As Australia closes the door on its most deadly year for COVID-19 infections, experts warn 2023 could be worse.
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As restrictions become a thing of the past, borders open and the vaccine program falls behind, COVID pressure is expected to impact medical services across Australia, with severe staff shortages in regional, rural and remote hospitals worsening the affects in those areas.
University of the Sunshine Coast nursing lecturer Matthew Mason said there was a nationwide desire to be done with the pandemic, but it wasn't over yet.
"We all want to be done with it, the problem is we aren't," he said.
"If we treat it as though we are, it's going to come back and bite us."
The total of confirmed deaths in Australia from COVID-19 just tipped over 17,000 people, with emerging variants and waning immunity these numbers are likely to continue into 2023.
"If we look overseas to see what's coming here, it's not looking great," Mr Mason said.
"Our vaccine program hasn't kept up, we're well behind."
There seems to be no respite in sight for an already strained healthcare system.
Medical services, particularly in regional, rural and remote areas, are under severe staffing pressures Mr Mason said.
Hospitals are lacking adequate allied health workers, doctors, nurses and midwives across Australia.
La Trobe University head of rural health Professor Jane Mill said rural nurses were, on average, older than their metropolitan counterparts and were beginning to retire.
"This is putting incredible pressure on our healthcare systems without that next wave of graduates coming through," she said.
The need is greater outside cities - people living in regional and rural areas are more likely to suffer from cancer, heart disease, diabetes and road accident trauma.
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The problem is graduating health professionals are not meaningfully incentivised to work outside metropolitan areas, according to Mr Mason.
The placement of medical schools has a lot to do with graduates staying in the city, he said.
Qualifying as a doctor requires six years of undergraduate school and up to four years of specialisation training, often based in metropolitan areas.
"By the time you've had eight to ten years of education, you've set up a life," he said.
"You're less likely to want to go work in rural and remote areas."
Medical staff working in metropolitan, regional and remote areas are exposed to vastly different workplaces.
Regional staff might be expected to work across a range of specialisations while metropolitan staff tend to focus on just one.
Regional areas have the potential to be "reasonably attractive" to recent graduates, with ready access to a variety of shops, cafes, pubs and schools.
While remote workers require a high level of experience and fortitude and have limited access to resources available in the city.
"You need a different skillset and mindset to work remote," Mr Mason said.
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Staff working in remote areas might be the only health care worker available for an extended period of time and be required to treat a range of conditions.
The key to attracting staff lies in offering the same opportunities for professional development and work-life balance for those choosing to work in remote districts.
"There's a lot of people who want to work remote," Mr Mason said.
"It's giving them the opportunities and experience to be able to do that."
Regional universities, training the next generation of medical staff, are fostering a love of regional, rural and remote work in their graduates.
Professor Mill said rural teaching facilities were making a "huge contribution" to incentivising rural and remote work by creating enjoyable student experiences in communities.
"They have a really positive experience in rural and remote areas which encourages them to come back and work," she said.
Professor Mill said first year medical cohorts have filled available spots at La Trobe's regional campuses next year.
"That will have a knock on effect in three years time when they graduate," she said.
"All we can do is continue to support our new graduates so they're as job ready as possible and enjoy their time working in these communities."