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The real crisis inside our hospitals

Jan 31, 2022 • 15m 25s

With the worst-case projections of the Omicron wave yet to be realised, Australia’s health system is still buckling under the pressure, leaving hundreds of thousands of Australians with inadequate or interrupted care. Today, senior reporter for The Saturday Paper Rick Morton on the crisis in our health system, and how our governments didn’t see it coming.

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The real crisis inside our hospitals

619 • Jan 31, 2022

The real crisis inside our hospitals

[Theme Music Starts]

RUBY:

From Schwartz Media I’m Ruby Jones, this is 7am.

Even though the worst case projections of the Omicron wave haven’t yet been realised, Australia’s health system is buckling under the pressure.

Thousands of healthcare workers are off work, and surgeries, palliative care and mental health services are all feeling the strain - leaving hundreds of thousands of Australians with inadequate or interrupted care.

Today - senior reporter for The Saturday Paper, Rick Morton, on the crisis in our health system and how our government’s didn’t see it coming.

It’s Monday, January 31.

[Theme Music Ends]

RUBY:

Rick, over the past week, it looks like COVID 19 case numbers have started to stabilize or even potentially decline across the country, there's some senior health officials, people like Victoria's Chief Health Officer Brett Sutton, who have said that it's likely that the peak number of Omicron cases has already occurred. So that sounds like good news.

RICK:

Yeah, yeah, it does. And it does look like case numbers might have peaked in Victoria and in New South Wales. The Chief Health Officer, Kerry Chant, is a bit more cautious, but we're still seeing some pretty positive signs. She's just warning us not to get ahead of ourselves. But we certainly aren't seeing the kind of dramatic growth in case numbers we were seeing earlier in the year.

But that reduction in the growth of case numbers isn't as clear cut as it might seem, so hospitalization figures aren't dropping at the same rate. And that's mainly because the first surge of omicron cases this year and over summer were largely amongst younger people, people in their 20s and 30s. You know, young people like us, right? The vast, vast majority of those cases didn't require hospitalization.

But now older Australians are making up a bigger chunk of our Covid cases, and as a result, hospitalization numbers are remaining relatively high.

And that means that we're definitely not out of the woods yet in terms of the pressure being placed on our health care system, which remains severe and is kind of just sitting there at this plateau at the moment.

RUBY:

Yeah, I mean, we're in year three of the pandemic now, Rick, and we are still hearing about our health system being in crisis. What does that actually look like, though, for a person who needs medical care right now?

RICK:

Well, one area that has been hit pretty hard is what we call elective surgery. Now, the phrase makes it sound like it's optional. You know, people getting surgery for fun or because it's a choice - that is not the case. In many, many instances, elective surgery is about pretty fundamental stuff. It's necessary surgery that is not immediately life threatening.

Archival tape – Queensland News:

Queensland is immediately suspending non-urgent elective surgeries across the state until at least March as Omicron cases surge.

RICK:

And right now, across much of the country, elective surgery has been frozen

Archival tape – Dominic Perrotet:

Today we are announcing that we will continue to suspend elective surgery for non-urgent surgeries…

RICK:

so those resources can be redeployed to help in-patients with Covid or elsewhere in the hospital system where the strain has been felt.

Archival tape – Victorian News:

Victorian doctors are calling on the Andrews government to reveal a plan to restart elective surgery…

Archival tape – Victorian Doctor:

It shouldn’t be something we can turn on and turn off because this isn’t unnecessary surgery…

RICK:

And that is having a significant flow-on impacts for thousands of Australians on surgery waiting lists.
And there's one Melbourne family I've been speaking to, and this story highlights this problem in a way that I'd rather it didn't highlight the problem, but here we are. And they were plunged into crisis when their young adult son suffered a traumatic brain injury after a skateboarding accident. This was in June last year, so June 2021. He underwent two rounds of emergency surgery to relieve bleeding on and around his brain. He spent 11 days in intensive care and was then moved to an acquired brain injury unit.

And after being finally released into care at home and with a third of his skull still sitting in a fridge at hospital, the man and his parents endured a long, often silent waiting game to find out when his cranio plastic surgery could be done. And all the while he's suffering from these really, really severe headaches. He's got nausea, he's sick. He can't eat properly. He's really unwell. And basically there’s been CT scans had along the way which show that there's some fluid floating around there. So this was classified as an elective surgery category two, which basically means it's not urgent, but it does need to be done within 90 days.

