Just five weeks ago, the southern region’s first community transmission case of Covid-19 since April 17 2020 was recorded in Queenstown.
We were warned how fast the new Omicron variant could spread, but since February 10 more than 18,000 cases have been reported in Otago and Southland. Five percent of the population has been infected and three people who had Covid-19 have died.
"And I think there’s no doubt that there has been under-reporting of cases," Southern District Health Board acting quality and clinical governance solutions director Dr Hywel Lloyd said.
"But no matter how many cases there have been, it certainly took off bloody quickly."
Dr Lloyd, a Mosgiel GP, was seconded to a senior role at the SDHB several months ago.
As Delta, and now Omicron, loomed, he was made the lead of the board’s Covid-19 response and asked to weave the many strands of the health system together to create a united, strong response.
Testers, vaccinators, GPs, nurses, welfare providers and volunteer organisations have all been marshalled and the region’s hospitals are slowly gearing up for when the numbers of those who need that level of care peak.
Omicron came to Dunedin quickly. The first cases were in the student quarter, where it spread like wildfire.
That created what Dr Lloyd calls a "false start" — a severe outbreak in a small enclave, rather than a slower spread throughout the wider area as other parts of the country have experienced.
"I was expecting us to take off and for the disease to seed quite quickly in the wider community from the student community, but what we saw was a significant drop-off in numbers after a three- or four-day peak," Dr Lloyd said.
"There was almost a reset and almost a week or 10-day delay before the disease really went through the wider community, which I was surprised by. I expected it to rise and rise and not drop back so quickly, but we have now fallen into a more predictable pattern of how the disease is spreading."
Unsurprisingly, Dunedin, Queenstown-Lakes and now Invercargill — which reported 200 cases on Thursday and now has more than 1300 active cases — are the southern hot spots.
Distance from the cities is affording little protection to the provinces though, and Central Otago, Waitaki, Clutha, Gore and wider Southland are now all recording high double-digit case numbers each day.
"Omicron is so infectious it is going to get in everywhere, unfortunately," Dr Lloyd said.
General practices have been asked to be the first port of call for all Covid patients, and doctors and nurses are supervising housebound patients and assessing if they need hospital-level care.
That system seemed to be working well, Dr Lloyd said.
"Primary care has really stepped up and they are doing great work, and they are regularly checking in with all their higher-risk patients.
"We did have some technical issues early on with the case management system, but we have corrected those now and it is easier for practices to have all the information they need for case monitoring.
"We don’t think we have many people falling through the gaps."
However, he was acutely aware the South’s two Covid peaks — the highest daily case numbers figure and the most admissions to hospital, which was usually 10 days later — were likely still to come, he said.
Modelling suggests Otago and Southland will hit a high tide mark of about 1500 daily cases within the next week to 10 days, although the likely under-reporting of rapid antigen test results makes that peak difficult to plot exactly.
However, the nature of the southern outbreak has had its advantages.
Because the first cases were younger and better able to resist Covid-19’s effects, fewer people have had to be admitted to hospital so far than has been the case elsewhere, a phenomenon which has allowed southern hospitals to rehearse their Covid preparations again, with a small number of real patients.
"Cases trickled in to the hospital to start with, one or two or three, and that continued for quite a while," Dr Lloyd said.
"That gave us an opportunity to hone our procedures, so we have been able to refine how we assess patients, how we move them around the hospital with actual patients, and there is nothing quite like that to get the right procedures in place."
The other factor softening the impact of the disease is that Otago and Southland were among the keenest places in New Zealand to be double-vaccinated — 98.5% of the eligible population have had two jabs, and 75% have also been boosted.
"There is no doubt being double-jabbed and boosted significantly reduces the hospital admission rate," Dr Lloyd said.
"I think we are reaping the benefits of that high vaccination rate at the moment ... Thankfully, our mortality rate has been low so far and that is because of vaccination."
