NSW hospitals prepare makeshift ICUs for growing number of extreme COVID-19 cases
Major hospitals around the state are scrambling to retrain staff as they brace for an “enormous tsunami” of extreme COVID-19 cases, with St Vincent’s Hospital transforming their public rooms into “satellite ICUs”.
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The intensive care unit of a major Sydney hospital will be cleared out to make way for sick and dying COVID-19 victims as NSW braces for a “tsunami” of cases.
St Vincent’s Hospital plans to move critically ill COVID-free patients into the private hospital’s ICU next door to cope with the expected virus surge in the next few weeks.
The main public ICU will be dedicated to keeping coronavirus patients alive.
Operation recovery rooms will be converted into “satellite ICUs” when the number of coronavirus cases soars and both the public and private ICUs are needed to treat them.
Nurses with previous intensive care experience are also undergoing rapid retraining to make up staffing shortfalls.
In an exclusive interview with The Sunday Telegraph, St Vincent’s Director of ICU Dr Priya Nair said preparations started early this month and will triple the ICU’s capacity.
“What we've done is to work out how we would best look after these patients and expand our services as the need grew,” Dr Nair said.
“Maybe I’m being falsely optimistic in a way but I feel quietly confident that we have done as much preparation as we can — we’re still doing preparation.”
Dr Nair said having the private hospital close by was a “huge advantage”.
“They have exactly all the equipment that we would want — the high-end type ventilators that we need for these patients and the advanced monitoring as well as trained staff,” she said.
“With the projections that we’re seeing, we should be able to look after the patients that we need to. Of course nothing is certain. We’re all learning as we go.”
Hospitals across NSW are ramping up to fight coronavirus with some converting operating theatres and beds from other wards to manage the forecasted ICU load.
Shortages of personal protective equipment have been widely reported with many doctors and nurses fearful for their own safety.
An intensive care nurse at a Northern Sydney hospital said the anxiety among healthcare workers was escalating as hospitals scrambled to train up staff and source ventilators.
The NSW Nurses and Midwives’ Association member has already intubated — inserting a tube into the airway so a patient can be placed on a ventilator — more than 10 COVID-19 patients, some in their 50s. Her colleagues had put patients “between 30 and 40” on ventilators.
While most patients with COVID-19 would be able to recover at home, one in five would require intensive care and not all would survive, she said.
“We are already under the pump” she said.
“We have enough personal protective clothing right now, but we will need more. Patients are intubated for up to 20 days on a ventilator, so that’s why the beds will be filling up quickly.”
Medical staff at Campbelltown Hospital had done everything “humanly possible” to get ready, Western Sydney University School of Medicine associate professor Dr Andrew McDonald said.
“I liken it to this enormous tsunami coming — we can’t quite see how big it’s going to be yet,” the Campbelltown Hospital paediatrician said.
“But the troops are ready, they’re locked and loaded, and they’ve done all the preparation they can and it will all come down to the size and how quickly things happen.”
Australian Doctors Federation chairman Dr Aniello Iannuzzi said regional hospitals including Orange, Bathurst and Tamworth were well-prepared but rural centres were causing “concern for doctors and communities”.
“We don’t have ICU beds so our fear is that when the surge happens, those towns that do experience outbreaks are going to be in a very difficult situation,” Dr Iannuzzi, a GP from Coonabarabran in the state’s central west, said.
“The traditional thing one does in those situations is to send patients to the base hospitals, sometimes even to Sydney and Newcastle, but that option will most certainly not be available to us because those places will be full.
“Some of these small hospitals don’t even have ventilators or if they do, they’re very small devices that are meant for temporary jobs.”
Sydney emergency physician Liz Swinburn, an Australian Salaried Medical Officers Federation council member, described the scene at her hospital as an eerie calm.
“It is like the water of the oncoming tsunami has gone out. There are less day to day things such as broken bones. People are staying away from the hospital,” she said.
“There are some COVID patients. We know this won’t last. It will be challenging.”
Dr Swinburn said now was the time to have a conversation with elderly family members on what they would want if they became seriously ill, or were being ventilated.