Rising COVID-19 cases combined with other respiratory diseases has meant a tough start to winter season for Australians, and it may get worse.
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Some hospitals in Victoria, ACT and South Australia have elevated their warning alerts, flagging that respiratory illnesses are causing health concerns and longer patient wait times.
ACT's North Canberra Hospital moved its COVID-19 status from "green to amber" on June 3. This means surgical masks are worn by everyone in the hospital, there is a visitor limit of two people and patients are undergoing PCR testing.
"Elective surgery at [North Canberra Hospital] is still continuing and the status of other Canberra Health Services facilities remains green," a Canberra Health Services spokesperson said.
A Victoria Department of Health spokesperson said that while there were no plans to stop surgery, the health service has moved to "stage two" of the Health System Response, utilising telehealth and stricter infection prevention and control protocols.
"Moving to stage two allows health services to put additional strategies in place based on local demand, to protect staff, patients and visitors - and it's not expected to interrupt clinical care, including planned surgery," the spokesperson said.
Elective surgery was paused in South Australia on May 30 as the health system buckled with staff illness and "significant demand", the state's health chief executive said.
Viral load
Dr Paul Griffin, an infectious disease physician and clinical microbiologist at the University of Queensland, said healthcare systems could be faced with multiple viral and bacterial infections.
While COVID-19 was escalating quickly, and Respiratory Syncytial Virus Infection (RSV) and influenza had currently plateaued, things could change, Dr Griffin said.
"Flu could continue to climb from here, and COVID is not yet at its peak, so that could mean we are in for a really challenging winter," he said.
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He said there were also higher rates of Mycoplasma, a bacterial respiratory infection and Pertussis, whooping cough, than typically expected at this time of year.
COVID-19 was the current cause of the greatest number of cases and hospitalisations, compared with RSV and influenza, Dr Griffin said.
He said an increase in multiple viruses could put pressure on hospitals.
"If we have unusually high season of even an individual one of these pathogens, let alone a combination of them, it does put a big strain on the healthcare system," he said.
"Each and every winter, our healthcare systems, which essentially operate at capacity at baseline, are stretched."
Dr Griffin said staffing levels could also be affected by increased rates of viruses in the community.
COVID-19, RSV and influenza rates
Released on May 24, the Australian Respiratory Surveillance Report found that since late April nationally notified COVID-19, influenza and RSV have been "steadily increasing".
Since early 2024, patients hospitalised with severe acute respiratory infection decreased but COVID-19 patients increased in recent weeks.
Victoria's Department of Health report up until May 24 showed the number of people in hospital with COVID-19 had increased.
The seven day average was 347 compared to 284 in the May 17 report.
In their May 17 report, NSW Health found that COVID-19 activity has been increasing, including emergency department presentations.
In the past week there was an increase of 23 per cent in COVID-19 notifications, an increase of 60 per cent in influenza notifications, and an increase of 16 per cent in RSV notifications.
According to NSW Health, Influenza was increasing but emergency department admissions remained low. While RSV continues to show high levels of activity.
ACT government recorded 28 COVID-19 cases in hospital from May 17 to 23.
What can we do?
"We need to maintain a better preparedness in our healthcare systems to cope with the inevitable surge in winter," Dr Griffin said.
He said vaccinations were crucial to protecting against both COVID-19 and Influenza.
"The fact that they [vaccination rates] are well below where we need them to be, is having an impact," he said.
"These vaccines don't necessarily prevent all infections but they go a very long way to helping and reducing severity and the likelihood of requiring hospitalisation."
For high-risk patients, Dr Griffin suggested speaking with their clinicians to come up with a plan.
He said Australians should follow basic strategies to reduce the risk of transmission and to stay home if not well.