Pomegranate Health

While waiting for COVID-19 vaccines to be rolled out, Australian jurisdictions adopted strong social restrictions to minimise community transmission of the virus. It’s estimated that together, these public health measures spared around 50,000 lives up to December 2022 and that vaccines saved three times as many again. While this public health response the pandemic is described as one of the most effective in the world it did cause unintended social harms and lingering resentment. Our leaders and community need some sober reflection on how to we might respond to the next such pandemic respiratory virus. 
 Over two podcasts we look carefully at the how the cost-benefit calculation stacks up for each of the major interventions.  In Part 1 we discuss the international borders closures and overcooked parochialism between state jurisdictions, and also how messaging around vaccine risks and mandates could be improved. In Part 2 we look at the controversial stay-at-home orders and interruptions to in-person schooling and even the evidence for faces-masks. Ultimately, there are some questions that can’t be answered scientifically, and it is for politicians and the public to decide what the cost of freedom and dignity against human lives left exposed. 
Chapters Part 2
3:38 Social restrictions
16:39 Facemasks
21:19 Missing behavioural and epidemiological data
30:35 Psychological morbidity from social restrictions
39:39 Human rights and moral preparedness

Guests
Professor Paul Kelly FRACP (Centenary Institute; Australia’s Chief Medical Officer during the pandemic)
Professor Catherine Bennett PhD GAICD (Deakin University; lead author of the “COVID-19 Response Inquiry” )
Professor James McCaw PhD (The University of Melbourne; modeler for the Federal government’s “National Plan”)
Lorraine Finlay PhD (Australian Human Rights Commissioner; lead author of the "Collateral Damage" report)

Production
Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Organic Textures 2’ by Johannes Bornlöf, ‘RGBA’ by Chill Cole, ‘Axon Terminal’ by Out to the World, ‘Soundbed’ by Blue Saga, and ‘Echo (Kerstin Ljungstrom Remix)’ by Bonsaye. Music courtesy of FreeMusicArchive includes ‘Namaste’ by Jason Shaw. Image by Westend61 licenced from GettyImages. 
Add Part 2 to MyCPD as educational activity or visit web page for a transcript and references.

While waiting for COVID-19 vaccines to be rolled out, Australian jurisdictions adopted strong social restrictions to minimise community transmission of the virus. It’s estimated that together, these public health measures spared around 50,000 lives up to December 2022 and that vaccines saved three times as many again. While this public health response the pandemic is described as one of the most effective in the world it did cause unintended social harms and lingering resentment. Our leaders and community need some sober reflection on how to we might respond to the next such pandemic respiratory virus. 
Over two podcasts we look carefully at the how the cost-benefit calculation stacks up for each of the major interventions. In Part 1 we discuss the international borders closures and overcooked parochialism between state jurisdictions, and also how messaging around vaccine risks and mandates could be improved. In Part 2 we look at the controversial stay-at-home orders and interruptions to in-person schooling and even the evidence for faces-masks. Ultimately, there are some questions that can’t be answered scientifically, and it is for politicians and the public to decide what the cost of freedom and dignity against human lives left exposed.

Part 1 Chapters
6:46 Border Closures
35:04 Vaccine Hesitancy

Guests
Professor Paul Kelly FRACP (Centenary Institute; Australia’s Chief Medical Officer during the pandemic)
Professor Catherine Bennett PhD GAICD (Deakin University; lead author of the “COVID-19 Response Inquiry” )
Professor James McCaw PhD (The University of Melbourne; modeler for the Federal government’s “National Plan”) Lorraine Finlay PhD (Australian Human Rights Commissioner; lead author of the "Collateral Damage" report)

Production 
Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘End of the Ocean’ and ‘Raised by Wolves' by Tellsonic, ‘RGBA’ by Chill Cole, ‘Organic Textures 1’ by Johannes Bornlöf and ‘Echo (Kerstin Ljungstrom Remix)’ by Bonsaye. Image by mrs licenced from GettyImages.
Add Part 1 to MyCPD as educational activity or visit web page for a transcript and references.

