Grattan: Australia confronts acute shortage of hospital beds

More excellent work from the Grattan Institute today, which projects that Australia’s hospital intensive care units (ICU) will soon be overrun with coronavirus cases:

The number of confirmed COVID-19 cases in Australia has been doubling every 3-to-4 days… a shutdown of anything that isn’t truly essential will be needed to avoid overwhelming the healthcare system…

Given Australia’s demographic make-up, the overall ICU rate is estimated at 2.2 per cent of diagnoses cases.

The Figure below shows that with Australia’s current rate of doubling of cases every 3-to-4 days, our ICUs will reach current capacity in mid-April. When we hit a trigger point of 12,000 new cases every day, then we know that we will hit our current ICU capacity soon after if new cases continue to grow.

In the scenario of cases doubling every three days, we would reach current ICU capacity on April 11. If cases double every four days instead, we reach ICU capacity a week later on April 18. Slowing the growth to doubling every five days would buy another week…

The initial plans to ‘flatten the curve’ would still lead to more than 100,000 new cases per day at peak fo the pandemic. While this approach will buy us time, we will still run out of ICU beds in Australia.

This will force us to confront ethical dilemmas as to who gets admitted to the ICU and for how long, and who remains in a hospital bed with less intensive treatment. These ‘tragic choices’4 that families and health professionals face are the consequences of broader social and political decisions about the toughness of spatial isolation policies. The quicker we can reduce the rate of infection, the better the health system will be able to cope. Older people are more at risk of ICU admission (and death) and so we should be particularly aiming to reduce infection in the elderly.

Our gloomy ICU forecast is primarily determined by the exponential growth in diagnosed cases. This is what needs to change. The goal should be to bring new cases in Australia down to zero as quickly as possible. All state governments must act decisively and bring in a broad shutdown now.

This is another damning indictment of the Morrison Government, which has acted far too late in closing Australia’s international border alongside shutting down schools and non-essential activities.

Leith van Onselen

Comments

  1. Only 5 more days to Uni census date! Can Scummo hold out that long? If he does close the schools straight after that date then him and the heads of the entire university sector need to be in court on manslaughter charges.

      • If they officially close schools and Uni’s before then, the international students in NSW can ask for a course fee refund

          • Yes true that, but the international students make up a huge portion of the income, for example nursing was $120k for international students for the year

          • Morrison has the intellect of an amoeba – he couldn’t possibly understand ‘exponential’.

      • We are about to find out. Don’t forget he shut the borders from Italy the afternoon after all the last Italian GP teams arrived that morning when Italy was already worse than Iran which he had closed borders from.

        • Charles MartinMEMBER

          yeah, I was in Melbourne for the F1, well, my hotel room on the Friday morning as all of the toing and froing was going on. When I saw a private jet manifest with two F1 drivers names on it leaving at 11:30, we knew it was over. Still waiting for my grandstand ticket refund, so I can put $500 towards my shut-in fund.

        • True. That gives him form. Goodness me, does he think no one would notice?

          Sociopaths are a funny bunch though – they simply don’t give a fck.

  2. Thanks Leith
    Ponder for a moment the plight of a country hospital as this progresses. Cases dribble in, initially able to be transferred away or palliated (die in minimal discomfort) if elderly.
    Ambulance service for transfer rapidly overwhelmed.
    First hypoxic youngish patient arrives suitable for intubation. Local anaesthetist has received no additional training in the highly specialised and dangerous procedure that is intubating a Covid patient. Staff have had some training but no prefitting of masks and other PPE. Every face is a different shape. All in the room have high dose exposure.
    Wards filling with dying Covid patients. Staff partially protected. Ambulances unavailable.
    Staff now falling sick. First anaesthetist included. 25% of critical care capability gone.
    Case numbers building. Second intubation by second anaesthetist. No ability to transfer.
    Rinse and repeat.
    40 to 50 year olds palliated on the wards. Except no Fentanyl left.
    Rinse and repeat
    The community is never the same for generations.
    I hope I’m wrong.

    • What you have written is entirely plausible. The problem is the “she’ll be right” attitude of most simply can’t comprehend this outcome. If it comes true this will leave a scar on the national psyche worse than the depression.

      • It’ll be us and any poor witness who cops it mainly. The rest will take solace from the grog and the Alan Jones successor who will spin some bullshit obviously.
        Fuck I hope I’m wrong. Young staff are “self isolating” now after a runny nose. This is not the dream they were sold. Old scrotes like me are checking the super balance and mentally saying goodbye to family, hopefully undetected.

