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Healthy people deluged Sydney’s emergency departments at peak of COVID crisis

St Vincent’s Hospital in Darlinghurst was worst hit, with 2746 more non-urgent presentations than March 2019, followed by Sutherland Hospital (2137 extra presentations), Concord (1921) Northern Beaches (1732), Royal North Shore (1701) and the Royal Prince Alfred (1500).

At the peak, 2571 non-urgent patients turned up at emergency departments in just one day (March 16) which was more than three times as many as the same day in 2019.

The vast majority of these non-urgent cases were presumed or suspected COVID-19 cases according to the diagnostic code and presenting problem that hospital staff assigned to the cases. That was despite testing criteria being restricted to returned travellers, known contacts of confirmed cases and healthcare workers, due to concerns that the state’s supply for test kits would be exhausted.

“It was a time of great stress and pressure on our staff and we certainly couldn’t see it continue that way,” NSW Health’s deputy secretary in charge of hospital performance Susan Pearce said. “We didn’t want our emergency departments overwhelmed for a variety of reasons, but we didn’t doubt we would get those clinics set up.”

But as the community began to self-isolate, the number of patients presenting with motor vehicle injuries and other traumas dropped off. Hospitals reported marked declines in presentations for triage categories 2 (emergency), 3 (urgent) and 4 (semi-urgent) throughout March.

With the exception of seeking COVID-19 tests, people also appeared to heed warnings from health authorities to stay away from emergency departments unless they needed emergency treatment, while others worried they would contract the virus if they left home.

“There have been some unintended, negative consequences of this,” Ms Pearce said, referring to reports of delays in cancer diagnoses and chronic disease patients avoiding care due to COVID concerns. “We need to make sure that people with serious illnesses are diagnosed in a timely fashion and we would never discourage people coming to see us if they are unwell.”

The number of patients arriving by ambulances was also down (by 2.8 per cent) compared to March 2019. But the proportion of ambulances responding to patients with breathing problems (a loose proxy for suspected COVID-19) started to increase in mid-March and remained high through the remainder of the month.

Elective surgery wait times also took a hit after national cabinet suspended all non-urgent procedures for six weeks from March 26. Overall, the number of elective surgeries performed in NSW dropped by 18.1 per cent compared to March 2019, but non-urgent elective surgeries fell by 26.3 per cent.

People queue at a coronavirus testing clinic St Vincent's Hospital in March.

People queue at a coronavirus testing clinic St Vincent’s Hospital in March.
Credit:Kate Geraghty

The daily snapshot on March 31shows the number of patients on the wait list for non-urgent procedures was 76,086 – up 10.7 per cent on the same day in 2019.

On Tuesday, Health Minister Brad Hazzard announced an extra $388 million to get thousands of elective surgery patients into operating theatres faster after COVID-19 restrictions delayed their procedures.

Bureau of Health Information chief executive Dr Diane Watson said the quarterly report spanned an extraordinary time for the people of NSW and their healthcare system.

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“In early January, the bushfire crisis was at its peak and it continued through that month, becoming the most devastating bushfire season on record. Meanwhile, the COVID-19 pandemic would go on to dramatically and rapidly change the world we live in well before the end of March,” Dr Watson said.

Overall, 764,658 people presented at the state’s emergency departments between January 1 and the end of March, up by 1.1 per cent (an extra 8581 patients) compared to the same period in 2019.

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