More hospitals called up to COVID front line as case surge looms

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Victoria’s largest public health service has opened it doors to COVID-19 patients of all ages as the state’s hospital network prepares for an influx of seriously unwell people on a scale beyond anything it has experienced in the pandemic.

Monash Health chief executive Andrew Stripp likened the extensive planning at his hospital to the adrenalin-fuelled days of February and March last year, when the state government feared the health system would be overrun by the novel coronavirus.

Monash Health chief executive Andrew Stripp inspects a bed in his hospital’s new COVID ward.Credit:Jason South

The difference now, Mr Stripp said, is that instead of developing new ways of managing staff, controlling infections and sourcing personal protective equipment, he is largely revising existing plans informed by what hospitals here and around the world have learnt over the past 18 months.

There is no sign of panic, nor even a pressing need for haste. Instead of facing an immediate crisis, Victoria’s hospital system is confronting a challenging new normal that could last for months or years.

“Last year, the commentary I would make to our employees is days are hours, hours are minutes and minutes are seconds,” Mr Stripp told The Age and The Sydney Morning Herald.

“What we are doing now is very much about refreshing and adjusting. People are tired. Our workforce are members of the community and this has been going on for a long time.”

Responding to last year’s second wave, Victoria’s Health Department developed a hospital “streaming model” that designates specific roles to certain hospitals in a COVID outbreak.

Until this week, the role of the Monash Medical Centre in Melbourne’s south-east was limited to accepting pregnant women infected with COVID-19. So far, it has treated four.

Following last week’s rise in case numbers, the hospital changed its status. As of Wednesday, it is accepting any adult who needs high-acuity treatment for COVID-19 and the Monash Children’s Hospital has started taking COVID-19 patients.

The Austin Hospital and University Hospital Geelong have also been added to the high-acuity, adult stream. They join The Alfred, Box Hill Hospital, the Northern Hospital and the Royal Melbourne Hospital at the pointy end of an outbreak that, on current projections, will closely follow Sydney’s curve.

Monash Medical Centre will take more COVID patients under the change in role.Credit:Eddie Jim

Monash this week opened a new 32-bed COVID-19 ward and has further capacity to accept up to 112 patients. This increases Victoria’s standing capacity to treat serious, adult cases in hospital to 585 beds, including 100 in intensive care. Under the streaming model, this can be increased, as required, with the addition of more wards and hospitals.

Mr Stripp said the big change from last year’s second wave was the vaccination of front-line hospital staff and the availability of proper-fitting protective equipment. All staff who come into direct contact with patients anywhere in the hospital are required to wear N-95 masks and face shields. They also get daily virus screening with mouth-swab PCR tests.

These protections mean that even if staff come into contact with COVID-positive patients who don’t know they have the virus, there is a very low risk of transmission.

So far this year, there is no known instance of a patient infecting hospital staff or hospital staff infecting a patient at any Monash hospitals. Mr Stripp said the admission of COVID-19 patients was no reason for people needing other healthcare to avoid hospital.

“The hospital is a safe place to get treatment,” he said. “If you are unwell, if you need care, don’t stay away.”

Nursing staff who work on COVID-19 wards will be segregated from other staff. They can be rostered onto non-COVID wards only after a three-day break and negative test.

Mr Stripp said Monash Health was exploring whether shorter, six-hour shifts for COVID-19 nursing staff could be used to reduce the physical toll of working in full protective equipment. Although the standard nursing shift is eight hours, some stretch over 12 hours.

At the start of the pandemic, when alarming models forecast that Australia would be swamped by COVID-19 infections, Monash Health rushed to create 200 intensive care unit beds. They were barely used during Victoria’s initial, mini-wave of infections and ICU capacity wasn’t seriously tested by the second wave, which peaked at 675 inpatients across the entire hospital system.

Mr Stripp said he hoped he was again planning for scenarios that would never be realised.

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