Episode #30 – Dr Nidhi Krishnan – Mythbusting COVID-19

Episode Transcription

Dr Marisa Lee Naismith 00:10

Hey, it’s Dr. Marisa Lee Naismith here and I’m so honoured to be sharing today’s interview round episode with you listen, and you will be inspired by amazing healthcare practitioners, voice teachers, and music industry professionals who will share their stories, knowledge and experiences within their specialised fields to help you live your best life every day. As singers, our whole body is our instrument and our instrument echoes how we feel physically, mentally and emotionally. So don’t wait any longer, take Charge and optimise your instrument now. Remember that to sing is more than just learning about how to use the voice. It’s about A Voice and Beyond. So without further ado, let’s go to today’s episode. Over the past many, many months, we have been inundated with news views, perceptions, misconceptions and conspiracy theories around COVID-19. To be honest, I am just as tired of it as most of you are. Much of what we read is based on hearsay and what the media wants us to know and not being drawn from rigorous research. Let me say first and foremost, I do stand for freedom of speech and freedom of choice. However, the unfortunate thing about all this misinformation is that it is causing a great divide between friends, families and communities. For this reason, we held an Ask me anything event some weeks ago, where we invited Dr. Nidhi Krishnan to join us to respond to all your questions. Dr. Nidhi Krishnan is the registrar in the paediatric ward of Logan Hospital in Queensland, Australia, and is an adjunct lecturer at the James Cook University. In this ama, it was my clear intention to seek answers to the more common and pertinent questions from a healthcare professional with a science background who has derived all her knowledge around COVID-19. from working on the front line, as well as receiving daily updates from the appropriate official sources. questions were asked around to the very existence of COVID-19 what it is, how it spread the variance, that types of vaccines, testing protocols, preventative measures, we can all take the effectiveness of lockdowns and the long term health impacts of having had COVID-19. All the information offered by Dr. Nidhi Krishnan was explained in a very clear and concise manner that made absolute sense. Based on the overwhelming number of requests to replay this ama, we have decided to release the replay as an episode. So here it is. This episode is not about changing people’s opinions. It is about education, and it is our hope that it may help to dispel some of the myths and conspiracy theories that are circulating in our communities creating anxiety and chaos. This is not to be missed information. So without further ado, let’s go to today’s episode. Welcome, everybody. And thank you for joining us at this live Ask me anything event around COVID-19. I appreciate you taking the time to be here, especially at the moment because there is so much fake news. There are so many misconceptions around COVID. There are myths there are conspiracy theories, and to be totally honest, I’m sick of hearing them. And so I’m uh I’m being a little bit selfish here in gathering everyone that I possibly can to join us for this event and to have some on who is in who is a healthcare worker, a professional in the healthcare industry, who comes from a science background, who is being educated on a daily basis, about COVID-19. The aim of this event is to try and dispel some of those myths that are out there to try and educate people if they’re willing to listen, to try and calm people down, because there is so much Nxd. And there is so much anxiety and a lot of these myths and rumours and, and these misconceptions are really causing chaos. And people are fearful. So if we can calm down even a handful of people via this event, I feel I’ve achieved what I wanted to achieve. Now, what I don’t want to do by having this event is we are not here to change people’s opinions. By that I mean, we are not here to brainwash people. We are not here to persuade people into doing anything they don’t want to do. We are not discouraging freedom of speech. But we are here to try and educate. So that is the goal of this event, and to provide information. So without further ado, I’d like to welcome Dr. needy Krishnan Nidhi. works at Logan hospital, she is the registrar in the paediatric department at the hospital. She also is an adjunct lecturer at James Cook University, and is in the front line dealing with everything that we are not dealing with. And so has far more much more experience and knowledge on the topic of COVID-19. So Nidhi Welcome to our ama. And thank you so much for offering your time to be here.

Dr Nidhi Krishnan 07:16

My absolute pleasure. I’m hoping to answer some questions that might be out there. And if I can’t answer them, point you in the right direction, at least.

Dr Marisa Lee Naismith 07:27

Well, thank you, because we did say in the marketing for the event that you are not an infectious diseases specialist. You are not an epidemiologist. But you are a healthcare professional, a doctor with a science background. So that is who you are. And if you don’t know anything, as you kindly said, you will refer people to the correct sources. People have been putting up on social media. Does anyone know? Anyone personally who has had COVID-19? Now? I’m assuming by that and it was yes or no, it was just put Yes or no? Now, I’m assuming by that people are asking or questioning the very existence of COVID 19. So can you please talk to us about your experiences with COVID?

Dr Nidhi Krishnan 08:34

Yeah, look, so I can speak both personally and professionally. I might quickly touch on my personal experience with COVID, which is actually I have a lot of family overseas being from immigrant background, most of my family is scattered all over the world. A lot of those people who are in India, and then India was quite literally suffering from a lot of this. A lot of my family members were affected. And I did have a couple of family members also passed away from this. So purely from a personal level. I think this is very, very real. Professionally, particularly being in the paediatric space. I’m lucky to not have treated anyone directly with COVID-19. As up until quite recently in Brisbane, this was predominantly affecting adults and not so much children. However, and a lot of my colleagues work on COVID wards at the PA hospital have been affected by patients and transmission and things like that in their workspace. So I think they would also 100% say that this is real. And I don’t think it’s you know, fake news that COVID-19 Yeah,

Dr Marisa Lee Naismith 09:50

yes, I know. I’ve heard every conspiracy theory there is I’m sure. As I think this has brought out the best in the worst in everybody. I to know people who have had COVID mainly from the UK in the US, and I know people who have lost family members also. Okay, so what is COVID? 19? Like what actually is the thing?

