As death stalks NSW, Berejiklian goes into hiding

The nihilistic pragmatism that drives the Australian political economy is as much ironic as it is useless.

Our political discussion can lurch from “black is white” to “white is black” in the blink of an eye. In the absence of context, memory and values beyond political tribalism, no truth has adhesive properties.

And so, as Gladys Berejiklian departs all medical advice and modeling there is almost nobody to call her to account.

The NSW premier clearly made a political and ideological decision to spread Delta COVID by doing half-arsed lockdowns. This was endorsed by the Morrison Government by refusing appropriate fiscal support so people would not be to able to stay home.

Now the piper is coming to be paid, The Saturday Paper:

National cabinet has been briefed on new data that represents a dramatic shift away from managing a short-term “disaster” overwhelming intensive care units, as is forecast to happen soon in New South Wales, to a scenario where serious pressure on hospital networks is sustained “for a protracted period of time”.

Although initial modelling was built around one month of crisis, the strain on the system is more likely to last half a year. What this means for an already exhausted hospital workforce is yet to be seen.

The briefing, provided to national cabinet on Friday, represents a realisation that a longer-term health system shock is now the most likely outcome from the national plan to gradually end lockdowns while chasing vaccination targets of 70 and 80 per cent of the adult population.

Although it is not yet clear how long hospital systems can sustain consistent, elevated levels of pressure, the Australian and New Zealand Intensive Care Society (ANZICS) sent surveys to more than 180 intensive care directors and nurse unit managers to gauge capacity for a marathon instead of a sprint.

The Saturday Paper understands these projections are more “realistic” than the “optimistic” numbers provided during pandemic planning last year, precisely because they will need to be stretched over a longer period of time. Under these arrangements, shortfalls will increasingly occur outside the intensive care units and ripple through the rest of the hospital system.

Non-urgent elective surgery has been halted in Greater Sydney since the end of July. In late August, some major private hospitals were restricted to performing “category 1” procedures only, as 600 private hospital staff were redeployed into the public sector and certain public patients were sent to private facilities.

In Victoria, these surgeries have been off and on since the middle of last year, with a halt on all but the most urgent operations being reinstated for the public system on August 23. Category 2 and 3 surgeries in the state, which can happen only subject to a “risk assessment” and tend to fluctuate with the threat of the virus, include hip and knee replacements, cataract surgery, colonoscopies and even the amputation of digits.

Noting these flow-on effects, the Victorian Agency for Health Information says: “The limits put in place in response to the Covid-19 pandemic have had significant, enduring effects on the volume, type and timing of elective surgery procedures undertaken at hospitals.”

In Sydney’s south-west, a Campbelltown Hospital source told The Saturday Paper “there are four full dedicated Covid wards that were once surgical wards”. This is only the beginning of these changes, they say: “There are plans for another two wards.”

Essentially, the need to divert resources towards the management of Covid-19 patients is creating issues elsewhere in the health network – which will continue for months, leading to the possibility of compromised care.

A day before revised capacity data was presented to national cabinet, NSW Premier Gladys Berejiklian announced the state government’s plan for a gradual granting of “freedoms” for fully vaccinated residents from October 22.

“What is beyond doubt is that we would not have been forced to make as many or maybe any decisions about who should be saved if we had more people vaccinated more quickly. That is simply a fact.”
Nationally, and in particular in NSW and Victoria, where Delta variant outbreaks have surpassed efforts at full control, a two-speed debate is happening about short-term disaster management as well as longer-term sustainability issues.

On Monday, Berejiklian released forecasts for the hospital system capacity over the coming months, with a peak demand for ICU beds of 947 in early November. The model suggested 560 of these would be used by Covid-19 patients. In total, the modelling, conducted by the Burnet Institute and augmented by state government health system data, estimates the number of people in hospital with and without Covid will peak at 3434.

But that modelling was done on the assumption that all current restrictions in NSW would remain in place. It does not factor in ongoing issues and how Berejiklian’s Thursday announcement will affect them.

