A NSW doctor has warned that staffing issues are looming in one regional area and they will impact service delivery.
With new supplies due this week for booster shots and vaccinations of 5-11 year-olds, he also is worried GP clinics won't have the staff available to roll out the jabs, but is even more concerned about staffing levels in aged care facilities.
"At the moment, nursing homes have the biggest problems," Southern Highlands Division of General Practice spokesman Dr Vince Roche said.
"Nursing homes are struggling, there are positive cases in a number of nursing homes, among both staff and patients.
"They're in an emergency set up with staff working 12-hour shifts, and they're geographically isolating infected patients in one wing.
"They're doing their very best - they've had 18 months to talk about it and rehearse it, so to their credit they're doing really well so far."
Regarding Bowral Hospital, he said that while it was managing at the moment, he foresees potential problems in the near future.
"Staff at the hospital are under huge pressure, particularly regarding the through-put of patients," Dr Roche said.
"Now that there are so many people sick out in communities, with nursing homes in lockdown, they can't discharge enough patients to make room for people who need to come in.
"There is a backlog of people sitting in emergency too long."
He added that in GP clinics, including his own at Southern Medical Centre, a number of staff have either contracted COVID-19 or are isolating with a positive family member.
This means staff levels are low just as they start booster and child vaccine roll-outs.
"One staff member at my clinic is infected and hasn't been back, there are two doctors awaiting results, and one GP working from home whose daughter has it," he said.
"That's absolutely the way it's going to be (in the future), and it's putting pressure on those staff who can work."
He is expecting a "huge drive" from parents wishing to book their children in for vaccinations ahead of school's return, although he is concerned that GPs and pharmacies won't have the capacity - from both staffing and vaccine supply angles - to meet demand.
"The biggest challenge is whether there'll be enough appointments available," he said, saying that at his own clinic they will be allowing 15 minutes for each child's vaccination, as opposed to the five minutes allocated for an adult one.
"But we will hopefully tighten up times as we go on.
"And there's been no transparency on how many we'll get - we've ordered a certain number of paediatric ones and we've mostly got what we've ordered in the past, although we had to cancel 70 people's booster appointments just before Christmas as we didn't get what we wanted."
Dr Roche said he wished the government had been more proactive with regard to the supply and ditribution of rapid antigen tests (RATs) in the lead-up to the summer break.
"Blind Freddie could see it was coming," he said, referring to the potential for Christmas and New Year to be super-spreader events.
"But our beloved leaders are more interested in winning elections than fighting the pandemic - when Scomo started turning it into election campaign rather than a coordinated health strategy, that's when we started getting into trouble.
"Basically, our politicians said 'let it rip' - but it's poor timing."
He said while he was onboard with NSW Health's new strategy of who should be tested and when, it was predicated upon having enough RATs available.
"There's now a well-recognised lack of RATs in the Highlands, and everywhere," he said.
He recommended that people take conservative measures to protect themselves.
"Go out as little as you're able, wear your masks around others, especially indoors, wash your hands and get whatever test you can if you develop symptoms, and try to stay on top of the suggested rules," Dr Roche said.
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