Pandemic panic: How Australia's health system would be plunged into CHAOS in the event of an outbreak of the deadly coronavirus

  • Public hospitals stretched already with patients waiting hours at emergency
  • An influx of people with breathing difficulties from COVID-19 would hit hard 
  • Hospital protocols would change to cope, surging staff from non-essential areas
  • Elective surgery may cease with staff redirected to the crisis
  • University students, NGOs, government agencies may provide extra staff
  • 'Hospital in the home' services used to manage most cases 
  • Health Department is working on a pandemic plan specifically for coronavirus 

Fears are rising that Australia's public health system could not cope with a coronavirus epidemic as numbers of infected people soar worldwide.

Confirmed cases of the illness, now called COVID-19, rose past 64,400 on Friday, with 506 of those outside China.

Just over 10,600 of those cases were in a serious condition, reported BNO News, which has been closely tracking the official data.

Most of those with a severe illness develop respiratory problems and some require ventilation. 

If the coronavirus epidemic were to break out in Australia and spread, it would put immediate pressure on Australia's public hospital system.

NSW Nurses and Midwives' Association general secretary Brett Holmes said NSW hospitals were already under enormous strain.

He said if a pandemic did occur protocols would change how hospitals operate to focus on the immediate crisis.

Some of the changes may include postponing non-urgent surgery and ceasing elective surgery, he said, with staff diverted to the crisis.

Mr Holmes said staff would be 'surged' from non-essential work areas to cope with the crisis and training would be postponed. 

Staff may be sourced from outside the public health system including from university students, other government agencies or non-governmental organisations, or brought in from other states and terrritories.   

Pandemic Assessment Centres (PACs) may be established as stand-alone facilities, separate from hospital emergency departments for triage.

More than a million Australians in need of urgent treatment waited longer than clinically recommended in hospital emergency departments in 2017-18 according to the Australian Medical Association. An coronavirus epidemic would put more pressure on the system

More than a million Australians in need of urgent treatment waited longer than clinically recommended in hospital emergency departments in 2017-18 according to the Australian Medical Association. An coronavirus epidemic would put more pressure on the system

More than 3500 people remain quarantined on the Diamond Princess cruise ship in Japan and 218 people from the ship have so far tested positive for the coronavirus that causes COVID-19

More than 3500 people remain quarantined on the Diamond Princess cruise ship in Japan and 218 people from the ship have so far tested positive for the coronavirus that causes COVID-19 

HOW HOSPITALS MAY CHANGE 

If a coronavirus epidemic strikes, hospitals may change their procedures by:

-  Surging staff from non-essential areas to deal with the crisis

-  Non-urgent and elective surgery may cease with staff redirected

- Postponing all training and administration not related to the pandemic

- Calling in staff from outside the system including university students

- Taking in staff from NGOs, government agencies, or less-affected states 

- A designated Public Health Controller can override normal management 

- Pandemic Assessment Centres (PACs) may be established. These are stand-alone facilities, used for triage, assessing individuals

- Reliance on ‘Hospital in the Home’ services to manage most cases 

Source: NSW Nurses and Midwives' Association 

If you are in NSW you can check your hospital wait times here 

According to Australian Medical Association figures, more than a million patients who sought help at emergency departments waited longer than clinically recommended for treatment in 2017-18, mainly due to a shortage of hospital beds.

The figures, from the most recent public hospital report card, showed public hospital services were not being funded enough to cope with rising levels of demand.  

'Emergency department performance is in decline,' the report said.

The AMA called on Friday for increased hospital funding. 

'Across all types of public hospital service, the rate of increased demand is outstripping the rate of population growth,' AMA president Tony Bartone told Daily Mail Australia.

Dr Bartone said the system is already so stretched that scheduled elective surgery is often cancelled as ward beds are needed by seriously ill patients turn up to emergency.  

He also called for the immediate establishment of an Australian National Centre for Disease Control (CDC), as a national body to oversee and co-ordinate epidemiology and research, health security and to take part in global heath surveillance. 

ABC News reported the nation's hospital system is buckling under the strain of 23,000 presentations a day, with ambulance crews 'ramping' patients, looking after them in a corridor or in the back of the ambulance while they wait for a bed - sometimes for hours.

