Australian Medical Association president Tony Bartone warned the number and the capacity of public hospital intensive care units equipped with ventilators “is going to be a significant issue” as health authorities responded to an “uncontrolled” COVID-19 outbreak.
“We’ll never have enough to cope with a health emergency, a national health emergency, of the scale that potentially this could evolve to,” Dr Bartone said.
It comes after Australian College of Emergency Medicine past president Simon Judkins warned doctors would have to make “tough decisions” about who could access an ICU bed if action was not taken to slow the spread of COVID-19, to spread out the number of patients needing a ventilator over a longer period.
AAP this week reported on a NSW Health presentation outlining preparations for a 10-week surge in demand for ICU beds that would put them at between 115 per cent and 330 per cent capacity, under modelling of a 22-week “first wave” coronavirus outbreak infecting 1.5 million people.
A medical device industry source, who spoke on condition of anonymity, told The Sun-Herald and The Sunday Age that while efforts were being made to secure ventilator supply chains, “in a complex and dynamic environment such as COVID-19, it is possible that availability may change rapidly”.
Most ventilators used in Australian hospitals are imported from Germany, Switzerland, Sweden and North America, with smaller suppliers located in China and South Korea.
Dr Holley said while a rapid surge in case would present a “challenge”, health authorities could boost the capacity of intensive care units “quite rapidly” by deferring elective surgery to free up beds and buying extra equipment, including ventilators, to convert ward beds into ICU beds.
“We could have a 30 per cent surge based exclusively on additional physical beds in ICU,” he said. “We could do that tomorrow.”
Professor Murphy has said the federal health department is preparing to respond to a number of modelled scenarios, including a “worst case” outcome where “some millions of people [are] infected over a period of several weeks”, including working to build the capacity of critical care beds.
Australia’s national COVID-19 pandemic plan outlines hospital surge capacity measures including higher patient-to-nurse ratios in ICU units, where a patient on a ventilator would normally have a dedicated intensive care nurse monitoring their vital signs.
Dr Holley said a low-cost ventilator sold for between $5000 and $10,000, while top-of-the-line models sold for $50,000.
The Queensland health department has so far acquired an additional 110 ventilators. “Our hospitals are prepared to triple emergency department capacity and double intensive care unit capacity, when required,” a spokeswoman said.
NSW Health, which has more than 1000 ICU beds, declined to say how many extra ventilators the state was buying. A spokeswoman said the department was “planning for a potential increase in presentations of people with respiratory illness” and working to “maximise available critical care resources”, including “monitoring intensive care bed availability, staffing and availability of critical infrastructure, such as ventilators”.
Dr Holley said the new guidelines for intensive care doctors and nurses would detail how to best test and treat patients with the coronavirus, including preventing its spread within the hospital.
Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.