The double threat of continuing high numbers of COVID infections and the emergence of flu is being felt at Ballarat Base Hospital.
In the past week the number of people presenting to the emergency department with flu-like illnesses has increased almost 50 per cent while the hospital continues to deal with COVID positive patients and staff furloughed after testing positive or isolating.
The dual threat comes as the emergency department continues to feel the pressure of the pandemic with staff working in protective equipment, a divided emergency department, and more severely ill patients coming in to emergency because they have delayed seeking medical treatment.
"The demand on our emergency department is like we haven't seen before," said Grampians Health - Ballarat executive director acute operations Ben Kelly.
"Our staff are continuing to work under stringent COVID 19 prevention and infection control measures which is important given the prevalence of COVID and flu in our community."
The result is longer waiting times in the emergency department which Mr Kelly acknowledges are frustrating for both patients and staff.
"Coupled with the fact that people may have delayed care and that may lead to more serious illness so the level of acuity of more patients is really quite high ... our community is waiting longer than we are comfortable with," he said.
"We are never comfortable with a long wait but the wait is even longer because of those circumstances."
With increases in COVID, influenza and respiratory infections anticipated over winter as more people spend time together indoors and mask mandates removed, the pressure on the health system could get worse before it gets better.
These pressures are not just a Ballarat problem, but shared by health services across the state.
Masks are critically important. They ... don't just reduce the likelihood of COVID, but of flu and other viruses- Ben Kelly
Mr Kelly said the frustration of some patients over waiting times was spilling over in to aggression against emergency department staff.
"I wouldn't say there's more (aggression) but it's ever present and ... we ask that people be respectful and acknowledge our staff don't like the waiting times any more than they do. Their best days in the ED are when they have good patient flow - that's when they feel like they are able to do their job in an uncompromised way."
Mr Kelly said the number of staff on furlough across all areas of the hospital - 67 as of Monday including 38 who were COVID positive - could also contribute back to emergency room delays.
"The furlough of staff in the health environment is not just a Ballarat or Grampians Health region issue but state-wide it continues to be significant challenge," he said.
"Staff furloughs might be in the ED, but also in the wards, and in our Hospital in the Home program that we rely on heavily to enable us to keep as many people at home as we have clinical staff to do so. We have times when that is effectively full because of staff furloughs."
Mr Kelly said January was a particularly challenging month with longer waiting times and 24 to 48 hour periods of "significant demand where we struggled to keep up" where patients needing to be admitted were unable to be moved from the ED to wards for up to 48 hours.
"We'd have one person staying a long period of time in ED and we'd put that person in to the next bed to become available but we had a second, third and fourth still waiting and we had a large number of people staying for an extended time, for 48 hours.
"That happened a couple of times in January and that's when things became stark for us as we continued to see people staying longer in the ED."
Mr Kelly said while Ballarat's increase in new COVID infections and active case numbers were high - with 348 new infections and 2056 active cases on Monday - the city's high vaccination rate meant relatively few people were needing hospitalisation.
As of midnight Monday there were nine COVID-positive patients at Ballarat Base Hospital and three awaiting test results.
"That's probably a little higher than average as we usually sit around five or six COVID positive over the course of this year," he said.
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The Australian Medical Association has called on Victorians to voluntarily wear masks in supermarkets, theatres and other places where people gather and viruses are easily spread - a move Mr Kelly supports.
"Mmasks are critically important," he said. "They ... don't just reduce the likelihood of COVID, but of flu and other viruses."
Two weeks ago the hospital had 40 people present to emergency with flu-like symptoms and last week there were 59. The number is slightly higher than for the same week last year but not as high as 2019 which was a particularly bad year for flu.
"We are really watching that closely but it all comes back to the fact that wearing a mask, washing your hands, getting the flu jab and making sure your COVID jabs are up to date really is our best defence," he said.
He also urged people to book an appointment with their GP to ensure health issues did not escalate, or take advantage of other health services such as pharmacists, after hours medical clinics or nurse on call
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