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Special Episode 9. New Vaccines with Professor Dale Godfrey

The Peter Doherty Institute was the first Australian laboratory to establish a Covid 19 PCR test and diagnose the first SARS- Cov 2 infection on Australian shores, its research scientist is heavily involved in developing novel diagnostic tools applied across many areas of medical science and the institute plays a key leadership role in advising state and federal government on best medical practice. It’s no great surprise therefore that we have learned of their ground-breaking development of a new subunit Covid 19 vaccine utilising the receptor binding domain at the tip of the virus’s spike proteins. This is the region responsible for virus attachment and infection and for eliciting over 90% of neutralising antibodies following SARS Cov-2 infection. Parallel with the subunit vaccine development, another Melbourne group – the Monash Institute of Pharmaceutical Sciences has developed a similar vaccine but using mRNA technology copying the virus’s genetic sequence that codes for the receptor binding domain.

The Peter Doherty Institute was the first Australian laboratory to establish a Covid 19 PCR test and diagnose the first SARS- Cov 2 infection on Australian shores, its research scientist is heavily involved in developing novel diagnostic tools applied across many areas of medical science and the institute plays a key leadership role in advising state and federal government on best medical practice. It’s no great surprise therefore that we have learned of their ground-breaking development of a new subunit Covid 19 vaccine utilising the receptor binding domain at the tip of the virus’s spike proteins. This is the region responsible for virus attachment and infection and for eliciting over 90% of neutralising antibodies following SARS Cov-2 infection. Parallel with the subunit vaccine development, another Melbourne group – the Monash Institute of Pharmaceutical Sciences has developed a similar vaccine but using mRNA technology copying the virus’s genetic sequence that codes for the receptor binding domain.

These vaccines enter the pantheon of other existing mRNA/viral vector/and subunit protein vaccines already available offering protection against Covid 19 but are different as they focus the immune response to the tip of the spike protein – the important receptor binding domain.

Both new Melbourne developed vaccines are entering phase 1 trials and results will be eagerly awaited.

Professor Dale Godfrey is a senior principal research fellow and immunology theme leader at the Doherty Institute and has played a major role in RBD subunit protein vaccine development.

Please join this conversation where Dale discusses the new vaccine development, their efficacy, and the phase 1 clinical trials evaluating the vaccines further.

References:

Professor Dale Godfrey: godfrey@unimelb.edu.au

doherty.edu.au

Phone: 83449325 for further trial information or at virgo-studies@unimelb.edu.au


To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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Special Episode 8. Myocarditis and Pericarditis in COVID19 patients with Dr James Sapontis

Covid vaccine induced Pericarditis-Myocarditis

Since the release of mRNA vaccines medical practitioners around the world have been receiving calls from patients complaining of chest discomfort typical of pericarditis some of these patients have also had associated ECG changes and cardiac enzyme elevation consistent with myocarditis. This phenomenon does not appear to be related to the non mRNA vaccines available.

Covid vaccine induced Pericarditis-Myocarditis

Since the release of mRNA vaccines medical practitioners around the world have been receiving calls from patients complaining of chest discomfort typical of pericarditis some of these patients have also had associated ECG changes and cardiac enzyme elevation consistent with myocarditis. This phenomenon does not appear to be related to the non mRNA vaccines available. 

As of the 14th of November Australian data shows there have been 329 reports of likely myocarditis from 23.4 million delivered mRNA vaccine doses, a further 592 suspected but not confirmed cases and 1370 episodes of pericarditis. Based on this the TGA reported data for Australia estimates the rate of myocarditis or pericarditis after the first dose for men across all ages to be 2.1 per 100,000 and for women after the first dose to be 0.9 per 100,000. Rates following the second dose are higher with estimates of 2.7 per 100 000 for men and 1.1 per 100 000 for women. By comparison rates associated with the Covid 19 virus are estimated at the much higher rate of 11 per 100 000.

It should be noted that background normal rates of pericarditis for males aged 18-34 is 37 per 100,000 and for females aged 18-34 years the rate is 16 per 100,000.

TGA statistics also show higher suspected rates of myocarditis and pericarditis for boys aged 12-17 especially after their second dose of Pfizer estimated at 8.5 cases per 100,000 which is more than 3 times the overall rate amongst all males (2.7 per 100,000).

