Join Hafta-Ichi to Research the article “Overcrowding in Victorian hospitals ‘bigger emergency than Covid’, expert warns | Victoria”
Overcrowding in Victoria’s healthcare system is a “bigger public health emergency than Covid,” according to a leading emergency physician who says the state’s doctors and nurses were exhausted even before the latest outbreak.
Victoria is in a seven-day lockdown with 30 cases of community transmission, more than 120 exposure sites, and 15,000 primary and secondary contacts of cases in isolation.
The Australasian College for Emergency Medicine Victoria faculty chair, Dr Mya Cubitt, said on Friday that doctors and nurses in public hospitals had been dreading such a situation because they were still recovering from Victoria’s second wave in 2020.
At its height, that outbreak saw more than 700 new cases in a single day. There were 768 deaths overall with hundreds of healthcare workers infected.
“We are in the worst crisis that healthcare has faced in many years,” Cubitt said.
“You could even say – and I’d love to speak with [chief health officer Prof] Brett Sutton about this – that the access block and overcrowding of the system is the bigger public health emergency at the moment. Whether we have a Covid outbreak or not, emergency clinicians, and all of the many colleagues that we intersect with in the healthcare system, are under extreme pressure.”
A number of factors had created the crisis, Cubitt said. There was still a backlog of people accessing healthcare following the extended lockdown in Victoria in 2020 when patients delayed seeking help.
A lack of beds in wards meant there was also nowhere to send people after they’d been in emergency.
There were “overcrowded waiting rooms where one hundred people haven’t been able to get through the front doors of the hospital and then tens of people in emergency departments who haven’t been able to be admitted,” she said.
“How do you socially distance that? In the current crisis our healthcare colleagues are facing, you overlay the complexity and process challenges of Covid-related infection control, and it is exhausting. People are exhausted. They haven’t been able to have a break.”
The emergency physician said sick leave among hospital workers was at record rates. Many had been sick with Covid, including Cubitt herself, and were still suffering fatigue and other effects.
“Sick rates are off the chart, especially in the emergency sector, and I’m really worried about our ability to retain the workforce,” she said.
“They do need time to recharge and recover. It doesn’t matter whether you were the one who had Covid or the one supporting colleagues through that. Everyone is fatigued – including the cleaners who are as exhausted as the rest of us.”
Cubitt said one positive was everyone was vaccinated now “which absolutely helps us feel safer”.
Health workers were also dealing with other novel illness trends alongside Covid, such as the unusually high rates of respiratory syncytial virus in children over the summer.
“Then there’s obviously the new and novel paediatric mental health problems that are unprecedented. It’s a combination of so many different things leading to increased demand in a new way that we haven’t dealt with. There are bottlenecks all over the place.”
An associate professor of public health at the University of Melbourne, Marie Bismark, who is also a psychiatry registrar working in emergency mental health service in Melbourne, said the latest Victorian outbreak had been triggering.
“Yesterday, I had to put a face shield on for the first time since last year, and as I put it on I suddenly felt my heart racing,” Bismark said.
“I realised that actually, there’s still some trauma there from working on the Covid ward and working in the intensive care unit with Covid-positive patients because that’s when I was last in the face shield. I had this kind of sympathetic nervous system response.”
Bismark said emergency departments were stretched long before the latest outbreak.
“What we’re seeing is this post-pandemic wave of mental health presentations,” she said. “Now we have the apprehension that another wave of a Covid pandemic is going to crash on us while we’re still dealing with the post-pandemic presentations after last year.”
She stressed it was important that people sought medical care and did not delay attending an emergency department if they were unwell.
“Last year there was some real concern about patients avoiding the emergency department because they were fearful of overwhelming the system, but we really do want patients coming in,” she said.
The Australasian College for Emergency Medicine is calling for greater cooperation and coordination between state, territory and federal governments to fix the acute hospital access crisis, which the college argues is placing patients at risk.
The Australian Medical Association last week warned the hospital system was not prepared for a significant outbreak of Covid-19.
The association’s president, Dr Omar Khorshid, said on Friday: “When the system is under stress the chances for error goes up and the quality of care is reduced.”
“The reason our hospitals are struggling is likely a combination of effects,” he told Guardian Australia on the first day of Victoria’s week-long lockdown.
“My suspicion is that we have many Australians overseas returning and less people who are travelling, so these people are also accessing medical care and getting healthcare they might have otherwise delayed or received overseas.
“There’s definitely a lot of sick people in hospital filling up the hospital beds, which may also be an impact of the lack of healthcare, particularly in Victoria, during that extended lockdown. That’s why it’s critical that people continue to seek healthcare.”
Source: The Guardian
Keyword: Overcrowding in Victorian hospitals ‘bigger emergency than Covid’, expert warns | Victoria