For the first time in Victoria's history, an emergency Code Brown alert has been activated across multiple hospitals in the state.
From 12pm Wednesday, health care staff and resources can be redeployed to different sites and non-essential services will be postponed as the emergency setting comes into force.
It comes as dozens of Australian Defence Force (ADF) personnel have been called to help drive ambulances and assist with planning.
The government hopes using this rare alert will allow overwhelmed hospitals to better manage a surge in patients as Omicron COVID-19 cases soar.
Health authorities expect more than 2,500 Victorians could be taken to hospital with COVID-19 at a rate of 100 admission per day in the coming weeks.
Here's what Code Brown means.
What is a Code Brown?
A Code Brown is a nationally recognised emergency alert usually reserved for transport accidents, chemical spills, natural disasters and mass casualty events.
It aims to ease the burden on health services by streamlining emergency management systems when there is an influx of patients over a short period of time.
Each hospital will have a different plan around what to do in a Code Brown event.
By triggering the code, hospitals can redeploy workers to areas of greatest need, postpone leave to boost staffing numbers, and redistribute resources to ensure critical patients are prioritised.
The name "Code Brown" is just one of many colourful emergency alerts used in Australian hospitals – other terms include "Code Grey" used in instances of clinical aggression, while "Code Red" indicates a fire or smoke hazard.
The state may also call on ADF personnel to assist hospitals.
Premier Daniel Andrews confirmed on Wednesday that defence personnel would help drive ambulances in the stretched paramedic network.
But he said it was unlikely the military would be asked to fill in for nurses or doctors.
"The notion that there are thousands of doctors and nurses in the ADF just waiting to be called up, that's not the way the ADF works," Mr Andrews said.
"We're very grateful for the most recent support that's been confirmed … if there's more that we need, we won't hesitate to ask."
Has it been used before?
This is the first time the alert has been used across the state for the pandemic, with all metropolitan hospitals and six regional hospitals affected.
But it has been called before.
The alert was previously activated during when the 2016 thunderstorm asthma event caused mass hospitalisations, during Black Saturday bushfires, and after the Bourke Street mall attack in 2017 where victims needed urgent medical treatment.
This time, the Code Brown responds to soaring COVID-19 hospitalisations, which are at their highest levels ever seen during the pandemic, coinciding with the isolation of thousands of health staff due to infections.
How might it help hospitals?
Extreme pressure on hospital staff has left workers exhausted and desperate, and many hope the Code Brown will provide some relief.
The activation will allow hospitals to free up staff so they can focus on priority services, allow outpatient services to be cancelled or delivered outside the hospital, and facilitate the rapid offload of ambulances to allow paramedics to hit the road quickly.
The Victorian branch of the Nursing and Midwifery Union said the activation recognised the crisis facing hospitals that are short-staffed and bracing for the worst.
"We have many bone-weary members … desperate to recharge, who are unable to get leave approved or are being recalled from leave," Secretary Paul Gilbert said.
The Victorian government has also developed a new response centre over the Code Brown activation period.
It aims to help hospitals distribute patients across the state network and coordinate the suspension of services if needed.
Why now?
In making the announcement on Tuesday, Acting Health Minister James Merlino said Victoria had "to act now" to issue the alert.
That's because not only is there extreme demand being placed on hospitals because of the pandemic, but also because masses of workers are being furloughed because of infections.
Up to 5,000 staff are currently not working because of COVID-19.
This demand is set to get worse — authorities predict COVID patient numbers will increase by hundreds in the coming weeks, before reaching a peak in mid-February.
Mr Merlino said hospitals had requested Code Brown be issued, and they have been developing plans to deal with the activation.
"We've always known that this would be the case, that as we move away from lockdowns and remote learning there will be a strain on our hospital system," Mr Merlino said.
"Our busiest hospitals have asked us to move forward as we approach the peak of the current Omicron wave."
The state opposition has blamed a lack of planning for the need to make the call.
"They haven't done what they said they'd do. The surge workforce capacity is not there," said Shadow Health Minister Georgie Crozier.
"The 4,000 intensive care unit beds they promised that need staff, aren't there. This government has promised so much and delivered so little."
When will it end?
The Victorian government expects the pandemic Code Brown to last four to six weeks.
Authorities are monitoring the situation to determine when it will be safe to begin winding down the new arrangements.
