Australian hospitals poorly equipped to cope with COVID-19

With cases of coronavirus multiplying across Australia, the NSW Chief Medical Officer has warned that 1.5 million people are at risk of contracting the virus in the state and have called on hospitals to ramp-up capacity:

Speaking at a Budget Estimates Committee, Dr Chant said that could result in about 20 per cent of the state’s population, or about 1.5 million people, becoming infected in the first wave, according to projections.

“We’re nowhere near the peak,” she told the committee…

Dr Chant said the state’s hospitals had been told to double the capacity of their Intensive Care Units and ventilator beds, in order to meet the anticipated burden of presentations due to coronavirus and the flu season.

This got me thinking: how well equipped are Australia’s hospitals to cope with the virus?

Well, according to data from the OECD, capacity is looming as a major problem for Australia, as illustrated below:

As you can see, Australia sits marginally above Italy’s level with 3.8 hospital beds per 1000. By contrast, Japan and Korea are more than 3-times that at more than 12 beds per 1000 people.

As we know, Italy’s hospital system has been badly overrun by the coronavirus. Thus, Australia’s hospital system faces a similar fate if the virus spread is not contained.

Leith van Onselen
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Comments

  1. C.M.BurnsMEMBER

    the 1.5 million figure comes from some modelling done by a USYD Professor and was his BEST CASE figure.

    Worst case as half the state’s population – nearly 4 million people

  2. Reverse Transcriptase

    And as I have been hammering on about everywhere, in 1980 we had 12 beds per 1000.

    Either the beds have gone away or the population has massively increased without building any new hospitals …

    Because these cannot be paid for in tolls and cost a fortune to run and because we are only importing healthy migrants who don’t smoke, pay all their taxes and never use social services. At least that is the current Federal Treasury line.

    But nobody dares to suggest that the ones like Westmead, Blacktown and Auburn are crammed full of elderly (and not so elderly) non english speaking migrants

    When the COVID Royal Commission comes next year, I hope this fact will finally get some airplay.

    Try posting any comment about this on ABC/DomainFax and it goes straight into the Censor’s bin.

      • Wasn’t so much the beds issue but the population denominator that’s put us into third world territory. Hope Gerry Harveyboff can get himself a bed.

        • Gerry Harvey collapses at Western Sydney Harvey Norman spruiking stimulus sales in store to New Australians.

          Taken to an overloaded nearby public hospital, diagnosed with COVID. Has to stay and wait for a spot in an overloaded ICU.

          His dying breath will be ‘but I have private health insurance!’.

    • many hospitals have been closed in late 90s and early 2000s
      a great example is South Sydney Hospital, closed to make space for tens of thousands of dogboxes to be built

    • I posted this below but the mod is taking too long.

      We all saw China build a non-critical hospital in a week.
      I think there might be an alternative that almost every city in the world could implement rapidly if required.
      Multi-level car parks. They’re all similar.

      https://www.steelconstruction.info/images/thumb/c/cb/M1_Fig6.png/350px-M1_Fig6.png

      The center gap should be adequate for plumbing of services. zig-zag cable trays and piping should be easy enough.
      All the walls are flexible – they’d be added prior to use. Internally could be as simple as wood frame + glued plastic.
      The floors are strong enough to carry whatever load would be required. Whether on, or hanging from (ie cable trays, air ducts).
      Split systems to roof radiators would be fairly trivial.
      HEPA filtered vents can be ducted externally – to the roof if necessary.
      It doesn’t matter too much about the building once the “ward’ is decommissioned. It can sit for a months if required.
      Vehicle access is obviously ok. Rooftop helipad plausible.
      Most have lifts albeit they may be too small for beds.
      Ground floor would be the decontamination/changing area.

      I figure it should be possible to convert one of these to a functional ‘hospital’ for the moderate patients (ie oxygen required but not critical) in a couple of weeks if the plans were ready.
      Guessing ~2 car parks average per ‘isolation room’.

      • Reverse Transcriptase

        I have a fair degree of inside knowledge, as my posts reflect, and I have to say this is an absolutely excellent idea.

        There are a number of very newly built carparks adjacent to large hospitals (in Sydney alone there are Westmead, NBH, HKH, Gosford) and pretty much every other hospital has an older one. Using these adjacent to hospital could use the nearby co-located pathology / even mobile x-rays – which run on charged batteries. The new ones have covered walls with basic meshwork (a new requirement to prevent people jumping) so easy to erect sheeting – argubaly leaving some space would aid ventilation but ?rain. Getting oxygen, piped air (to drive vents and suction), power and reasonable data would be the big items. Water could be via large tanks on the roof, gravity fed. Waste is mainly bedpans anyway so you could get by without sewage. Infectious waste bins could be wheeled in/out the entrance and trucked away.

        The lift space wouldn’t matter so much since you could wheel the beds the long way round (i.e. as the cars drive) using electric golf carts or similar to tow them and other heavy items.

      • That gets you a building. Where do you get the equipment to fill it with?
        I’m guessing our health system doesn’t have multiple hospitals worth of excess equipment lying around, and demand will skyrocket globally as manufacturing capacity collapses so good luck importing any.

  3. Leith, you guys have some clout with people.
    Please, have a quick look at this, and pass it on. It might be viable.

