Fears over Lakes ICU Covid capability
"A disaster waiting to happen."
That's how Rotorua MP Todd McClay describes Lakes DHB's ability to cope with a Delta outbreak after it was revealed there are only four fully staffed intensive care beds in Rotorua.
McClay is calling on the Government to urgently increase intensive care capacity in the area, where seven cases of Covid-19 have been confirmed since Saturday.
Waiariki MP Rawiri Waititi said the Waiariki region could face a "huge catastrophe" in an outbreak and wanted to see more support for people self-isolating.
Waiariki MP Rawiri Waititi. Photo. File. Dan Campbell.
Lakes District Health Board chief executive Nick Saville-Wood said the biggest challenge was staff resourcing and vaccination rates need to increase.
A Ministry of Health spokesman says all DHBs had done "significant planning and preparation work" to manage an outbreak, and Health Minister Andrew Little said he was confident DHBs could care for people ill with Covid.
Lakes DHB confirmed it had six intensive care unit beds, of which four were resourced, which refers to staffing. There are also six coronary care unit beds, four of them resourced.
The DHB had 16 ventilators and 14 were resourced.
According to the Ministry of Health, there are 116,370 people in the DHB's region, which covers Rotorua and the wider Taupō and Tūrangi area. Rotorua and Taupō have hospitals.
Toi Te Ora Public Health indicative modelling reported on November 6 by the Rotorua Daily Post found at a 90 per cent eligible vaccination rate, 190 Covid cases a week were estimated for the Lakes DHB area in 2022, with 12 hospitalisations and 1 death.
As of Thursday, 71 per cent of the Lakes DHB eligible population was fully vaccinated and 83 per cent had received at least one dose, with 24,046 people to go to reach the 90 per cent fully vaccinated target. For Māori, 70 per cent had one dose and 53 per cent had both.
McClay said in his view the Government hadn't shown the necessary urgency over the last 18 months to prepare for outbreaks and he was worried the Lakes hospitals would struggle.
He said it had a knock-on effect to people who needed intensive care and or ventilators for reasons other than Covid and he was concerned it could cost lives.
"It also puts extreme pressure on our doctors and nurses."
McClay said other countries had increased intensive care capacity as a response to Covid-19 but he believed the New Zealand Government had not in any significant way.
"They have spent money on cameras on fishing boats and the arts.
"If you're going to borrow money for Covid [response], spend it on Covid."
The approach was in his view "deeply disappointing and extremely worrying" as the Lakes DHB area was "vulnerable with very low vaccination rates".
"It feels like a disaster waiting to happen. The people of Lakes should not be forgotten or left out.
"It needs to be fixed and questions need to be asked why we're in this situation."
Waiariki MP Rawiri Waititi said he broadly agreed with McClay's view that there should have been more Government investment in health sector preparedness for a community outbreak.
He said he did not believe the DHB had the ability, at this stage, to deal with a Delta outbreak.
Waititi said capacity needed to be ramped up but early detection was crucial, as was giving Māori and iwi-led organisations such as Whānau Ora the resources and data to reach people and support them.
"We need to ensure our people have the right support. If not, we could have a huge catastrophe in Waiariki."
He believed the whole health system was "broken from the start" and district health boards had been "failing Māori for a long time".
He said the solution was to let Māori-led organisations such as Whānau Ora do the work and "tidy up the mess".
He said testing needed to be ramped up across the region and it needed to be accessible.
DHB chief executive Nick Saville-Wood said the biggest issue was staff resourcing.
"Like all DHBs ... we have a huge amount of ongoing vacancies and our nurses have been under the pump for two years."
He said based on current projections and Auckland's experience, Lakes DHB did have capacity but staffing was still a challenge. Today, 90 people were in hospital in Auckland and seven were in ICU or high dependency care units.
"The breaking point won't necessarily occur within intensive care, it may occur in other services such as the emergency department, inpatient, how sick they are, if they are requiring a short and sharp stay or long and projected," Saville-Wood said.
"The easiest way to deter overloading our health system is to be vaccinated."
He said the situation was "very concerning" as at current vaccination levels there was a "strong likelihood" demand for hospital services would increase if Covid spread.
"The lower the vaccination rate means that the level of care for the unvaccinated remains high."
At a DHB meeting on Friday morning, before cases were confirmed in the area, board members expressed concern for the wellbeing its Māori population should there be an outbreak.
A Ministry of Health spokesman said all DHBs, including Lakes, had done "significant planning and preparation work" towards ensuring its hospital and community health services were best able to manage Covid-19.
"The DHB has had significant Covid-19 experience, having had three MIQ facilities operating in its region. The Ministry led preparedness programme is also providing additional support and advice as necessary."
He said Lakes DHB had four resourced intensive care beds with two more "available if necessary".
"Importantly they are well supported by the Australian and New Zealand Intensive Care College and can operate a comprehensive ICU service."
The spokesman said the DHB was in regular discussion with primary care ensuring it could care for people in the community while enabling access to hospital services if necessary.
He said all Covid-19 planning and preparedness had been done on the basis intensive care and ventilators would also be required for other needs.
"If necessary non-essential planned care can be deferred to allow more intensive care unit capacity to be available to support people with Covid-19."
Minister of Health Andrew Little said the Government had been preparing for an outbreak since August last year.
He said additional ICU capacity was available where needed, and the ministry had a store of 250 ventilators in addition to the 430 deployed around New Zealand.
The vaccination campaign meant fewer people with Covid would require hospital care and would instead be able to recover at home with involvement from primary and community care, including Māori-led organisations.
"That is what is being put together at the moment and I'm confident that with every DHB now having appointed a lead person for care in the community, as well as groups of DHBs coming together and regions also coordinating regionally, means that we will be providing the support and care that people need if they become ill with Covid."