In the event of an epidemic, hospitals would change the way they work, potentially cancelling all elective surgery and repurposing all staff in non-essential areas to deal with the crisis

In the event of an epidemic, hospitals would change the way they work, potentially cancelling all elective surgery and repurposing all staff in non-essential areas to deal with the crisis

Workers set up beds at an exhibition centre converted into a hospital in Wuhan on February 4. Vietnam is setting up field hospitals for thousands of patients in case the epidemic hits

Workers set up beds at an exhibition centre converted into a hospital in Wuhan on February 4. Vietnam is setting up field hospitals for thousands of patients in case the epidemic hits

While many people who contract the COVID-19 illness from the new coronavirus will recover without hospitalisation, studies show more than 15 per cent of people who go to hospital then go on to need intensive care.

A study of 99 coronavirus patients hospitalised in China published in medical journal The Lancet found 17 per cent developed acute respiratory distress syndrome, which requires a ventilator. 

A later study of 138 people hospitalised with the virus, also published by The Lancet found about 26 percent needed intensive care, including some patients who appeared only mildly or moderately ill at first but who took a turn for the worse up to a week into their illness.

Australian National University (ANU) Associate Professor of Medicine Sanjaya Senanayake said if the epidemic were to sweep through Australia, it would have an impact on hospitals even if most cases were mild.

'If a small percentage need hospital care, it would still be a large absolute number and be likely to impact the public health system,' he told Daily Mail Australia on Friday.

'Hopefully it wouldn't be for long, weeks or months.' 

Although scientists are still learning about the illness, experts who study it say it is quite infectious and likely to spread.

The rate at which the virus spreads is determined by its 'R0' number, which is the average number of people infected by one person.

If the number drops below 1 then it will die out, but if it is greater than 1, then the virus will spread.

According to a scientific study published in The Lancet on January 31, the R0 number for coronavirus was estimated at 2.68, and the epidemic inside China had a doubling time of 6.4 days. 

According to research published in respected medical journal The Lancet, the coronavirus is highly infections with an R0 value of 2.68. That means each infected person spreads the virus to 2.68 others, who in turn do the same. If a virus has an R0 less than 1, the virus dies out

According to research published in respected medical journal The Lancet, the coronavirus is highly infections with an R0 value of 2.68. That means each infected person spreads the virus to 2.68 others, who in turn do the same. If a virus has an R0 less than 1, the virus dies out

The rapid increase from just over 40,000 cases on February 12 is due to a change in testing, said Dr Roger Seheult, a pulmonary disease specialist who founded medical education website MedCram.com.

China didn't have enough test kits for the Wuhan coronavirus RNA, Dr Seheult said in his YouTube update on the virus.

Instead, China is now testing for the illness caused by the virus, which has been officially called COVID-19, resulting in a rapid increase in numbers of confirmed cases as more people fit the new definition.

Countries around the world are preparing for a potential pandemic as the disease continues to spread.  

The US is using at least six military bases as quarantine facilities, Business Insider reported on February 6.

Vietnam, which had 16 confirmed cases as of Friday, has set up field hospitals with thousands of beds to handle a potential influx of coronavirus cases, the Straits Times reported on February 5.

The southeast Asian nation shares a porous border with China and has set up beds for close to 3,000 patients in northern provinces near the border.

In the capital Hanoi, two military facilities have been turned into quarantine centres for up to 1,500 people while central Vietnam has centres ready for as many as 3,700 people. 

A ward at Liverpool Hospital pictured in 2013. Australia's doctors and nurses say the public health system is stretched to maximum capacity. If the epidemic hits, procedures will change

A ward at Liverpool Hospital pictured in 2013. Australia's doctors and nurses say the public health system is stretched to maximum capacity. If the epidemic hits, procedures will change

Daily Mail Australia asked the federal Health Department what Australia was doing to prepare for the event of a COVID-19 epidemic.

'The risk to Australians is currently very low, but there are plans in place should this escalate,' a spokesperson said. 

Daily Mail Australia asked what those specific plans were, if they involved field hospitals or extra staff training.

The spokesperson said the Health Department is now finalising a specific pandemic plan to deal with the coronavirus which will outline triggers for a pandemic, and response actions.   

