When Westmead Hospital declared a yellow emergency last week, it provided an uncomfortable glimpse of what our future of living with COVID might look like.
Perfection in a global pandemic is impossible. However, Westmead was forced to put a 24-hour pause on accepting new patients, source an extra 100 private beds and redirect cases as far as Wollongong for a simple reason: it was being overwhelmed. “We acknowledge we are no longer operating in a business-as-usual environment,” acting general manager Jenelle Matic wrote to staff.
There’s no doubt our local health system is under pressure while western Sydney bears the majority of the state’s COVID caseload. Based on figures released by Health Minister Brad Hazzard, Westmead was managing 121 COVID cases in its wards, including 23 in Intensive Care units, as of mid-last week. Ambulances brought in 280 COVID patients over the preceding seven days. Staff have been handling hundreds more cases in the community.
Despite these heroic efforts, there has obviously been a logjam transferring patients between settings.
When paramedics have to ramp patients in the hospital car park for six hours, it’s a sure sign the system has hit crisis point.
It also raises the question: if this is what hospitals like Westmead look like under a lockdown scenario, what happens when Sydney opens up?
Vaccination is our main tool to reduce community transmission. It’s good that 50 per cent or more of adults have had their first dose across most of Parramatta LGA with Carlingford, Epping, Winston Hills and Toongabbie doing particularly well. Cumberland continues to run somewhat behind. Yet case numbers continue to rise and even Dr Kerry Chant warns they will go “way above” 1000 a day.
The vaccination rate will max out at some point. Only now is the rollout beginning to extend to children. As other nations are finding, we’ll also need a booster strategy to combat vaccine waning effectiveness over time.
This indicates our health system needs to be prepared. Many have more detailed working knowledge than me, but the key challenges are apparent. What are the projected case numbers that hospitals like Westmead will face in future? Do we have the necessary capacity – and importantly staff? Already, it’s taking too long to give many of our health and aged care workers the jab. Some paramedics are working 21-hour shifts. When busy health teams are forced to isolate for 14 days due to COVID exposure, it places operations at risk.
Hospital infrastructure is another issue along with workforce planning. Tragically, we’ve seen so many fatalities at hospitals like Liverpool, Nepean and St George where the virus seeped into non-COVID patients. So, what are the physical changes needed to expand capacity and make wards safe? Do we need to build new COVID-only hospitals or temporarily repurpose existing ones?
Finally, how will we continue to care for other conditions that are a major cause of morbidity, including heart attacks and strokes? At Westmead, live donor transplants have reportedly been cancelled indefinitely as resources are diverted. But what is termed elective surgery is essential surgery if you’re the person requiring it.
If you listen to the federal and state governments, moving to ease restrictions, the response is essentially “nothing to see here”. We all want to open up safely, but the Prime Minister and Premier can’t dismiss reasonable questions. We need to be vigilant now about what living with COVID means for our health system.
Alan is a journalist and communications specialist. He writes a weekly column for Parra News.