Auckland's hospitals have been down a quarter of their staff some days during the Covid-19 outbreak.
Photo: RNZ / Dan Cook
After weeks of stories of stresses from the shop floor because of doctor and nurse shortages, the true extent has been revealed.
The clincial director for the city's joint district health board Covid-19 response, Andrew Old, said hospitals regularly ran with up to 15 percent fewer staff than ideal because of existing shortages and unplanned leave.
But during the Covid-19 outbreak, there had been another 10 percent of staff off - some of them with the virus, some caring for family members with the virus and some sick for other reason.
The shortages, particularly among frontline staff, had caused strain on frontline staff and the hospital system.
All but the most urgent care has been put on hold to allow for more Covid-19 patients.
At Middlemore, there were five Covid-19 wards, with scope to open another one if needed.
Middlemore emergency department (ED) head Vanessa Thornton said her teams had been working incredibly hard amid the shortages.
Orderlies had been in particularly short supply this week.
Physios, occupational therapists and pharmacists have stepped in to do the vital logistical work in the ED.
Many nursing shifts had been hard to fill, with doctors sometimes asked to step in, and a bonus $500 given to nurses who did overtime.
Northern Region Health Coordination Centre chief clinical officer Andrew Old. Photo: RNZ
Dr Andrew Old said the cash was a short-term solution, particularly focused on hard to fill night shifts.
"It is a recognition that ... for two years we've been asking people to go above and beyond and now we're asking them to go above and beyond beyond," he said.
Across the country, 10 more deaths were recorded today.
There were 19,566 cases and 930 people in hospital with the virus, more than two thirds of them in Auckland.
Dr Old said the city's hospitals had reviewed 400 patient notes to determine the proportion of people in hospital because of their virus symptoms, as opposed to there for other reasons.
They found a third were there with Covid-19 symptoms as the primary reason, another third were there with the virus as a secondary reason, and a quarter were diagnosed after they arrived, with the contribution the virus had made to their condition unclear, he said.
Over the past week, data was reinforcing that the virus has peaked in Auckland and he felt a sense of relief about it.
But people needed to keep taking care to avoid a second wave, he said.
The rest of the country had not yet peaked.
The areas outside of Auckland with the most people in hospital were Waikato with 66 and Wellington, including the Hutt Valley, with 65.
What treatments are being used
Auckland City Hospital intensive care specialist Dr Colin McArthur told Checkpoint there were a range of treatments available for hospitalised patients, including remdesivir which is given intravenously,
"It can be given up to within seven days of symptom onset, so for some patients who come into hospital that is appropriate and we have access to that.
"Although supplies are limited, expanding its use into the community is a bit more challenging because it's given intravenously, but there are also some high-risk patients who should be able to receive that in the community to reduce the chance of them needing to come to hospital."
Outside of the hospital setting, use of the drug in Auckland's community was currently being targeted to those most at risk of hospitalisation, he said.
Oral antiviral tablets, expected to arrive in New Zealand soon, may potentially be here after Omicron has peaked, but Dr McArthur said they would still be very useful.
"The peak in fact will fall down to lower levels, but we will continue to see a number of cases, quite significant numbers in the community and certainly the potential for further peaks to occur, so these agents coming will be very helpful."
However, the challenge with these treatments was that the window for when they should be used for most effectiveness was shorter than ones like remdesivir, he said.
"That's why systems are being set up to give the [oral] treatments in the community first, before patients get to hospital, so they are given at a time when they're effective.
"But there are a few steps in the way that need to be organised - recognising the need, diagnosing the Covid as the cause, and getting the treatment to the patient - and those processes are being set up at the moment ahead of when we will expect to have the oral agents available."