Post by Nadica (She/Her) on Oct 15, 2024 0:04:51 GMT
Thousands of patients caught COVID in NSW hospitals last year and hundreds died, new data shows - Published Oct 13, 2024
By Hayley Gleeson
Thousands of patients caught COVID in NSW public hospitals last year and hundreds died, fuelling concerns among infection control experts and healthcare workers that hospitals are not taking strong enough precautions against airborne viruses.
NSW Ministry of Health data released under freedom of information laws shows at least 6,007 patients caught COVID in hospital in 2023 and 297 died — about 115 laboratory confirmed infections and six deaths per week, on average.
Similar figures were recorded in the first few months of 2024, with 1,729 patients catching COVID and 86 dying between January and April this year. For context, about 2,100 people died from or with COVID in NSW in 2023, suggesting about 14 per cent of those were patients who contracted the virus in hospital.
The data was released following an application by lawyer Peter Vogel who, for 18 months, was pointed between the Ministry of Health — which initially denied holding "complete and accurate records" of hospital acquired COVID infections — and the Clinical Excellence Commission, which directed Mr Vogel back to the Ministry of Health, which eventually released the data he had sought.
The figures are only a snapshot of the pandemic's ongoing impact on hospitals, and NSW Health would not clarify how it is collecting data on hospital acquired COVID infections or provide more detail on deceased patients' ages and genders, or data for previous years.
Still, experts say infection control protocols in hospitals are not good enough, with some doctors warning widespread indifference to COVID is costing too many lives and adding unnecessary pressure to a health system already under strain.
Hospitals know how to stop COVID spreading
Stéphane Bouchoucha, president of the Australasian College for Infection Prevention and Control, said the new figures were "concerning and tragic" especially for the families of people who had died.
"We know how COVID is transmitted and we know how to prevent healthcare associated infections," Dr Bouchouca said — by ensuring good ventilation and air filtration, testing and contact tracing, isolating infected patients and requiring healthcare workers to wear masks.
If hospitals were recording similar numbers of deaths from golden staph infections, Dr Bouchoucha said, swift action would be taken. "But I think people react differently because it's COVID — 'It's alright, it's a respiratory disease, it's not so bad' — trying to minimise the fact it is still a healthcare associated infection," he said.
"This is the core business of infection prevention and control … The premise that we can allow some deaths, to me, is wrong."
For months experts and healthcare workers in several states have been warning that too many patients are catching COVID in health facilities, with Victorian data showing about 9 per cent of those who caught the virus in hospital last year died.
In NSW, hospitals have shifted from an "emergency" pandemic response to managing COVID in line with other transmissible infections. Local health districts now must conduct their own risk assessments and adjust infection control protocols accordingly. Staff are no longer required to wear masks unless they're caring for COVID patients, when they must use N95 respirators, which are significantly more effective at preventing transmission of respiratory viruses than surgical masks.
But some doctors say that guidance is not always enforced, with healthcare workers in some hospitals choosing to wear surgical masks around COVID patients. Others are concerned that COVID testing is not conducted frequently enough and that staff are discouraged from ordering PCR tests to save money.
'The government has some really serious questions to answer'
Amanda Cohn, NSW Greens spokesperson for health and a former GP, said she was "surprised" to learn that data on hospital acquired COVID infections and deaths had been released because she had repeatedly asked Health Minister Ryan Park and Chief Health Officer Kerry Chant about it. Dr Chant told a Budget Estimates hearing last October that the Clinical Excellence Commission — the lead agency for infection prevention and hospital acquired infections — did not "collect and aggregate" it in a "systematic way".
"I have been reassured by the chief health officer that NSW Health is 'conscious of taking every step we can to minimise the risk of [COVID] transmission' in hospitals," Dr Cohn told ABC News. "But these figures make me very concerned that that's not the case."
Dr Cohn pointed to a recent study by the Burnet Institute and the Victorian Department of Health which found testing hospital patients for COVID on admission and staff wearing N95 respirators could prevent hundreds of deaths statewide and save the health system tens of millions of dollars each year.
"To know that those things aren't happening in New South Wales, meanwhile thousands of people are catching COVID in hospitals that should be safe — I think the government has some really serious questions to answer," she said.
Of particular concern, Dr Cohn said, is NSW Health's policy on taking transmission-based precautions — requiring healthcare workers to wear N95 respirators only when dealing with patients who are confirmed or suspected to have COVID.