Dr Nidhi Krishnan 10:17

Yes, sir. Look to not get super sciency about it, but it is a virus and it’s a part of a family of viruses called Coronavirus. So I know that people have referred to COVID-19 as Coronavirus, but it’s actually a type of Coronavirus. And the family of viruses called Coronavirus, does exist on a spectrum of severity in terms of the symptoms that they can call us. To give some examples, the other ones that you might have heard of in the last few years was actually SARS, and MERS, which Luckily, we weren’t hugely affected by in Australia, but they also exist in the family of coronaviruses. And then, you know, there’s other virus families like influenza, or Rhino virus, which is the common cold. So it’s it’s a virus.

Dr Marisa Lee Naismith 11:09

Right. So what are the variants? As far as I know, there’s alpha, and there’s the Delta? Are they the only two at this point of time?

Dr Nidhi Krishnan 11:21

Yeah, so we’ve actually identified four variants. So alpha, beta, gamma, and delta, but you’re 100%, right, in terms of what we talk about, is predominantly alpha and delta. And I think that’s because beta and gamma that exists kind of in the middle there, don’t behave that differently to the other variants. So whilst it does exist in the lab, to try and decide where this we use the variants to actually track where the virus is originated, and where it’s come from. But in terms of how it affects individuals, there wasn’t a huge difference until this delta variant seems to have reared its head a little bit. And then now we’re actually talking about variants,

Dr Marisa Lee Naismith 12:05

right? And what are the differences? We will keep it then to alpha and delta? What are the differences between the two variants?

Dr Nidhi Krishnan 12:15

Yes. So the way that the variants actually come about is, the longer the virus kind of circulates in the community, it adapts it’s very intelligent, it’s a living thing. And it’s trying to survive much like every living thing on this planet, right. It’s adapting, and it’s changing to try and survive, survive itself. So with that, is how we get these variants. And they do all behave slightly differently with regards to alpha and delta. So the evidence out there at the moment suggests that vaccination is useful against both variants. Certainly, there’s some concern that when you’re vaccinated with and you have the Delta variant, you might be more likely to transmit that and pass, in fact, other people with the Delta variant, and there are some concerns that the Delta variant is causing more severe illness, particularly in the unvaccinated population.

Dr Marisa Lee Naismith 13:17

Right. So how do we detect the virus?

Dr Nidhi Krishnan 13:22

Yep, so we can do it a couple of different ways. The most common one is the swab up the nose and the swab in the throat, which, whilst very uncomfortable, is not painful. I’ve had multiple over the last 18 to 24 months. And it’s a very safe test. The other way that sometimes in very specific circumstances, we can do some blood tests. And that’s often how we can kind of tell certain details about the virus, but for the general population, it’ll be a swab up the nose and a swab at the back ear throat.

Dr Marisa Lee Naismith 13:58

And will that tell us which variant it is?

Dr Nidhi Krishnan 14:02

So not straight away, but they can certainly do further analysis to do that. And that’s exactly how they’re tracking the spread of this through the community.

Dr Marisa Lee Naismith 14:09

Right? Are the symptoms between the two different So is there a different sip the symptoms between alpha and delta?

Dr Nidhi Krishnan 14:20

Yeah, so as far as I’m aware, I think the symptoms especially the initial symptoms are very much the same, which is your classic cold and flu type symptoms. So it does make it quite difficult to identify because it’s your coffee, sore throat, your runny nose, some fevers, all relatively nonspecific. The concern with the Delta variant is that it can then progress to being quite severe.

Dr Marisa Lee Naismith 14:44

Right, the two variants are they spread differently?

Dr Nidhi Krishnan 14:50

Not the spread exactly the same.

Dr Marisa Lee Naismith 14:53

Okay. So one is not more contagious than the other. So I think the

Dr Nidhi Krishnan 14:58

concern is more about that. The way that it’s spread is coming into close contact with other people. And particularly we call it droplets spread so that they’re coughing or sneezing. And the other thing to keep in mind is droplets can also live on surfaces. So kitchen counters, railings, elevator, escalator hand, but handlebars and things like that. So it’s spread by a droplet, no matter what there is, there are some concerns that the Delta variants is potentially more contagious. So it might exist on surfaces for longer, more likely to potentially be infected by it. I think a lot of the details around that are still coming out. And I couldn’t say that I know the specifics about about that.

Dr Marisa Lee Naismith 15:43

So how does the 14 day period that people are isolated? How does that help stop the spread? What is it about 14 days.

Dr Nidhi Krishnan 15:55

So it’s all kind of based on every virus out there has a different what’s called an incubation period. So kind of how long it takes for it to start kind of affecting you and developing symptoms and things like that. We know that typically, with COVID, the incubation periods, around five days, 97% of people will develop symptoms by about 11 to 12 days, with 99% of people developing symptoms in 14 days. So yes, there is a margin of error, nothing is 100% in this world, so there will always be people outside of that 14 day period. And those are those kind of freak stories that we’re hearing are they didn’t have any symptoms, and they tested positive later. But it’s all based on kind of what is the safest option? And it’s because 99% of people will have symptoms in 14 days. That’s where that 14 days has come from. Right.

