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Can we cope?


Region’s health resources already at breaking point
A hospital insider tells SUE TEODORO that Wairarapa Hospital would struggle to cope with a widespread covid outbreak in the community.

Figures show the hospital’s small numbers of critical care beds are already under pressure, with no known covid in the region.

Wairarapa Hospital’s high dependency unit [HDU] was at full capacity in 13 of 38 days from August 17 to October 11 this year. The numbers indicate the HDU was at full capacity on 34 per cent of those days. On a further seven of those days, the HDU was from 80 to 100 per cent full.

This was the second-highest of any DHB in New Zealand, after Hawke’s Bay at 36 per cent. Wairarapa Hospital does not have an ICU but has a limited number of HDU beds and ventilators.

Seriously-ill patients in Wairarapa are generally sent to Wellington Hospital after a short time.

Prime Minister Jacinda Ardern spoke exclusively to The Times-Age, during a visit to Makoura College about the importance of high vaccination levels in protecting our hospital and healthcare systems.

The region is at 86 per cent at first dose of the vaccine, with about a further 1800 people needing their first dose before the government’s 90 per cent target would be within reach.

“In a vaccinated environment, the call on intensive care is much reduced, which is why our goal is for a highly vaccinated New Zealand.”

Ardern said most covid-related hospitalisations in this outbreak were unvaccinated people.

“That’s why the push has to be in every corner of New Zealand. It is not just an issue in the urban or more populated areas that we want vaccinations.”

Ardern stressed unvaccinated people were more likely to put pressure on the health service. She said the Government was also making plans for surge capacity for local and other hospitals in an outbreak.

Those plans included sharing resources to access the care they needed. Ardern said HDU were counted the same way as ICUs for covid.

“It provides the needs for those cases,” she said.

“Of all the cases in an unvaccinated environment, you tend to see about 12 per cent who might need a hospital. Of that 12 per cent, maybe 20 per cent might go into the ICU.”

Ardern’s comments come as a well-placed staff member at Wairarapa DHB spoke confidentially to the Times-Age about their concerns for the community and the hospital if there were significant cases in the region.

“We would really struggle at this DHB if there were a significant community outbreak. Although there are contingency plans in place for such an event, the staffing would be stretched to the limits very quickly,” they said.

“At Wairarapa Hospital, we can generally manage an unwell patient on a ventilator for up to a day or two, but not longer. This is due to the limited number of nursing staff with the training and confidence to look after a critically-ill patient.”

They said ventilated patients needed one-on-one nursing.

“We also don’t have any intensive care specialists here. Doctors and nurses caring for a covid patient would not be allowed to look after other hospitalised patients due to the risk of transmission.”

The insider said Wairarapa Hospital relied very heavily on the ICU at Wellington Hospital to manage the sickest patients.

“If neighbouring DHB’s ICUs [Wellington, Hutt, and Palmerston North] were full of covid patients, we would not have the opportunity to transfer our own patients. Tough decisions would have to be made as care would have to be rationed,” they said.

The DHB has a significant work programme under way to manage a covid outbreak.

Wairarapa DHB chief executive Dale Oliff said the hospital was getting prepared, although it was expected many could recover at home.

“If and when covid cases are reported locally, we know hospitalisations are inevitable,” she said.

She said modelling showed covid cases in the region were expected, and the DHB was getting ready.

“There is much to be done to equip a hospital to manage covid, and we have a team putting every effort into ensuring we can stand up isolation quickly and effectively. It is a very big piece of work, on top of business as usual,” she said.

  • The DHB website has more information, including where to get vaccinated at www.wairarapa.dhb.org.nz

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