RUBY:

So what happened Rick? Did he get surgery within 90 days?

RICK:

So for context, you know, he was in the public system. He was at the Alfred, which is some of the best trauma specialists in the country. And indeed, they saved his life when he first had this injury. But every time the family tried to book him in for this cranioplasty, it got pushed back or they didn't get a firm answer.

So, you know, time was blowing out. He was suffering these headaches and they just couldn't get him in, even though he was supposed to be seen within 90 days. And they were coming up on that 90 day threshold this year in January.

They didn't know what to do. And you know, this is a pretty well-resourced family. They're not rich by any stretch of the imagination, but they're, they're well educated. They own a home and they're struggling to make sense of the system.

So eventually, because of one physician who basically told them, go to this private hospital, tell them about the headaches. I can do the surgery on the Sunday, if you do that. So the family was lucky to get this spot. They paid $5000 out of pocket after private health insurance to get this surgery done. And when it was done, the CT scan showed quite a lot more fluid on the brain than they had been led to believe. And the surgeon actually said this should have been done six to eight weeks after he left hospital the first time around with the brain injury. So, in other words… much sooner.

And this is one story I have been inundated with stories like this, you know, to the point where I actually couldn't keep up with all of the emails coming in when I put a call out on social media and it speaks to a hospital system that really is at crisis point.

RUBY:

We’ll back in a moment.

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RUBY:

Rick, we're talking about the state of Australia's hospital system, the crisis point that we've reached. And I wonder, is this situation? Is this just the inevitable result of rising cases of Omicron or is there something else underpinning this?

RICK MORTON:

So the really big issue here, as it has been all along, is staffing… and the lack of it.

Archival tape – Victorian News:

6600 Victorian health service staff are unavailable to work after contracting Covid or being required to isolate as a close contact…

Archival tape – Queensland News: At midnight the Victorian ambulance service called a code red - for three hours it did not have the staff to meet the extreme demand for medical care…

RICK MORTON:

So in the New South Wales government's most recent weekly update that I had available when I was writing this story, there were more than four thousand five hundred hospital and health care workers furloughed, and in isolation because of community exposure or potential workplace exposure.

Archival tape – Sydney News:

A leading Sydney hospital has offered its nursing staff cash incentives to cancel their annual leave to cope with critical staffing shortages caused by coronavirus…

RICK:

That doesn't include aged care workers by the way, this is acute care primary health workers. At the same time, there's thousands of patients in hospital with COVID, in addition to the normal strain and stress that this system was already under before the pandemic even began.

And you know, there's been an almost unbelievable lack of preparation, and that is what is ultimately behind our health care system being at crisis point. And it's why hundreds of thousands of Australians have been left with inadequate or interrupted care. This is not just about people with COVID. This is not just about people having trouble in a hospital setting with or without Covid. This is about every other element that links into health care in this country, so elective surgery is just one part of it.

But alcohol and drug services have been completely hobbled. Palliative care has been reduced to this kind of inhumane light touch, where services can't see their clients who are dying in the community. Aged and disability care is suffering. Chronic disease management has been paused or reduced, and that stuff adds up over time.
Mental health services for people with moderate to high needs. Yeah, it's almost impossible to access a psychologist. And of course, what we were discussing, unnecessary surgeries have been delayed, and all of this is really down to a failure to prepare.

Now it's really like policymakers in Australia thought we would never have to deal with the reality of the pandemic. Or, you know, this common theme over the years where it's like we endure one wave of the virus and then we think everything is going to get back to normal? How many times have we heard, you know, the economy is bouncing back? We pass through the worst of it, all of that stuff. And, there's another story that I've been digging into that exemplifies all of this, I think, and it has to do with the potentially life saving treatment for COVID 19 that, despite being available around the world right now, still can't be accessed in Australia.

RUBY:

OK, so tell me about the new treatment for COVID 19 and why it's not available here.

RICK:

OK, so on October 17 last year, the Health Minister, Greg Hunt, announced the federal government had secured.

Archival tape – Greg Hunt:

500,000 units of Pfizer’s new oral antiviral, which can be provided early in the course of the disease

RICK:

500,000 courses of Pfizer's oral antiviral tablet Paxlavid, that's Paxlavid.

Now early clinical trials were quite promising for this drug. And they showed that it could dramatically slash hospitalization rates amongst COVID 19 infected people with high risk conditions, particularly amongst the unvaccinated, by the way. Now, after this deal, the new round of clinical trial data came out, and it showed that this tablet that was developed by Pfizer could reduce hospitalization and death by 89 per cent from any cause compared to the placebo control in the patients in the study.

