COVID IMPACT ON ICU IN NSW AND VIC

NEW SOUTH WALES

  • It is extremely difficult for the public to understand the current state of control over the COVID-19 Delta spread due to the degree of conflicting information being given by state government officials, healthcare workers and various media organisations
  • NSW currently has 844 staffed ICU beds available all with ventilators available if required
  • As of 5th September, 2021, NSW has 173 ICU beds – 20.5% – occupied by COVID-19 patients
    • This is in keeping with Prime Minister Scott Morrison’s predication on August 30th, 2021, NSW would see 20% of their ICU beds filled by COVID-19 patients
    • More broadly, throughout the whole of Australia, COVID-19 patients are occupying roughly 10% of all ICU beds
    • Due to the higher level of care for COVID-19 patients in the ICU – being the patients more likely to require a ventilator, requiring healthcare workers to don extensive PPE gear, any increase in the number of COVID-19 patients requiring ICU puts significantly more pressure on these units
    • President of Australian and New Zealand Intensive Care Society, Professor Anthony Holley, states that if 50% of ICU beds were to become occupied by COVID-19 patients, due to their higher care requirements, the system could be overwhelmed
  • A COVID-19 patient in ICU generally requires longer stays in ICU compared to a non-COVID-19 ICU patients
    • Any patient in ICU requiring ventilation stays a median of 16 days, and one in five of these patients die
    • There are currently 813 COVID-19 patients in hospital in NSW, but of all patients hospitalised for COVID-19, roughly 10% require an ICU admission either from the outset or at some point during their stay
  • As of 5th September, 2021, there are no ICU capacity issues in NSW
    • The federal government is starting to rely more on the input and advice of intensive care doctors to ensure the system can cope with a rise in COVID-19 patients as the pandemic continues to surge through the state
    • Health Minister Greg Hunt has stated the Australian healthcare system has 7500 ventilation, 2000 of which are in NSW
    • As on August 22nd, 2021, NSW Health Minister Brad Hazzard, stated that the healthcare system of the state retains excess capacity to cope with an increasing number of COVID-19 patients requiring ICU admission, stating the availability of 2000 ventilators, a rise from 500 ventilators in 2020
  • Although NSW has the capacity to create 2000 physical ICU beds, it would be almost impossible to staff this many beds
    • There is a significant disinterest of nursing and healthcare staff if being trained and working in ICU
    • Of 170 nurses and healthcare staff who became trained in working in an ICU setting last year, only 5 workers have expressed any desire to return to the ICU

Useful Links

  1. Australian Government Department of Health website provides a daily-updated graph detailing the number of current COVID-19 cases in a) hospitals and b) intensive care units in each state and territory

https://www.health.gov.au/resources/current-covid-19-cases-in-hospitals-and-intensive-care-units-icus

Sources:

ICU IN VICTORIA

  • Victoria is in a very different situation compared to NSW in terms of its capacity to cope with a surge of COVID-19 and the potential effects of the Delta strain on the healthcare and hospital system.
  • In April 2020, the initial forecast by the Australian government based on modelling by epidemiologists predicted a daily demand for 5000 to 35, 000 ICU beds due to COVID-19 cases. Although this modelling was far from what happened last year, Victoria was the only state to commit to preparing their hospital systems for the worst possible outcome, and invested $1.3 billion in the state’s healthcare system, dwarfing all other states and territories in their response to the pandemic. As part of this investment, Victoria tripled their ICU bed capacity, and has the capacity to increase its number of bed to 4000 if necessary.
  • However, as with NSW, it is not only a matter of increasing the physical number of ICU beds within hospitals. The real problem lies in having adequately trained staff – ideally ICU-trained nurses and doctors – who are able to care for these patients, as well as ensuring adequate amount of PPE and other necessary medical and safety equipment.
    • Victoria’s most pressing problem is not the number of ICU beds available, as there is currently plentiful capacity, but staff shortages that are calling into question whether the state would be equipped to handle a surge in critically ill COVID-19 patients
    • Recently, a significant number of nurses and doctors in Victoria were forced into two weeks of quarantine due to many hospitals within the state being exposure sites (Sunshine Hospital, Footscray Hospital, Royal Melbourne Hospital, Werribee Mercy Hospital, Dandenong Hospital)
    • Victoria has recently flown in 350 medical staff from overseas, 90% of whom are doctors, in attempt to handle staff shortages, but longer term solutions are required. Director of Intensive Care at Austin Health, Dr Stephen Warrillow, points to the need to have an element of improvisation to cope with staff shortages, including identifying medical staff who may not be specifically trained in intensive care, but have skills that could cross-over well with intensive care and be available to assist if necessary.
  • As of 5th September, 2021, Victoria has 89 hospitalised COVID-19 patients, 24 of whom are in intensive care, 13 of whom are requiring ventilator support.

Useful Links

  1. Australian Government Department of Health website provides a daily-updated graph detailing the number of current COVID-19 cases in a) hospitals and b) intensive care units in each state and territory

https://www.health.gov.au/resources/current-covid-19-cases-in-hospitals-and-intensive-care-units-icus

Sources: