South braces for the surge

Southern healthcare workers are preparing for hundreds of people with Covid-19 to recover in their homes as New Zealand transitions to a new normal of skyrocketing case numbers.

WellSouth has bought 600 pulse oximeters to monitor oxygen in patients’ blood at home.

The devices were ready to be used across the South, chief executive Andrew Swanson-Dobbs said.

Although he did not know how many pulse oximeters might be needed in a southern Delta outbreak, he was confident the healthcare network would cope.

"If that’s too many, or not enough, we don’t know," Mr Swanson-Dobbs said.

"But, again ... the discussions that have occurred locally are sufficient to give me confidence that if we did have to manage people with Covid at home, we could."

Yesterday, the Government announced plans to deal with a worst-case scenario, where even with a 90% vaccination rate, Covid-19 case numbers in the Auckland and Northland area alone could hit 5300 a week over a six-week period.

The Government’s plan is for more than 90% of those patients to recover at home.

General practitioner Dr Jeff Lowe said public health would do two assessments of positive cases to define both a patient’s medical risk and social risk to determine if they could recover at home.

"Ninety to 95% of people who get Covid-19 will have a mild to moderate viral illness which requires no treatment, but will need monitoring, usually at home," Dr Lowe said.

The modelling revealed yesterday was part of the Government’s planning for how hospital and intensive care unit (ICU) systems would cope.

Health Minister Andrew Little said at present ICU and high-dependency units (HDU) were at about two-thirds’ capacity.

He said 16% of available ventilators were now in use across the hospital network.

He was confident hospitals could accommodate the additional patients and planning was in place to make sure the situation was managed carefully.

Following the example set by the United Kingdom’s National Health Service, nurses had been trained to allow them to work in an ICU environment under the supervision of fully trained ICU nurses, he said.

The capacity of ICU and HDU beds nationwide could "surge" to 550 beds.

An issue was the logistical challenge of an outbreak taking place in an area served by a smaller hospital, Mr Little said.

In such a situation, some staff and patients might need to be relocated.

Planning for that scenario was under way, he said.

University of Otago Business School dean Prof Robin Gauld, who is co-director of the Centre for Health Systems and Technology, said New Zealand had lost an opportunity to be ahead in its planning.

"We could have had all these systems in place quite some time ago with the benefit of hindsight," he said.

But now New Zealanders probably had to trust the advice officials were giving.

"They are either just trying to keep us calm — the last thing they want is a frenzy and an outcry, and a deeply concerned population about a system we have no confidence in — or they are actually doing a lot of work on this and receiving pretty good advice that they can confidently say we will make it through this."

The Southern District Health Board (SDHB) yesterday did not answer how many cases per week could be expected in a similar worst-case scenario for the south.

Critical care director Dr Craig Carr said at the start of the pandemic Dunedin Hospital had 26 ICU capable ventilators and Southland Hospital had four.

Now, there were 34 in Dunedin and eight in Invercargill.

WellSouth medical director Dr Carol Atmore said government planning drew on best practice elsewhere, including Ontario and Sydney, where people were cared for in their own homes and with strong links into hospital services in place when needed.

"We are planning on how we would manage such an outbreak if it were to happen, as well as working through how we would manage a future where Covid-19 becomes part of the ‘new normal’ in New Zealand next year and beyond," Dr Atmore said.

Draft plans had received a "very positive response" from a group of general practice teams at a webinar this week, she said.

There were 71 new Covid-19 cases in the community in Auckland yesterday, a number director of public health Dr Caroline McElnay called sobering but not unexpected.

Deputy Prime Minister Grant Robertson said based on the number of people each positive case passed the virus to (between 1.2 and 1.3), case numbers would now head towards triple digits.

He blamed people gathering in other’s homes for the rise,

and said restrictions worked only if everyone followed the rules.

Meanwhile, the SDHB said it had accepted an expectant mother last week who was transferred to Dunedin Hospital after the Covid-19 exposure in an Auckland neonatal unit.

SDHB operations general manager Megan Boivin said it was normal practice for transfers to take place from time to time between DHBs, depending on neonatal capacity.

The SDHB had not been asked to receive any other patients from Auckland at this stage, she said. — Additional reporting RNZ




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