THE number of confirmed cases of coronavirus in the Hunter has climbed to seven, as the region's hospitals get prepped to cope should there be a surge in cases.
A woman in her 40s who had recently returned from the US is one of two more confirmed cases of COVID-19 in the region.
A female in her 60s is also receiving care at Manning Hospital while the source of her infection continues to be investigated.
Hunter New England Health said on Tuesday afternoon there was no connection between these two new cases and any previously confirmed cases.
The woman in her 40s arrived in Sydney on American Airlines flight AA0073 from Los Angeles on March 11. NSW Health is asking anyone who travelled on this flight to be alert for fever or respiratory symptoms.
There are now 210 confirmed cases in the state.
Dr Paul Craven, the medical controller for the Hunter's COVID-19 response, said they had spent the past two months preparing and planning the best way to manage a potentially rapid rise in coronavirus patients in the region. They had been reviewing bed numbers, staffing, and the availability of respiratory equipment, and had identified different spaces to set up extra intensive care units.
"We recognise that when we do need to do it, we will need to do it fast," Dr Craven said. "It is always difficult to know what is going to happen. No one really knows.
"But what we have done is predicted to surge to double the capacity we are at the moment, and we have audited all of the ventilators in the area to make sure we have enough, and to ensure that if we didn't have enough, that we purchase some."
Dr Craven said they had been preparing a pandemic plan around what to do when patients present to the Hunter's hospitals, how they would flow through the emergency departments, and how to increase bed capacity.
"We looked at how are we going to increase our ICU, and also, what we are going to do when our normal bed base is already full to actually surge beyond that as well," Dr Craven said.
The John Hunter Hospital has 24 intensive care beds.
The Calvary Mater has six.
"At the moment, every patient would go into an intensive care space. And in future, we might have to put a patient in a non-traditional intensive care space - into a surge space," he said. "We have an ability to set up intensive care units in areas of the hospital that aren't traditionally used as intensive care areas.
"That is not happening at the moment. There is no requirement for that to happen at the moment. But when we need to do it, we will need to do it fast. We are prepared. We are aware of the space, we are aware of the equipment, and we are aware of the staffing that we will require to open those additional beds.
"We are also aware that we might have to do things differently to our traditional way of doing things."
Dr Craven said they already had a "pool" of respiratory equipment, such as ventilators, in intensive care units.
"But we also know where all the ventilators are right around the district," he said. "We know where all the private rooms are, the negative-pressure rooms, so we know where we can search and pull from at the same time. I think we are in a very good position to manage what we are doing at the moment and into the future."
Last week Hunter New England Health established a screening clinic and testing centre at the main entrance of John Hunter Hospital.
Growing demand led to the service opening a second screening clinic at Maitland Hospital on Monday.
"These are people who were coming through our emergency department anyway - so it was really to say, at the door, 'Are you coming to emergency? Are you coming because you are concerned about COVID-19?'
"What we found was there were people who were definitely sick, who needed to go to emergency, and we wanted to streamline that. But there were a lot of people still coming through who were not particularly unwell at the time, but were concerned enough that they wanted the test. That's where we were able to say to them, 'We can offer you an opportunity to get an assessment, make some observations, make sure you're alright, get tested, and get home again safely'. It offered reassurance, and it was also a way to keep well people out of emergency."
Hunter New England Health has also reduced the number of visitors it is allowing into the region's hospitals.
Patients may only be visited by their main carer or significant other, and are limited to one visitor at a time.
"If we can contain COVID-19, that is much better than trying to treat it, and the way we will do that is by reducing the amount of traffic through our hospitals," Dr Craven said.
The John Hunter Children's Hospital has also restricted visitors to inpatients with cancer - and the number of people attending outpatient appointments in the Cancer and Haematology Day Unit - as a precautionary response to the COVID-19 pandemic.
For inpatients, only parents or carers can visit or stay. Siblings, extended family and friends are temporarily unable to visit.
For outpatient appointments in the Cancer and Haematology Day Unit, only one parent or carer can stay with them. But telehealth consultations would be offered to suitable patients and their families. Similar rules apply to the Neonatal Intensive Care Unit at the John Hunter Children's Hospital. Only parents could visit their sick or premature babies.
Dr Craven said elective surgeries would continue in the region.
"We will monitor this on a day-by-day basis," he said.
"What we would like to do is any urgent surgery now, while we have the opportunity to do that in our hospitals.
"But we are asking that if you have travelled overseas in the last 14 days, or have had contact with a known patient with COVID-19 - we don't want you coming in for routine outpatient or elective surgery. We don't want people who have travelled, or who are at risk, coming into the hospital."
The NSW Government has announced a $2.3 billion health boost and economic stimulus package, including $700 million to help double the state's intensive care capacity, prepare for additional COVID-19 testing, buy additional ventilators and medical equipment, establish acute respiratory clinics, and bring forward elective surgeries to private hospitals.
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