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We need to talk seriously about country hospitals in Australia and their ability to withstand attack from Covid-19. It's not good.
A thread.
Please retweet it. People should know.
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A thread.
Please retweet it. People should know.
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I am a rural GP / rural emergency doctor. I have spent a little while in tiny country hospitals in Australia. Many of them are old, some very old. Many have minuscule numbers of nursing staff and only one doctor, or less. Some are a bit larger. None are flush with staff.
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These country hospitals are a lifeline for their communities. They all have a "COVID plan". In my opinion, the chance of any of them withstanding a single case of COVID coming through the door is pretty much zero.
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Remember, the tertiary hospitals in Melbourne couldn't manage it, with all their staff and all their expertise and much more modern ventilation systems.
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I work in a tiny hospital, where the "COVID room" is approx 3m by 4m with no ventilation at all. None. There is a connecting door to another, cramped room with all the equipment in it, where donning and doffing take place in the same tiny space.
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Access to this room is via the main corridor, past the main waiting room. Out of hours, there are two nurses in the combined hospital and aged care unit. If the doctor and one nurse are gowned, there is no runner. You're stuck.
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The COVID room has no oxygen, no equipment of any kind, which all has to be brought in. It is a completely unsuitable space in which to look after a sick patient. If you put an oxygen mask on a patient in there the air will turn immediately into COVID soup.
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And of course the guidelines in most of Australia - strictly enforced - are still to treat a known or suspected COVID patient in this environment with only a surgical mask and droplet precautions. It is now known globally that this policy is literally murderous to HCWs.
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I have seen this situation replicated in country hospitals around Australia. They will not able to cope. The measures in place currently amount to no more than performative tokenism. They allow managers to tick a box, one which says "COVID plan in place".
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Many who work in these hospitals have no illusions and know that the measures and procedures are a joke. But what can they do? It's pointless to raise concerns in an environment where you are ignored at best and bullied at worst. Others have their heads in the sand.
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The best analogy I can come up with is that the staff in our country hospitals are like Dad's Army, the British Home Guard in WW2, if they'd ever had to come up against crack German paratroopers. They wouldn't have stood a chance and knew that from the start.
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They would have done the best they could, with the farcical weapons they had. They would have fought bravely, but they would have known it was hopeless. And so it is for many of the staff in our country hospitals.
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I want people to know all this, because I want to highlight, once again, how important it is for us to keep this virus out. And to take proper precautions, not tick box precautions. And to speed through the best vaccination program possible.
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And to come down like a ton of bricks on outbreaks like the Sydney one, because there are no second chances with this virus. I thought we'd learned that in Victoria, but I fear we may be about to learn it again in Sydney.
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