Health Minister confident country prepared for Omicron while National ridicules ICU capacity claims

In the face of modelling that suggests Aotearoa could face a peak of 80,000 Omicron infections a day, Minister of Health Andrew Little says he is "very confident" the country is prepared.

But National Party's health spokesperson Dr Shane Reti says Little is "dreaming" when it comes to the intensive care unit (ICU) capacity he says we have.

The Institute for Health Metrics and Evaluation (IHME) projections, updated last Thursday, predicted an outbreak in New Zealand lasting about three months, with death rates projected to total more than 400 by 1 May.

Little told Morning Report: "We've had two years of experience of this particular virus and its forms and the level of preparation and planning that has gone into each phase and each stage has left us - compared to most other countries in the rest of the world - somewhat of a leader in terms of minimising harm to people.

"That's the approach we continue to take at this point."

Modelling estimated at the peak of the outbreak in early March, 458 ICU beds could be needed, and occupancy could come under "extreme stress" for a number of weeks.

Last year Little said there were 289 ICU or High Dependency Unit beds available, insisting that could be increased to up to 550 under surge capacity if needed.

That was strongly challenged by clinicians and ICU experts who said the extra capacity was more like 67 - totalling 356.

Asked about ICU capacity today, Little said the level of intensive care or high dependency unit care needed for a Covid-19 patient was "not the same as somebody who's been through major trauma and has multiple issues that need to be dealt with".

"Intensive care is needed to ensure that a person is breathing properly and supported and cared for and the experience from overseas, particularly from Britain (is) that staff were given additional surge training, and working under the supervision of fully experienced and qualified ICU nurses and other staff can provide the care that is needed.

"In New Zealand, those have turned up to hospital to get treatment have got the best treatment available and that is the reason why we have one of the lowest mortality rates in relation to Covid compared to pretty much every other country in the world.

"I'm confident that our health workforce, who have been under pressure, who will continue to be under pressure, and a system that is under pressure, will continue to perform and do the best for those who turn up needing hospital level care."

IHME modelling had not told him "anything that gives me any greater cause for concern".

"The same international evidence that you're talking about is what informs the ministries, the leadership of the DHBs and their preparation for the outbreak of Covid and in this case Omicron."

Reti told Morning Report that "fundamentally, what the modelling shows is starting next month, the hospital system will be under high stress with 10 to 20 percent occupancy with coronavirus.

"The month of March, peak hospitalisations will occur at around about 3000 … if we drill into that hospital component … this is a worrying story because what the modelling suggests is that the area of extreme stress for intensive care for us here in New Zealand will be around about the 2nd of March, where our ICU need will exceed our ICU capacity."

Reti said of Little's claim ICU capacity could surge to 550: "Everybody says he's dreaming if he thinks he's got 550 ICU beds. He's absolutely dreaming".

"Ask anyone in sector if they really think they've got surge capacity... I think if we look back clearly we were under prepared, but that's been and gone. Done.

"What we need to be doing now is looking forward as to if we accept that we're going to prepare the ICU sector."

Estimates accurate so far, but miss nuances

Meanwhile, University of Otago epidemiologist Professor Michael Baker told Morning Report estimates of overseas outbreaks from the research organisation have been accurate to date.

He believed because New Zealand's outbreak came later than expected, the dates in the modelling could be shifted a by a week.

The modelling assumes that about one in eight cases is being detected.

Baker said the research only took New Zealand's response to the outbreak into account in a broad way and would miss some of the nuances.

"Interestingly, they build into their model something like the alert level system, which they consider to be a good model, and they are assuming that all countries are taking action," he said.

"I think we can definitely improve on these results."

Once Omicron passed what the government was calling phase one, it was explosive, Baker said.

The number one thing someone could do to get ready was to get a booster, particularly the elderly and immunocompromised, he said.

Reducing contact with people outside your family unit when the outbreak was peaking was the second thing Baker advised.

"The other thing I think that really comes through in this modelling is that masks really do make a difference."

If going out you should wear a N95 mask or similar, he said.

People with discretionary events coming up should be postponing them.

Reti's advice for those looking at the numbers shown in modelling with concern was, "This is modelling. It has a lot of variance ... it is just modelling.

"Secondly, We can only control what we can control and what we're asking citizens to control is to control their social distancing, to control their mask wearing, to control their hand washing, to control sneeze etiquette, to be vaccinated, to get the booster.

"Those are the levers that individual New Zealanders have that that that can make a change, and we'll make a change to the modelling. In fact, the modelling takes into account mask wearing and it shows reductions in both hospitalisation and ICU hospitalisation with just mask wearing. Those are the things that we're asking New Zealanders to do."