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

crazy 88 wrote: »

I have asthma and thought I qualified as per the "continuous use of corticosteroids" in cohort 7 criteria. Contacted my GP and they said I would have had to have been on oxygen to qualify... which sounds more like cohort 4 to me.

GPs seem to be making their own interpretation of the criteria. I have heard of some giving it to adults who got an asthma diagnosis as a child but haven't taken any inhalers or suffered any symptoms since.

The other GPs refusing to do cohort 7 at all are a disgrace. They have a duty of care to their patients.

I agree, that's what the GP receptionist said to me, Cohort 4 is people who rely on hospital treatment regularly enough (oxegen, nebuliser, fusions etc) whilst Cohort 7 dealt with less serious cases and more manageable respiratory diseases, but you were still high risk if you got the virus.

Wesser wrote: »

What percentage of cohort 7 have been vaccinated?

It is actually unknown. There are some very frustrated people here and in other parts of social media but they are small samples. As the portal moves down through the age groups it is also slowly reducing. If, as the HSE claim, they have a defined pathway for Group 7, once it's up and running the group should be done pretty quickly.

iamwhoiam wrote: »

We have no clue how many seriously upset people are out there . Many are not vocal on social media
But the fact remains clear as day that cohort 7 was let down and were not organised early enough
They were group 7 , deemed at higher risk after 6 and before 8 and 9 and 10 but now many are simply abandoned by GPs and the HSE and have to slot into their age group
That leaves a young chronically ill 20 year old till last behind a healthy fit 30 year old and it quite simply is wrong . It should not have happened .

We have been hearing about the HSE plan for weeks now and still that group sit upset and anxious and seriously frustrated . I absolutely cannot blame them and sympathise with them
My own daughter is in cohort 7 , she had a vaccine a fee weeks ago via her hospital consultant . We are grateful for that but there are many who were not so lucky
She is also on her GPs list and has heard nothing at all from her yet by the way

The vaccine rollout was a huge undertaking and I admire how it ran and I think it was run exceptionally well in the whole . But we must accept a major flaw with the at risk 4 and 7 and learn from it . It should have been set in motion last year and lists organised before we ever had a vaccine so it could be well sorted by then
Flaws happened in this rollout , some understandable some not so . We must learn from it and have a system in place if this ever happens again and get it right next time .
Having cancer sufferers waiting for a vaccine while healthy people get it is not acceptable and shouldn’t be accepted by those who organise this system . They need to step up and accept that and fix it

The suggestion is that the plan was underway when the ransomware attack. As that unwinds we'll see if it in any fit state to be rapidly implemented. The only real alternative until that happens is portal by age.

iamwhoiam wrote: »

Or GPs stepping up and taking care of their at risk patients . .

And what was the HSEs excuse before the ransomware attack ? There was a serious flaw long before that happened
It must be accepted or we will never learn from it

I agree on that first one. TBF it looks like a multitude of factors, the first one being the HSE assuming that Group 7 would be taken care of by GPs. While some aspects of the rollout may seem slow, it's no easy task to add up to 150K into the vaccine management programme. Even so the levels we are up to now would likely care of that group very fast, once they are in the system.

I wouldn't be surprised to see a news report of someone with a shotgun forcing a GP to vaccinate them.

In my opinion any GP who opted out should have ensured his high risk patients were being vaccinated elsewhere or a system in place for them . If they were not convinced that there was an alternative then they should have looked after them

Frontline didn’t opt out when things got tough , they worked extra shifts , they didn’t see family they simply carried on .
Some GPs just threw in towel and gave up on their high risk patients and gave no alternative or information .
Its a pandemic , it’s important so step up and be there for your most vulnerable would be my advice to any GP who opted out because it didn’t suit them
Yes some were stressed so were ambulance crews and A and E staff and ICU staff . They got on with it and carried on
Shame on any GP who couldn’t be bothered with some extra work for a few weeks

odyssey06 wrote: »

The system was never in place though... it should have been up well before the hack.
The gap between them knowing gps werent doing the cohorts and the hack was too long.

When the system went down a fallback process with letters should have been adopted.

And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system. It is designed, as we've seen, to go through age groups in descending order and is doing so pretty well.

is_that_so wrote: »

And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system. It is designed, as we've seen, to go through age groups in descending order and is doing so pretty well.

I reject that really. Of course they could have been accomodated if they were made a priority and they were not. Cohort 4 and 7 are higher risk than healthy 50 somethings. The system is not designed well if it fails to deal with one of its priorities and cant respond to events.
Yet we have seen mvcs reallocated because of regional mismatches.
These cohorts have been handled dreadfully by the hse and the gps that abandoned them.

odyssey06 wrote: »

I reject that really. Of course they could have been accomodated if they were made a priority and they were not. Cohort 4 and 7 are higher risk than healthy 50 somethings. The system is not designed well if it fails to deal with one of its priorities and cant respond to events.
Yet we have seen mvcs reallocated because of regional mismatches.
These cohorts have been handled dreadfully by the hse and the gps that abandoned them.

