8 Mar 2022

Ministry of Health fronts as Covid-19 patients flood hospitals

3:15 pm on 8 March 2022

Hospitals around the country are feeling the pressure as more Covid-19 patients need care while many doctors and nurses are off work isolating.

Director of Public Health Dr Caroline McElnay and the Ministry of Health's technology and change leader Michael Dreyer provided an update on the country's capacity of RATs, PCRs, and hospitalisation numbers.

Watch the Covid-19 update here:

McElnay said one thing put in place to address this is allowing critical healthcare workers who have Covid to return to work earlier than usual if their absence would mean a critical health service would stop functioning.

It would include allowing Covid-positive staff to work on Covid wards, or allowing critical workers to leave isolation six days after returning two negative rapid antigen tests.

"This can only occur if the case meets strict criteria and all steps are taken to protect the safety and wellbeing of the staff themselves, their patients and other staff."

The workers must use a well-fitted N95 mask, follow infection control procedures, take care in any shared break and eating areas, avoid public tranport where possible, and follow standard advice for cases outside of work.

They must be also fully vaccinated, asymptomatic or only mildly symptomatic, must agree to return and not feel pressured to return, and must be in a situation where their absence puts an essential service at risk.

She said this approach is a pragmatic one which would allow the health system to continue functioning, "but it also balances the significant risk to patients when hospital services are not being able to operate against the small risk to patients from staff who have Covid with all the protections in place".

Minister for the Covid-19 Response Chris Hipkins said it was something hospitals around the world had needed to adapt to.

"I've got full confidence in them managing infection prevention and control in a really responsible way so that we can make sure that if peopel are having to go back to work that they're managing the risks around that carefully."

He said the health system was still fit for purpose with Omicron yet to peak.

"Obviously the fewer people we have in hospital the better, but at the moment they are within the range of what we'd been expecting.

"We've been working really closely with Auckland's hospitals. They are suggesting that things have eased a little bit in the last 24 hours but certainly there's a lot of support there but they are under an enormous amount of pressure."

ACT leader David Seymour said the move was only common sense, and they should be extended to the rest of the workforce.

"The way hospitals are at the moment, it's essential. At the moment I'm hearing from medical professionals who are saying they're having to cancel a quarter of their surgeries - they're saying cancer surgeries are being cancelled because they don't have enough staff."

"The idea that we'd let people stand down when a negative test says they can come back to work? Absolutely, total common sense. The question is why are we decimating the rest of the economy with unworkable 10-day isolation.

"Let's just be clear, in the rest of the civilised world if you test positive you isolate for three or five days and with a couple of negative tests you no longer have Covid, you're out. That should be the case for everybody.

He said if workers were in an environment where they had Covid-19 and the people around them had Covid-19, they had no underlying conditions and they were happy to do it, then it also made sense for them to work.

Hipkins said he expected to say more about the possibility of general changes to isolation length in the next 24 to 48 hours, having just received advice.

"It's very close to being able to talk more about that."

Things like vaccine mandates and passports were likely to change after Omicron peaked, he said, and the traffic light system was nimble enough to adapt as needed.

Today's numbers

Today the Ministry of Health is reporting 23,894 new cases of Covid-19, with 9881 in Auckland.

McElnay says Aucklanders yesterday recorded their highest number of rapid antigen results ever, 43,735 - some 25 percent higher than the previous highest day, last Monday.

She says there are 756 people in hospital with Covid-19. The actual number of cases in the community is expected to be considerably higher, but this is hard to gauge when using rapid antigen testing as the primary test. This is why the ministry is focusing on hospitalisations.

Hospitalised numbers in Auckland are about the same as they were yesterday, she says, and ICU numbers are also similar to yesterday. The DHBs report continued pressure on staffing, particularly with cover through the night, she says, but occupancy levels remain manageable.

McElnay says the lesser severity in comparison to the Delta outbreak is strongly related to the highly-vaccinated status of the New Zealand population.

Unvaccinated people are four times overrepresented in current hospitalisation data, she says. Just 3 percent of eligible people aged over 12 have had no doses of the vaccine, but 17 percent of people hospitalised since community transmission of Omicron was detected were unvaccinated.

Just 1.6 percent of cases were in ICU on Sunday, 6 March, which compares with 13.6 percent in ICU on 10 November during the Delta outbreak last year when the percentage was highest.

McElnay says health services are stretched, with large numbers of staff being required to isolate.

Doctors are stepping in to help cover nursing shifts at Auckland's Middlemore Hospital, which is grappling with critical staff shortages.

There are nearly 200 people with Covid-19 in the hospital and hundreds of frontline staff off because of the virus.

McElnay says they don't have exact numbers for how many hospital staff are off work with Covid-19.

She says this is because the management of staff absenteeism is managed at the DHB level, so the DHBs will have that information separately.

She says there's "quite a bit" of movement of staff doing duties that are not their usual.

Hawke's Bay Hospital has had to scale back some of its services and operations, as the number of Covid-19 patients in the hospital grows.

McElnay says the ministry has been very thorough in making sure that all risks are covered as much as possible in the system allowing Covid-positive staff to return to work.

"We knew that it was likely to be needed but in terms of when it was implemented, it was last week."

She says she's not aware of any staff currently doing so but will check.

McElnay herself says she is working from Napier today, not in isolation but she has some symptoms so is at home as a precaution.

NZ's Covid-19 response has saved an estimated 2750 lives - research

McElnay says new research from Professor Michael Baker and Nick Wilson finds that New Zealand's Covid-19 response has saved an estimated 2750 lives.

Separately, the research has also found that compared to overseas experiences New Zealand has seen a very low number of deaths over the first two years of the pandemic.

McElnay says the ministry has been looking at the long-term effects of Covid-19, and is working with Victoria University of Wellington to establish studies into that. Dreyer says more information is set to be added about the long-term effects to the health hub website.

Apology to people affected by incorrect storage of Covid vaccines

On the people affected by incorrect storage, McElnay says the problem with the vaccine storage in Queenstown was to do with the cold chain systems which aim to ensure the cold temperature is maintained throughout.

McElnay says Southern DHB will be doing an investigation and review into how the error occurred, but she does not have the details right now.

"I think this is very unfortunate that this has happened and I apologise to those individuals."

She says all those affected have received a letter from the DHB outlining what happened and apologising.

It also includes information about how they can go get revaccinated.

Self-reporting RAT tests online

Dreyer says after changes in the last few weeks, people can now self-report RAT tests online, order RATs via the same channel, record where they've been through an online tracing form, and visit a one-stop health hub to find relevant information.

The Covid clinical care module provides joined-up health information about each case for healthcare workers so they can ensure those they are caring for can access the support they need. A peak during busy mid-morning periods meant this system was being delayed but further capacity has since been added meaning the system can now handle about 20,000 cases an hour.

The RATs requester site is now fully operational and a bug has since been fixed on this, he says.

Later this week people will be able to report a RATs result on behalf of someone else, such as a child under 12, via the My Covid Record tool. There is also an 0800 number for this or it can be done through your GP.

He says the online contact tracing has also been streamlined to focus on high-risk events or exposures and welfare needs, reducing average completion time from 30 minutes to eight minutes.

From 10 March they will also be going live with text messages that notify people their isolation period is complete, and reminders are also being considered for people who have ordered and received RAT tests but for whom results have not yet been logged.

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