Covid-19: Capacity crisis as Queensland hospitals brace for pandemic to arrive

Queensland hospitals have turned away patients under ‘code yellow’ declarations in the past month. Doctors say the system can’t cope with Covid.

Health workers at a drive-through Covid-19 testing clinic at Murarrie in Brisbane. Picture: Dan Peled

Queensland hospitals have turned away patients under dozens of ­capacity-driven “code yellow” declarations in the past month, with senior doctors saying the problem is so bad the system will not cope with a surge in Covid-19 cases.

Despite low rates of Covid-19 in the community, emergency physicians said Queensland’s health system was already at “breaking point” and feared there would not be enough room to care for Covid patients during an outbreak.

Figures obtained byThe Australian show there were 31 capacity code yellows – when hospitals start to run out of beds and ambulances are forced to divert to other emergency departments – in Queensland facilities in September. The majority of the code yellows were declared in regional hospitals, which are more exposed to a large outbreak because vaccination rates are lagging behind the national average.

More than a dozen capacity-driven code yellows were declared at Wide Bay, north of Brisbane, in September, while in the northwest, where there are no ICU beds, code yellow was declared six times.

John Hall, the president of the Rural Doctors Association, said communities with low vaccination rates might need to be “ring-fenced” if borders open based on statewide inoculation averages.

“Most rural hospitals are running on low levels of staff anyway so Covid-19 cases could have a massive impact on workforces, particularly if healthcare workers are exposed and need to quarantine,” Dr Hall said.

“It would only take two or three critically unwell cases to overwhelm those country hospitals.”

 

Meanwhile, chronic ward bed shortages in the southeast corner are triggering a dangerous backlog in emergency departments, with patients being treated in hallways.

Half of all category two patients suffering “imminently life-threatening” injuries were not seen within clinically recommended times at seven public hospitals in the June quarter, including the Royal Brisbane, Brisbane Mater Public, Logan, Ipswich, the Gold Coast, Bundaberg, and Robina.

Crisis talks between emergency specialists, surgeons and doctors will resume on Wednesday as they warn bed shortages must be fixed before the inevitable outbreak of the Delta strain in Queensland.

Kim Hansen, director of emergency at Brisbane’s St Andrew’s War Memorial Hospital, said the state was not ready for widespread transmission. “We are already at breaking point and we need to do more preparations,” said Dr Hansen, who is chair of the Australian Medical Association Queensland ramping roundtable. “Our hospitals should be operating at 90 per cent capacity, not more than 100 per cent like we currently are.

“We are already full, I really do not know where we would put Covid patients right now.”

A Queensland Health spokeswoman said there were 393 staffed and equipped intensive care unit beds across the state, with the ­capacity to expand to 576 beds. She also assured all emergency department walk-ins would be treated, even during a code yellow.

Dr Hansen said she feared Queensland hospitals would be overwhelmed as they have in NSW and Victoria. “It is crisis mode down there,” she said.

“The ambulances are queued up for hundreds of metres outside hospitals, they have tents and marquees because they cannot get patients into the emergency department, and they cannot get them into the hospital.”

AMA Queensland president Chris Perry said in the past month paramedics had begun leaving patients on stretchers in hospital hallways so they could get ambulances back on the road.

“The big issue is getting patients into the wards because there are not enough beds there. It is the same issue for every jurisdiction in Australia,” he said.

More money was needed to be invested in home hospital programs and aged care so patients were not taking up beds when they could be discharged.

As reported in The Weekend Australian on Saturday, state health ministers wrote to their federal counterpart Greg Hunt over concerns elderly and NDIS patients were occupying beds and putting pressure on the hospital system. They have asked the commonwealth to cover the costs for NDIS and aged-care patients who exceed the date of discharge, but Scott Morrison insists states had already been “showered in cash” and had almost two years to prepare their systems.

Annastacia Palaszczuk has warned she would not open her state’s border once the Covid-19 vaccine coverage reaches 80 per cent if hospitals were not ready to cope with a rise in cases.

Asked on Monday if hospitals were struggling with capacity problems, Deputy Premier Steven Miles said: “While they cope, there will be an impact. Hospitals in NSW and Victoria have dramatically scaled back non-urgent elective surgery.”

But Queensland Liberal National Party leader David Crisafulli said it was Ms Palaszczuk’s job to prepare the health system during the pandemic.

“If our hospitals can’t cope, it’s at the feet of the Premier,” he said.

“What has the state government been doing for the past 18 months to prepare our health system for what we are facing?”

Mr Hunt on Monday said the government was in “advanced” discussions about purchasing an experimental treatment known as molnupiravir, which early tests have shown halves the instances of hospitalisation or death with those who have mild Covid-19 symptoms. The commonwealth has already purchased thousands of doses of sotrovimab, which cuts the likelihood of hospitalisation and death by 79 per cent.