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Racing Against the Virus From Inside Australia’s Healthcare System Racing Against the Virus From Inside Australia’s Healthcare System
(1 day later)
The Australia Letter is a weekly newsletter from our Australia bureau. Sign up to get it by email. For this week’s issue, the newsletter is written by one of our readers, Dr. Amaali Lokuge, an emergency physician at The Royal Melbourne Hospital.The Australia Letter is a weekly newsletter from our Australia bureau. Sign up to get it by email. For this week’s issue, the newsletter is written by one of our readers, Dr. Amaali Lokuge, an emergency physician at The Royal Melbourne Hospital.
When my director cut short his camping holiday on Australia Day, to come back to the emergency department at the Melbourne hospital where I work as an emergency physician, I thought he was unnecessarily sacrificing his life for the sake of his work. Covid-19 was still mainly confined to China. Italy was not yet in crisis and New York wasn’t even on our radar. But in hindsight, his return was prudent.When my director cut short his camping holiday on Australia Day, to come back to the emergency department at the Melbourne hospital where I work as an emergency physician, I thought he was unnecessarily sacrificing his life for the sake of his work. Covid-19 was still mainly confined to China. Italy was not yet in crisis and New York wasn’t even on our radar. But in hindsight, his return was prudent.
The fever clinic attendances surged. We were seeing 30 to 100 extra patients per day in an already stretched system. A coordinated emergency department and hospital strategy was required, and unfolded as if by magic.The fever clinic attendances surged. We were seeing 30 to 100 extra patients per day in an already stretched system. A coordinated emergency department and hospital strategy was required, and unfolded as if by magic.
It wasn’t magic though; If you looked closely, you could see the signs of people working way beyond their scheduled hours. Doctors and nurses and support staff were at the hospital hours before the day shift began and we would see them late into the evening shift. The tired lines around doctors’ eyes etched a little deeper each day as they rushed past at a speed just below running.It wasn’t magic though; If you looked closely, you could see the signs of people working way beyond their scheduled hours. Doctors and nurses and support staff were at the hospital hours before the day shift began and we would see them late into the evening shift. The tired lines around doctors’ eyes etched a little deeper each day as they rushed past at a speed just below running.
It wasn’t until March that the reality of what we were facing started to filter through. A hundred patients died overnight in Italy and we were speechless with grief. Was this what was coming for us?It wasn’t until March that the reality of what we were facing started to filter through. A hundred patients died overnight in Italy and we were speechless with grief. Was this what was coming for us?
We would not be able to cope with a similar onslaught. There are around 30 ICU beds in our hospital — how quickly would these be full? This is not something we have had to face before.We would not be able to cope with a similar onslaught. There are around 30 ICU beds in our hospital — how quickly would these be full? This is not something we have had to face before.
People often ask me how I cope with the stress of emergency room medicine. But the reality is, we have so many resources where I work that when patients come in sick and dying we can usually resuscitate them. People rarely die because we don’t have the facilities to help them.People often ask me how I cope with the stress of emergency room medicine. But the reality is, we have so many resources where I work that when patients come in sick and dying we can usually resuscitate them. People rarely die because we don’t have the facilities to help them.
But this disease was different. It seemed to take and take and take, until there was no more to give. We were not ready to face patients dying because we didn’t have a ventilator to help them breathe, or because we didn’t have the nursing staff to care for them.But this disease was different. It seemed to take and take and take, until there was no more to give. We were not ready to face patients dying because we didn’t have a ventilator to help them breathe, or because we didn’t have the nursing staff to care for them.
In those early weeks of March, we worked at what felt like superhuman speeds to get ready. Always at the back of our minds, the mantra we kept repeating: it’s coming, it’s coming, and we are not prepared.In those early weeks of March, we worked at what felt like superhuman speeds to get ready. Always at the back of our minds, the mantra we kept repeating: it’s coming, it’s coming, and we are not prepared.
Somewhere deeper down lingered other anxieties: Would we get sick like the health workers overseas? Would our loved ones be safe? How would we cope with so much death?Somewhere deeper down lingered other anxieties: Would we get sick like the health workers overseas? Would our loved ones be safe? How would we cope with so much death?
Everyone was worried about someone: the elderly parent; the child with an immune deficiency, which may be deadly; the sister who was currently immunosuppressed from chemotherapy.Everyone was worried about someone: the elderly parent; the child with an immune deficiency, which may be deadly; the sister who was currently immunosuppressed from chemotherapy.
To add to our anxieties, the emergency department became eerily quiet. The patients would trickle in at single digits per hour. Was this the quiet before the storm?To add to our anxieties, the emergency department became eerily quiet. The patients would trickle in at single digits per hour. Was this the quiet before the storm?
Every morning we would read the international news with dread and horror. People were dying because systems were overwhelmed. Health care workers were preparing their wills before it was too late. Families with emergency physician parents were sending their children away to safety. We devoured the information, always wondering when it was coming for us.Every morning we would read the international news with dread and horror. People were dying because systems were overwhelmed. Health care workers were preparing their wills before it was too late. Families with emergency physician parents were sending their children away to safety. We devoured the information, always wondering when it was coming for us.
Then something miraculous happened. Restrictions applied with lightning speed were curtailing the spread. People stayed home despite the chafing irritations of isolation. Everyone was doing what was necessary to look after the weak and the elderly. And in a way they were to looking after us, the health care workers, too.Then something miraculous happened. Restrictions applied with lightning speed were curtailing the spread. People stayed home despite the chafing irritations of isolation. Everyone was doing what was necessary to look after the weak and the elderly. And in a way they were to looking after us, the health care workers, too.
