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Intensive care units across Victoria are struggling to find staff to fill shifts as thousands of health workers from cleaners to specialist doctors are furloughed after being infected or exposed to COVID-19.
Coronavirus hospitalisations have jumped 50 per cent in a week to 644 patients – equivalent to at least one large Melbourne hospital – with the vast majority arriving in congested emergency departments before going into general hospital wards. The number of COVID-19 patients in ICU has remained relatively steady with 106 patients recorded on Friday, compared to 97 a week ago.
Ambulances and hospitals have been slammed by Omicron.Credit:The Age
Meanwhile The Age can reveal that, across Australia on Friday, more than 700 critical care staff were unavailable for work. The figures are likely to be a significant underestimate because some hospitals don’t report their staff absences to the national database. Of these, more than 300 were Victorian doctors and nurses, according to the federal Critical Health Resource Information System, a database used to monitor ICU capacity nationally.
Some healthcare workers were struggling to access rapid antigen tests, while dozens of ward assistants, who help transfer critically ill patients who arrive in the emergency department, had been forced into quarantine after being exposed or infected with virus. Hospital cleaners, who are crucial to infection control, were also isolating in significant numbers.
Emergency physician Simon Judkins said Melbourne hospitals were being crippled by the staff shortages which had also left dozens of beds in emergency departments’ short stay units unable to be opened.
“The dam wall has well and truly broken,” Dr Judkins said. “The system is about as stretched as it could possibly be right now. It is all hands on deck to try and manage the most acute patients.”
Some healthcare workers whose family members and other close contacts have tested positive will be allowed to continue working at hospitals.
Victoria reported another 21,728 coronavirus infections on Friday, taking the known number of active cases to 69,680, though experts warn the true number is far higher than official reports.
Dr Judkins, who sits on the board of the Victorian branch of the Australian Medical Association, said staff were left shell-shocked and distressed this week by the soaring numbers of patients arriving in emergency departments and the stream of ambulances ramped out the front of hospitals every night.
“There are patients deteriorating in the waiting room and in the back of the ambulance while they’ve been waiting to access care,” he said, adding he was not just “desperately worried” about rising coronavirus patients, but also mental health presentations which were skyrocketing again.
Earlier this week, Ambulance Victoria issued a code red alert warning patients to expect delays if they called an ambulance, citing “extreme demand” in the metropolitan region. The code red – the same declaration issued in Victoria for the Black Saturday bushfires and the deadly thunderstorm asthma event of 2016 – came a day after people were warned not to visit major emergency departments in hospitals in Melbourne’s western suburbs due to extreme pressure on the units.
In an attempt to reduce the number of absentees, some healthcare workers whose family members and other close contacts have tested positive will be allowed to continue working at hospitals.
A memo seen by The Age sent to some staff said household contacts could continue working, with caveats including being asymptomatic, having a negative rapid test daily and remaining in quarantine outside of work.
Despite rising COVID-19 case numbers, Acting Premier Jacinta Allan said the Victorian government had no immediate plans to replicate NSW’s tighter coronavirus restrictions announced on Friday – including a ban on singing and dancing at public venues.
“We’ll closely monitor their settings and the impact they may be having on helping manage the spread of the virus in the community and we’ll continue to do that in the context of reviewing what’s appropriate for Victoria.”
Head of the Department of Critical Care at the University of Melbourne, David Story, said medical staff who were not specialists in emergency medicine or intensive care, were increasingly being asked to fill in shifts for furloughed senior doctors, nurses and allied healthcare workers.
“We are trying to provide the best possible supervision of those people but it’s just increasingly hard with more and more people being exposed every day,” the senior anaesthetist said.
Senior ICU doctor David Pilcher said every intensive care unit in Victoria was now finding it difficult to staff beds, with so many workers furloughed as they caught or were exposed to COVID-19 in the community.
The number of Victorian critical care staff who were unavailable to work was three times higher than ever before, with previous peaks occurring at the height of earlier COVID waves, he said.
There are roughly 400 ICU beds open across Victoria, higher than usual for this time of year, when many people including surgeons conducting operations that result in ICU admissions take leave. But Professor Pilcher said staffing shortages were being felt most on general wards where the vast majority of COVID patients were being looked after.
As Omicron spreads disproportionately among young adults, Australian and New Zealand Intensive Care Society spokesman Dr Anthony Holley said there were about one or two trainee doctors and nurses unable to work every day in every unit in Australia.
The remaining staff were working harder and longer to maintain the standard of care that Australians were accustomed to.
“That goes for everybody, the administrators, people rewriting rosters … there’s a huge infrastructure to ensure that the workforce keeps ticking along,” said Dr Holley.
Emergency medicine representative for the Australian Medical Association’s federal council Sarah Whitelaw said the federal government’s focus on hospital admissions of coronavirus patients nationally as a measure of whether the health system was coping was “flawed and misguided”.
“The emergency department is going to be our Achilles heel of the health system and we wish the federal government would stop pretending everything is fine and say ‘we understand that things are not normal and this is what we are going to do about it’,” she said.
She said the AMA was aware of reports nationally of pressure being placed on some healthcare workers to return to work even if they had tested positive to the virus.
“It is simply not acceptable and dangerous for all of us,” she said. “We cannot let that happen.”
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