Dr Marisa Lee Naismith 16:52

Who is that most risk of contracting? COVID-19? Are there any age groups or any, any areas where people are at higher risk?

Dr Nidhi Krishnan 17:07

Yeah. So at the moment, the advice out there is if you’re over 70, you’re definitely at high risk. If you’ve got any specific health, health concerns, particularly stuff like your kidneys, your liver, your heart, your lungs, obesity, diabetes, to just name a few. And then the other thing that we might not think about that much is any areas of high density living in Australia, we’re very, very lucky to kind of not have a lot of high density living land. Where it does apply to us is stuff like nursing homes, group living, correctional and detention facilities, where people are in very close proximity to each other. And that’s why internationally, we’ve seen places with high density living have been significantly more affected by this.

Dr Marisa Lee Naismith 17:56

Yep. So someone’s had COVID-19. How do you know that they’re no longer infectious? At what point? Are they no longer infectious?

Dr Nidhi Krishnan 18:07

Yeah. So the studies at the moment, tell us that around 10 days from the onset of your symptoms, and then if you also had resolution of all your symptoms, and you’ve not had a fever for 24 hours, you’re no longer infectious. However, what I would advise is to follow your local public health guidelines with regards to this. So especially in Australia, at the moment, if you do come back with a positive test, someone will be in very close contact with you personally, to let you know when you’re safe to be back out in the community and no longer infecting people.

Dr Marisa Lee Naismith 18:45

Right. So if you contract the virus, for how long after, from the time you contract it, when you keep giving a positive result? I mean, will you continue to give positive results? Or will there come a time where there’s no longer a positive result?

Dr Nidhi Krishnan 19:08

Yeah. So ideally, what should be happening is that you shouldn’t have a positive swab anymore when you’re not actively infected. However, some people were finding that even when they aren’t actively infectious, or they don’t have the virus, they seem to still be getting positive swabs. Now there are that’s where the blood tests and things can come in handy. Because what the blood test can show us is, is this a past infection that you now have some immunity to? And potentially that’s what’s being picked up on the swab tests, or is this still an active infection for some reason that we’re not able to clear?

Dr Marisa Lee Naismith 19:45

Yes, because I actually know of a case where that happened. And I think they allowed 120 days from the time when the person had the virus and because this person still tested It is, after the 120 days, they thought that he still had was infectious, and put him in isolation as well as everyone that had come into close contact. So the question here would be, is it possible to contract the virus more than once?

Dr Nidhi Krishnan 20:21

So there’s been cases out there all over the world that say, yes, you can get the virus more than once. Is it likely at this stage? Probably not. But it’s certainly not impossible.

Dr Marisa Lee Naismith 20:33

Right. Okay. Let’s

Dr Nidhi Krishnan 20:36

all end up Sorry, just, it would fall into much the same kind of territory as you can get the virus despite being vaccinated. So you have some immunity. But nothing’s 100%

Dr Marisa Lee Naismith 20:48

right. It’s like people if they’ve had measles or chickenpox or something like that. You had the freak of nature thing happened that they have it a second time twice. Yeah. Yep. Makes sense. Let’s talk about vaccines. Let’s Let’s rule that dirty word. vaccination. Can you explain the difference? The differences between the vaccines and whatever you might know about Madonna as well, please?

Dr Nidhi Krishnan 21:20

Yeah. So Madonna and Pfizer are actually very similar scientifically, with what kind of vaccine they are. So it’s developed by a different kind of pharmaceutical company. But the way that the vaccines been made is very similar to Pfizer. So I think you can kind of put them in the same box for that purpose. There are slight differences with AstraZeneca, and Pfizer. Without getting, again, super sciency about it. The way that the Astra Zeneca works is it actually takes a different virus altogether, and pops a small amount of COVID material inside that different virus. Wow. And then they give you that. And what your body does is that the different virus your body’s not really affected by that there’s lots of viruses we’re exposed to every day that we don’t get sick from, and that’s one of the viruses they choose. And then what your body does is it detects the small amount of material, the COVID material that they’ve put in there, and develops an immune response to that. So that’s it’s called a viral vector vaccine. So it uses that different virus as a vector to deliver some it COVID information to your immune system. So that’s how the AstraZeneca vaccine works with regards to the Pfizer vaccine, so they call that an RNA vaccine. And basically what RNA is, is it’s a protein that’s found in COVID-19. It’s not DNA before anyone gets confused. They are not injecting viral DNA into your body to interact with your DNA. That’s not happening.

Dr Marisa Lee Naismith 22:59

What about microchips on my 5g

Dr Nidhi Krishnan 23:03

has never been better Mercer, I must say.

Dr Marisa Lee Naismith 23:09

I heard we’re all starting to talk Chinese.

Dr Nidhi Krishnan 23:13

And I think we’re gonna develop into lizard people at some point, too, I don’t. But but with the, with the RNA, it’s again, just a protein that they put in the vaccine. And again, your body recognises that and then develops an immune response. So that if you ever get exposed to that, again, your body’s like, I know what to do with this. I don’t like this. And it’s already got that kind of first line of defence that first wall to say, No.

Dr Marisa Lee Naismith 23:41

We have a question here. Thank you. How long do you think it will take for Australia to have 80% of the population vaccinated?

Dr Nidhi Krishnan 23:51

I think that’s, I think that’s a really good question. I would like to think that actually, with all the recent lock downs, and with how difficult a position New South Wales has been in, it’s actually brought to the forefront the importance of vaccinations to try and get back to normality. I think prior to that, because we were very lucky to be in the position that we were people were kind of just happy to sit back and just see what happened. And why take the risk. Because at the end of the day, I’m not gonna sit here and say there’s no risks at all, our decision making processes or a risk benefit evaluation, and people just didn’t see the benefit. If everything was kind of happy, and we were living our lives. I think realising that this is not going away anytime soon. We’ve already seen vaccination rates go up. And we’re only opening that up to more and more availability. So keeping keeping in mind a lot of people haven’t even been able to access the vaccine until recently because of all the, you know, age limitations and,

Dr Marisa Lee Naismith 24:54

and also depends on location. Yeah, I believe this Just if you can just clarify, when you talk about symptoms, were you talking about clots? Was that one of the symptoms? You were talking about blood clots? symptoms of

Dr Nidhi Krishnan 25:12

COVID? Or vaccinate

Dr Marisa Lee Naismith 25:14

vaccination? Yes. Are the risks when you talked about the?

Dr Nidhi Krishnan 25:20

Yeah, so I’m with the AstraZeneca. Specifically, there’s certainly been some concerns about the blood clotting come out. Yeah. It’s, it’s there, it’s been identified risk on higher risk in those under about 60, which is, again, why the recommendation has been that the older you are, the less likely you are to actually have that as a side effect. So that’s why they say it’s safer for the older people in our population. However, just to keep in mind, so the risk with blood clots with AstraZeneca it’s thought to be 0.004%. To put that in perspective, when you take the oral contraceptive as ladies 0.1%, of having blood clots, smoking 0.2%, and having blood clots when you actually have COVID is 15%. So it’s not that the risk isn’t there. But it’s again, it’s all about that risk benefit evaluation.

Dr Marisa Lee Naismith 26:25

Yes. And having perspective, I think we need to have some kind of perspective here. Is it true that the worst the resist the reaction to the vaccine, the better your resistance to the virus?

Dr Nidhi Krishnan 26:43

Interesting thought, um, I don’t, I don’t know if there’s any evidence to say one way or another. Certainly having a reaction to the vaccine seems to suggest that you’re definitely mounting an immune response. And that’s all it tells you is that you’ve developed the immune response that the vaccine was set out to do. It doesn’t necessarily mean that if you didn’t have any symptoms, but you didn’t mount that immune response.

Dr Marisa Lee Naismith 27:10

Why do we have to have two vaccines and we can’t have the full vaccine in one dose? Yeah.

Dr Nidhi Krishnan 27:20

So again, not being a specialist in vaccinations. If you think about kind of, it’s about trying to introduce your immune system to recognise something. So it’s about finding that sweet spot about how many times you have to show your immune system that are this pup, this virus is still out there. So think about it as a booster shot. So certainly without tetanus, we have to get a tetanus every five to 10 years, we have to get a whooping cough every five years. A lot of vaccinations even if you think about in childhood, for those of us who have children, you have to get a few measle mumps and rubella vaccines to build that immunity. Yeah, I think he’s exactly the same. And that’s not new in the world of vaccinations.

Dr Marisa Lee Naismith 28:09

Yes. Do you think that we may have to have a third shot in the future?

Dr Nidhi Krishnan 28:16

Yes. So I think because the COVID vaccine is still in its relative infancy at this point. That’s a little bit difficult to know. It may be like the flu backs where we’re looking at getting a booster every year. It may be like, as I said, the tetanus way you’re looking at every five years, or it might be a one and done. I think slowly. They’re just seeing how long that immunity lasts for. And that will only evolve with time, unfortunately.

Dr Marisa Lee Naismith 28:47

Yes. Why is it that the second fires the vaccine is more likely to cause reactions, and I’ve heard that the first AstraZeneca vaccine is more likely to cause reactions is that the general rule of thumb?

Dr Nidhi Krishnan 29:03

I think that is the general rule of thumb. Honestly, I have no idea. Um, it must have something to do with the way that your body responds to the different ways that that that component of COVID is presented to your immune system. But I actually have no idea I must say, though, that is the general rule of thumb is that the first AstraZeneca is bad. And the second Pfizer’s, you Yes, that in terms of how you feel within yourself,

Dr Marisa Lee Naismith 29:29

yes. What kinds of things can we be doing to protect ourselves and minimise risk and to prevent the spread?