The premier has previously said that at any one time there are about 400 non-Covid patients in the state’s intensive care units. The modelling allows for a peak of 387. But on September 2, for example, there were 519 patients in NSW ICU beds who did not have Covid-19, according to the real-time monitoring platform nicknamed CHRIS.

The Critical Health Resource Information System was developed last year to aid decision-making for state and federal leaders and has been used to routinely update national cabinet about the situation in Australia’s intensive care wards. On the same day in early September, the Burnet model forecast a total of about 515 patients with and without Covid. The actual number on that day was 689.

Late on Wednesday, Victoria released its own projections for hospital demand, with figures detailing the state will reach 18,000 cases by mid-October, 800 of which would be hospitalised. According to the CHRIS platform readout on Thursday morning, there were 31 patients in Victoria’s ICU wards with Covid-19.

Although officials say the state can surge to a similar number of emergency ICU beds as NSW – about 1500 – that figure represents a more than fourfold increase on the ordinary operating number. In NSW, reaching that surge capacity equates to slightly less than a doubling of the usual ICU beds.

Plans have already been drawn up for a worst-case scenario in the health network. In NSW, doctors and nurses have been told by hospital managers that life-saving support may not be provided, or potentially even be withdrawn, for those with a median age of 72 during the “overwhelming” phase of the current Delta outbreak – which is forecast for late October and early November.

Australia was always going to have to face this moment. Reopening was inevitable. Some were always going to die and be traumatised.

But let’s not pretend that this is that. Gladys Berejiklian has made it much worse than it needed to be for NSW and VIC for no better reason than political pride and ideology.

So, what is her response? This:

Premier Gladys Berejiklian has announced NSW’s daily 11:00am COVID-19 press conference will cease from Monday, as the state recorded 1,542 new infections and nine deaths.

The number of cases is a new record for an Australian jurisdiction, but despite that, the government will stop providing the regular opportunities for politicians and health authorities to be questioned in person.

Instead of the daily briefing, NSW Health will publish daily videos outlining the latest information.

Hopefully, a political death awaits her at the ballot box.

Houses and Holes
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Comments


  1. Hopefully, a political death awaits her at the ballot box.

    It could be as far away as March 2023 though, if I understand correctly. Lots of twists and turns between then and now.

      • Lots of staff bring redeployed into COVID facing roles, including allied health not trained for those roles (my wife is allied health)
        Mad scramble to convert wards into COVID wards. Serious infection risk around the hospital including via patients and staff.
        The idea that they have been preparing for this is and are ready is total and utter bullsh*t.

        Things are getting worse and fast.
        My wife and others pulling the pin. Not worth the risk.

          • I really feel for the doctors and nurses, and you guys as family.

            However, there needs to be an en-masse protest of medical practitioners to highlight to the country how badly #KoalaKiller has stuffed things up. Otherwise the Liberal propaganda machine will spin it all away for her.

          • Charles MartinMEMBER

            Brad is just following orders from higher up the chain given his little NWO remark from a few months ago.

        • Arthur Schopenhauer

          I’ve also heard NSW Covid Home Hospitalization get you 2 phone calls a week, and a great deal of resistance getting into hospital if things go down hill.

          So far, 13 people have died in “Home Hospitalization”.

          • From the Govt’s perspective it is better have them die at home rather than come to the hospital. They can be hidden better if they die at home.

          • Anybody still wondering why people would rather put their faith in horse paste/homeopathy/ginger tea, etc. etc.?

          • My feeling is that is was less a decision not to prepare than a failure to prepare.
            They just didn’t do what they needed to.
            Lack of leadership. Bad minister. Bad Government.

            Now they are scrambling…

          • Arthur Schopenhauer

            Mostly lack of imagination by Department Heads and Ministers. They have been drinking their own Kool-Aid for 21 months.

            There’s an “always somebody else’s problem” culture.

