High risk/cohort 7 - GP doesn't seem too interested

Strumms

brendanwalsh wrote: »

Donnelly the absolute parasite getting a jab while thousands of those more vulnerable are still waiting to get one. No problem with him getting it, but he has skipped the queue because those more vulnerable are still waiting

He’s the minister for health during a deadly pandemic... he’s an essential worker if there was ever one :rolleyes:

Bubbaclaus

brendanwalsh wrote: »

Donnelly the absolute parasite getting a jab while thousands of those more vulnerable are still waiting to get one. No problem with him getting it, but he has skipped the queue because those more vulnerable are still waiting

He hasn't skipped any queue, he got it in his age category.

Unrealistic

Bubbaclaus wrote: »

He hasn't skipped any queue, he got it in his age category.

He hasn't skipped the queue in the format that the HSE is currently managing it but he most certainly has skipped the queue as defined by the risk categories published by his own department. That a healthy 45 year old is getting vaccinated ahead of people his own department has defined as "at high risk of severe disease and death" is seriously messed up and he should be taking ownership of that.

is_that_so

Unrealistic wrote: »

He hasn't skipped the queue in the format that the HSE is currently managing it but he most certainly has skipped the queue as defined by the risk categories published by his own department. That a healthy 45 year old is getting vaccinated ahead of people his own department has defined as "at high risk of severe disease and death" is seriously messed up and he should be taking ownership of that.

Again it's an entirely separate process for those groups except for any of them who have signed up via the portal. That it seems to be a process now stuck in limbo is not of his making.

Unrealistic

namloc1980 wrote: »

This is silly. His age cohort is now getting it so why shouldn't he? Should we put the entire programme on hold until every vulnerable person gets it first?

I don't think anyone is saying the entire programme should be put on hold.

Personally I think the following would be reasonable to expect:

1) An acknowledgment that the HSE took a decision in April, or even earlier, that they were going to prioritise the healthy general public over the group it had designated as 'high risk' and an explanation of the scientific basis for doing so, if one exists.

2) A commitment that GPs who are participating in the vaccination of Cohort 7 will be prioritised in the distribution of vaccines. (If my GP is ready to vaccinate 90 high risk patients on a Tuesday why isn't his practice getting the 90 doses to do so but the MVC 3km away is being given enough doses to inject thousands of the general public on the same day?)

3) The immediate launch of a pathway for high risk patients whose GPs are not participating in the Cohort 7 vaccinations to get referrals to MVCs. (This pathway can be as lo-tech as is deemed necessary under the current circumstances but the current HSE position that it is being deferred completely until the HSE's IT systems are fully restored is not acceptable.)

iamwhoiam

is_that_so wrote: »

Again it's an entirely separate process for those groups except for any of them who have signed up via the portal. That it seems to be a process now stuck in limbo is not of his making.

It may not be of his making but it is for him to fix.I have no issue with him getting a vaccine but I do have issues with his complete silence on the mess made of the at risk cohorts rollout

is_that_so

iamwhoiam wrote: »

It may not be of his making but it is for him to fix.I have no issue with him getting a vaccine but I do have issues with his complete silence on the mess made of the at risk cohorts rollout

No, the HSE will ultimately fix it. They are managing the programme and they have never commented on any aspects of how they do that. A MoH throwing shapes has never fixed anything in the health system.

Unrealistic

is_that_so wrote: »

Again it's an entirely separate process for those groups except for any of them who have signed up via the portal. That it seems to be a process now stuck in limbo is not of his making.

The decision back in April or earlier to start on the general public before starting on Cohort 7 was of his making.

The decision to continue to this day to prioritise MVC's serving the general public over GPs serving Cohort 7 when distributing vaccinations is of his making.

The failure to recognise that the shabby way GPs were treated by the HSE during the vaccination of earlier cohorts was going to reduce uptake by GPs when it came to vaccinating later cohorts, and to make alternative arrangements, is of his making.

The failure to have a robust system in place to refer Cohort 7 patients to MVCs, when this was necessary anyway for those who would be referred by specialists/consultants rather than GPs, is of his making.

