A total of 34 intensive care unit beds are available across the Waikato, Bay of Plenty and Lakes District Health Boards, home to more than 800,000 people.
However, most patients needing hospital-level care for Covid-19 won't be needing an ICU bed, a DHB leader says.
Covid-19 intensive care unit. (File photo). Photo: 2020 Getty Images
Waikato DHB currently has 16 resourced ICU beds with the ability to increase this to 22 ICU level beds.
A spokesperson for the DHB said it could expand to 33 ventilator beds, combining both ICU and high dependency beds, for the Covid-19 response.
"Additional staff have received training as part of our plan to assist with the resourcing of these beds, should the situation arise where we need to utilise them."
The spokesperson did not specifically say whether anaesthetists or theatre nurses were trained, but said a further 17 post-anaesthetic assessment unit beds were available for intensive care if required.
"Additional staff have received training to assist with resourcing additional beds and may be redeployed from other areas of the hospital as required."
Those not needing ICU treatment, which provides a patient with a sole-focused nurse, would be admitted to a general ward. This ward would be focused on positive Covid-19 patients when the time came, the Waikato DHB spokesperson said.
Beds on the ward can be completely isolated and have negative pressure capacity.
Covid-19 wards
Wards like these would be paramount when for the care of Covid-19 patients, Bay of Plenty DHB chief operating officer Bronwyn Anstis said.
She said greater capacity of ward beds for Covid-19 patients was more important than the number of ICU beds.
"From Auckland's experience, a lot of patients who have been admitted to hospital aren't cared for on a ventilator, they can manage them without the ventilator which is a good thing."
An orthopaedic ward at Tauranga Hospital is currently undergoing renovations to ensure it is fit for purpose when positive cases arrive, she said.
"It's good to have this as well, we currently have some other negative pressure areas within the hospital but this just gives us greater capacity.
"It is quite disruptive doing these Covid works but I think in the bigger picture, we will be very pleased we have done them."
The 24-bed ward would have additional oxygen supply and improved air management. Areas of the intensive care unit was also having an upgrade.
"The work in this ward is being undertaken to provide an area for treatment of Covid-19 patients where high volumes of oxygen and high-performance air management systems can be made available.
"These changes will enhance the care of patients and improve safety for staff, should the need arise."
She said additional training for nurses on the ward had taken place, and in the first instance, those admitted to hospital with Covid-19 would be cared for by those with respiratory experience.
"We are needing to think about patients that come in, potentially with Covid, in the future could have any other sorts of comorbidities or they could come in with trauma. All nursing staff would need to know how to look after a patient with Covid."
Like Waikato, Anstis said anaesthetists would "definitely" be part of the team.
Lakes DHB facing shortage of ICU nurses
Lakes DHB is upgrading its ICU ventilation system in line with the Bay of Plenty DHB work.
It has a total of six beds and nine ventilators.
Chief operating officer Alan Wilson said the hospital's medical unit was also already able to be isolated into two areas, physically and by the ventilation system, creating a 22-bed area for Covid-19 patients.
However, Wilson admitted there was a shortage of ICU nurses.
"We have several nursing vacancies in ICU and critical care unit currently, but we also have many nurses in other roles who also have experience in ICU nursing and who would be assisting with Covid patients if needed.
"With new treatment regimes a lot of patients around the country admitted to ICU with Covid will not need to be ventilated but they will be treated using other equipment."
He said anaesthetists, anaesthetic technicians and some theatre nurses were trained for ventilated patients.
Wilson said the Lakes DHB's capacity to care for patients would be dependant on the speed at which the virus evolved locally: a gradual build-up or a sudden influx.
"Currently the vaccination rate with the DHB, while increasing quickly, is still far too low."
He said vaccinated patients would have milder cases and be cared for outside of the hospital.
"For unvaccinated patients who get Covid the situation is very different. Large numbers will need hospitalisation in a medical ward, large numbers will need intensive care and significant numbers will die.
"Lakes DHB's ability to care for a local population outbreak will be determined by the percentage of the population which is vaccinated or not."
Despite the changes made across hospitals in the Bay of Plenty and Waikato, ICU and wards were just the tip of the iceberg a leading Waikato based doctor believes.
Fear of virus transmission in hospital
Australasian College of Emergency Medicine president John Bonning said up to eight times more people would be accessing emergency departments compared to those in ICU with Covid-19.
"No person will get into intensive care without going via the emergency department.
"Often with Covid you don't necessarily get acutely sick really quickly - you get sick and then you gradually deteriorate. Possibly the biggest message we have got is that we are wanting Covid to be managed in the community, at least initially."
At Waikato DHB, where Bonning practices, the children's ED area has been converted to a separate Covid-19 stream separated from the department.
The hope is to minimise the risk of transmission but he said the risk was still there.
"It's been a tough 18 months and we know we have a tough three-to-six months to go in this new phase.
"A figure that I heard was that 20 percent of patients in the UK with Covid caught it in hospital so yes, cross-transmission is greatly concerning."
Oxygen supply, environment systems upgrade
The Ministry of Health confirmed the upgrades at Lakes and Bay of Plenty DHBs were part of the Covid-19 Response.
Work to improve oxygen and air-handling systems was also taking place at Canterbury, Capital and Coast, Counties Manukau, Hawke's Bay, Hutt Valley, MidCentral, Northland, Tairāwhiti, Taranaki and Waitematā DHBs.
"The nature and scale of the work vary from hospital to hospital, the focus being to improve oxygen and air handling systems where prudent," a ministry spokesperson said.
That meant minimising the spread of Covid-19 through the hospital and allowing designated wards to be "better equipped" when treating Covid-19 positive patients, the spokesperson said.
"The ministry is working with these DHBs to improve air-handling, filtration and ventilation and minimise the risk of transmission of viruses.
"Possible oxygen supply and usage scenarios were considered at the start of the programme, resulting in further supply planning protocols and onsite improvements to oxygen storage, conversion and reticulation systems."
Health Minister Andrew Little said last week, the number of people currently in ICU and HDU was roughly two-thirds of capacity.
He said the capacity of ICU and HDU beds nationwide can be surged to 550 beds.