'It considers options when resources are in high demand, including ways mild cases can be managed outside the hospital system,' the spokesperson said.

The Health Department's website says Australia is well-prepared, but does not list what they would do in the event of an epidemic if large numbers of people require hospital care at once, instead focusing on testing, screening and tracing people to prevent an outbreak.   

ANU Professor Peter Collignon, said Australia may be better placed to deal with an epidemic as it had better housing, less crowding and more space between people, potentially making the virus easier to contain.

Prime Minister Scott Morrison announced on Thursday that Australia would extend entry restrictions on foreign nationals who have recently been in mainland China for a further week. 

The restrictions will be reviewed by the Australian Health Protection Principal Committee next week. 

A total of 532 Australians have now been evacuated from Wuhan, China, the Prime Minister said. 

The extended travel ban is likely to hit the universities' $39 billion international student industry.

University schedules could be thrown into chaos if 100,000 international students are unable to return to Australia in time for the start of semester.

WHAT DO WE KNOW ABOUT THE DEADLY CORONAVIRUS IN CHINA?

Someone who is infected with the coronavirus can spread it with just a simple cough or a sneeze, scientists say.

More than 1380 people with the virus are now confirmed to have died and more than 64,400 have been infected in at least 28 countries and regions. But experts predict the true number of people with the disease could be as high as 350,000 in Wuhan alone, as they warn it may kill as many as two in 100 cases.  Here's what we know so far:

What is the coronavirus? 

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body's normal functions. Coronaviruses are named after the Latin word 'corona', which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a 'sister' of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: 'Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals. 

'Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses). 

'Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.' 

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.

Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died. 

By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.

By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.  

By February 5, there were more than 24,000 cases and 492 deaths.

By February 11, this had risen to more than 43,000 cases and 1,000 deaths. 

A change in the way cases are confirmed on February 13 – doctors decided to start using lung scans as a formal diagnosis, as well as laboratory tests – caused a spike in the number of cases, to more than 60,000 and to 1,369 deaths. 

Where does the virus come from?

According to scientists, the virus has almost certainly come from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in the city, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat. 

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent similar to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: 'The discovery definitely places the origin of nCoV in bats in China.

'We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.'  

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans' lungs.  

Another reason for concern is that nobody has any immunity to the virus because they've never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: 'Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

'Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we're talking about a virus where we don't understand fully the severity spectrum but it's possible the case fatality rate could be as high as two per cent.'

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die. 

'My feeling is it's lower,' Dr Horby added. 'We're probably missing this iceberg of milder cases. But that's the current circumstance we're in.

'Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.'

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. 

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.

There is now evidence that it can spread third hand – to someone from a person who caught it from another person.

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients – at least 97 per cent, based on available data – will recover from these without any issues or medical help.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people. 

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world. 

This allows others to study them, develop tests and potentially look into treating the illness they cause.   

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China's Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.   

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has so far killed 1,370 people out of a total of at least 60,381 officially confirmed cases – a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

However, experts say the true number of patients is likely considerably higher and therefore the death rate considerably lower. Imperial College London researchers estimate that there were 4,000 (up to 9,700) cases in Wuhan city alone up to January 18 – officially there were only 444 there to that date. If cases are in fact 100 times more common than the official figures, the virus may be far less dangerous than currently believed, but also far more widespread. 

Experts say it is likely only the most seriously ill patients are seeking help and are therefore recorded – the vast majority will have only mild, cold-like symptoms. For those whose conditions do become more severe, there is a risk of developing pneumonia which can destroy the lungs and kill you.  

Can the virus be cured? 

The COVID-19 virus cannot currently be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it's not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people's temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?   

The outbreak is an epidemic, which is when a disease takes hold of one community such as a country or region. 

Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the 'worldwide spread of a new disease'.

The head of WHO's global infectious hazard preparedness, Dr Sylvie Briand, said: 'Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,' the Guardian reported.

She said that most cases outside of Hubei had been 'spillover' from the epicentre, so the disease wasn't actually spreading actively around the world.

Advertisement

Pandemic panic: How Australia's health system would be plunged into crisis in a coronavirus outbreak

The comments below have been moderated in advance.

The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.

What's This?

By posting your comment you agree to our house rules.