14 Oct 2021

Watch: Health Minister Andrew Little on hospital preparedness for Covid-19

11:14 am on 14 October 2021

Health Minister Andrew Little says the hospital system is preparing to handle Covid-19 cases, along with progress in home isolation and therapeutic medicines.

The minister, Chief Medical Officer Dr Andrew Connolly and GP Dr Jeff Lowe revealing the plan for how the health system could manage cases following the current vaccination drive.

Watch Health Minister Andrew Little detail the plan here:

Little says currently, the number of people in ICU and HDU is roughly two-thirds of capacity.

He says 16 percent of available ventilators are being utilised across the hospital network.

"In terms of capacity to respond for additional patients, I'm confident that it is there and the planning is there to make sure we manage that carefully," Little says.

He says the capacity of ICU and HDU beds nationwide can be surged to 550 beds.

"If we had to provide additional surge capacity to convert beds for ICU-level care then as a result of the work that started at the end of last year the DHBs tell us they can surge that up to 550 beds - that would be at the cost of other treatment and other patient care."

Little says nurses have been given pre-emptive training which enables them to work competently in an ICU environment under supervision of fully trained ICU nurses.

This surge-style ICU preparedness follows a similar model used by the UK National Health Service, he says, British ICU counterparts have provided advice to ICU leaders around New Zealand.

Little says one issue of concern is the logistical challenge of an outbreak taking place in an area served by a smaller hospital.

In this situation, there may be a need to relocate some staff and patients, and planning for this scenario is underway, he says.

"The best response to ensure we don't put undure pressure on our health system is vaccination ... maximum vaccination will mean minimising the pressure on the system."

Ministry of Health Chief Medical Officer Dr Andrew Connolly says the average stay in ICU for Covid-19 patients can vary.

"It varies highly, there are really two distinct groups, those who need a short sharp burst of hospital care particularly with special masks which deliver higher doses of oxygen but short of needing ventilation and then there are that very small number who need intensive care which with Delta varies between 0.2 and 0.4 percent of people who catch the virus.

"In the intensive care group again there are some people who deteriorate very fast but respond very quickly, that will be influenced by their general health going into the infection but for people who have pre-existing health disease or present to hospital quite late and are very sick when they arrive they can spend some weeks in intensive care and further weeks regaining strength."

Home isolation and recovery

The Ministry of Health expects a worst case scenario of up to 5300 cases of Covid 19 per week in the Auckland and Northern region, assuming a 90 percent vaccination rate can be achieved. The modelling is part of planning for how hospital and ICU systems would cope.

"I know there have been figures mentioned about the modelling of at the peak of this in 2022 what number of cases we might have. For the Northern region this looks like 5300 cases of Covid-19 per week, the important thing about that is it's predicted that 5270 of those cases will be managed in the community," GP Jeff Lowe says.

Little says in the future the vast number of people with Covid-19 will recover at home.

He says work is going into developing support for people recovering from Covid-19 in the community. They are likely to be vaccinated people.

There are likely to be daily or twice daily welfare checks.

Dr Connolly says those figures are generated by the experts who look at a variety of scenarios.

"They look at the trends of infections and we all hope that Auckland will stay low but at some stage, there is the potential for further cases."

Dr Connolly says the key to the best case is vaccination and wearing our masks, distancing, catching up with mates but doing it as the rules state.

"We don't want the modelling to scare the public but it does emphasise the huge value of the vaccination and every single jab we give means that we all have much better access to the healthcare we all need for any condition."

Little says some people recovering from Covid-19 at home may need to be provided with a pulse oximeter which sits on a patient's finger and measures their oxygen levels.

He says health authorities would call these patients and ask them to provide a reading from time to time to ensure their oxygen levels are not deteriorating.

Little says alternative accommodation will have to be found for people recovering from Covid-19 who live in homes that hold a large number of people.

Dr Lowe says public health will do two assessments of positive cases to define both their medical and social risk which will determine whether they can recover at home.

He says the medical risk of a patient will take into account ethnicity, age and other medical conditions, meanwhile, the social risk of a patient will look at whether they are able to self-isolate at home and if their family have needs which need to be met.

"90-95 percent of people who get Covid-19 will have a mild to moderate viral illness which requires no treatment but will need monitoring, usually at home.

"We can alter those figures with high levels of vaccination so that's still the job at hand."

Lowe says primary care will be in daily contact with hospitals regarding people who are showing signs of a more severe infection while recovering at home.

On when home recovery will be implemented, Little says the closer "we get to that 90 percent vaccination rate then we can start making decisions about what happens next".

"But we've already made commitments about the early part of next year about when we expect to see for example the relaxation of borders and those sorts of things so it will be very much driven by how quickly we can get that vaccination rate up."

Two days ago, Little told Morning Report since the start of the pandemic about 100 ICU beds had been added nationally.

Connolly told Nine to Noon this week the worst case scenario would see up to 150 people hospitalised at a time.

Covid-19 Response Minister Chris Hipkins has said people with Covid-19 would soon be asked to quarantine at home as a necessary step to prevent MIQ places being further limited for people coming from overseas.

"There's no question we're going into a period where we are likely to see quite significant growth in the number of cases," he said.

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