Hospitals brace for 'endemic Covid'

The new cases - announced by the Ministry of Health on Saturday night - follow two others...
Auckland's Middlemore Hospital. Photo: NZ Herald
Hospitals are planning how to cope when Covid becomes endemic in New Zealand and the unvaccinated turn up seriously sick.

Sarah Dalton, executive director of the Association of Salaried Medical Specialists union, told the Herald discussions were taking place among DHB leaders.

"We may be moving into a phase of what the DHBs are calling endemic Covid - even if we manage a form of elimination this time, as soon as the borders reopen, we will have Covid come back.

"It is going to be a massive challenge."

Covid-19 becoming endemic means the virus won't disappear even with high vaccination rates, but will instead regularly circulate in the population for months and years to come, possibly flaring up into significant outbreaks.

The high transmissibility of the Delta strain means the unvaccinated minority are most vulnerable, including to serious illness and hospitalisation.

Treating infectious and potentially infectious patients is resource intensive, with staff needing to obey strict protocols and put on and remove PPE. Different areas of hospitals would be needed for Covid patients.

A senior specialist at an Auckland hospital told the Herald how the health system would be affected by endemic Covid cases was a major concern for frontline workers.

"We will have to keep hospital resources available to treat a steady number of endemic Covid cases. No doubt about this. This is just how Delta works in a population where the vaccination rate is less than 100 per cent.

"We need extra manpower and extra time to cope with the fitting and removing of PPE for Covid cases. Doing surgery on a Covid case is very time consuming. Some nurses are not yet vaccinated and this may cause difficulties in work allocation."

The system was already under stress, he said, so dealing with endemic Covid cases would have a knock-on effect and lead to delays in treatment for non-Covid patients.

Another current focus is the huge number of people who have had their planned care put off or delayed to some extent because of the current lockdown even including some cancer cases, he said.

DHBs often look to send patients to private facilities to help cope with demand, but private hospitals will need to work through their own patient backlogs.

Health Minister Andrew Little has previously told the Herald that a "front and centre" consideration in loosening border restrictions will be the burden the unvaccinated would put on the health system, should Delta or future variants circulate. It will be difficult to boost capacity in the medium-term, he said.

"We have got a ways to go to improve facilities, to fill a lot of the vacancies that are in the workforce at the moment."

Comments

Covid will come, no doubt. We can't hide forever so we need very high vaccination rates. Are those who don't vaccinate examples of Darwinism?

Great to hear that they are planning for the inevitable
The big question is why now?
Why not 18 months ago when this all started?
COVID was never going to go away, it likes the human body to much and we are social beings which helps it get around
This second lockdown is because the MIQ system failed
It was known how contagious Delta is but they kept using the same system!
Having a seperate part of a hospital for COVID would be as stupid as having MIQ in the midst of our largest population centre
Everyone undergoing Chemo treatment will be unvaccinated and despite what the MH website says, I know Chemo patients are not being vaccinated on doctors recommendations
As to the backlog of work that needs to be done, why was that ever allowed to get so out of hand?
For these people treatment is as essential as a supermarket shop yet the numbers going through a hospital facility would be considerably less
So many issues have simply been kicked down the road for someone else to sortout sometime later, that there must be an almighty crunch coming sometime soon and that is not just with health issues

Well, better now than in six months time. But I think you're right. Our health system has been failing to deliver even a basic standard of care to our communities for years now, and the Minister just keeps blaming DHBs for not "living within their means", despite funding not keeping pace with population growth and demographic change. The wretched state of our health system has taken 3 decades to create, so it will take a while to undo that mess assuming any government actually wants to. Wrt MIQ failure, I don't think the MOH really appreciated how difficult Delta would be to contain--after all, our MIQ worked ok for Alpha,--and we all heard the persistent calls from business groups and the opposition to open NZ up, so stricter measures were always going to be problematic politically. So here we are. Get vaccinated. Get tested. It's the one thing we can do for those chemo and other patients who are unable to be vaccinated themselves.

'Why not 18 months ago when this all started?' Simple answer, there was no vaccine available 18 months ago. The quick thinking of our P.M. at the time helpfully avoided the horrors suffered by millions in other countries. You could have missed this fact if you had been living under a rock I guess.

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