...brace for case explosion in Victoria in the weeks ahead..
...getting vaccinated is a race now, the one who is late will have to settle for a late date- you don't immediately get it when you want it, and then you need to get the second shot and wait another 2 weeks before it can be effective.
Victoria braces for sixfold leap in COVID-19 hospitalisations
Tom BurtonGovernment editor
Sep 8, 2021 – 6.27pm
Victoria is bracing for a more than sixfold jump in hospitalisations, with expectations that 800 COVID-19 patients will be in hospital in late October, but health planners are confident there will enough beds and staff to meet the demand, despite the state not having hit its peak of virus cases.
Using NSW data, Victorian health planners are forecasting that about 270 COVID-19 patients will be in intensive care units of hospitals. Based on clinical experience about half of those will require ventilators.
Sustaining high levels of ICU will be challenging unless there is widespread vaccination, Austin Hospital director of intensive care Stephen Warrillow said. Justin McManus
The projections for late October are based on expectations of a state caseload of 18,000 infections, but with a possibility that cases could be higher if the current growth in infections doesn’t taper. The state has 1920 cases.
Victoria is epidemiologically about six weeks behind the NSW delta outbreak and about two weeks behind in vaccination coverage,
NSW released
Burnet Institute modelling on Monday that predicted a peak of 3434 hospitalisations and 560 ICU patients in late October. The state is managing nearly 27,000 cases and daily new cases are expected to peak next week as the key reproduction number, which measures how the virus spreads, slowly tapers towards one.
There were 1480 new cases in NSW on Wednesday and nine deaths.
Victorian health planners say that about a third of patients who go into hospital are being transferred to ICUs, with Premier Daniel Andrews and Health Minister Martin Foley claiming the delta variant was causing more acute sickness than previous variants.
“Delta is a nastier variant of the coronavirus, and it does more damage, and it makes more people, more unwell, quicker,” Mr Foley said.
While the state has only 33 COVID-19 patients in ICU now, hospitals are bracing for a surge.
“We do have the benefit of knowing what works last year,” the director of ICU at the Austin Hospital and past president of the Australian and New Zealand Intensive Care Society, Stephen Warrillow, said.
”It will start to look and feel a bit more like what happened last year, where pretty much all of the major hospitals will be managing COVID in a manner similar to last year,” Dr Warrillow said.
He cautioned that while the ICU staff were well-prepared, they were weary from 18 months working under pandemic conditions.
“The thing I am more challenged by, personally, is the sustainability of the responses.”
“I’m very confident that we expand capacity and meet the immediate demands – that really doesn’t worry me – acknowledging the challenges associated with that.”
“It’s more than I think everyone involved in the delivery of the bedside care, has now had 18 months, with not a lot of respite and doing that for week to a couple of months I’d be very confident about.”
“I think it’s going to be the community that bails us out. Ultimately, it’ll be the speed with which the community accepts and adopts as close to 100 per cent vaccination as possible that is going to be the key determining factor whether ICU can sustain the response, because it can’t be forever,” Dr Warrillow said.
The state recorded a slight dip in its latest daily case count, with 221 cases recorded on Wednesday. Officials are anxiously hoping this could be the start of a long-awaited tapering in case growth, avoiding a predicted explosion in case numbers.
The northern suburbs of Melbourne continued to be the source of growth, with 86 per cent of new cases being aged under 50. Six regional cases were also reported.
Victoria has 120 COVID-19 patients in hospital with about 10 per cent of cases presenting for admission. A three tier system is used to triage possible patients with the state also having about 1600 infected patients being managed in its hospital-at-home system.
Learning from last year, the state is streaming COVID-19 patients to major hospitals to avoid infections into the broader hospital system. Hospital administrators also say there is much greater collaboration with private hospitals.
Several major public hospitals have been activated in the last few days after cases rose sharply in the northern and western suburbs over the last week.
Hospital planners say the system has staffing and beds for 1500 patients if required. This compared with a typical ICU capacity of about 400. After a $1.3 billion injection, the system has contingency for up to 4000 acute care beds, but this would require a radical change in staffing as well as the deferral of most admissions other than emergency care.
“ICU nurses and specialists do not grow on trees,” Mr Foley said, calling on people to continue to comply with public health rules.
The enormous amount of planning for the state’s expected third wave comes as new research by Deakin University epidemiologist Catherine Bennett for the Sax Institute suggests indoor mask-wearing and event capacity limits are likely to remain in place into next year.
“Masks indoors will be the last precaution to go, and large gatherings the last banned activity to return, although large events will no doubt happen sooner if we go the way of adopting vaccine passports as have other countries,” Professor Bennett said.
