Fears Delta outbreak may be bigger than we think

Fears are growing about the extent of undetected Covid cases in Victoria with dozens of patients turning up at hospitals without being previously diagnosed.

High rates of Covid patients needing hospital treatment ­including intensive care are raising fears that Victoria’s Delta outbreak may be even larger than officially reported.

Health officials have revealed 27 positive Covid patients turned up at Victorian hospitals in the past week without being previously diagnosed.

Of the 670 cases between August 26 and September 1, 49 people either presented to an emergency department or were admitted.

Of that number 27 were diagnosed for the first time upon their entry to hospital.

It is understood that in some cases, hospitalised ­patients were revealed to have been in contact with known Covid-positive family or friends, but the relationship had not been disclosed to ­contact tracers until their ­condition deteriorated.

Because only about one in 20 people with Covid become sick enough to need hospital treatment, those patients have heightened concerns about the full extent of undetected cases circulating in the community and fuelling the outbreak.

Only about one in 20 people with Covid become sick enough to need hospital treatment. Picture: David Caird

Those fears are underlined by Victoria’s disproportionate number of extreme Covid cases requiring intensive care. Currently, 2.1 per cent of the state’s Delta cases end up needing ICU treatment, compared to just 0.7 per cent in NSW, and less than 1 per cent overseas.

Of Victoria’s 1029 active cases, 5.6 per cent are in hospital, compared to 4.7 per cent of NSW’s 19,040 active cases.

Deputy chief health officer Professor Ben Cowie on Wednesday confirmed some positive cases were not being found until they were presented to emergency departments.

“We’re still having people waiting a week, getting seriously unwell and turning up to hospital without having been diagnosed until they get to hospital,” he said.

“That’s terrible for that individual, it’s devastating for their family, but its contributing to ongoing transmission as well.”

Prof Cowie said there was “absolutely no question” that early diagnosis of Covid prevented people from ending up in intensive care.

Melbourne hospitals are regularly seeing patients with advanced Covid infections who had not been tested. Picture: Daniel Pockett

Once a person tests positive for the virus they are given the opportunity to be monitored by health professionals and ­referred to other programs that can check on their wellbeing.

“If their condition starts to deteriorate, we can get them into hospital and give them treatment that keeps them out of intensive care,” he said. “We can keep them out of ICU, a large proportion of those people, using very simple drugs.

“Once someone comes into an emergency department who requires a tube put down their throat immediately to breathe, that’s it, they are in intensive care, usually for weeks.”

While the number of critical patients is too small to draw firm conclusions about the scale of undetected cases, the head of ICU at Royal Melbourne Hospital, Associate Professor Chris MacIsaac, said a slightly higher rate of severe Covid cases could indicate there was more virus circulating than tests revealed.

“We have had, and I know other hospitals around Melbourne have had, several ­patients turn up to emergency departments very unwell, late into the illness who have not come forward for testing.

“That is challenging for everybody, and these cases show how important it is for every Victorian to attend for a test as soon as they become even a little unwell,” he said.

Northern Health chief nursing and midwifery officer Lisa Cox said they were also seeing undetected Covid-­positive patients “day-by-day”, though most did not know they were infected.