Phase three of the plan includes cancellation leave for hospital staff and ramping up telehealth services to limit patients coming in and out of all public and private acute-care hospitals.
One source briefed on the modelling,who was not authorised to speak publicly,said “bleak” projections from the Burnet Institute had reminded the government of the potential gravity of the looming health burden in a winter when cold and flu cases were already clogging hospitals and GP clinics.
Another said the modelling showed Victoria was on a similar case trajectory to Britain,where hospitalisations have risen by one-third in a week because of the infectious and vaccine-evasive new sub-variants.
Contingency plans for the worst-case scenarios outlined in the Health Department’s winter COVID-19 strategy include consideration of a coordinated “code brown” response,which includes pausing elective surgeries.
A state government spokesman toldThe Age the government had “no intention” to call another code brown.
Loading
A stage-four response includes a code-brown declaration,prioritising emergency surgeries and deploying additional crews to offload patients from ambulances to avoid “ramping” outside hospitals. Stage three includes regular emergency meetings,cancelling leave and ramping up telehealth consultations,while stage two involves deploying modular emergency department units,deferring non-urgent surgery and changes to shift lengths for healthcare workers.
The Victorian government last called a system-wide code brown in January to reduce pressure on the hospital system as the Omicron wave peaked. The emergency response measure,which typically lasts for a day or two,continued for nearly a month and created a backlog of elective surgery cases.
The hospital system has not fully recovered,with the nurses’ union claiming legislated nurse-to-patient ratios had not been met since December last year.
Australian Nursing Federation Victorian branch secretary Lisa Fitzpatrick said personal leave among nurses was increasing due to extreme exhaustion and burnout,and she urged Victorians to wear masks in settings where they could not socially distance to avoid crisis-level demand on hospitals in coming weeks.
“Whether that’s at a restaurant,or whether that’s sitting at the football,if you cannot socially distance from the person next to you,you should have a mask on,” she said.
Australian Medical Association Victorian president Roderick McRae,who was briefed on the winter strategy,described the current healthcare workforce shortage as serious and said it warranted an emergency response.
“If the system seizes up,the health minister would declare a code brown,but functionally we’ve almost already reached that stage,” he said,adding that many hospitals were individually enacting emergency measures equivalent to a stage-four response.
McRae called on the government to expand mask mandates,while also criticising the removal of masks in airports during the school holiday period and the lack of enforcement on public transport.
“There’s no question that when there is a mask mandate,the transmission of the virus is reduced,” he said.
Senior ministers,speaking toThe Age on the condition of anonymity,reaffirmed the government’s commitment not to reintroduce any further COVID-19 restrictions. They cited high vaccination rates and low compliance with existing rules.
“People understand how to manage their risks,but at some point the place has to go on,” one minister said. “They have earnt the right to make the decisions.”
Another minister said:“There are mask mandates on public transport but no one wearing them.”
“It’s time for people who are crook to manage their symptoms and others who are worried about their own health will either avoid dangerous settings or take precautions.”
Mandates would also be difficult to enforce because the Victorian government has in effect disbanded its COVID-19 management apparatus,including the thousands of authorised officers who enforced rules in the streets.
Professor Margaret Hellard,who is part of the Burnet modelling team but was prohibited from divulging details,said use of masks across the community reduced overall transmission by 20-30 per cent.
She said it was impossible to be certain about whether a mandate would lead to higher levels of mask-wearing,but said it was important for governments and community leaders to refocus public attention on methods to keep people safe.
“We need to create a situation where people don’t feel foolish for wearing a mask indoors,” she said. “Our health system will be overwhelmed if we aren’t careful.”
“The hope some people held that COVID would just go away is not consistent with what we’re seeing in Australia and globally.”
Chair of epidemiology at Deakin University Professor Catherine Bennett broadly backed the government’s approach,saying education campaigns would be more effective than rules.
Loading
“If they brought in rules now,it wouldn’t make a difference,” Bennett said.
A new state government campaign titled Stay Well in Winter will emphasise the importance of third and fourth vaccine doses and educate people on the benefits of good ventilation and wearing mask indoors.
From Wednesday,Victorians will also be required to follow test-and-isolate requirements from four weeks after an infection,down from 12 weeks,in line with a recommendation of the Australian Health Protection Principal Committee late last week.
A Victorian government spokesman said:“The global pandemic has put health systems all over the country under extreme pressure – Victoria is no different. We are working very closely with the health services as we navigate this time together,but we currently have no intention of moving to a statewide setting for code brown.”
“We have a pandemic repair plan,and we are continuing to support our health system,health workers and patients through this peak. We have done it before and we will do it again.
“People can support the health system by following the advice and getting their third or fourth dose.”
The Morning Edition newsletter is our guide to the day’s most important and interesting stories,analysis and insights.Sign up here.