Australian COVID deaths will soon reach 10,000: who will die?

In older people, the most serious symptoms of an Omicron infection are often not the respiratory tract, but affect physical and cognitive function, causing, for example, delirium, which leads to an overall decline. “They don’t recover to what they once were, and some of those people die,” Naganathan said.

Victorian geriatrician associate professor Michael Murray, who oversees a number of outreach teams in residential aged care, said he saw “many more COVID-related deaths than ICU [admissions] now”.

In the week ending June 25, only eight people were admitted to NSW ICUs with COVID-19. Stephen Warrillow, director of intensive care at Austin Hospital in Melbourne, said the ICU unit, once full of people seriously ill with the coronavirus, was now treating only “one or two” COVID patients a day.

This difference between deaths and ICU admissions is mainly due to the high number of deaths in aged care, following the lifting of strict lockdown restrictions.

In 2021, only 13 percent of deaths from COVID-19 in NSW were in aged care, but by 2022 it was about 40 percent of the 2,900 reported deaths in the state. Most aged care residents – more than four-fifths – die without being transferred to hospital.

Chant said this was because frail elderly people with underlying health conditions may not be “suitable” for intensive intensive care treatments and will better manage their infection in the facility with antivirals.

“It’s about patient-centered care and respecting their wishes,” she said.

Nationally, there were deaths from January 1 to June 24, 1906 in elderly care from COVID-19, compared to 686 in 2020 and 231 in 2021.

The uptake of the fourth dose in aged care is slow — only about 65 percent of eligible residents — although geriatricians are also concerned about the first booster shot and the hundreds of residents who have not received any vaccinations.

Paul Sadler, the interim director of the Aged and Community Care Providers Association, said the booster program was ongoing and generally working well. While aged care workers should be vaccinated, with restrictions on facilities admitting visitors easing, the aged care sector remains vulnerable to virus outbreaks.

“It is vital that the government urgently addresses the staff shortage in the elderly care sector to help prevent staff shortages and interruptions in care,” he said.

About 40 percent of NSW-reported COVID deaths occurred in retirement homes.

About 40 percent of NSW-reported COVID deaths occurred in retirement homes.Credit:Fairfax

Naganathan rejected the suggestion that seniors in geriatric care who died from the virus would likely have died of another bug within the same time period.

“The data continues to show that the mortality from COVID-19 is higher than that of the flu,” he said.

Indeed, across the population, measurements of “excess mortality” have shown above-average death rates this year.

The Australian Bureau of Statistics says there were 4,732 more deaths than expected in the first two months of 2022. The Actuaries Institute has modeled that there were 5,100 additional deaths in the first quarter of the year (13 percent more than expected before the pandemic), with about 60 percent of those deaths from COVID-19.

Associate Professor David Muscatello, an infectious disease epidemiologist at UNSW who has modeled deaths for NSW Health, said these numbers indicated that COVID-19 was still directly and indirectly causing more deaths than we expected, a phenomenon also seen during flu seasons. .

“What we’re going to see this winter is the impact of both COVID and flu causing excess mortality,” he said.

In her practice, Dr Charlotte Hespe, NSW and ACT Chair of the Royal Australian College of GPs, sees infections in “vulnerable people whom we have protected very well over the past two years”.

“Now it’s creeping in,” she said.

Warrillow said he also saw an increasing number of immunocompromised people, including organ recipients, seriously ill with the virus, despite taking all the right precautions, including having their boosters on.

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“I’ve certainly personally taken care of a number of patients lately, who are living healthy, busy lives and that’s the success of their organ transplants, but they’ve been terribly unlucky,” he said.

Many of the dead would have benefited from up-to-date vaccinations. In NSW, all 104 people who died in the week ending June 25 were eligible for a booster shot, but only 69 percent had received a third dose.

“We see underpenetration” [of vaccines] in some high-risk communities,” Murray said of the Victorian experience, expressing a need to increase acceptance among culturally and linguistically diverse groups.

Unlike previous waves of the virus, Australia now has a range of treatments for COVID-19. While antivirals once had to be administered in hospital, the federal government has purchased 1.3 million doses of two COVID-19 oral antivirals.

Paxlovid was mentioned on the PBS in March, but antivirals must be taken early to be most effective.

Paxlovid was mentioned on the PBS in March, but antivirals must be taken early to be most effective.Credit:Bloomberg

However, the absorption of the drugs is low. Data from the Federal Ministry of Health up to June 19 shows that about 49,000 people have received Molnupiravir, sold as Lagevrio, since it was put on PBS in March, while nearly 7,000 received scripts for Paxlovid.

“We have the potential to do more,” Chant said. “There’s a bit of confusion in the community about who qualifies.”

While the antivirals are highly recommended for the unvaccinated, it is not a prescription requirement. But there are some limitations. For example, while elderly care residents are automatically eligible, contraindications with other medications mean some can’t get Paxlovid. The drug should also be administered within five days of the onset of symptoms.

Chant and Hespe urged patients likely to require antivirals to make a plan with a primary care physician, with Hepse noting that they were more effective when administered on day one rather than on day five.

Professor Greg Dore, an infectious disease physician at St Vincent’s Hospital, said this time constraint demonstrated the importance of a continuous testing and isolation regimen.

But while the antivirals can save lives, Naganathan said it was important to remember that antivirals were given on a “trat many to save one” basis and that a serious infection like COVID-19 can always lead to death in some vulnerable people. would lead.

With the monthly number of coronavirus deaths now above 1,200, Murray said it was greater than Australia’s worst flu month.

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“This is one’s mother, grandmother and one’s relative, so of course it’s very distressing for the individual and their family,” he said.

“It’s the price of opening up to people in the community who aren’t careful enough about trying to prevent transmission, or not getting vaccinated or not getting their third or fourth dose, which I think increases everyone’s risk.” .”

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