Regional hospitals fear increased coronavirus cases

Many regional hospitals are not equipped for a safe handover of Covid-positive patients and are understaffed – with one short 64 full time nurses.

Healthcare organisations have expressed concerns regional health services may not be prepared for rising coronavirus case numbers as Victoria prepares to open travel between Melbourne and the regions on Friday.

Long patient wait times for transfers, unsafe conditions for ambulance staff and critical staff shortages are among a list of serious concerns raised by the Rural Doctors Association of Australia, the Victorian Ambulance Union and the NSW Nurses and Midwives’ Association.

Danny Hill, secretary of the Victorian Ambulance Union, said conditions for regional ambulance workers were “shocking”, with only 15 per cent of staff surveyed across the state fit tested for Covid-safe masks.

This was despite staff assisting with the transport of Covid-19 positive patients in regional areas being exposed to the airborne virus in confined, unventilated spaces like the back of transport vehicles for prolonged periods, he said.

In contrast to metropolitan hospitals, Mr Hill said many regional hospitals were “not kitted out” for a safe handover of Covid-positive patients at ambulance bays, and did not have waiting bays and outside facilities available for staff.

“Latrobe Regional Hospital doesn’t even have toilet facilities for our members. So if they’re bringing a patient in and they’re waiting out the front of the hospital, they have to go searching to find toilet facilities,” he said.

“Having good structured processes is really important the front of the hospital (to prevent) an infection being spread throughout the hospital.”

Dr Megan Belot, president-elect of the Rural Doctors Association of Australia, said the safest way to transport a Covid-positive patient long distances was by air, because it would reduce the amount of time staff were exposed to the virus.

But she said 24 to 48 hour wait times for patient transfer flights meant regional hospitals had to be prepared to care for seriously ill patients for extended periods.

This was despite many regional hospitals having a shortage of doctors, nurses and facilities to care for Covid-positive patients.

“Most of our small rural hospitals don’t have negative pressure rooms. Negative pressure rooms keep the air from one room circulating into other rooms, and they are vital for keeping health staff safe when caring for patients with infectious diseases like Covid,” she said.

Not all small rural hospitals have even basic technology like ventilations hoods to isolate Covid-positive patients, Dr Belot said.

“We need to be ready (to treat patients with oxygen support in local hospitals,” she said. “But I’m not so confident that we are.”

Brett Holmes, the branch secretary of the NSW Nursing and Midwives’ Association, said managing Covid patients with high-flow oxygen required “nursing and medical care at a higher staffing level than would be normally provided to patients in respiratory ward”.

Many regional hospitals were already suffering staff shortages, and “recruitment of additional staff is never easy,” he said.

Wagga Wagga hospital was down by 64 full time equivalent nursing positions as of two weeks ago, he said, and Deniliquin hospital was down 10 nursing staff.

At Swan Hill Regional Health Service, Peter Abrahams said the service was successfully managing 63 Covid patients in the community and had transferred two to Melbourne hospitals.

But even in normal times, the “consistently high” staff vacancy rate at the hospital presented a “real challenge” to operating basic services, he said.

In a statement, a spokesman for Ambulance Victoria said the organisation was not currently seeing a significant increase in transfers from regional hospitals to Melbourne and any patient requiring urgent treatment at a metropolitan hospital would be “transferred without delay”.

“We have increased the capacity of our retrieval services to manage and plan for potential increases in rural demand as a result of impending population movement with the easing of restrictions, and will add further resources if required,” the spokesman said.

The NSW Health Department, and the Victorian Department of Health and Human Services were contacted for comment but did not respond by deadline.