A 62‐year-old man is undergoing a CT‐guided core biopsy of a lung nodule when he develops an iatrogenic pneumothorax. After admission to the Royal Adelaide hospital he has ongoing dyspnoea, oxygen desaturation, and chest pain not helped by a preexisting Chronic Obstructive Pulmonary Disease. The treatment for the patient’s symptoms doesn’t immediately go to plan but his care team apply a combination of recent technologies to bring the condition under control. Pomegranate [Case Reports] have been developed to help Trainees rehearse diagnostic problem solving and case presentation.
Guests
Associate Professor Arash Badiei FRACP (Royal Adelaide Hospital; Adelaide University)

Hosts
Associate Professor Stephen Bacchi FRACP (Northern Adelaide Local Health Network; Adelaide University)
Dr Brandon Stretton (Central Adelaide Local Health Network;)

Production
Produced by Dr Stephen Bacchi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Desert Whispers’ by Tellsonic and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan and med students Srishti Sharma, Prakriti Sharma and Cindy Shi. 
Key Reference (Spoiler Alert)
*
 *
 *
 *
 *
Persistent air leak successfully treated with endobronchial valves and digital drainage system [Altree, Respirol Case Rep. 2018]

Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify, Castbox or any podcasting app.

Médecins Sans Frontières has projects in more than 70 countries that might be affected by natural disasters, armed conflict or disease outbreaks. Its clinics see over two million emergency room admissions a year and another 16 million outpatient consults. Emergency Paediatrics consultant Josephine Goodyer and ID consultant Tasnim Hasan are two of more than a hundred Australians and New Zealanders who contributed to MSF’s missions last year. Between them they have covered practice settings as varied as Kiribati, South Sudan and Gaza. In this interview they describe the experience shipping out with MSF on their first assignment and then the kinds of responsibilities one is given with more experience. We’ll also hear how gaps of six months or more affect career progression and financial stability back home.
Chapters
3:05 Starting out with MSF
15:04 Practicing in a conflict zone
50:53 Career impacts
Guests
Dr Josephine Goodyer FRACP (Canberra Hospital; Australian National University)
Dr Tasnim Hasan FRACP (Western Sydney LHD; University of Sydney)
Dr Aidan Tan (Sydney Children’s Hospital Network)
 

Production
Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Intimacy’ by Alex Kehm, ‘At the end of nothing’ by Silver Maple, ‘Below the Horizon’ by Dawn, Dawn, Dawn and ‘Nagba Algooah’ by Ebo Krdum. Image by Pablo Tosco ©2018 used with permission by MSF. Editorial feedback kindly provided by members of the podcast editorial group Dr Aidan Tan, Dr Stephen Bacchi, Dr Rahul Barmanray, Dr Maansi Arora and Dr Leon Li. 
Add educational activity to MyCPD or visit web page for a transcript and references.

A 75 year-old man with severe aortic stenosis is deemed unsuitable for surgery on the basis of a porcelain aorta detected with cross-sectional imaging. The patient had, a decade earlier, been diagnosed with hypertrophic cardiomyopathy after presenting with cardiac arrhythmia. A dual chamber ICD was implanted at the time for secondary prevention and other comorbidities were managed. 
The patient is now being considered for staged alcohol septal ablation (for the HCM) and transcatheter aortic valve replacement (for the aortic stenosis), however, additional complications force an experimental two-in-one procedure.
Guest
Professor Ross Roberts-Thomson FRACP (Central Adelaide Local Health Network; University of Adelaide)

Hosts
Associate Professor Stephen Bacchi FRACP (Northern Adelaide Local Health Network; University of Adelaide)
Dr Alistair Leslie (Central Adelaide Local Health Network;)

Key Reference (Spoiler Alert)
*
 *
 *
 *
 *
Two-in-one: Combined transcatheter therapy for hypertrophic cardiomyopathy and aortic stenosis [IHJ Cardiovascular Case Reports (CVCR). 2020]
 
 
Production
Produced by Stephen Bacchi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Desert Whispers’ by Tellsonic and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP.

Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPDto record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.