Reverse order: Massive spike in COVID-19 cases demands reinstatement of masks indoors and other restrictions | AMA (WA)


Reverse Road

Reverse order: Massive spike in COVID-19 cases demands reinstatement of masks indoors and other restrictions

Wednesday May 11, 2022

After a record 12,390 COVID-19 cases were reported yesterday, there was a dramatic spike to 17,033 COVID cases up till 8pm last night. While there was already a strong call from the AMA (WA) for the Government to consider re-introducing masks indoors and bringing back appropriate Level 1 restrictions, those calls culminated in a much more urgent plea for action from AMA (WA) President Dr Mark Duncan-Smith, when he spoke to the media this afternoon.

“I am urging the McGowan Government to reverse the decision of 29 April and reintroduce masks and some restrictions. If not, I am begging the McGowan Government to reintroduce masks into areas other than hospitals, where they’re still mandatory, to help flatten the curve.

WA is now setting unenviable records with more than 17,000 cases today. We now have the highest infection rate per capita of any state or territory in Australia.

New South Wales has three times the population of WA but fewer new cases. If we applied our numbers to NSW, there would be over 50,000 cases a day, if they had our rate of infection.

Although hospital and ICU admissions are stable at the moment, they won’t stay that way. There is a lag of a week between hospitalisations and case numbers.

Just as it has taken a week for the numbers to go up significantly following the reduced restrictions and dropping the mask mandate, any new public health initiatives will take a week before they have effect. Also, to suppress the curve in that week, there is a danger that our medical system may get smashed. It is in danger of being overrun in the next week.

We started the pandemic with the lowest reserve. We had the lowest number of beds and ICU beds of any state or territory in Australia. The lack of capacity in the system is evident from August 2021 when we had no COVID, and yet saw record ramping at 6,500 hours a month. A month later, we cancelled elective surgery due to ramping, not COVID.

Studies in the UK are revealing that long COVID is occurring at a rate of 8 per cent, and for over half of those people, that interferes with their ability to get back to work.

I can see where this is going, and it scares me greatly. Our medical system is teetering as it is. We have critical staff shortages in ED at Bunbury Hospital. We have ‘bed state black’ in some of the ICUs, and ‘code yellows’. We have about 30 per cent nursing absenteeism. We have wards with no junior doctors. We have fewer consultants in the hospital system.

Elective surgery at one of the major teaching hospitals this week was reduced because the ICU was full. Our intensive care units are not empty because there’s not many COVID patients. There are still patients with strokes, heart attacks, sepsis and car accidents.

While our 80 per cent boosted vaccination rate is protecting us, 2 per cent will still get severe disease. When you crank up the new cases, that 2 per cent can become a big number very quickly.

I was expecting, based on the figures I saw over the weekend, that we’d be reaching 12-13,000 cases this week. I was staggered when we hit 17,000.

The Government made a decision on 29 April, which has now led to this problem. If we look at the seven-day average, we were on a relatively steady plateau. Cases have now jumped significantly. What I’m hoping is that new restrictions or the re-introduction of restrictions will take us back to a plateau phase.

I think, at a minimum, we need to have masks worn indoors. Masks are cheap, effective and well tolerated. And if it protects our medical system and individuals, then it’s a good thing to do. I’m continuing to wear my mask indoors and I suggest you do as well.

But ultimately, that’s up to the Government. They’re the ones that can look at all this, and hopefully give us answers based on modelling data. 

I think a smart move at this stage would be to contact those people scheduled for elective surgery in the public system next week,  and advise that it may be necessary to cancel their procedure at short notice. I would do that as a precaution; I wouldn’t cancel at this stage. We still need to see exactly where the numbers go, but the concern is a large jump in initial cases usually leads to more hospitalisations and possibly higher ICU numbers.

It’s not just about the fragility of the system; it is the reduction in staff availability. It’s being reported to me that nursing staff in the private sector are experiencing about 10 per cent absenteeism, with about 30 per cent in the public sector. 

The flat line we used to see on the graphs where we were always told about flattening the curve, is not actually a flat line. The ability of the medical system to cope is actually reduced and that flat line has actually declined as the pandemic goes on.

That’s what we’re seeing at the moment. Hospitals, even the one I’m sitting in right now, are unable to do full elective surgery because they don’t have enough staff.

The bottom line is, if you don’t control COVID, you don’t control your economy. We’re already hearing reports of restaurants and businesses closing because quite simply, there is no staff.

It has taken just over a week for a significant jump in cases after restrictions were reduced. For the Premier not to reintroduce some restrictions at this stage may be unforgivable.