Crisis meetings and investigations are continuing after Middlemore ED's long wait times appear to have cost a life on Wednesday.
Another short statement from Counties Manukau District Health Board today reiterated "extreme pressure" at the Middlemore, with "abnormally high" demand for services.
The heath board said patient presentations had jumped a full 17 percent on pre-Covid levels in 2019 - an extra 400 patients a week - and were still going up.
It has been reviewing the woman's death, which happened after she showed up at the ED early on Wednesday, left and returned just a few hours later critically ill.
Late this afternoon Health Minister Andrew Little fronted media saying hospitals were doing the best they could in busy times.
He declined to speak on the individual case.
"I know that there are individual hospitals that are facing very, very serious pressures. The system as a whole, I think, is coping," he said.
"When I look at the Auckland region I look at the cooperation between hospitals. So hospitals that are under extreme pressure are seeing patients that would otherwise go there, go to other hospitals nearby. That is a system that is doing its job."
New Zealand Resident Doctors Association national secretary Deborah Powell called the death "a doctor's worst nightmare".
"Doctors go to work to help people - and if they don't get to help them because they don't even get to see them ... its another psychological hit at the moment, that would be fair to say," she said.
"Already tired, pretty much exhausted and then this sort of thing happens. It's really hard out there."
Exactly how long people are waiting in the ED is not clear.
National health spokesperson Shane Reti said there was no way of knowing because the government did away with public health targets last year.
The final data set from Middlemore, last June, showed a fifth of people - 21 percent - were waiting longer than the target six hours in the ED.
"The more it looks like our waiting times have been a factor in this really tragic and unfortunate case, the more we need to look back and say 'why did it stop getting reported, and what's being done to fix it?'" Reti said.
It has been reported the woman left Middlemore ED after being told the wait time would be eight hours, and that she died from a brain bleed.
Powell said the death had already prompted one emergency meeting between unions and health boards.
Another is due to happen on Monday.
She said they were considering bolstering staff numbers at Middlemore by taking resident doctors from other parts of the country.
"If we've got five other EDs, say, just off the top of my head, where they could manage with one less registrar and five registrars can come into Counties, that could be a good thing to do," she said.
"We have to look at those sorts of options to make sure that where there's greatest need [we act] - and let's be honest, people dying while waiting to be seen in ED, that's about as bad as it can get. So we're going to have to get more flexible in looking at those sorts of options."
Little acknowledged shortages in other parts of the health system had contributed to the ED pressure problem.
"We know that there are people turning up to a hospital, EDs in particular, because they can't get to a doctor or they can't get that other primary level care. We have to fix primary care. But if people need hospital-level care, then they should go to hospital," he said.
Emergency doctors and the Nurses Union said they had been warning for months that extreme workloads for health workers would cause something to be missed.
The Australasian College for Emergency Medicine said the $11.1 budget boost allocated to the health system did not target areas that contribute to overcrowding of emergency departments.
Reti took aim at health reform funding.
"Their decision to spend $486 million on health reforms, and restructure a health system in the middle of a pandemic - that has not helped at all, the waiting times that are increasing across the country," he said.
Counties Manukau District Health Board declined to be interviewed about the death, saying its focus was on managing the demands and pressure on the health system.
It said it offered deepest sympathies to the family involved.
Little did not believe the pressure on EDs at the moment warranted a shift to the red traffic light setting.