News.com.au, 13 September 2021:
The wife of a Sydney man stricken with Covid-19 has given a harrowing account of how the “hospital at home” program is operating revealing her husband was told to remain at home even when he was coughing up blood.
The family, who spoke to news.com.au on the condition of anonymity, have raised serious concerns over the “call centre” approach to caring for patients which often involves call centre operators, not doctors or nurses, running through check lists of symptoms with patients.
Doctors have raised concerns about the “hospital in the home” Covid treatment system after more than 15 people died at home since August 1.
NSW has been left with little choice other than to rely on the hospital at home program after the number of Covid infected patients ballooned and the number of people in hospital and ICU continues to rise.
There are currently over 14,000 people with “active” Covid infection in NSW and the vast majority are being left alone at home to battle the illness.
In the case of the 37-year-old man whose family spoke to news.com.au, he was “fit and healthy” and had no underlying conditions.
“He is incredibly fit and healthy, a rugby player, he’s very into his health and his diet and fitness and doesn’t have any pre-existing health issues,’’ his wife said.
“My husband was diagnosed on September 2. He had really mild symptoms at that point. He received a text. He was told to isolate. And they told him to stay home. They said they would call him every day,’’ she said.
“But he didn’t have a GP contacting him. We just had NSW Health Unit contact which was like a call centre. He never really saw a doctor at all. He did have one phone call with a doctor.”
In the first week, she said she was given a list of things that would require her husband’s case to be escalated or taken to hospital. The woman is trapped in Victoria where she was trying to help him over the phone.
“If you’ve got freezing cold skin and you can’t warm up no matter what you do. If you’ve got shortness of breath, chest pain, infrequent urination, and if you’re coughing up blood. So those are the things. We felt in good hands at that point. Then, he started to deteriorate,’’ she said.
A week ago on Sunday, he started “coughing up blood and having respiratory distress”.
“We monitored that overnight and on September 6, we called NSW Health to tell them that he was presenting with one of those symptoms, requiring hospitalisation along with shortness of breath,’’ the man’s wife said.
“They then told us that the health advice had changed, and that that was very normal and that we should not be alarmed. And that he should continue to stay home and just take Panadol, which I thought was really striking because I don’t see how the health advice on coughing up blood could change. I could not understand it. The system was overwhelmed, struggling, I can understand that. But I don’t see why the health advice would change.
The woman said she “knew something was not right”.
“We had that anxiety, we kind of knew it wasn’t right. And that’s when I called the ambulance on September 6, because the blood, it was quite a lot of blood, it’s like in his mucus, it was not just like a few droplets, the mucus that he was bringing up was entirely blood.”
At this stage, the man was home alone in an apartment with a flatmate who was also battling Covid. But the ambulance said he should still stay at home.
“The ambulance arrived and did a check. They were satisfied with his vitals, at that point. And they told him to monitor the colour of his blood. So if it changed to a deep red or brown, he should call them again. So he felt quite good at that point because he’d had medical attention. NSW Health called him to follow up and said that they would have a GP contact him every day, from that point to monitor where he’s at with those systems and the colour of the blood, and his breathing.”
However, the promised daily contact from a GP never happened. The next time the man contacted his wife he was so sick he couldn’t speak.
“Well, the GP, he called one time, one time was on Thursday, that’s like in four days. It was getting worse. And then on Saturday morning, my husband sent me a text message saying that he needed an ambulance. He couldn’t even speak.
“So I called the ambulance and it attended, and they did an oximeter reading and took him to hospital because he did need oxygen, and they were concerned about it. They put a camera down (his throat) to check what’s going on and then they removed all the blood in his respiratory tract, and gave him three injections. They gave him one to open up his lungs. And yeah he’s receiving oxygen.
The woman said she was terrified her husband could have died at home.
BACKGROUND
Well into the second year of the global SARS-CoV-2 pandemic’s intrusion into Australia and New South Wales was at a point on 15 June 2021 of having no locally acquired COVID-19 transmission for the last 41 days and infection growth in the community had ceased.
The only COVID-19 infections within NSW were those that had come into the country from overseas and just 39 confirmed active cases from all sources remained.
By this time NSW had been vaccinating those people 16 years of age up to 90+ years since 22 February 2021.
On 16 June 2021 the Berejiklian Government became aware that the Delta variant of SARS-CoV-2 had entered the state and suddenly there were 4 locally acquired cases within 24 hours.
Three days later that had climbed to 10 cases, two days after that the number rose to 25 and the average growth factor of locally acquired cases was calculable again at 1.4.
In that first week the West Hoxton superspreader event had occurred and its risk disastrously underestimated by the Berejiklian Government and its advisers.
The Bereijiklian Government continued to underestimate the nature and virulence of the Delta variant of SARS-CoV-2 over the coming weeks until basic public health social measures, contact tracing systems and the NSW hospital system began to buckle under the the caseload numbers.
The public health system alert level turned Red on 26 June 2021 in metropolitan areas and then statewide by 17 August, where it has remained ever since.
By 12 September 2021 Covid-19 confirmed infections remained at over 1,000 recorded per day and the number hospitalised on a given day was similarly high. Deaths of those with a COVID-19 diagnosis were being announced daily.
The average growth factor of the Delta strain fluctuates weekly but never falls below 1.3. A safe level is 1 or below for 4 or more weeks, at which point community transmission is thought to cease.
However, intransigent as ever, the Berejiklian Government, openly encouraged by Australian Prime Minister Scott Morrison and in defiance of the wishes of National Cabinet, maintains its intention to open NSW borders and significantly lower public health social measures around mid-October 2021. At which time its 70% fully vaccinated 16 year-olds to 90yrs and over target is expected to be reached.
It is highly unlikely that 70% of the real NSW resident population numbering est. 8,172,500 men, women and children (ABS Dec 2020) will be fully vaccinated by mid-October this year or that viral infection growth in the community will have ceased.
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Of the 1,257 locally acquired COVID-19 cases in NSW Local Health Districts reported for the 24 hours to 8pm on Sunday 12 September 2021:
427 are from South Western Sydney LHD,
314 are from Western Sydney LHD,
181 are from Sydney LHD,
127 are from South Eastern Sydney LHD,
78 are from Nepean Blue Mountains LHD,
27 are from Illawarra Shoalhaven LHD,
22 are from Northern Sydney LHD,
18 are from Hunter New England LHD,
16 are from Central Coast LHD,
12 are from Western NSW LHD,
7 are from Far West LHD,
2 are from Southern LHD,
8 are in correctional settings,
18 cases are yet to be assigned to an LHD.
There were est. 35 public hospitals where on 12 September 2021 a combined total of 1,189 COVID-19 patients were currently admitted and est. 20 of these hospitals had a combined total of 222 infected patients in intensive care unit beds.
As at 7 September 2021 there were 3,446 people with a COVID-19 infection receiving "hospital in the home' care in New South Wales and another 445 receiving "out of hospital care".
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Sources:
https://aci.health.nsw.gov.au/covid-19/critical-intelligence-unit/dashboard
https://www.health.nsw.gov.au/news/Pages/2021-nsw-health.aspx
Evidence of NSW Chief Medical Officer Dr. Kerry Chant before the NSW Legislative Council Standing Committee inquiring into the NSW Government’s Management of the COVID-19 Pandemic https://www.parliament.nsw.gov.au/lcdocs/transcripts/2689/Transcript%20-%20Pandemic%20inquiry%20-%2010%20August%202021%20-%20UNCORRECTED.pdf
