain medicine physician, and has helped to develop the medical school at Deakin University.
How has Australia been dealing with the Coronavirus pandemic?
How significant the effect of Covid-19 might be in Australia was not fully appreciated until early in March. The public healthcare specialists and epidemiologists did have it on their radar from early January. The first restrictions imposed upon the general public by the federal government suggested gatherings should be limited to fewer than 500 people (March 23rd). At this time sporting events were continuing and schools continued to operate as normal. The image of Bondi Beach packed with people on a Friday afternoon was the stimulus for stricter enforcement and tighter restrictions.
A moratorium was put on non-urgent elective surgery in public and private hospitals. Schools started distance learning. All non-essential businesses were closed and a huge number of people were encouraged to work from home if possible. As it did in many first world countries this resulted in significant numbers of people losing their jobs and seeking unemployment support with the social welfare system (Centrelink). In Australia the main source of the virus was returning tourists and visitors coming from cruise ships, and returning holidaymakers and visitors from the US. Of the 97 deaths here to date, at least 35 were passengers on cruise ships.
Hospitals across the country began an intensive training programme, reorganised services and planned for an expected huge number of patients. The provision of personal protection equipment (PPE) caused significant concern. In Geelong the two private hospitals and the university teaching hospital provided a uniform approach to the expected crisis.
To date, fewer than four patients have been admitted to the public hospital, none to the private hospitals and no patient required high-dependency or intensive care management. Across the country the numbers of people tested for Covid-19 increased enormously and to date the number identified as being infected is fewer than 7,000, with 97 deaths. On this date (May 12th), the numbers across Australia include 16 people in intensive care 11 requiring ventilation out of a total of 49 currently in hospital.
As a pain specialist, how is Covid-19 making a difference to your work?
Patients with persistent pain, particularly those who attend specialist clinics, require regular (though not always frequent), review and supervision. Those who have implantable devices, use powerful medication or have associated psychological distress and mental illness need the support of a multi-disciplinary pain service. It is therefore very important that we continue to interact with these patients - electronically but often also in person. We have been able to provide some cognitive behavioural therapy and mindfulness programmes by telehealth and they have been more successful than we had expected. The changes we have put in place may very well persist long after this crisis has (hopefully) resolved.
How does your day look at the moment?
At our consulting rooms there are significantly fewer patients. We have rapidly scaled up the use of telemedicine, which is a technology we have been used to over the last number of years. Some of our patients live up to three and some up to six hours drive from us. Some of them live in a different time zone.
We are still free to offer pain-relieving procedures to those with acute severe pain and cancer-related pain
Consulting by telemedicine has its challenges, but also its rewards. Patients appear to be somewhat more relaxed in their own environment, happier to share information about their medical condition, which perhaps they may not do so in person. We have had patients introduce us to their pets, virtually-toured their gardens, been asked opinions on where to hang a picture and offered a glass of wine (at 11am!)! We are still free to admit patients to the hospital (after a rigorous screening process). In line with the Federal government’s instructions we have scaled back our interventions, but are still free to offer pain-relieving procedures to those with acute severe pain and cancer-related pain.
Has the current situation made a difference to your life outside work?
The activities of daily living outside of work and school have contracted drastically. We are encouraged to remain at home. In addition to repeated instructions around hand washing, the only reasons for being away from your home address is for work or education, medical appointments, shopping for food and exercise. Beaches are closed, all sporting codes have been discontinued including sailing and kayaking. Cycling is permitted, but not in large groups. The weekends are not crowded with children’s sporting and extracurricular activities.
In the last few days the federal government has released a plan of opening the economy. The states and territories have the final say on how rapidly this is this will occur. My state of Victoria is progressing very cautiously, though a return to school is going ahead later this month in a staged process.
There is now a concept of an Australia-New Zealand bubble allowing travel between the two countries, which would be advantageous for both nations. The ski season in New Zealand is a major draw for Australians and Kiwis enjoy escaping the winter cold with holidays in the tropics of Queensland and the Northern Territory too.
Can you get food in the same way?
All supermarkets are open and well stocked. There was a run on toilet paper and tissues in the early days, but this was for no logical reason but was a reflection of the general anxiety in the community. All restaurants are closed to sit-down customers, however many have developed takeaway options with some extraordinarily elaborate creations, which can be delivered or collected.
Does being Irish count there at the moment?
I work with three other Irish-Australian pain specialists. Obviously, in addition to looking at the figures graphs and projections here in Australia, we keep an eye on events in Ireland. The political leadership, unified approach and innovation demonstrated is certainly a reason to be proud. Concern for our parents and families in Ireland persists. My own mother lives in Bantry, West Cork. She appears to be coping very well though.
Is there anything you are missing about Ireland?
When I visited in January, I returned with an adequate supply of brown flour! The biggest concern is when we might be able to get back to Ireland, see our families and enjoy some of the finest food in the world: salmon, mackerel , mussels, scallops, bread, cheese. I’m getting hungry just thinking about it,.
