Photo: Westmead Hospital Infection Control and Disease Prevention Team and WSLHD Biopreparedness Team (L-R) Nicole Bohlken, Trish Ferguson, Kirsty Kuoppala, Stephanie Toovey, Kathleen Reitsma, Michelle Montrose, Ruth Barratt, Mary Wyer, Prof. Ramon Shaban, Feliz Vargas, Beth White, Miechelline Magallanes, Kathy O’Donnell and Jennifer Sealy.
Westmead Hospital is a world-class centre for infection prevention and disease control with the infection control team at the forefront of fighting COVID-19 since the very beginning, treating NSW’s very first patients with coronavirus.
We caught up with Clinical Chair of Infection Prevention and Disease Control, Professor Ramon Shaban, and Beth White, Clinical Nurse Consultant and Manager of Westmead Hospital’s Infection Prevention and Control Program to find out what this has meant not only for infection control staff, but also the changes that have occurred across Westmead Hospital.
Professor Shaban told us that Westmead Hospital received the first run of patients with COVID-19 in NSW.
“At the inception we brought the first two patients into the Intensive Care Unit and quarantined them. Then we started receiving more patients, so we set up a clinic for screening and then a dedicated ward to manage patients with COVID-19”.
Beth said that the specialist ward worked very effectively, and the priority for the team was setting up the ward and the model of care to ensure high quality and safe care. Paying tribute to the biocontainment nurse educators and clinical nurse consultant within the team, Beth told us how the team had gone above and beyond to ensure preparedness for safe practice, by providing a rolling program of comprehensive training across the hospital.
Working with their colleagues Professor Tania Sorrell, Service Director Infectious Diseases and Sexual Health, Director of Infectious Diseases Dr Nicky Gilroy and Infectious Diseases Physician and Clinical Lead Dr Trish Ferguson, the COVID-19 Service at Westmead Hospital has grown over the past three-and-a-half months to increase operational capacity in anticipation of a large number of patients. Beth explained that the infection control and infectious diseases teams led the process, to help the facility move their services around to cope with COVID patients, whilst ensuring other services like emergency and the operating theatres continue with business as usual.
Professor Shaban is proud of the fact that Westmead Hospital was able to very quickly set up a new service to manage COVID as well as everything else for our patients in the district and the state more broadly, and in a way that has protected staff and patients.
“We had to trouble-shoot our model of care based on best practice and international experience of COVID, from assessment, testing and all the way through to management. Once we worked our way through setting up the systems and processes, we then rolled-out the service model and shared our work with our peers across the state.”
Furthermore, Professor Shaban considers that one of the team’s biggest achievements has been its adaptability to respond in such a dynamic way, having constantly changed to meet the new and emerging information about testing.
“At the start of January we knew very little about this disease and since then there have been some 28 or so key updates to national guidance as new information has emerged, which tells you how much the science has changed and how we have had to adapt our knowledge, evidence and applications”.
Reflecting on other aspects of her work, Beth commented that the biggest challenges were staff anxiety about the disease and the volume of information coming through was sometimes overwhelming, and so the team made a conscious decision to go back to basics.
“The thing about infection control is that we are like the canaries in the coal mines; fielding everyone’s questions and concerns and helping lower their anxieties and fears, and providing support, education and training.”
Professor Shaban agreeing, pointed out that although presented with a new infection that they knew almost nothing about, the team relied upon well-exercised principals of infection control and prevention that have held true for decades. The team relied upon the existing principals and deployed standard and transmission-based precautions to protect staff and patients from the risks in an ever-changing environment.
“Australia is the envy of many other countries globally, because we have in a very short period pulled the curve down, and so have not experienced the rates of infection and deaths experienced in many other countries, such as Italy, USA, Iran, Europe and the UK.”
Westmead Hospital’s infection prevention and control team has had to ‘write the rule book for COVID-19’ day by day and has delivered safe, world-class care:
“Importantly, although this is a new infection, in many ways there is nothing new about our response to it, as in there is no new specific piece of equipment or mask, drug or vaccine. But we pay this infection the same respect that we pay any other respiratory infection and apply the same principals of infection control and prevention that have kept us safe for eons.”
Professor Shaban and Beth and their colleague roll up their sleeves, together with the entire infection control team and work emergency, intensive care, and the COVID wards. All the team worked on the COVID wards when it first opened. They know that they often repeat information to folks who are ‘anxious and fearful’, but they stand by their principals that in Infection Control, they never ask a healthcare staff member to do anything that they haven’t done ourselves.
Beth added, “Westmead Hospital is a very well managed hospital, and our staff genuinely care about the patients and we work well together, and the teams work very collaboratively, and this is how we get things done”.
According to Professor Shaban, one of the flow-on effects of this pandemic will be the sustained implementation of infection control measures that will help reduce the incidence and/or stop the next infection:
“The measures we are using for COVID-19 are in many ways similar for influenza, and so we hope for a better season this winter with fewer infections.”
Professor Shaban left us with this thought:
“COVID is a game-changer; we are going to be looking at life through the lens of COVID for many decades to come”.
A new NSW Health state-of-the-art facility for the prevention, containment, and management of high consequence infectious diseases at Westmead Hospital is scheduled to open in October 2020.
Facts about Westmead Hospital and COVID-19
Westmead Hospital is:
- an approved COVID-19 hospital and treated NSW’s first patients with COVID-19.
- the designated Viral Haemorrhagic Fevers (VHF) and High Consequence Infectious Diseases (HCID) facility for NSW.
- has the only PC4 level 4 laboratory in NSW licensed and accredited to safely test viral haemorrhagic fevers like Ebola.
- a referral hospital receiving patients and working with other facilities across the state, and an outreach service for hospitals needing support, services and training like Personal Protective Equipment (PPE) training.
- is currently actively case-finding COVID-19 cases with lots of testing to break the chain of infection.
Westmead Hospital Foundation has a long association working with Westmead’s infection control team, publishing their statistics and other public health information each month on our in-hospital screens.