"Only taking precautions after you know somebody is confirmed to be infectious is not good enough," she said, adding: "We need to see leadership from the health minister."
Dr Cohn said she had also spoken to many medically vulnerable patients who reported having to ask hospital staff to wear masks. "We would never expect people to have to individually ask their surgeon to wash their hands, we just expect that high standards are followed when we go into a health facility, that you will be safe."
Are hospitals prepared for future pandemics?
Marilyn Cruickshank, professor of nursing at the University of Technology Sydney and a board member of the International Federation of Infection Control, said there were several factors likely influencing the drop-off in infection prevention and control efforts in NSW hospitals. These include high levels of exhaustion among healthcare workers since the onset of the pandemic, sector workforce challenges and budget restrictions — all of which are causing "strain and tension" in hospitals.
From a policy perspective, she added, high rates of vaccination against COVID and fewer deaths in recent years mean the "perceived risk" of the virus is much lower now than it was in, say, 2020. "It's not just that people don't want to do the right thing," Professor Cruickshank said. "There's a story behind it."
Still, she said, the new data suggests current infection prevention measures are "not good enough". "From a personal point of view, I would like to see staff continuing to mask in hospitals" using N95 respirators, Professor Cruickshank said — particularly those in emergency departments and wards that care for immunocompromised patients or other vulnerable groups like newborns.
"As healthcare workers, we should ensure that our hospitals are as safe as we can make them," she said. "So to me, it's a patient safety issue to try to keep the levels of hospital acquired COVID as low as possible."
However the "biggest change" she'd like to see is more support for hospital infection control teams, which need "good epidemiological skills and the resources to be able to quickly respond to outbreaks".
"Unfortunately, I don't think COVID will be the last pandemic that we see — there will be others in future," Professor Cruickshank said. "So we need people who are trained up to be able to deal with whatever comes next."
'It's too late for my mum' but we can still protect other patients
For Ravi Fernando, whose 79-year-old mother Thelge died in hospital in August 2022, it's frustrating and upsetting to know patients are still dying after catching COVID in a place they should be safe.
Mr Fernando's mother was admitted to St George Hospital in Sydney's south after suffering a subarachnoid haemorrhage due to a ruptured brain aneurysm in late June 2022. She had successful emergency surgery and, for a few days, seemed to be recovering well in the ICU. But soon she began deteriorating and the hospital informed Mr Fernando that Thelge had caught COVID, most likely from one of her nurses.
A quality management consultant who has worked with aged care facilities, Mr Fernando was shocked but not surprised: most of the staff in ICU were wearing surgical masks, not N95 respirators, he said — some wore them down around their chin. "Maybe I should have raised concerns, but I wasn't in that frame of mind at the time," he said. "But I remember noticing that because back then, COVID was still a big deal."
Thelge was intubated and given antivirals only after Mr Fernando requested them, which still bothers him, but she died a couple of weeks later. An investigation by the Healthcare Complaints Commission (HCCC) found there was no evidence that her death was caused by COVID: St George Hospital's assessment concluded her COVID infection "did complicate the management" of her presenting condition but did not contribute to her death.
But Mr Fernando strongly disagrees. "She was clearly recovering before she got COVID … there was no question about that. Of course, aneurysms are complicated, so you never know, but there was a clear trigger for her deteriorating," he said. "The death of a loved one is distressing regardless. But when you know that it was preventable, it's very distressing."
Had St George Hospital "genuinely listened" to his family's feedback and improved its infection control protocols, he added, more deaths could have been prevented (the HCCC said it was "satisfied" with the hospital's COVID safe protocols). "It still would have been too late for my mum, but at least others are not going to be hurt in a similar way," Mr Fernando said.
ABC News requested interviews with the Health Minister Ryan Park and Kathy Dempsey, NSW Chief Infection Prevention and Control Practitioner and Healthcare Associated Infection Advisor at the Clinical Excellence Commission — NSW Health declined on their behalf.
NSW Health also did not respond to specific questions including about whether it was comfortable with current levels of illness and death in hospitals, if it would be reviewing infection control policies and whether it had conducted audits and upgrades to ventilation and filtration systems.
"NSW Health continues to closely monitor and assess the way we respond to acute respiratory infections, including COVID-19, to keep patients, staff and visitors to our health facilities safe," a spokesperson said.
"We remind the community if they are experiencing cold or flu symptoms, they should stay at home, where possible, to protect others. If someone has cold or flu symptoms and they need to go out, they should wear a mask to protect others. Symptomatic people should also avoid visiting high risk settings like hospitals, aged and disability care facilities or people who are at higher risk of severe illness."
