Doctors warn NSW emergency departments face five times the number of Covid patients as ICUs

Doctors are warning that hospital emergency departments in New South Wales will face almost five times the number of Covid patients than intensive care wards, as the sector calls for a coordinated approach to manage surging demand.

Modelling undertaken by the Australasian College for Emergency Medicine suggests that almost 20% of Covid cases will present to emergency departments and between 15% and 17% of these cases will be admitted into general wards, with less than 5% going into intensive care.

President of ACEM, Dr John Bonning, said the group’s figures were based on the surge experience of the pandemic overseas and warned that emergency departments could become a bottleneck in the system.

Given “business as usual” demand on emergency departments was continuing, Bonning described the Covid outbreak as “a real stress on our already overburdened system”.

Information released from the NSW government this week suggested that hospitalisations in the state would peak in late October, with total admissions at 3,434, including about 560 Covid patients in ICU.

But Bonning said the ICU requirements were the “tip of the iceberg” for the expected demand on the hospital system.

“For that number of people that are going to come in and require intensive care, they’ll still come in via an emergency department, and need admission,” Bonning told Guardian Australia.

“We can show with our modelling that five times more patients than those ICU numbers are going to come and need hospitalisation.”

“We need to coordinate, because we know this is coming in terms of approximate volumes, and how many are going to need admitting, and it is going to need absolute statewide coordination.”

The ACEM figures are more pessimistic than the modelling undertaken by the Burnet Institute for the NSW government which suggested a hospitalisation rate of about 11%.

Bonning said in NSW many hospitals were not accepting Covid patients, meaning some small emergency departments were already overwhelmed, while some larger departments were not.

“That’s not fair, and it needs statewide global coordination to share the load,” Bonning said.

According to a report in the Sydney Morning Herald, the Westmead, Liverpool and Nepean hospitals were caring for the overwhelming majority of Covid cases in NSW, while some larger hospitals, such as the Royal North Shore and Royal Prince Alfred had fewer than 40 cases.

Bonning said that states needed to ensure that patients were being properly coordinated across the state’s hospital network, warning that failure to do so would see unnecessary diversions and inefficiencies. He said other states should look to what was happening in NSW to prepare for similar surge requirements before an outbreak occurred.

“I don’t want to give a picture of complete chaos, but it’s something that just needs to have real planning, particularly in the states that aren’t under extreme duress, like NSW,” he said.

Federal health minister, Greg Hunt, said the federal health department had been coordinating with the states in preparation for the surge in demand, and he was confident they would cope despite the “challenging” situation.

“The hospitals themselves and state systems are strong and prepared, whether that be in terms of emergency departments, ICU or ventilator capacity,” Hunt said.

“And that’s always been, continuously been focused upon, and each of the states and territories, in my observations and in our government’s, is well prepared and is doing an excellent job.”

The warning from the emergency sector comes as the federal health secretary, Brendan Murphy, prepares to update state and territory leaders about the country’s hospital system’s ability to cope with surging cases resulting from the Delta outbreak.

On Tuesday, Australia reported 1,485 new local cases of Covid-19, including 1,220 in NSW, 246 in Victoria and 19 in the ACT.

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