‘Unclear’ information and lack of supplies block hospitals’ pandemic plans, said Greg Hunt | Health

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An organization representing 80 Australian hospitals has warned Health Minister Greg Hunt that “unclear and convoluted” information from governments and a dire lack of equipment is hampering emergency preparedness for the pandemic, and could strain staff in these hospitals. nonprofit hospitals make “tough decisions” about which patients they can treat.

Hospitals across the country are bracing for the peak of the pandemic, which in the worst-case scenario could leave Australia’s intensive care units overwhelmed and struggle to cope with the influx of critically ill Covid-19 patients.

Modeling published by the Medical Journal of Australia suggested that the country’s intensive care capacity of 2,200 beds could be exceeded at around 22,000 cases of Covid-19 “around April 5 if public health measures fail. to slow down the growth rate ”.

Australia is trying to double its intensive care capacity and dramatically increase inventories of ventilators in preparation, and intensive care experts believe the number of beds can quickly reach 5,000.

Important regional facilities like Wagga Base Hospital are making plans to double intensive care capacity, while in Sydney, the Royal Prince Alfred Hospital has prepared a dedicated and specially designed Covid-19 intensive care unit .

To relieve the pressure, plans are being made for large hotels to potentially be used as venues, and in Victoria, the government is making plans to convert the Melbourne convention and exhibition center into a hospital and mortuary.

Health services are also planning how they could make the types of extremely difficult decisions imposed on doctors in Italy – where a shortage of equipment and beds has left frontline staff deciding who lives and who will die.

Canberra Health Services, which has given Guardian Australia an overview of its preparations, is developing a plan for how it will make treatment decisions if there are more patients than clinicians or equipment to treat them.

“Clinicians have to make these decisions all the time,” said CEO Bernadette McDonald.

“We haven’t developed this yet, we are looking at it, but we want to make sure we bring the voice of the consumer and caregivers into our discussions on this. “

Non-government hospitals are also starting to promulgate their emergency preparedness protocols as Covid-19 submissions increase and expand their testing capacity to try and reduce the burden on state-run facilities.

Private health insurers have warned that nongovernment hospitals will have to take over from state-run facilities.

But a letter seen by the Guardian shows that one of the country’s largest non-government hospital groups – Catholic Healthcare Australia – told the Minister of Health it was “gravely concerned” about convoluted government communications and obstacles to access to stocks of masks and gowns. through the national medical stock.

“We are concerned if we continue to face these obstacles in accessing vital supplies, especially [personal protective equipment], the result will be reduced access to hospital care for the community at a time when access to medical treatment is most critical, ”wrote CEO Pat Garcia.

The CHA represents 80 non-governmental hospitals which alone have more than 10,000 beds, including 2,700 public beds.

Its own PPE supply chains are under immense pressure amid the global pandemic, and hospitals are now trying to gain urgent access to equipment stored in the national medical stockpile through state and local governments. territories.

This has caused enormous difficulties, as a single hospital organization that crosses state borders has to deal with multiple governments.

This is further complicated by “unclear and convoluted” information about access, Garcia said.

He urged the government to plan its response to the pandemic in a way that uses public and non-government hospitals as “a seamless network in the fight against Covid-19”.

“You know that PPE is an essential part of infection control, protecting clinicians and patients from transmission of the virus,” he said.

“Without it, clinical staff will have to make difficult decisions about what services they can provide and which patients they can treat.”

More generally, hospitals are preparing by training staff to resuscitate patients while wearing protective gear, performing simulations on how to treat certain types of Covid-19 positive patients, such as women in labor, and ethical planning if the number of patients exceeds the available resources.

At Canberra Health Services, a task force meets daily to discuss critical issues – supplies, logistics, clinical care (especially emergency and intensive care), clinical advice, screening and testing.

David Caldicott, an emergency department consultant at a Canberra hospital and lecturer at Australian National University School of Medicine, said emergency physicians around the world regularly talk about what is happening in each of their countries and different approaches to the crisis.

“One of the basic rules of disaster response is to plan for the worst case,” he said.

“We can hope that things will turn out a certain way, but we also have to anticipate the possibility that they will get significantly worse. It’s just smart disaster planning.

He added that Australia’s trajectory will depend on the extent to which the majority of the population adheres to social distancing measures.

“The front line is at your doorstep,” Caldicott said.


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