NSW ICU beds: Who will get them if Covid cases explode

New guidelines have revealed who will be eligible to get ICU beds if the NSW hospital system is overrun during Covid, and not everyone is happy about it.

Exclusive Patients with less severe illness as well as those at greatest risk of dying will be excluded from public hospital Intensive Care Units under a surprise protocol that governs the rationing of scarce hospital beds.

News Corp has obtained the guidelines that determine who gets an ICU bed if the system becomes seriously overwhelmed with Covid-19 cases.

And we can reveal the harsh rules were briefly applied in some Sydney hospitals in the last two weeks.

The rationing of ICU beds applies not just to Covid patients but to all people who need a bed, including emergency heart attack victims, people recovering from complicated surgery and those at the end of their lives.

“It may be necessary at some point to begin prioritising limited critical care resources to those with a need for treatment and those who are most likely to survive,” the guidelines say.

Doctors would have to begin “facilitating end of life discussions and decisions in those appropriate ICU patients assessed as not reaching a meaningful recovery”.

Nurse attends to a Covid-19 patient in the ICU-C ward. Picture Chris Pavlich

While it may have been expected that the oldest sickest patients were likely to be denied scarce beds, it has also emerged the 25 per cent of ICU patients who have less severe illness could also miss out on high level care.

A key NSW study found this protocol made the most number of ICU beds available when resources were stretched.

“If beds are tight you don’t have that luxury and you have to have harder conversations,” a senior doctor, who did not want to be named, told News Corp.

Some Sydney hospitals were already rationing access to ICU beds and removing the least sick patients from ICU wards two weeks ago before high vaccination rates stemmed the rising tide of hospital admissions.

“We were on the brink,” the doctor said.

“We needed hundreds of extra hospital beds.

“Then the number of patients admitted dropped dramatically.”

Frontline doctors are reporting hospitalisations appear have peaked a full month before they were meant to.

“I didn’t think just one dose of the vaccines would be enough against Delta but it has caused a big drop in hospitalisation which surprised us all,” the doctor said.

NSW Covid cases peaked at 1599 on September 10, hospitalisations peaked four days later at 1253 on September 14 and ICU admissions peaked at 244 on September 21 and have been trending down since.

The drop off happened when more than 80 per cent of residents in Sydney’s hotspot suburbs had received a single jab and more than 40 per cent had received two shots.

Originally modelling done for the NSW government estimated hospitalisations would peak in the final week of October and ICU admissions were predicted to rise to a peak at the beginning of November.

“I think we are now reassessing those predictions,” the doctor said.

Vice president of People with Disability Australia Kelly Cox. Picture: Supplied

It is possible cases and hospitalisations could begin to rise again once lockdown restrictions are eased.

A NSW Health spokesperson said the government was continually monitoring hospital capacity and had “well developed workforce surge and demand management plans in place”.

Vice president of People with Disability Australia Kelly Cox, who has muscular dystrophy and lives in Australia’s anti-vaccination heartland, northern NSW, fears she might be denied ICU care.

A local outbreak could mean there were not enough ICU beds and ventilators for everyone and if she caught the virus her disability meant the odds of recovery were stacked against her.

“As a disabled person I know I can’t rely on my body all the time,” she said.

“I just don’t think I would have any chance of fighting it if I get it.

“With the triaging process, these people that don’t follow health orders, wear a mask or get vaccinated – they will probably get a respirator. I’m probably less likely too – and that’s really unfair,” she said.

Originally published as NSW ICU beds: Who will get them if Covid cases explode