‘It’s not even winter yet’: Doctors fear months ahead as hospitals fill up

Conditions inside Victorian hospitals are as dire right now as healthcare workers would expect in the depths of winter, as they grapple with dual flu and COVID-19 outbreaks and a spike in ambulance queues.

A code red was declared for Victoria’s ambulance service early on Friday morning when a triple-zero system crash coincided with a surge in patient demand that reportedly left about 70 patients waiting for an ambulance to arrive.

Some patients were waiting up to 20 hours in the emergency department, according to Royal Melbourne Hospital’s Mark Putland.Credit: Joe Armao

“This is the state we would be worried about getting into at wintertime. It’s here. It’s not even winter yet,” said Mark Putland, emergency department director at the Royal Melbourne Hospital. “It is a serious concern.”

Putland said the average waiting time at the hospital’s emergency department now hovered between nine and 10 hours, but other patients were waiting more than 20 hours due to bed shortages.

The problem is not confined to Melbourne, with text messages seen by The Age showing there were no free ambulances available to respond to new callouts in Shepparton and Bendigo on Wednesday night.

The message sent to paramedics urgently sought staff to come in during their time off “due to 0 [per cent] fleet availability”.

Senior health staff in Victoria are calling for alternative accommodation to be urgently found for hundreds of elderly people or those with a disability, who are ready to be discharged but do not have anywhere else to go, saying it would immediately help get things flowing at clogged emergency departments.

Thousands of new cases of influenza have been detected this week, pushing the current yearly total of 14,371 detected infections. This is above the same time of year in 2019, a particularly deadly flu season in Australia, while more than 570 coronavirus patients continue to fill hospital wards across the state.

Austin Hospital infectious diseases physician Jason Trubiano described it as the silent pandemic.

“We’ve still got the same number of COVID cases that we had during some of our biggest peaks and now we are starting to see a rise in flu presentations,” he said.

Crowded hospitals are leading to even bigger queues of patients waiting with paramedics, unable to be overloaded at overflowing emergency departments.

One senior paramedic not authorised to speak to the media described the current state of ambulance ramping as shocking, saying the number of patients forced to wait on stretchers inside or outside the hospital had quadrupled over a year.

Among them, they said, were those who were critically ill: people unconscious following a serious overdose, those having seizures or strokes, and patients having heart attacks who needed to be immediately seen and treated by a cardiologist.

“Their coronary artery needs to be opened up so their heart stops dying,” they said.

The paramedic joined other senior health staff in calling on the federal and state governments to urgently work together to begin to move patients waiting for an aged care bed or National Disability Insurance Scheme (NDIS) support.

“There’s literally hundreds [of patients] in Melbourne that are occupying beds that they don’t need to be in. If we move them today, we’ll start flowing.”

Victoria’s public hospitals are run by the state government, but the NDIS and aged care are largely the responsibility of the federal government, which did not respond to a request for comment.

A Victorian government spokesman said the pressure on hospitals was expected to increase over winter due to increasing flu numbers and ongoing COVID-19 outbreaks.

At the Austin Hospital, up to 50 COVID-19 patients are in wards on any given day. The hospital is also reporting between 15 and 20 new flu patients daily.

Many of the coronavirus patients being admitted are elderly or have underlying health conditions. A small number were unvaccinated or had not yet had their third dose.

A rapidly growing number of coronavirus patients were now being diagnosed incidentally after arriving at hospitals for other illnesses and injuries.

Trubiano said most COVID-19 patients were not severely ill due to the effects of widespread vaccination. But their care was still complex and posed significant challenges, including the need to isolate them from other patients, as well as provide early therapies such as antiviral treatments.

Putland said every hospital desperately needed more beds before winter, but the difficulty would also be finding available staff to care for patients in those beds.

“It’s about somehow finding a couple of extra wards for every hospital,” he said. “We could do with a couple of aged care wards to decamp out long-standing medical inpatients so we could move patients from the ED through hospital. If we had an extra 30 to 50 beds [at the Royal Melbourne Hospital] that would help enormously.”

Trubiano implored Victorians to get their flu vaccination to reduce the chance they will end up in an emergency department with influenza. He also urged people to start wearing a face mask indoors again, socially distance and stay home when they were unwell.

An Ambulance Victoria spokeswoman said the code red escalation activated on Friday was resolved within about 30 minutes.

Victorian Ambulance Union state secretary Danny Hill said he was hearing from members that code oranges were now being declared two or three times a week, meaning the ambulance service was unable to meet demands.

He said when there were no crews at all available, as was the case for a period in Shepparton and Bendigo this week, “the chances are you’re either not getting an ambulance or you’re getting one that’s significantly delayed”.

With Nell Geraets.

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