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NSW Covid: Modelling shows hospital beds at or near capacity in ‘worst case scenario’


Dominic Perrottet has assured NSW that the health system will cope with the Omicron surge. But under one scenario things could get very dicey.

New modelling released today by Premier Dominic Perrottet has forecast that under the best estimates of New South Wales health officials, the current wave of Covid-19 hospitalisations in the state should peak around the third week of January and be within the capacity of the health system.

However, there was also a concerning detail in the projections. If the modelled “worst case scenario” prediction of hospitalisation pans out then NSW’s hospital bed and intensive care unit (ICU) capacity could well be maxxed out in just a couple of weeks’ time.

Even a more optimistic trajectory of cases will likely mean the private health sector has to be leaned on to help during an expected spike in hospitalisations to around 4700 people.

Health officials also revealed that of the most serious Covid cases in NSW hospitals, the large majority have the Delta variant in their systems, not Omicron.

On Friday, Mr Perrottet revealed that new restrictions would be put in place to deal with the nation’s worst Omicron outbreak.

In the previous 24 hours, 39,625 new cases were recorded in the state; 1738 people were in hospital with 134 in ICU which is just over one tenth of the current ICU capacity.

The restrictions, which will last until January 27, include the prohibition of singing and dancing in hospitality venues, entertainment facilities and major recreation facilities.

Some major events could also be axed or modified if health officials deem them to be of a high risk of spreading the virus.

“This is a challenging time, not just in NSW, but around the world, but the efforts that our people have made has kept NSW safe, has kept NSW open and kept NSW strong,” Mr Perrottet said.

NSW due to reach hospitalisation peak by end of month

Mr Perrottet presented new modelling on the forecast trajectory of the current wave, compiled by NSW Health, which showed that the need for hospital beds – including in ICUs – should remain within what’s available.

“We’ve modelled three different (scenarios) as this pressure builds on the health system over the next few weeks,” he said.

“What is encouraging from this model is that even on a worst-case scenario we have the capacity in our health system right now.”

NSW Health mapped out three outcomes – a best, most likely and worst case scenario. Even the latter showed beds taken up by Covid-19 patients at the peak of the current wave would be below the state’s bed capacity in public hospitals.

Worst case scenario could come close to capacity

However, not everyone in hospital or in ICU is there because of Covid. Many are there for other reasons, such as a car accident or other illnesses.

When you add those patients into the worst case Covid trajectory – listed by NSW Health as the “red scenario” – it gets within a whisker of exhausting every hospital bed available even if you add in those from the private sector.

The red scenario is based on the current surge in New York which has regularly seen as many as 45-55,000 cases a day in the last few weeks.

If a similar curve occurred in NSW that would see a peak in hospitalisation of approximately 6000 people around January 25. That’s well below the 9500 beds available in the public system and the extra 3000 in private hospitals.

But right now there are around 6500 people in hospital beds for non-Covid reasons

Add those in to the 6000 peak and that’s 12,500 people needing beds in late January – or exactly the amount likely to be available.

It’s a similar story with ICU beds where the capacity is 1000. The red scenario assumes a peak of 600 Covid positive people in ICU in late January. But there is regularly between 300 and 400 people in ICU for reasons other than Covid. Put those together at the peak and you hit the 1000 bed capacity.

If that 1000 bed limit was reached, it’s understood NSW Health would then call in the limited extra capacity from private hospitals.

It should be noted there are more than 1000 physical ICU beds in the NSW Health system. Nonetheless, the number available is capped at around 1000 because that’s the estimated amount of ICU patients that can be looked after in the public system with expected staffing levels.

Cases scenario most likely to unfold in NSW

But NSW Health officials have stressed that they don’t believe a New York style worst case scenario will unfold in the state.

Nor do they think the current wave will steeply rise and plummet in the same way as appears to be occurring in the South African province of Gauteng – where Omicron first came to attention – or in London.

This best case trajectory is known as the “green scenario” in the modelling. If this happened in NSW, the peak of hospitalisations would be within the next fortnight and would be much lower with 3158 people in hospital and 270 of those in ICU.

While NSW has high rates of vaccination, comparatively few people have had Covid previously – unlike in South Africa and the UK – and that means there may be less in the tank to combat the virus here.

Rather, the most likely outcome is a middle ground between London and New York which NSW Health has labelled the “blue scenario”.

This sees a hospitalisation peak in late January with 4700 beds taken up by Covid patients, more than double the current figure, and 270 of those in ICU.

On this trajectory, total hospital beds taken up by Covid and non-Covid patients would be 11,200. That’s more than the public health capacity but still leaves around 1000 private beds free.

A third of ICU beds would still be available.

“The middle line is the one that we think is the most realistic of the three at the moment,” NSW Health deputy secretary Susan Pearce said.

“That takes into account our experience here in NSW, it considers factors such as the health of our population and our vaccination rates.

“We believe that by mid-February we will certainly be past the peak of this and we expect that peak to occur in or around the last week of January.

“So we have got some challenging weeks ahead of us.”

Ms Pearce said while NSW might need to call on private hospitals to help, the private and public systems were now “as close together as they’ve ever been”.

Most cases in ICU are Delta, not Omicron

Authorities also revealed that the majority of Covid ICU cases in NSW were still caused by the Delta variant rather than Omicron.

Genomic testing is still being undertaken on the most recent cases but the latest data suggests around 65 per cent of serious cases are Delta with 35 per cent Omicron.

Officials said people hospitalised with Omicron cases were spending less time in hospital compared to those with Delta.

Read related topics:Sydney



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