Shoalhaven District Hospital is as prepared as possible for the COVID-19 emergency.
The hospital's head of medicine and Illawarra Shoalhaven Local Health District co-director of the division of medicine, Dr Bill Pratt said preparations were "ongoing" and had been carried out over the past three weeks. They include a second intensive care unit (ICU) to come on line
So far the Shoalhaven has only two recorded positive cases of COVID-19, with both patients being treated in the hospital's ICU.
"On any one day we have something between four and eight people awaiting results as possible cases," Dr Pratt said.
"Work is already beginning on establishing a third ICU at the hospital if needed.
"The hospital is shaping up quite well."
Dr Pratt said it was hard to estimate the expected peak of local cases but the figures and estimates he's seen indicate late May.
"If we do well, if all the things we are doing in the community like isolating and taking precautions go well, the peak will occur later and hopefully won't be as high," he said.
"'The sacrifice we make now is important and will lessen the number of people who die from this virus.
Myself and my colleagues are incredibly grateful for the sacrifice people are making out there in the community in order to deal with this emergency and lessen the impact on the community.Dr Bill Pratt
"The Shoalhaven has an aged population compared to the state average and that is a big concern.
"We have a disproportion of younger and old residents which is a worry and makes the population a bit more vulnerable when it comes to wide spread community transmission.
"And there are the socio-economic factors as well."
He said every hospital world wide was struggling with the best way to prepare for this pandemic.
"We do have the the benefit of seeing what's happening overseas and learning from their lessons, seeing what is working overall and implement that into our preparations," he said.
"I have reason for cautious optimism with what the community is doing locally with isolating. It is a bit early to tell but the recent numbers are encouraging.
"The hospital has been doing multiple things like the reorganisation of the services in wards, for critical patients and, of course, the expansion of the ICU. We are just about ready to open a second ICU out of the operating theatre complex. In coming weeks we will look to make more refurbishments to establish a third ICU if required - I'd love to think it's not going to be needed but we will be prepared.
"ICU has four ventilators to help people to breath, which has been increased to nine machines and in a short time that will grow to 17.
"The final number of how many [ventilators] we eventually end up with is not yet clear."
He admitted it was a "real challenge" and staff were trying to still "operate as a day to day hospital".
"We recognise the sacrifices being made by the community in routine services like elective surgery," he said.
"Just because it's elective doesn't mean its not required. A considerable number have been delayed and it appears will be for some time.
"Never the less, we are still dealing with people with urgent conditions, there are still admissions for people in emergency situations. The ED is stlil operating and emergency patients are being operated on, as are other cases like cancer patients.
"We are keen to try and maintain business as usual, as much as possible but that is and will be determined by the number of COVID patients that come through the doors."
Life is radically different in comparison to normal. We understand it's a big change. But the more things we do now could lessen the impact of the virus later on.Dr Bill Pratt
He praised the Shoalhaven community for its efforts with self isolating and urged residents to continue the practice.
"Myself and my colleagues are incredibly grateful for the sacrifice people are making out there in the community in order to deal with this emergency and lessen the impact on the community," he said.
"What everyone is doing in the community at the moment will really determine how bad it's going to be in the hospital.
"What people are doing is so important.
"Inevitably, people will need to go out to get provisions and food - there will be an ongoing need.
"People need to try to do it as responsibly as possible - if people could get away with doing it just once a week would be fantastic
"Supermarkets are making the effort with hand sanitisers on entry, restricting shopping times, arranging deliveries - it all makes a difference.
"Life is radically different in comparison to normal. We understand it's a big change. But the more things we do now could lessen the impact of the virus later on."
He said positivity rates remained reasonably low, which is where health authorities want them to stay.
"From our testing we want positive results to remain in that 1 to 2 per cent range," he said.
He reiterated it was unnecessary to test someone who didn't have any symptoms.
"Tests are not reliable in the absence of symptoms," he said.
Tests are not reliable in the absence of symptoms.If you have no symptoms and are tested it could give you false reassurance.Dr Bill Pratt
"If you have no symptoms and are tested it could give you false reassurance.
"Three or four days later if you do develop symptoms, you might think you are fine because you were previously negative."
Dr Pratt said anyone who has COVID-19 symptoms - a fever, dry cough, shortness of breath, a sore throat in some cases, along with aches and pains, has travelled overseas in the past 14 days (that's a very important risk factor, notably on cruise ships) or if they've had contact with someone who has tested positive, should be tested.
"Those who come in with symptoms will of course be tested and, if needed, hospitalised or put into isolation until their tests results are available."
He paid credit to the staff manning the COVID-19 testing clinic at Shoalhaven Hospital.
"They are doing a fantastic job," he said. "They have busy days and quieter days. It is a difficult job, some people turn up anxious with credible concerns but do not meet the testing criteria.
"They are providing reassurance - I know some people aren't satisfied - this public testing and that of patients with symptoms through private pathology referred by general practitioners is so important.
"This community testing and the COVID clinic is the cornerstone to try and deal with the pandemic."
He again reiterated the importance of the simple task of washing your hands in combating the virus.
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