Emergency departments are short of staff every shift (think eight hours of nursing work that won’t be performed because of each absent nurse,and 10 hours of doctor work for each missing doctor). The hospitals are attempting to fill nursing shortages from other areas,but these nurses have different skills and experience;they are not necessarily trained for emergency work.

Patients and their families are upset,anxious and scared. Some feel guilty they are not vaccinated,or because they have infected others. Some are angry. They phone their GPs at all hours trying to get help,but they also come to the emergency department,which has become the overwhelmed frontline at this stage of this pandemic.

To take the pressure off emergency departments,the health system needs to fund fit-for-purpose respiratory clinics as quickly as possible for newly diagnosed COVID-19 patients. Some hospitals are already setting them up. Vaccinated people diagnosed with COVID-19 are unlikely to need hospital treatment but could access such clinics for information,guidance and support.

COVID-19 sufferers who are short of breath and have comorbidities (diabetes,obesity,immunocompromised) need prompt assessment,especially of their oxygen levels. The clinics could carry out this assessment and refer to hospital those who require further treatment. Clinics will also enable doctors to make decisions about the early use of new treatments,for example the monoclonal antibodies that help to keep people from getting so severely ill,and GPs can also refer patients directly to the clinics for specialised assessment and management.