By Hayley Gleeson
Thousands of patients caught COVID in NSW public hospitals last year and hundreds died, fuelling concerns among infection control experts and healthcare workers that hospitals are not taking strong enough precautions against airborne viruses.
NSW Ministry of Health data released under freedom of information laws shows at least 6,007 patients caught COVID in hospital in 2023 and 297 died — about 115 laboratory confirmed infections and six deaths per week, on average.
Similar figures were recorded in the first few months of 2024, with 1,729 patients catching COVID and 86 dying between January and April this year. For context, about 2,100 people died from or with COVID in NSW in 2023, suggesting about 14 per cent of those were patients who contracted the virus in hospital.
The data was released following an application by lawyer Peter Vogel who, for 18 months, was pointed between the Ministry of Health — which initially denied holding "complete and accurate records" of hospital acquired COVID infections — and the Clinical Excellence Commission, which directed Mr Vogel back to the Ministry of Health, which eventually released the data he had sought.
The figures are only a snapshot of the pandemic's ongoing impact on hospitals, and NSW Health would not clarify how it is collecting data on hospital acquired COVID infections or provide more detail on deceased patients' ages and genders, or data for previous years.
Still, experts say infection control protocols in hospitals are not good enough, with some doctors warning widespread indifference to COVID is costing too many lives and adding unnecessary pressure to a health system already under strain.
Hospitals know how to stop COVID spreading
Stéphane Bouchoucha, president of the Australasian College for Infection Prevention and Control, said the new figures were "concerning and tragic" especially for the families of people who had died.
"We know how COVID is transmitted and we know how to prevent healthcare associated infections," Dr Bouchouca said — by ensuring good ventilation and air filtration, testing and contact tracing, isolating infected patients and requiring healthcare workers to wear masks.
If hospitals were recording similar numbers of deaths from golden staph infections, Dr Bouchoucha said, swift action would be taken. "But I think people react differently because it's COVID — 'It's alright, it's a respiratory disease, it's not so bad' — trying to minimise the fact it is still a healthcare associated infection," he said.
"This is the core business of infection prevention and control … The premise that we can allow some deaths, to me, is wrong."
For months experts and healthcare workers in several states have been warning that too many patients are catching COVID in health facilities, with Victorian data showing about 9 per cent of those who caught the virus in hospital last year died.
In NSW, hospitals have shifted from an "emergency" pandemic response to managing COVID in line with other transmissible infections. Local health districts now must conduct their own risk assessments and adjust infection control protocols accordingly. Staff are no longer required to wear masks unless they're caring for COVID patients, when they must use N95 respirators, which are significantly more effective at preventing transmission of respiratory viruses than surgical masks.
But some doctors say that guidance is not always enforced, with healthcare workers in some hospitals choosing to wear surgical masks around COVID patients. Others are concerned that COVID testing is not conducted frequently enough and that staff are discouraged from ordering PCR tests to save money.
'The government has some really serious questions to answer'
Amanda Cohn, NSW Greens spokesperson for health and a former GP, said she was "surprised" to learn that data on hospital acquired COVID infections and deaths had been released because she had repeatedly asked Health Minister Ryan Park and Chief Health Officer Kerry Chant about it. Dr Chant told a Budget Estimates hearing last October that the Clinical Excellence Commission — the lead agency for infection prevention and hospital acquired infections — did not "collect and aggregate" it in a "systematic way".
"I have been reassured by the chief health officer that NSW Health is 'conscious of taking every step we can to minimise the risk of [COVID] transmission' in hospitals," Dr Cohn told ABC News. "But these figures make me very concerned that that's not the case."
Dr Cohn pointed to a recent study by the Burnet Institute and the Victorian Department of Health which found testing hospital patients for COVID on admission and staff wearing N95 respirators could prevent hundreds of deaths statewide and save the health system tens of millions of dollars each year.
"To know that those things aren't happening in New South Wales, meanwhile thousands of people are catching COVID in hospitals that should be safe — I think the government has some really serious questions to answer," she said.
Of particular concern, Dr Cohn said, is NSW Health's policy on taking transmission-based precautions — requiring healthcare workers to wear N95 respirators only when dealing with patients who are confirmed or suspected to have COVID.
"Only taking precautions after you know somebody is confirmed to be infectious is not good enough," she said, adding: "We need to see leadership from the health minister."
