The country should have moved to phase two of the Omicron response plan last week, to give GPs more time to prepare for dealing with the outbreak, a doctor says.
Dr Rawiri Jansen. Photo: LDR / Stephen Forbes
Prime Minister Jacinda Ardern announced the move yesterday, and the country will shift into the next phase at 11.59pm today.
National Māori Pandemic group co-leader and Māori health leader Dr Rawiri Jansen says authorities have not been able to thoroughly contact trace cases since last week, another reason why we should have moved to phase two earlier.
"The increasing number of cases means that inevitably we can't contact trace every everybody in the way we used to do it… We just simply cannot do that," Jansen said.
"We can't do that today, we couldn't do it last Friday."
But the change to phase two was important because it was time to "turn our focus to those who are most at risk of being unwell rather than the vast majority of people who are going to have a mild to moderate illness", Jansen said.
There were a range of challenges facing management of home isolation, too.
"I'm saying we should have been at phase two last week" - Dr Rawiri Jansen
"Under Omicron, we're saying all of your household's going to get it but there's 17 people overcrowded in a three-bedroom house. We're not trying to get one or two people isolated within their household. We're saying as a household isolate, what do you need?
"We now need to think ... what do we need to offer differently so that we can keep their whole family safe."
Jansen said some people had been reluctant to get tested because of the length of isolation times.
"It's quite a significant barrier to getting tested. We want to make it as easy as possible.
"We've got to get all the right people to be supported through that, you know, let's make it really easy to get tested and make it easy to get isolated and make sure people have got what they need to be supported."
Jansen said GPs did not have all of the answers for what alternative accommodation there was available.
"We've got people busy working on trying to identify all of that in Auckland, and I know that Auckland response will be different to Waikato, will be different to Wellington ... we're looking at one of the campervan options that might help find those whānau stay safe.
"That's one of the reasons why I'm saying we should have been at phase two last week - we could see all of this last week and getting those settings right helps us to get to a better position in terms of looking after whānau who need us."
Concerns around GP workloads
Royal New Zealand College of General Practitioners president Dr Samantha Murton has called for more support for GPs as the Omicron response moves into the next stage.
"The level of care that will be provided will continue to increase like we have seen for the last couple of years and it's the fact that Covid care can't be necessarily done in peace and needs to be done virtually and therefore the options for patients to go places is restricted.
"So over a seven-day period, they'll need to be able to access some care, and it's where do GPS will need to be doing more work than they usually do and probably over the weekend as well.
"I think there will be practices that can manage and others that can't, and I think across the country will be different places ... it depends on the environment that you're in, the level of workloads that you already have and also the supports that are around you.
"We're expecting that most people will be able to manage for themselves at home have mild symptoms and not too much disease, whereas there will be some people who do need that care and what we need to do is make sure that if the practice isn't doing it, that there's other services that are available for patients to go to."
Murton was "hugely concerned" about the increased workloads.
"I think there will be practices that can manage and others that can't" - Royal New Zealand College of General Practitioners president Dr Samantha Murton
"I think general practice has majorly stepped up in the last couple of years with all the vaccinations they're doing, all the swabbing they're doing - a complete change to how we provide care, using a lot more telehealth services, using a lot more electronic services but that all still takes time and the industry is feeling under pressure, however, totally dedicated to making sure that patients get what they need, and that's what we've been doing."
Every practice needed to think about what they were capable of, she said.
"Hopefully we won't have large numbers in our own personal practice of people who are very unwell all at once, so it will be a sustained effort over the next six to 12 weeks as Omicron comes through, but it is keeping its momentum going and also keeping people energised to do the work."
Murton said there needed to be recognition that dealing with Omicron was outside GPs' normal work.
Support for GPs from the Ministry of Health and the hospital sector needed to be considered, she said.
"In places where if there is a workforce that aren't doing as much work - and we know that general practice will be doing a lot more work - that people are considering how they can support the work out in the community."