7 May 2020

Epidemic Response Committee discusses palliative care

11:30 am on 7 May 2020

The Epidemic Response Committee met with the Cancer Society, Funeral Directors Association and representatives of the palliative care sector today.

Cancer Society medical director Dr Chris Jackson began the meeting.

He said the lockdown has kept people with cancer and immune-suppressive issues safe.

However, there have been problems, around people getting treatments, being away from their families while undergoing treatment etc.

Fewer scans, tests have resulted, meaning fewer cancers being diagnosed - around 30 percent.

Dr Jackson said the health system will need to catch up or cancers will go undetected and result in deaths.

"We know that for every month in the delay and prognosis in colon cancer, there will be 5 percent more deaths."

He said the health system was already stretched before Covid-19 so is unsure how a catch up will be possible without additional funding and resource.

Jackson says radiology waiting lists will be particularly stretched and a bottle neck will occur.

The the wage subsidy has helped the Cancer Society but being a charity, Jackson said he is worried that a recession will mean less donations from the public.

Following on from Jackson, the committee heard from the Funeral Directors Association chief executive David Moger and president Gary Taylor.

"We estimate over 2000 people have died and because of the lockdown their friends and family have been unable to grieve properly together," Taylor said.

"The restrictions to viewings have been particularly hard," he said.

Taylor said he and the association believes there needs to be a specific recognition to all of those who died during the lockdown, not just those who died from Covid-19.

He's calling on the government to hold a minute's silence across NZ for those who died.

Taylor said the funeral services sector has lost between 30-70 percent in revenue during the lockdown.

"We have suffered from not having adequate transition time."

Moving forward, Taylor wants greater guidance from the government around what funeral services can and cannot do during level 2 and wants unrestricted travel as well.

"Families need a meaningful farewell for the proper grieving process."

Next to speak to the committee was Hospice New Zealand chief executive Mary Shumacher.

She represents 34 hospices around the country who provide palliative care.

Around 22,000 people and their whānau use a hospice each year in New Zealand and one in three people who have died are provided care by hospices.

She says hospices have needed to adapt during the lockdown, trying to maintain care over the phone where possible as well as at home visits when needed.

Shumacher said moving from level 4 to level 3 lockdown has eased pressures a little bit but hospices are not yet back to normal operations.

The hospice sector, like others, has faced significant challenges she said - namely through their retail stores having to shut during the lockdown where 50 percent of their income comes from.

She estimates hospices could lose $19m over three months, says the wage subsidy has helped but is hoping to work with the government on how to solve the funding issues they face.

The committee then heard personal accounts from members of the public.

New mother Rebekah Burgess, who gave birth to her baby Trinity during lockdown, described her experience as traumatic.

She was planning to have a natural birth at home but her midwife pulled out at 38 and a half weeks of pregnancy. She tried finding another midwife in time but was unable to.

She said felt vulnerable and unsafe and had no one to advocate for the natural birth she wanted.

She was terrified to go to Wellington Hospital because her one support person, her partner Cameron, was not able to stay with her. He was removed from the room just after her baby was born. He was distraught, she said.

Burgess said she was provided substandard care at the hospital, was criticised for not having enough nappies. She said hospital staff didn't seem to have the time to help her during the first two days after her birth.

None of the birthing staff wore PPE, she said.

She says she doesn't know how many times she cried during the 48 hours in hospital, she resented her baby at first but luckily, she says, that passed when she left the hospital.

"Trinity is an absolute blessing and I love her so much."

She is still angry and never wants to see a midwife or hospital again.

"It's a shame my birthing process left me so disempowered," she said.

She says the leadership New Zealand showed was just lip service and she found it hard to find proper guidance and leadership.

Burgess said New Zealand's approach contravened the WHOs guidelines for pregnant women giving birth during the pandemic.

She says she wants a holistic approach to birthing and that a one size fits all approach is unacceptable.

Burgess, like those who spoke before her, moved a number of the committee members, including chair Simon Bridges, who reminded members to contact support services if they were struggling with today's discussion.

Bjorn Reymer was the final personal address, sharing it on behalf of he and his wife.

During the later stages of level 4, he and his wife found out their pregnancy needed a scan and that she could only do it alone.

Two days after New Zealand went into level 3 he dropped his wife off at Auckland Hospital and she had to navigate the wards alone.

His wife found out after a scan that she had a suffered a miscarriage. She was then given a box of tissues and left alone to deal with the trauma.

She then had to return to the carpark where her husband was to tell him that they lost their baby.

He wasn't aware of the compassionate consideration, he says the whole process lacks common sense.

Reymer said the Auckland Hospital staff were fantastic and even apologised to his wife that she had to do it alone.

He said the Ministry of Health needed to show more compassion for situations like his and many others.

Last to address the committee was Director-General of Health Dr Ashley Bloomfield.

Committee chair Simon Bridges got straight into questions with Dr Bloomfield, quizzing him on why New Zealand is still in level 3 when the MOH has reported two days of zero cases in a row.

Bridges said for every day New Zealand stayed in level 3, an addtional 1000 people were applying for the benefit.

He also said if numbers are going to keep creeping up over the forseeable future until a vaccine is created, then the level system is irrelevant and the economy should be open.

Dr Bloomfield said that the two-week level 3 period will give the MOH a chance to discover any community transmission that hasn't been detected yet as the incubation period for Covid-19 is 14 days.

He said the Ministry will have a clearer understanding later this week if there is any undetected community transmission.

Yesterday the education sector had their say at the meeting.

Meanwhile, Simon Bridges, the chair of the committee, has been blamed for the lack of Māori voices at the meetings.