Leaked emails reveal hospital Covid crisis: Like a war zone in our wards

A leaked email has revealed a hospital system in crisis, moving onto a ‘war footing’ similar to that used during the AIDS epidemic, as Covid patient numbers skyrocket.

Covid patients will no longer be kept in segregated wards and surgical staff will wear full protective gear permanently as at least three major hospitals move onto a “war footing” similar to that employed during the HIV/AIDS epidemic.

Crippled by rising Covid ­patient numbers and a staff shortage, Liverpool Hospital, Nepean Children’s Hospital and St George Hospital are changing the way they deal with Omicron.

Dr Mark Nicholls says hospitals are at capacity and they will be stretched as Covid cases continue to rise. Picture: Sam Ruttyn

A leaked email sent to staff from Professor Mohammad Khadra, head of surgery at ­Nepean Hospital, outlined a health district in crisis due to growing caseloads and a staff shortage exacerbated by close contact isolation rules.

It follows dozens of nurses and doctors and their organisations saying they are ­“insulted” the state government keeps claiming hospitals are coping with the latest outbreak.

“Numbers are growing and staff are diminishing with more and more positives in the ­facility. We are at ­capacity with the two wards for Covid and will be opening another ward ­shortly,” the email said.

“More importantly, I think we have to assume that in any theatre, the probability is ­either the patient or staff are positive. We have to move forward with universal precautions. All the evidence indicates that the best way to protect ourselves is to wear protective masks, eye cover and hand hygiene.

“I have agreed with Bruce Graham (Head of Anaesthetics Nepean) and with Jill (nurse unit manager) to do away with treating Covid positive patients any differently to Covid negative patients.

“They are both going to be treated as a negative patient but with universal precautions of mask ­(including the patient), eye protection and hand hygiene.

“To be clear, that means normal recovery and no runners and additional precautions.”

Runners are staff, like ­orderlies or a nurse or doctor outside a Covid theatre who deliver necessities to the ­anaesthetic bay to minimise aerosol spread.

“Those of us who are old enough to have lived through the AIDS epidemic saw permanent bloodborne precautions become the norm. Now we need to move forward with permanent airborne disease precautions as the norm — masks, eye protection and hand hygiene,” the email said.

The health district includes Lithgow, the Blue Mountains and the Hawkesbury area.

Nurses take care of a Covid patient in hospital. Picture: Kate Geraghty

A doctor who spoke on condition of anonymity expressed concern the move could mean more people catch Covid while in hospital.

“They won’t differentiate between Covid/non-Covid ­patients any more. Means non-Covid won’t be separate from Covid patients … it’s nuts,” the doctor said.

At 1738 cases, Covid hospitalisations have hit a pandemic high in NSW, surpassing the height of the Delta hospitalisations by more than 450.

Meanwhile, some 3800 medical staff are either on leave or have been forced to stay home because of Covid.

Dr Danielle McMullen.

Intensive care admissions are still lower, but Australian Medical Association NSW President Dr Danielle McMullen said doctors were insulted by the government line that hospitals were coping.

“Hospitals and primary care are collapsing under the weight of these massive case numbers,” she said.

“We knew this was coming and everything we are hearing is more and more hospitals are under strain, wards full and emergency departments flooded. It is not fun in the trenches.

“We had been working hard in the public hospitals to keep Covid separate but with ­increasing numbers we are seeing a lot of people admitted for something else — and Covid positive — so we are seeing intermingling of positive and negative patients.

“That means increased lines of transmission with vulnerable people in hospital, so we think the government needs to do something to flatten the curve, slow the Omicron so we can maintain ­capacity to deliver urgent and usual care.”

Emails obtained from other hospitals paint a similar picture of increasing pressure, including one from St George.

“We reopened our 2nd Covid ward on 6B before New Year. We now are in the position of having more Covid positive patients than we have Covid positive beds for and have exhausted all other options to manage. Therefore we will be (imminently) opening a 3rd Covid ward again, much like we did in September,” the email said.

An email from Liverpool said it “has in ­excess of 200 Covid admissions, far more than during the peak of the Delta outbreak”.

Dr Nark Nicholls, a Sydney-based intensive care specialist and President of the Australian and New Zealand Intensive Care Society said the nation had a surge capacity of 2500 ICU beds but there were 600 staff furloughed with Covid, bringing it back to 1900 beds. Currently there are 282 Covid patients in ICU.

“From an intensive care point of view we have capacity at the moment, so we are coping, but we are expecting there will be increasing intensive care numbers,” he said.

“At this point of time it is difficult to estimate what number of patients will need intensive care across the country.”

‘WE CAN’T KEEP UP WITH DEMAND’

Ambulances have been travelling from the Central Coast to Western Sydney for urgent call-outs amid spiralling cases and staff shortages.

Paramedics are also stretched, with many working overtime with no breaks. Picture: John Grainger

“Work at the moment is diabolical,” intensive care paramedic Brett James from Kogarah said.

“We thought we had seen the worst of it with the Delta outbreak and we were sort of bracing ourselves, knowing restrictions would ease, but what we have is completely beyond anything that we could have imagined.

“With other outbreaks there would be peaks and then it would settle down but with this there is no end in sight.”

Mr James is a Paramedic Association delegate who has been with Ambulance NSW for 13 years.

Veteran paramedic Cheryl Clement moved to Shoalhaven three years ago and said wait times and demand was currently as bad as anything she experienced over decades of working in Sydney.

In the past week she had worked two overtime shifts with one including “no break at all and no opportunity to get a break”.

Asked if the system in the Illawarra was coping, the Paramedic Association delegate said: “Absolutely not.”

NURSES ON THE EDGE OF LOSING IT

Frontline medical staff say they have reached breaking point, and warn that government leaders claiming the outbreak is under control are living an “alternate reality”.

Doctors and nurses from across the state describe harrowing conditions, many fearing they will burn out before the pandemic is over.

An Illawarra hospital nurse, speaking on the condition of anonymity, said the hospital was short three or four nurses every shift.

“We are close contacts, casual contacts and some nurses are positive, so that wipes out those who have been working with them for the seven-day period,” she said.

“Multiple staff have to do overtime every shift to help fill the gap, but even then everyone’s tired and it can’t keep up for much longer.

Nurses have hit back at the suggestion the health system is coping. Picture: John Grainger

“Beds have been shut on other wards to help spread the staff out but it’s not enough.

“There isn’t enough staff. It’s an absolute shit fight trying to get adequate staffing and fatigue is a massive issue at the moment.”

Another nurse said she works in a state of “constant anxiety” and bursts into tears because of the exhaustion and stress of what’s next.

“Saying this is under control is just wrong,” she said.

A Nepean nurse said working at a hospital had become “pretty scary”.

“We will run out of nurses probably next week,” she said.

A northern Sydney hospital nurse said the hospital was “at breaking point”.

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