The decision to halt all attempts to vaccinate Cohort 7 patients not being served by GPs until the HSE IT systems are fully up and running is of his making.

Turtwig

Unrealistic wrote: »

He hasn't skipped the queue in the format that the HSE is currently managing it but he most certainly has skipped the queue as defined by the risk categories published by his own department. That a healthy 45 year old is getting vaccinated ahead of people his own department has defined as "at high risk of severe disease and death" is seriously messed up and he should be taking ownership of that.

I really don't understand your issue. It feels from reading your posts that you expect the vaccines to be administered in perfect medical vulnerability order and date of birth uniformly throughout the country. Speed is far more important here than anything else. Cohort 7 is based on international consensus. Actually determining if some patients qualify for cohort 7 is almighty pain. See for example the confusion asthma has caused in so many countries.

There was always going to come a point where the general population age cohorts would overlap even overtake the medically vulnerable or risk cohorts.

iamwhoiam

is_that_so wrote: »

No, the HSE will ultimately fix it. They are managing the programme and they have never commented on any aspects of how they do that. A MoH throwing shapes has never fixed anything in the health system.

He is the elected Minister for Health and ultimately responsible for all decisions made

is_that_so

Unrealistic wrote: »

The decision back in April or earlier to start on the general public before starting on Cohort 7 was of his making.

The decision to continue to this day to prioritise MVC's serving the general public over GPs serving Cohort 7 when distributing vaccinations is of his making.

The failure to recognise that the shabby way GPs were treated by the HSE during the vaccination of earlier cohorts was going to reduce uptake by GPs when it came to vaccinating later cohorts, and to make alternative arrangements, is of his making.

The failure to have a robust system in place to refer Cohort 7 patients to MVCs, when this was necessary anyway for those who would be referred by specialists/consultants rather than GPs, is of his making.

The decision to halt all attempts to vaccinate Cohort 7 patients not being served by GPs until the HSE IT systems are fully up and running is of his making.

Not really, although your line seems to be to blame Donnelly for everything. GPs were believed to be doing Group 7 and you are ignoring the overarching aim of programme is to get as many people vaccinated as possible. I agree it was a mess but for a variety of reasons. Some GPs opted out after Group 4, some got fed up with the supply issue and opted out and the HSE continued to assume that the groups were being addressed in a separate process.

Is the issue here some sudden new level of risk to this group or the perceived unfairness that other people are getting jabbed first?

Unrealistic

is_that_so wrote: »

No, the HSE will ultimately fix it. They are managing the programme and they have never commented on any aspects of how they do that. A MoH throwing shapes has never fixed anything in the health system.

So I take it you have never watched any of the regular 1 hour plus NPHET press briefings, that include HSE officials, where they comment in detail on the vaccine rollout and answer questions from journalists?

is_that_so

iamwhoiam wrote: »

He is the elected Minister for Health and ultimately responsible for all decisions made

In his department yes but not in the HSE, that's Paul Reid.

is_that_so

Unrealistic wrote: »

So I take it you have never watched any of the regular 1 hour plus NPHET press briefings, that include HSE officials, where they comment in detail on the vaccine rollout and answer questions from journalists?

Not entirely sure what the point of the question is.

Dempo1

is_that_so wrote: »

In his department yes but not in the HSE, that's Paul Reid.

I'm afraid any decision made by Paul Reid (and that's rare with such an expert on Deflection) is ultimately approved by the Secretary General of the Department of Health, who in turn reports directly to the Minister.

is_that_so

Dempo1 wrote: »

I'm afraid any decision made by Paul Reid (and that's rare with such an expert on Deflection) is ultimately approved by the Secretary General of the Department of Health, who in turn reports directly to the Minister.

And I'll ask you for some form of a link to prove said link because this looks very made up. I am aware of the organisational structure but nothing like this claim.

https://www.hse.ie/eng/about/who/

iamwhoiam

is_that_so wrote: »

In his department yes but not in the HSE, that's Paul Reid.

