On 18 January, Australia broke yet another record, suffering the worst day of its COVID pandemic, with a total of 77 deaths recorded, exceeding the previous national high of 57 a week before. With prime minister Scott Morrison’s approval ratings collapsing and Labor moving into a leading position months out from a federal election, the opposition leader, Anthony Albanese, blamed the government for not being prepared enough to handle rising COVID-19 cases and hospital admissions.
Anthony Albanese’s accusations reflect the government’s own Productivity Commission data, which shows that for every $100 currently spent on disasters, only $3 is spent on mitigation and preparedness. About $97 is spent on post-disaster recovery.
Australia’s health system is a complex mix of public and private service providers, which collectively serve the physical and mental health care needs of Australians.
The current overwhelming of the system shows that despite previous waves of the COVID pandemic, continuing ‘Black Swan’ events like the Omicron variant are still able can catch the system out. More could be around the corner.
Professor Nassim Nicholas Taleb first coined the term ‘Black Swan event’ to refer to high-profile, hard-to-predict, and rare events that are beyond the realm of normal expectations in history, which humans seem hard-wired and fated to ignore, over and over again.
In Australia, the result is that in the worst-case scenario, almost all of the 12,500 beds across public and private hospitals in NSW could be occupied — by both COVID cases and regular patients — when pressure from the state’s Omicron outbreak peaked in late January. There are serious concerns about whether our hospitals are prepared to cope with 6,000 people who could be hospitalised with COVID in the first weeks of February.
While there are processes and tools in place for demand and capacity planning in our hospitals, the pandemic has highlighted serious shortcomings in our current approaches, as the medical workforce struggles with critical shortages, the government implements emergency powers to tap into private health care system resources, and patients in NSW’s public hospitals are being moved to private facilities to make beds available as infections escalate.
Hospitals have been forced to suspend non-urgent elective surgery in haphazard ways, with, for example, IVF procedures being suspended for 90 days in Victoria and experts warning of further disruption to elective surgeries into the future because of staff shortages.
The current chaos in Omicron management in NSW, which has led to the world’s highest rise in daily cases, has highlighted the need for new approaches to hospital demand and surge capacity planning, to avoid the risk of overwhelmed hospitals from future waves of the pandemic that we must anticipate and expect.
It may seem surprising, but very little is known about how we might best reconfigure and restructure our hospitals in the event of pandemics. We simply haven’t done enough research.
However, researchers at UNSW and UTS have developed optimisation models for effective restructuring and reformatting of hospitals and healthcare facilities under calamitous situations such as fires, floods, storms and pandemics. Such tools can be used to make our health infrastructure more disaster resilient, creating less pressure for healthcare front-line staff and ultimately saving lives in coping with future crises which may test the limits of our current systems and planning strategies.
It is well known that lots of practice and planning are effective for future disaster management and making our health system more resilient, but the time and resources to do it are often limited. However, computer simulations powered by cutting-edge optimisation algorithms can overcome this problem.
Our research shows that simulations can help health system planners and decision-makers predict what will happen, and optimise disaster-management outcomes for staff and patients, making the best use of the limited resources available in the shortest possible time.
They do this by allowing everyone involved in a possible future disaster to play in a virtual online space, with different disaster scenarios, patient profiles and inflows, hospital capacity, including ward and bed availability, staff availability and rosters, transport and ambulance availability, evacuation options to other health facilities, including releasing non-urgent patients, equipment availability, medical supplies and the functionality and flexibility of different existing treatment spaces. For example, a recent analysis of one public hospital overseas using this optimisation modelling showed how hospital managers could potentially restructure a hospital of 200 beds capacity to create a hospital of 370-bed capacity by reconfiguring existing resources.
Future natural disasters are inevitable and, if the past is anything to go by, all of them will be made worse by a lack of disaster preparedness. We need to invest more in disaster preparedness and we need to invest more in research that can harness the untapped power of new simulation technologies to help decision-makers make better decisions before, during and after they occur.
One of the biggest revelations for many people from the COVID-19 pandemic has been the knowledge and ability that resides in our academic institutions.
This is not a surprise to those who work in the system. After years of criticising universities and cutbacks in funding for research and education, especially in areas that do not align with the government’s business sympathies like environmental studies, academics have continued to forge ahead because they are committed to making a difference to the communities in which we work.
Politicians are lucky that academics are resilient and they showed no shame in lauding the power of science to guide their decisions during the COVID-19 pandemic.
While it is positive that the Morrison government recently announced more than $200 million in funding for four universities for research to advance Australian manufacturing, it’s not all about big business and we need to pull our heads out of the sand and fund more research into disaster preparedness at a local level.
This would be the best type of investment in our future because it is almost certain that without such investments, the future natural disasters on the horizon will cause unnecessary suffering and loss of life.