Doctors warn NSW premier ICU Covid patient numbers not only metric in battling Omicron | Health

Health workers have warned that intensive care numbers are not the only metric the NSW premier, Dominic Perrottet, should be considering as he resists mask mandates, with senior clinicians warning staff are exhausted and even quitting their jobs altogether as they face a third year of Covid.

Respiratory physician and president of the Royal Australasian College of Physicians (RACP), Prof John Wilson, called for state and territory governments to reintroduce or maintain mandatory mask wearing, QR code check-ins, and restrictions on numbers of people at indoor public venues where Covid is spreading.

The call came as NSW reported a record 3,057 cases on Tuesday.

Perrottet on Monday rejected calls for more government-mandated health restrictions and said it was time for “personal responsibility”. He described intensive care presentations as “the key metric for the state” to monitor in relation to Covid-19, and said the numbers were low. There are 39 people with Covid-19 in intensive care in NSW.

But Wilson said the health system comprised more than just intensive care, and that health workers across the system were furloughed due to being sick with or exposed to Covid-19, or were quitting their jobs due to exhaustion.

“The phenomenon of job walkaway is a real one,” Wilson said. “Health is a sector where people have been asked to go the extra yard many times, time after time, and put together with a situation where they have families that they haven’t seen, where their own health is at risk, where the industrial incentives have not matched the clinical demand, it’s not surprising that some are actually leaving.

“Of course natural attrition in the workforce will also occur, but there are factors like Covid-19 and the lack of response that actually speed up that decision making, and I think we’re seeing some of that right now.”

Guardian Australia asked NSW Health about the number of health workers furloughed, but is yet to receive a response.

Wilson said the RACP wants governments to listen to their chief health officers first and foremost.

“If not checked, a surge in cases will further burden our already exhausted health systems due to an overwhelming rise in hospitalisations,” Wilson said. “The relaxation of restrictions in some jurisdictions, especially those associated with mask-wearing, QR code check-ins and large gatherings, can have dire consequences.”

The RACP has been joined in their concern and call for restrictions by the Australian Medical Association, and leaders from Australia’s top infectious diseases research institutes. Later on Tuesday, AMA president, Dr Omar Khorshid, will hold a press conference where he is expected to urge national Cabinet to institute a national plan to tackle Omicron, citing concern from infectious diseases physicians.

He described Perrottet as “reckless”.

“DIY contact tracing, watered-down check-in requirements, the abandonment of mask wearing mandates, and the removal of density limits are together, a recipe for disaster and by the time hospital admissions and ICU cases grow beyond whatever benchmark he is working to – it will be too late.”

But the prime minister, Scott Morrison, echoed Perrottet’s comments saying on Tuesday that “we have to move from a culture of mandates to a culture of responsibility”. “That’s how we live with this virus into the future,” he said.

The comments have alarmed some health workers in NSW, who say the entire system is stretched.

A clinician at one NSW hospital said the public health unit where she works is dealing with many more Covid-19 cases in people from vulnerable settings than at the Delta peak earlier in the year.

“Aged care and disability care predominate, both residential and community settings,” she said.

“There are cases of Covid in staff, carers and clients. Not many seem really sick yet and most are vaccinated, but it is early days. Getting staff to provide ongoing personal care to cases and close contacts in becoming very difficult. They need training in PPE and often key staff are required to isolate as close contacts of the client or staff cases.”

The public health and disability workforces were also losing staff, she said.

“It’s a casualised workforce with often no entitlements so there is not much loyalty to employers,” she said. “I would think most who work through an outbreak do so for the clients, to whom many of these low paid carers are incredibly loyal. But transfer to hospital for elderly or disabled cases with high care needs is becoming more difficult.

“Hospital transfer and health hotels have been our safety net to stop transmission and provide care to vulnerable people. I can see these options being exhausted in the lead up to Christmas.”

Managing outbreaks is labour intensive, she said, requiring coordination between public health, clinicians, hospital executives, the private provider and the department of health.

“Everyone is stretched,” she said. “Everyone is faced with the dilemma of how we can safely and compassionately do less. People, particularly those in aged and disability care, have borne a disproportionate burden of loss of quality of life during Covid. It’s particularly galling to me that they stand to lose out yet again, for the sake of ‘freedoms’ for the general population that surely could have been bestowed more slowly and mindfully.”

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A health worker in regional NSW said it was not just Sydney being affected. She said her hospital is experiencing “severe staffing issues all across the hospital from the emergency department to ICU to maternity”.

“We are not coping with day-to-day operations, let alone a Covid outbreak,” she said.

“In January, we are expecting an extra 15,000 people to travel to our area for a county music festival from all over the country. Has there been planning, funding or just anything from the state government? There hasn’t.”

Staff are tired from filling multiple roles for the last two years during the pandemic, she said.

“My comment to the premier is that we do not have the resources to deal with this, or the planning and leadership we need to steer this ship. Is there a national leader out there who understands what is going on, who can pull this nation together and have us all moving in one direction together instead of individually states?”.

Do you know more? melissa.davey@theguardian.com

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