There are multiple factors at work here, my own feeing is that it was more of a GP thing to pass them off to the HSE to figure out. Anyway they will get done, some sooner by age in the portal and the rest when the IT is back up.

iamwhoiam wrote: »

They could have sorted the lists of high risk group and organised the GPs and hospital consultants to start organising the lists long before vaccines arrived . They lesser detail of how and where would then have run smoother if the ground work was done.I thought that would be obvious that doing the groundwork first will always aid the process when the time comes .

The lists were not even ready when the plan was put in place and cohorts chosen by NIAC . They decided that they would have two cohorts and out them in groups 4 and 7 ahead of all other groups with almost nothing in place to insure it ran smoothly .
We now end up with young cancer patients etc waiting while GP's are vaccinating 30 year olds with extra doses

NHPET worked on the vaccination group lists and they did offer a health rationale for each group. NIAC didn't exist at the time. I don't disagree with some of your ideas here but when you've got such a very wide range of conditions, a simple hospital or GP approach was an obvious choice. If there are failings, it's there you'll find most of them.

I think people have unrealistic expectations of the GPs here. There were struggling with workloads before Covid. Not enough doctors and admin staff. Most of the admin staff are not well paid and most GPs do not have good office systems.

fun loving criminal wrote: »

Stephen Donnelly received his vaccine and was privileged to receive it.

He makes me sick as minister for health while those in group 7 continue to wait.

Personally I think all Ministers should have had it long ago .

PCeeeee wrote: »

With respect, that makes no sense if they are young and healthy.

It does to me . We need to have a functioning Government in a pandemic .
I object to HSE staff who work at home getting it months ago , I personally know of 2-3 young men who work from home in Hse who got it in February . The rational for that was so the HSE could continue to function
But yes I think higher Government and NPHET should have been vaccinated early

I have a huge issue with how cohort 4 and 7 were let down but have no problem with Ministers being safe to be honest

is_that_so wrote: »

GPs too have also received more than expected. Not sure how you imagine two groups with very disparate health issues, who had never been quantified before would be identified in a manner to be added to a national system.

The list of groups and criteria were published in early December so there has been six months to build lists of patients. The groundwork had already been laid prior to that as GPs were defining people as being at risk back in September to call them for flu vaccines. GPs are reporting that they had their lists ready and have been trying to provide them to HSE for weeks/months but no one in the HSE could tell them how this was supposed to be done.

is_that_so wrote: »

GPs may not be fully to blame but there was a plan that they would be doing Groups 4 & 7 and then many of them weren't so some of this group then fell through the cracks.

You might also fault the HSE but in fairness to them you can't just produce a new process or pathway overnight, when it turns out the system you thought was in place is falling apart.

Two problems with that statement:
1) While there are anecdotal stories about some GPs having extra doses there are much more widespread reports of GPs not getting the doses they need for their Cohort 7 patients. My own GP reported that situation and advised me to register through the portal as they didn't know when they'd be able to get to me with the trickle of vaccines they were getting. And we know that there had been zero Cohort 7 doses delivered when the HSE started on the general population on April 23. This was a conscious decision by the HSE to rearrange the priority but not admit it. Some GPs choosing not to handle Cohort 7 is a significant issue but still secondary compared to the HSE's deliberate deprioritisation of the High Risk cohorts.
2) It was possible to put something in place at short notice. The Cohort 7 issue blew up on social media on May 11th. On May 12th, by amazing coincidence, the distraction about some of Cohort 7 having been vaccinated as Cohort 4 was the main news story on Morning Ireland. Then on May 14th the HSE announced that a portal for GPs to register would 'start going live' the following day. It was all quite cagey and wasn't mentioned during the addresses at the press conference. It was in the back pocket as a response when one of the journalists present brought up the issue of Cohort 7. The ransomware attack kicked in that night, so we don't know to what extent that was more PR spoofing or a real launch, but if we take it at face value it was possible to set something up quickly. That Salesforce hasn't been tasked with adding this on to the main portal is a great disappointment.

is_that_so wrote: »

And I made the point that it is neither quick nor easy to do that, not from a systems perspective. The HSE say they had started on that pathway. The vaccination programme had enough to deal with from unreliable suppliers to managing groups that were in the system. It is designed, as we've seen, to go through age groups in descending order and is doing so pretty well.

But the HSE still won't admit they have designed a system that is deliberately circumventing priority groups. They still maintain the fiction that they are abiding by the 9 priority groups. So if they are saying one thing and doing another, and it's about what can be a life or death issue for those impacted, it's not surprising that they are generating huge resentment.

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

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 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.

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 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 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.