Healthcare workers fear reopening Australia with just 70 per cent of the eligible population vaccinated could lead to the health system collapsing, as they brace for a spike in COVID-related intensive care unit admissions.
The federal government is scrambling for advice from intensive care doctors about how much the wards can cope amid ongoing demand, particularly in New South Wales where COVID-19 cases continue to increase.
On Tuesday, NSW Premier Gladys Berejiklian warned admissions to intensive care units are not expected to peak until October, when vaccination rates should start bringing down COVID case numbers.
But Sydney ICUs are already stretched.
One nurse in a busy ICU ward at a busy Sydney hospital, who spoke to The New Daily on the condition of anonymity, said they recently been forced to move a patient out of ICU early, so another patient could receive care.
On Tuesday, Ms Berejiklian sought to reassure the state that the health system was ready – emphasising the fact the NSW government had bought 2000 ventilators in the past 12 months.
“The health system is prepared, but will it be stretched, absolutely,” Ms Berejiklian said.
But the Sydney ICU nurse told TND there were not enough staff to operate 2000 ventilators, and no clear plan for what happens when COVID cases surge.
“They’re saying we’ve upskilled nurses, but these nurses have never looked after a ventilated patient,” she said.
“It takes 12 months of ward training to learn how to use a ventilator. Then it’s 12 months post-training to be a really good ICU nurse.”
Hospital staff have been told that if the ward is overrun, each ICU nurse will manage six newly trained ones, who will all have one patient each.
“I don’t know how much the system can take once we get overloaded,” the nurse said.
‘It’s awful’: ICU staff struggle
ICUs are often hit 10 days after daily case numbers rise, as that’s how long, on average, it takes COVID patients to become very sick.
This means nurses and doctors working in the wards can prepare for the oncoming tsunami.
They’re already pulling 12-hour shifts. They’re tired and they’re worried they’re about to be overrun.
The patients they are seeing are often from lower socio-economic situations, migrants and essential workers.
“The deaths we’ve had have been tragic,” the nurse said.
“You’re there holding someone’s hand. Their families are on Zoom. You are the last person that person touches,” she said.
“You become a surrogate for that family, and they get to talk to their loved one, but it’s not the same as sitting there stroking their head and holding their hand.
Health system ‘at capacity before COVID’
Australian Medical Association vice president Chris Moy said the health system could not handle Australia reopening at 70 per cent unless political leaders were prepared for horror scenes and thousands of patients dying.
“Let’s be realistic, the health system across Australia has been at capacity before COVID,” Dr Moy said.
Dr Moy said the AMA was “very respectful” of the Doherty Institute modelling, but opening up at 70 per cent without getting the healthcare system ready would mean some patients do not receive adequate care.
“It can’t be a zero-sum hell or high water situation. [The Doherty modelling] is a guide of where we should be heading to,” he said.
“But now we need to make an assessment of our health system and make sure it’s ready to go.”
But Dr Moy said extra ventilators would be useless without the staff to work them.
“Honestly some of the discussions they’re having – saying we’ve got 2000 ventilators. Well, if we need those we are really in hell at that point,” he said.
“The ventilators don’t run by themselves. They’re useless without a large number of nurses and doctors.”
In the past year, hospitals around the country have trained thousands of extra staff to work in ICUs.
But it will likely not be enough if we open up at 70 per cent with thousands of cases in the community, Dr Moy said.
“There will be a lot more people dying,” he said.
Bracing for an onslaught
Across the world, the warning has been clear – open up too early with rising cases and not enough people vaccinated and hospitals will become overwhelmed.
University of Sydney research released last week indicated that COVID-19 cases would continue to climb and could peak between 1500 and 6000 a day by early October.
Without restrictions they could climb to 40,000 a day, the research showed.
Australia’s ICU capacity is set to be front and centre of discussion at the meeting of national cabinet this week, after Department of Health secretary Brendan Murphy wrote to the Australian and New Zealand Intensive Care Society asking for estimates about how much pressure could be put on the system.
Prime Minister Scott Morrison told Parliament this week that coronavirus patients will take up 10 per cent of the nation’s ICU capacity within a week under government forecasts.
“We know from the information that has been presented that in ICUs that we can anticipate around about up to 20 per cent in NSW of their capacity being used up because of COVID,” Mr Morrison said.
“And for the rest of the country that’s around 10 per cent. That’s over the next week or so.”
The Australian Nursing and Midwifery Federation’s Victorian branch secretary Lisa Fitzpatrick said politicians needed to explain to the public what opening up at 70 per cent would do to the health system.
“Especially if we open up with thousands of cases in the community and 20 or 30 per cent of unvaccinated adults, that’s between four and six million adults,” Ms Fitzpatrick said.
“‘Opening up’ with 30 or 20 per cent of eligible adults unvaccinated is not just about being able to go out with your friends, modelling suggests it will also mean thousands of new infections and hospitalisations.”