Victorian hospitals can enforce mask mandates if they choose to cope with surging Covid cases

Struggling emergency departments are ‘running on less staff than in 2020’ while trying to respond to a spike in cases amid the eighth wave of infections.

Victorian emergency departments are “running on less staff than in 2020”, a leading doctor has warned, after the health department quietly raised their internal ratings for hospital demand.

The state’s healthcare system was moved to a “stage two operational response” overnight, amid an increase in Covid cases.

The four-level system, designed in 2022 during concerns of a winter surge, outlines various measures individual hospitals should consider such as mass mandates and increased telehealth to respond to growing demand.

Australian Medical Association Victoria vice president Dr Simon Judkins, who works in regional and metropolitan emergency departments, said the system was “incredibly stretched”.

“The shortfalls in staff across many of our emergency departments is quite profound,” he said.

“Most emergency departments are really struggling to actually have staff on the ground.

“In fact, we’re running many EDs on lesser staff than we had back in 2020.”

He said he knew the community was tired of Covid, but warned rising cases were “another unwanted pressure” on top of GP shortages, the impact of mental health and difficulties discharging elderly hospital patients into aged care and the impact of mental health.

“A lot of our hospitals are really suffering at the moment from a high level of worker fatigue, burn out, a lot of sick leave,” he said.

Mask mandates can be enforced in hospitals from midnight. Picture Dylan Coker

“Presentations are increasing, length of stay in a lot of emergency departments is increasing because the hospital system’s full and then you bring into that already stretched system an increase in Covid presentations.

“There has been a huge recruitment drive to try and bring in extra staff internationally back into Australia, but there’s a time lag to get that done.”

He said hoped cases do not continue surge and the community responds to their warning, but that Covid was too unpredictable to say whether tougher hospital restrictions would be needed.

“Emergency departments and urgent care centres, we’re a little like a canary in the coalmine when it comes to surges in the community,” he said.

“I think a lot of hospitals, EDs over the last couple of weeks have actually started to increase their Covid precautions.

“We hope that everybody will just do the right thing when these public health messages come out so we can avoid unnecessary pressure on the healthcare systems and hospitals.

“I think there is a bit more science and rigour about what we can do to actually prevent an increase in numbers but of course, if there is a surge, things like elective surgery will inevitably be impacted.”

Stage two measures are far less drastic than higher settings — such as such as a level four rating which can see the cancellation of elective surgery – and allow individual hospitals to make their own rules as opposed to following statewide mandates.

Victorian hospitals can choose to enforce the rules if they see fit. Picture: Tony Gough

Hospitals’ new policies under the stage two system can include increasing telehealth services, asking staff to wear N95 masks, mandating visitor masks, or trying to free up beds through programs like hospital in the home and the virtual emergency department.

The latest Covid figures, released on Friday, show deaths have continued to increase, with more than 100 patients dying in the past 28 days.

This week’s daily average for hospitalised Covid patients was 270 — up from 233 last week — while intensive care unit figures remained steady at 12, down from 13.

Wastewater testing — which provides a better indication of community spread now that the public no longer needs to report positive test results — showed the levels of Covid continued to increase in metropolitan catchments last month.

When questioned about rising Covid cases earlier on Friday, Victoria’s chief health office Dr Clare Looker acknowledged cases had spiked and said she was “alert, but not alarmed”.

“It’s not unexpected, it’s what we plan for,” she said.

“We know that the new normal is to continue to see waves of Covid activity.”

A health department spokeswoman said there had been “an operational staged response to assist health services respond to increasing Covid-19 cases” throughout the pandemic.

“A road map to guide hospital responses has also been in place since June 2022,” she said.

“During a stage two operational response, health services have additional levers they can pull to prepare for an increase in demand to protect staff, patients and visitors.”

It comes just one week after the acting chief health officer decided to issue an alert, warning that Covid cases were increasing to levels “not seen since May” and multiple variants were on the rise.