          • It is difficult to imagine there have not been a bunch of people saying “this is going to be a problem” and subsequently told “don’t worry about it” or “don’t do anything until you’re told to”

          • They did prepare over the last 18 months and COVID ward expansion plans have unfolded at a large number of hospitals as anticipated.
            It is not to say it isn’t difficult or resource consuming but just because some guy on a random blog with an allied health wife claims something along with another guy who lives in Victoria doesn’t actually make it so.

          • Easier to bring forward a planned retirement by a few years than resign and move to a different field, so if people like Gramus’ partner a resigning when they aren’t in a position to leave the workforce forever yet, even more people will find retirement an enticing option.

    • We are going to have to hope that the vaccine rates come at the end of October (given NSW is 78% double dosed) do create a temporary reprieve on the system. Of course this shows this is no ordinary flu.

      People I know in the health system are saying the same thing. It isn’t what it used to be, no one has respect for health staff anymore. Many of the smart ones want out, even if they got into it for the right reasons.

      If they had actually been governing in the first place we would still have zero-COVID most probably. Instead NSW hubris has got us into this mess. Gold standard contact tracing (an administrative risk control) being more powerful than quarantine (elimination) or vaccines (engineering control) was always a fallacy.

    • FUDINTHENUDMEMBER

      Yah was just listening to talkback on abc melbourne. Nurses calling in saying they’re quitting/have resigned. General gist was: Not paid enough to wear full PPE with no breaks for an indefinite period of time. Happy to do it last year, but more is a bridge too far. Fair enough

      • TheLambKingMEMBER

        My wife is a midwife/nurse and is ready to quit. People do not understand what ‘wearing full PPE’ means. It means that you assume the outside of your gear is infected. So every time you want to eat/drink/toilet you need a ‘spotter’ to check that you take off the gear to stop cross contamination and the same when you put new PPE gear back on. It is mentally and physically exhausting AND the thought of bringing Covid back to your family is terrifying. Which is one of the reasons I get so made with the moronic, idiot anti-vaxxers!

        • And they are just as mad at you. You confuse what people with political power are doing to you, with people that are doing nothing to you.

          If you are under 50, with no complicating health factors, there is very little chance of dying from covid.

          • TheLambKingMEMBER

            A comment that proves you are a moronic, idiot anti-vaxxer!

            60% of the Australian population have an ‘underlying condition’ – about 16mil. And 1/3 of the population is over 50 – about 9 mil. So around 18-20 million of Australia’s population has a non-trivial chance of dying from this.

            Just F’n get vaccinated.

    • If money and systems were better, would she have stayed? Thinking things like a crisis loading or a risk loading based on what incremental risk you are taking working in the system.

      Same thing happens with military people who have really good skills, they end up going into the commercial sector because they are taking the risk anyway, may as well get paid for it. Airforce had to mandate 5 (or 10yrs, cannot remember) service if they made it into the fighter program. They used to get certified then move into commercial on 4x the money.

  2. Mining BoganMEMBER

    See her final press conference yesterday? As soon as questions about her facing ICAC were asked she had minders yelling out last question and she ran away.

    She’s in witness protection now.

    • There are two things Dan got wrong.

      1) Didn’t close the border with NSW.
      2) Let the anti-lockdown protest happen.

      For both NSW and Victoria, the “inflection point” of COVID infection, happened 2 weeks after the protest.

      • SnappedUpSavvyMEMBER

        i don’t think he got anything wrong, this delta variant cannot be stopped when the population is over lockdown, gladys never had a chance either yet she’s a psycho …
        Anyway, thank god her press briefings are over

        • What was the lesson he was supposed to learn from the 2020 lockdown he didn’t apply here? The main lesson seemed to be lockdown as early and hard as possible – he applied that to lockdown 6, skipping the d*cking around with local lockdowns that did nothing in 2020 but it didn’t work as well as it did last time (although it did bring the Reff down from 5 even if not below 1).

          He pretty much did exactly what you’d expect someone who didn’t want to repeat what went wrong with Vic’s 2020 outbreak to do.

    • Vic is about a month behind in vaccinations. All Dan has to do is be no less than month behind in infections and/ or speed up vaccinations so that Vic catches up with NSW to some degree.

