There were 20 deaths in Victoria announced on Saturday of people aged in their 50s, 60s, 70s, 80s and 90s, and a total of 1791 since the pandemic began.

While patients are generally not as sick as those previously infected with the Delta variant, doctors say some are more frail and complicated to treat.

Hospital doctors say they have now seen three distinct large waves of COVID-19 patients in Victoria, beginning with the second wave in 2020 which resulted in the deaths of more than 600 aged care residents.

The Delta wave of 2021 was marked by younger unvaccinated patients, including pregnant women, falling severely unwell.

In the current wave, Dr Singh described an older group with moderate to severe COVID-19 infection, usually not requiring ICU treatment. They may have had one or two vaccine doses but not their booster, and underlying lung disease, diabetes and other conditions that make them more susceptible to falling very ill.

There’s also another big cohort of frail older people admitted because they are no longer able to remain at home because the illness has made them harder to care for, or their carer is sick.

It’s a marked contrast to Delta wave, when the median age of COVID-19 patients hospitalised at the Royal Melbourne was 46 years at one point, and the typical patient was a younger and unvaccinated person who was finding it increasingly difficult to breathe.

While Dr Singh said it was a relief not to be seeing as many very unwell patients who needed longer hospital stays, the new wave of patients had more complex needs.

As was the case earlier in the Delta wave, she is seeing patients who were booked in to have their next vaccine, but got COVID-19 before their appointment.

Patients who have received a third dose of COVID-19 vaccine represent less than 4 per cent of current hospital admissions up to Saturday, according to Health Department data. It’s a significant statistic since almost 30 per cent of adult Victorians have now received a booster, and those that become eligible first are more likely to have conditions putting them at higher risk from COVID-19.

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It’s a trend reflected in UK studies, which have found three doses of COVID-19 vaccine reduces the risk of hospitalisation with the disease by more than 80 per cent compared to those that are not vaccinated. Two doses are also protective against hospitalisation, with rates 65 per cent lower compared to those who were unvaccinated.

Meanwhile, recent analysis of Victorian ICU data showed unvaccinated patients made up between 22.2 to 37.2 per cent of admissions, despite less than 6 per cent of the adult population being unvaccinated.

Dr Stephen Parnis said the vast majority of patients he was seeing in the emergency department were well enough to be managed at home. He estimated he was admitting roughly one in four COVID-19 patients presenting at the ED.

“I see a number of people who have worries about all sorts of symptoms that have the potential to be serious – things like chest pain – but when you go into it, it all turns out to be relatively mild and certainly non-sinister.”

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The number of people with COVID-19 who are being treated largely due to another illness, injury and condition, is thought to be at rates higher than previous waves because of the sheer number of people with COVID-19 in the community.

However, Royal Melbourne Hospital chief medical officer Cate Kelly said in many cases it was impossible to rule out the virus as a contributor to people’s illness.

″ If you have heart failure and you have COVID-19 you might come in with exacerbation of heart failure,” Dr Kelly said.

“There’s a group clearly sick with COVID, [another] clearly incidental with COVID-19 and have no symptoms and there’s this group in the middle who are a bit of a mixed bag.”

Victoria recorded 16,016 new COVID-19 cases on Saturday. Active cases dropped by almost 14 per cent from Friday’s number, falling by nearly 35,000 from 252,399 on Friday to 217,505 on Saturday.

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