Public Health
Be prepared
A key finding of the Commonwealth Government inquiry into the COVID-19 response is that pandemic preparation requires a robust and resilient health.
Almost five years after the COVID-19 pandemic broke out “there is much to experiences”, the inquiry found.
While emphasising that “there was much to be proud of as a nation” from the country’s response to the crisis, the inquiry acknowledged it took its toll on the health system and its workforce and there was some loss of community trust in public health orders.
“We heard from many individuals across government and in the community about the toll the pandemic response had taken,” it said.
“People worked beyond normal limits, and many of the public health professionals, frontline community service and health staff, political leaders, health experts and public servants we relied on to get through the pandemic are no longer in their positions.
“This poses risks to our resilience to face another crisis. Trust has also been eroded, and many of the measures taken during COVID-19 are unlikely to be accepted by the population again. That means there is a job to be done to rebuild trust.”
These consequences of COVID-19 continue and are still impeding the delivery of patient care today, the report said.
“Workforce shortages across the system, burnout, ongoing sickness and the furloughing of staff have impeded health services in their recovery to business as usual, let alone enabling them to find the additional capacity needed to address substantial backlogs.
“These system-wide issues are having an ongoing impact on Australians in need of health care.”
The report points out that almost five years after the pandemic began, large backlogs in elective surgery remain due to its suspension during the pandemic.
The focus on controlling the spread of COVID-19 meant broader health issues were often given a lower priority. These issues included increased poor mental health due to the negative impacts of social isolation and increased anxiety, and reduced access to usual health care, such as cancer and other disease screening, non-emergency surgery and chronic disease management.
A key lesson to be learnt from the crisis is “the stronger the existing health systems are the greater the resilience Australia will have in a future pandemic” the report emphasised.
AGED CARE WAS PARTICULARLY VULNERABLE
The lack of preparedness for the pandemic was most clearly seen in aged care, the report says.
Inadequate staffing and precarious employment among aged care staff exacerbated the sector’s existing vulnerabilities.
A lack of staff and agency and surge workforce was repeatedly mentioned as the most significant challenge faced by aged care workers when dealing with COVID-19 and was a fundamental contributor to the degree of crisis faced by the sector.
Notwithstanding the early success in containing the spread of the virus, the majority of the approximately 900 COVID-19 associated deaths in 2020 were among older Australians.
While outbreaks impacted only a small number of residential aged care facilities, they accounted for 75 per cent of all COVID-19 deaths.
Pre-existing vulnerability in the aged care system, including insecure employment arrangements and workers operating across multiple facilities; a lack of planning and preparation; cases of weak leadership at the provider level; inadequate infection prevention and control; and a lack of mechanisms to share learnings and experiences were all contributing factors.
GET READY FOR THE NEXT GLOBAL HEALTH CRISIS
The panel that conducted the inquiry warned that another global health crisis will happen, even if it is hard to predict when.
“Human history tells us that it will occur, and it will once again test us in ways that are hard to imagine. Acting today will ensure in the future we are better prepared, benefiting from our learnings of what worked well and what didn’t during the COVID-19 pandemic,” the panel said in its conclusion.
The inquiry said it consistently heard in submissions that throughout the pandemic, ‘the plane was being built while it was flying’, and this meant there was little ability to think ahead and anticipate the next challenges as the crisis unfolded.
The lesson for the future is that, in a pandemic, the unimaginable can quickly become necessary and planning should cover the full suite of possible responses.
“Preparedness involves building the strength and resilience of systems to efficiently respond to and manage an emergency. Specific actions governments can take include st reng t hening t he healthcare system.
“The capacity of systems to respond to a pandemic is an important part of preparedness and cannot be built at sufficient speed during a crisis. Australian governments need to ensure their collective resources, capabilities, services and workforce are ready ahead of time.”
The inquiry report made special mention of the “continuing failure of the healthcare system to utilise nurses and midwives to their full scope of practice”.
“(It) is limiting consumer access to evidence-based, cost-efficient nurse and midwife-led models of care.”
It recommended as an immediate action: nationally consistent reforms to allow health professionals to work to their full training and experience.