Reliable data for the Moderna mRNA vaccine are not yet available in Australia however overseas data suggests higher rates of myocarditis and pericarditis for male recipient's under the age of 30 years compared with the Pfizer vaccine.

It was a real privilege to have this conversation with Dr James's Sapontis director of cardiology at St John of God Hospital Berwick who has been fielding calls from primary practitioners seeing such patients and attending emergency admissions.

References:
Dr James's Sapontis : www.jamessapontis.com

www.health.gov.au :Covid 19 vaccination-Guidance on myocarditis and pericarditis

www.cdc.gov :Myocarditis and pericarditisafter mRNA Covid 19 vaccination

www1.racgp.org.au :TGA updates post-COVID vaccine myocarditis ratesTo be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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Special Episode 6. Mental Health in a time of Covid (and the polyvagal ladder) with Brenda Sutherland

Mental health has become a major casualty of the Covid pandemic that has swept across the globe and been responsible for rolling lockdowns throughout Australia restricting personal freedoms, social contact and the ability to prosper financially. No one is exempt from this unprecedented event and the anxiety, depression and anguish wrought is having a major effect on the health and wellbeing of our communities.

Mental health has become a major casualty of the Covid pandemic that has swept across the globe and been responsible for rolling lockdowns throughout Australia restricting personal freedoms, social contact and the ability to prosper financially. No one is exempt from this unprecedented event and the anxiety, depression and anguish wrought is having a major effect on the health and wellbeing of our communities.

To discuss the indicators that a patient or friend may be experiencing evolving or established mental health difficulties and learning methods for shifting patients holistically out of collapse we have a conversation with psychologist Brenda Sutherland founder and director of The Awakening Group. Brenda teaches us about the polyvagal ladder and how to use an understanding of this insight to instructively and empathically assist our most vulnerable patients.

Brenda's extensive knowledge of the human mental state in distress and happiness and her work with Bessel van de Kolk, Stan Tatkin and Byron Katie have placed her in an outstanding position to guide us on this subject.

Please enjoy the conversation.

References:

The Awakening Group.com.au

https://awakening.com.au/lms/2021/08/24/ventral-vibes-project/

Mental health services in Australia, COVID-19 impact on mental health

Weekend Australian - Aug 28-29 pages 1&6

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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Special Episode 4. Covid-19: My Indian Experience with Dr Shashikanth Manikappa

In this episode, we share an intimate conversation with Dr Shashi Manikappa who has spent the past 18 months in India’s heartland volunteering medical care to those affected by the Covid pandemic. Whilst over 400 million Indians have received at least one dose of vaccine to date, on the ground in India treatment protocols embracing the use of Ivermectin in combination with other drugs have gained significant popularity and anecdotal support as an effective treatment. Shashi discusses the value of these protocols as used in India and the medical experience and perspective gathered during his time there. It is acknowledged that the protocols discussed in this episode have not been endorsed for use in Australia.

In this episode, we share an intimate conversation with Dr Shashi Manikappa who has spent the past 18 months in India’s heartland volunteering medical care to those affected by the Covid pandemic. Whilst over 400 million Indians have received at least one dose of vaccine to date, on the ground in India treatment protocols embracing the use of Ivermectin in combination with other drugs have gained significant popularity and anecdotal support as an effective treatment. Shashi discusses the value of these protocols as used in India and the medical experience and perspective gathered during his time there. It is acknowledged that the protocols discussed in this episode have not been endorsed for use in Australia.

Dr Shashikanth Manikappa, MBBS,MD, DNB, FANZCA, FCA, PG Dip Echo

Specialist Anaesthetist I Cardiac Anaesthesia and Perioperative Medicine, Melbourne Australia

Adj. Professor, ESIC Medical College & Hospital, Hyderabad, India

Adj. Professor, Raja Rajeswari Medical College & Hospital, Bangalore, India

Honorary Clinical Senior Lecturer, The University of Melbourne, Melbourne, Australia

Adjunct Senior Lecturer, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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Special Episode 3. COVID-19 Vaccines with Professor Tony Cunningham

As the Covid pandemic continues to spread around the world with over 187 million recorded infections and 4 million deaths, countries including Australia have embarked upon vaccination programs including the use of mRNA (Pfizer and Moderna), viral vector (Astra Zeneca), and subunit protein vaccines (Novovax).

