Close to 46,000 cases, 2100 hospitalisations and 210 deaths - that's the worst case scenario the Southern DHB is preparing for next year if Covid-19 becomes endemic in the community.
Southern DHB chief executive Chris Fleming says it is vital to prepare for living with Covid-19. (File image) Photo: 123RF
The region has celebrated a milestone, hitting a 90 percent rate for first doses of the Pfizer vaccine.
But the Southern DHB (SDHB) says Covid-19 remained the single biggest risk to the community and itself that could overload the health system.
At a meeting on Tuesday, board members discussed the latest modelling and what it meant for their community.
The worst case scenario modelling painted a grim picture for a health system already under pressure.
It translated to close to 900 people becoming infected with Covid-19 every week, including 40 hospitalised and up to four requiring intensive care.
But that was just one of three scenarios for the Southern region using government modelling - they were all based on the 90 percent double vaccination rate.
The majority of cases would be managed by primary care providers in the community
Chief executive Chris Fleming said it was vital to prepare for living with Covid-19.
The majority of cases would be managed by primary care providers in the community
But if not effectively managed, he warned the region's health system would be placed under more and more strain, and access to planned care would be jeopardised.
"The new number one strategic risk is Covid endemic. I think this is a significant issue and we must take it seriously and other priorities will fall by the wayside if we have to let them fall by the wayside to ensure that we are responding appropriately and adequately," he said.
Chris Fleming. Photo: Supplied / Southern DHB
A steering group and a governance group were being created to tackle the issue and would meet regularly.
SDHB quality and clinical governance solutions director, Hywel Lloyd, was leading its planning and outlined the three different scenarios at today's meeting based on public health controls - tight, loose with a more relaxed border or unmitigated.
The only variable that changes was the percentage of the population who were exposed - with the strictest scenario preparing for one percent of the population exposed, 36 percent for loose and 62 percent for an unmitigated scenario.
"If we remained with tight lockdown-type scenarios, then there's a significant drop off in the numbers," Dr Lloyd said.
"So overall, we would only expect 50 hospitalisations would be made. But clearly, these measures are completely socially unacceptable."
Under the loose model with more relaxed border and public health controls, there were about 510 cases a week with 24 people in hospital and two deaths.
The DHB's plan used Dunedin Hospital as the base for all Covid-19 cases to be admitted, with Southland and rural facilities being used for testing and holding patients awaiting transport, Dr Lloyd said.
"Therefore Dunedin Hospital has to have the capacity to deal with all of the southern cases and transport capacity and capability needs to be in place to be able to deliver that model.
"In an unmitigated scenario, Dunedin would require three Covid wards and have very limited capacity to do non-Covid cases."
It was important to start preparing because they would need an effective public health system, including good contact tracing, he said.
"The number one effect during containment is having an effective public health service doing tracking and tracing and isolation, and if we don't have enough capacity in that space, then the likelihood of that unmitigated scenario happening is much, much higher."
The board's chair, Pete Hodgson, said the modelling served an important reminder about what could happen, and the public needed to step up and get vaccinated.
"Our mitigation will be dependent on the health system, but it will be dependent on society, and I just want to use every opportunity I have to say that this is a thing that doesn't involve the health system alone."
Chief medical officer Nigel Millar said ensuring each vulnerable community reached 90 percent double vaccinated would be important whatever the scenario.
"It's not 90 percent until we're all 90 percent and that means all of our important communities, 'til Māori is at 90 percent, 'til Pasifika is 90 percent.
"We can't claim 90 percent until we actually have done that."
The board passed a resolution at the meeting, saying it was determined to double vaccinate at least 90 percent of each ethnic group, age group and urban and rural community in the Southern region.