22 Nov 2021

Confusion from government over taking the pulse for Covid-19

3:07 pm on 22 November 2021

Health officials and government ministers are at odds over whether every household isolating with a positive Covid-19 case should get a critical device which measures their oxygen levels.

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Photo: healthline.com

One GP said even though there is high demand for the pulse oximeters, they have not been all that easy to get.

Director-General of Health Dr Ashley Bloomfield said not every single Covid-19 positive household gets one, but the Ministry of Health said they do - while Minister of Health Andrew Little said they don't necessarily, and Grant Robertson said everyone does.

Firstly, what is a pulse oximeter? An explainer video from the UK NHS described it like this:

"A pulse oximeter monitors how fast your heart beats and the level of oxygen in your blood. An ideal blood oxygen level is between 95 and 99 percent. Go to A&E immediately if your oxygen level is 92 percent or less."

It is a potentially life-saving piece of equipment, and now many of the nearly 2500 Aucklanders isolating at home have one.

Dr Matire Harwood

Dr Matire Harwood Photo: Supplied

Papakura Marae GP Matire Harwood visits a number of Covid-positive patients in their homes, and said the devices provide people comfort.

"People want them, and those people that do have them find them really reassuring. They know how to use them, and it helps them take charge and manage the illness," she said.

But it is not clear if every Covid-19 household is supposed to get one.

Dr Bloomfield said last week in a Health Select Committee that not everyone in home isolation will.

"Not necessarily, that's part of the assessment we'd do. If it's a young person, or a couple of young people in a flat and they have no history of any medical problems then they may not need a pulse oximeter.

"But we certainly have got plenty, and if there's any doubt then we would provide that."

But in a statement to RNZ, the Ministry of Health said every household with a positive case will get a pulse oximeter.

Asked if that was a change in policy, the ministry said no.

Just last month Minister Little said not everyone would get one, and that it depends on a clinical assessment.

"And that assessment would determine: does this patient need a pulse oximeter? What's the state of their health, what are their living circumstances?"

This month, there was a different view from Deputy Prime Minister Robertson.

"Yes, everyone gets issued with those, yes," Robertson said.

And aside from that confusion, Dr Harwood said some people are outright asking for them, and it is still taking some time to get them.

"The person that waited five days says she asked each day for one. She's got good health literacy - she works in the health system, so she knew to ask.

"Some of the guidelines are saying now 'if they need an oximeter we will provide one', but my understanding was that everybody should get one. How else can we know if they're unwell or not?"

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ACT Party health spokesperson Brooke van Velden. Photo: RNZ / Samuel Rillstone

ACT Party health spokesperson Brooke van Velden says it is "sad" that people with Covid-19 at home have varying levels of healthcare.

"It's not good enough that the government doesn't know whether everybody is being issued a pulse oximeter. It's clear that everybody should be given a pulse oximeter because it helps to monitor before people even look like they've got symptoms that they should be sent to hospital to get better care."

Van Velden asked Covid-19 Response Minister Chris Hipkins in August - after this lockdown started - whether he had received any advice on the use of pulse oximeters.

Hipkins replied: "I have not received any advice relating to the use of pulse oximeters."

"They had 18 months and they didn't even look internationally to see whether pulse oximeters could be in use in the community, and that's just not good enough," van Velden said.

It is not as though there is a shortage of pulse oximeters right now - the ministry said there are over 10,000 ready to be used, and a further 5000 coming in a couple of weeks.

But only 1300 are in use in Auckland for the 2400 cases at home, some of whom may be in the same household.

In a statement, the Ministry of Health said the "vast majority" of cases receive an information pack, including an oximeter, within 24 hours of their home isolation starting.

"However, we acknowledge there have been a small number of delays in these packs being delivered including in instances where the address is incorrect or the person is unable to be contacted.

"We are reviewing our processes and procedures to identify how they can be improved to ensure pulse oximeters are always received with 24 hours of referral to home isolation. Anyone who is experiencing delays should call Healthline or their GP."

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