As the Covid pandemic continues to spread around the world with over 187 million recorded infections and 4 million deaths, countries including Australia have embarked upon vaccination programs including the use of mRNA (Pfizer and Moderna), viral vector (Astra Zeneca), and subunit protein vaccines (Novovax).

In Australia currently, less than 10% of our population have been fully vaccinated leaving our population exposed and subject to repeat widespread population lockdowns and contact tracing via local health departments.

Hesitancy to receive vaccination in part relates to perceived side-effects from vaccines as much as from difficulties relating to supply delivery.

In this episode, we are joined by Professor Tony Cunningham, Infectious disease physician and co-director of the Centre for virus research at WIMR who generously discusses vaccine side-effects including vaccine-induced thrombosis with thrombocytopenia syndrome (VITT), myocarditis and pericarditis as well as anaphylaxis. In this conversation, we delve into some very interesting aspects of vaccination and speculate on how the future may look for us all.

Please welcome Professor Tony Cunningham.

References include :

Australian Government Department of Health - joint statement from ATAGI and THANZ on thrombosis with thrombocytopenia syndrome and the use of COVID-19 vaccine Astrazeneca (23rd May 21 ) The ATAGI statement on revised recommendations on the use of COVID-19 vaccine Astrazeneca (17 June 2021) Professor Tony Cunningham, www.westmead institute .org.au

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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Special Episode 1. COVID-19 Vaccinations with Professor Gabriel Barbash

Australia is in the dawn of its vaccination program against SARS-COV2, inoculations commenced this week among frontline health workers and aged care residents as well as our Prime Minister. By comparison, Israel’s vaccination rollout has been the fastest in the world, half the population has received one dose already and one third has received both inoculations.

Australia is in the dawn of its vaccination program against SARS-COV2, inoculations commenced this week among frontline health workers and aged care residents as well as our Prime Minister. By comparison, Israel’s vaccination rollout has been the fastest in the world, half the population has received one dose already and one third has received both inoculations.

In a sense, Israel has become a real-time global experiment watched by health authorities and governments across the locked down world as Israel opens itself up again to those vaccinated. Australia has much to learn from their experience. In this special episode we are joined by Professor Gabriel Barbash from Israel, Professor of Epidemiology and Preventive Medicine in the Sackler School of Medicine, Tel Aviv University and at the forefront of Israel’s inoculation program who discusses :

•Vaccine choices

•Vaccine safety and efficacy

•Mutant strains - their impact

•Special cases to consider - the immunosuppressed patient, those with previous allergies, Guillain Barre, •Pregnant and breastfeeding women

•Herd immunity

•Children and vaccination

This was a fascinating conversation and I was deeply honoured to have Professor Barbash join us with many key points covered. Please enjoy.

References

www.nejm.org/covid-vaccine/faq

www.weizmann.ac.il

www.health.gov.au

www.cdc.gov

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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Episode 5. COVID-19 with Dr Babak Rad

Covid 19 has brought forth upon the world a pandemic unrivalled since the Spanish flu (1918 - 1920) caused by H1N1 influenza A. Described by Australian Treasurer Josh Frydenberg as the "new and invisible enemy", every doctor has had to avail themselves of knowledge regarding this highly contagious virus.

Covid-19 has brought forth upon the world a pandemic unrivalled since the Spanish flu (1918 – 1920) caused by H1N1 influenza A. Described by Australian Treasurer Josh Frydenberg as the “new and invisible enemy”, every doctor has had to avail themselves of knowledge regarding this highly contagious virus.

Today we are joined by expert infectious disease specialist Dr Babak Rad who will discuss:

· Our knowledge regarding the incubation period of Covid 19

· Virulence

· Quality of testing

· Asymptomatic spreaders

· The immunocompromised patients

· Medical therapies

· Vaccines

Much of our knowledge continues to be a work in progress, by the time this pandemic passes Covid 19 may be the best-known pathogen ever studied by humankind. Please join me in this interesting conservation with Dr Babak Rad.

Useful references include:

www.babak.rad.com

www.health.gov.au

www.o.int

www.cdc.gov

www.cidrap.umn.edu

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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