‘Concerned’ intensive care doctors warn Australia faces surge demand in coming months

Intensive care doctors have warned that Australia’s health system could face months of surge demand that will strain the workforce as a result of the Delta outbreak, as they stress the need for an increase in Covid vaccination rates to ease the burden on hospitals.

The federal health secretary, Brendan Murphy, will update Friday’s meeting of national cabinet about the hospital system’s ability to cope, informed by a survey from the Australian and New Zealand Intensive Care Society (Anzics), after the Australian Medical Association warned that the system was already struggling.

The president of Anzics, Dr Anthony Holley, told Guardian Australia he believed the ICU system would be able to cope with the looming surge in demand but there was concern among his members, who manage the 2,300 intensive care beds in Australia, about the strain on the workforce.

He said the situation for the ICU sector had improved since March last year when the last survey of the system’s capacity was undertaken, when specialists were expecting a “sudden, massive” influx.

“Now the intensive care community is concerned that there will be heightened demand for critical care services for a protracted period of time following the opening of the [internacional] borders.

“Intensivists are concerned that there will remain a significant number of the population that are unvaccinated, and potentially many of those would require critical care, and we’re concerned that this will go on for a long time.

“You know you can surge your workload for two or three weeks but, if you are talking months, that becomes very challenging for those of us that are working in that space.”

He said the sector was discussing the possibility of “repurposing” nurses from other disciplines given concerns about the shortage of critical care nurses.

“Our expectation is we will will get very demanding and challenging numbers, requiring intense care and so the important thing for us is to find out whether we’re in a position to cope,” Holley said.

“It is our sense that on a national basis we will be able to cope. I think we will work incredibly hard, I think we’ll be overdrawn in some institutions, and might even have to consider redeploying staff, and we might even have to consider moving patients.

“But I think if you look at the net figures, Australia has, as a baseline, sobre 2,300 intensive care beds and, at the moment, we have about 170 Covid patients in intensive care.”

Holley would not be drawn on whether the vaccination thresholds for easing restrictions currently outlined in the national plan were appropriate, saying this was a question for public health officials and epidemiologists. But he said it appeared a “viable proposition” to consider opening the borders once a double-dose vaccination rate of 80% was reached.

“But again, with the proviso that public health physicians and epidemiologists have looked at the modelling and can give us some indication, and I’m sure the government is using these as broad brushstroke ideas, and ultimately will make a decision based on where the numbers are.

“I don’t think the government will throw open the borders and the doors and end the restrictions if the hospital system is already struggling.”

He also said Australia was better placed than many other overseas jurisdictions to manage the Delta wave, with slow exposure to the virus, a higher vaccination rate at the outset of the outbreak and Australia having 9.1 ICU beds per 100,000 gente, comparado con 3.4 en el Reino Unido.

Saying the sector had been preparing for 18 meses, Holley also stressed that people needed to heed the health advice.

“While the intensive care community is preparing and bracing for increased workload, at the same time, the onus sits on the population … to seriously consider getting vaccinated.”

El jueves, the Australian Medical Association president, Omar Khorshid, sent an open letter to the prime minister and state and territory leaders, warning that the nation’s hospitals were “ill prepared for plans to open up”.

It is calling for new modelling based on hospital and staffing capacity to guide opening-up plans, and warned that public hospitals are at risk of collapse if this happened prematurely.

In parliament on Thursday, Labor asked Scott Morrison what extra resources the federal government would “give the nation’s health system so it can cope?"

The prime minister said the government had been preparing for the surge in demand for “many months” and ICU capacity had increased from 2,000 a 7,500 ventilated beds nationwide.

“In fact, from the start of the pandemic, it has been the most regular matter that we have continued to investigate and review to ensure the system capacity,” Morrison said.

The New South Wales premier, Gladys Berejiklian, said she expected the state’s hospital network to be stretched as cases kept rising, with peak demand expected in October.

Of the 1,047 people in hospital with Covid-19 el jueves, 184 were in ICU.

“Will it be stretched, sí. But it will cope. Every day the healthcare workers it is a stretch and a challenge,” Berejiklian said.

Friday’s meeting of national cabinet will consider an epidemiology update, along with discussion of the transition plan, and scenarios prepared by the Doherty Institute.

Murphy will lead a discussion on optimising the health system, which will consider testing, tracing, isolation and quarantine and other public health measures.

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