When COVID-19 hit, Echuca Regional Health prepared for the worst. Staff set up dedicated intubation facilities in its two negative pressure rooms, which prevent cross contamination between beds, for any patients who required hospitalisation. But as ANNA McGUINNESS discovered when she spoke to nurse Sue Jilbert, it was the community's fear that was almost worse than the disease.
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HOW history judges Victoria’s response to the 2020 pandemic will make fascinating reading — but if Echuca-Moama gets a mention it will surely be as a footnote.
Because, at the time this story goes to print, the twin towns have pretty much escaped it all.
Eight months into the COVID-19 era and Campaspe Shire has recorded just nine infections. Murray River Council has not even had one.
But at the start of the pandemic, as death tolls in the Northern Hemisphere soared and the spread of the virus was mapped as almost daily its tentacles stretched further out to encompass the world, Echuca Regional Health was preparing for the worst.
Staff set up dedicated intubation facilities in its two negative pressure rooms, which prevent cross contamination between beds, for any patients who required hospitalisation.
Those staff had also been trained to look after ventilated patients, were constantly put through their paces with simulation training and had a back-up plan to transfer patients to Bendigo if they needed more intensive support.
It was equally clear COVID-19 would prove just as dangerous for healthcare workers as their patients, and infected staff would simply multiply the domino effect of the virus.
Making a treatment strategy that would deliver the care and support local cases would require while ensuring vital frontline staff were not put at risk was absolutely vital.
The immediate solution was technology — in this case, telehealth.
For COVID-19 patients who didn’t require hospitalisation, Echuca Regional Health's Hospital in the Home (HITH) staff used video calls to monitor patients enduring their illness in home quarantine.
Leading the HITH team are co-coordinators Sue Jilbert and Alira O’Brien.
Sue, who started nursing more than 40 years ago, said they developed a plan in April to use telehealth when the first wave of COVID-19 hit Australia.
“That initial wave was really in Sydney and I read one day there were actually more patients admitted to HITH with COVID-19 symptoms than there were put in hospital beds,” she said.
“I discussed with other HITH services in the state and worked out how we could do that when we needed to in Victoria.”
The strategy needed to keep healthcare workers safe, while ensuring the patients were well monitored.
“When we developed it back then we only had one COVID-19 patient in Campaspe Shire; and he was relatively well.
“Then in this second wave there were three people diagnosed initially — one returned to Melbourne and the other two people who remained here were monitored twice a day by us using the telehealth connection.”
Once a positive case was confirmed, community nurses would deliver a thermometer and pulse oximeter to the patient’s home and activate the telehealth program with an emphasis on monitoring oxygen levels while still keeping an eye on any other symptoms.
Oxygen levels were the litmus test for the infected as reports from the rest of the world had shown a patient’s condition could really deteriorate between days five and 11 — with suddenly and rapidly falling percentages of oxygen in the blood as the early alarm their condition was going downhill.
“Because they’re in isolation, they could deteriorate without anyone knowing, and that’s been proven in other parts of the world; people just died in their apartments on their own because no-one was providing that care and support,” Sue said.
An escalation process was put in place if the patient’s levels did start to drop, incorporating a standby for an ambulance for an immediate response if necessary.
Sue said the plan was a success.
“It’s about providing support and care for them and it was good to be able to see them and for them to see us,” she said.
“The community fear has almost been worse than the disease. The repercussions of the community’s reaction to that positive test is huge.”
In September, as regional Victoria was set to come out of stage three restrictions, a false positive COVID-19 test was recorded in Echuca.
The man in his 60s tested positive before being told a day later that there had been a “rare laboratory error” and he was in fact negative to COVID-19.
Sue said the man was well supported through the process.
“We’d already enveloped him in care, he was admitted to the program, the equipment was dropped off and we’d started the phone calls.”
The support was more than just keeping an eye on symptoms; the staff also delivered provisions and educated patients about home delivery of meals and supplies.
“We were fortunate people in our community were relatively well and only had mild symptoms but we were able to provide that support and the emotional and mental support as well,” Sue said.
“We had some really good responses from the care we delivered to people with COVID-19 in the community.”
And for everyone in the twin towns it was a valuable comfort factor knowing the local support was on standby for them, around the clock, if things got worse.
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