      • Vic is trailing 4 weeks behind the daily case numbers. Victoria’s 6-8 week head start on the outbreak to enable vaccination has been squandered and we’ll end up in a similar or perhaps worse situation than NSW. Here’s hoping Australia’s famous luck can get everybody through…

        • Almost exactly 1 month behind on cases – hit 7 day average of 312 on Saturday, 11th September in Vic, NSW hit same figure on 11th of August.
          Different projections see Vic hitting the 70% and 80% vax milestones a month and a day or two after NSW. Question is whether they can accelerate to beat those projections.

  3. From the ABC:

    The New South Wales government waited to lock down all of Sydney until two days after health authorities discovered they had not contained a super-spreader event blamed for the Delta outbreak in the city’s west.

    As Sydney’s marathon lockdown enters its 12th week, answers to questions on notice to a parliamentary inquiry reveal NSW Health knew on June 24 it had failed to contain a COVID cluster linked to a birthday party at Hoxton Park, in south-west Sydney.

    The State Government announced stay-at-home orders only for Sydney’s city and east on June 25.

    It extended the lockdown to Greater Sydney on June 26 because of the West Hoxton cluster, which it blames for spreading the Delta outbreak to the city’s west.

    The new information from NSW Health and Health Minister Brad Hazzard is at odds with comments from him and chief health officer Kerry Chant to the parliamentary inquiry into the management of the pandemic last month.

    Not good.

  4. If the majority get their freedom back and are not materially affected by the disease, why would they not vote for her? Some are making it sound like all people think about is the ICU situation. Majority would spend more time thinking about their morning coffee run than they do about the ICU situation. And why wouldn’t they, most people dont need an ICU regularly but do enjoy catching up with friends and family, going on holidays, leaving your house etc. You know, normal stuff.

    • Majority would spend more time thinking about their morning coffee run than they do about the ICU situation.

      Obviously – unless it’s someone they’re close to who’s in hospital or a body bag.

      • True, these are the people who will change votes. The majority just wont care and will reward whoever gives them back a resemblance of a “normal” life.

        If I was still in NSW I would vote her out due to corruption, not due to CV-19.

        • So my point is that people have 10 or more people they care about it in their lives. 1000 cases per day for a year is 365,000 people – there’s 3.6 million people who care care about those people. Even the 1000 odd people in hospital with covid right now probably have 10k people who care about them. At the same time, elections aren’t really decided by the majority, they’re decided by a handful of voters in marginal seats. A relatively small number of ICU cases and deaths in the wrong locations could have a disproportionate effect on the electoral outcome, even while the majority enjoy their freedom.

          • Agree, but if you do the analysis the outcome would have been the same under a liberal or labor government (see Vic example). They are both terrible and people will realise that no matter which party was in power it was going to be a sh!t sandwich. Lets be clear, every single state and territory govt has underinvested in health services and ICU for such a crisis. NSW and VIC are just being found out sooner. As such, you will vote for the party which infringes on your freedoms less considering politicians can only maintain the health outcome moral high ground if they are delivering health outcomes (Qld/WA ). With that said, there time will come and then watch the story change “we had to open”, “we need to get back to normal”, politicians will lean into whatever narrative helps them look good…none of them really give a stuff about their constituents.

  5. Brave Berejiklian ran away.
    (“No!”)
    Bravely ran away away.
    (“I didn’t!”)
    When danger reared it’s ugly head,
    She bravely turned her tail and fled.
    (“I never!”)
    Yes, brave Berejiklian turned about
    And gallantly she chickened out.
    (“You’re lying!”)
    Swiftly taking to her feet,
    She beat a very brave retreat.
    Bravest of the brave, Berejiklian!

  6. I don’t blame any doctor or nurse for resigning.

    My ex was a theatre nurse and the things she had to deal with… and they get lied to and cheated by the hospital administration and government at every turn.

    As for that Berejiklian woman, one look at her and you just know she’s a piece of work…

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