Covid NSW: Hospital at home system under scrutiny as 15 people die

Caring for Covid patients at home is a model to keep people out of an already stretched hospital system, but questions are now being asked after 15 patients have died at home.

Doctors have raised concerns about the “hospital in the home” Covid treatment system after 15 people died at home since August 1, including two more announced on Saturday.

One in 11 of the 170 Covid-related deaths have now occurred at home, with eight in the past week.

A specialist who works in the public system, who spoke on the agreement of anonymity, said patients can deteriorate rapidly with Covid and the “hospital in the home” system, which relies on doctors phoning the patient each day, could not cater for that.

“We have had two deaths at Nepean where the doctor has spoken to them in the morning and the patient suddenly died that afternoon,” he said.

“It is quite concerning because hospital in the home is teleconference medicine and to get full grasp of a patient you need to see them. A lot of patients won’t admit they are unwell because they do not want to come to hospital, because they have fear. So the deaths have been quite sudden and in the younger age group.”

Aude Alaskar, 27, died at home after contracting Covid. Pictured with his wife Yasmin. Picture: Supplied

According to NSW Health “the role of Hospital-in-the-Home (HITH) is to provide hospital-level patient-centred care that can safely and effectively be delivered at home to keep patients out of hospital”.

NSW Health confirmed there were more than 11,000 people with Covid-19 who are being cared for with 1156 cases in hospital, 207 in intensive care and 89 of them requiring ventilation.

“The far majority of these, over 90 per cent, are being cared for in the community at home or in NSW Health’s Special Health Accommodation,” a NSW Health spokesman said.

On Saturday, Health Minister Brad Hazzard announced two more deaths at home — a man in his 30s from western Sydney and another man in his 40s from south west Sydney — with both men testing positive to Covid after they were found dead.

On Friday two men also died. One aged in his 70s from Sydney’s south and one in his 60s from Western Sydney.

Ianeta Isaako, right, died at her Emerton home on August 25. Picture: Facebook

Jamila Yaghi died at home from Covid on September 3. Picture: Facebook

On September 3, mother of four Jamila Yaghi, aged in her 30s, died at her Guilford home and 30-year-old mother of three Ianeta Isaako was found unresponsive at her Emerton home on August 25.

NSW Premier Gladys Berejiklian said on Friday that if people were “at home and breathless” they need to call an ambulance.

“A lot of doctors who have been asked to do it (hospital in the home) have refused because they think it is unsafe. Nepean has about 800 patients managed in hospital in the home and as they deteriorate they are slowly being brought into the hospital,” the doctor said.

“The problem with Covid is we find the patients are sick for about two weeks and then they suddenly drop their bundle. With those who are young and died suddenly, we have to wait for the coroner, but some have had health problems, like cardiac problems.”

Covid positive patients have complained that no one from NSW Health has called them.

“As hospital in the home gets bigger and bigger, some patients are not being contacted for a week or two after Covid,” the doctor said.

Australian Medical Association President Dr Omar Korshid said it was a symptom of an overstretched health system.

“You can only get hospital in the home working if hospitals are working and ambulances working, they are all joined up. Pre-Covid, even before this, most hospital systems were stretched,” Dr Korshid said.

“With Covid you can get severe clotting and it comes on out of the blue, a sinuous thrombosis in the brain or a clotting in the guts, you might just think you’ve eaten something and all of a sudden you are very unwell.”

Sydney paramedic Alan O’Riordan with the Australia Paramedics Association said Covid could be a very deceptive disease and people sometimes suffer what is called “happy hypoxic” where they are very unwell but feel fine and so may not call for help.

“You get people who are calling and they are short of breath, but others just feel a bit off and you look at them and they look horrific and their numbers are horrific and they themselves feel well, just feel a bit off, so there is a group where the body is confusing the patient,” he said.

In a statement on Friday, NSW Health said all people with Covid were clinically assessed as to the care level required for their management.

“Sadly, NSW Health has been notified of the deaths of 162 people who had Covid-19

related deaths in NSW since 16 June 2021.

“Of these, 13 have been outside of a hospital setting (by Friday). In some cases, Covid-19 was identified in people who have passed away after their death.

“Every Local Health District has dedicated Covid-19 community care teams to provide

virtual care and daily clinical and welfare checks for Covid-19 patients at home.

“The daily clinical checks assess patient condition, and there are clear escalation

triggers in place for medical reviews and transfer to hospital if needed.”

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Originally published as Covid NSW: Hospital at home system under scrutiny as 15 people die