    We all saw China build a non-critical hospital in a week.
    I think there might be an alternative that almost every city in the world could implement rapidly if required.
    Multi-level car parks. They’re all similar.

    https://www.steelconstruction.info/images/thumb/c/cb/M1_Fig6.png/350px-M1_Fig6.png

    The center gap should be adequate for plumbing of services. zig-zag cable trays and piping should be easy enough.
    All the walls are flexible – they’d be added prior to use. Internally could be as simple as wood frame + glued plastic.
    The floors are strong enough to carry whatever load would be required. Whether on, or hanging from (ie cable trays, air ducts).
    Split systems to roof radiators would be fairly trivial.
    HEPA filtered vents can be ducted externally – to the roof if necessary.
    It doesn’t matter too much about the building once the “ward’ is decommissioned. It can sit for a months if required.
    Vehicle access is obviously ok. Rooftop helipad plausible.
    Most have lifts albeit they may be too small for beds.
    Ground floor would be the decontamination/changing area.

    I figure it should be possible to convert one of these to a functional ‘hospital’ for the moderate patients (ie oxygen required but not critical) in a couple of weeks if the plans were ready.
    Guessing ~2 car parks average per ‘isolation room’.

    Shit. Just so the mod sees it.

  4. boomengineeringMEMBER

    At Manly atm, didn’t get warned to hold my breath as
    an old Asian wearing a Burka on her face went past.

    • Commonwealth bank ATM at Cronulla ran out of $20 bills earlier in the week. I’ve never had it happen there. They have 3 ATMs. Guy at one of the other ATMs pulls out a massive wad of cash, I start to walk towards it for my turn and he sticks another card in and goes again!

      • you should have been quietly drawing out small bills bills cash at least a few weeks ago …

    • And 70% of the population getting might be ok – but only if it is spread out over a couple of years. But the way we are heading with the lack of testing and people still going to big events we might get that in a few months and we are in Italy territory where people are left to die without treatment.

  5. Is the Australian figure for beds in Public hospitals or does it include Private Hospital beds.
    A typical Private hospital does not have any ICU capability so if the Private are included our effective Critical care beds might be a much much lower number then published.

  6. Amazing to see the Chinese send medical teams and equipment to Italy as the have experience with treating this virus. Very saddened by the unconscious bias we have towards the Chinese.

    A month ago, we were accusing them of downplaying the numbers, but today, no one is accusing the US of the same, even as their state officials say close to 1% have the virus, despite the official tally being 1600+.

    This virus may precipitate a new world order in some respect. I think the Chinese will emerge as world leaders in Health Services, mainly because the US will be exposed as being naked now that the tide has gone out.

    I would expect Trump’s goose is cooked, but I have learnt never to underestimate the stupidity of the average American.

  7. I have heard that if no respirators are available due to being used for COVID19, it is likely that NO OTHER SURGERY can be done, as a respirator is required for anaesthetic. Apparently some trauma (eg car accident) patients in Italy have been ignored as they cannot do surgery.

    So if you get out of control, the death rate goes beyond just the virus case fatality rate, to include death from unrelated causes that could otherwise have been avoided.

    Don’t get sick or injured for the next few months.

    Also, it is possible to envisage that all elective surgery will be cancelled due to risk of infection and lack of resources. A lot of elective surgery is done by private hospitals. It will be interesting to see how private hospitals will pitch in for this health crisis. Hard to see how treating a COVID patient is likely to be profitable but surely they will provide resources for this crisis?

  8. boomengineeringMEMBER

    Btw The old Asian only had a burka on her face nowhere else, either that or it was an oversized mask

  9. I think the Hospitals will be moving to critical care mode soon. If you are not really sick with the virus or something else life threatening you’ll be sent home. Then I would think the nurses and support staff will walk off the job. Why risk your life for $45k.

    • What nurses and support staff are on 45k?
      What clinical staff are going to imperil sick people. Not many.

      • Graduate nurses(without overtime, night shift) would be on about $45k. The support staff who clean the blood and shit on the floor would also be on about $45k, or less. My point is hysteria will reign. The nurses will be thinking of their children at home or looking after sick people they have no emotional attachment to.

    • They won’t tolerate those that mill around in the emergency room waiting areas instead of going to a GP.

      They won’t have any patience for migrants that aren’t gravely ill, who are visiting families (and are without Medicare, private health insurance, or travel insurance).

  10. You know if at least a medium worst case situation does not occur in this country the politicians and populace will never listen to science again.

  11. Apparently half of the Covid-19 test reagents in Australia have been used in the last three days. No more tests when current stocks are gone – which will be soon. So much for being prepared. It’s probably part of the plan – we won’t be able to confirm new cases.

    • What would be really nice to have now is a screening test instead of a diagnostic one…….at the moment you are always lagging the action

  12. Total ICU beds in aus is 2000. So once we hit 40000 cases they will be 100% saturated, and thats not accounting for their present occupants and local demand.

  13. Arthur Schopenhauer

    I got tested today in Melbourne. A lot of people in the carpark waiting to get tested. Results back in 2-7 days. Apparently all the GPs in the practice are furious with state and federal government. No guidelines, no process and no quick testing.

    They feel like they are on their own. The mood was one of shock, as the trickle is turning into a stream. The testing Doctor understood exponential math.

  14. boomengineeringMEMBER

    Went to Long Reef pie shop, nearly sat down when a an Asian guy with his family, sick as a dog coughing, fluids weeping from his face. Ate them at the dog park instead.

  15. If we aren’t closing the borders, can we at least stop those coming from countries, on tourist visas, who are notoriously clogging up emergency rooms (elderly visiting families, especially those from China and India)?

    And to curb those making dubious asylum claims (who get Medicare coverage), can we make it a condition of entry on tourist visas, that asylum can’t be claimed.