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CICM 2021 ASM: Respiratory
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Presentation Description

Victoria reported its first case of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 25th January 2020. What followed was a roller coaster ride for Victorians involving hard lockdowns, curfews and border closures.
Over the course of the year, 20,000 people were infected, 271 patients needed ICU and 820 lives were lost. 2599 health care workers (HCW) in Victoria were infected with SARS-CoV-2 in the healthcare setting the majority of whom worked in aged care, as nurses or aged-care workers. 
Both the virus and the restrictions affected the most vulnerable. The economic and social inequalities were laid bare. Melbourne’s northern and western suburbs, home to a majority low income, casualized workforce, bore the brunt. One health service in the western suburbs managed 21% of Victorians requiring ICU. The Victorian Cluster Response, initiated by ICU Directors and supported by ANZICS worked closely with Adult Retrieval Victoria (ARV) and transferred patients within the state to ensure best care. Consequently, no ICU in the state operated above capacity.
Everyone stepped up. The general public, who stayed home and the frontline workers, who showed up to work.  A drive to improve the workplaces and protect HCWs led to innovations. The ‘Patient Isolation Hood’, invented for use in an open ICU was TGA approved and shown to reduce aerosol counts by 98%. 
In the ICU, nursing and medical staff worked 12 hour shifts and skillfully managed the critically unwell, providing reassurance to families over a computer screen. They juggled patient care with information overload from constantly changing guidelines and the fear of lack of PPE in the early days. Anxiety, fear, dread, exhaustion- just some of the emotions many described.
All Victorians have worked hard. Currently, there are no cases of community transmission. Perhaps, it is now time to bravely reflect on 2020 to address the social inequalities in our community and the systems that struggled to protect our HCWs. The work needs to continue to keep us together

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