Many health workers on the front line are reporting burnout. (Image: Adobe)

So far, it seems COVID-19 policy has been a game of catch-up. A case here, so we wear masks. A case there, so the border is shut. And then we go about our lives, as though this pandemic belongs in India or the United States or some other far-flung country.

Reactive politics has been the winner over proactive policy at every turn.

Let’s hope like hell that yesterday’s decisions by states, in the wake of the latest outbreak, to shut borders, up restrictions and issue stay-at-home orders fixes it all again.

But what if it doesn’t? Are we able to cope with an outbreak of the Delta strain — or any other strain, for that matter?

It’s hard to imagine, after consulting a swag of the GPs and specialists who will be charged with keeping us well.

Indeed, if burnouts and spikes in suicide rates and patient impacts are even half of what Crikey has been told, we need to move the dial to looking after our frontline workers, who are already spending their days and nights looking after the rest of us.

In one state, a young female medico recently told a counselling service that she and her peers hoped to contract the virus, because that would be the only means of taking a few days off work. It would stave off burnout.

She wasn’t being unprofessional; just honest. Long hours, diminishing health budgets, COVID clinics, high anxiety, increased mental health presentations, even mandatory reporting (simply when a young medico seeks help themselves) is all contributing to a tsunami of concerns being raised by doctor groups — and falling on deaf ears.

Here’s just a snapshot, one that should concern us all, even before any outbreak fills our hospital beds:

  • Increasing rebates for psychology sessions means more people can pay for a psychologist — but there has been no increase in the number of those practising. In some states, the wait now extends beyond 12 months. That is useless when a teen is contemplating suicide today.
  • The level of anxiety among teenagers is higher than some medicos have ever seen previously, including immediately after 9/11. Self-harm, eating disorders and teen suicides are not being reported, but incidents are escalating. Some of the children taking their lives haven’t finished primary school. Schools say no one is listening. Doctors say they can’t see more patients; they’ve had to close their books. Psychologists describe it as like having a finger in a dyke, knowing what lays ahead.
  • First- and second-year university students are among those finding it hardest. While a focus has been put on those in the final year of school — by dropping assessments, for example — university students have largely been ignored. Connections are lost. University-in-person has been swapped for online lessons, conducted in bedrooms. Use of Tinder, and other dating apps, has replaced social events. What’s the impact of that in a few years’ time? “I’ve got young people saying they can’t cope by themselves at home,” one GP says.
  • The first lockdown meant patients went without regular medical checks, like breast mammograms and prostate checks. Now the queue is long, but telehealth remains, meaning some medicos are working all day and then conducting telehealth appointments late into the night. Two years ago, few went to the doctor with a cold. Now, people are lining up for COVID tests and medical certificates.
  • Waiting lists at hospitals in some places are longer than they have been for years, which means more complex patients are having to be treated by GPs, without expert support. And waiting lists of aged care homes have blown out because, as one aged care registrar explained, “people were putting off moving in for a few years, but COVID means they want to move in while they can”.

“There is this chronic pressure that we all have not knowing what COVID will bring the next day,” one medico explains.

First it was access to PPE, then it was about when it should be used, and then how it should be used. “Every day there is a new and ongoing pressure,” she says.

Doctors tell of colleagues who have ended their own lives, while others — a handful of years shy of retiring — are making an early exit.

And this is the scene before any real outbreak of COVID. But is it enough for Scott Morrison and his merry band of state decision-makers to stop politics, consult the professionals, and provide proactive policy? Unlikely.