Of course the elected Minister for Health has the ultimate say in decisions and he is well able to announce those decisions when it suits his agenda .But funnily enough he is gone quiet now on the shambles of the high risk groups being abandoned to their own devices .

https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/



https://www.independent.ie/world-news/coronavirus/gps-get-power-to-use-spare-vaccines-on-younger-cohorts-40489901.html


https://www.irishexaminer.com/news/arid-40285097.html

Unrealistic

Turtwig wrote: »

I really don't understand your issue. It feels from reading your posts that you expect the vaccines to be administered in perfect medical vulnerability order and date of birth uniformly throughout the country. Speed is far more important here than anything else.

I'm not expecting a perfect outcome at all; just reasonable consistency and honesty. If speed is far more important than anything else then why didn't we just start on an age basis or first come first serve basis from day 1?

Turtwig wrote: »

Cohort 7 is based on international consensus. Actually determining if some patients qualify for cohort 7 is almighty pain. See for example the confusion asthma has caused in so many countries.

So is it justifiable to then take a decision to not even try to prioritise Cohort 7? If it is justifiable why not say so instead of pretending they are still being prioritised but actually pushing the younger members of this cohort to the back of the queue?

Turtwig wrote: »

There was always going to come a point where the general population age cohorts would overlap even overtake the medically vulnerable or risk cohorts.

In Ireland's case this has been done by design, it hasn't just happened. The decision to move to the general population in April when Cohort 7 hadn't been started makes that clear.

Dempo1

is_that_so wrote: »

And I'll ask you for some form of a link to prove said link because this looks very made up. I am aware of the organisational structure but nothing like this claim.

https://www.hse.ie/eng/about/who/

If you look closely at the organisational chart you see quite clearly the HSE is an organisation within the HSE, much like the CMO"s office. All report to the Secretary General of the Department of Health, I'm not sure what part of this your not understanding. Anyway not going to get bogged down with samantics, particularly on such a beautiful morning

Incidently I offered no link, you did

Turtwig

Cohort 7 is a medical risk group. They are not however a group you can easily identify. No matter how much people piss and moan about it. This is a problem that hasn't been unique to Ireland. To complicate this further some gps have been off the ball since this pandemic began. Others have gone above and beyond. The vaccines are a mix of gp capability and hse supply. It's never going to be perfect and I do not feel neither cohort 4 or 7 were let I down. Some patients in all cohorts may have been let down. But in general I think the cohort 7 squealing is a mountain out of a molehill. Some are no doubt legitimate. I sympathise a lot with them. Same for the over 60s still caught in the queue. I can't see this yet as part of a broader issue though within the rollout. Or that cohort 7 is. forgotten.
There is only sporadic anecdotes.

iamwhoiam

https://merrionstreet.ie/en/news-room/releases/minister_simon_harris_announces_government_approval_to_publish_the_health_service_executive_governance_bill_2018.html


Ends

Notes to the Editor
The Bill provides for a 9 person non-executive Board including the Chairperson and the Deputy Chairperson. The Board will have authority to perform the HSE's functions and will be accountable to the Minister for the performances of its functions

iamwhoiam

Turtwig wrote: »

Cohort 7 is a medical risk group. They are not however a group you can easily identify. No matter how much people piss and moan about it. This is a problem that hasn't been unique to Ireland. To complicate this further some gps have been off the ball since this pandemic began. Others have gone above and beyond. The vaccines are a mix of gp capability and hse supply. It's never going to be perfect and I do not feel neither cohort 4 or 7 were let I down. Some patients in all cohorts may have been let down. But in general I think the cohort 7 squealing is a mountain out of a molehill. Some are no doubt legitimate. I sympathise a lot with them. Same for the over 60s still caught in the queue. I can't see this yet as part of a broader issue though within the rollout. Or that cohort 7 is. forgotten.
There is only sporadic anecdotes.

