The understanding about Australia’s current hospital capacity is not sufficient to know the impact of policy settings that will see the nation ‘living with the COVID-19’, the peak professional body for doctors has warned.
President of the Australian Medical Association Dr Omar Khorshid published a letter calling for the prime minister, state premiers and chief ministers to obtain new modelling about hospital capacity to cope with planned easing of COVID-19 restrictions.
“Our hospitals are not starting from a position of strength. Far from it. As well as ambulance ramping, we have the lowest bed-to-patient ratio in decades, our emergency and elective performance continues to decline, and our doctors and nurses continue to barely cope with their workloads and the constraints of the system,” Korshid said.
In his letter, Khorshid said the hospital system was in danger of ‘being locked into a permanent cycle of crisis’ if public health measures were relaxed before adequate modelling about how the hospital system would cope had been undertaken.
“Even pre-COVID, emergency departments were full, ambulances ramped, and waiting times for elective surgery too long.
“We must urgently prepare our health system before opening up and to do that we need new modelling based on our hospitals’ ability to cope with the associated increase in caseload,” Khorshid said.
According to the prominent doctor, prior to the pandemic the hospital system was already stretched. It would not be enough for the National Cabinet to consider only giving additional resources to intensive care units in the event of a potential COVID surge, he added. More money needed to be directed at the longer-term ‘public hospital funding crisis’.
He went on to say that a reform agreement and funding for increased beds and additional hospital staff were essential to adequately prepare Australia’s hospitals for a COVID surge.
“Even pre-COVID, emergency departments were full, ambulances ramped, and waiting times for elective surgery too long,” Korshid said.
“Our hospital system will need to adapt to incorporate new facilities, staff and processes required to stop the spread of COVID-19, especially recognising airborne transmission,” he said.
Part of adapting hospital settings in preparation for a COVID outbreak surge included actions focused on improving infection control, and where COVID-positive and negative patients were being treated, Korshid said. The proposed modelling should take this into consideration, along with the cost, efficiency impact and supply of PPE.
Models are guidelines, not tramlines. Politicians will have to be pragmatic re opening-up scenarios. https://t.co/A35amHxR1d
— Prof. Peter Doherty (@ProfPCDoherty) September 2, 2021
Another important consideration was Australia’s healthcare workforce in hospitals and the primary care sector, which has been thinned as a result of international border closures. Korshid said a clear solution to this problem was mandatory vaccination of all employees and contractors who work in hospitals. The national group representing Australia’s private hospitals was recently petitioning the governing to mandate COVID-19 vaccines for its staff, in addition to those working for the public system.
“The practice of furloughing staff exposed to COVID-19 won’t be sustainable once caseloads increase and this is one of the reasons the AMA called for vaccination to be mandated for all employees and contractors in hospitals and community health settings,” Korshid said.
For vaccination rates of the Australian population generally, Korshid said he believed a target of 80% fully vaccine coverage of adults was required to avoid repeated lockdowns and the capacity of the healthcare system.
“If we throw open the doors to COVID we risk seeing our public hospitals collapse and part of this stems from a long-term lack of investment in public hospital capacity by state and federal governments.”
Last week Scott Morrison had announced that a working group led by Health Secretary Brendan Murphy would review Australia’s hospital capacity and report back to the National Cabinet by Friday.