January 24, 2020 was the day everything changed in Australia.
That was the day staff at Westmead Hospital received confirmation they were treating the country’s first case of COVID-19.
Since then Western Sydney Local Health District (WSLHD) has performed more than 420,000 COVID-19 tests at dozens of clinics and treated 661 people with the disease, all while keeping hospitals running safely thanks to the dedicated efforts of staff and management.
As we look back on this momentous date, The Pulse spoke to two staff members who were on the ground for this historic occasion.
Infection prevention and disease control expert Professor Ramon Shaban was looking forward to celebrating his birthday over the weekend when confirmation arrived on the Friday afternoon.
A man in his 50s who had recently travelled to Wuhan arrived in Sydney on January 19 and presented to Westmead Hospital days later with a high temperature, cough and sore throat. Tests soon confirmed what the experts already suspected.
“We were expecting this,” Prof Shaban said.
“Our team led by Nicky Gilroy [director of infectious diseases] was monitoring the situation in Wuhan very closely and making the necessary preparations, including setting up the relevant pathology tests.
“There were a lot of long hours and long weekends at that time. We didn’t do much but work.”
Westmead Hospital is the designated high-consequence infectious diseases facility in NSW. This meant despite the unknowns of the new disease, staff were prepared to handle a respiratory outbreak.
“We applied very straightforward control measures and practices, such as isolation, hand hygiene, physical distancing and use of PPE [personal protective equipment]. These basic things we do are what has kept us safe,” Prof Shaban said.
“I take great comfort that we’ve kept a pretty steady ship using basic measures.”
Westmead Hospital’s first patients were fortunate to have relatively mild infections.
It wasn’t until late March and early April, when NSW was seeing hundreds of new cases every day, that the first desperately sick patients arrived in intensive care.
The ICU made the decision to quarantine all COVID-19 patients in one zone, led by intensive care consultant Hemal Vachharajani.
At first there were four patients. By the end of the week it was eight, all of them intubated – unconscious, with a tube down their throat to keep them breathing.
“They got sick very quickly and required a lot of care. We needed extra medical and nursing staff to look after them and make sure everyone was using their PPE properly, while still ensuring they took breaks,” Dr Vachharajani said.
“They were really long days in the designated COVID zone.”
Besides caring for patients, Dr Vachharajani carried the extra burden of worrying about the safety and wellbeing of her staff.
“There was the added fear of the unknown. We had new information every day, sometimes twice or thrice a day, which was a bit scary. I worried whether we were doing the right thing, the right treatment, while trying to assure staff with their concerns.”
Dr Vachharajani said the support of her colleagues and management, notably ICU director Dr Dani Goh and COVID coordinator Dr Tom Solano, made the difficult task possible.
“I only have praise and respect for the staff here, and gratitude for the support I received from everyone. Medical, nursing, allied health, social work; we all looked after each other’s wellbeing.
“The acute situation made us forget our differences and work together as a team to the common goal of caring for the sickest patients. We couldn’t achieve what we did without teamwork.”
Most patients from the first wave eventually recovered but sadly it become clear one would die, presenting staff with their biggest logistical challenge: allowing the COVID-positive family members to visit their loved one for the final time.
“I had to protect and assure my staff while also finding a way for family members to come in, even just for five minutes in full PPE,” Dr Vachharajani said.
“That was completely against what we normally do for end of life care. It was phenomenally hard. We want families to be able to say goodbye in peace but we had to protect everyone.”
WSLHD chief executive Graeme Loy said the anniversary was an important time to remember the contributions of healthcare staff.
“I am constantly amazed by the hard work and dedication of all of our staff. Over the past 12 months in particular they have done an incredible job supporting our patients and each other,” Graeme said.
“Thank you to the public as well who have acknowledged and supported their hard work, and made sacrifices to help keep everyone safe.”
Prof Shaban said strong leadership from the WSLHD executive team empowered everyone involved to get on with the job.
“As far as crises go, this was exceptionally well-managed from the outset. Enormous teams of people right across the district have contributed all the way along, and they continue to do so. Everyone deserves recognition for doing their part in keeping us safe and keeping our hospitals and health services running.”
While the COVID-19 vaccination program is soon to begin, Prof Shaban warns that life is definitely not about to return to normal.
“Hopefully people continue to physically distance, practice hand hygiene regularly, isolate when they’re unwell and get tested without delay,” he said.
“Australia is extremely fortunate to be where we are now, and that’s no accident. That was only possible with enormous goodwill and teamwork. This disease is still rampant in many countries around the world, and we must protect against complacency.”