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It has been yet another eventful month, with snap COVID-19 lockdowns in Victoria, New Zealand and Western Australia, as well as bushfires and floods in that state.

As has been the case throughout the pandemic, we continue to look for signs of optimism amid the ongoing uncertainty. It was welcome, therefore, to see that as of late February, the rollout of the first vaccinations against COVID-19 had started in Australia and New Zealand, with some of our colleagues among the early recipients.

We expect many more of us will follow in the weeks ahead, as the mammoth logistical effort of trying to achieve the highest possible vaccine coverage across our two countries progresses.

Though the rollout is enormously welcome, it is not the end of the struggle. Vaccinating 25 million people in Australia and 5 million in New Zealand—twice—including rural and remote communities is no small feat.

With those vaccines approved and deemed safe by our regulators now to be rolled out, and others expected to come online during the year, we will continue to support these largescale efforts. The vaccine is of course our only chance to reduce the critical impact of this virus. Speculation over differential efficacy of one vaccine over another is just that at this stage, speculation. More longitudinal data is needed and there are no head-to-head trials of different vaccines. What we do know is that those vaccines which have been approved have been shown to reduce serious illness and death, and therefore, we hope, impact on our health systems and societies.

This is an important outcome as, with the virus endemic in the world, elimination is unfortunately not possible.

The overriding hope is that as a layer of vaccination defense against COVID-19 is formed, we can take another step towards COVID-normal, the eventual opening of our international borders, and a safer and more stable world generally. Time will tell us if this can be achieved.

Of course, this also requires a focus beyond our immediate borders. Much international attention has been on the dire situations that have unfolded in the United States of America, the United Kingdom, Europe and other parts of the world where COVID-19 has run rampant, and where vaccination programs are already well advanced.  As I write this blog the global curves are showing signs of slowing ever so slightly in their relentless rise, and in my recent discussions with RCEM in the UK, there is a feeling that they have entered a “deceleration phase”. So there is hope.

The reality is, however, that the global nature of the COVID-19 threat means that for the world to recover any semblance of certainty, vaccination coverage must reach as much of the planet’s population as possible.

This of course includes some of our nearest neighbours in the Pacific and Melanesian region who, although thankfully have been spared some of the ravages of COVID-19, still remain vulnerable to major outbreaks.

We acknowledge undertakings from our governments to assist our neighbours with various vaccination efforts, and stress the importance of ensuring such programs, along with relevant communications, advance as soon as possible.

While there is much focus on vaccination, many of the common issues we face as emergency clinicians have persisted. These include problems with ambulance ramping, access block, ED crowding, dangerously long waits for mental health patients, and the longer term issue of maldistribution of the medical workforce in rural and regional areas in almost every jurisdiction.

With the ongoing pandemic response continuing to provide additional complexity and uncertainty, the College has consistently pressed the importance of addressing these issues on governments and health system leaders. While we have started 2021 with some strong advocacy on these fronts, there is still much work to do.

Just as we did throughout 2020, the College also continues to work hard on its important business; supporting members and trainees, and providing as much certainty as possible in relation to College education, training and examinations, as well as College events.

We will continue to provide regular updates as the latest developments and other information come to light. Whilst the pandemic tornado is showing signs of easing, persistent strong headwinds are still contributing to rapidly shifting goalposts.

Given the enormously trying times our members and trainees have experienced, another important focus is the wellbeing of our emergency medicine workforce. Fatigue and burnout are real and present risks with our work. We must all remain mindful of this and look out for each other. Remember the importance of compassion; for our patients, our colleagues, and ourselves.

Please remember that the College has a partnership with an assistance program provider, offering services to support members and trainee wellbeing. The College has also created the ACEM Wellbeing Network, where you can access information, resources and initiatives that support you as an emergency medicine practitioner. I also encourage you to have a listen to the workforce wellbeing audio series that was developed and launched last year.

Please also take heart from the many wonderful initiatives, achievements and activities our members and trainees have been involved in – from the impressive stories of recent diversity award winners to achievements in research, including securing NHMRC grants, to acknowledgements in annual honours lists. There is much to celebrate and be proud of.

We continue our advocacy on workforce, access block, time-based targets and mental health with politicians, health managers and others we partner with as we try to improve the care for our patients, in our EDs, run by our people.

As we move towards a hopefully more stable time, thank you, as always, for your tireless work.

Nga Mihi,

Dr John Bonning
ACEM President

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