Dr Nidhi Krishnan 29:39

So look, I’m going to be probably saying things that most of us already know. But social distancing, as I said, close proximity. That’s how its spread. hand hygiene. Wash your hands if you weren’t doing it before, do it now. wearing a mask. Obviously again, it’s that concept of if To people are wearing a mask and you have a sneeze or a cough or you know, you spit a little bit when you’re talking, if you’ve got to mask barrier, it’s far less likely to have that droplet transmission. And then other things like cleaning the surfaces in your house. If you’re not already doing that, super regularly, I’d suggest doing that more frequently. And then, you know, in my household being a frontline worker, it’s about when I come home from work, taking my clothes off, putting them straight in the wash, having a shower, the second I walk in the door, to try and leave as much as I can outside outside of the house setting. And certainly if you’re in a position to be able to do that, no matter where you go, that could also be helpful.

Dr Marisa Lee Naismith 30:44

Does there appear to be a certain environment where COVID-19 thrives? Like in terms of temperature? Or? I don’t know. Overnight?

Dr Nidhi Krishnan 31:00

I think it’s fairly non discriminatory, as we’re seeing that all over the world seems to be affected hot called doesn’t differentiate by the colour of your skin or your religious beliefs or whatever. I think it’s COVID-19. Unfortunately, fair game for everybody.

Dr Marisa Lee Naismith 31:16

Yes. How effective are the masks? Because there are some people that refuse to wear a mask, then there are people that have said there is no research to back up the claim that masks are effective. So what what is the science telling us? Is there science out there to to

Dr Nidhi Krishnan 31:40

research out there, there is research out there both in the context of COVID. But also, we need to remember that COVID is just a virus. So there’s lots of research out there as to how masks help prevent the transmission of every other virus. And you’re looking at about 60 to 80%, depending on what studies you read. So again, it’s not 100%. But what we’re looking at is it’s that extra barrier and that extra level of protection, along with everything that we spoke about before, like social distancing, and hand hygiene that get you closer and closer to that 100%. I don’t think we’ll ever get to 100. But we’re getting closer. And that’s the goal.

Dr Marisa Lee Naismith 32:20

Right? When they talk about communities spread, what actually does community spread mean?

Dr Nidhi Krishnan 32:30

So I think that’s a really good question. So community spread. And the reason that all politicians and everyone on our TV screens seem to kind of get a little bit nervous about community spread, is it’s actually when there are cases in our community that we cannot link to other cases that we already know about. So it’s the new ones that pop up that we go, we don’t know where this person is contracted COVID from. And that’s where that’s why it is concerning. If, for example, there is a community spread case of someone in a household, and then everyone else in that household also tests positive for COVID-19. The people the other people in that household are not considered part of community spread, because it’s expected you live with people, you’re going to probably be infected with the same virus.

Dr Marisa Lee Naismith 33:20

Yep, everything you’re saying is just so easy to understand and common sense. Why do people make it so hard? But I mean, it all seems very black and white. Why do we have to have so many shades of grey like wasn’t the movie enough? Like? Okay, who should get tested for Coronavirus? Yeah. COVID-19.

Dr Nidhi Krishnan 33:49

Yeah, I think at this point, anyone who’s got symptoms, and those symptoms are what I spoke about earlier, coughs colds, runny noses, sore throats, fevers. So basically your common cold flu type symptoms, I think you should go get tested. Luckily, at the moment in Australia, the likelihood is those symptoms are still coming from probably the flu or the common cold, which haven’t gone anywhere. They’re still out there in the community. But I think for the safety of our community, it’s important to go get tested.

Dr Marisa Lee Naismith 34:19

Right? What if I don’t have symptoms? In what circumstance Then should I be tested?

Dr Nidhi Krishnan 34:26

Yeah, so I think if you’re completely symptom free, then it should only probably really need to go get tested if it’s in keeping with your public health governance. So again, if there’s been an alert put out to say that you’re a close contact or something like that, and someone’s gotten in touch with you to say that maybe you’ve been in contact with someone, that’s when I would go get tested if I was completely symptom free.

Dr Marisa Lee Naismith 34:51

Okay. Now, just assuming that I am an asthma sufferer or I suffer from seasonal allergies. Should I still go and get tested if I have any of those symptoms?

Dr Nidhi Krishnan 35:06

Yeah, I think as a disclaimer, I would say Speak to your doctor at the time you have those symptoms to make that decision together. However, as a general rule, you should not get fevers with asthma or allergies. The other thing to keep in mind is things like itchy noses and throats as opposed to like an actual cough or something. If you’re feeling itchy, itchy eyes, itchy throat, itchy nose, it’s probably more likely to be allergic than it is to be COVID. Right. However, again, make that joint decision with your healthcare provider at the time that you’re thinking about, do I get tested to or not?

Dr Marisa Lee Naismith 35:45

Okay. Now, if I’m vaccinated, should I still get tested?

Dr Nidhi Krishnan 35:51

Yes. As we’ve already said, Sorry, vaccines, none of this is 100%. So you could still have COVID-19. So if you have no symptoms, at this point in time, the advice would be still go get tested.

Dr Marisa Lee Naismith 36:06

Oh, is so fever is the most obvious symptom, then.

Dr Nidhi Krishnan 36:13

Fever might be the most obvious symptom, but certainly if you have a milder infection, it could just be runny nose, a coffin, a sore throat. And certainly in my personal experience, especially working with children, where all of them that I see work hard, runny noses, coughs and sore throats. I occasionally become unwell with runny noses, coughs and a sore throat. So I’ve had quite a number of private tests over this timeframe. And none of them did I have fevers with so I think it’s important that even if you just generally feel a bit cloudy flowy, even without a favour, go get tested. Okay.

