Many timely reflections in this recent article re the capacity of health systems and workforce now and into the future… #AusPol #COVID
On the importance of timely lockdowns & continuing other sensible public health measures, Prof @JBraithwaite1 says: "I would argue for prudence and holding the course. We risk unprecedented cases, deaths, and economic mayhem otherwise...
"I’d go for 90 percent, not 70 percent, vaccination rates, and counsel continuing public health measures, as stringently as possible," says @JBraithwaite1
On challenges facing people in rural, regional, remote areas, @coopesdetat says "they stand – again – to be disproportionately impacted by plans to open up the country without a detailed blueprint for accommodating hundreds of thousands of extra cases and thousands more deaths"
"This must address staffing in a realistic and properly resourced way, appreciating from experience overseas that a whole generation of doctors and nurses are burning out under the burden of immense moral injury primarily due to system failures": @coopesdetat
Says @JenniferDoggett: "We don’t know how well the health system is equipped to cope with the likely escalation in COVID-related demand and that is a problem in itself....
"The lack of transparency around health system capacity and any planning that is underway to prepare for increased demand will add to the anxiety the community is already experiencing." @JenniferDoggett highlights workforce constraints and lack of coordination across systems.
Says @JenniferDoggett: "Unfortunately, it is always communities already under-served by health and social care systems that are most vulnerable when systems are under stress." #HealthEquity
Says @LeanneWells63 @CHFofAustralia: Commonwealth & states are taking some reassuring steps to boost system’s capacity (eg, private/public co-operation, w private hospitals making facilities available, etc). Most/all jurisdictions have set up surge centres to treat COVID patients
Says @claski @acemonline: Our hospitals have v ltd surge capacity at the best of times. We will need to redirect resources to meet the demands of COVID-19 and this will involve making compromises...
"We will need to use all resources – acute hospital beds, trained staff, equipment, medication and oxygen – as efficiently and effectively as possible. This will require teamwork, collaboration, and communication across the entire health system...: @claski
"We need to make sure we have an integrated whole-of-system response – including primary and community care": @claski
Says @LRussellWolpe: There are two caveats to my optimism about the ability of the system to cope with both continued COVID-19 infections and the ongoing need for non-COVID-19 treatment and care.
"First, if the current rate of vaccination stalls for any reason (lack of supplies, complacency) or vaccination rates in certain population groups remain low, then healthcare professionals can rightly be expected to protest, perhaps in ways that are disruptive.
"Second, with the capacity of health systems stretched to the limit by COVID-19, they could well break if a new coronavirus variant or a virulent flu or another disaster – a terrible bushfire season, an earthquake or a terrorist attack – happens": @LRussellWolpe
Issues highlighted by @JudkinsSimon inc: the longer term morbidity and mortality for every other illness that isn’t COVID...issues of increased morbidity and mortality associated with system overcrowding will not be apparent until we look back at the data...
"Delays to stroke care, cath lab cases, treatment of sepsis, delays to cancer diagnoses, complex surgeries all of background issues being impacted in ways we don’t appreciate" @JudkinsSimon
"Govt talks of having enough ventilators, but we don’t have enough staff to manage them. Many parts of the country don’t have a ventilated bed within 100km, & we haven’t accounted for ongoing furloughing of staff, increases in staff dropping hours, dropping out...
Katherine Isbister, @CRANAplus highlights workforce concerns for remote, isolated areas: "In small health services that run on minimal staff, there only needs to be 1 COVID-19 case that affects staffing, & the ability to deliver care to that community is significantly impacted
@RuralDoctorsAus highlights potential for retrieval services to be overwhelmed, which would lead to lengthy delays in moving patients from rural hospitals. #ruralhealth…
From @jpatto12 @AMSANTaus "The lessons of western NSW are stark reminders of the threats facing Aboriginal people across Australia as we face the pandemic...
"Our hearts ache for countrymen and women in places like Wilcannia and Dubbo — a number of our staff here in the Territory have relations and close ties with them.
Says @jpatto12: "Our remote clinics are already chronically understaffed and tasked with dealing with the day-to-day problems of massive overcrowding and co-morbidities that would make our people particularly susceptible... #SDOH
Please RT: "The targets suggested of 70 or 80% vaccination are totally fraudulent if applied to remote Australia. They do not take into account already low & uneven vaccination levels; they do not take into account the demographics of a high number of children in our communities.
"These targets may or may not work in the northern beaches of Sydney: they would totally fail our people." Read more from @jpatto12 here:… #AusPol
Says @MegBastard: "There is an urgent need to use local community structures to increase access to vaccinations – use the strengths & knowledges of local leaders & local organisations...
"This could be used as an opportunity for community development, not the divisiveness and fear that comes with the sense of punitivity from bringing outsiders in such as the defence force and police": @MegBastard
Govts also need to invest in/support the #publichealth workforce, says @terryslevin @_PHAA_ "They were understaffed from the beginning and various commitments to boost the public health workforce seem to have not been adequately advanced" #AusPol #NSWpol
Kim Webber from @cohealth says: We also want to keep people away from hospitals more than ever, which means investing in more community-based primary healthcare that supports people to be able to stay healthy, safe at home + early intervention to prevent conditions deteriorating.
On the question: What is the single most important action to help ensure the system and health professionals are better placed to cope? Read more from these experts here:…

