ED crowding fix urgently needed in response to SA COVID outbreak

The sudden surge of COVID-19 cases in South Australia highlights the urgent need for strong responses based on latest evidence to contain and manage outbreaks while keeping the community and healthcare workers safe, says the Australasian College for Emergency Medicine (ACEM; the College).

This must include urgently addressing major and dangerous issues of emergency department (ED) crowding and hospital access block, which continue to burden many of the state’s hospitals.

“Coordinated, consistent and emphatic responses are needed as part of efforts to bring the situation under control,” said ACEM South Australia Faculty Chair Dr Mark Morphett.

“It is particularly concerning that one of the initial confirmed cases in this latest outbreak relates to a patient who spent some time waiting for treatment at an Adelaide hospital.

“This highlights many issues ACEM has repeatedly, and over a long period, raised with the government, as part of efforts to find solutions to dangerous ED crowding. Even when we’re not dealing with a pandemic, crowded EDs and hospital access block increase the risk of worse outcomes for patients.

“Given the enormous risks of COVID-19 transmission in crowded EDs, addressing these completely unacceptable and longstanding issues must be an urgent priority in response to the current outbreak. ED crowding and access block must immediately be addressed in a whole of hospital, network and state-wide effort to preserve the safety of our communities and healthcare workers. We know that in Victoria, EDs were vulnerable to outbreaks, and special measures such as physical distancing, consistent use of personal protective equipment (PPE) and avoidance of ED crowding and access block are very important in managing the infection risk.”

ACEM President Dr John Bonning said the South Australian response to the latest outbreak must reflect the lessons learned from Victoria, and other jurisdictions which have faced serious and major outbreaks.

“We have seen how quickly this virus can spread out of control and take hold, particularly affecting already vulnerable or at-risk members of the community,” said Dr Bonning.

“Lessons learned must be heeded and implemented in South Australia as part of the public health response. Part of this must include strong measure to protect already vulnerable groups in our communities, such as residents of aged care homes.

“The government, healthcare systems and settings must also do everything in their power to avoid a repeat of the Victorian situation, which resulted in far too many healthcare workers becoming infected; causing immense strain on parts of the healthcare system, as well as the individuals affected.

“Urgently addressing ED crowding and access block is one very important part of this, as is ensuring healthcare workers and the communities we serve are properly protected with correct PPE, and other infection control measures based on the best available evidence.”

Throughout the pandemic, the College has published and regularly updated Clinical Guidelines for the management of COVID-19 in Australasian emergency departments, informed by the latest evidence to best manage the ongoing response to the coronavirus.

Background:

ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au

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