A nation’s capacity: COVID-19

Each of us has experienced the pandemic in a different way. However, collectively as a profession, it has provided immense challenges in delivering timely and safe care while coming to terms with an unfamiliar feeling for most doctors – that our workplace is a potential hazard to ourselves, our colleagues and our families.

I started working for the Federal Department of Health on 23 March 2020. Opportunity often comes up at odd times. Like many doctors working in the public system I was feeling tired and burnt out, wondering which direction my career would head in – and in desperate need of a break after a torrid summer of east coast bushfires. The call from Professor Paul Kelly was out of the blue. Paul and I had been colleagues in ACT Health and knew each other from my previous role as Executive Director of the National Critical Care and Trauma Response Centre in Darwin. In a short instant, I was on the phone to my wife, excited and daunted by the prospect of working nationally to guide the pandemic response.

My first day in the National Incident Room (NIR) at the Department of Health in Canberra felt similar to other emergency responses I had been involved in, just on a far grander scale. The NIR is named for the late and great Professor Aileen Plant, the mother of field epidemiology in Australia. It was a hive of activity, the engine room of a ‘whole of government response’. What was clear from the first instant was the sheer amount of human capital being brought to bear on this problem. Far from being a creaky, lumbering bureaucracy, what I saw gave me immense confidence in the nation’s capacity to manage COVID-19.

But the mood was very different out in the profession and in the general public. Early restrictions were being introduced, and stories were emerging of health systems being overwhelmed and large numbers of healthcare worker infections. The immediate thought that entered my mind was how to convey to my colleagues the confidence I felt at seeing the inner workings of the national response to the community.

What followed was six months of providing a link between hospital-based clinicians and the Department of Health, and more time than I thought possible in front of TV cameras. A lot of my work ended up being trying to facilitate good ideas which required government support. Working alongside the National COVID-19 Clinical Evidence Taskforce and helping the Australian and New Zealand Intensive Care Society and Ambulance Victoria roll out a national ICU bed capacity monitoring system were but two of many highlights during this time.

As I head back to the ‘frontline’ so to speak, the issue of healthcare worker infections weighs heavily, with more than 3,400 health and aged care workers in Victoria contracting COVID-19. One of the things we must do better is to provide confidence that lessons are learned that will protect us in the workplace. The debate over airborne transmission of COVID-19 has been particularly polarising.

The presence of clinical leaders, within hospital administration and health bureaucracy, is critical in navigating these issues and providing confidence that the guidelines and policies we work to are indeed best practice. COVID-19 is here to stay, and we all need to work together to adapt to it.