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Ministry of Health fronts as Covid-19 patients flood hospitals

Mar 08, 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 are providing an update on the country's capacity of RATs, PCRs, and hospitalisation numbers.

Today the Ministry of Health is reporting 23,894 new cases of Covid-19, with 9881 in Auckland. There are 757 people in hospital with the virus - 16 in intensive care.

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.

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 three 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.

And 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 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.

"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."

She says there are two pathways available for these people - critical healthcare workers can return six days after two negative RAT tests, and the second allows Covid-positive staff to return to work on wards where all the patients are also Covid-positive with no stand-down period.

McElnay says this allows the health system to keep functioning.

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.

This approach is a pragmatic one, McElnay says, "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".

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 March 10 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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