We're weeks away from the NSW Health system collapsing, and flying blind according to Professor of Health Services Research Kathy Eagar.
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Prof. Eagar, who is also director of the Australian Health Services Research Institute at the University of Wollongong, says Australia is one of the only high-income countries in the world with no idea how many active COVID cases it has.
"In the UK for example the NHS has set up a website where you log in, plug in the QR code from your rapid antigen test and log your results," she said.
"They're able to count those numbers - we desperately need something similar.
"The daily case numbers we have now are completely meaningless, pathology is swamped. We could actually have as many as 50,000 new cases a day or more in NSW now, we really have no idea."
Prof Eagar said despite Premier Dominic Perrottet saying the focus needed to move away from case numbers, case numbers remain important, because they enable health to predict demand for hospital and ICU care.
Prof Eagar slammed the NSW government's decision to abandon QR codes and masks ahead of Chrostmas as "reckless, and against all health advice".
She said the chaotic test lines, rising hospital numbers and disruptions to business could have been easily avoided, without another lockdown.
"If the premier had given three months notice he was going to do away with masks and QR codes and open up entirely, that would have given health and pathology time to prepare," she said.
"We could have geared up for rapid antigen testing, vaccinated every child between five and 11 who's parents wished them to be vaccinated and gotten everyone a booster.
"Now we're in a position where those who had Astra Zeneca at the reduced interval have essentially no protection, the vast majority of children haven't been vaccinated and teens can't get boosters even if they want them.
"The government really failed to prepare for opening up."
The consequences won't just be felt in the immediate wave of COVID infections and hospitalisations, Prof Eagar said.
In the long term, those who have been unable to get access to a PCR test may not get the care they need while they're sick, and later, if they develop long Covid, they may not be able to access care because they have no proof they had the disease in the first place.
The increased pressure on hospitals will also hurt those who need ongoing medical care for conditions such as cancer and diabetes.
It may also lead to a shortage of health care workers in years to come.
"The number of people resigning from sheer exhaustion and distress will go through the roof and we will face shortages for years to come," she said.
"In the short term, we know when staff are exhausted they make mistakes."
She said the argument that the only options were to lock down or "let it rip" was a straw man, and a middle path was possible.
"There was always a sensible middle course,"she said.
"With the case numbers where they are we can't put the genie back in the bottle, but we can try to find that middle course again."
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