The surge did not occur when it was supposed to. We worked so hard, filled the hospital to capacity with extra staff and equipment, wrote guidelines on treatment and made plans for the influx of patients, all within days. But the patients failed to arrive. The wave never swelled to a tsunami.The surge did not occur when it was supposed to. We worked so hard, filled the hospital to capacity with extra staff and equipment, wrote guidelines on treatment and made plans for the influx of patients, all within days. But the patients failed to arrive. The wave never swelled to a tsunami.
We are now caught in a limbo of waiting. People aren’t dying in the numbers we predicted when observing the disease in other countries. The tragedy has, so far, failed to unfold.We are now caught in a limbo of waiting. People aren’t dying in the numbers we predicted when observing the disease in other countries. The tragedy has, so far, failed to unfold.
Updated August 4, 2020 Updated August 6, 2020
Economists have started to write about the cost of this strategy in terms of money spent per human life years saved. People question the wisdom of Australia’s harsh social distancing restrictions, which will have repercussions for years to come.Economists have started to write about the cost of this strategy in terms of money spent per human life years saved. People question the wisdom of Australia’s harsh social distancing restrictions, which will have repercussions for years to come.
But as I think of what we might have faced — the sheer sadness of so many lives lost in so short a time, the trauma of being helpless in the face of a disease we don’t know how to control — I am so grateful that my country may be spared what others have had to suffer.But as I think of what we might have faced — the sheer sadness of so many lives lost in so short a time, the trauma of being helpless in the face of a disease we don’t know how to control — I am so grateful that my country may be spared what others have had to suffer.
The tyranny of distance and the shocking bushfires that kept the tourists away delayed the inevitable spread of virus in Australia, enabling a brief glimpse into our possible futures. This has meant that we were able to choose the path of humanity — and not economic rationalism — to deal with this disease.The tyranny of distance and the shocking bushfires that kept the tourists away delayed the inevitable spread of virus in Australia, enabling a brief glimpse into our possible futures. This has meant that we were able to choose the path of humanity — and not economic rationalism — to deal with this disease.
We will have to pay for our response for years to come. But my hope is that we will still be whole, and free from the scars of failure and grief.We will have to pay for our response for years to come. But my hope is that we will still be whole, and free from the scars of failure and grief.
Do you have a story to tell about the way your workplace has dealt with the current situation? Let us know at nytaustralia@nytimes.com.Do you have a story to tell about the way your workplace has dealt with the current situation? Let us know at nytaustralia@nytimes.com.
Here are this week’s stories.Here are this week’s stories.
People Are Talking About ‘Travel Bubbles.’ But Could They Work? Australia and New Zealand floated the idea of a regional alliance that would let those inside travel but keep the coronavirus out. But in other parts of the world, establishing one would be tricky.People Are Talking About ‘Travel Bubbles.’ But Could They Work? Australia and New Zealand floated the idea of a regional alliance that would let those inside travel but keep the coronavirus out. But in other parts of the world, establishing one would be tricky.
The Best Movies and TV Shows New to Netflix, Amazon and Stan in Australia in May Our picks for May, including ‘Hollywood,’ ‘Upload,’ ‘Billions’ and ‘Hannah Gadsby: Douglas’The Best Movies and TV Shows New to Netflix, Amazon and Stan in Australia in May Our picks for May, including ‘Hollywood,’ ‘Upload,’ ‘Billions’ and ‘Hannah Gadsby: Douglas’
China Mounts Aggressive Defense to Calls for Coronavirus Compensation Beijing has adopted a “no-holds barred” diplomatic push to quash criticism of its handling of the outbreak and to fend off efforts, including by President Trump, to hold it financially accountable.China Mounts Aggressive Defense to Calls for Coronavirus Compensation Beijing has adopted a “no-holds barred” diplomatic push to quash criticism of its handling of the outbreak and to fend off efforts, including by President Trump, to hold it financially accountable.
A Scramble for Virus Apps That Do No Harm Dozens of tracking apps for smartphones are being used or developed to help contain the coronavirus pandemic. But there are worries about privacy and hastily written software.A Scramble for Virus Apps That Do No Harm Dozens of tracking apps for smartphones are being used or developed to help contain the coronavirus pandemic. But there are worries about privacy and hastily written software.
Samin Nosrat Wants Us to Make Lasagna Together The “Salt Fat Acid Heat” author has long gathered people around a table. But what will happen when the festivities move to that sometimes-terrible place, the internet?Samin Nosrat Wants Us to Make Lasagna Together The “Salt Fat Acid Heat” author has long gathered people around a table. But what will happen when the festivities move to that sometimes-terrible place, the internet?
How Long Will a Vaccine Really Take? Experts say at least 18 months. Here’s how to shorten the timeline.How Long Will a Vaccine Really Take? Experts say at least 18 months. Here’s how to shorten the timeline.
How to Stay Optimistic When Everything Seems Wrong Optimism isn’t about ignoring negative feelings. It’s about being hopeful about the future, even when the present seems wholly negative.How to Stay Optimistic When Everything Seems Wrong Optimism isn’t about ignoring negative feelings. It’s about being hopeful about the future, even when the present seems wholly negative.
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For more Australia coverage and discussion, start your day with your local Morning Briefing and join us in our Facebook group.For more Australia coverage and discussion, start your day with your local Morning Briefing and join us in our Facebook group.