That’s not just hospitals. A stretched health system affects the interaction between you and your GP, the availability of medicines, the policies of the aged care home your mother is in, the research that brought you vaccines, the mental health-care provider, Medicare and more.
The situation is very different to earlier COVID waves. Now, we have fewer public health measures in place. Health staff are also exhausted from almost three years of the pandemic.
Here’s what needs to happen next for our health systems to cope with the latest COVID wave.
The current COVID wave (Australia’s fourth) is being fuelled by ever-more “pushy” Omicron subvariants such as BQ.1 and XBB, waning immunity from past infection and vaccination, and fewer public health measures. Luckily it appears the new subvariants don’t cause more severe disease.
However, health professionals are burnt out.
Globally, health-care systems are seeing more-complex cases compared with before the pandemic, for a number of reasons. This includes increased complexity of conditions due to our ageing population, delayed care over the pandemic and because COVID is complicating existing conditions and care processes.
Globally, health systems have also had to deal with surges in other viruses – such as influenza and, especially in children, respiratory syncytial virus.
During this latest COVID wave, more health staff will likely become infected. This will result in workforce absences, which will be difficult to fill over the coming summer period. Nursing shortages continue.
Health systems will revisit what we know has worked during past COVID waves.
As case numbers climb, hospitals may need to cancel elective surgeries. They may need to boost their intensive care unit (ICU) capacity, by redeploying staff and facilities. They can assess COVID patients outside to minimise the risk of viral transmission, as they’ve done before.
Telehealth services could be expanded, we could see more use of existing community fever and respiratory clinics.
But these old measures may not be enough. The health system is bursting at the seams in multiple places simultaneously. It’s like we had an old pair of shorts, COVID came along, and is causing holes in multiple places where things were already worn.
1. Reduce COVID transmission
As policies about wearing masks, testing or isolating after testing positive have been diluted, improvements such as improving indoor air quality, take on increased importance.
2. Strengthen primary care
So we need to bolster existing services, and to continue to address the aged care, disability and mental health care sectors to help with timely support of patients through the hospital system and out into other types of care.
3. Gather and share information for decision making
We should strive for better national data on health and the health system, building on existing valuable information held nationally and by state and territory health departments.
We could access and analyse data on individuals from across primary care and hospitals, public and private – other countries do.
This would allow us to better and more efficiently understand resource strengths and gaps across the health system (for instance improving wait-times for surgery). It would also help us to better understand needs (for instance, workforce needs) and to respond quicker, to ultimately improve people’s health.
COVID is here to stay. So we all play a role in reducing the impact on our health systems. Reduce the number of times you are infected. Get vaccinated. Wear a good quality mask in crowded, closed, close-contact settings.
Vote well. Politics are playing a hefty hand in our response to COVID locally and globally.
There will be more COVID waves. We need to focus on equity and social determinants of health, reducing the need for people to access the health system in the first place.
Health care is the pointy end of COVID. We need to aim to build stronger and fairer systems for the years ahead.
This article was first published in The Conversation as "Our health system is like a ‘worn pair of shorts’. This latest COVID wave will stretch it even thinner". Professor Alexandra Martiniuk is a clinical epidemiologist at the School of Public Health, University of Sydney and an Honorary Senior Research Fellow at The George Institute for Global Health.
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