Dr Marisa Lee Naismith 36:48

Just I would like to question the effectiveness of the testing. Because we hear stories that you can be tested in the morning and you’re negative, you have a test in the afternoon and it’s positive, you may go and have another test after having a positive test. And it’s negative. So is there like a percentage where it’s not effective?

Dr Nidhi Krishnan 37:20

Yeah, throw it. Again, no testing is perfect. With any tests, what we talk about is what is the likelihood of having false positives and false negatives. And that’s with any test we do. Now, with the COVID, nasal swab testing, that exists somewhere in the realms of about 98% is the recent statistics that I read. So it’s pretty good. But again, as I’ve said, all through this, it’s not 100%. I think the other thing to keep in mind is that, you know, the news and the media always do sensationalise, these kind of outlier cases. And that’s what we hear about. No one’s got me on the TV going. Dr. Krishna has had 20 COVID tests over the last 18 months, and they were all accurate and appropriate. We always hear about the one or two and we’re testing 1000s and 1000s of people a day. So yeah, yeah, I don’t think.

Dr Marisa Lee Naismith 38:20

Yeah, absolutely. Now just say you test and your test is negative. But your symptoms persist. Should you go and get retested?

Dr Nidhi Krishnan 38:35

Yeah, so I think your local public health guidelines will be able to guide you a little bit on that. If it would, it would really depend on how long the symptoms persisted for how long you’ve been unwell if you develop any new system symptoms. And the other thing to keep in mind is that we can test for some of the other viruses that are out there as well. So certain with exactly the same nasal swab, so you can make that decision kind of with your GP as to whether it’s worth investigating, is it something else that’s causing this so that we can kind of pin it on to something? I don’t think there’s any clear guidelines necessarily around if you have the same illness, and you’re just not gotten better at what you do.

Dr Marisa Lee Naismith 39:21

Right? What is the difference between a close contact and a casual contact?

Dr Nidhi Krishnan 39:29

Yeah. So again, this the way that we kind of define close and casual contact is based on where did the contact occur? Was it indoors or outdoors? Was it for how long was it for so there’s a few factors that kind of go into that. I think the most important thing again, will be every state releases the contact list and it will tell you whether you are close or casual contact. The only reason that they do that is Just about risk stratification. So if you’re a close contact, you’re probably going to be higher risk. And the reason that we define those people as close contact is that at the moment, in Queensland at least, if you’re a close contact, even if you have a negative swab, you have to isolate for the 14 days. If you’re a casual contact you, I still advise to go get a swab. But if that comes back negative, you can go back to doing your life as you were before, okay.

Dr Marisa Lee Naismith 40:28

This might sound like a dumb question. But can animals contract? COVID-19?

Dr Nidhi Krishnan 40:37

Sorry, I’ve actually been asked this question a number of times before

Dr Marisa Lee Naismith 40:42

they sell for Dummies. Okay.

Dr Nidhi Krishnan 40:45

Funnily enough, yes, sorry. Um, household pets of people that have had positive diagnoses or COVID-19 have also tested positive. However, they haven’t been become particularly unwell with the COVID-19. So please don’t be concerned that your dog or your cat is going to, or any other animals you might find is going to become unwell from this. And the other thing to keep in mind is that the animals can’t then pass it on to anyone else. So it might be you to your dog or your cat or your household pet. But then that’s kind of where that chain stops.

Dr Marisa Lee Naismith 41:19

All right. Now children are contracting the delta of variant in this spreading that, will children be as sick as adults with that variant?

Dr Nidhi Krishnan 41:34

Yeah, I think the Frank answer is we don’t know. Um, there was initially with the initial outbreaks, everyone kind of felt quietly confident that children weren’t getting as unwell. And we’re also less likely to transmit it to other people. So we kind of, for better or worse, ignored the the, the child population or the youth population. Certainly, at least with the school outright that we’ve had in Queensland, none of those children knock on wood pain, particularly unwell from this, but I think the information will come out as we’re getting more and more, we’re certainly seeing cases overseas of children, unfortunately, becoming very unwell passing away from the Delta barrier. So I think it’s too early to be too complacent about it.

Dr Marisa Lee Naismith 42:28

I did read somewhere about a multi system inflammatory syndrome. That children? Yeah, that is a serious condition associated with COVID-19. Can you tell us a little bit about that one, please. needy.

Dr Nidhi Krishnan 42:45

Yeah, so that’s typically how most of the young people that have been severely affected by COVID-19 have been affected. And it’s basically what the name suggests, every part of your body becomes incredibly inflamed, she talking heart, lungs, brain, everything, and your body just can’t function under that. And then, unfortunately, some of those people just haven’t really recovered. And the best way to kind of describe what happens is that it’s just a severe immune response and your immune system just inflamed everything.

Dr Marisa Lee Naismith 43:20

Well. What about the recovery road? From COVID-19? Now, colleagues that I know in the US, they’re talking about a brain fog? Another another? complaint is severe fatigue for months on end? Are they the general kind kinds of health, ongoing health concerns? Or are there others that you’re aware of?