We have absolutely no idea how many of cohort 4 or 7 are vaccinated so we cannot say its a mountain out of a molehill unless we know how many are done .They are now registering online in their age groups so we wont know the real figures of who quite simply gave up being prioritised as promised and registered in their age group

iamwhoiam

Turtwig wrote: »

Cohort 7 is a medical risk group. They are not however a group you can easily identify. No matter how much people piss and moan about it. This is a problem that hasn't been unique to Ireland. To complicate this further some gps have been off the ball since this pandemic began. Others have gone above and beyond. The vaccines are a mix of gp capability and hse supply. It's never going to be perfect and I do not feel neither cohort 4 or 7 were let I down. Some patients in all cohorts may have been let down. But in general I think the cohort 7 squealing is a mountain out of a molehill. Some are no doubt legitimate. I sympathise a lot with them. Same for the over 60s still caught in the queue. I can't see this yet as part of a broader issue though within the rollout. Or that cohort 7 is. forgotten.
There is only sporadic anecdotes.

Both these sentences show a lack of empathy with chronically ill people who deserve better .And here is a list of those you accuse of pissing and moaning





People aged 16 to 64 at high risk
List of conditions
Cancer
Haematological - within 1 year.

Haematological - within 1 - 5 years.

Non-haematological - within 1 year.

All other cancers on non-hormonal treatment.

Chronic heart (and vascular) disease
Chronic heart disease, for example: heart failure, hypertensive cardiac disease.

Chronic kidney disease
Chronic kidney disease with eGFR <30ml/min.

Chronic liver disease
Chronic liver disease, for example: cirrhosis or fibrosis.

Chronic neurological disease or condition
Chronic neurological disease or condition significantly compromising respiratory function and/or the ability to clear secretions, for example: Parkinson's disease, cerebral palsy.

Chronic respiratory disease
Other chronic respiratory disease, for example: stable cystic fibrosis, severe asthma (continuous or repeated use of systemic corticosteroids), moderate COPD.

Diabetes
All other diabetes (Type 1 and 2).

Immunocompromised
Immunocompromise due to disease or treatment, for example: high dose systemic steroids (as defined in Immunisation Guidelines for Ireland Chapter 3), persons living with HIV.

Inherited metabolic diseases*
Disorders of intermediary metabolism not fulfilling criteria for very high risk.

Intellectual disability*
Intellectual disability*** excluding Down Syndrome.

Obesity
BMI >35 Kg/m2.

Severe mental illness*
Severe mental illness, for example: schizophrenia, bipolar disorder, severe depression.

*additional or updated medical conditions

** APECED - autoimmune polyendocrinopathy candidiasis ecto- dermal dystrophy

*** WHO definition of intellectual disability as “impairments in adaptive, social, and intellectual functioning (IQ<70), requiring daily support, with onset in the developmental phase (<18 years)

Turtwig

iamwhoiam wrote: »

Both these sentences show a lack of empathy with chronically ill people who deserve better .And here is a list of those you accuse of pissing and moaning





People aged 16 to 64 at high risk
List of conditions
<>

I haven't accused anyone of with medical need of pissing and moaning. I'm well aware of the criteria list for who belongs in what cohort. What I do not think you are aware of is just how bloody complicated the cohort delineation is. It's a bit like assuming there exists an average size of human hands. When in the real world no such pair of hands exists.

I do not think it's as clear cut as if you're in cohort 7 you should be vaccinated before someone in general pop who's 40 or 50. That's a a matter for different discussion though. I feel your posts are overly judgemental on people who disagree with you. Perhaps instead of assuming we don't care about others situations. We do. You could try understand where we're coming from. Rather than copy and pasting a list which could just as easily be the terms and conditions of the apple store.

I've seen nothing to suggest a large scale systemic issue with cohort 7 vaccination. Aside from the usual issues that occurred in all the other cohorts on the way down. In fact, I've seen less with the cohorts as we go down. The program has gotten better. And we're now getting to the point with whether you get the vaccine from age or medical cohort is thankfully becoming a moot point. Identifying the exact specification of who is cohort 7 would slow things down.

