AMA Transcript - Prepare hospitals & health system now for rise in Covid cases AMA urges National Cabinet

26 Aug 2021

Transcript:   AMA President, Dr Omar Khorshid, RN Breakfast with Fran Kelly, Thursday, 26 August 2021

Subject:   AMA TRANSCRIPT –  Prepare hospitals & health system now for rise in Covid cases AMA urges National Cabinet

FRAN KELLY: Well, millions of us locked down in New South Wales are waiting anxiously to hear what measures might be eased today. The Premier Gladys Berejiklian has promised some kind of reward for the state reaching 6 million vaccinations, but with record case numbers of the infections yesterday, the state's health system is now under significant pressure. Victoria too, is feeling the pressure, announcing a plan to fly 350 medical staff in from overseas, as it braces for the next phase of the pandemic. Other states are going to extreme measures to keep the virus out. WA barring all travellers from New South Wales, and Queensland's hard border expected to be in place until the end of October.

Omar Khorshid is the President of the AMA. He joins us from Perth. Omar Khorshid, welcome back to Breakfast.

OMAR KHORSHID: Morning, Fran.

FRAN KELLY:  Just that notion of a vaccination passport, we were talking to the Minister there. Would the AMA welcome a measure like that to try and stop the spread of the virus?

OMAR KHORSHID: We are certainly going to need to be able to prove our vaccination status going forward and whether that's to individual businesses or to allow us to travel. It's very hard to imagine any other alternative, that we're going to be living with this virus for the foreseeable future, possibly for the rest of our lives. And that threat is just going to be there and we're going to have to demonstrate to people that we've been vaccinated. So, I think it is part of our future.

FRAN KELLY: Okay. Can we go to the situation in our health system, particularly our hospitals? There are 645 people with COVID in hospital now. In New South Wales, 80 per cent of the state's intensive care beds are full already. Victoria, as I've just said, they're flying in more than 350 extra medical staff to help. What does this say about our hospitals' readiness for dealing with this new phase of the pandemic?

OMAR KHORSHID: Well, for a start, Fran, I think it's worth remembering that our hospitals are usually full all the time. They- the ICU beds in many states and territories are above 80 per cent capacity normally. So, whilst these numbers look alarming, I think people do need to remember the hospital system will be there for them. But what we need to be doing is planning for the future. And right now, the reality is in New South Wales, there's no elective surgery going on, that's freed up a whole lot of ICU beds. And the number of beds is not the only measure. You've also got the staff that actually run those beds and that's really been the biggest problem in Victoria. It's been a problem in New South Wales as well, where your furloughed staff, your staff who've had to isolate because they've been exposed outside of the hospital, or staff have actually been infected. Those can't run their ICU beds. And you can have a ventilator; you can have a bed, but unless you've got your staff, you can't actually use it. So, all that stuff…

FRAN KELLY: [Interrupts] Sure. But that's a problem that's only going to get worse, isn't it, until the Delta variant outbreak is controlled?

OMAR KHORSHID: Correct. It is, it is going to get worse as the numbers go up. You know, it's 645 at the moment.

FRAN KELLY: [Interrupts] So do we have the staff? Do we have the staff to back up, more and more, hospital staff who are furloughed because of infections?

OMAR KHORSHID: We don't have staff just on tap. There are a finite number of staff, and the only way to get more is actually to stop doing other types of health care. So, as I said, elective surgeries already been stopped. That's a logical decision given the crisis in Sydney. They've started to close private hospitals or to stop them doing their normal work. Now, there's a few more private hospitals that they can do that to. So, you can find a few more staff. But at the end of the day, you're going to reach a point where your, I guess, already trained staff are no longer available, and you have to go then to the next level. People who don't normally do those sorts of jobs, have to retrain them. And that's all the stuff you do in a crisis. And I know every state and territory, every hospital has their plan. They've all- they're all ready for this. But you want to avoid it. At the end of the day, you don't want an orthopaedic surgeon like me running an ICU bed, that's not ideal, but it's something you do in a crisis.

FRAN KELLY: No. So, they may be prepared, but as you say, you want to avoid it. How do you avoid it and what's coming down the tunnel at us? When we hit vaccination targets of 70, 80 per cent, the idea is we stop focusing on cases and start making hospital rates the key number and we open up, you know, which will see many, many more, we know, perhaps, thousands more infections and hundreds more hospitalisations. How do the hospitals prepare for that? What's the plan for that?