Dr Nidhi Krishnan 43:53

Yeah, so like, most commonly, it is that just really genuinely fatigued, where you just don’t feel like yourself in function like yourself. Some people are saying up to six to 12 months. However, there’s been a lot of people that have been left with, you know, ongoing cognitive and physical impairments that are affecting their heart, their lungs, their brain, as well. So, again, I think it comes back to this is without, you know, trying to change people’s minds necessarily about vaccination, because that’s not what I’m here to do. It’s just to draw attention to the risk and benefit. We, a lot of people say that, you know, we don’t know what’s going to happen in 10 years with the vaccine. Are we all gonna, as I said before, grow a second skin and another head and we, quite frankly, we don’t know. I think it’s very unlikely and time would suggest that vaccines have been incredibly safe for a long time. But we don’t know. However, on the flip side, we actually don’t know what the repercussions are actively having had co In the next 10 years are either and a lot of this, these symptoms don’t seem to be particularly positive for the long term outcomes of COVID-19.

Dr Marisa Lee Naismith 45:12

Just say I contract the virus. At what point of time Do I need to go to hospital?

Dr Nidhi Krishnan 45:20

Yeah. So I think that’s a really difficult question. Especially with a lot of evidence coming out now that people are becoming quite unwell quite quickly. My general health advice, whether it’s COVID-19 or not, is that if you feel unwell, and you want to seek more advice, go to a hospital. And that’s for any health health concern at all is that if you feel like things are getting worse, that you’re not improving, you should go to hospital, however, specific symptoms to talk about are any trouble breathing, if you’re not eating, not sleeping, not keeping anything down, I’m not really able to function at all within some realm of normality, I think you should definitely be re reviewed.

Dr Marisa Lee Naismith 46:10

Okay. And I guess that goes the same with the vaccine. If you’re feeling really really unwell after being vaccinated, go in and be just go to hospital

Dr Nidhi Krishnan 46:24

100%. And I’ve seen lots and lots of people come through with those exact concerns. They’ve had the vaccine, they’re not particularly feeling well. And I think the important thing to keep in mind is that as doctors, yes, our job is to diagnose and treat. But a lot of our job is also to provide reassurance so to provide a you know, a educated assessment, and provide some reassurance and advice for things you can do at home as well. And we appreciate that the general population are not medical, and they’re not nor should they have to be.

Dr Marisa Lee Naismith 46:59

Yes. Is there anything that you would like to add? Or are there any other questions from attendees? I have gone through all the questions that I had in mind, and the questions that I’ve been sent from other people. So is there anything that you would like to add perhaps that I you feel people should know about nifty?

Dr Nidhi Krishnan 47:26

I think we’ve actually covered a lot of the the kind of more pertinent, common questions that come up. I think vaccine safety is probably been everyone’s biggest concern at this point. And that’s kind of been where the hesitancy has been. So kind of what I just wanted to quickly touch on is, I think what I hear a lot of is how can this vaccine be safe, it’s come about so quickly. And to keep in mind that, you know, vaccine trials in general aren’t actually that long, even for other destinations that are rolled out previously. So what we’re looking at, let me just look at some of my statistics to make sure I get all of this accurate. So most vaccine trials are usually such they run it a stage three trial, and that’s when it’s kind of tested on people before the official rollout. And that normally takes about 12 months. However, in the 57 vaccines that have been tested in this is American statistics. But in America in the last couple of decades, the safe point in that 12 month period has actually been up two months, only one vaccine was pulled off the market because of side effects after that two month period. So it’s actually incredibly short study time periods. And with the COVID-19 vaccine, that testing ran for about four to six months before rollout so we’re actually comfortably in that period of safety. And it has been quite rigorously tested.

Dr Marisa Lee Naismith 49:13

Mm hmm. Yeah, and I think I know Time flies, but it’s already 18 months is like it’s so it’s 18 months since this whole thing started. We thought we were going to be out of like living normal lives. After three months, we’re all told, oh, you know, this is only going to be a few months, but it’s almost 18 months and we’re still here. So we have to find a way out of it, don’t we? Exactly. It’s got to come a point that we have two lives have to go back to it will probably never be our normal, what we’ve known that it has to go back to business. as being able to trade, people being able to, you know, have their livelihoods back. And and people just feeling not as stressed, not the anxiety, mental health concerns reducing, yeah, that there has to come a time where that kind of thing will be our normal, not perhaps the normal that we knew before. Exactly. We have to be able to get on with living, we must be able to get on with our lives at some point.

Dr Nidhi Krishnan 50:37

Yeah. Yeah, I think I’ve just seen a question from Andrew that I might not have answered. Which, which is, is it normal to have multiple vaccine options? Yeah. So it’s certainly not unusual, um, vaccines all work in slightly different ways to reach the same result, and there’s other vaccines out there that definitely have different ways that they work. In Australia, we have adopted a kind of streamlined approach, where as part of our normal vaccination schedule, they all tend to be the same vaccinations. But that doesn’t necessarily mean another country uses the same type of vaccine for the same illness. But part of the reason why we have multiple different types of vaccines is purely supply to get that much supply in into a country in the timeframe that we need it from one manufacturer. If we kind of adopt a few different routes, then we can try and vaccinate our population faster.

Dr Marisa Lee Naismith 51:41

Hey, they’re all just pretty much as effective as one another, aren’t they?

