One of the best gems I heard was linked from the ABC News website. It was a talk on 6 March 2020 Controlling Coronavirus in Australian with WHO Expert Dr Bruce Aylward to an audience of Australian health professionals.
One of the important messages was the aggregation of COVID-19 cases into hospitals run for COVID-19. In Singapore, it appears they implemented this in days, with the air-conditioning in the designated hospitals installed with single pass air flows. This was part of their pandemic planning after SARS devastated Singapore.
Normal hospital air-conditioning recycled the air many times, a bit like cruise ships (and office buildings). Running with a single pass requires about three times the cooling power. It would be interesting to know if there was any pandemic planning in Queensland that designated hospitals for pandemics and installed this higher air cooling capacity. It may still be possible to run with a single pass as we approach winter.
When I worked for the University of Queensland as their corporate occupational hygienist, I got the visit the plant rooms which were shared by the university and the public hospitals. The university air filters were well maintained but the Health Department ones were often covered with a couple of cm of dust. Air filtered though this was returned to the wards. Respirable particulates containing COVID-19 would go straight through these filters. The filters were good for small birds and large insects. I hope things have changed since, but I suspect not.
I would also expect a hospital designated for COVID-19 to have many vulnerable staff – from doctors to cleaners by reason of age and chronic disease. They could be moved to safer hospitals and the whole hospital treated as one large contagious disease hospital, a bit like the old TB Hospitals. It would also make for a more efficient location of ventilators and other critical equipment – and staff. A telepresence by experienced but vulnerable physicians could work well.
To me hospitals like QEII would be ideal as they do not have as much of radiotherapy, dialysis and other things like transplant surgery which would tend to have particularly vulnerable patients. The major hospitals would still have to have isolation beds and wards, but the bulk would be better moved to a designated COVID-19 hospital in the next few days before the needs skyrocket.
