Almost all of the 12,500 beds across public and private hospitals in New South Wales will be occupied – by both Covid cases and regular patients – when pressure from the state’s Omicron outbreak peaks in late January, if worst-case scenario modelling is realised.
On Friday, after NSW’s chief health officer, Kerry Chant, acknowledged that the 38,625 new cases recorded were an “underestimate” of the actual total, health authorities released fresh hospitalisation modelling, alongside the announcement of a pause on elective surgeries and new restrictions to slow the speed of Omicron.
Pressure on the state’s health system will peak in the third or fourth week of January, the modelling based on vaccination coverage, general health and outbreak data from NSW and abroad predicts, with beds in intensive care and other wards likely to be stretched.
“By the middle of February we will be certainly well past the peak of this,” NSW Health deputy secretary Susan Pearce said.
Under the most realistic scenario, which is based on NSW’s infection data and current parameters, 4,700 patients with Covid will be hospitalised at the peak, with 273 Covid patients in intensive care.
Under the worst-case scenario, which is consistent with what has been seen in New York, 6,000 people are predicted to be hospitalised with Covid at the peak and 600 ICU beds to be occupied by Covid patients.
If the best-case scenario eventuates, the modelling – which is consistent with outbreaks seen in London and the South African province of Gauteng – predicts there will be 3,158 Covid patients hospitalised at the peak, with 270 of those people in ICU.
NSW’s public hospital bed capacity is about 9,500, and on Thursday, 8,000 of these beds were occupied by 1,600 patients with Covid and 6,400 people receiving treatment for other illnesses.
Should demand for hospital beds exceed 9,500, the government will be able to access at least 3,000 beds in private hospitals across NSW, taking the state’s total hospital bed capacity to 12,500.
Under the worst-case scenario, 6,000 people with Covid will require beds, in addition to the baseline figure of more than 6,000 people in hospital for treatment of illnesses that aren’t Covid.
NSW’s ICU capacity is 1,000 beds, and on Thursday, 467 of these beds were occupied, including by 134 patients with Covid and a baseline of 333 non-Covid patients requiring intensive care.
Under the worst-case scenario, whereby 600 ICU beds will be occupied by Covid patients, the state’s intensive care capacity would be hovering just under capacity.
The modelling predictions are in stark contrast to the way in which the Delta outbreak placed pressure on the state’s hospital system in 2021, when Covid hospitalisations peaked at just 1,266 but ICU admissions with Covid were 244.
This pressure on ICUs experienced during the Delta outbreak is comparable with the most realistic and best-case scenarios predicted for the upcoming Omicron peak, despite different overall hospitalisation figures – a prediction in line with evidence that the Omicron strain is milder.
Pearce noted that the state’s ICU bed capacity had been “quite significantly” revised down from the planned surge capacity during the Delta outbreak, as authorities are conscious that the number of health staff available to care for those patients will be affected by isolation requirements.
“We obviously consider very carefully our workforce,” Pearce said, encouraging registered health professionals not currently working to rejoin the workforce. “If I need to put on a uniform myself and go and work I will.”
The premier, Dominic Perrottet, acknowledged that while there was already “significant pressure” on the health system, the modelling showed that “even on a worst-case scenario, we have the capacity in our health system right now”.
However Danielle McMullen, the NSW president of the Australian Medical Association, said that “aside from the worst case, even in the most realistic scenario, there will be a serious strain on our health system and workers”.
“These are pretty shocking predictions for people in the health system. The next six to eight weeks will be a big challenge.”
McMullen believes health workers will “rise to the occasion” and cope with the peak, but warned that “it’s not going to be a fun time to work in the health system”.
“At no other stage of the pandemic have we needed that volume of private hospital capacity,” she said. “We’ve mostly leaned on it for staffing and elective surgeries, but to have the level of overflow of patients even under the most realistic prediction will be unprecedented.”
McMullen also cautioned that the modelling only illustrates hospital bed capacity and doesn’t show likely emergency room levels, which continue to bear the brunt of the pressure.
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She also said “there’ll be a multitude of that pressure affecting general practice”, especially as health workers are also tied up administering booster shots and initial Covid vaccine doses to children.
McMullen warned people in NSW to have different expectations for health care in coming months.
“To reach the capacities in the model, the threshold for entering hospital will have to adjust,” she said. “Some infections, such as urinary, skin and chest infections, can be managed at home, and so for borderline cases, those people will instead have to receive care in their home.”
This week, Guardian Australia has revealed the pressure that Omicron spread has placed on hospitals, including multiple claims of Covid-positive nurses being asked to work shifts in breach of health protocols and overworked staff at a regional hospital quitting.
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