Front­line troops in Syd­ney’s life and death war

IN­SIDE THE COVID-19 ICU READY FOR THE ON­SLAUGHT

The Daily Telegraph (Sydney) - - Front Page - MATTHEW BENNS EDI­TOR-AT-LARGE

IN­TEN­SIVE care spe­cial­ist Dr Tim South­wood is ex­actly who you want by your bed­side if you con­tract coro­n­avirus and need hospi­tal care.

He and his col­leagues are putting their lives on the line at Royal Prince Al­fred Hospi­tal on the virus front­line car­ing for pa­tients strug­gling to breathe.

“Any­one who says they are not wor­ried about dy­ing would be few and far be­tween,” Dr South­wood (pic­tured) said.

THEY are Aus­tralia’s qui­etly spo­ken front­line he­roes al­ready putting their lives on the line with the es­ca­lat­ing coro­n­avirus pan­demic — and they’re braced for much worse to come.

Yes­ter­day The Daily Tele­graph went in­side Royal Prince Al­fred Hospi­tal’s pur­pose­built “Red” COVID-19 in­ten­sive care unit to meet the doc­tors and nurses suit­ing up for bat­tle.

“Any­one who says they are not wor­ried about dy­ing would be few and far be­tween,” in­ten­sive care spe­cial­ist Dr Tim South­wood said.

But de­spite the con­cerns the call out for vol­un­teers to staff the new COVID “Red” unit was far be­yond what was needed. For now.

The 16-bed unit was built from scratch in just one week and has only been open for five days. It al­ready has nine pa­tients.

Ev­ery doc­tor and nurse in the unit wears sur­gi­cal scrubs, plas­tic gowns, gloves, sealed breath­able masks, gog­gles and a head cov­er­ing.

A mem­ber of the newly formed “Tiger Team” is on duty at the sealed en­trance to the unit to en­sure no step in the rig­or­ous sani­tis­ing and personal pro­tec­tion equip­ment reg­i­men is missed. An­other Tiger Team mem­ber re­peats the process in re­verse as they leave.

The med­i­cal staff are lit­er­ally plac­ing their lives and those of their families and loved ones in the ef­fec­tive­ness of those world stan­dard pro­cesses.

“It is fright­en­ingly sim­ple,”

Dr South­wood said, pump­ing hand sanitiser onto his hands for the fourth time in as many min­utes. “Hand hy­giene.”

“I am wor­ried about fam­ily and friends at work catch­ing it,” he said. “But I don’t think I am any more wor­ried about catch­ing COVID-19 in here than I would be walk­ing around on the street.”

Med­i­cal staff on the coro­n­avirus front­line in other coun­tries have suc­cumbed to the dis­ease in alarming num­bers with spec­u­la­tion that re­peated ex­po­sure to the virus can in­crease its im­pact.

Across Italy, France and Spain more than 30 health care pro­fes­sion­als have died from the virus. In Spain 14 per cent of the coun­try’s 40,000 con­firmed coro­n­avirus cases are med­i­cal pro­fes­sion­als — 5400 badly needed doc­tors and nurses off work and in iso­la­tion. “We are all wor­ried that could be a pos­si­bil­ity here. We have seen that hap­pen in Italy and Wuhan,” Dr South­wood, 40, said.

He con­cedes his wife Lauren, mother of their two young chil­dren, is wor­ried. “But I think she is con­fi­dent that we can do this.” By that he means meet the pan­demic head on when it re­ally hits. “Ev­ery­thing we have done with the ‘Red’ unit is scal­able,” he said.

The new unit in­creases the hospi­tal’s in­ten­sive care bed ca­pac­ity from 54 to 70 with the 11 Green in­ten­sive care beds also cur­rently ded­i­cated to COVID-19. Surge plan­ning means that staff, equip­ment and beds have been iden­ti­fied to ex­pand across the en­tire third level of the hospi­tal to make it a gi­ant COVID-19 in­ten­sive care ward.

NSW Chief Health Of­fi­cer Dr Kerry Chant yes­ter­day con­firmed the state had 500 ven­ti­la­tors with 16 coro­n­avirus pa­tients in ICU. She has said she is look­ing to double those ven­ti­la­tor num­bers.

Health Min­is­ter Greg Hunt said the coun­try’s ven­ti­la­tor ca­pac­ity in ICUs would be in­creased from 2000 to 4000 by bet­ter us­ing ex­ist­ing units in hos­pi­tals.

“They are us­ing spare ma­chines, they are us­ing ma­chines that have been, you know, some­times put aside as back­ups, ma­chines that might have been re­placed by the ab­so­lute lat­est,” he said.

“But then we’re go­ing into pro­duc­tion.”

Mr Hunt said the Govern­ment had tasked lo­cal com­pa­nies to adapt sim­i­lar prod­ucts for use as ven­ti­la­tors.

“We have com­mis­sioned with ResMed ... they do sleep ap­noea ma­chines but they also have a ca­pac­ity with ven­ti­la­tors and the ca­pac­ity to adapt what they do,” he said. Com­bined with anaes­thetic com

pa­nies that would cre­ate an ad­di­tional five thou­sand ven­ti­la­tors.

De­spite this Dr South­wood is still des­per­ate for peo­ple to self iso­late and slow the spread of the virus be­cause “I am con­cerned that the health sys­tem will not cope”.

Down­stairs at RPA in Cam­per­down a com­pletely new coro­n­avirus emer­gency department has been set up to re­ceive and test peo­ple who be­lieve they may have the virus. At its peak last week it was test­ing 460 peo­ple a day.

“Af­ter ev­ery swab our staff have to re­move their gloves and sani­tise their hands,” emer­gency physi­cian Dr Dane Chalk­ley said. “Their hands are red raw by the end of the day.”

The doc­tors and nurses on duty are com­pletely cov­ered in the same personal pro­tec­tion equip­ment as the COVID “Red” unit staff. “It is very iso­lat­ing be­cause you can­not see any­one’s emo­tion. And it is hot be­ing en­cased in plas­tic.”

How­ever the phys­i­cal prob­lems are not the ones wor­ry­ing Dr Chalk­ley, 46, a father of two, who is brac­ing for the next phase of the out­break. “Pan­demics change. At the mo­ment we are in con­tain­ment mode and try­ing to re­duce the num­ber of peo­ple who catch the virus and come into the hospi­tal sys­tem at the same time.

“The next phase will be see­ing sick peo­ple come here in sig­nif­i­cant num­bers. When we get to that point we will have to re­visit all of our pro­ce­dures and change them,” he said.

There is an es­ca­la­tion plan in place to cope with that

“when” it hap­pens. COVID-19 emer­gency department nurse Lucy McWil­liams, 35, said: “I am a lit­tle bit ner­vous be­cause it is hard to an­tic­i­pate what’s go­ing to come.

“If it gets to the point like Italy we will be hav­ing to make de­ci­sions on who gets put on a ven­ti­la­tor and who doesn’t.

“It will also be ab­so­lutely dev­as­tat­ing for our staff.”

In­ten­sive care spe­cial­ist Tim South­wood in the “Red” Unit.

A masked Dr South­wood con­ducts a tour of the Royal Prince Al­fred Hospi­tal coro­n­avirus fa­cil­i­ties. Pic­tures: Rohan Kelly COVID-19 ED nurses Deni Cor­rea and Lucy McWil­liams and (right) Dr Dane Chalk­ley.

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