SA needs to double its hospital beds as Covid arrives, ED docs say

Covid is coming and SA only has half of what it needs to be ready, warn emergency staff, but the government insists its preparations are well underway.

Frontline emergency department doctors say South Australia needs to double its hospital inpatient bed numbers as a first step to deal with the looming arrival of Covid outbreaks.

The Australasian College for Emergency Medicine (ACEM) called for all available beds to be opened and staffed and warn existing staff shortages are set to worsen due to burnout as well as exposed staff being put into quarantine.

Leases on the former Wakefield St private hospital and College Grove as backup hospitals have expired, and ACEM has suggested the government look interstate and overseas for “innovative solutions” — overseas, this has included makeshift hospitals in parks.

The state government is yet to release its plan to deal with rising numbers as borders open but SA Health has briefed the Australian Medical Association that it expects active cases to hit a peak of 4000 — however, not all will require hospital care.

Dr Michael Edmonds, Deputy Chair of ACEM SA.

Health and Wellbeing Minister Stephen Wade said the government has recently opened 60 new inpatient beds, is hiring more than 370 nurses, plans to increase its intake of graduate nurses and will pivot its vaccine workforce into other duties.

“More than 60 additional beds that are coming online now as part of our plan to ensure our hospital network is Covid-ready,” he said. “This is just the beginning — we have more announcements in the pipeline.

“A key element of our plan is opening up more inpatient capacity in the hospital network to meet demand, and we have already begun doing this.

“I have no doubt health sector organisations will welcome the increased resources we are putting into easing the pressure our on our health system and getting ready for more Covid cases in South Australia. I assure them that there is more to come.

“We are also significantly increasing our workforce. There are more frontline health staff in South Australia right now than ever before and we want to grow that number even further.”

ACEM South Australian deputy chair, Dr Michael Edmonds, said even without Covid, SA’s healthcare system is under tremendous pressure with “code yellow” critical incidents being called due to overcrowding, and regular ambulance ramping.

“The public health systems in SA have done a spectacular job with our outbreaks to date. How will they cope when Covid numbers rise?” he said.

“As our governments push the narrative towards ‘living with Covid’, we need to recognise that when we flip that switch in SA, our healthcare system is going to struggle.

“Now is the time to put strategies in place with a clear focus on how we plan to live with Covid and how we plan to manage the significant increase in demand on our healthcare system.

“SA is not adequately prepared, and we need to learn from interstate and overseas experiences on how to correct this, what has worked and what does not.”

ACEM stresses prevention is the key with vaccination, testing, tracing, isolation and quarantine the backbone of a prevention strategy with the healthcare system the safety net.

Minister for Health Stephen Wade. Picture: Morgan Sette

However, Dr Edmonds said SA’s public hospital system has been running at more than 100 per cent for years.

“ACEM estimate that, just to meet the OECD average, the healthcare system in South Australia must double the amount of current inpatient beds — that’s just to provide an appropriate level of care in the absence of increased Covid demand,” he said.

“To prepare for even further increased demand due to Covid, the SA government should immediately look to open and staff every possible bed and should look for creative ways to maximise current resources.”

Innovative approaches tested interstate and overseas, such as home monitoring of Covid cases, are needed, as is “whole of system planning” including support for primary, community, ambulance and emergency department care, according to ACEM.

Dr Edmonds warned one of the biggest limitations will be workforce, saying SA already has shortages.

“Current conditions are seeing many experienced and skilled emergency clinicians burning out or just leaving,” he said. “We have seen in other states large numbers of frontline healthcare workforce furloughed and quarantined due to Covid exposures.

“There are simply no reserves in the local workforce for when this happens, and this requires clinicians to take on even more hours, or leave large sections of our health service understaffed.

“This is dangerous for staff and patients, and we urge the SA Government to plan for this, and to start enacting this plan now. There is no magic button to create a bigger skilled workforce, and even reassigning healthcare professionals to areas outside their normal practice to reinforce the frontline will take time to deploy, train and orient.”

Dr Edmonds said “winter has passed, but Covid is coming.”

“While your emergency departments will always be available when you need them, your frontline healthcare workers do not feel ready to face this coming challenge,” he said.

“We don’t have long to prepare.”