Dr Cohn said she had also spoken to many medically vulnerable patients who reported having to ask hospital staff to wear masks. "We would never expect people to have to individually ask their surgeon to wash their hands, we just expect that high standards are followed when we go into a health facility, that you will be safe."
Are hospitals prepared for future pandemics?
Marilyn Cruickshank, professor of nursing at the University of Technology Sydney and a board member of the International Federation of Infection Control, said there were several factors likely influencing the drop-off in infection prevention and control efforts in NSW hospitals. These include high levels of exhaustion among healthcare workers since the onset of the pandemic, sector workforce challenges and budget restrictions — all of which are causing "strain and tension" in hospitals.
From a policy perspective, she added, high rates of vaccination against COVID and fewer deaths in recent years mean the "perceived risk" of the virus is much lower now than it was in, say, 2020. "It's not just that people don't want to do the right thing," Professor Cruickshank said. "There's a story behind it."
Still, she said, the new data suggests current infection prevention measures are "not good enough". "From a personal point of view, I would like to see staff continuing to mask in hospitals" using N95 respirators, Professor Cruickshank said — particularly those in emergency departments and wards that care for immunocompromised patients or other vulnerable groups like newborns.
"As healthcare workers, we should ensure that our hospitals are as safe as we can make them," she said. "So to me, it's a patient safety issue to try to keep the levels of hospital acquired COVID as low as possible."
However the "biggest change" she'd like to see is more support for hospital infection control teams, which need "good epidemiological skills and the resources to be able to quickly respond to outbreaks".
"Unfortunately, I don't think COVID will be the last pandemic that we see — there will be others in future," Professor Cruickshank said. "So we need people who are trained up to be able to deal with whatever comes next."
'It's too late for my mum' but we can still protect other patients
For Ravi Fernando, whose 79-year-old mother Thelge died in hospital in August 2022, it's frustrating and upsetting to know patients are still dying after catching COVID in a place they should be safe.
Mr Fernando's mother was admitted to St George Hospital in Sydney's south after suffering a subarachnoid haemorrhage due to a ruptured brain aneurysm in late June 2022. She had successful emergency surgery and, for a few days, seemed to be recovering well in the ICU. But soon she began deteriorating and the hospital informed Mr Fernando that Thelge had caught COVID, most likely from one of her nurses.
A quality management consultant who has worked with aged care facilities, Mr Fernando was shocked but not surprised: most of the staff in ICU were wearing surgical masks, not N95 respirators, he said — some wore them down around their chin. "Maybe I should have raised concerns, but I wasn't in that frame of mind at the time," he said. "But I remember noticing that because back then, COVID was still a big deal."
Thelge was intubated and given antivirals only after Mr Fernando requested them, which still bothers him, but she died a couple of weeks later. An investigation by the Healthcare Complaints Commission (HCCC) found there was no evidence that her death was caused by COVID: St George Hospital's assessment concluded her COVID infection "did complicate the management" of her presenting condition but did not contribute to her death.
But Mr Fernando strongly disagrees. "She was clearly recovering before she got COVID … there was no question about that. Of course, aneurysms are complicated, so you never know, but there was a clear trigger for her deteriorating," he said. "The death of a loved one is distressing regardless. But when you know that it was preventable, it's very distressing."
Had St George Hospital "genuinely listened" to his family's feedback and improved its infection control protocols, he added, more deaths could have been prevented (the HCCC said it was "satisfied" with the hospital's COVID safe protocols). "It still would have been too late for my mum, but at least others are not going to be hurt in a similar way," Mr Fernando said.
ABC News requested interviews with the Health Minister Ryan Park and Kathy Dempsey, NSW Chief Infection Prevention and Control Practitioner and Healthcare Associated Infection Advisor at the Clinical Excellence Commission — NSW Health declined on their behalf.
NSW Health also did not respond to specific questions including about whether it was comfortable with current levels of illness and death in hospitals, if it would be reviewing infection control policies and whether it had conducted audits and upgrades to ventilation and filtration systems.
"NSW Health continues to closely monitor and assess the way we respond to acute respiratory infections, including COVID-19, to keep patients, staff and visitors to our health facilities safe," a spokesperson said.
"We remind the community if they are experiencing cold or flu symptoms, they should stay at home, where possible, to protect others. If someone has cold or flu symptoms and they need to go out, they should wear a mask to protect others. Symptomatic people should also avoid visiting high risk settings like hospitals, aged and disability care facilities or people who are at higher risk of severe illness."