OMAR KHORSHID: Yeah. Well, it's actually going to be very difficult, and this is something that we've been calling for. So right now, the only way to protect those hospitals is actually to keep looking at these numbers. We've got to get the numbers down, we've got to get the vaccination rate up, in order to allow the hospitals right now in Sydney to cope, and in Melbourne, and to be able to keep providing healthcare. We're looking forward to when we open and, you know, we're not talking about a particular number, whether it's 70, 80, or 90 per cent of the population vaccinated, but at some point, when we open, when we start to live with COVID and we have many thousands of cases, some of whom will even be in vaccinated people, we need to have a health system that's there for everybody. And that planning must be done. Now, some of that is capacity, some of that's money, some of that is getting extra staff, and we've heard a little about that in the last few days about what governments might be doing. But it's also about looking at processes, rules, you know, are you going to keep furloughing if staff have been exposed? Because everyone's going to be exposed. This is going to be our future. So, we need to change our approach.

FRAN KELLY: [Interrupts] So who's leading that? Is the Federal Government? Are you calling on the Federal Government or the state governments to do more in these spaces?

OMAR KHORSHID: We certainly are. So, I think at this stage in our current situation, it's National Cabinet that needs to indicate to everybody that they are looking at it. I mean, we kind of understand that we'll be okay. You know, we hear some health ministers or premiers saying we're ready, we're going to be okay. But that sounds like a platitude to us because we don't see it on the ground. Our members don't see it. Those of us who work in hospitals don't see it because our hospitals are always full. And yes, we can…

FRAN KELLY: [Interrupts] So what do you need- I'm just trying to get clear, Omar, sorry to interrupt you, what you need from National Cabinet then. It's meeting again tomorrow, for instance. What specific action and planning, and perhaps resourcing, do you want from our state and federal governments?

OMAR KHORSHID: Okay, so we want the plan for opening up to look at hospital capacity and to recognise that that will be perhaps the biggest constraint. And then to say, okay, how do we prepare our hospitals? Number one, money. Because delivering health care during a COVID outbreak or endemic COVID will be more expensive. Number two, capacity. Have we got enough hospitals? Got the right types of hospitals, have we got enough ICU beds, et cetera? Number three, staff. What's your plan for staff? How do we get more? Given that we don't have open borders to bring people in from overseas. Then number four, processes. Furloughing staff approaches to COVID, even in general practice. How do you run a general practice, when people want to bring their child in with a cough or a cold, or they're concerned that it could be COVID? Anybody with any respiratory symptoms, could be COVID. Are GPs going to wear full PPE all day, every day? Are they going to run their clinics like a COVID clinic every day? So, there's a whole lot of process stuff, planning that just hasn't been done. And it needs to be, throughout the health system, and that's something that we're calling for.

FRAN KELLY: Okay. The head of the AMA in WA, Mark Duncan-Smith, says the Federal Government is relying too heavily on that's Doherty modelling, and the opening up at 70 and 80 per cent vaccination levels of the adult population, he says, would be, quote, bordering on child abuse. Do you support that statement? Is it safe to open up before kids are vaccinated?

OMAR KHORSHID: So, we're very concerned about children, but at the end of the day, the- as Alan Tudge just said, although kids are getting infected with Delta, they're vastly less susceptible to severe illness or hospitalisation or death. So, we don't need to be terrified about the thought that our children might get COVID, because they're more robust than we are, they're going to get it through more likely than we are. Right now, we have no vaccine that is licenced for children under the age of 12 anywhere in the world. So, whilst we'd like to be able to vaccinate children, we'd like to be able to say, let's do that before exposing them to COVID, we simply don't have a safe and effective vaccine that's licensed anywhere. So, it's a little academic. We're hoping that we'll get the data on that from America by September, October, that it may mean that we're in a position to actually roll the vaccine out before the end of the year to children.


OMAR KHORSHID:  But I think right now, what we need to be focussing on is preparing for when we open and whether that is at 75, or 85, or 95 per cent, is going to depend on the circumstances at the time. We need Australians to roll up and get vaccinated. No point talking about a target if we're not going to hit it. So, I think rather than focussing too much on whether it's 70 or 80, let's focus on the job of getting all the adults vaccinated, preparing ourselves, hopefully vaccinating our teenagers, and if we have a safe and effective vaccine for younger children by the end of the year, we'll tweak the plan to make sure that they're protected, too.

FRAN KELLY: Omar Khorshid, thank you very much for joining us.