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Defence personnel will be deployed to drive ambulances and triage tents are going up outside many Melbourne hospitals as part of a string of extraordinary measures designed to protect the state’s health system from being overwhelmed by a growing wave of COVID-19 patients.
For the first time in Ambulance Victoria’s history, two paramedics will no longer be deployed in each ambulance. In a bid to improve response times, crews will instead be split, and a single paramedic will be joined by a driver from the Australian Defence Force, St John Ambulance Australia, State Emergency Service or student paramedics.
Tents outside Sunshine Hospital’s emergency department on Thursday.Credit:Jason South
In an interview with The Age, Ambulance Victoria executive director of clinical operations Mick Stephenson said ten defence staff are expected to start work next week, and there is a request for more.
“It’s something we would have liked not to have done, but that is the state of the nation, we’re in such dire circumstances we have to do it,” he said.
Associate Professor Stephenson said demand for ambulances had climbed to record levels and the service had in the last two weeks reported four of its five busiest days in history, with similar demand to the deadly thunderstorm asthma event in 2016.
He said it was now taking an average of around 50 minutes for people to be offloaded from their stretcher after arriving at hospital, a 20-minute increase from late 2019, before the pandemic began.
There are now about 560 people with COVID-19 in Victorian hospitals, an increase of more than 40 per cent from a week ago. There are more than 15,000 active cases of coronavirus, and the state is recording daily case totals well above 1000. On Thursday, Victoria recorded 1638 new cases of community transmission.
The number of “lights and sirens” cases rose by about 15 per cent last week, driven by the influx of sick COVID-19 patients that is expected to worsen significantly by the end of the month. While Ambulance Victoria was last year managing just a handful of confirmed COVID-19 cases each day, paramedics are now seeing more than 200, and the patients are sicker than before.
Modelling showing that paramedics will likely need to cater for an extra 100 COVID-19 patients a day by next week has led the service to adopt unprecedented measures, in planning since last year, in a bid to prevent the system being overwhelmed.
In the coming weeks, hundreds of people who would usually get an emergency ambulance response will instead be managed by a secondary referral service and be spoken to by a nurse or paramedic. They might be asked to go to their GP or make their own way to hospital.
“Unless they’re really sick, they won’t get an ambulance,” Associate Professor Stephenson said, adding that paramedics would continue to be there for those that needed it.
Associate Professor Stephenson said there had already been cases where paramedics had been unable to get to sick patients in the time that was appropriate for the seriousness of their illness. Last week, hundreds of ambulance patients spent more than two hours waiting in a queue in or outside hospitals.
As some ambulance patients face waits of up to 10 hours to get emergency care, Ambulance Victoria is employing student paramedics and highly trained first aid officers from country areas to wait in the queues and care for the patients, to allow paramedics to return to the road. In a sign of the growing strain on the health system, triage tents to help with this task are being set up outside almost every hospital in Melbourne.
Several health sources, speaking to The Age on the condition of anonymity as they were not authorised to speak publicly, said some intensive care units in Victoria were extremely full on Sunday night due to high numbers of coronavirus patients needing critical care.
Australian Medical Association Victorian president Roderick McRae said this meant some patients had to be transported to Geelong for intensive care to free up hospitals.
He said he was increasingly concerned about “every citizen in Victoria” who will require healthcare in the coming weeks.
“Today, it is really bad,” he said. “Every part of the hospitals are saturated today and that is the only news I am getting. I think Victorians are going to be really shocked by just how much pressure our health system will be under in the coming weeks.”
“Nobody seems to want to say this, but we are in a healthcare emergency. Nobody seems to want to say this is a crisis. The Victorian government still hasn’t declared a statewide disaster, which I think is needed so people realise just how tough the circumstances are.”
Associate Professor Stephenson urged people to get vaccinated and follow public health orders closely, saying he was still hoping the unprecedented demand could be managed, despite being pushed to the upper limit.
“The measures that have been put in place and the planning that has occurred to date has left us in a reasonable spot.”
Mya Cubitt, the Victorian faculty chair of the Australasian College for Emergency Medicine, said hospitals were well versed in disaster medicine and managing surges in demand for healthcare, and urged people not to be afraid to go to hospital if they needed care.
Tents at Sunshine Hospital’s ambulance rank on Thursday.Credit:Jason South
“We have the processes in place to handle whatever comes,” she said.
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