17 Dec 2021

ICU capacity: 'This is where the rubber hits the road'

6:07 pm on 17 December 2021

High rates of ICU occupancy across the country throughout the latest outbreak paint an incredibly concerning picture if more people end up needing hospital care over the summer, says the National Party.

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National Party health spokesperson Shane Reti Photo: RNZ / Samuel Rillstone

Health spokesperson Shane Reti says despite several warnings and a global pandemic, ICU capacity remains woefully short.

"This is where the rubber really hits the road," he says, with what he describes as "alarming" figures.

There was single digit average availability across the district health boards, except in Auckland's Counties Manukau and Waitematā (at 16 and 10 respectively) from 24 August this year to the 2 December.

This includes only one available bed in Hawke's Bay - with the highest average occupancy of 88 percent - one in Lakes and the same in Whanganui. There were only two beds available in Hutt Valley, in Wairarapa and West Coast. Bay of Plenty, MidCentral, South Canterbury, Tairāwhiti each had three beds available.

In the larger centres, there were six available in Wellington's Capital and Coast and in Canterbury, five in Southern, and 33 between the three Auckland DHBs.

There were 95 beds in total available across the country, with an average occupancy rate of just over 64 percent.

This all shows the government has "failed to build enough ICU beds from the first outbreak 18 months ago to the present", says Reti.

"When one considers that an average ICU stay for coronavirus can be 14 days, and for a ventilated patient may be 28 days, one can see how it doesn't take many patients to entirely consume ICU resources for a long period of time."

The first critical element is specialised nurses - with just over five needed to run one ICU bed - and there's already a "chronic staffing problem", he says.

The second is occupancy rates, which show how "chronically under-prepared we have been...and the very thin margins that we're running on".

"We've got to take normal occupancy: heart failure, renal failure, road traffic accidents - we've got to take all of that into account and then see what's left for coronavirus."

Health Minister Andrew Little recently announced a major investment in ICU capacity, however it will still be some months before many of the projects are finished.

Each DHB had been asked to "stress test" their capacity, in anticipation of the move to the traffic light system, and provide a "detailed plan" of what would happen in the event of an outbreak, he says.

"How quickly are they going to step up their services to the public health services, the clinical assessments that are needed for people and places for them to stay, or ability of the hospital to admit them and provide the care."

A team led by Whanganui District Health Board chief executive Russell Simpson, acting for three months as director of health system readiness, then went through the plans, with a focus on smaller hospitals in regions with lower vaccination rates.

After that work the team was "satisfied with where things were at", says Little,"and that right across the country the system is in a position to respond and cope effectively".

If there are outbreaks in areas with smaller hospitals, they would be supported by larger DHBs.

Reti, though, remains unconvinced the health system is fully geared up to deal with a major spike in cases, particularly when you add Omicron into the mix.

"I don't want to be alarmist, but my sense is this is too little, too late - we're one Christmas too late."

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