A senior doctor on the frontline of Queensland’s coronavirus wards has issued a stark warning to those who are dragging their feet on getting vaccinated: “You really don’t want to be my patient.”
After 18 months of preparing for a surge in cases, doctors and nurses at the Gold Coast University Hospital (GCUH) have taken ABC News inside the intensive care unit as they brace for a wave of Delta patients when borders open, or earlier.
Intensive care specialist Jon Field said severe COVID-19 requiring intensive care treatment was “a disease of the unvaccinated”.
“Unvaccinated patients with COVID who get respiratory failure firstly end up on a respirator … we put a tube in the windpipe, we give you a general anaesthetic, we provide oxygen via the respirator,” Dr Field said.
Other treatments for people who are seriously ill with the virus include prone ventilation, where patients are turned on their stomachs to aid oxygenation.
“We’ve had patients who’ve been here for hundreds of days … families aren’t allowed to visit … general anaesthesia and deep sedation for weeks or months to get through it.”
He strongly urged all eligible Queenslanders to get vaccinated.
“You can virtually guarantee not to get COVID pneumonia and be my patient if you get vaccinated,” he said.
COVID-19 also takes a toll on health staff who care for patients in full personal protective equipment.
Intensive care nurse Havalene Palmer said caring for patients was “definitely harder with PPE on.”
“It’s quite exhausting, it’s quite warm and hot … you get dehydrated, pressure sores around the ears and nose.”
She said the team is ready “to look after each other” when COVID numbers rise.
COVID doctors want vaccination rates above 90 per cent
As the vaccination rollout continues, the Queensland government is yet to outline when the state will open its domestic and international borders.
Infectious disease specialist at the GCUH, Kylie Alcorn, said the hospital was prepared for a “big number” of patients if borders opened when 80 per cent of eligible people were vaccinated.
“With 80 per cent we still could see anywhere between two to four wards with COVID and a significant number on our virtual ward in the community,” Dr Alcorn said.
She said it was difficult to say whether the hospital would be overwhelmed.
“It really depends on our local vaccination rate, if we can get to that 90 per cent locally of eligible community being vaccinated, then we will be in a really good position to not be overwhelmed.
“If we don’t get the vaccination rates up and we do open up I am concerned that we will have a significant amount of sick people,” she said.
Dr Alcorn said a large COVID outbreak in unvaccinated people would have knock-on effects for the health system.
“The less COVID we have in the hospital the more we can keep our outpatients open, the more we can keep our elective surgery going.”
The director of COVID-19 services at the Royal Brisbane and Women’s Hospital (RBWH), Andrew Redmond, also wants to see high vaccination rates before border restrictions ease.
“COVID is almost certainly coming to Queensland. COVID is very likely to be affecting all of our communities and all of our families,” he said.
Dr Redmond said: “It’s going to be very difficult” for hospitals if Queensland opens up “at just 80 per cent vaccinated.”
“I think that the health care system would be in a better state with higher numbers of people vaccinated.”
How will COVID-19 transform our hospitals?
Dr Redmond said elective operations, including major cancer surgery, at the RBWH would be triaged when COVID-19 puts more pressure on the already “very busy” hospital.
“It will be a struggle … we have had times, even with the limited number of cases that have occurred in Brisbane, where there have been delays to urgent surgery and that’s a real concern.”
He said urgent operations could be done at the new Surgical, Treatment and Rehabilitation Service (STARS) located next door to the RBWH.
“It is our plan to try to keep STARS as a COVID-free hospital which will potentially allow us to prioritise high-category surgical service.”
He said a “virtual ward program,” where people were looked after in their own homes, would be triggered when there were about 50 COVID patients in the hospital.
“Once the cases go higher still, then the care of people with very mild disease will be very community based with general practitioners managing cases … and the hospitals will just be for people who really need hospital-level care,” he said.
Rapid COVID tests are likely to be used to identify infected staff, patients and visitors.
“Pathology Queensland are helping us to evaluate the rapid tests … there were four rapid tests we were looking at just yesterday in the pathology centre and which ones are suitable for use.
“Once there is a lot of COVID in the community, we will be trying to evaluate whether people have it before they come into the hospital, so I think that will be the model that we will try to pursue, but we’re still working through that,” he said.
What about regional areas?
Dr Redmond said doctors in the major city hospitals “will do our best to support our regional colleagues” to care for COVID patients.
“But a lot of that will be supporting them to provide care in a regional setting, it’ll really only be very specialised cases that need to be brought from a regional setting to Brisbane.
“It’s not practical to move a whole lot of COVID patients around anyway, the risks are quite high of moving people around,” he said.
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