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More from @MelissaSweetDr

31 Aug
Lock down smarter, not harder. Excellent article by @engagedpractx… Thanks @insidestorymag for permission to cross post #publichealth #AusPol
"Instead of putting police and the military on the streets of LGAs with significant migrant populations from war-torn countries, [a smart lockdown] would further invest in building the capacity of affected communities to respond to the outbreak...
"The same interpersonal networks that can transmit a pathogen or misinformation can be harnessed to pass on resources & skills for protecting yourself, your loved ones and your community from the crisis...
Read 4 tweets
31 Aug
What is needed to deliver on the investment in the Medical Research Future Fund? Part 2 of an investigation by @LRussellWolpe… #AusPol
"As previously noted, the $20 billion that makes up the capital of the MRFF is savings from the Health and Indigenous Affairs portfolios.... #MRFFtransparency
Says @LRussellWolpe : "I argue this increases the onus on the MRFF to show that it is privileging research and translation efforts to improve the health of all Australians and especially the lives of Aboriginal and Torres Strait Islander people...
Read 6 tweets
31 Aug
Overdose deaths remain stubbornly high: here are 5 ways to do more to save lives… By @dan_lubman & @DrSuziNielsen on #IOAD21
1. Naloxone must be freely accessible everywhere
We must urgently increase access to the life-saving overdose reversal drug naloxone, which is available as an easy-to-use nasal spray. #IOAD21
2. We need more medically supervised injecting centres
Medically supervised injecting centres save lives, help people access treatment, reduce public drug use and related harm, and take the pressure off our health care system. #IOAD21
Read 7 tweets
31 Aug
Interesting to look at some of the connections between these two @CroakeyNews stories, on antibiotic overuse in Australia, and our poor record on addressing health inequities... cc @evelynedeleeuw @ACSQHC
Here's a hint: "On global comparisons, primary care antimicrobial prescribing in Australia continues to outstrip Canada and most European countries, with rates more than double those of benchmark countries such as The Netherlands....
Looking at the connections between these articles reminded me of this 2015 paper: #PLOSONE: Antimicrobial Resistance: The Major Contribution of Poor Governance and Corruption to This Growing ...…
Read 6 tweets
31 Aug
Interesting analysis/comparison of health equity/inequities in Australia, the Netherlands, Denmark etc… By Professor @evelynedeleeuw, Director of CHETRE, UNSW, and Editor-In-Chief of Health Promotion International. #SDOH
"The success of Nordic and Bismarckian welfare states has not been the result of a conscious (autocratic or democratic) decision but rather the result of centuries of relatively close-knit joining of forces...
"Our (local, state/territory, federal) governments time and again claim pride in being the wealthiest and luckiest, and even among the healthiest, countries in the world. They refuse to face the truth – we are also one of the most unequal and inequitable nations."
Read 4 tweets
29 Aug
COVID sparks sharp fall in antibiotic use, but threat of antimicrobial resistance remains via @CroakeyServices… HT @ACSQHC #sponsoredcontent #publichealth
"While the pandemic-driven shifts in primary care prescribing are welcome, AURA 2021 shows many areas of antimicrobial use across Australia where improvement is needed...
"On global comparisons, primary care antimicrobial prescribing in Australia continues to outstrip Canada & most European countries, with rates more than double those of benchmark countries such as The Netherlands, where there was also far less use of broad-spectrum preparations
Read 4 tweets

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