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Health sector at risk in a virus outbreak

Healthcare workers on strike outside Wairarapa Hospital. PHOTO/FILE

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Health experts say staff shortages and limited critical resources mean the healthcare system in Wairarapa is at risk of tipping over in a covid outbreak.

The news comes as numbers of covid patients in Auckland hospitals rose to 49.

Senior healthcare workers said a large covid outbreak in the region could put the entire system at risk, although the Wairarapa District Health Board said that facilities were available.

The DHB confirmed the hospital had no Intensive Care Unit and only four ventilators, meaning the critically-ill were often sent to other centres.

“Wairarapa Hospital currently has capacity. We do not have an Intensive Care Unit. We do have six High Dependency Unit beds and seven negative pressure isolation rooms,” a DHB spokesperson said.

“We have four ventilators available in our hospital, all of these are paediatric capable.”

They said the hospital was part of a regional network which collectively managed intensive care capability.

The main difference between intensive care and high dependency care was the nurse-patient-ratio, with more staff required for an ICU than a HDU.

Long-standing nursing staff at the hospital report there has been no ICU for more than 20 years.

Negative pressure rooms, also called isolation rooms, keep patients with infectious illnesses away from other patients, visitors, and healthcare staff.

Chairwoman of the New Zealand College of Critical Care Nurses Tania Mitchell confirmed that Wairarapa had restricted resources.

“Wairarapa hospital has limited capacity to care for critically-ill patients.”

She said patients needing a ventilator or with other high needs would be moved to places with expertise and resources like Wellington.

“This is dependent on the hospital they are asking to take over the care of the patient having capacity to care for them.”

Since the pandemic started, ICUs worldwide had been overwhelmed.

“The health system in New Zealand is under-resourced compared with other OECD countries, so it is reasonable to anticipate if Delta takes hold throughout New Zealand our ICU’s will be overwhelmed and there will be a shortage of beds with suitably trained staff to look after these patients,” Mitchell said.

The Wairarapa DHB spokesperson said the hospital had made preparations.

“It is likely that people that contract covid-19 would be cared for in the community and at home.

“In the event there was a need for hospital care, we are ready to provide that,” they said.

They said the DHB regularly managed infectious illness, with additional precautions now in place.

Lucy McLaren is a nurse practitioner in the Emergency Department of Wairarapa Hospital and a Wairarapa delegate of the New Zealand Nurses Organisation.

She said the new covid variant presented challenges.

“It is more contagious and has a shorter incubation period and so it will move faster through the community.”

Although the hospital had made preparations within resourcing constraints, she expected a large outbreak to be challenging.

“As the NZNO has been saying for the last 12-plus months, we have an overstretched and tiring health system.

“Should we have a big outbreak of the virus which needs to have multiple admissions to hospital this will tip the system over.”

Intensive nursing machines needed staff with the relevant skills and experience and care for HDU beds was almost exclusively provided by nurses.

“As overseas is showing us this is hitting younger people and the recovery time is extensive,” she said.

All three agreed prevention was the best way to safeguard the healthcare system.

“Keeping this Delta variant down is the only way to survive, if we don’t the system will fall – it’s down to all of us,” McLaren said.

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