Rather what I want now is cohort 4 and 7 equivalents of under 16s identified. So they can be prioritised. This is what I feel is the most efficient use of resources now for vaccine priorisations. That, gps and mvcs continue as they were. Even this prioritisation has a limited return. Unless we were to run into major supply issues.

iamwhoiam

Turtwig wrote: »

I haven't accused anyone of with medical need of pissing and moaning. I'm well aware of the criteria list for who belongs in what cohort

You said people on cohort 7 pissing and moaning and squealing.
If you are in cohort 7 you have medical needs ?

We can agree to differ but I think the group 7 were let down badly by their GPs who had a duty of care to the most vulnerable of their patients .It’s something I feel quite passionate about as it was a matter of a few extra weeks of hard work and they chose not to do it . Frontline staff have battled on for over a year and never threw in the towel because they were stressed or overwhelmed

Turtwig

iamwhoiam wrote: »

You said people on cohort 7 pissing and moaning and squealing If you are in cohort 7 you have medical needs ?

What I mean was just because someone shouts that's they're cohort 7. It doesn't mean they technically are. Taking them on good faith is the best approach imo. But then there is the night mare that gets others up in a tizzy when they feel others are vaccinated ahead of them. Despite the fact they have no way of actually knowing another person's medical history.

That's what I mean by the pissing and moaning it's juvenile. For example, I've seen people who are legit cohort 4 piss and moan because someone who is also legit cohort 4 (but neither individual understands why) piss and moan that someone else got the vaccine before them. That's just one example. They are plenty and they do not reflect well on certain aspects of our society.

Turtwig

iamwhoiam wrote: »

You said people on cohort 7 pissing and moaning and squealing.
If you are in cohort 7 you have medical needs ?

We can agree to differ but I think the group 7 were let down badly by their GPs who had a duty of care to the most vulnerable of their patients .It’s something I feel quite passionate about as it was a matter of a few extra weeks of hard work and they chose not to do it . Frontline staff have battled on for over a year and never threw in the towel because they were stressed or overwhelmed

Many gps completely overestimated their capacity for handling the vaccination as well their usual clinic stuff. Some displayed incompetence. Others did their level best. It's a lottery for the patient. That's the worst part. As it was for what services their GP offered during covid. This wasn't a cohort 7 problem. It was a cohorts all the way down problem. Well intentioned as they were they created an unfortunate bottleneck. That coupled with some HSE supply mix ups and you have the effects of a traffic jam that will take some areas time to clear.

iamwhoiam

Turtwig wrote: »

Many gps completely overestimated their capacity for handling the vaccination as well their usual clinic stuff. Some displayed incompetence. Others did their level best. It's a lottery for the patient. That's the worst part. As it was for what services their GP offered during covid. This wasn't a cohort 7 problem. It was a cohorts all the way down problem. Well intentioned as they were they created an unfortunate bottleneck. That coupled with some HSE supply mix ups and you have the effects of a traffic jam that will take some areas time to clear.

I agree , some GPs stepped up admirably . Others were overwhelmed and threw in the towel , others shamefully vaccinated young friends before the vulnerable ( that was evident by posts on the vaccination thread.

I admire any GP who tried his or her best and managed to keep going and get organised . It can be done with effort and time and some did exactly that . Our GP had a gazebo in the garden with chairs set out for his over 70s and was efficient and considerate and kudo to him and others who did
But we cannot deny that some did not but in the effort and allowed their vulnerable patients fend for themselves .

ironictoaster

Just got an automated text telling me to attend Helix on Saturday. Clearly GPs can still refer patients to MVCs

fun loving criminal

Just read this. It has absolutely nothing to do with those waiting in group 7. But HSE working on a new vaccination plan because of the Indian variant. To do with giving the second astra zeneca earlier than planned to give a greater protection against the Indian variant.

Great that they recognise the seriousness of the Indian variant and doing something. But absolutely no mention of those in group 7. So we will continue to sit in limbo.

https://m.independent.ie/irish-news/health/delta-variant-driving-hse-to-overhaul-its-covid-vaccine-plan-as-health-officials-meettoday-aboutlimerick-outbreak-40500898.html