There were 1480 new cases in NSW on Wednesday and nine deaths.

Victorian health planners say that about a third of patients who go into hospital are being transferred to ICUs, with Premier Daniel Andrews and Health Minister Martin Foley claiming the delta variant was causing more acute sickness than previous variants.

“Delta is a nastier variant of the coronavirus, and it does more damage, and it makes more people, more unwell, quicker,” Mr Foley said.

While the state has only 33 COVID-19 patients in ICU now, hospitals are bracing for a surge.

“We do have the benefit of knowing what works last year,” the director of ICU at the Austin Hospital and past president of the Australian and New Zealand Intensive Care Society, Stephen Warrillow, said.

”It will start to look and feel a bit more like what happened last year, where pretty much all of the major hospitals will be managing COVID in a manner similar to last year,” Dr Warrillow said.

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He cautioned that while the ICU staff were well-prepared, they were weary from 18 months working under pandemic conditions.

“The thing I am more challenged by, personally, is the sustainability of the responses.”

“I’m very confident that we expand capacity and meet the immediate demands – that really doesn’t worry me – acknowledging the challenges associated with that.”

“It’s more than I think everyone involved in the delivery of the bedside care, has now had 18 months, with not a lot of respite and doing that for week to a couple of months I’d be very confident about.”

“I think it’s going to be the community that bails us out. Ultimately, it’ll be the speed with which the community accepts and adopts as close to 100 per cent vaccination as possible that is going to be the key determining factor whether ICU can sustain the response, because it can’t be forever,” Dr Warrillow said.

The state recorded a slight dip in its latest daily case count, with 221 cases recorded on Wednesday. Officials are anxiously hoping this could be the start of a long-awaited tapering in case growth, avoiding a predicted explosion in case numbers.

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The northern suburbs of Melbourne continued to be the source of growth, with 86 per cent of new cases being aged under 50. Six regional cases were also reported.

Victoria has 120 COVID-19 patients in hospital with about 10 per cent of cases presenting for admission. A three tier system is used to triage possible patients with the state also having about 1600 infected patients being managed in its hospital-at-home system.

Learning from last year, the state is streaming COVID-19 patients to major hospitals to avoid infections into the broader hospital system. Hospital administrators also say there is much greater collaboration with private hospitals.

Several major public hospitals have been activated in the last few days after cases rose sharply in the northern and western suburbs over the last week.

Hospital planners say the system has staffing and beds for 1500 patients if required. This compared with a typical ICU capacity of about 400. After a $1.3 billion injection, the system has contingency for up to 4000 acute care beds, but this would require a radical change in staffing as well as the deferral of most admissions other than emergency care.

“ICU nurses and specialists do not grow on trees,” Mr Foley said, calling on people to continue to comply with public health rules.

The enormous amount of planning for the state’s expected third wave comes as new research by Deakin University epidemiologist Catherine Bennett for the Sax Institute suggests indoor mask-wearing and event capacity limits are likely to remain in place into next year.

“Masks indoors will be the last precaution to go, and large gatherings the last banned activity to return, although large events will no doubt happen sooner if we go the way of adopting vaccine passports as have other countries,” Professor Bennett said.

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