‘Extraordinary’ vax effort drives down threat to healthcare system

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Victoria’s sharply rising vaccination rate, plus key modelling assumptions turning out to be pessimistic, have combined to slash predictions of a huge surge in demand for hospital beds – dramatically cutting the risk of overwhelming the healthcare system.

Modelling by the Burnet Institute, commissioned by the state government and released in September, predicted huge caseloads and an overwhelmed healthcare system as Victoria reopened.

The caseload projection was right – but the length of time sick people stay in hospital is much lower than expected, updated modelling released on Sunday shows.

That modelling underpinned Premier Daniel Andrews’ decision to bring forward the relaxing of some restrictions to Thursday.

Modelling released on September 18 projected a peak hospitalisation demand of between 1950 and 4400 people, with a greater than one-in-two chance of overwhelming the healthcare system. Updated projections released on Sunday are far more rosy. Peak hospital demand is now predicted to fall between 971 and 1460.

“With the very high vaccination coverage, our health system – which will continue to have significant challenges – it will cope,” said Chief Health Officer Brett Sutton.

Peak demand represents the maximum number of Victorians needing hospital care for COVID-19 at any one time. Victoria has about 1500 beds available for COVID-19 patients.

Predictions on the number of Victorians hospitalised with the disease had been accurate, said Professor Margaret Hellard, co-author of the modelling, but they were staying in hospital for a much shorter time.

“First, we’ve got better information on the length of stay in hospital, which is shorter than was originally the case,” she said. “Second, as people get vaccinated – and as they got vaccinated faster – the number of people who go into hospital goes down, and if you’re vaccinated, the average length of stay in hospital also goes down.”

Burnet Institute epidemiologist Professor Margaret Hellard. Credit:

The Burnet Institute’s modelling of NSW’s outbreak also predicted full hospital beds and missed the mark – also put down to vaccination rates increasing much more quickly than expected.

Its initial modelling predicted Victoria would reach 70 per cent double-dosed on or about November 1. The state is on track to do it almost a week and a half earlier than that, about October 21.

“It’s really been an extraordinary story. We’ve gone from 0 to 35 per cent coverage in 150 days. The 35 per cent to 70 per cent is going to happen much, much faster than that,” said Professor Sutton. Victoria was now vaccinating “faster than almost any other country in the world”, he said.

Despite NSW benefiting from an influx of Pfizer doses from Poland, Victoria is only a couple of weeks behind the state on vaccination rates, Mr Andrews said.

Victoria’s testing rate, particularly among those vaccinated, has also held up extraordinarily well, said Professor Hellard – beating predictions of a drop as people who were vaccinated ignored symptoms.

The vaccines may also be more effective at preventing hospitalisation than hoped. The Burnet Institute’s model assumes they are about 87 per cent effective; new data from Britain and the Netherlands puts this at closer to 95 per cent.

Because vaccination rates are higher, patients who turn up in hospital are more likely to be vaccinated, meaning they are less sick and don’t need a bed for as long. And hospitals are managing to get patients out faster – or keep them away altogether with new home-based treatments.

Asked why Victoria’s case numbers were much higher than NSW’s, Professor Sutton said lockdown fatigue probably played a role.

“It is related to Victoria’s experience with 2020. There is fatigue. There hasn’t been the same level of compliance. That means our effective reproduction number is a little bit higher right through. I find that understandable – we’re all human beings, we all struggle against some of those really difficult restrictions.”

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