Acting Health Minister James Merlino stated that the healthcare system was collapsing under the Omicron wave, expecting a peak in hospitalizations in the coming weeks with around 2500 coronavirus cases.

“Our hospital system is under tremendous strain, as evidenced by the hazards associated with COVID hospitalizations,” he stated.

On Tuesday, 4067 public healthcare employees in Victoria were unable to work due to exposure to or infection with COVID-19.

The code brown will take effect at 12 p.m. on Wednesday, allowing hospitals to recall workers from leave in order to address major staff shortages.

The unusual step, which is generally saved for shorter-term crises such as train catastrophes or bushfires, aims to alleviate pressure on the health system. It will be applicable to all metropolitan hospitals as well as six regional hospitals.

What does the term “code brown” mean?
This is a measure to alleviate hospital pressures.
Typically, it is reserved for abrupt, short-term emergencies, such as a train wreck or bushfire (for example, a code brown was called during the 2016 thunderstorm asthma event).
During a code brown situation, hospitals may cancel employee leave in order to maintain an adequate workforce.
Additionally, they can postpone less critical services.
This code brown period begins at 12:00 p.m. on Wednesday. It is anticipated to last between four and six weeks.
It will apply to all public hospitals in the metropolitan area. Regional Victoria includes Barwon Health in Geelong, as well as Grampians, Bendigo, Goulburn Valley, Albury Wodonga, and Latrobe Regional health organisations. Private hospitals may initiate its own code brown.
Normally, a code brown lasts only a day or two, but this time, the measure will last four to six weeks.

The state is likely to hit a peak in hospitalizations next month, with up to 100 new COVID patients admitted daily.

“Our healthcare system has reached a stage where it is balancing severe staff shortages with a large number of patients with COVID-19 who require hospitalisation. Along with that, there is an incredible workforce that is completely depleted,” Mr Merlino explained.

He stated that the code brown would enable hospitals to redeploy staff to areas of highest priority, including offloading ambulance patients to re-route paramedics, changing services to allow staff to work in emergency departments, and transferring patients between the private and public health systems to meet demand.

Additionally, it is possible that healthcare personnel will be compelled to undertake additional duties and will be asked to cancel their leave.

“A nurse or doctor who is ordinarily assigned to elective surgery, which has been drastically reduced in scope, may now be redeployed, for example, to the emergency department, which has a much greater caseload,” Mr Merlino explained.

This is the first time the state has issued a system-wide code brown alert, and it is also intended to send a message to the community that patients should avoid hospitalisation if they can manage their care at home or with their primary care physician.

Roderick McRae, president of the Australian Medical Association in Victoria, said the doctors’ advocacy organisation has been pleading with the state government to declare a code brown for weeks amid a worsening crisis in the hospital system.

“This is an accurate reflection and an acceptable response in these unprecedented circumstances, as the health system is under far greater strain than has been widely publicised,” Dr McRae explained. “It is critical that the community recognises the gravity of the situation.”

Private hospitals will also be able to activate the code brown in the coming weeks. The six regional hospitals covered by the code brown will be Barwon Health in Geelong, Grampians Health in Bendigo, Goulburn Valley Health in Goulburn Valley, Albury Wodonga Health in Albury Wodonga, and Latrobe Regional Hospital in Latrobe.

Senior nurses and doctors told The Age on Sunday that conditions in Melbourne’s hospitals are the worst they’ve ever seen, with standards of care eroding as understaffed facilities attempt to cope with record COVID-19 admissions.

With hospitalizations projected to continue their upward trend in the coming weeks, more harsh measures such as a moratorium on category one elective surgery and adjustments to allow asymptomatic coronavirus-infected healthcare professionals to continue working should be explored.

Tom Symondson, the head of Victoria’s peak body for public hospitals, said several of the hospitals would be experiencing a code brown for the first time, highlighting the health system’s precarious state at the moment.

“The next month may be the most trying time our healthcare staff have ever encountered,” he said.

“The Victorian government identified this as a code brown situation at the appropriate time.

“Our ambulance service and hospitals are already struggling to meet demand for COVID-19 patients while also providing other necessary healthcare, and the situation is expected to deteriorate further over the next month.

“This unprecedented demand has the potential to affect any Victorian in need of healthcare at any moment.”

He stated that a system-wide strategy would enable healthcare personnel to prioritise treating the sickest patients first as demand increases.

Georgie Crozier, Victoria’s opposition health spokesperson, claimed the government had two years to prepare for the pandemic but had failed to plan adequately for COVID-19 cases.

“Code brown reflects the magnitude of the health catastrophe,” Ms Crozier explained. “It could have been avoided with proper planning and preparedness.”

Fiona Patten, leader of the Reason Party, expressed hope that the state was nearing the peak of Omicron cases and that hospitalizations would begin to fall.

“My heart goes out to healthcare professionals. They’ve already been working hard, but code brown indicates they’re going to work even harder,” Ms Patten explained.

“They will be denied leave.” They could be assigned more shifts or overtime.”

Under the new declaration, hospitals will defer fewer urgent services and more will convert to streaming hospitals able to accept COVID patients, reconfiguring their services to free up employees.

This may include providing outpatient care outside of the usual hospital setting and rapidly unloading ambulance patients to emergency departments in order to re-route personnel.

Additionally, they may close part of their facilities to reallocate staff to areas of clinical priority.

Code browns have been activated in hospitals in Victoria in response to catastrophic transport accidents, chemical spills, and natural disasters such as fire or flooding. More recently, Barwon Health activated a code brown to assist them in treating patients affected by the 2016 Geelong thunderstorm asthma.

The decision to declare the code brown was made in consultation with hospitals and labour organisations, who endorsed the idea.

Dr McRae stated that it could not be ruled out that certain category one surgeries will need to be postponed as hospitals face increased strain and are compelled to prioritise emergency situations as the number of coronavirus patients grows.

Procedures classified as category one are intended to be performed within 30 days. They apply to conditions that have the potential to rapidly deteriorate and become life threatening.

The removal of a breast lump or a malignant skin lesion, as well as certain types of heart surgery, are under category one. At the moment, less urgent category two and three elective procedures are prohibited statewide.

Dr McRae stated that hospital healthcare staff and physicians had been left “broken” as hospital circumstances deteriorated.

“Senior and junior medical professionals have been relocated, while the general practitioner workforce has been slashed and under-resourced,” he explained.

“This could not continue in this manner. A circuit breaker was required.”

The announcement came on a day when Australia’s COVID-19 death toll increased to 22, with 36 in Victoria, 36 in New South Wales, and 16 in Queensland.

On Tuesday, Victoria’s official daily case count was 20,180, with over 60% of those cases resulting from positive self-reported quick antigen testing.

In the state of New South Wales, 29,830 positive cases were reported. A little more than half of them came from PCR tests.

Both NSW and Queensland had their highest death tolls during the pandemic.

Adam Horsburgh, Victoria’s deputy COVID response commander, said COVID-related hospital admissions had risen in the last two weeks and were projected to continue growing in the coming weeks.

“It is to this trend that we are responding today [with the code brown],” he explained.

Mr Horsburgh stated that the departments most under pressure were emergency departments, intensive care units, and COVID-19 wards.

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