    • I queried lack of equipment and protective gear of DIL a front line specialist, young has baby, told its a policy issue, they have no say. Scummo strikes again.

  3. PolarBearMEMBER

    Too busy at work to analyze their figures. But does this analysis account for the almost 10 day lag in between a person contracting the virus and having a positive test result confirmed? Eg the average person notices symptoms on day 6, gets a test on day 7, test result returned on day 9. And also account for mild cases we have missed? If you remember the x 10 period is about 8 days. This puts actual cases at 10 times official cases. I think the dates for ICU overload are optimistic.

  4. Coup de Whiskey

    It’s looking more and more that we should let the virus just run rampant. Short sharp pain is better than long term pain.

    We’re too late and too badly governed in Australia to flatten the curve. Let the “boomer doomer” virus rip. Hopefully a better society emerges.

      • Totes BeWokeMEMBER

        That is going to happen no matter what we do from here. They’ve already fked it enough for that to be inevitable.

      • There trying to keep the death toll under 100,000…. Good luck with that.

        Wuhan and Italy plenty of warning….

        Can the Politicians be sued for professional negligence or is it more a pitchfork thing??

        • Cayman accounts probably can’t be touched by an Aus court. Looking like a pitchfork exercise. Remember to take out all their heirs as well, so no one gets the stashed bounty.

  5. Totes BeWokeMEMBER

    Found this

    Petition; Let the army/military take charge

    http://chng.it/scMbZtkD

    Coronavirus WILL AFFECT YOU

    Given current rates of infection, we are projected to be 100k infected by the 5th of April, 200k four days later, 1.6m two weeks after that. ICU’s cannot possibly cope. The time to act is now.

    We want the virus stopped

    We want forced isolation for everyone (other than essential services incl grocery/food delivery)

    Government have misstepped the entire way

    We want the army/military to take over from Scott Morrison

      • Totes BeWokeMEMBER

        Yep.

        I’m asking for someone sensible to step forward, push aside these vested interested, corrupt clowns, and fix the situation.

        Nothing silly about that.

      • FUDINTHENUDMEMBER

        If they don’t go martial law they’ll get the opposite. Ie. You wouldn’t want to be in the suburbs.

  6. Unlike Italy Australia will reserve ICU for IP owners in order to protect the the housing market. We can always import more younger renters anyway. We’ve been eating our young already so we can continue to do the same through this crisis. ScoMo will organise a Critical Care (boat phone) to direct the key decisions personally based upon available medical advice. We will hear more in coming weeks.

    • I was actually thinking ICU triage priority could be inversely proportional to negative gearing tax loss and/or franking credit refunds paid whilst being a zero taxpayer.

  7. But let’s keep here the temporary visa holders, not doing essential work and give them access to the few hospital beds we do have.

    Insanity.

  8. Steven Roberts

    We are living an NP problem.
    The only thing that matters is slowing the growth rate of the infection. We are making trade offs between epidemiology and economics when one is urgent and the other important but not urgent. The ONLY thing that matters is bending the curve.
    We are treating it as if it is a P problem. We can go to the footy on the weekend and mop it up the next week with a bit more medical resource. Or delay lockdown for a couple more days because we don’t want to deal with 2 million unemployed this week instead of 1 million.
    It doesn’t work. Every single trade off the government makes, loses. No amount of medical resource will change the outcome. You could quadruple the number of doctors in the country and quadruple the number of hospitals and it would not change the outcome.
    That’s what it means to be an NP problem. Any attempt to add more resources is overwhelmed within a couple of days.The ONLY thing that matters is the rate of growth. And to this point we have decided not to attack it. Right now, 80 per cent of Australians will contract COVID19, unless our politicians choose otherwise. Eventually it will reach an equilibrium when there are just enough uninfected Australians to attack to survive against the acquired immunity. That’s the path we are on right now,

    So what does work?
    – Shut downs
    – Testing (at clinics, but also basic body temperature reads before entering a supermarket)
    – Quarantine
    – Masks (when worn universally, noting COVID19 sheds 8 hours before symptoms)

    The Chinese have beaten this. Korea has beaten this. Hong Kong is beating this. Let’s do what they did.

    P.S. shame on the chief medical officer for saying it didn’t matter whether we shut down events a couple of days earlier or later.

  9. We are on track at current rates for total ICU capacity washout around 8-10 April.

    That would be if cases were ideally distributed. We know they won’t be. Pockets of demand will outstrip supply by an order of magnitude or more. Choices will be made.

    Does it make it better, or worse, that we can see this coming and not able to do a damn thing about it.