So, one observer told me that Paxlavid is the greatest weapon after vaccinations in the fight against COVID 19 on the frontline. And we don't have it.

RUBY:

So why not and when can we get it, Rick?

RICK:

So it's complicated, of course.

So according to the sources that I was speaking to for this piece, the first prescription of Paxlavid probably won't happen in Australia until early March.

Now the United States and Israel. They've been using Paxlavid for more than a month alongside a less effective oral pill from Merck. Now, neither drug has reached Australia. We have done a deal for 800,000 courses of both of them, 500,000 of Paxlavid, which is the far more effective one. But since December one, we've had more than twelve hundred deaths as a result of COVID 19 here in Australia since December one. In fact, that figure is even higher now as we speak.

So with the vast majority of those deaths, they happened this month in January, and according to one source I spoke to, the unavailability of Paxlavid has meant that many people have died who otherwise wouldn't have.

RUBY:

Hmm. So, Rick, we're in the situation where patients with COVID 19, they can't get the best possible treatment, and the reasons for that remain unclear, but as a result, hospitalisations are remaining high and that's having this flow on effect into the rest of our healthcare system, which is impacting the quality of care that people can receive. It really does seem like things are at their worst point, despite the fact that we've had several years now to prepare for this.

RICK:

It's an interesting point in time, actually, because this is all happening at the same time that we are, of course, being told and you know, people like myself are hoping that we can start to resume some sense of normality. And so there's this cognitive dissonance, I think, happening at the moment where it's like, but we were told everything was good… But then we've got, you know, some of the biggest numbers of people dying from COVID in a day since the pandemic happened.

And we're double vaccinated. We've, we've got boosters coming - a lot of people have had theirs now.
So what do we do? Like, why is this happening now? Why is this happening to us? We did all the right things, right?

And it's partly it's partly mismanagement of the Christmas period of not adapting plans when the Omicron variant arrived in Australia. Paxlavid is a very effective drug. It would have been helpful to have had it and that what we are seeing now is a kind of accumulative crisis.

The health care workforce is running on empty and they're running on empty because we've endured - on the backs of workers who are underpaid by the way - we've endured the rolling crisis to a point. But the question now becomes, how much longer can we do this without significant resources, without significant change?
And we don't know what is going to happen next. There may be more waves. There may be more variants. Omicron happened pretty bloody quick. That's what we're seeing. It's a problem of imagination. I think over a couple of years now where at every turn it seems like we're just we're playing catch up and it's not good enough anymore.

RUBY:

Hmm. Rick, thank you as always for your time.

RICK MORTON:

Thanks, Ruby. Thank you for having me.

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RUBY:

Also in the news today…
The NSW government has announced over $1 billion in economic support for businesses impacted by the Omicron wave this summer.

The bulk of the spend will be focused on small businesses that lost 40 percent or more of their revenue in January. A support package for the performing arts sector was also announced.

And the Ukrainian tourism board has urged potential holidaymakers to “keep calm and visit” the country.

The Ukrainian government is seeking to reassure tourists, despite increasing tension with Russia - which has massed 100,000 troops on its border.

We’ll be covering the situation in Ukraine later this week, so make sure you’re following the show.

I’m Ruby Jones, this is 7am, see ya tomorrow.

[Theme Music Ends]

Even though the worst case projections of the Omicron wave haven’t yet been realised, Australia’s health system is still buckling under the pressure.

Thousands of healthcare workers are off work, and surgeries, palliative care and mental health services are all feeling the strain - leaving hundreds of thousands of Australians with inadequate or interrupted care.

Today, senior reporter for The Saturday Paper Rick Morton on the crisis in our health system, and how our government’s didn’t see it coming.

Guest: Columnist for The Saturday Paper, Rick Morton.

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7am is a daily show from The Monthly and The Saturday Paper. It’s produced by Elle Marsh, Kara Jensen-Mackinnon, Anu Hasbold and Alex Gow.

Our senior producer is Ruby Schwartz and our technical producer is Atticus Bastow.

Brian Campeau mixes the show. Our editor is Osman Faruqi. Erik Jensen is our editor-in-chief.

Our theme music is by Ned Beckley and Josh Hogan of Envelope Audio.


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619: The real crisis inside our hospitals