As Te Tai Tokerau prepares to move down alert levels, a Whangarei doctor is pleading with people to get vaccinated - saying the effects of not doing so, will be absolutely devastating.
There are still around 45,000 people in Northland who have yet to have a single vaccine - nationwide that figure is more than 600,000.
As delta bears down on Northland's southern border, health teams in Te Tai Tokerau are urgently trying to boost vaccination rates.
Whangarei emergency Dr Gary Payinda said the need to get more people immunised is immediate, as the health system was already struggling.
Dr Payinda was recently on his weekend off when he got an urgent text from a colleague, asking for help to manage a backlog of patients.
"There were over a dozen patients backed up in the waiting room who were significantly sick and needed to be seen in a timely fashion - these are not patients who are low acuity and can go somewhere else, these are patients who genuinely need care."
He admitted all but one of the patients he saw that day to the hospital, and said that pressure on the system showed how vulnerable it already was.
"Just imagine if that's a normal Saturday without covid, how can we possibly say that we're prepared to respond to a covid surge?"
Dr Payinda said there was a sense of foreboding for the roughly 15 percent of New Zealanders who had yet to be vaccinated.
"600,000 unvaccinated adults - that is like dry tinder just waiting for a match, and what I and other emergency doctors - and doctors of all kinds - worry about is a huge surplus of demand, as and when covid sweeps through."
Dr Payinda said wait times, growing wait lists, delays in treatments and staffing struggles were already issues - and it wouldn't take many covid cases to bring hospitals to their knees.
"There will be a shutdown of the health system - there will be not just weeks but months of having crippled hospitals that can't take care of people who are coming in with heart attacks and strokes and broken hips."
Dr Payinda knows it's grim to hear, but he said New Zealand needed to discuss the harsh realities of covid - like how many New Zealanders would likely die.
It's not just the deaths which will devastate - Auckland University Immunologist Anna Brooks is studying the effects of long covid and said the lasting impacts could not be underestimated.
"We don't want to be in a position of scare mongering but it's all about cold-hard facts now; this virus is dangerous, it's not just a mild respiratory infection, this virus can cause absolute havoc in your body, even without you knowing it and that is what's so frightening about this.
Brooks said it was a nervous time waiting for lagging vaccination rates to rise as there was no treatment for long covid.
Data indicated people who had covid 19 months ago were still suffering - and the symptoms varied from mental fatigue to heart conditions.
The threat of covid is particularly severe to Maori, with 560 covid cases recorded in the delta outbreak and vaccination rates below those of the general population.
In the last two weeks Maori have made up 45.7 percent of total cases, versus 28 percent throughout the entire outbreak.
Today the Associate Minister of Health Peeni Henare said covid was on the doorstep of many houses and he urged whanau to get vaccinated.
Henare has promised further announcements around the Maori vaccination rates later this week.