Media release

New report shows impact of COVID-19 Delta outbreak on NSW health system

The Bureau of Health Information (BHI) has today released its latest Healthcare Quarterly report, showing activity and performance for public healthcare services in NSW during July to September 2021, when the COVID-19 Delta variant outbreak was at its height.

BHI Chief Executive Dr Diane Watson said that overall hospital and ambulance activity was down from record highs in the preceding quarter.

“The report shows the impact of lockdown restrictions on health system activity, particularly in metropolitan areas where the outbreak was concentrated,” said Dr Watson.


There were 314,281 ambulance responses, down from the record high of 329,709 in the preceding quarter and below pre-pandemic levels.

Dr Watson said while overall demand decreased, paramedics responded to a record number of the most serious priority 1A (P1A) cases.

“There were 9,322 responses to these patients with life-threatening conditions, about 30% more than in July to September 2019 and the highest of any quarter since BHI began reporting in 2010,” said Dr Watson.

“At the height of the outbreak from late August, the number of emergency ambulance responses also increased markedly in metropolitan areas.”

Patients tended to wait longer for ambulances to arrive:

  • The highest priority (P1A) cases had the longest median response time (8.8 minutes) and lowest percentage of responses within the 10-minute target (60.4%) of any quarter since BHI began reporting in 2010.
  • The median response time for emergency (P1) cases was 14.4 minutes, the longest of any quarter since 2010.

Emergency department

There were 719,143 emergency department (ED) attendances, down from the record high of 807,124 in the preceding quarter and well below pre-pandemic levels. Three-quarters of patients (74.5%) were seen on time.

Dr Watson said: “Although EDs were generally less busy, the 100,113 triage category 2 – or imminently life-threatening – presentations were the highest of any July to September quarter since BHI began reporting in 2010.

“Six in 10 of these patients (60.5%) had their treatment start on time, slightly below pre-pandemic levels seen in July to September 2019.”

Elective surgery

There were 44,768 elective surgeries performed in the July to September 2021 quarter, down from the record 64,599 in April to June 2021.

When it came to waiting lists:

  • There were 92,276 people on the overall waiting list at the end of September 2021, up from 85,296 at the end of June 2021 but still well below the record 101,024 in mid-2020.
  • Of those patients on the waiting list, 6,611 had waited longer than the clinically recommended timeframe, up from 2,108 at the end of June 2021. The increase was concentrated in the nonurgent and semi-urgent categories.

“Prior to the Delta outbreak, sustained efforts by hospitals to increase elective surgery activity had brought the waiting list down from its highest ever level following the first wave of COVID-19,” said Dr Watson.

“While the suspension of non-urgent elective surgery in Sydney hospitals from early August meant fewer of these surgeries were performed than the preceding quarter, they remained above the levels seen during the first wave of the pandemic.”

This quarter, the main report includes additional insights into the impact of the Delta outbreak on healthcare system activity in metropolitan, and rural and regional areas.

Find and compare results, including for the 77 larger hospitals and 91 local ambulance areas, in the Bureau of Health Information Data Portal. Snapshots of hospital results can also be found in the Activity and performance profiles.

Page updated: 14 Dec 2021