Dr Nidhi Krishnan 51:47

Mostly. So there is some evidence to say that maybe the the fires are slash moderniser, the RNA vaccines are slightly more effective, but you’re looking anywhere between kind of 85 to 95%. There’s some studies coming out of Europe at the moment that actually suggest that it’s safe to have both vaccines and that provides the best coverage. So Australia’s always taken because again, we’re in a very privileged situation, we’ve always taken a bit of a watch and wait approach to see what happens overseas and and other populations. But that might be some advice that we start getting over the coming few months.

Dr Marisa Lee Naismith 52:24

Yes. And there’s a question Is it okay to have a relaxant such as Valium prior to having the vaccine

Dr Nidhi Krishnan 52:33

100%, whatever, it’s gonna make it most comfortable and easy for you to have the vaccination. That’s what I’d recommend. You know, again, working with children, some of those people are terrified of needles. And we’ve got lots of different techniques, both medical and you know, non medical, to support them to have needles in their vaccinations, speak to your local GP as well about other options to kind of work around fears of needles and things like that, because that’s certainly something that is an issue for a lot of people. And as healthcare professionals, we’re used to kind of formulating plans for people on an individual basis. But value, it’s totally fine to take a small amount before if it calms you down.

Dr Marisa Lee Naismith 53:25

Okay, any other questions? No, I think we’ve covered a lot. You’ve been amazing. I think the biggest takeaway for me, is common sense. It has been Thank you. It’s been so important, informative, but it’s common sense and everything so black and white. It as I said before, all these variables and all this, when I listen to you speak, I just go This just makes so much sense. It’s so easy to understand. Why has it become such a big thing, like, you know, it’s not even a mountain out of a molehill. It’s like, the whole mountain ranges out of the molehill.

Dr Nidhi Krishnan 54:15

You know, none of none of this advice is new. This this type of advice to minimise infection has been around for decades. And it’s really interesting. If you have a look at old documentation about the plague and influenza back in the day, it was all the same advice, I think, hesitant.

Dr Marisa Lee Naismith 54:36

Sorry, so that put something up on social media. Last night was probably the smartest thing I’ve seen for a long time. It was a really old document. And I think I screenshot it and it was things to do to prevent influenza. Yeah, that would have been 100 year old document and will it ever It’s the same same but different virus. Yeah,

Dr Nidhi Krishnan 55:04

I think part of the, probably the mountain from a molehill issue comes from, again, a place of privilege, I suppose where, you know, we all have this wonderful ability to speak our minds and have free choice and free will. And I feel like there’s people out there that just potentially feel like that choice is being taken away from them. And I totally I empathise with that. And to those people, I guess I just say, you know, try and do your research, really good resources on your local, state government websites, the national government website in Australia, the World Health Organisation, and America, CDC actually has a lot of great resources as well. Yes, the other thing is, is that with this, it’s not going to take one person, it’s going to take all of us. So it’s not necessarily about the individual anymore, is where we’re at. It’s about bonding together as a community as a society, to try and, you know, get all of us to some level of normality.

Dr Marisa Lee Naismith 56:15

I think the biggest problem with many people is that they don’t actually understand what research is. Now you have a medical degree, I have a PhD, and to earn a PhD, it takes rigorous research. People don’t understand what that means. It’s not finding something on Facebook, and it’s not finding an article, if you do any sort of research, what you find on the computer does not count that as as that they will not allow that as part of your literature review. Exactly. That is not research, research requires rigour. And that is not rigorous empirical information. It is not. So that’s what I get angry about.

Dr Nidhi Krishnan 57:14

Exactly. Don’t get Google.

Dr Marisa Lee Naismith 57:18

Dr. Google needs to be fired. Thank you so much that that you know everything you’ve said, I’m sure we’ve all heard 100 times before, but it’s just having it explained in layman’s language, and not having media put a spin on it. Just having it said, as it was said was beautifully articulated. Nidhi Thank you so much. My

Dr Nidhi Krishnan 57:45

absolute pleasure.

Dr Marisa Lee Naismith 57:59

Hey, I hope you enjoyed this episode have a voice and beyond. Now is an important time for all of us to spread positivity and empowerment in our singing voice community. It’s time for you to invest in your own self care, personal growth and education. use every day as an opportunity to learn and to grow. So you can show up for your students feeling energised, empowered, and ready to deliver your best. Be the best role model and mentor you can possibly be and watch your students thrive as you do. Thank you so much for listening to this episode. If you enjoyed it, please make sure to share it with a friend or a colleague who you think will be inspired by this, copy and paste the link and share it with the people you think will enjoy listening to this show. Please share it on social media and use the hashtag a voice and beyond. If you would like to help me please rate and review this podcast and cheer me on by clicking the subscribe button on Apple podcasts right now. I would love to know what it is you enjoyed the most about this episode. And what was the biggest takeaway for you? I promise you there are many episodes to follow as I’m committed to bringing you more inspiration and conversations just like this one. I’d like to finish up with my final thoughts. Remember that to sing is more than just learning how to use the voice as singers. Our whole body is the instrument and our bodies echo what we feel physically mentally and emotionally. So singing is not just about the voice. It’s about a voice and beyond. Please take care of yourself and I look forward to your company next time.

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