Intensive care beds: Stephen Duckett responds to Health Minister Greg Hunt
Published in Croakey, 13 July 2020
On ABC TV’s 7.30 on 9 July, Federal Health Minister Greg Hunt accused me of making an “irresponsible and dangerous” statement about intensive care unit demand risks during the COVID-19 crisis.
Interviewer Virginia Trioli said: “Australia’s leading health economist, Stephen Duckett, now says that Australia should switch strategies and pursue elimination, not suppression. Are you starting to think that he’s right?”
The Minister replied: “No. The particular person you quoted said in March that we would run out of ventilators in three weeks and that was a wildly incorrect and irresponsible and dangerous statement…”
What we said was neither irresponsible nor dangerous and was correct at the time. As with any statement, context is important. We were concerned that if trends continued as they were, then ICU capacity would have been overwhelmed. Following our commentary, government introduced social (spatial) distancing restrictions, changing the underlying trends, and ICUs were not overwhelmed. We chalked that up as contributing to a good outcome.
We published two Grattan Blog posts in March on this issue. In both, we used conditional statements: if no action was taken, then XX would be the outcome.
We concluded our 24 March post:
Our gloomy ICU forecast is primarily determined by the exponential growth in diagnosed cases. This is what needs to change. The goal should be to bring new cases in Australia down to zero as quickly as possible. All state governments must act decisively and bring in a broad shutdown now.
Governments subsequently introduced restrictions, but we were still unsure of their effect and so in our blog post of 27 March we concluded:
Whether the measures Australia has put in place will slow the spread here will not be known for about 10 days. By then, if our COVID-19 case numbers continue to rise exponentially, our ICU beds will have started to fill up.
We were not the only ones to be concerned about ICU capacity.
For example, Melbourne University professorial fellow John Mathews, a former Australian deputy chief medical officer and head of the National Centre for Disease Control, said in an interview with The Australian published on 2 April that Australia could run out of intensive care beds that month unless it sufficiently flattened the “exponential” COVID-19 curve.
In a 20 March article in The Conversation, three health experts wrote that, based on data, statistician Megan Higgie from James Cook University had suggested that Australia ‘could run out of ICU beds in early April’.
A similar view, supported by a modelling study, was published in the Medical Journal of Australia.
And the Federal Government’s own ‘Impact of COVID-19’ report, published in April, had this to say:
The theoretical modelling finds an uncontrolled COVID-19 pandemic scenario would overwhelm our health system for many weeks.
Governments across Australia acted to increase dramatically the number of ventilators, and the good news is we did not run out of ICU capacity.