NEW modelling, published online today by the Medical Journal of Australia, suggests that Australian hospitals do not currently have the capacity to accommodate possible demand and, as a result, the future mortality rate of COVID-19 may be much higher than expected.
They estimated that, given Australia has around 2200 ICU beds currently, “Australia's ICU capacity will be exceeded at around 22 000 COVID-19 cases sometime around 5 April, 2020 … if public health measures fail to curb the rate of growth”.
“How many intensive care unit beds (ICU) will the pandemic require?” asked the authors.
“To answer this question, we propose a simple model based on an average ICU length of stay of 10 days and we then compare this model against recent real-world data from Lombardy, Italy.”
In an accompanying editorial, MJA editor-in-chief Distinguished Laureate Professor Nick Talley wrote that “the model is simple and grim”.
“It proposes a hypothetical Australian hospital facing new positive COVID-19 admissions each and every day, where one in 20 community cases end up in ICU, an ICU admission is 10 days long, and there is a 20% increase in SARS-CoV-2 community case load each day.
“By day 15 (presumably around the time ICU beds run out), the mortality steadily increases linearly, as has happened in Italy.”
Professor Talley wrote that “bureaucrats must step to the sidelines”.
“In my view, we will also require our health system leadership to understand at a time like this the structure in every hospital should be a military-like command-and-control one, led by senior frontline clinicians and health professionals with a designated clinician leader.
“While the results reported [in the MJA research] may represent a worst-case scenario and may not come to pass, we must better prepare, now,” he wrote.
“Over the coming months it’s going to take courage, brains and a concerted unified effort by the medical profession and health professionals to manage SARS-CoV-2 infection.
“Let’s not leave anyone behind.”
- Cate Swannell1
- Medical Journal of Australia