CoSTAT 2 called as COVID cases on the rise in SA


23 December 2021

With an increase in the number of positive COVID cases in South Australia, and a likelihood for this to continue to rise, SA Health has moved to CoSTAT 2 stating this is to continue to protect the health and wellbeing of patients, staff and visitors.

The ANMF (SA Branch) understands that CoSTAT 2 has a heavy emphasis on planning and public information functions, as well as the commencement of the Incident management team, created by the Network Incident Command Centre and Commander.

Other actions that will occur are: 

The RAH will continue its role with State wide services e.g. Burns and spinal and will continue its emergency surgery caseload as the states quaternary hospital.
LHN’s will utilise private hospital capacity to manage elective surgery demand as possible and appropriate. Plans to be created in conjunction with DHW. Any decisions to suspend elective surgery will be made by the Incident Management Team. 
LHNs will undertake to commence communication and training of select surgical staff (Nursing, Resident Medical Officers and Interns) in other specialties at different locations e.g. Intensive Care Unit, General Medicine 
As a system, all hospitals will attempt to minimise intra and interstate transfers and will develop a strategy to manage the transfer of any long stay patients with DHW
Where appropriate, post-acute patients will be relocated to other sites and repatriation to Country hospitals will be a focussed effort. 
The RAH has been designated as the COVID-19 receiving hospital for South Australia and will be the primary inpatient facility caring for adult COVID-19 positive patients during Co-STAT-2 through Co-STAT-4. 
Women’s and Children’s Hospital will cohort paediatric and family confirmed COVID-19 patients in negative pressure or single rooms. 
Flinders Medical Centre will cohort neo-natal and high risk pregnancy confirmed COVID-19 patients in negative pressure or single rooms
The RAH will need to create capacity by reducing current inpatient occupancy, in a controlled, systematic manner to optimise proportionate and suitable capacity and capability, reducing planned and emergency activity and moving patients to alternate locations. 
The support of the entire system, both within CALHN and externally (including SAAS, RFDS, SA Health, neighbouring LHNs and private providers) is needed to facilitate this capacity creation. 
The next level of Co-STAT-3 has the largest planning and service configurations required. A summary of the service shifts currently planned are outlined below which will reduce the noncritical care footprint at the Royal Adelaide Hospital from 627 beds to 241 beds assuming full implementation and execution. 
Details regarding the creation of capacity through decanting can be found in the RAH Decant Plan.

The Australian Nursing and Midwifery Federation (SA Branch) welcomes staged escalation of the health system as we move to a greater demand associated with the pandemic spread across the state.

“We continue to have grave concerns about the capacity of the health system which is already under pressure, and we will continue to advocate for additional measures that will improve protections for the wellbeing of our health workforce,” said ANMF (SA Branch) CEO / Secretary Adjunct Assoc Professor Elizabeth Dabars AM.

Given the rate of growth in the number of people testing positive to COVID it is very likely that we will see a move to CoSTAT 3 in the coming days or weeks.

“With Christmas and New Year celebrations, and a number of interstate travellers, the increase in COVID 19 patients is inevitable, and the ANMF (SA Branch) has been lobbying the State Government to address the issue of staff shortages that are leading to fatigue and exhaustion of nurses, midwives and personal care workers well before this situation,” said Ms Dabars.

We will need to address the issues of demand for other health care which will be competing with the COVID load in the period ahead. We have called for consideration in the reduction of non-urgent elective admissions, load-sharing across the system and greater use of private hospital capacity and resources to ease the pressure on nursing and midwifery staff.

We are also working to negotiate agreements for staffing of intensive care services as they come under increased pressure and hope that this can be resolved in the next few days.

“We also need to ensure that community services are well in place – hospital at home care, mental health care, aged care. This way our members are best equipped to provide the level of healthcare needed by the community.”