Associate Professor Shane White | Breast Oncologist

July 2021

Dear all, it has been a while since I blogged, a tricky time for all. Reflecting back, twelve months ago there was speculation we may never have a vaccine against this virus. Fast-forward twelve months, the world will become we hope a safer place with the development of a number of vaccination strategies , including two available in Australia.

Many of my patients are particularly vulnerable to this virus, if they have advanced cancer, undergoing chemotherapy , or simply because of their age or other health issues. However, recent transmission of the Delta variant with illness occuring even in young, previously healthy people tells us noone is guaranteed safety from COVID19.

I strongly recommend you all get vaccinated. If aged 60 and over, you can access the AZ vaccine and i strongly urge you to do so. The TTS (thrombosis/ thrombocytopenia syndrome) associated with the AZ vaccine is exceedingly rare and far outweighed by the protection provided against death and serious illness from COVID 19. If you are under 60, ATAGI has recommended non-AZ vaccines (Pfizer and later in the year, Moderna) but the decision about waiting for access to these vaccines or receiving AZ now might be aided by a discussion with your GP or myself. AZ is a highly effective vaccine that is worthy of consideration even in younger age groups who want to move forward with vaccination immediately. Remember you won’t achieve adequate immunity from COVID 19 till your second shot. For the AZ vaccination, the interval between shots is 12 weeks, based on current recommendations. My comments as of today July 26th may not be relevant if the community numbers of COVID19 change in the next few months.

You can book a vaccine through coronavirus.vic.gov.au/book-your-vaccine-appointment or at Austin Health https://www.austin.org.au/getvax/.

Dear all, given the current situation -our rooms have moved to teleconferencing or phone calls for appointments unless there is an extreme need for a face to face appointment. This is with the intention of protecting; 1) the patients, who may be at higher risk of significant infection from age or. being immunocompromised, and; 2) the staff, because we cannot guarantee backup if we fall ill.

There is government funding to bulk bill patients deemed at risk of COVID 19. This funding does not realistically support the cost of a private practice in the medium term and we may still need to charge you a private fee rather than use the bulk bill consultation code depending on the time of the consultation, the need to post scripts, dictate letter and so forth.

With regard to the choice of teleconferencing or phone, I would much prefer to ‘see the patient’ by video. I am using encrypted software for privacy. This will work best on a computer, especially with a direct Ethernet connection rather than WiFi although the latter is reasonable.

These consultations are intended to be equivalent to a room consultation, without the examination. Please take the time to eliminate distractions at home so you can get the most value from your consultation. I recommend you have a pad and pen ready, with prepared questions as you might when you normally come to the rooms.

The software will also work with any smartphone. We can either email the link to your computer or SMS it to your phone. All you need to do is accept the link. Please contact Melissa if you have any concerns by phone or email.

I am hoping this will only be short term, although I can see the advantages in the future for telehealth when a short chat is required without an examination.

Good luck, stay well and #stayathome. Shane

Dear all , this is a difficult and stressful time for all- whether patients, families or health providers, united also by a risk of catching the same virus that has plagued many areas of the world.

For many this will be a common cold experience. for some, a more significant health event. At a community level common sense ‘social distancing’ (> 1.5 m) and hand washing are our best defences against a (too) rapid escalation of the infection in Melbourne. The slower the rate of infection, the better chance hospitals and GP practices will have to help you. I think working from home if feasible is wise for all and minimising public exposure particularly in groups.

At a personal level, this is stressful for everyone. Be compassionate and supportive of friends and strangers. If you are age >70, have a chronic condition or have a weakened immune system there is the opportunity through Medicare to videoconference or phone conference appointments whilst this crisis lasts. We may utimately encourage all patients to avail themselves of this service while the crisis lasts. Please email or call us to discuss this in more detail.

I would recommend those elderly patients or those on chemotherapy or with advanced cancer go to greater lengths to physically isolate at home when you can. Have one or two key family or friends who can provide support including delivery of essentials. Stay connected with others via the phone or Facetime or Facebook. Join an on-line book club or watch music or shows on line. Keep up physical exercise with regular walks, gardening. Please update your influenza vaccination.

Regarding my patients on follow-up who would be regarded as being in remission, I would regard your risk of serious infection as the same as others with the same age and health. I would suggest you take the usual precautions we should all take.

The situation is fluid and we can keep you updated on this website. There is an informative webinar posted on Youtube by my infectious disease colleague Assoc Prof Pat Charles https://youtu.be/rK0dBMvqLhc